An art therapy intervention for cancer patients in the ambulant aftercare - results from a non-randomised controlled study

Abstract

Art therapy in psycho-oncology is gaining increasing importance, but systematic evaluations of its effects are rare. The aim of this study is to investigate the effects of an art therapy intervention for cancer patients in ambulant aftercare on psychological distress and coping. The intervention consisted of 22 sessions. At three points of measurement (t1: before intervention, t2: following intervention, t3: 6 months after t2), participants responded to questionnaires (Freiburg Questionnaire on Coping with Illness, Perceived Adjustment to Chronic Illness Scale, Hospital Anxiety and Depression Scale). A group of haemato-oncological patients served as the comparison group (CG). Pre-post comparisons and analyses of variance were applied for statistical analysis. Relevant confounders were controlled. Fifty-four patients (intervention group, IG) with various cancer diagnoses completed the intervention. One hundred and twenty-nine data sets were available for the CG. Analyses of variance included group membership (IG vs. CG) and the following factors: gender, other psychosocial help and major life events. None of these variables was a predictor for changes in depression, anxiety and coping. Therefore, we could not prove intervention effects over time. Our results contradict those of preliminary studies and raise important questions. Further work on evaluating art therapy is necessary to explore which intervention concepts in which setting at which treatment stage show significant effects. Therefore, controlling for relevant confounders is needed.

Painting Therapy in Cancer Care: A Descriptive Systematic Review

“…The qualitative study [12] concentrating on how patients express the meanings of hope in drawing highlighted that painting therapy gave a new understanding of the experience of hope. The rest one had no detectable effect on participants' psychological anxiety and depression [15].…”

“…Possible explanations for inconsistency could be small sample size, heterogeneity in cancer population, measuring instrument and statistical methods [15] [16] [18]. Randomized trials in this topic are few and only 4 randomized controlled trials were retrieved in this review.…”

“…Most painting therapies are composed of several sessions although there is no universally applicable standard procedure. Usually, the sessions took place in groups of mixed gender and age and consisted of 5 to 8 patients each group [15] The included studies reported phased tasks with aims and methods during painting therapy. In Geue's study [16], the intervention was consisted of 3 phases: participants learned use of material and practiced experimental drawing in phase I (session 1 -7); then participants started to express their ideas and make use of watercolor in phase II (session 8 -13); finally, participants created a book telling their own stories in phase III (session 14 -21).…”

“…Four studies reported coping with illness as an outcome (Table 1), of which only one reported an overall increase of coping resources among patients at 2 months and 6 months after baseline measurement [17]. The remaining 3 studies [15] [18] [21] presented no significant improvement in post-traumatic growth, coping with illness or self-image. However, participants in the study of Geue [16] expressed positive subjective experiences through the whole intervention process.…”

Transforming Pain into Beauty: On Art, Healing, and Care for the Spirit

“…Music therapy has been found to reduce pain, improve mood, enhance communication, and reduce spiritual distress [10], and creative arts also help reduce pain [9]. For oncology or hematology patients, quantitative studies of art therapy interventions have shown a reduction in depression [29, 30], improved fatigue/sluggishness levels [29, 31], reduced anxiety [30], and improved coping resources [32], although these results have not always been consistently replicated [33, 34]. …”