Abstract
ABSTRACT Despite advancements in arts and health research, the processes through which arts activities contribute to wellbeing and care remain ambiguous. This study aims to shed new light on causal links surrounding the impact of improvisational drama workshops on people with dementia and their carers at care facilities, using both participatory and goal-free evaluation. The article outlines challenges and strategies in addressing causality in the arts, followed by methodology and research context. Findings are discussed framed by key considerations for arts impact: negative impacts, uniqueness of the arts, artistic quality, and long-term outcomes. We conclude that a two-layered causal process, micro and macro, contributes to meaningful impact. This perspective emphasizes learning from negative impacts, integrating artistic elements with other relevant factors through trial and error, and reassessing shared goals during implementation. Sustained efforts in this endeavor can lead to significant long-term outcomes, extending beyond individual behavioral changes to community growth.
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