A Conceptual Framework for Approaches to Art Therapy Research in Paediatric Hematology/Oncology Settings (Un cadre conceptuel pour des approches de recherche en art-thérapie en milieu d’hématologie/oncologie pédiatrique)

Background This paper describes a structured group approach for women vulnerable to psychological distress following treatment for breast and/or gynaecological cancer. Aims Set in Hong Kong, the aim was to develop and pilot a brief art therapy intervention sensitive to local concerns and the specific needs of service-users. Methods A mixed methods study was developed and piloted in two phases over six-years in collaboration with female service-users recovering from breast and/or gynaecological cancer treatment. Key therapeutic goals and core themes were identified in phase 1 leading to the piloting of a six-session structured intervention with six groups in phase 2. This was evaluated using qualitative and quantitative methods: through service-user feedback and reflections; informal feedback captured through the art therapy process; and pre and post assessment of emotional distress (Distress Thermometer) and mental wellness (C-SWEMWBS). Results A consistent six-session structure was developed addressing four therapeutic goals: stress release and relaxation; amelioration of psychological and emotional distress; exploration of self-image; promotion of self-acceptance and awareness. Six core themes relating to loss and readjustment were established through the art therapy process. Participants experienced statistically significant reductions in psychological distress and increased mental well-being. Conclusion A new brief, structured, group art therapy approach was developed for women recovering from breast and/or gynaecological cancer treatment. Implications for practice/policy/future research The study contributes to the evidence base for the efficacy of art therapy in psycho-oncology and highlights the importance of service-user involvement in the design of a tailored, culturally sensitive, intervention responsive to local concerns. Plain-language summary This paper describes a brief art therapy group approach for women in recovery from treatment for breast and/or gynaecological cancer who are finding it difficult to adjust to changes in their bodies and the way they see themselves in the world. The aim of the project was to explore the use of a participatory approach to develop and test a brief art therapy intervention designed to meet the specific needs of such women. The project took place in Hong Kong, in a community cancer service offering support with the emotional impact of a cancer diagnosis and treatment. The theme-based group model was developed in two phases over six years in collaboration with female participants, all of whom were over the age of eighteen and had received treatment for breast and/or gynaecological cancer in the previous two years. Four therapeutic goals were identified: relaxation, reduction of emotional distress; exploration of feelings about oneself in the world, and awareness and acceptance of various aspects of oneself and one’s situation. Common issues relating to feelings of loss and difficulties adjusting to bodily changes led to the further identification of six core themes. These were creatively explored through the art therapy process leading to the development of a consistent six-session structure. The themed group approach was evaluated through service-user feedback and reflections, informal feedback during the art therapy process, and established measurement tools for assessing emotional distress and mental wellness. Results suggest an overall reduction in emotional distress with improvements in mental wellbeing. This contributes to the evidence base for the efficacy of art therapy in cancer care. Positive outcomes also reflect the participants’ involvement in the design of a culturally sensitive intervention responsive to local needs.

Background Few studies have investigated brain responses to different art media. Investigations into brain processes during art making have highlighted important structures. Neuroimaging tools have been used to investigate activation of brain areas whilst artmaking, but not in a therapeutic setting. This review highlights recent advancements in this area and encourages researchers to be the first to apply this in the UK. Aim To understand how the principles of neuroscience are currently informing the literature to explain the effects of art media in art therapy practice. Methods Review of published peer-reviewed research between years 2000 and 2020 on neuroscience and art therapy. Results Findings were summarised into categories discussing psychological/neurobiological issues, art media, neuroimaging technology, and models posited. Forty-six studies were found; majority discussed the structure and function of the brain to explain art therapy processes. The Expressive Therapies Continuum (ETC) model theorised that media properties stimulate different levels of visual and cognitive processing. The novel Mobile Brain/Body Imaging (MoBI) neuroimaging technology may be used as a means of quantifying data. Conclusion Significant progress has been made in attempting to explain brain responses during the art therapy process. However empirical data is needed to prove theoretical models. The use of neuroimaging has started this process to lead research into evidence-based practice. Implications for practice/further research Evidencing the ground-breaking ETC model, using neuroimaging and MoBI technology is needed through close collaboration between transdisciplinary departments. Art therapists should be encouraged to use the ETC to inform art therapy assessment, planning and treatment. Plain-language summary Neuroscience is the study of the brain and its processes, and recently technology has been available to researchers to examine brain processes in detail. This systematic narrative review explores recent literature that uses the principles of neuroscience to investigate the effects of art therapy, with a specific interest in art media. A systematic narrative review is when the findings of the study rely on the use of words to summarise the data. Art media is an important part of art therapy, as it is through artistic expressions that the client communicates their inner troubles. Different art media has been shown to elicit different feelings and behavioural responses in clients. However, research showing brain responses to different art media is limited. This study highlights ways in which further research in this field can take place. Results show that significant advancements have already been made that identify important structures and functions of the brain accessed during art therapy. Important models which incorporate neuroscience principles and theorise the art therapy process are highlighted. A significant model is the Expressive Therapies Continuum. This model explains how the brain processes information when different art media is used. However empirical data is needed to substantiate the theory behind this model. The use of neuroimaging technology is one way to achieve this. Therefore, this paper encourages transdisciplinary research to further investigate the effects different art media has on the brain during the art therapy process.

Moments of change in the art therapy process

Identifying conflicts of anorexia nervosa as manifested in the art therapy process

We aimed to evaluate the existing evidence base for the efficacy of art therapy with parent-infant dyads. We undertook an integrative review, following the PRISMA protocol, systematically searching 4 electronic databases, and grey literature, for papers describing art therapy with parents and infants together. 14 papers were identified for inclusion. These were evaluated for quality, data was synthesised for evidence of change, and we undertook a narrative synthesis of intervention model and thematic analysis drawing together mechanisms of change within the art therapy process. Papers described a group approach to art therapy and contained a mixture of methodological approaches. Themes highlighted the beneficial aspects of the art therapy process that might be common to group psychotherapy approaches and those which were unique to art making, such as the qualities of the materials, the making process and the final art works. The themes identified provide a basis for further research into mechanisms of change within parent-infant art therapy. Those papers which presented quantitative evidence demonstrated promising evidence for the value of art therapy but we identify the need for larger participant numbers and control measures, for this evidence to confidently state the impact of art therapy. Plain language summary This paper is based on a review of the current evidence for an art therapy approach to working with parents and their infants together. We searched data bases and other online sources and put out calls for unpublished work to art therapy organisations. We looked for art therapy for parents together with their 0–3s and this could be with the individual pairs or with groups. We reviewed the papers we found and 14 were included in the final stage of this review. We have compared their models for art therapy work and their results and we have also looked for the common themes about why art therapy seems to be helping in order to provide a solid basis for future research in this area. We think there is promising early evidence that art therapy can help parents and infants in a number of areas, such as building the parent-infant relationship and improving parental well-being but this research highlights the need for further, larger scale and controlled studies.

Short-term art therapy with an adolescent male

The evidence base for the effectiveness of art therapy continues to grow, even as a mechanistic understanding of how art therapy works remains limited. One promising avenue for increasing our understanding of how and why art therapy works is through the lens of neuroscience. A neuroscience-based approach to art therapy provides opportunities for improving understanding of the neural processes that underlie the complex interaction between perception, cognition, emotion and behavior that play out in the art therapy process. Understanding how therapeutic change occurs can result in improved treatment and better outcomes for clients. However, it can be tricky to connect art therapy and psychological theory directly to neural responses. The purposes of this perspective are to provide an overview of the current evidence and limits of neurobiological concepts of neuroplasticity, mirror systems, and interoception as applied to art therapy practice, and to provide updated information about outdated concepts that are still actively used in clinical practice. Critical analysis and understanding of the current scientific knowledge base can then be used to guide art therapy practice and support the development of hypothesis-based research to determine the primary mechanisms that drive the observed effects of art therapy interventions.

Art therapy in pediatric burn care: A conceptual framework for clinical practice

Absent direct research on the neural concomitants of the processes involved in art therapy, art therapists have relied on theories of visual perception and imagery to form their understanding of expression through art media. The theory of convergence-divergence zones (CDZs) in the brain's architecture involved in imagery formation in recognition and memory offers a potential model for understanding basic art therapy processes. Emphasizing the importance of sensorimotor brain activity in imagery formations, early studies of imagery in art therapy suggests that divergent sensorimotor activity is involved in imagery formations. This paper considers the potential compatibility of the CDZ framework with three aspects of art therapy: the process of art therapy, art therapy approaches that emphasize the sensorimotor aspects of visual expression, and the perception of images as living entities.

The study aims to explore the experience of young people in an Australian high school setting who engage in art therapy. It will also seek to examine and clarify the role of art therapists who work with children and young people, as well as the researcher's own reflective and reflexive experience. Art therapy in Australia is a relatively new profession with small numbers. With a small research base in Australia, art therapy remains underutilised as a treatment option for mental health issues. To date, art therapy is an unregistered profession with an unprotected title. This has implications for the art therapist's identity and can impact on their work. This naturalistic inquiry seeks to clarify the art therapy process from several perspectives, and it is anticipated that the investigation will focus on why it can be a successful intervention for high school students.

Art practices have become an effective means of facilitating recovery and maintaining individual mental health in an activity called art therapy. Whether carried out according to medical advice in the form of intervention or non-intervention, both types of art therapy delivery practices have produced many positive things. This research article wants to read how art therapy practices and art itself are used in different social and scientific disciplines where the application is carried out according to scientific methods. Happiness, the regulation of human consciousness and control of emotions, can apparently be triggered by artistic activities and is accepted in medical practices. Based on the research method in this article which uses a literature study approach, there are differences from those in America and England. In Indonesia, the practice of art therapy still stands alone and is carried out by medical personnel, psychologists and psychiatrists. This is different from the practices carried out by Adrian Hill, Edward Adamson and Edith Kramer. The three art therapy experts explained that in the practice of art therapy, a medical therapist must be accompanied by an art practitioner or someone who has an art educational background as a counselor. It is important to ensure that the art therapy process is carried out with a deep understanding of creative exploration, aesthetics and local cultural context. The rest of this article also examines that art therapy is also very beneficial for the general public without diagnosed health problems in maintaining their mental health.

Should I save my marriage?: Addressing couple relationships by means of art therapy intervention

The Study of Therapeutic Effect of Hill's Dream Work in Art Therapy

Background Engaging in creative arts and heritage have both been shown to improve wellbeing. Aim: The aim of the current study was to explore veterans’ experiences of attending the Creative Wellbeing Programme programme (CWP) in a military museum. Methods Seven veterans who attended the CWP programme were invited to share their experiences through a qualitative, semi-structured interview. The interview explored experiences of engaging in this type of programme and the impact this had on them. The interview was transcribed, and a thematic analysis was conducted. Results Themes concerned three stages of involvement: Pre-programme, Programme experiences, and Post-programme. Pre-Programme themes concerned reasons for participation, pre-programmes feelings, hopes and expectations. Programme Experiences concerned general experiences, the role of social support, the role of the museum, and the art therapy process. Post-Programme themes concerned perceived outcomes. Overall, the museum created a relaxed and informal environment, and the familiar items in the museum stimulated the creative process. However, for some this led to disengagement due to fear that objects may prompt negative emotions. Conclusions The findings suggest that engaging veterans in art therapy in a museum environment is beneficial. Future programmes should aim to focus on support post intervention. Implications: The study provides insight into the acceptability of art therapy within a military museum environment. It also adds to the growing international evidence concerning the role museums have in supporting mental health and wellbeing. Plain language summary This study aimed to explore the experiences of veterans who took part in a Creative Wellbeing Programme (CWP). This programme involved using art and discussion in a museum environment as a way of supporting veterans with potentially traumatic memories. The group environment facilitated connection and a sense of belonging through discussion of museum items. Seven veterans were interviewed via MS Teams about their experiences engaging in the programme, exploring potentially positive and negative aspects of participating. The transcripts were transcribed by MS Teams and anonymized before being analysed for potential themes. Themes were identified relating to pre-programme, during the programme and following the programme. Pre-programme themes were centred on the reasons veterans participated, and their hopes and expectations about the programme. Programme themes were the role of social support in the groups, the role of the museum, art therapy process. Post-programme themes centred on the outcomes veterans felt had resulted from taking part in the programme. Overall, the familiar items in the museum facilitated discussion and creativity despite some veterans feeling that the items prompted negative emotions. The study findings indicate the potential benefits of a museum group environment for veterans experiencing mental health difficulties.

Introduction: Quality of life (QoL) in oncology captures the well-being of a patient and is considered a significant outcome criterion. Breast cancer (BC) is the most diagnosed cancer in women, however, standardizing integrative therapies to alleviate the burden of cancer and improve QoL is still an unmet need. Art and music therapy might mitigate psychological and emotional distress. We sought to evaluate their efficacy compared to control among patients with BC during or after active therapy. Methods: Seventy-six treated patients with Stages I-III BC were randomly assigned to art, music therapy, or routine oncology care standard of care arm (SOC) for 3 months and received two sessions per month by a licensed therapist (including in-person/virtual and group sessions). The primary outcome was an improvement in QoL measured by the Functional Assessment of Cancer Therapy–Breast (FACT-B) questionnaire and secondary outcomes included: cognitive function measured by Functional Assessment of Cancer Therapy–Cognition (FACT-Cog), response to a 4-component Cleveland Clinic Visual Analog Scale (CCVAS), indicators of anxiety and depression assessed by the Generalized Anxiety Disorder-7 item (GAD-7) and Patient Health Questionnaire-9 item (PHQ-9). All questionnaires were assessed at baseline, 30, 90, and 180 days. Statistical considerations included stratified randomization, and a mean difference in 15 points between either of the interventions. SOC arm was considered relevant at the 3-month mark. Mean improvement within groups was performed using paired t-tests whereas independent t-tests were used to evaluate mean improvement between interventions (1 or 2 vs. SOC arm). All analyses were performed using SPSS version 26 (IBM, Armonk, NY). Results: Forty-five participants completed the study to date and were included in the interim analysis. Median age was 58 (57-59), white race (51.1%), patients on active treatment (45%), art therapy group (n=16), music therapy (n=15) and standard of care (n=14). Significant improvement was noted in the art therapy arm at 3 months in FACT-B physical well-being (p=0.04), functional well-being (p=0.008) domains as well as GAD-7 (p=0.003), PHQ-9 (p=0.04) and FACT-Cog section “impact on quality of life” (p=0.03). At 6 months, the art therapy arm demonstrated lower scores in the CCVAS questionnaire total score, emotional distress (p=0.01) and anxiety (p=0.004) scales. Music therapy participants reported a significant improvement only in GAD-7 index(p=0.04) at 3 and 6 months compared to SOC. No significant difference was found between art and music therapy arms. Conclusion: Art therapy patients exhibited significant improvement in overall QoL (including anxiety, depression, improvement in cognitive function) and 4-scale CCVAS (emotional distress, anxiety, depression, and pain). Music therapy improved anxiety scores (GAD-7). Art and music therapy should be considered in the care of patients to manage cancer associated distress and improve their quality of life. Table 1. Comparison of test changes from 3 months to baseline within groups Table 2. Comparison of test changes from 6 months to baseline within groups Citation Format: Maria Herran, Mohamed Mohanna, Saad Sabbagh, Barbara Dominguez, Kaylee Sarna, Rachel Upton-Rice, Angie Burdine, Zeina Nahleh. A Randomized Controlled Trial to Assess the Benefit of Art & Music Therapy on Quality of Life in Patient with Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-11-03.