Online art therapy in elementary schools during COVID-19: results from a randomized cluster pilot and feasibility study and impact on mental health

Abstract

Background Emerging literature on the current COVID-19 crisis suggests that children may experience increased anxiety and depression as a result of the pandemic. To prevent such school and mental health-related problems, there is a timely need to develop preventive strategies and interventions to address potential negative impacts of COVID-19 on children’s mental health, especially in school settings. Results from previous child clinical research indicate that art-based therapies, including mindfulness-based art therapy, have shown promise to increase children’s well-being and reduce psychological distress. Objective The goal of the present pilot and feasibility study was to compare the impact of an emotion-based directed drawing intervention and a mandala drawing intervention, on mental health in elementary school children (N = 22), in the context of the COVID-19 pandemic. Both interventions were group-based and delivered online and remotely. A pilot study using a randomized cluster design was implemented to evaluate and compare both interventions in relation to child anxiety, depression, inattention and hyperactivity symptoms. Results Analyses of covariance revealed a significant effect of the type of drawing intervention on levels of inattention, after controlling for baseline levels. Participants in the emotion-based directed drawing group showed lower inattention scores at post-test, when compared to participants in the mandala group. Post-hoc sensitivity analyses showed significant decreases in pre-to-post scores for levels of hyperactivity for the complete sample. Conclusion Overall, results from this pilot and feasibility study showed that both an emotion-based directed drawing intervention and a mandala drawing intervention may be beneficial to improve mental health in elementary school children, in the context of the current COVID-19 pandemic. From a feasibility standpoint, results indicate that the implementation of both interventions online and remotely, through a videoconference platform, is feasible and adequate in school-based settings. Further work incorporating larger sample sizes, longitudinal data and ensuring sufficient statistical power is warranted to evaluate the long-term impact of both interventions on children’s mental health.

Child and Adolescent Psychosocial Support Programs Following Natural Disasters—a Scoping Review of Emerging Evidence

“…The studies identified by this review were carried out in different countries across Asia [26, 27•, 28, 29•, 30, 31], the Americas (four, with two interventions from the USA [32,33] and two from Canada [34,35], Europe [36•], Africa [37] and Oceania [38]).…”

“…The interventions were carried out between 2006 and 2020, although four studies did not report when the post-disaster intervention occurred (and how long after the disaster) or its duration. Four interventions were implemented while the COVID-19 pandemic was happening [30,32,34,35], two interventions were carried out within a few months of a disaster [29•, 37] and three interventions were implemented 1 year after the disaster or shortly after the first anniversary [26,33,38]. Interventions for child mental health were performed in response to pandemics-mostly COVID-19 [29•, 30, 32, 34, 35, 37], earthquakes [31, 36•, 38], floods [27•], hurricanes [33], tsunamis [31], typhoons [26] and volcanic eruptions [28].…”

“…The interventions identified in this review were based on a diverse set of frameworks, drawing mostly from therapeutic approaches like cognitive-behavioural therapy [27•, 32, 38], EMDR [36•], art therapy [35,37], yoga therapy, play therapy, child development [37] and group therapy [28,31], but also from mindfulness [30,34], philosophy for children [34], health promotion and education [29•, 33], communitybased interventions [33], coaching [26] and peer education [29•] (see Appendix 1).…”

“…Six interventions corresponded to level 1 in the stepped care model [26,28,[33][34][35]37] [27•, 32, 38], art [35,37], play [31,37], group therapy techniques [28], philosophy discussions [34], volunteering in the community [33], engaging in disaster recovery [33], and EMDR group sessions [36 •]. Most interventions had fixed contents, meaning they were designed to deliver standardised content in a standardised format [26, 27•, 28, 29•, 30, 34, 35, 37, 38], although researchers in one study reported that the frequency of sessions could not be kept the same across sites [26].…”

The Impact of COVID-19 on College Students’ Physical Activity: A Protocol for Systematic Review and Meta Analysis

“…The coronavirus disease 2019 (COVID- 19) is a global pandemic [1] leading to a global shutdown that closed schools for months [2,3]. In many nations, schools were closed to students [4], and teachers directed educational activities remotely via digital devices or homeschooling resources [5]. However, different from exercising at school, home exercise during the COVID-19 pandemic was affected by various factors [6,7], such as limited venues, family sports atmosphere and incomplete equipment, college students' physical activity was di cult to reach the school requirements [8][9][10][11].…”