Creative Therapies Research Articles

Creative therapy in health and disease: Inner vision.

Can we better understand the unique mechanisms of de novo abilities in light of our current knowledge of the psychological and neuroscientific literature on creativity? This review outlines the state-of-the-art in the neuroscience of creativity and points out crucial aspects that still demand further exploration, such as brain plasticity. The progressive development of current neuroscience research on creativity presents a multitude of prospects and potentials for furnishing efficacious therapy in the context of health and illness. Therefore, we discuss directions for future studies, identifying a focus on pinpointing the neglected beneficial practices for creative therapy. We emphasize the neglected neuroscience perspective of creativity on health and disease and how creative therapy could offer limitless possibilities to improve our well-being and give hope to patients with neurodegenerative diseases to compensate for their brain injuries and cognitive impairments by expressing their hidden creativity.

Bilateral Movement and Artmaking: Hemispheric Integration Across the Midline (Mouvement bilatéral et création artistique : intégration hémisphérique sur la ligne médiane)

Bilateral art making is a self-regulatory and brain-based practice experienced through gesture, gross and fine motoric expression whether in the air, on paper, canvas, or nontraditional surfaces. The structural effects of integrating bilateral movement and art making on the brain are largely unknown; this article explores the implications of specific bilateral movements and corresponding gestural marks on hemispheric integration across the midline. The authors of this theoretical article are father and daughter collaborators merging their respective backgrounds in neuroscience and expressive arts therapy. This collaboration resulted in the four different considerations in bilateral movement: simultaneous, continuous, overlapping, and midline crossing. The corresponding bilateral movements and art making were demonstrated as part of a single case study (n-of-1 trial). The results consider the neurological structural benefits and regulatory responses in regards to bilateral movement and art making.

Growing a small world: College students’ perceptions of making and tending an expressive terrarium

Expressive terrariums are a recent intervention in the field of ecological art therapy, which combines nature-based horticultural therapy with arts-based activities. An expressive terrarium consists of a plant terrarium in a glass bowl that contains living plants and objects that form a personal artistic-creative whole. The aim of this preliminary qualitative study was to explore the meanings and effects of making and tending an expressive terrarium, as well as its potential as an intervention tool in creative arts therapies. Twenty-three college students were asked to describe their experiences. The findings yielded three themes: (1) their perceptions of the terrarium building workshop, (2) their experiences and feelings while making the terrarium and when (3) tending the terrarium over time. The building phase was shown to facilitate an experience of flow, emotional expression, transformation and elicitation of cognitive skills. The tending phase was perceived as building a relationship with the growing and changing terrarium. The terrarium itself was seen as promoting self-observation. Making and tending the terrarium allowed the participants to engage in developmental tasks and experiences related to young adulthood. These facets of the participants’ experiences thus support the use of the expressive terrarium in therapeutic settings.

Pengaruh Expressive Arts Therapy terhadap Self-Acceptance Narapidana Kasus Narkoba

Drug abuse is a serious problem in many countries, including Indonesia. Drug convicts have a high risk of experiencing mental health problems and difficulties in accepting themselves, which can affect the rehabilitation process. Expressive arts therapy has been used as an additional therapy to improve individual mental well-being and can be an alternative choice to increase self-acceptance. This study aims to evaluate the impact of expressive arts therapy on the level of self-acceptance of prisoners who experience drug cases. Expressive arts therapy includes aspects of self-expression that can trigger positive emotions, reduce stress, and indirectly increase self-acceptance. This therapy is carried out in groups to strengthen social support, which is a key factor in increasing self-acceptance according to Ryff (2005). This study used a pretest posttest control group design with the participation of 50 drug convicts (25 participants as an experimental group and 25 participants as a control group). This study also used an adapted self-acceptance scale as a measurement instrument. Data analysis was performed using the t test using SPSS software version 22.0. The results show that there is an effect of expressive arts therapy on self-acceptance as indicated by the t test result of 0.034. Furthermore, based on the effectiveness test using the Cohen formula, it is known that expressive arts therapy has a role in the medium or medium category to increase self-acceptance in drug case convicts with an effect size score of 0.6. As a recommendation expressive arts therapy can be an effective alternative therapy to help drug convicts in their recovery process.

THE ROLE OF EXPRESSIVE ART THERAPY AND NEUROFEEDBACK ASSESSMENTS IN IMPROVING CLINICAL HYPNOSIS ADHERENCE AMONG ANXIETY SUFFERERS

Despite worldwide concern on anxiety, preventive measures in public health industries remained scarce. Previous studies found that therapeutic adherence is vital for the treatment efficacy of anxiety sufferers; polyvagal theory may address adherence issues by considering biopsychosocial perspectives. As such, this research intends to generate polyvagal-focused therapeutic guidance in line with anxiety sufferers. This study examines the effectiveness of the Creative Brain Health Intervention (CBHI), which includes expressive art therapy and neurofeedback assessments, as well as clinical hypnosis for anxiety sufferers. The study utilizes a qualitative method with a grounded theory approach to explore helpful and unhelpful factors of CBHI. The study samples were found to have minimal scores at a mild level (on anxiety or stress subscales) of eight (for the anxiety subscale) and 15 (for the stress counterpart) under DASS-21 following a screening procedure. Particularly, the samples were analyzed after CBHI through in-depth interviews for data collection. A total of 45 participants were recruited to generate the outcomes of this study, and the results show that mental healthcare can be enhanced by addressing adherence, stigma, and support through a public system and education, backed by six domains for anxiety treatment and innovative therapeutic approaches. The study recommends early intervention and prevention phases in future research to address stigmas and prevent mental disorder. Resultantly, therapeutic adherence could be enhanced with a polyvagal-focused framework CBHI established for this study. Consequently, the study suggests insights for developing therapeutic guidance to enhance adherence and prevent full-fledged anxiety complexities.

The spirit of time and the spirit of depth: Psychodynamic approaches in public mental health services in Israel

AbstractThis article examines the interplay between psychodynamic psychotherapy and other approaches to psychotherapy in mental health services in Israel, describing the history of psychotherapy approaches, education and training, current dilemmas and service examples. Israel has a system of universal healthcare, education and social care which includes mental health services for all citizens and permanent residents. Mental health services and interventions are provided by psychiatrists, clinical psychologists, educational psychologists, social workers, clinical criminologists and creative arts therapists. Despite being public, accessibility is undermined by long waiting times, inequitable geographic distributions and cultural‐linguistic barriers. The interplay between approaches is clearly visible in public mental health services. Many therapists are trained primarily in psychodynamic approaches and receive psychodynamic‐oriented supervision. However, public services often cannot provide suitable conditions for psychodynamic oriented psychotherapy, and the therapists are required to adjust their interventions to treatment plans, reimbursement and reporting. This paper describes in detail two programs that implement psychodynamic approaches in the medical and education systems respectively. The first is “Lkol Nefesh” (“for every soul”) that provides long‐term intensive psychoanalytic psychotherapy for individuals suffering from severe mental disorders. The second is the system of creative arts therapies delivered in schools that provide psychotherapy as part of special education services. The paper concludes with a discussion of the influence of the spirit of time on psychotherapy, and the opposite tendencies evident in the state of affairs of psychodynamic psychotherapy in Israel.

The effectiveness of a day hospital mentalization-based therapy programme for adolescents with borderline personality traits: Findings from Touchstone-Child and Adolescent Mental Health Service.

Individuals with borderline personality disorder (BPD) are at a substantial risk of harm to themselves and others, experience high levels of functional impairment and typically are high users of tertiary healthcare to address their mental health concerns. As indicators for BPD typically emerge in adolescence, a day therapy service in Bentley, Western Australia, Touchstone Child and Adolescent Mental Health Service (CAMHS), was developed as an intensive intervention for adolescents with indicators for BPD and its associated symptomology. Touchstone utilizes mentalization-based therapy (MBT) in a therapeutic community setting, where the current study sought to document the anecdotal outcomes using the data provided at Touchstone, to enable a greater understanding of this treatment approach for adolescents with indicators for BPD. Forty-six participants attended the Touchstone programme between 2015 and 2020. The programme involved 6months of MBT (group and individual), occupational therapy, education and creative therapies. Measures of self-injury, mood and emergency department presentations were collected pre- and post-programme. Results indicate that participants show a reduction in non-suicidal acts and thoughts, as well as a reduction in negative moods and feelings from pre-Touchstone to post-Touchstone. There is also a decrease in participant presentation to tertiary emergency departments for mental health concerns. The current study shows evidence for the efficacy of Touchstone as an MBT therapeutic community intervention to reduce symptoms of emerging BPD and effectively reduce presentations to emergency departments for mental health presentations, alleviating pressure on tertiary hospitals and reducing economic impact of adolescents within this demographic.

Evaluation of Integrative Community Therapy with Domestic Violence Survivors in Quito, Ecuador.

Integrative community therapy (ICT) is a methodology used in the public health arena to deal with problems facing communities such as depression, substance abuse, and stress. This approach is unique as it builds on critical pedagogy, cultural anthropology, communication, resilience, and systems theory. Additionally, creative arts therapies point to the utility of music as a therapeutic tool. This study employed ICT and a music workshop with domestic violence survivors in Quito, Ecuador, via a pre-post comparison group design. A total of 87 women completed the six-week study-49 in the intervention group and 38 in the comparison group. Measures were taken on self-esteem, general health, resilience, dating violence attitudes, and social support. Additionally, the intervention group answered open-ended questions about their experience, and some participated in a focus group (n = 21). The quantitative results indicated that there was improvement in the domains of general health, self-esteem, and social support for the intervention group compared to the comparison group. Themes from the qualitative responses indicated changes in the relationship with the aggressor, psychological and emotional changes, changes in feelings of social support, and changes for the future. The study found promising results for this approach with domestic violence survivors, possibly leading to a community-grounded, non-hierarchical, culturally-responsive intervention for this population.

Systematic Review of the Effectiveness of Complementary and Alternative Medicine on Nausea and Vomiting in Children With Cancer.

Nausea and vomiting are distressing symptoms reported by pediatric oncology patients during cancer treatment. More than 40% of them experience these symptoms even after receiving antiemetics. Given the limitations of pharmacological interventions, this systematic review synthesized the evidence for the effectiveness of complementary and alternative medicine in controlling nausea and vomiting among pediatric oncology patients. Ten databases were searched to identify relevant randomized controlled trials. The risk of bias of selected studies was graded using the Cochrane risk-of-bias tool for randomized trials. The primary outcomes were nausea and vomiting. The secondary outcomes were intervention adherence and number of adverse events. Nineteen papers met the inclusion criteria and were included in the review. Sixteen studies showed high risk of bias. The tested interventions were acupuncture, acupressure, aromatherapy, hypnosis, massage, active cognitive distraction/relaxation techniques, creative arts therapy, psychoeducation, and combined massage and acupressure. Acupuncture, hypnosis, and massage interventions improved nausea and vomiting. Fifteen trials reported intervention adherence; only 7 monitored adverse events. The most common reason for dropout was refusal from patients and/or their guardians. A total of 34 adverse events were noted. There is insufficient evidence that complementary and alternative medicine is effective, feasible, or safe in controlling nausea and vomiting among pediatric oncology patients due to high risk of bias. Acupuncture, hypnosis, and massage appear to have therapeutic benefits. However, more robust studies are needed to address the identified methodological issues and determine the real value of these 3 interventions.

Creative arts intervention to reduce burnout and decrease psychological distress in healthcare professionals: A qualitative analysis

Creative arts therapy (CAT) can potentially mitigate the unprecedented levels of healthcare professional (HCP) burnout that have been exacerbated by the COVID-19 pandemic. However, empirical evidence about the impact of CAT programs is lacking. We conducted focus groups with HCPs (N = 20) who participated in a 12-week CAT clinical trial to enhance the understanding of the effectiveness of the intervention. For HCPs experiencing burnout and psychological distress, our CAT program supported healing and resiliency through building a sense of community. Participants reported that several programmatic components contributed to this sense of community including: 1) diversity of participants’ disciplines, roles, and geographic locations; 2) physical separation between the conduct of the CAT program and their primary place of employment; 3) facilitator skill; 4) collectively contributing to a group project; and 5) being pushed out of their “comfort zone” through the creative activity. Although participants described the particular need for the CAT program in light of additional stressors induced by the COVID-19 pandemic, they believed that this program would have been beneficial pre-pandemic and in the future. To build long-term resiliency, participants suggested that CAT interventions should continue after the 12-week program.

Lifting the ‘knee on the neck’ through virtual collaboration within creative and therapeutic art methodologies

Police brutality towards Black people and People of Colour (POC) has been a thorn for centuries in South Africa and the world. The advent of COVID-19 escalated this struggle to unimaginable heights, illuminating, amongst other things, the epistemological and ontological limitations underpinning modernity (). Nevertheless, the killing of George Floyd moved masses across the globe to reflect critically on the injustices that Black people endure. Equally, social media shone a spotlight to mobilize consciousness amidst the pandemic restrictions. Moved by the mood of the time, we (a group of primarily arts practitioners and thinkers) organized virtual ‘intergenerational and intercontinental dialogues’ to explore how the dialogic approaches informed by the principles of applied theatre may catalyse drama therapy approaches. Through conversations that we named ‘epistemological injustice’, we made discoveries that included noticing how the biases we all carry may serve as enablers or constraints in embracing therapeutic encounters across disciplines. This article shares insights from the ‘#Talks’ and generates reflective material for creative arts therapies and applied theatre methodologies.

Research Progressin the Application of Creative Arts Therapy to Behavioral and Psychological Symptoms of Dementia

Behavioral and psychological symptoms of dementia (BPSD) are common in the patients with dementia.Creative arts therapies (CAT) are one of the safe and effective non-pharmacological interventions for BPSD.This paper elaborates on the therapeutic effects of four common CAT,including art therapy,music therapy,dance therapy,and drama therapy,on BPSD.Despite the shortcomings,CAT offer a new gateway for the safe and noninvasive treatment of BPSD.

Aesthetic mutuality: A mechanism of change in the creative arts therapies as applied to dance/movement therapy

The discipline of Creative Arts Therapies (CATs) has begun to articulate mechanisms of change and therapeutic factors that are shared across the various modalities (dance/movement, drama, music, art, poetry) while also identifying specific factors within a discipline. Further development of this work is imperative towards establishing theories that can be tested to advance the efficacy of the CATs. Through an in-depth literature review and a supporting clinical case study, Aesthetic Mutuality (AM), a CAT fundamental mechanism, is further developed to provide a theoretical framework and taxonomy for “picking up” within dance/movement therapy (DMT). Furthermore, the theory of AM reveals, deepens, and connects shared aspects of active ingredients within the Arts in Health discipline while also differentiating from the CATs through the therapeutic relationship. Specifically, eight components of the therapeutic movement relationship are identified and described within DMT. Aesthetic mutuality enriches both the CAT and AiH disciplines, offering implications for education, research, and practice.

An interprofessional collaborative approach to alleviate workplace stress among medical college faculty during COVID pandemic

Introduction and Aim: Job and stress are not mutually exclusive; in fact, stress is inherent to job. In the present era of COVID pandemic, working as health care providers may entail highest levels of stress leading to burnout. Thus, affecting work efficiency of faculty, in turn reflecting on students’ performance and health care services to patients. However, de-stressors like yoga and art-based interventions are scarce and not well documented to date. Hence, the present study was undertaken to determine the efficacy of stress alleviating yoga and creative art therapy through interprofessional collaborative approach. Methods: Sixty medical faculty of either gender aging 30-60 years, were randomly divided into two equal groups - control and intervention group. The intervention group underwent yoga and creative art therapy for 10 days duration each. International stress management association (ISMA) stress questionnaire and Kessler’s psychological distress (K-10) scale were administered before and post-intervention, to compare the stress levels. Blood pressure (BP), pulse rate, body mass index (BMI) and waist hip ratio (WHR) were also measured. Comparative analysis of pre-post test scores was done using Student’s paired ‘t’ test. Results: According to ISMA and K-10 scores, the intervention group showed statistically significant (p 0.05) decrease in stress levels among faculty. However, BP, BMI and WHR didn’t show any significant change after the intervention. Conclusion: Yoga and art therapy were proved to be beneficial in reducing the stress levels among faculty significantly. Comparative analysis also showed significant reduction irrespective of their gender and specialty.

Analysis of the Effect of Music Therapy Interventions on College Students with Excessive Anxiety.

In order to explore and analyze the effect of music therapy interventions on college students with excessive anxiety, this paper selected 240 year 2017- to year 2020-enrolled undergraduates from a comprehensive university in Taiyuan City, Shanxi Province, in Central China as research objects. These college students had been diagnosed as excessive anxiety and were randomly divided into two groups-intervention group and control group-with 120 students in each group. The control group received conventional mental health treatment for college students, while the intervention group received music therapy interventions on this basis with 3 times a week for 24 times. The instruments used in the music therapy include piano, percussion instruments, melodic instruments, and diffuse instruments; the specific implementation of each therapy is divided into five parts: warm-up, rhythm percussion, song singing, instrumental ensemble, and music appreciation. The study results show that before treatment, the excessive anxiety score of college student in the control group was 63-76 with an average score of 72.58 ± 5.27; after treatment, that was 45-64 with an average score of 54.46 ± 6.82; before treatment, the excessive anxiety score of college student in the intervention group was 62-78 with an average score of 72.56 ± 5.51; after treatment, that was 26-44 with an average score of 33.19 ± 5.51. Before treatment, there was no significant difference in the excessive anxiety scores between the two groups of college students (P > 0.05); after treatment, the excessive anxiety scores of the two groups were lower than those before treatment, and the reduction degrees in the intervention group were bigger than those in the control group, with statistically significant difference (P < 0.05). Therefore, music therapy interventions can significantly reduce the excessive anxiety of college students; the analysis also shows that factors such as gender, grade, major, origin, repertoire type, therapy type, and anxiety type could affect the effect of music therapy interventions to some certain extent. For example, the effect of music therapy interventions on college students in psychology or related majors is better than that of students in other majors; the effect of receptive music therapy is better than that of creative and improvised music therapy; the effect of music therapy interventions on college students' life event, romantic relationship, and social anxiety is better than that on college students' test and job-hunting anxiety.

Applying principles of mentalizing based therapy to music therapy methods

Mentalizing is the process of making sense of behavior in oneself and in others. Mentalization-based treatment (MBT) is a theoretical framework that is parallel to creative arts therapies in that it seeks to foster co-regulation of affect, improve reflective functioning, and influence adaptive changes in personality by addressing the attachment needs of the client. While there has been a limited amount of investigation on the application of MBT concepts to music therapy, the primary focus has been on musical improvisation, neglecting its application to the other three methods in music therapy (receptive, compositional, re-creational). Here, we provide a review of MBT concepts, an explanation of the therapeutic function of music in mentalizing, and approaches to apply MBT concepts to all four methods of music therapy through fictional vignettes. The ability of music to help people better understand themselves and others suggests that it is a welcome addition to therapy that incorporates the principles of mentalizing.

3. Artistic Education and Creative Art-Therapy

Abstract As for the phrase “artistic education”, in this paper work, it was used in the way of cultivating individual, authentic artistic talent, of acquiring individual skills, abilities and techniques, with the aim of training artists in different fields of arts, as well as the assimilation of theoretical and practical knowledge from the fields of theory, aesthetics, criticism and history of arts etc., adapted to natural, innate capacities with a view to non-verbal creative expression and development plastic expressiveness. Art education and art therapy have in common the fact that they are forms of applications of art that integrate theories and practices of art pedagogy in a supportive environment: museums, art galleries, ambient art - street or interior - nature, classrooms or creative studios, where artists use the influences offered by the environments specific to the practice of the arts, which by their pluri/inter/trans-disciplinary character, encourage freedom of creation, thought, expression and imagination. Being “postmodernist” in art therapy, as Shirley Riley sees it, assumes a renunciation of programmed knowledge. For the art therapist it is essential to become the “student” of the client and to “learn from each client the meaning of the situation that he brings”. Through “co-constructive” therapy with the client, the art therapist becomes a collaborator in the therapeutic activity. Art therapy, as a component of occupational therapy, aims to correct the consequences of the disease that caused the disability or handicap, the development of adaptive skills, so that a person with a certain degree of incapacity can make the most of his or her remaining potential, in order to recover (both at family and professional level), by integrating into a useful activity at the highest level accessible to him. The therapeutic methods of the current era experiment with ways specific to each art, to achieve interdisciplinary exchanges. They connect to disciplines such as psychology or psychiatry, anthropology, history, religion, to experience the primary therapeutic values of contemporary art.

Personhood, QOL, and Well-being in People with Dementia undergoing Creative Arts-based Therapies: A Scoping Review

ABSTRACT Creative art-based therapies (cABT) provide a creative non-pharmacological approach in therapy to people with dementia and can potentially improve their personhood. This review identified cABT that focused on the personhood of persons with dementia living in residential facilities and determined how quality of life (QOL) or well-being were assessed. Searches were conducted on PubMed, Medline (Ovid), EMBASE, CINAHL (EBSCO), PsycINFO (OVID), and SCOPUS databases, to gather articles from 2010 to 2020. In this review, cABT encompassed art, music, and theater/drama. An overall of five studies were included and, in these studies, art programs were seen in the form of water painting, an intergenerational art program, live music performances, and medical clowns. QOL and well-being were assessed using the Greater Cincinnati Well-being Observation Tool, a QOL checklist, and transcribed from conversations to develop themes on participation and mental well-being. Personhood was promoted through self-expression and self-creativity. Increased number of participants are required for future cABT to further understand the impact the arts may have on personhood, on the QOL and well-being, and enhancing creativity for people with dementia.

Death Education for Palliative Psychology: The Impact of a Death Education Course for Italian University Students.

The present study investigated the effects of a hybrid online course on a group of Italian Master's degree students involved in a European Erasmus+ project. The course was composed of nine modules about death education, palliative psychology and the use of creative arts therapies-such as psychodrama, intermodal psychodrama and photovoice-in the end-of-life-field. The project involved 64 students in the experimental group (who attended the course) and 56 students as the control group. Both groups completed an online questionnaire before and after the delivery of the course and 10 students from the experimental group participated in a focus group at the end of the course. The quantitative analysis revealed that the experimental group students showed lesser levels of perception of death as annihilation, fear of the death and death avoidance, while they increased their levels of death acceptance, creative self-efficacy and attitude toward the care of the dying. Qualitative analysis identified three main themes: the positive impact of the course on death education and end-of-life care; the role of art therapies on death and end-of-life care; and the unhelpful facets of the course. Overall, this intervention changed the perception and the feelings of the students regarding the themes of death and palliative psychology and increased their creative self-efficacy and their interest in working in an end-of-life field.

Recent Progress in Mind-Body Therapies in Cancer Care.

Mind-body therapies (MBTs) are integrative medicine modalities that continue to grow in popularity among people with cancer. MBTs are used to enhance well-being and most commonly include relaxation and imagery, hypnosis, yoga, meditation, Tai Chi and Qigong, and creative therapies. Biofield and psychedelic-assisted therapies are also gaining momentum as MBTs. Herein, recent literature was narratively reviewed to summarize the effectiveness of these MBTs within the context of cancer care. There is growing evidence for the effectiveness of MBTs for addressing a myriad of physical (e.g., pain) and psychosocial (e.g., depression, fatigue) symptoms and biomarkers of stress and immune function in people with cancer. Psychedelic-assisted therapies have robust, sustained effects on symptoms of depression, anxiety, and distress in small clinical trials to date. However, across modalities, MBT studies continue to struggle with methodological issues such as intervention standardization, facilitator training, small sample sizes, and short follow-up. Accumulating evidence supports the use of MBTs for people with cancer. Future research should work to address methodological issues and focus on creating knowledge translation tools; these can be leveraged to better educate health care providers and patients regarding evidence-based MBT options to support patients in making informed decisions about their health.