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From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review.

ABSTRACT: Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear how and why the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review (N _studies = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: "embodiment," "concretization," and "symbolism and metaphors." The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.

SUBMITTER: de Witte M

PROVIDER: S-EPMC8336579 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review.

de Witte Martina M Orkibi Hod H Zarate Rebecca R Karkou Vicky V Sajnani Nisha N Malhotra Bani B Ho Rainbow Tin Hung RTH Kaimal Girija G Baker Felicity A FA Koch Sabine C SC

Frontiers in psychology 20210715

Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear <i>how</i> and <i>why</i> the CATs have positive effects, and which therapeutic factors account for these changes. ...[more]

PMID: 34366998

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Project description:IntroductionMental health care provided to offenders with psychiatric problems in forensic settings mainly consists of verbal oriented treatments. In addition, experience-based therapies are used such as (creative) arts therapies: (visual) art therapy, music therapy, drama therapy and dance (movement) therapy. There are indications for effectiveness of arts therapies, but a systematic overview of effect studies of all arts therapies in forensic care is lacking.MethodsFirst, we performed a systematic review. Second, Thematic Analysis was used to synthesize the qualitative narrative results and define the hypothesized mechanisms of change. Third, we performed a meta-analysis to investigate the effects of arts therapies in reducing psychosocial problems of offenders. Twenty-three studies were included in the review. Quality and risk of bias was assessed using EPHPP (Effective Public Health Practice Project).ResultsThe included studies were heterogeneous in type of outcome measures and intervention characteristics. Synthesis of mechanisms of change involved in the methodical use of the arts in arts therapies resulted in a description of regulatory processes which are stimulated in arts therapies: perceptive awareness (interoceptive and exteroceptive), the regulation of emotions, stress, impulses, cognitions, social regulation, and self-expression. These processes play a role in developing prevention, coping and self-management skills. Eighteen studies were included in the meta-analyses (11 RCTs/CCTs; 7 pre-post studies). The meta-analyses indicated significant effects on both risk factors (psychiatric symptoms and addiction) and protective factors for criminal behavior (social functioning and psychological functioning). Effects on criminal and/or antisocial behavior were not significant, but this outcome measure was scarcely used among the studies.DiscussionThe analyses in this study should be considered explorative. More research is needed to gain more solid conclusions about effectiveness and mechanisms of change of arts therapies in forensic institutions. However, the results of this first systematic review, synthesis of mechanisms and meta-analysis in this field are promising and show effects of arts therapies on risk and protective factors in individuals in forensic institutions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020217884, identifier: CRD42020217884.

Project description:ObjectiveWe aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of people with neurological conditions.MethodsA systematic search was employed to identify studies that examined creative arts interventions for older informal caregivers, which were synthesised in this integrative review. We searched the following databases: MEDLINE, PubMed, EBSCO, CINAHL, EMBASE, PsycINFO, Cochrane Library, Scopus, Web of Science, and Google Scholar. We also backwards searched references of all relevant studies and inspected trials registers.ResultsOf the 516 studies identified, 17 were included: one was quantitative, nine were qualitative and seven used mixed methods. All included quantitative studies were pilot or feasibility studies employing pre- and post-test design with small sample sizes. Studies varied in relation to the type of creative intervention and evaluation methods, which precluded meta-analysis. Large effect sizes were detected in wellbeing measures following singing and art interventions. The qualitative synthesis highlighted that interventions created space for caregivers to make sense of, accept and adapt to their identity as a caregiver. Personal developments, such as learning new skills, were viewed positively by caregivers as well as welcoming the opportunity to gain cognitive and behavioural skills, and having opportunities to unload emotions in a safe space were important to caregivers. Group creative interventions were particularly helpful in creating social connections with their care-recipients and other caregivers.ConclusionsThe current review revealed all creative interventions focused on caregivers of people living with dementia; subsequently, this identified gaps in the evidence of creative interventions for informal caregivers of other neurological conditions. There are encouraging preliminary data on music and art interventions, however, little data exists on other art forms, e.g., drama, dance. Creative interventions may appeal to many caregivers, offering a range of psycho-social benefits. The findings of the current review open the way for future research to develop appropriate and creative arts programmes and to test their efficacy with robust tools.

Project description:IntroductionPersonality disorders (PDs) cause much suffering. In treating patients with PDs, it is important not only to focus on reducing symptoms, but also on promoting psychological adaptability and well-being. The experiential nature of Creative Arts and Psychomotor Therapies (CAPTs) contributes to working on psychological adaptability and improving well-being, although more evidence is needed. This protocol paper describes a study to develop and evaluate a CAPTs-intervention aimed at promoting psychological adaptability and well-being in people with PDs.Methods and analysisThe CAPTs-intervention will be developed using the Intervention Mapping method. A mixed method design will be used for the evaluation of this intervention, using a multiple baseline single case experimental design (MBSCED) with at least 17 participants with a PD included. Quantitative measures that will be completed weekly are the Generic Sense of Ability to Adapt Scale, the Self-Expression and Emotion Regulation in Art Therapy Scale and the Schema Mode Inventory (SMI, healthy adult and happy child). The Mental Health Continuum Short Form, the Brief Symptom Inventory and the SMI (complete) will only be completed at week 1 and 10 of the intervention. Qualitative instruments are an online survey for Experts by Experience, focus groups for CAPTs-therapists, psychologists, managers and referrers, and semi-structured interviews with patients. Quantitative outcomes will be analysed with linear mixed models. Qualitative analysis will be performed using thematic analysis.Ethics and disseminationThis study has been approved by the Research Ethics Committee of the HAN University of Applied Sciences (ref: ECO 471.07/23). All participants will sign an Informed Consent and data will be treated confidentially. Study findings will be published Open Access in peer-reviewed journals.Trial registration numberThis study has been registered at https://www.Clinicaltrialsgov (trial registration number NCT06219122).

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From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review.

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From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review.

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