_Background:_ Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems (...) in children and adolescents. _Method:_ A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. _Results:_ Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre–post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. _Conclusions:_ The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements. (shrink)

Although fertility is fundamental to spiritual health, it is often taken for granted. When a desired pregnancy fails to occur, stress and grief frequently follow. Visual expression of feelings through “art therapy” has proved a powerful healing tool for women brave enough to give it a try at the McMaster University Fertility Clinic. The objective and subjective findings of this ongoing project suggest that through simple visual self-expression, stress, anxiety and hopelessness may be reduced. This form of art therapy also (...) provides a joyful social experience of sharing with other women, who are dealing with these issues. (shrink)

BackgroundPsychotherapy interventions increasingly utilize digital technologies to improve access to therapy and its acceptability. Opportunities that digital technology potentially creates for art therapy reach beyond increased access to include new possibilities of adaptation and extension of therapy tool box. Given growing interest in practice and research in this area, it is important to investigate how art therapists engage with digital technology or how practice might be safely adapted to include new potential modes of delivery and new arts media.MethodsAn integrative (...) review of peer-reviewed literature on the use of digital technology in art therapy was conducted. The methodology used is particularly well suited for early stage exploratory inquiries, allowing for close examination of papers from a variety of methodological paradigms. Only studies that presented empirical outcomes were included in the formal analysis.FindingsOver 400 records were screened and 12 studies were included in the synthesis, pertaining to both the use of digital technology for remote delivery and as a medium for art making. Included studies, adopting predominantly qualitative and mixed methods, are grouped according to their focus on: art therapists’ views and experiences, online/distance art therapy, and the use of digital arts media. Recurring themes are discussed, including potential benefits and risks of incorporating digital technology in sessions with clients, concerns relating to ethics, resistance toward digital arts media, technological limitations and implications for therapeutic relationship and therapy process. Propositions for best practice and technological innovations that could make some of the challenges redundant are also reviewed. Future directions in research are indicated and cautious openness is recommended in both research and practice.ConclusionThe review documents growing research illustrating increased use of digital technology by art therapists for both online delivery and digital art making. Potentially immense opportunities that technology brings for art therapy should be considered alongside limitations and challenges of clinical, pragmatic and ethical nature. The review aims to invite conversations and further research to explore ways in which technology could increase relevance and reach of art therapy without compromising clients’ safety and key principles of the profession. (shrink)

Objective: To systematically analyze the effects of art therapy on the levels of depression, anxiety, blood glucose, and glycated hemoglobin in diabetic patients.Methods: We searched Cochrane Library, PubMed, Embase, and ClinicalTrials.gov databases from inception to January 24, 2021. The language of publication was limited to English. Randomized controlled trials that used art therapy to improve mental disorders in diabetic patients were involved. After selection of eligible studies, data were extracted, including the first author's full-name, year of publication, the first author's (...) country of residence, number of intervention and control groups, the mean age of participants, method of intervention, duration of follow-up, and outcome measures. Assessment of quality of the included studies and data extraction were independently carried out by two researchers. RevMan 5.3 software was used to perform statistical analysis.Results: A total of 396 samples from five studies were included, and the eligible studies were RCTs with a parallel design. Methods of art therapy included music therapy and painting therapy. The results showed that compared with the control group, art therapy could positively affect the levels of depression [standardized mean difference, −1.36; 95% confidence interval, ; P < 0.00001] and blood glucose in diabetic patients [mean difference, −0.90; 95% CI, ; P < 0.0001], while it had no influence on the levels of anxiety [SMD, −0.31; 95% CI, ; P = 0.32] and glycated hemoglobin [MD, 0.22; 95% CI, ; P = 0.07].Conclusion: Art therapy may have significant effects on the levels of depression and blood glucose for diabetic patients. (shrink)

In recent years, the field of virtual reality (VR) has shown tremendous advancements and is utilized in fields ranging from entertainment, scientific research, social networks, artistic creation as well as numerous approaches to employ VR for psychotherapy. While the use of VR in psychotherapy has been widely discussed, little attention has been given to the potential of this new medium for art therapy. Artistic expression in virtual reality is a novel medium which offers unique possibilities, extending beyond classical expressive art (...) mediums. Creation in virtual reality includes options such as three-dimensional painting, an immersive creative experience, dynamic scaling and embodied expression. In this perspective paper, we present the potentials and challenges of virtual reality for art therapy and outline basic principles for its implementation. We focus on the novel qualities offered by this creative medium (the virtual environment, virtual materials and unreal characteristics) and on the core aspects of virtual reality (such as presence, Immersivity, point of view and perspective) for the practice of art therapy. (shrink)

This paper first elaborates ‘Art’ and the aesthetic as these concepts emerged in the eighteenth century, and uncovers the conflict between the resulting ideal of ‘art for art’s sake’ and the increasing use ‘art therapy’ for personal and social purposes. Taking this conflict to be a reason for the rejection of ‘Art’, it considers two accounts of ‘the end of Art’, one by Arthur Danto and the other by Nicholas Wolterstorff. The paper argues that both accounts fall short of adequately (...) recognizing the presence of the aesthetic in everyday life, and that once we do acknowledge the properly aesthetic character of ‘Design’, a way of thinking is opened up that can make better sense of art therapy. The paper concludes with a brief indication of where the next philosophical question about art therapy lies. (shrink)

In recent years, the field of art therapy has sought to adapt traditional treatment approaches to today’s innovative technological environments when working with adolescent “digital natives.” In their clinic, art therapists often struggle with lack of cooperation when treating adolescents during sessions. This article presents two case studies that explore how Virtual Reality technology can be combined with traditional art therapy to treat adolescents suffering from anxiety and social difficulties. It is suggested that this type of technology may lead to (...) a better understanding of the needs of adolescents by adopting their vantage point and hence better outcomes. (shrink)

The purpose of this scoping review is to investigate the value of creative arts therapies in healthy older adults. This article aims to shed light on current knowledge concerning the effectiveness of art therapies for the prevention of common age-related conditions using the definition of art therapy provided by the American Art Therapy Association, as well as Cohen’s conceptual framework for the psychological conceptualization of the relationship between the arts and health in later life. The objective (...) is to carefully capture subthreshold situations of distress, which are often not taken into account and primarily involve psychological aspects that are crucial in the multidimensional perspective of healthy aging. Twelve articles were selected and examined following an initial electronic search on 3 databases. A thematic analysis of the results identified four major themes: improving cognitive performance and proprioception; enhancing self-identity and meaningful life; reducing feelings of loneliness and depressive symptoms; and the importance of socialization. All these aspects constitute the basis for preventing psychological distress and enhancing mental well-being for healthy aging. (shrink)

Research in School-Based Art Therapy has been widely discussed in recent years, and the number of studies that examine staff perceptions and the special characteristics of art therapy within the education system has risen considerably. The current study explored the critical issue of adolescent clients’ perceptions of art therapy in school, from their point of view as clients. The methodology and data analysis were conducted according to the principles of Consensual Qualitative Research (CQR). The sample was composed of 12 adolescent (...) clients, aged 14–18 (M = 16), who took part in in-depth semi-structured interviews. The findings were organized into five domains that emerged from the interviews: referrals and initial engagement with therapy, the setting within school, the nature of art therapy at school, the relationship with the art therapist, and the impact of art therapy on these clients. The analysis revealed that although some participants initially agreed to art therapy because it got them out of class and let them have fun instead, they realized after a period of time of art therapy that they were engaged in a personal and emotional process focusing on them which allowed them to express their feelings without the fear of judgment. Participants at times used the word “mother” to describe their relationship with the art therapist, and stated that the presence of the art therapist at school made them feel safer and helped them deal with day-to-day problems. School-based... (shrink)

Imagery Rehearsal Therapy is effective for trauma-related nightmares and is also a challenge to patients in finding access to their traumatic memories, because these are saved in non-verbal, visual, or audiovisual language. Art therapy is an experiential treatment that addresses images rather than words. This study investigates the possibility of an IRT-AT combination. Systematic literature review and field research was conducted, and the integration of theoretical and practice-based knowledge resulted in a framework for Imagery Rehearsal-based Art Therapy. The added value (...) of AT in IRT appears to be more readily gaining access to traumatic experiences, living through feelings, and breaking through avoidance. Exposure and re-scripting take place more indirectly, experientially and sometimes in a playlike manner using art assignments and materials. In the artwork, imagination, play and fantasy offer creative space to stop the vicious circle of nightmares by changing theme, story line, ending, or any part of the dream into a more positive and acceptable one. IR-AT emerges as a promising method for treatment, and could be especially useful for patients who benefit least from verbal exposure techniques. This description of IR-AT offers a base for further research. (shrink)

In this paper, we present a review of research on the role of traditional and indigenous forms of visual artistic practice in promoting physical health and psychosocial well-being, particularly as it relates to the discipline of art therapy. Using extant literature we present an overview of how art making has historically had a therapeutic role in human lives and how it can inform the modern interpretation and profession of art therapy. Thereafter, we provide a critical review of specific studies that (...) reference traditional and indigenous art forms in art therapy in order to invite discussion, dialogue, and awareness of the role of the arts in human development and the therapeutic role of the arts. Gaps in research areas for further study are proposed. Implications for clinical practice including expanding the scope of traditional forms of creative self-expression and promoting an informed and respectful understanding of the role of these artforms in the profession of art therapy worldwide, are also discussed. (shrink)

The purpose of this study was to examine the effect of group art therapy using traditional Chinese materials on improving the self-efficacy and social function of individuals diagnosed with schizophrenia. In China, little research has been conducted on patients to measure the effectiveness of group art therapy, especially using traditional Chinese materials. To address this research gap, 104 individuals diagnosed with schizophrenia were tested in a group art therapy program that included 30 treatment sessions and used a wide variety of (...) materials, including traditional Chinese materials, such as Chinese calligraphy, traditional Chinese painting, Chinese embroidery, and Chinese beads. The effect of art therapy was analyzed using the General Self-Efficacy Scale and Scale of Social Skills for Psychiatric Inpatients. This study demonstrates that group art therapy using traditional Chinese materials can improve self-efficacy and social function, reducing social and life function problems, and promote the recovery of individuals diagnosed with schizophrenia. (shrink)

The recognition and incorporation of evidence-based neuroscientific concepts into creative arts therapeutic knowledge and practice seem valuable and advantageous for the purpose of integration and professional development. Moreover, exhilarating insights from the field of neuroscience coincide with the nature, conceptualization, goals, and methods of Creative Arts Therapies, enabling comprehensive understandings of the clinical landscape, from a translational perspective. This paper contextualizes and discusses dynamic brain functions that have been suggested to lie at the heart of intra- and (...) inter-personal processes. Touching upon fundamental aspects of the self and self-other interaction, the state-of-the-art neuroscientific-informed views will shed light on mechanisms of the embodied, predictive and relational brain. The conceptual analysis introduces and interweaves the following contemporary perspectives of brain function: firstly, the grounding of mental activity in the lived, bodily experience will be delineated; secondly, the enactive account of internal models, or generative predictive representations, shaped by experience, will be defined and extensively deliberated; and thirdly, the interpersonal simulation and synchronization mechanisms that support empathy and mentalization will be thoroughly considered. Throughout the paper, the cross-talks between the brain and the body, within the brain through functionally connected neural networks and in the context of agent-environment dynamics, will be addressed. These communicative patterns will be elaborated on to unfold psychophysiological linkage, as well as psychopathological shifts, concluding with the neuroplastic change associated with the formulation of CATs. The manuscript suggests an integrative view of the brain-body-mind in contexts relevant to the therapeutic potential of the expressive creative arts and the main avenues by which neuroscience may ground, enlighten and enrich the clinical psychotherapeutic practice. (shrink)

The purpose of this preliminary qualitative research study is to explore the role and function of multiple dynamic interactive aesthetic and intersubjective phenomena in the creative arts therapies process relative to transformation in perception, behavior, relationship, and well-being. A group of doctoral students and faculty studied these phenomena in an analogous creative arts therapies laboratory context using a method called Intrinsic Arts-Based Research. Intrinsic Arts-Based Research is a systematic study of psychological, emotional, relational, and (...) arts-based phenomena, parallel to those emergent in the creative arts therapies, using individual and collective intrinsic immersive and reflective experience in combination with qualitative and arts-based research methods. Our primary goal was to simulate the creative arts therapies experience in order to identify, document, and describe the complex transformative phenomena that occur at the nexus of arts-based expression, reflection, and relationships in the arts therapies. For the purposes of this paper transformation is defined as “.... a significant reconfiguration of perception and thought resulting in the lessening of psychic restraint and pain, allowing for the emergence of new psychological perspectives that contribute to living a more creative life” (Gerber et al. 2012, 45). Through a deductive thematic analysis of written accounts of these simulated creative arts therapies experiences by participant/researchers in the laboratory we identified three primary dynamic and interactive broad constructs that together, with more specific modifying themes, might account for and describe change within the creative arts therapies. These broad dynamic interactive themes are: ruptures, resolutions, and transformation; relationship and intersubjectivity; and, arts-based expressive processes. The more specific modifying themes include dialectical rupture and resolution, relational attunements and ruptures, imaginational flow, transcendence and ruptures, sensory/kinesthetic/embodied ways of knowing, and intersubjective transcendence. We propose that change in the creative arts therapies is driven more by a dynamic system of interactive phenomena the varying combinations of which create conditions for relational attunement, imagination, dialectical tensions and creative resolutions, and the ultimately creative transformation. (shrink)

Within the Australian university context, research has uncovered increasing levels of psychological distress, in the form of stress, anxiety and depression. Higher rates of psychological distress have been reported in undergraduate students specifically enrolled in creative arts programs. Despite these increasing levels of psychological distress, university students are reluctant to engage with mental health and wellbeing supports. To explore ways to meet the mental health and wellbeing needs of creative arts university students, the Creative Arts and Music (...) Therapy Research Unit at The University of Melbourne commenced a project exploring the benefits and pitfalls of a brief creative arts therapies approach for students attending a campus based wellbeing clinic. This exploratory research study formed the art therapy component of this much broader research endeavor. Creative arts students in this research study were invited to participate in a single session art therapy encounter that involved the visual exploration of the miracle question, asking students to visually depict “what the problem looks like and how it will look when the problem is resolved or you feel like you can cope with it better?” The descriptive findings of this exploratory research study revealed how the combination of art therapy used within a single session framework was able to afford students a novel means to externalize problems, leading students to forming a less internalized view of the self. (shrink)

We describe work in progress to conduct a systematic review of research on effects of arts-based programs for mental health in young people. We are at the stage of searching for relevant studies through major databases and screening extant systematic reviews for additional research which meet our inclusion criteria. At this stage, however, concerns have arisen regarding both the quality of existing primary studies and of recently published systematic reviews in this area of arts and health. As a (...) case in point, in this paper we focus on one research report on art therapy with adolescent girls and its inclusion in three systematic reviews. We demonstrate that the reviews fail to undertake a robust critique of the Bazargan and Pakdaman paper and that the paper and reviews are flawed. Drawing on recent criticisms of systematic reviewing, we consider the value of proceeding with our systematic review as initially planned. (shrink)

The current global refugee crisis revealed that refugee children, youth, and adults are uniquely vulnerable to traumatic events. Yet, there are only a few studies available that report robust systematic data on art therapy interventions with mental health in recent refugee populations. The purpose of the study is to synthesize and evaluate the available research evidence on the use of art therapy in reducing post-traumatic stress disorder levels in refugees, and the quality of empirical evidence for each of the reviewed (...) studies. The authors adopted the Council for Exceptional Children evidence-based practice standards and quality indicators to evaluate the methodological soundness of the reviewed studies and the evidence-based classification of art therapy as a treatment intervention. We systematically searched electronic databases of pertinent review articles for the period from 2010 to 2020 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Systematic searches identified 70 research articles but yielded eight eligible journals as per the inclusion criteria. Results indicated that, though considered a promising treatment approach, art therapy is presently classified as an intervention that falls under the category of practice with insufficient evidence. The findings suggest the need for further methodologically sound experimental studies to strengthen the evidence behind art therapy as an intervention to reduce PTSD symptoms in refugees around the world. (shrink)

본 연구의 목표는 듀이 경험철학의 ‘표현’ 개념을 중심으로 표현예술치료의 철학적 토 대를 마련하는 것이다. 듀이는 인간의 경험이 생존을 위한 결핍과 충족의 과정에서 일어나 는 충동에서 비롯된다고 보았다. 이 충동은 새롭게 마주한 환경에 의해 형성되어 과거 경 험과의 결합을 통해 새로운 의미를 만들어낸다. 충동의 표출로서 표현 행위는 상상의 작용 을 통해 이미 있는 것과 새로운 것의 통합으로서 질적 특성을 변형시킨다. 표현 행위에 관 한 이러한 탐구는 표현예술치료의 과정을 유기체의 경험으로서 예술로 이해하려는 시도이 다. 나아가 표현예술치료의 핵심 기법이자 목표라고 할 수 있는 (...) 창조적 연결은 듀이가 예 술을 통해 궁극적으로 말하고자 하였던 경험의 공동체로 확장된다. 이는 인간을 고립된 자 기만의 세계에서 벗어나게 하며 서로 다른 개인들을 예술적 언어로 연결하는 표현예술의 진정한 가치라고 할 수 있다. 이와 같은 연구는 실천적인 기법에 편중된 표현예술치료의 한계를 보완하고, 보편적인 언어로서 예술이 가지는 의사소통의 가능성을 바탕으로 언어 중심 상담을 넘어서는 표현예술치료의 보편성을 드러내 보일 수 있을 것이다. (shrink)

BackgroundOver the last decades there has been a change in the way schooling is perceived recognizing that children’s learning is closely linked to children’s health. Children spend most of their time at school, which is often the place where problems are identified and interventions are offered, not only for treatment but also prevention. Embedding arts therapies into the educational system may help address children’s emerging needs and have a positive impact on their wellbeing.MethodsA pilot cross-over randomized controlled design (...) was employed to investigate the effectiveness of an arts therapies intervention on a series of child- and teacher-reported outcome measures, specifically, health related quality of life, wellbeing and life functioning, emotional and behavioral difficulties, as well as duration of sleep. Sample size calculations for future large-scale studies were also performed, and the sustained impact of the intervention was evaluated at 3, 6, and 12 months follow-up. The pluralistic theoretical and therapeutic framework of this intervention was informed by a systematic review on school-based arts therapies interventions and is presented in detail in the study protocol. Participants were 62 children with mild emotional and behavioral difficulties.ResultsImprovements in HRQOL and CORS were greater in those engaged in the arts therapies intervention than the control groups and were maintained at the follow-up stages. Significant improvements were only found for duration of sleep and SDQ. Minimal clinically important differences as defined in the published protocol were found for CORS, SDQ and duration of sleep, but not HRQOL.DiscussionFindings indicate that the arts therapies interventions were having a clinically significant effect on life functioning, duration of sleep, emotional and behavioral difficulties. Findings also indicate a small effect size for health related quality of life, suggesting the intervention was having a small positive effect on this outcome measure. The study indicates that all outcome measures assessed here would be suitable for inclusion in a larger randomized controlled study utilizing these arts therapies interventions, and that a sample size of 225 participants would be required if these outcome measures were used. (shrink)

This article reviews Stephen K. Levine’s 2019 book, Philosophy of Expressive Arts Therapy: Poiesis and the Therapeutic Imagination. The book, complete with poetry and anecdotes is connected to larger concepts in psychology, phenomenology and philosophy. The article summarizes the books contents and offers a review from the perspective of phenomenology and the expressive art practice.

In _Expressive Arts Education and Therapy_ we see how the creative process in a dance theatre lab evolved into a Creative Process-based Research project that included the director/choreographer and participants in a collaborative sense-making project.

Studies have underscored the complexity of the encounter between ultra-Orthodox society and psychotherapy, as well as the challenges involved in developing a therapeutic relationship in cross-cultural therapy. However, there is scant research on therapy for ultra-Orthodox children, especially when it comes to arts therapies that take place in a cross-cultural setting. The current study examined the perceptions of 17 arts therapists who are not ultra-Orthodox, and who currently work or have previously worked with ultra-Orthodox children. Semi-structured interviews (...) were conducted with the therapists and analyzed using the principles of Consensual Qualitative Research. The study covered four domains: perceptions of the significance and objectives of arts therapy with ultra-Orthodox children; the influence of the cultural difference between therapist and client on the emotional experience and the therapeutic relationship; the use of arts in therapy; systemic aspects. The findings indicate significant perceptual and value-based disparities between therapists and clients, which pose difficulties and challenges to all participating parties and require therapists to be highly sensitive. Aside from the difficulties, the findings suggest that this cultural difference may also have certain advantages for clients as well as therapists. The findings likewise attest to the multifaceted process of change that is taking place within Haredi society in its attitude toward psychotherapy in general and arts therapy in particular. (shrink)

The last 20 years have seen the development of a new form of therapy, compassion focused therapy. Although CFT has a growing evidence base, there have been few studies of CFT outside of an Anglo-European cultural context. In this paper, we ask: Might a CFT-based approach be of value for Indigenous Australians? If so, what kind of cultural adaptations might be needed? We report the findings from a pilot study of an arts-based compassion skills training group, in which usual (...) CFT group processes were significantly adapted to meet the needs of Indigenous Australians. At face value, CFT appeared to be a promising approach to enhancing the social and emotional wellbeing of Australia’s Indigenous peoples. However, despite initial consultations with Indigenous health professionals, the first attempts to offer a more conventional group-based CFT to Indigenous clients were largely unsuccessful. Following a review and advice from two Indigenous clients, we combined elements of CFT with visual arts to develop a new approach, “arts-based compassion skills training”. This paper reports an evaluation of this pilot ABCST group. The group had 6 × 4 h sessions of ABCST, facilitated by two psychologists and two artists. There were 10 participants, who attended between 2 and 6 sessions: five were clients, five were health professionals. Between 1 and 3 months later, six of the participants were interviewed. Qualitative analysis of interview data identified that two key processes—creating a positive group atmosphere and channeling compassion skills training through the medium of visual arts—led to four positive outcomes for participants: planting the seeds of new understandings, embodying the skills of compassion, strengthening relationships with others, and evolving a more self-compassionate relationship. We suggest that the preliminary results are sufficiently encouraging to warrant further development of ABCST in Indigenous communities. (shrink)

Aim: The aim of this paper is to present the development and evaluation of an art psychotherapy brief treatment method for complex depression for patients referred to mental health services.Background: Art Psychotherapy literature describes a range of processes of relational change through the use of arts focused and relationship focused interventions. Complex depression has a prevalence of 3% of the population in the West and it is recorded that in 2016 only 28% of that population were receiving psychological treatment. (...) This study was developed to test the hypothesis of whether an accessible and acceptable approach to the treatment of complex depression could be developed in relation to existing evidence-based practice within mental health services.Method: The United Kingdom Medical Research Council phased guidance for complex intervention development was used to develop the intervention. The process included producing a literature overview, systematic description of clinical practice, including a logic model and a clinical protocol. The art psychotherapy protocol described an arts-based dynamic interpersonal therapy approach, offered 1:1 over 24 sessions. Further to this the intervention was tested for referrer acceptability. The intervention is in the early stages of evaluation, using changes to the patient's depression and anxiety measured pre- and post-treatment with a follow-up measure at 3 months following completion of treatment.Results: Phase I of the study provided a good basis for developing a logic model and protocol. The authors found that there was good clinical consensus about the use of a structured clinical art psychotherapy method and the literature overview was used to support specific examples of good practice. The verification of clinical coherence was represented by a logic model and clinical protocol for delivering the intervention. The acceptability study demonstrated very high levels of acceptability for referrers reporting that ADIT was acceptable for patients with complex/major depression, that they were likely to refer to ADIT in the future that the use of arts was likely to improve accessibility the use of arts was likely to improve outcomes and that offering ADIT was an effective use of mental health resources.Discussion: Phase I of this intervention development study demonstrated theoretical and practice coherence resulting in a clinical protocol and logic model. Whilst Phase II of this study showed promising results, Phase II would need to be sufficiently scaled up to a full trial to further test the intervention and protocol. (shrink)

The connection between art therapy and specific theories of positive psychology such as Antonovsky's theory of salutogenic sense of coherence (SOC) has been less articulated in the literature. This paper draws a methodological connection between arts therapy and SOC, that is, meaning, manageability and comprehensibility, as the components of coping. This theoretical and methodological connection is then explored with a group of participants dealing with the health-stress of cancer. Method We conducted a large-scale, qualitative study that included fifty transcribed (...) hours of thematically analyzed arts processes and one hundred art works, used to explore salutogenic theory within a support group for recovering oncological patients. Results The results point to the arts as including mechanisms that enhance meaning, manageability, and comprehensibility in an embodied and synergetic way. The art makes it possible both to separate and to 'fill' these three components, while on the other hand, integrating them into a cyclical element. We outline theoretical and methodological implications of understanding art therapy as a methodology to enact and concretize positive psychology theories, as well as presenting a protocol for using arts to enhance salutogenic coping. (shrink)

Art therapy encourages the use of art materials to express feelings and thoughts in a supportive environment. Art materials differ in fluidity and are postulated to thus differentially enhance emotional response (the more fluid the material the more emotion). Yet, to the best of our knowledge, this assumption has not been empirically tested. The current study aimed to examine the emotional and physiological responses to art making with different art materials. We were particularly interested in vagal activity, indexed by heart (...) rate variability (HRV), because of its association with numerous health related outcomes. In this study, fifty adults (mean age 33 ± 10.27 years, 52% males) participated in a repeated measures experiment, in which they were requested to draw with three art materials (order randomized) differing in their level of fluidity (pencil, oil-pastels and gouache paint) intermittent with periods of music. We measured the emotional response to art making with each material using a self-report measure and matrices of HRV using a wearable electrocardiogram (ECG) device. We calculated two indices of HRV, one indicative of parasympathetic nervous system (PNS) activity, and one indicative of sympathetic nervous system (SNS) activity. Art making with gouache paint and oil pastels resulted in improved positive mood, while pencil did not. Art making explained approximately 35% of the variability in parasympathetic reactivity, which may indicate changes in emotional regulation processes during the art-making task. Yet, fluidity was not sufficient to explain the reaction to art-making. Surprisingly, the largest suppression of PNS and augmentation of the SNS occurred during art-making with oil-pastels and not with Gouache. Moreover, PNS and SNS reactivity to oil-pastels were related to emotional valance, which may point to emotional engagement. We can conclude that art-making with oil-pastels, first created in Japan in 1924 to increase self-expression of students, results in a unique emotional and physiological responses. These findings might be explained by the enhanced tactile experience of art-making with oil-pastels along with their relative fluidity, triggering an arousal pattern. Further studies that take the format and presentation of the materials as well as the content of the artwork, into account, are needed. (shrink)

Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to significantly increase in coming years as the number and proportion of older adults in the population rises all around the world. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama and music modalities, are utilised (...) internationally to target depression and depressive symptoms in older adults. This includes interventions led by trained arts therapists as well as other health and arts professionals. However, to date there has not been a systematic review that reports effects and examines the processes (why) and mechanisms (how) of creative arts interventions are used to address depression in this older age group. This systematic review of studies on creative arts interventions for older adults experiencing depression examined: outcomes of four creative arts modalities (art, dance movement, drama, and music); with particular attention paid to processes documented as contributing to change in each modality; and mechanisms considered to result from these processes. Our analysis of 75 articles (17 art, 13 dance, 4 drama and 41 music) indicates mostly significant quantitative or positive qualitative findings, particularly for interventions led by creative arts therapists. Mechanisms of change gleaned from the studies that were common across modalities include physical (e.g. increased muscle strength; neurochemical effects, such as endorphin release), intra-personal (e.g. enhanced self-concept, strengthened agency and mastery; processing and communication of emotions), cultural (e.g. creative expression, aesthetic pleasure), cognitive (e.g. stimulation of memory) and social (e.g. increased social skills and connection), that were all considered to contribute to reduced depression and symptoms. Recommendations for future research include a stronger focus on testing of processes and mechanisms. (shrink)

Artistic images, of a universal nature and validated by global culture, are carriers of an emotional potential that can be used for therapeutic purposes in cultural centers as well as in clinical spaces. Esthetic studies reveal the mobilizing power in their contemplation and the capacity to bring out personal stories with healing potential. The general objective of this paper is to design and validate the PROJECTA instrument, consisting of the therapeutic use of artistic images to approach trauma or difficult conditions (...) in therapy, by means of the association between art images and emotions, feelings or states of mind related with a traumatic experience. A mixed approach of investigation with a concurrent triangulation design has been used for the integration of qualitative and quantitative results, where qualitative research outweighs quantitative, but both have been QUAL → quan sequentially developed. The study was carried out in two phases. The first was a systematic review of the literature. The second, divided into five steps, consisted of the validation of artworks and the associated emotions with the participation of students, experts in art therapy, psychologists and educators through focus groups, interviews and an online questionnaire. The analysis techniques were qualitative and quantitative. A set of 220 artistic images linked to emotional states were proposed by experts in education, psychology and art therapy, and validated through an online questionnaire. The respondents included 228 students and professionals and for 64.55% of these images a consensus of over 80% was obtained. These images and their associated emotions were again reviewed by a confirmatory focus group. Finally, 92 artistic works were linked to primary, secondary and tertiary emotions such as love, joy, victory, surprise, balance, sense of humor, anger, sadness, fear, and emptiness. In addition, there are mobilizing images that have not been related to any emotion because of the polysemy of their meanings. It concludes that PROJECTA is a visual art therapy tool that provides professionals with a resource that helps facilitate the identification, expression or demonstration of emotions or feelings related with trauma, and in challenging situations of vulnerability, psychological discomfort or post-traumatic stress. (shrink)

BackgroundAdolescents living with human immunodeficiency virus (HIV) experience challenges, including lack of involvement in their care as well nondisclosure of HIV status, which leads to poor adherence to antiretroviral therapy (ART). Parents have authority over their children, but during adolescence there is an increasing desire for independence. The aim of the study was to explore adolescents’ experience of challenges identified by adolescents ages 10–19 years attending HIV care and treatment at Temeke Regional Referral Hospital in Tanzania. MethodsAn exploratory descriptive qualitative (...) design was employed in the HIV Care and Treatment Centre (CTC) in the Out-Patient Department at the Temeke Regional Referral Hospital in Tanzania with adolescents living with HIV who were 10–19 years of age. A total of 22 adolescents participated in semi-structured face-to-face interviews after parental consent and adolescent assent were obtained. Participants were interviewed about their participation in decisions to be tested for HIV and enrolled in the CTC, concerns surrounding disclosure of their HIV status to the adolescent or to others, stigma and discrimination, and the effect of these challenges on their adherence to medication. All interviews were audio-taped, transcribed verbatim in Swahili, and back-translated to English. Data analysis included both inductive and deductive thematic analysis.ResultsQualitative themes identified included lack of participation in decisions about HIV testing, challenges to enrollment in care and treatment; issues around disclosure of HIV status, such as delays in disclosure to the adolescent and disclosure to other persons and benefits and harms of such disclosures; and factors supporting and interfering with adherence to ART, such as parental support, organizational (clinic) support and problems, and self-stigmatization and shame.ConclusionLack of adolescents’ involvement in their care decision making and delayed disclosure of HIV status to the adolescent were identified concerns, leading to poor adherence to ART among adolescents. Disclosure to others, especially teachers, helped adolescents at school to take their medication properly. Disclosure to others led to stigma and discrimination for some adolescents. More research is needed to better understand the role of disclosure and its benefits and challenges for HIV-positive adolescents in Tanzania. (shrink)

The author presents a varied menu of ideas and experiences in many areas - in research, in diagnosis, and in psychotherapy, each using art media with patients of all ages. She integrates art, phenomenology and gestalt psychology, describing specific techniques and findings. Part I of the book lays out the theoretical foundations and the techniques; Part II addresses the formal components used in art therapy - line, shape and colour in their interrelated dynamics and discusses other aspects and modes of (...) symbolic expression found in clients' work. Part III looks at symbolic expression through the scribble, offering a system of classification, diagnostic possibilities and case studies of work with eating disorders. Part IV focuses on art expression for art therapy diagnostics, including a method for qualitative diagnostics, and a first full diagnostic battery for adolescents. Part V is devoted to Holocaust children's art expressions, highlighting the power of art expression in children under ultimate stress, the intensity of their inner experience, and its visualization in the structure of the pictures. The book is for art therapists and advanced students. It can be used as a textbook on phenomenological art therapy; for therapeutically-oriented art teachers, educators and social workers; and for practicing psychotherapists, to see that art is a source of expression demonstrating how a person is. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bernard Mandeville and the Therapy of “The Clever Politician”Harold J. CookAs the institutional authority of the learned physicians of Augustan London waned, new threats to the classical foundations of medical practice appeared. 1 Patients had more freedom to chose from a variety of practitioners and practices, giving both consumer demand and the advertising skills of suppliers an even more powerful hand in medical affairs. While the burgeoning medical marketplace (...) developed mostly because of the profound socio-economic and political changes of the late Stuart period, intellectual transformations were at play, too. The new science appeared to encourage empiricism and the development of new remedies based on experimentation, devaluing university education in medical classics, but conversely the new science could strengthen physicians’ claims to superiority over mere patients and practitioners. Medical materialists, for instance, could turn the classical advisor/client relationship into that of an expert contolling a passive recipient (patient) for his or her own good.One contemporary debate that shows the implications of materialism for medical relationships is the theory of the passions. The passions linked mind and body. According to most classical accounts, one could (or should) control the passions by applying reason, resulting in both a virtuous and a healthy life. But according to a strong version of materialism, the mind could not hope to control the passions. A doctor therefore could no longer appeal to patients’ reason; rather, he had to manipulate the patient’s passions for his or her own good. Hence for a materialist, the doctor was not an adviser to the patient but an expert therapist, not a teacher of health and virtue but a “clever politician” who ordered bodily passions. Some versions of the new science, then, favored [End Page 101] the expertise of physicians while undermining older views about learned authority. Such an outlook is clear in the work of Dr. Bernard Mandeville, whose famous Fable of the Bees shows how the “clever politician” played on passions to make the body politic run smoothly. Mandeville held coherent views on politics, economics, moral philosophy, and medicine. Like many doctors of his time, he fought to establish his expertise in the new science. His views are expressed most clearly in the theory of the passions. By examining his discussion of the passions in both his social commentary and his medical dialogues, we can note similarities among his various writings and glimpse one of his fundamental positions on medicine and humanity.The Fable and its CriticsTo many English minds of the early eighteenth century, no one exemplified materialism’s threat better than Dr. Bernard Mandeville. Mandeville’s famous slogan, the subtitle of his Fable of the Bees—“private vices, public benefits”—seemed to epitomize materialism’s inherent immorality. The book seemed to argue that what most people recognized as human vices were the main engines of the collective good. Mandeville’s famous book pictured human nature as animalistic, in which the passions held sway over reason. In Mandeville’s world, it appeared, reason became little more than the ability to rationalize, the instrument of hypocrisy, merely letting people cover their true motives (grounded as they were in the passions) with empty words pretending to more exalted ends.His Fable had begun as a little, anonymous, satirical poem in 1705, titled “The Grumbling Hive: or, Knaves Turn’d Honest.” It began by speaking of “A Spacious Hive well stockt with Bees, / That liv’d in Luxury and Ease.” Many of the bees were knaves, with no calling free of deceit, but while “every Part was full of Vice, / Yet [was] the whole Mass a Paradise; /... Such were the Blessings of that State; / Their Crimes conspir’d to make them Great.” Avarice, prodigality, luxury, pride, envy, vanity, folly, fickleness, and inconstancy employed millions, encouraging ingenuity and industry and creating pleasures and comforts “To such a Height, the very Poor / Liv’d better than the Rich before.” But many of the thriving bees complained, shouting for honesty and virtue. When Jove “rid / The bawling Hive of Fraud,” economic collapse followed, with the consequent end of arts and sciences as well; population declined; the hive’s territory decreased; and the remaining bees toiled long and... (shrink)

Crisis events, such as the COVID-19 pandemic, can have a devastating effect on communities and the care professionals within them. Over recent years, arts-based interventions have helped in a wide range of crisis situations, being recommended to support the workforce during and after complex crisis but there has been no systematic review of the role of arts-based crisis interventions and whether there are cogent themes regarding practice elements and outcomes. We, therefore, conducted a systematic review to (i) define (...) the arts-based change process used during and after crisis events, and (ii) explore the perceptions of intermediate and long-term mental health benefits of arts-based interventions for professionals in caring roles. Our search yielded six studies (all qualitative). All data were thematically aggregated and meta-synthesized, revealing seven practice elements (a safe place, focusing on strengths and protective factors, developing psychosocial competencies to support peers, emotional expression and processing, identifying and naming the impact of the crisis, using an integrative creative approach, and cultural and organizational sensitivity) applied across all six studies, as well as a range of intermediate and long-term benefits shared common features (adapting, growing, and recovering; using the community as a healing resource; reducing or preventing symptoms of stress or trauma reactions, psychophysiological homeostasis). The ways in which these studies were designed independently from one another and yet used the same practice elements in their crisis interventions indicates that there is comparability about how and why the arts-based practice elements are being used and to what effect. Our findings provide a sound basis and meaningful parameters for future research incorporating quantitative and qualitative approaches to firmly establish the effectiveness of art-based interventions, and how arts can support cultural sensitivity, acceptability and indicated outcomes, particularly those relating to stress and trauma during or following a crisis. (shrink)

_Supervision of Sandplay Therapy_, the first book on this subject, is an internationally-based volume that describes the state of the art in supervision of sandplay therapy. Recognizing that practitioners are eager to incorporate sandplay therapy into their practice, Harriet Friedman and Rie Rogers Mitchell respond to the need for new information, and successfully translate the theories of sandplay therapy into supervision practice. The book provides a meaningful connection and balance between theoretical principles, practical application, and ongoing therapeutic encounter involved in (...) sandplay. Divided into six sections, contributors cover: original supervision models contemporary supervision models special challenges in supervision international sandplay supervision supervision of special groups connections with other arts therapies. _Supervision of Sandplay Therapy _expands the vision of what is possible in supervision and will be vital reading for those studying supervision and sandplay therapy, as well as for those wanting to provide a depth-oriented approach during supervision. (shrink)