What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review

Wood, Michele; Molassiotis, Alex; Payne, Sheila

doi:10.1002/pon.1722

Cited by 205 publications

(131 citation statements)

References 32 publications

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“…The patients miss the good times when they were well, and they desire to get back their life and have hope for the future. They sometimes express their hopes for the future, and art therapy promotes this behavior and may facilitate readjustment [14].…”

Section: Relaxation Id8mentioning

confidence: 99%

Psychological utility of art therapy for patients with advanced cancer

Ando¹,

Hayashida²

2017

Clin Case Rep Rev

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Patients with advanced cancer experience various kind of suffering such as physical pain, psychological suffering, or existential suffering. Art therapy is one of the most effective psychological cares. The aim of this study was to investigate the psychological utility of art therapy for patients with advanced cancer. Eight patients with advanced cancer received art therapy with an art therapist from two to four times in a general hospital. They made art including drawing pictures or making collages to express their feelings and thoughts. Each patient explained his art after each session and discussed changes that they had undergone between sessions. The therapist wrote down patients' words including explanation toward arts, their emotions, and thoughts, then categorized to evaluate the utility of the art therapy, and the following categories emerged: "Promotion of communication with other patients," "Promotion of communication with family members," "Hope for the future," "Making psychological space to forget illness," "Missing the good old times," and "Relaxation." These results suggest that art therapy has psychological utility for patients with advanced cancer such as promoting communication, finding hopes for the future, and adapting to life in the hospital.

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Section: Relaxation Id8mentioning

confidence: 99%

Psychological utility of art therapy for patients with advanced cancer

Ando¹,

Hayashida²

2017

Clin Case Rep Rev

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“…Proponents of art therapy [17][18][19] and of the arts therapies 20,21 only relatively recently have come to realise that randomised controlled studies of art therapy are needed in order to create a pluralistic body of evidence. As a consequence there has been limited formal synthesis of evidence 16,22 for the clinical effectiveness and cost-effectiveness of art therapy in order to assess its relevance as a treatment for the most common mental disorders in the NHS.…”

Section: Description Of Interventionmentioning

confidence: 99%

Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

Uttley

Scope

Stevenson

et al. 2015

Health Technology Assessment

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BackgroundMental health problems account for almost half of all ill health in people under 65 years. The majority are non-psychotic (e.g. depression, anxiety and phobias). For some people, art therapy may provide more profound and long-lasting healing than more standard forms of treatment, perhaps because it can provide an alternative means of expression and release from trauma. As yet, no formal evaluation of art therapy for non-psychotic mental health disorders has been conducted.AimThis review aimed to evaluate evidence for the clinical effectiveness and cost-effectiveness of art therapy for non-psychotic mental health disorders.MethodsComprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in major health-related and social science bibliographic databases including MEDLINE, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Allied and Complementary Medicine Database (AMED) and Applied Social Sciences Index and Abstracts (ASSIA) from inception up to May 2013. A quantitative systematic review of clinical effectiveness, a qualitative review to explore the acceptability, relative benefits and potential harms, and a cost–utility analysis of studies evaluating cost-effectiveness of art therapy were conducted.ResultsIn the quantitative review, 15 randomised controlled trials (RCTs) were included (n = 777). Meta-analysis was not possible because of clinical heterogeneity and insufficient comparable data on outcome measures across studies. A narrative synthesis reports that art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 10 out of the 15 studies. The control groups varied between studies but included wait-list/no treatment, attention placebo controls and psychological therapy comparators. Four studies reported improvement from baseline but no significant difference between groups. One study reported that outcomes were more favourable in the control group. The quality of included RCTs was generally low. In the qualitative review, 12 cohort studies were included (n = 188 service users;n = 16 service providers). Themes relating to benefits of art therapy for service users included the relationship with the therapist, personal achievement and distraction. Areas of potential harms were related to the activation of emotions that were then unresolved, lack of skill of the art therapist and sudden termination of art therapy. The quality of included qualitative studies was generally low to moderate. In the cost-effectiveness review, a de novo model was constructed and populated with data identified from the clinical review. Scenario analyses were conducted allowing comparisons of group art therapy with wait-list control, group art therapy with group verbal therapy, and individual art therapy versus control. Art therapy appeared cost-effective compared with wait-list control with high certainty, although generalisability to the target population was unclear. Verbal therapy appeared more cost-effective than art therapy but there was considerable uncertainty and a sizeable probability that art therapy was more clinically effective. The cost-effectiveness of individual art therapy was uncertain and dependent on assumptions regarding clinical benefit and duration of benefit.ConclusionsFrom the limited available evidence, art therapy was associated with positive effects when compared with a control in a number of studies in patients with different clinical profiles, and it was reported to be an acceptable treatment and was associated with a number of benefits. Art therapy appeared to be cost-effective compared with wait-list but further studies are needed to confirm this finding as well as evidence to inform future cost-effective analyses of art therapy versus other treatments.Study registrationThe study is registered as PROSPERO CRD42013003957.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…In addition to salutogenic effects, art therapy may help in the psychological management of, and readjustment to, cancer, with general effects on healthrelated quality of life and coping. 55 There are first hints from a pilot study on cancer patients undergoing chemotherapy that the anthroposophical approach of painting therapy in addition to traditional treatments can improve depressive symptoms and influence CRF. 25 An outcome study showed that health-related quality of life and symptoms improved in chronic conditions.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Therapy Concept and Aerobic Training in Breast Cancer Patients With Chronic Cancer-Related Fatigue

et al. 2012

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Hypothese: Cancer-related fatigue (CRF) and sleep disorders are some of the most wearing and common symptoms in disease-free breast cancer patients (BC). Aerobic training (AT) is the treatment with the best available evidence, even though it seems to be insufficient with regards to improvements in cognitive fatigue. We introduced a new multimodal therapy concept (MM) consisting of psycho-, sleep-education and new approaches based on anthroposophic medicine such as eurythmy and painting therapy. Study design: This pilot study will test the implementation of MM and yield first results of the MM and AE in our centres. Methods: 31 out of 34 patients suffering from BC and CRF were fully assessed in a ten-week intervention study. 21 patients chose MM and 10 decided on AT. CRF was measured with the help of the Cancer Fatigue Scale (CFS-D), and the global quality of sleep was measured with the Pittsburgh Sleep Quality Index (PSQI). We also captured autonomic regulation (aR) and patients' satisfaction with questionnaires. Statistical analysis was done with SAS 9.1.3 for windows. Results:The new MM therapy can be implemented with high satisfaction among patients. Significant improvements were found in the MM group with regards to CFS-D, global quality of sleep, sleep efficiency (PSQI), aR and rest/activity regulation compared to baseline (all p<0.05). In the AT group aR orthostatic-circulatory and rest/activity regulation improved significantly (p<0.05), too. However, no improvement in cognitive fatigue was seen in either group. Conclusion: The multimodal therapy concept was feasible and improved cancer fatigue, sleep quality, autonomic and rest-/ activity regulation in breast cancer patients. It may therefore constitute a valuable treatment option in addition to aerobic training for BC patients with CRF. A further study with larger sample size needs to be carried out to assess the efficacy of combined multimodal-aerobic therapy.

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What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review

Cited by 205 publications

References 32 publications

Psychological utility of art therapy for patients with advanced cancer

Psychological utility of art therapy for patients with advanced cancer

Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

Multimodal Therapy Concept and Aerobic Training in Breast Cancer Patients With Chronic Cancer-Related Fatigue

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