Effectiveness of Dance Movement Therapy in the Treatment of Adults With Depression: A Systematic Review With Meta-Analyses

Abstract

Background: Depression is the largest cause of mental ill health worldwide. Although interventions such as Dance Movement Therapy (DMT) may offer interesting and acceptable treatment options, current clinical guidelines do not include these interventions in their recommendations mainly because of what is perceived as insufficient research evidence. The 2015 Cochrane review on DMT for depression includes only three studies leading to inconclusive results. In a small and underfunded field such as DMT, expensive multi-centered Randomized Controlled Trials (RCTs) are as yet rare. It is therefore, necessary to not only capture evidence from RCTs, but to also look beyond such designs in order to identify and assess the range of current evidence. Methods: We therefore conducted a systematic review of studies that aimed to explore the effectiveness in the use of DMT with people with depression. This led to a qualitative narrative synthesis. We also performed meta-analyses that calculated the effect size for all included studies, studies with RCT designs only, followed by a subgroup analysis and a sensitivity analysis. In all meta-analyses a random effects model was used with Standardized Mean Differences (SMD) to accommodate for the heterogeneity of studies and outcome measures. Results: From the 817 studies reviewed, eight studies were identified as meeting our inclusion criteria. Three hundred and fifty one people with depression (mild to severe) participated, 192 of whom attended DMT groups while receiving treatment as usual (TAU) and 159 received TAU only. Qualitative findings suggest there was a decrease in depression scores in favor of DMT groups in all studies. Subgroup analysis performed on depression scores before and 3 months after the completion of DMT groups suggested changes in favor of the DMT groups. When sensitivity analysis was performed, RCTs at high risk of bias were excluded, leaving only studies with adult clients up to the age of 65. In these studies, the highest effect size was found favoring DMT plus TAU for adults with depression, when compared to TAU only. Conclusions: Based on studies with moderate to high quality, we concluded that DMT is an effective intervention in the treatment of adults with depression. Furthermore, by drawing on a wide range of designs with diverse quality, we were able to compile a comprehensive picture of relevant trends relating to the use of DMT in the treatment of depression. Despite the fact that there remains a paucity of high-quality studies, the results have relevance to both policy-making and clinical practice, and become a platform for further research.

The Effects of Dance Movement Therapy in the Treatment of Depression: A Multicenter, Randomized Controlled Trial in Finland

“…DMT focuses on embodied experiences emerging through body movements, expressions, and interactions with the environment (Koch and Fischman, 2011). In addition, participants can benefit from the physical responses related to exercise (Meekums et al, 2015;Karkou et al, 2019). In DMT, the participants can tune their awareness to these embodied experiences of their own self in a group therapy setting with others.…”

“…This can result in an improved perception of one's body image, that is, increased awareness of the embodied phenomena, a more accepting and more neutrally descriptive relation to one's body, and improved tolerance of others (Pylvänäinen and Lappalainen, 2018). Therapeutically, the creative change process is the core component of DMT, involving movement metaphors that surface in clients' postures or movement experiences (Ellis, 2001;Meekums, 2002;Meekums et al, 2015;Karkou et al, 2019). Metaphors can yield information about a client and shape new perspectives, aiding in working through problematic experiences (Ellis, 2001).…”

“…A growing body of research suggests that DMT is an effective treatment for participants with depression. The mechanisms of change have been suggested to relate to participating in dance, which can be an art form as well as exercise, emphasizing one's experience, sensation, presence, and expression through movement (Pylvänäinen et al, 2015;Karkou et al, 2019). For instance, a Cochrane review concluded that exercise can be as effective as antidepressants or psychological therapies in reducing the symptoms of depression (Rimer et al, 2012).…”

The Profiles of Body Image Associate With Changes in Depression Among Participants in Dance Movement Therapy Group

“…The structured DMT intervention was offered in different cities in Finland by 12 dance movement therapists. The benefit of this multi-center research was that results were more likely to be due to the effects of DMT rather than the characteristics or skills of a specific therapist ( Karkou et al, 2019 ).…”

From general factors to response generalisation: the importance of the cerebellum for mental health and social effectiveness

“…Relatedly, there have been recent efforts to link this 'Common factors' approach to the general factor of psychopathology presented as part of General factors and the cerebellum 32 the HiToP model (Ruggero et al, 2019). Finally, it's likely that the underlying mechanism of action of other cognitive and behavioural treatments for psychopathology such as psychosocial treatments for schizophrenia and bouldering and dance therapy for depression, also likely recruit the cerebellum (Karkou, Aithal, Zubala, & Meekums, 2019;Luttenberger et al, 2015;Mueser, Deavers, Penn, & Cassisi, 2013). Therefore, I argue there is clear evidence supporting a general factor of psychopathology and the cerebellum.…”