Can arts-based interventions improve health? A conceptual and methodological critique of art therapy

Abstract

Can art improve health and wellbeing? The rapidly growing art therapy literature claims that there is solid evidence that engaging with art ameliorates mental and physical disorders and increases wellbeing. This claim is used to justify numerous arts-based clinical interventions and health policies, so it deserves thorough scrutiny. Here we show that the evidence cited in favor of the efficacy of art therapy interventions is conceptually and methodologically flawed. Conceptually, experiments investigating the effects of arts-based interventions on health do not include appropriate tests nor control conditions that would allow demonstrating that the putative effects actually owe to the healing power of art: (i) they fail to define what art is, making it impossible to compare the effect of “art” and “non-art” stimuli and activities on health and wellbeing; (ii) they fail to demonstrate that “art” stimuli and activities elicit a distinct class of “art” experiences that modulate the mechanistic causes of disorders; (iii) and they fail to include causal manipulations of physiological processes believed to be mechanisms of action that could prove that art-induced processes affect the etiology of disorders. Methodologically, most studies cited as proof for the efficacy of art therapy lacked such common clinical trial procedures as defining the therapeutic agent, randomizing group assignment, controlling for patient or researcher allegiance, controlling for the effects of other concurrent interventions and medications, comparing art-based interventions to other kinds of interventions, or conducting and reporting statistical analyses appropriately. We conclude that there is no compelling evidence that art objects and activities can induce physiological changes to the human nervous system that result in health improvements and wellbeing. We discuss why proponents of art therapy have neglected these problems and the ethical implications for patients who are treated using art therapy.

The well-being benefits of virtual art galleries: Examining the roles of emotion, immersion, and individual differences

“…Further, we found that visually engaging with art was a more immersive experience than learning about visual art via art historical readings, in line with the RAISE model (Tay et al, 2018). Given limitations of prior arts and well-being work not including robust control conditions (Skov & Nadal, 2023), future work should consider relevant readingbased controls as is appropriate.…”

“…This control was designed to provide art historical information, and thus still a form of art engagement, but to be less immersive than a virtual gallery visit based on the conceptualization in the RAISE mechanism model (Tay et al, 2018). Further the inclusion of such a condition addresses critiques of art and well-being research lacking meaningful control conditions to art engagement (Skov & Nadal, 2023).…”

Ecological decoding of visual aesthetic preference with oscillatory electroencephalogram features—A mini-review

“…The field of neuroaesthetics studies the neural correlates of aesthetic experience (AE) (Vessel, 2022 ). While some of this research looks at aesthetics from the lens of economics and aims to discover sensory objects feature that increase economic interests such as product sales (Costa-Feito et al, 2019 ), an increasing number of studies report positive correlations between AEs and health and wellbeing (e.g., Fancourt and Finn, 2019 ; see Skov and Nadal, 2023 , for a critique of such reports). With the internet and social media, many humans have now an unprecedented access to artworks.…”