Women with breast cancer and gendered limits and boundaries: Art therapy as a ‘safe space’ for enacting alternative subject positions

Öster, Inger; Åström, Sture; Lindh, Jack; Magnusson, Eva

doi:10.1016/j.aip.2008.10.001

Cited by 30 publications

(55 citation statements)

References 21 publications

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“…One study 81 did not report any details of the intervention, and two studies 73,80 reported on perceptions of patients who had taken part in a variety of different interventions, although details of each were not reported. Of the remaining eight studies assessing patient views of art therapy, in four studies 77,82,83,84 the art therapy had been conducted in a group, with group sizes ranging from four to nine participants, while three studies 76,78,79 reported on individual sessions; in one study, 72 the format was not reported. In six studies 72,76,79, it was reported that the intervention had been delivered by an art therapist.…”

Section: Intervention Descriptionmentioning

confidence: 99%

“…Five studies 77,[81][82][83][84] did not report the gender of the participants. In four studies, 72,73,76,78 all participants were female, while one study 79 included 69 men and 88 women and a final study 80 included four women and one man.…”

Section: Study Respondentsmentioning

confidence: 99%

“…In seven studies, 72,74,76,77,79,82,84 the art therapy took place in secondary care; one study 81 took place in primary care and one study 78 took place in a state correctional facility (USA). In another study 73 participants had taken part in art therapy in varied settings including secondary care and private sessions.…”

Section: Benefits and Potential Harms Of Art Therapymentioning

confidence: 99%

“…NIHR Journals Library www.journalslibrary.nihr.ac.uk conducted in European countries, Sweden, 76 Germany, 77 France, 72 Italy 79 and Switzerland, 84 and provided data from patients.…”

Section: Benefits and Potential Harms Of Art Therapymentioning

confidence: 99%

“…Where age range was reported, 73,[76][77][78] ages ranged from 26 to 82 years. Five studies 77,[81][82][83][84] did not report the gender of the participants.…”

Section: Study Respondentsmentioning

confidence: 99%

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Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

Uttley

Scope

Stevenson

et al. 2015

Health Technology Assessment

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BackgroundMental health problems account for almost half of all ill health in people under 65 years. The majority are non-psychotic (e.g. depression, anxiety and phobias). For some people, art therapy may provide more profound and long-lasting healing than more standard forms of treatment, perhaps because it can provide an alternative means of expression and release from trauma. As yet, no formal evaluation of art therapy for non-psychotic mental health disorders has been conducted.AimThis review aimed to evaluate evidence for the clinical effectiveness and cost-effectiveness of art therapy for non-psychotic mental health disorders.MethodsComprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in major health-related and social science bibliographic databases including MEDLINE, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Allied and Complementary Medicine Database (AMED) and Applied Social Sciences Index and Abstracts (ASSIA) from inception up to May 2013. A quantitative systematic review of clinical effectiveness, a qualitative review to explore the acceptability, relative benefits and potential harms, and a cost–utility analysis of studies evaluating cost-effectiveness of art therapy were conducted.ResultsIn the quantitative review, 15 randomised controlled trials (RCTs) were included (n = 777). Meta-analysis was not possible because of clinical heterogeneity and insufficient comparable data on outcome measures across studies. A narrative synthesis reports that art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 10 out of the 15 studies. The control groups varied between studies but included wait-list/no treatment, attention placebo controls and psychological therapy comparators. Four studies reported improvement from baseline but no significant difference between groups. One study reported that outcomes were more favourable in the control group. The quality of included RCTs was generally low. In the qualitative review, 12 cohort studies were included (n = 188 service users;n = 16 service providers). Themes relating to benefits of art therapy for service users included the relationship with the therapist, personal achievement and distraction. Areas of potential harms were related to the activation of emotions that were then unresolved, lack of skill of the art therapist and sudden termination of art therapy. The quality of included qualitative studies was generally low to moderate. In the cost-effectiveness review, a de novo model was constructed and populated with data identified from the clinical review. Scenario analyses were conducted allowing comparisons of group art therapy with wait-list control, group art therapy with group verbal therapy, and individual art therapy versus control. Art therapy appeared cost-effective compared with wait-list control with high certainty, although generalisability to the target population was unclear. Verbal therapy appeared more cost-effective than art therapy but there was considerable uncertainty and a sizeable probability that art therapy was more clinically effective. The cost-effectiveness of individual art therapy was uncertain and dependent on assumptions regarding clinical benefit and duration of benefit.ConclusionsFrom the limited available evidence, art therapy was associated with positive effects when compared with a control in a number of studies in patients with different clinical profiles, and it was reported to be an acceptable treatment and was associated with a number of benefits. Art therapy appeared to be cost-effective compared with wait-list but further studies are needed to confirm this finding as well as evidence to inform future cost-effective analyses of art therapy versus other treatments.Study registrationThe study is registered as PROSPERO CRD42013003957.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Intervention Descriptionmentioning

confidence: 99%

Section: Study Respondentsmentioning

confidence: 99%

Section: Benefits and Potential Harms Of Art Therapymentioning

confidence: 99%

“…NIHR Journals Library www.journalslibrary.nihr.ac.uk conducted in European countries, Sweden, 76 Germany, 77 France, 72 Italy 79 and Switzerland, 84 and provided data from patients.…”

Section: Benefits and Potential Harms Of Art Therapymentioning

confidence: 99%

“…Where age range was reported, 73,[76][77][78] ages ranged from 26 to 82 years. Five studies 77,[81][82][83][84] did not report the gender of the participants.…”

Section: Study Respondentsmentioning

confidence: 99%

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Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

Uttley

Scope

Stevenson

et al. 2015

Health Technology Assessment

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What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review

2011

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Objective: Common psychosocial difficulties experienced by cancer patients are fatigue, depression, anxiety, and existential and relational concerns. Art therapy is one intervention being developed to address these difficulties. The purpose of this research was to assess and synthesize the available research evidence for the use of art therapy in the management of symptoms in adults with cancer.Methods: A literature search of electronic databases, 'grey' literature, hand searching of key journals, and personal contacts was undertaken. Keywords searched were 'art therapy' and 'cancer' or 'neoplasm'. The inclusion criteria were: research studies of any design; adult cancer population; and art therapy intervention. There were no language or date restrictions. Data extraction occurred and quality appraisal was undertaken. Data were analyzed using narrative synthesis.Results: Fourteen papers reporting 12 studies met the inclusion criteria. Symptoms investigated spanned emotional, physical, social and global functioning, and existential/ spiritual concerns. Measures used were questionnaires, in-depth interviews, patients' artwork, therapists' narratives of sessions, and stress markers in salivary samples. No overall effect size was determined owing to heterogeneity of studies. Narrative synthesis of the studies shows art therapy is used at all stages of the cancer trajectory, most frequently by women, the most common cancer site in participants being breast.Conclusion: Art therapy is a psychotherapeutic approach that is being used by adults with cancer to manage a spectrum of treatment-related symptoms and facilitate the process of psychological readjustment to the loss, change, and uncertainty characteristic of cancer survivorship. Research in this area is still in its infancy.

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The effects of Self‐Book^© art therapy on cancer‐related distress in female cancer patients during active treatment: A randomized controlled trial

et al. 2018

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Although no statistically significant differences were present between the groups for the primary outcomes, several positive trends were noted. Thirty percent of Self-Book art therapy participants reported postintervention emotional distress scores that were below the abnormal range for emotional distress, compared with only 5% of standard care control participants, suggesting that Self-Book art therapy may have clinical value. Further studies are recommended to better understand the therapeutic mechanisms of Self-Book art therapy for enhancing psychological well-being.

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Women with breast cancer and gendered limits and boundaries: Art therapy as a ‘safe space’ for enacting alternative subject positions

Cited by 30 publications

References 21 publications

Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review

The effects of Self‐Book^© art therapy on cancer‐related distress in female cancer patients during active treatment: A randomized controlled trial

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Women with breast cancer and gendered limits and boundaries: Art therapy as a ‘safe space’ for enacting alternative subject positions

Cited by 30 publications

References 21 publications

Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review

The effects of Self‐Book© art therapy on cancer‐related distress in female cancer patients during active treatment: A randomized controlled trial

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The effects of Self‐Book^© art therapy on cancer‐related distress in female cancer patients during active treatment: A randomized controlled trial