Creative Arts Interventions to Address Depression in Older Adults: A Systematic Review of Outcomes, Processes, and Mechanisms

Abstract

Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to significantly increase in coming years as the number and proportion of older adults in the population rises all around the world. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama, and music modalities, are utilized internationally to target depression and depressive symptoms in older adults. This includes interventions led by trained arts therapists as well as other health and arts professionals. However, to date there has not been a systematic review that reports effects and examines the processes (why) and mechanisms (how) of creative arts interventions are used to address depression in this older age group. This systematic review of studies on creative arts interventions for older adults experiencing depression examined: outcomes of four creative arts modalities (art, dance movement, drama, and music); with particular attention paid to processes documented as contributing to change in each modality; and mechanisms considered to result from these processes. Our analysis of 75 articles (17 art, 13 dance, 4 drama, and 41 music) indicates mostly significant quantitative or positive qualitative findings, particularly for interventions led by creative arts therapists. Mechanisms of change gleaned from the studies that were common across modalities include physical (e.g., increased muscle strength; neurochemical effects, such as endorphin release), intra-personal (e.g., enhanced self-concept, strengthened agency and mastery; processing and communication of emotions), cultural (e.g., creative expression, aesthetic pleasure), cognitive (e.g., stimulation of memory), and social (e.g., increased social skills and connection), that were all considered to contribute to reduced depression and symptoms. Recommendations for future research includes stronger focus on testing of processes and mechanisms.

Playback theatre in adult day centers: A creative group intervention for community-dwelling older adults

“…These therapies employ an intentional and systematic utilization of arts to foster psychological growth. A growing body of research has established the positive impact of creative arts therapies in terms of improving various aspects of older adults' mental health [11][12][13][14][15][16]. Visual arts, music, dance-movement, drama and theater provide additional means of self-exploration and expression within a therapeutic relationship [17].…”

Mental Health Interventions: Reflections on a Radio Program as Alternative for Stigma Reduction and Social Integration

“…Regarding treatment of patients with mental health issues, a great deal of research demonstrates significant benefits of using alternative methods of integration into common social activities such as media outlets, art, and traditional and digital games (Silverman, 2006(Silverman, , 2009Grocke et al, 2009;Lipe et al, 2012;Crone et al, 2013;Hohmann et al, 2017;Mahendran et al, 2017;Dunphy et al, 2019). Patients treated with alternative mental health interventions become more resilient and engage in understanding their condition, which translates into positive outcomes (Brandao et al, 2019;Dunphy et al, 2019). For instance, patients with chronic mental illness benefited from arts intervention experiences, since these provided them with opportunities to relieve stress and develop coping skills (Lipe et al, 2012;Oklan and Henderson, 2014).…”

Dance as a Catalyst for Stress Busting

“…Creative arts interventions, including art, dance movement, dramas and music, are used to target depression and depressive symptoms in adults and children (Dunphy et al, 2019). This includes interventions led by trained arts therapists as well as health and arts professionals.…”