Experiences and impacts of visual art-based interventions on perinatal well-being: an integrative review

Abstract

ABSTRACT Background The first 1000 days (conception to 2 years postnatal) are crucial for parent and infant health. Visual art-based interventions are used to promote positive parental mental health, but currently, there are no comprehensive insights into how these interventions can support new parents during this critical perinatal period. Aims To synthesise research on visual art-based interventions designed to promote parents’ mental well-being during the first 1000 days to understand if and how these interventions made a difference and to identify any barriers or facilitators to parents’ engagement. Method A keyword search of five databases (CINAHL, Embase, Medline, PsychInfo and Scopus), searches via Google Scholar and backward and forward chaining were undertaken. Quality appraisal was conducted using design appropriate tools, and a narrative thematic approach was used. Results 4417 hits were identified, and 10 studies met eligibility criteria and were included. Interventions were classified as art therapy (n = 8) or creative arts (n = 2), and overall, a lack of robust evidence was highlighted. Six themes were constructed that describe the psychosocial impacts and experiences of the interventions and relational and contextual factors that influenced parents’ engagement. While both types of interventions had benefits, art therapy had the most profound impacts. Challenges regarding sustainability of impacts and facilitator skills were noted for creative arts, rather than art therapy interventions. Conclusion While art therapy interventions promote positive parental mental health and well-being, high-quality evidence is needed. Implications for future research More robust evaluation designs to identify mechanisms of effectiveness in art therapy interventions are needed. Plain-language summary In this study, we aimed to combine and summarise all available published research on visual art-based interventions (such as art therapy and creative arts) that had been designed to improve parents’ mental health and well-being during pregnancy or up to two years after birth. We wanted to find out if and how these interventions made a difference to parents, and what helped or did not help parents to take part. We found 10 relevant studies that involved different art-based interventions – eight were art therapy interventions delivered by a trained art therapist and two interventions were creative arts interventions delivered by other professionals (e.g. specialist health visitor, arts officer). Most studies (80%) were undertaken in high-income countries, used different study designs, and often only included a small number of participants. Overall, there were benefits of both types of interventions for parents, but the most lasting and significant impacts were for art therapy. Parents in arts therapy studies felt the intervention had helped to increase awareness of their mental health issues, improved their confidence and self-esteem, helped them to build positive parent-baby connections and encouraged them to seek out further help. Group-based art therapy also helped parents to form connections and friendships and to reduce social isolation and loneliness. Some factors that influenced parent participation were positive relationships with the therapist and being provided with clear information. Barriers to engagement were generally reported in creative arts, rather than art therapy interventions. Overall, the evidence suggests that art therapy could be an important intervention for parents who have poor mental health. However, more research is needed.