Group art therapy as an adjunctive treatment for people with schizophrenia: multicentre pragmatic randomised trial

Abstract

Objectives: To evaluate he clinical effectiveness of group art therapy for people with schizophrenia and to test whether any benefits exceed those of an active control treatment.\ud Design: Three arm, rater blinded, pragmatic, randomised controlled trial.\ud Setting: Secondary care services across 15 sites in the United Kingdom.\ud Participants: 417 people aged 18 or over, who had a diagnosis of schizophrenia and provided written informed consent to take part in the study.\ud Interventions: Participants, stratified by site, were randomised to 12 months of weekly group art therapy plus standard care alone. Art therapy and activity groups had up to eight members and lasted for 90 minutes. In art therapy, members were given access to a range of art materials and encouraged to use these to express themselves freely. Members of activity groups were offered various activities that did not involve use of art or craft materials and were encouraged to collectively select those they wanted to pursue.\ud Main outcome measures: The primary outcomes were global functioning, measured using the global assessment of functioning scale, and mental health systems, measured using the positive and negative syndrome scale, 24 months after randomisation. Main secondary outcomes were levels of group attendance, social functioning, and satisfaction with care at 12 and 24 months.\ud Results: 24 participants were assigned to either art therapy (n=140), activity groups (n=140), or standard care alone (n=137). Primary outcomes between the three study arms did not differ. The adjusted mean difference between art therapy and standard care at 24 months on the global assessment of functioning scale was -0.9 (95% confidence interval -3.8 to 2.1), and on the positive and negative syndrome scale was 0.7 (-3.1 to 4.6). Secondary outcomes did not differ between those referred to art therapy or those referred to standard care at 12 or 24 months.\ud Conclusions: Referring people with established schizophrenia to group art therapy as delivered in this trial did not improve global functioning, metnal health, or other health related outcomes.\ud Trial registration: Current Controlled Trials ISRCTN46150447

Individual Music Therapy for Mental Health Care Clients with Low Therapy Motivation: Multicentre Randomised Controlled Trial

“…Dropout rates as well as non-completer rates were generally low. This compares favourably to previous studies [10,11,63,70], especially when considering that this study was focused on clients with low motivation for therapy. The comparison of dropout rates between groups (where dropout was defined as not attending the psychiatric assessment) also suggested that MT might help to keep clients in contact with psychiatry.…”

“…The ITT analysis is an important feature which affects the population to which results can be generalised. In psychotherapy studies, it is typical that as many as 30-60% do not complete therapy as intended [10,11]; in a recent study on art therapy, 40% did not attend any session [63]. Because we intended to generalise our effect estimates to all those who are offered MT, as opposed to the smaller group of those who complete it, we chose an ITT analysis.…”

Empowerment in a Mental Health Institution

“…As a conclusion, we can say that to increase the personal empowerment of forensic patients it is needed the presence of a positive clime (Jakusovaite et al, 2014), showing interest, giving a positive feedback and not judge, to pay attention to patients' needs through an active listening of their life experiences and supporting their autonomy (Crawford MJ et al, 2012) promoting the active participation in decision taking (Secker et al, 2011) offering support and counseling to let them express their emotions, being aware that patients need time and give them the appropriate time to take their own decisions (Paterson, 2001;McWilliam et al, 1997;Cooper, 2003;Kettunen 2006;Pibernik-Okanovik 2004., cit. in Aujoulat et al 2006.…”

Update: Negativsymptome. Psychopathologie, Epidemiologie, Pathophysiologie und Behandlungsoptionen.

“…[91]. D aneben gibt es interessante Ansätze zur V erbesserung von Negativsymptomen durch Musik-und Kunsttherapie [92][93][94], wobei hier sicherlich weitere Untersuchungen erforderlich sind.…”