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To understand service user and therapist experiences of an outdoor arts therapies group, their views on its benefits and challenges. There is a lack of systematic research on the effectiveness of outdoor arts therapies. This article presents a systematic, qualitative evaluation of an outdoors arts therapies intervention for adults with mental health problems in the United Kingdom (UK). Semi-structured interviews were held with service users and therapists providing the intervention. A thematic analysis was conducted on the interview transcripts. Key themes identified were: Benefits of Therapy Outdoors, Inclusive Understanding of Creativity and Engagement Challenges and Support. The outdoor setting was found to have a positive effect on group cohesion as well as on mood. Nature was experienced as an active participant in the therapy and this overlaps with an inclusive understanding of what it means to be creative. These findings broadly support the findings of the extant literature. Arts therapists should be aware of the distinct therapeutic potential of outdoors arts therapies interventions and need to be creative and flexible in adapting their practice to make it suitable to the outdoor space. This study employs only qualitative methods and lacks quantitative data. Outdoor arts therapies can have a positive effect on participants' mental health and wellbeing and that the natural environment plays a significant part in this. An inclusive understanding of creativity supports service users to engage creatively and therapeutically with the environment. The arts therapies are generally provided in indoor settings but in recent years there has been a growth of outdoor provision. This is done in order to make use of the beneficial effects of natural environments, the experience of which becomes a source of sensory, aesthetic and psychological stimulation and thus an active element in the therapy. There is a growing literature on this type of provision but there is a lack of systematic investigation, including regarding provision for adults with mental health problems. This article reports on a qualitative evaluation of an outdoor arts therapies group for individuals with mental health problems in the UK National Health Service. The group met weekly in a carefully chosen, local green space in the outer zone of a large city. The location and the structure of sessions were designed to enable participants to safely explore personal thoughts and feelings in this public space. Interviews were conducted with service users and therapists from the group and these were then analysed to elicit themes. The theme Benefits of Therapy Outdoors included the sensory stimulation of the surroundings and how the surroundings prompted participants to look outside themselves as well as evoking positive associations. The theme Inclusive Understanding of Creativity included the use of natural materials and creative responses to the environment being about more than just art making. The theme Engagement Challenges and Support included challenges of 'bad' weather and anxieties about travel. The results of this evaluation broadly confirm the benefits of outdoor arts therapies as they appear in the literature. However, the data come only from people's testimony, with no quantitative data. The authors recommend that future studies contain some quantitative data. [ABSTRACT FROM AUTHOR]

Introduction: Arts therapies offer effective non-pharmacological intervention for Sleep Initiation and Maintenance Disorders (SIMDs), encompassing both passive and active modalities. This review assesses their effectiveness and ethical considerations, focusing on music therapy, meditation, and Tai Chi. Methods: Following PRISMA guidelines, a detailed search across PubMed, the Cochrane Library, Web of Science, and CNKI identified 17 relevant RCTs. Utilizing the Joanna Briggs Institute (JBI) quality criteria and the PICO(S) framework for data extraction ensured methodological integrity. Results: Analysis shows arts therapies significantly improve sleep quality. Music therapy and meditation yield immediate benefits, while Tai Chi and Qigong require longer commitment for significant outcomes. Discussion: The link between SIMDs and mental health issues like anxiety, stress, and depression suggests arts therapies not only enhance sleep quality but also address underlying mental health conditions. The evidence supports a wider adoption of arts therapies in treating SIMDs due to their dual benefits. [ABSTRACT FROM AUTHOR]

Background and purpose: Parkinson's disease (PD) causes a decline in motor function, cognitive decline, and impacts the mental health of patients. Due to the high cost and side effects of conventional treatments, the medical community has begun to explore safer and more cost-effective alternative therapies. In this context, arts therapies have gained increasing attention as innovative treatments. This review plans to explore the role and potential of various arts therapies in the rehabilitation of PD patients by analyzing existing literature and case studies. Methods: This review comprehensively searched the literature in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure, to assess the effectiveness of different arts therapies in the rehabilitation of patients with PD. Results: From 3440 articles screened, 16 met the inclusion criteria. These studies included a variety of therapies, including music, meditation, yoga, art, dance, theatre, video games and play therapy. These different types of arts therapies had a positive impact on the motor, psychological and cognitive rehabilitation of PD patients, respectively. Conclusion: The existing literature highlights the great potential of arts therapies in the rehabilitation of people with PD, further confirming the efficacy of arts therapies in enhancing the motor, psychological and cognitive rehabilitation process of people with PD. In addition, this review identifies research gaps in the use of color therapy in PD rehabilitation and highlights the need for further exploration of various arts therapies modalities.

The Expressive Terrarium is a new intervention tool in the field of ecological arts therapy. The terrarium is a glass bowl containing plants and other objects from nature, art materials, as well as miniature and found objects. Quantitative and qualitative data were collected from a sample of students and administrative staff from the same college to better understand the experiential process for future use as a clinical intervention tool. The findings showed that both groups had high positive attitudes toward the terrarium experience. The qualitative data showed that the participants experienced feelings of enjoyment and a sense of calm while engaged in building and tending their terrariums. The terrarium was perceived as enabling self-expression and as a symbolic-narrative-oriented personal space. Thus, this preliminary mixed-method study suggests that the Expressive Terrarium could be implemented in individual and group therapy or as a community-based intervention in schools and academia. [ABSTRACT FROM AUTHOR]

Background: Arts therapies are widely but inconsistently provided in community mental health. Whilst they are appealing to patients, evidence for their effectiveness is mixed. Trials to date have been limited to one art-form or diagnosis. Patients may hold strong preferences for or against an art-form whilst group therapies rely on heterogeneity to provide a range of learning experiences. This study will test whether manualised group arts therapies (art therapy, dance movement therapy and music therapy) are effective in reducing psychological distress for diagnostically heterogeneous patients in community mental health compared to active group counselling control. Methods: A pragmatic multi-centre 2-arm randomised controlled superiority trial with health economic evaluation and nested process evaluation. Adults aged ≥ 18, living in the community with a primary diagnosis of psychosis, mood, or anxiety disorder will be invited to participate and provide written informed consent. Participants are eligible if they score ≥ 1.65 on the Global Severity Index of the Brief Symptom Inventory. Those eligible will view videos of arts therapies and be asked for their preference. Participants are randomised to either their preferred type of group arts therapy or counselling. Groups will run twice per week in a community venue for 20 weeks. Our primary outcome is symptom distress at the end of intervention. Secondary outcomes include observer-rated symptoms, social situation and quality of life. Data will be collected at baseline, post-intervention and 6 and 12 months post-intervention. Outcome assessors and trial statisticians will be blinded. Analysis will be intention-to-treat. Economic evaluation will assess the cost-effectiveness of group arts therapies. A nested process evaluation will consist of treatment fidelity analysis, exploratory analysis of group process measures and qualitative interviews with participants and therapists. Discussion: This will be the first trial to account for patient preferences and diagnostic heterogeneity in group arts therapies. As with all group therapies, there are a number of logistical challenges to which we have had to further adapt due to the COVID-19 pandemic. Overall, the study will provide evidence as to whether there is an additive benefit or not to the use of the arts in group therapy in community mental health care. Trial registration: ISRCTN, ISRCTN88805048. Registered on 12 September 2018. [ABSTRACT FROM AUTHOR]

The Erasmus+ project "Death Education for Palliative Psychology" (DE4PP) under the coordination of the University of Padua investigated the effects of teaching palliative psychology with psychodrama and arts therapies, as positive effects on students' attitudes towards life and death were suspected through the use of these forms of treatment. Five countries participated in this project funded by the European Commission (Austria, Israel, Italy, Poland, and Romania). In Klagenfurt (Austria), 34 students from the University of Klagenfurt completed the pilot course entitled "Palliative Psychology" generated by the project partners. Course participants filled out psychological and satisfaction questionnaires at the beginning and end of the course, to measure the impact of teaching palliative psychology with psychodrama and arts therapies. The research involved a control group. In addition, six participants in the course participated in a focus group interview at the end, which included questions about their experience of the course; the impact of arts therapies and psychodrama techniques; experiences of verbal and artistic processing of death anxiety; and the meaning of life and death, representation of death, and associated feelings. The results, in summary, showed that processing of life and death had occurred in the participants due to the course they had completed. As part of the course, creative arts and psychodrama were bridges to death. Filling out satisfaction questionnaires, photovoice assignments, role reversal, and visualizing a personal social atom were seen by students in Klagenfurt as particularly effective methods for self-reflection. [ABSTRACT FROM AUTHOR]

Abstract Background Arts therapies are widely but inconsistently provided in community mental health. Whilst they are appealing to patients, evidence for their effectiveness is mixed. Trials to date have been limited to one art-form or diagnosis. Patients may hold strong preferences for or against an art-form whilst group therapies rely on heterogeneity to provide a range of learning experiences. This study will test whether manualised group arts therapies (art therapy, dance movement therapy and music therapy) are effective in reducing psychological distress for diagnostically heterogeneous patients in community mental health compared to active group counselling control. Methods A pragmatic multi-centre 2-arm randomised controlled superiority trial with health economic evaluation and nested process evaluation. Adults aged ≥ 18, living in the community with a primary diagnosis of psychosis, mood, or anxiety disorder will be invited to participate and provide written informed consent. Participants are eligible if they score ≥ 1.65 on the Global Severity Index of the Brief Symptom Inventory. Those eligible will view videos of arts therapies and be asked for their preference. Participants are randomised to either their preferred type of group arts therapy or counselling. Groups will run twice per week in a community venue for 20 weeks. Our primary outcome is symptom distress at the end of intervention. Secondary outcomes include observer-rated symptoms, social situation and quality of life. Data will be collected at baseline, post-intervention and 6 and 12 months post-intervention. Outcome assessors and trial statisticians will be blinded. Analysis will be intention-to-treat. Economic evaluation will assess the cost-effectiveness of group arts therapies. A nested process evaluation will consist of treatment fidelity analysis, exploratory analysis of group process measures and qualitative interviews with participants and therapists. Discussion This will be the first trial to account for patient preferences and diagnostic heterogeneity in group arts therapies. As with all group therapies, there are a number of logistical challenges to which we have had to further adapt due to the COVID-19 pandemic. Overall, the study will provide evidence as to whether there is an additive benefit or not to the use of the arts in group therapy in community mental health care. Trial registration ISRCTN, ISRCTN88805048 . Registered on 12 September 2018.

Background and objectiveThe COVID-19 global pandemic has necessitated the urgency for innovative mental health interventions. We performed a comprehensive review of the available literature on the utility and efficacy of arts therapies in treating mental health problems, with special emphasis on their deployment during the COVID-19 pandemic, aiming to provide some evidence for the application of this therapy.MethodsThe potential studies were systematically sourced from five authoritative databases: PubMed, Embase, the Cochrane Library, Web of Science, and the CNKI database. The evaluation of these studies was conducted based on stringent criteria, including validity, suitability, therapeutic potential, and consistency. Each piece of included literature was meticulously scored in accordance with these criteria, thus ensuring the inclusion of only the most robust studies in this review. The data from these Randomized Controlled Trials (RCTs) were carefully extracted using the PICO(S) framework, ensuring a comprehensive and systemic approach to data collection. In order to emphasize the variability in the effects of differing arts therapies on COVID-19-induced psychiatric disturbances, the sourced literature was systematically categorized and scrutinized based on distinct modalities.ResultsOut of the 7,250 sourced articles, 16 satisfied the inclusion conditions. The therapies were predominantly meditation (n = 7), supplemented by individual studies on color therapy (n = 3), music therapy (n = 2), and single studies on horticultural therapy, dance therapy, mindfulness and music therapy, and yoga and music therapy (n = 4 collectively). These various forms of arts therapies had a positive short to medium-term impact on the mental health of COVID-19 patients. Besides improving patients' physical and mental health, these therapies can also be employed to mitigate mental health issues among healthcare professionals.ConclusionThe COVID-19 pandemic has profound and long-lasting implications for public mental health. Diverse forms of arts therapies are potentially effective in addressing related psychiatric symptoms. The integration of artificial intelligence might further enhance the efficacy and scalability of arts therapies in future implementations.

Background: Dramatherapy, a creative form of psychotherapy, may be a useful treatment for child and adolescent mental health. As there is a growing evidence base, this systematic review sought to identify, describe and evaluate dramatherapy with children and adolescents who were experiencing emotional distress (anxiety, depression and trauma) in order to inform future research in this area. Methods: Seven databases (PsychInfo, PubMed, Scopus, Web of Science, CINAHL, EMBASE and Cochrane) were searched for peer‐reviewed articles exploring dramatherapy as a treatment for child and adolescent emotional distress. Hand searches of relevant journals were also conducted. Two reviewers coded articles for eligibility and independently appraised papers using the Joanna Briggs Institute Critical Appraisal Tools. Details relating to intervention and participant characteristics were extracted and, where data were available, effect sizes on measures relating to emotional distress were calculated. Results: Fifteen papers were included. Studies showed that dramatherapy was often delivered in schools (46%) and clinical settings (20%) and was more frequently delivered to adolescents (53%) (>11 years) than children (26%) (8–11 years). Dramatherapy was used as a treatment for diagnostically heterogeneous groups (40%), for emotional and behavioural difficulties (33%) and following a shared, traumatic, experience (20%). Seven papers reported relevant quantitative data however, just three of these studies were controlled and none were blinded. Pre‐to‐post intervention effect sizes ranged from d = 0.17 to d > 2 yet samples were small and participant response to treatment was not always consistent. The largest effects were seen in dramatherapy employed following trauma and in clinical settings. Medium to large effects were also seen in early intervention school‐based dramatherapy. Conclusion: Despite promising results with regards to the treatment of child and adolescent emotional distress, the evidence base for dramatherapy is small and methodologically flawed. Larger, methodologically robust trials should test the efficacy of dramatherapy in future research. [ABSTRACT FROM AUTHOR]

Abstract Background Dramatherapy, a creative form of psychotherapy, may be a useful treatment for child and adolescent mental health. As there is a growing evidence base, this systematic review sought to identify, describe and evaluate dramatherapy with children and adolescents who were experiencing emotional distress (anxiety, depression and trauma) in order to inform future research in this area. Methods Seven databases (PsychInfo, PubMed, Scopus, Web of Science, CINAHL, EMBASE and Cochrane) were searched for peer‐reviewed articles exploring dramatherapy as a treatment for child and adolescent emotional distress. Hand searches of relevant journals were also conducted. Two reviewers coded articles for eligibility and independently appraised papers using the Joanna Briggs Institute Critical Appraisal Tools. Details relating to intervention and participant characteristics were extracted and, where data were available, effect sizes on measures relating to emotional distress were calculated. Results Fifteen papers were included. Studies showed that dramatherapy was often delivered in schools (46%) and clinical settings (20%) and was more frequently delivered to adolescents (53%) (>11 years) than children (26%) (8–11 years). Dramatherapy was used as a treatment for diagnostically heterogeneous groups (40%), for emotional and behavioural difficulties (33%) and following a shared, traumatic, experience (20%). Seven papers reported relevant quantitative data however, just three of these studies were controlled and none were blinded. Pre‐to‐post intervention effect sizes ranged from d = 0.17 to d > 2 yet samples were small and participant response to treatment was not always consistent. The largest effects were seen in dramatherapy employed following trauma and in clinical settings. Medium to large effects were also seen in early intervention school‐based dramatherapy. Conclusion Despite promising results with regards to the treatment of child and adolescent emotional distress, the evidence base for dramatherapy is small and methodologically flawed. Larger, methodologically robust trials should test the efficacy of dramatherapy in future research.

Introduction: Mental health care provided to offenders with psychiatric problems in forensic settings mainly consists of verbal oriented treatments. In addition, experience-based therapies are used such as (creative) arts therapies: (visual) art therapy, music therapy, drama therapy and dance (movement) therapy. There are indications for effectiveness of arts therapies, but a systematic overview of effect studies of all arts therapies in forensic care is lacking. Methods: First, we performed a systematic review. Second, Thematic Analysis was used to synthesize the qualitative narrative results and define the hypothesized mechanisms of change. Third, we performed a meta-analysis to investigate the effects of arts therapies in reducing psychosocial problems of offenders. Twenty-three studies were included in the review. Quality and risk of bias was assessed using EPHPP (Effective Public Health Practice Project). Results: The included studies were heterogeneous in type of outcome measures and intervention characteristics. Synthesis of mechanisms of change involved in the methodical use of the arts in arts therapies resulted in a description of regulatory processes which are stimulated in arts therapies: perceptive awareness (interoceptive and exteroceptive), the regulation of emotions, stress, impulses, cognitions, social regulation, and self-expression. These processes play a role in developing prevention, coping and self-management skills. Eighteen studies were included in the meta-analyses (11 RCTs/CCTs; 7 pre-post studies). The meta-analyses indicated significant effects on both risk factors (psychiatric symptoms and addiction) and protective factors for criminal behavior (social functioning and psychological functioning). Effects on criminal and/or antisocial behavior were not significant, but this outcome measure was scarcely used among the studies. Discussion: The analyses in this study should be considered explorative. More research is needed to gain more solid conclusions about effectiveness and mechanisms of change of arts therapies in forensic institutions. However, the results of this first systematic review, synthesis of mechanisms and meta-analysis in this field are promising and show effects of arts therapies on risk and protective factors in individuals in forensic institutions. [ABSTRACT FROM AUTHOR]

IntroductionMental health care provided to offenders with psychiatric problems in forensic settings mainly consists of verbal oriented treatments. In addition, experience-based therapies are used such as (creative) arts therapies: (visual) art therapy, music therapy, drama therapy and dance (movement) therapy. There are indications for effectiveness of arts therapies, but a systematic overview of effect studies of all arts therapies in forensic care is lacking.MethodsFirst, we performed a systematic review. Second, Thematic Analysis was used to synthesize the qualitative narrative results and define the hypothesized mechanisms of change. Third, we performed a meta-analysis to investigate the effects of arts therapies in reducing psychosocial problems of offenders. Twenty-three studies were included in the review. Quality and risk of bias was assessed using EPHPP (Effective Public Health Practice Project).ResultsThe included studies were heterogeneous in type of outcome measures and intervention characteristics. Synthesis of mechanisms of change involved in the methodical use of the arts in arts therapies resulted in a description of regulatory processes which are stimulated in arts therapies: perceptive awareness (interoceptive and exteroceptive), the regulation of emotions, stress, impulses, cognitions, social regulation, and self-expression. These processes play a role in developing prevention, coping and self-management skills. Eighteen studies were included in the meta-analyses (11 RCTs/CCTs; 7 pre-post studies). The meta-analyses indicated significant effects on both risk factors (psychiatric symptoms and addiction) and protective factors for criminal behavior (social functioning and psychological functioning). Effects on criminal and/or antisocial behavior were not significant, but this outcome measure was scarcely used among the studies.DiscussionThe analyses in this study should be considered explorative. More research is needed to gain more solid conclusions about effectiveness and mechanisms of change of arts therapies in forensic institutions. However, the results of this first systematic review, synthesis of mechanisms and meta-analysis in this field are promising and show effects of arts therapies on risk and protective factors in individuals in forensic institutions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020217884, identifier: CRD42020217884.

The Erasmus+ project “Death Education for Palliative Psychology” (DE4PP) under the coordination of the University of Padua investigated the effects of teaching palliative psychology with psychodrama and arts therapies, as positive effects on students’ attitudes towards life and death were suspected through the use of these forms of treatment. Five countries participated in this project funded by the European Commission (Austria, Israel, Italy, Poland, and Romania). In Klagenfurt (Austria), 34 students from the University of Klagenfurt completed the pilot course entitled “Palliative Psychology” generated by the project partners. Course participants filled out psychological and satisfaction questionnaires at the beginning and end of the course, to measure the impact of teaching palliative psychology with psychodrama and arts therapies. The research involved a control group. In addition, six participants in the course participated in a focus group interview at the end, which included questions about their experience of the course; the impact of arts therapies and psychodrama techniques; experiences of verbal and artistic processing of death anxiety; and the meaning of life and death, representation of death, and associated feelings. The results, in summary, showed that processing of life and death had occurred in the participants due to the course they had completed. As part of the course, creative arts and psychodrama were bridges to death. Filling out satisfaction questionnaires, photovoice assignments, role reversal, and visualizing a personal social atom were seen by students in Klagenfurt as particularly effective methods for self-reflection.

There is little research on the transformational processes of creative arts therapies (CATs) students during training compared to other healthcare professions. CATs training relies on arts‐based experiential learning that can develop the therapist's creative self‐beliefs, psychological mindedness, and perspective‐taking. This single group pre–post study examined the changes in these unstudied, yet essential, creative and personal factors in a sample of 191 CATs students in the first year of their master's degree program in Israel. It was hypothesized that students would report a statistically significant increase in creative and personal measures from the beginning to the end of their first year of training, but this hypothesis was only partially supported. There were different development trajectories in each CATs discipline in terms of creative identity, creative self‐efficacy, psychological mindedness, and perspective‐taking. The discussion sheds light on these results by considering the domain‐specific differences between the CATs disciplines and their respective training approaches, and through follow‐up interview data collected from trainers in each CATs track. This study thus contributes to a better understanding of the trajectories of change of these attributes in CATs students. Training programs should consider these results when building curricula, to nurture the balance between students' artistic and helping competencies. [ABSTRACT FROM AUTHOR]

The present study reports findings from interviews conducted with 12 arts therapists on their perceptions of a model they developed for working with parents in the education system. The therapists, who are also the co-researchers, initiated and took part in all stages of the study. They provided the initial directions for a semi-structured interview which was administered to them by the external researchers. These two external researchers then analyzed the interview data according to the principles of thematic analysis (Clarke & Braun, 2014), after which four focus groups were held to discuss the findings. The findings resulted in a preliminary model for working with parents in the education system that consists of the goals, approaches, the parents and arts therapists it is designed for, the work contract, how the arts are introduced, the main types of interventions, contact with the educational staff, as well as the difficulties. Alongside dilemmas related to the accuracy of the model, and the challenges regarding its application, parental accompaniment is a growing trend and, in many cases, can lead to change or to a better understanding of the importance of this change. • Working model of parental accompaniment. • Semi-structured interviews with 12 arts therapists as co-researchers. • Parental goals vs. systemic goals. [ABSTRACT FROM AUTHOR]

BackgroundDramatherapy is a practice of working and playing that uses action methods to facilitate creativity, imagination, learning, insight and growth.MethodsA pilot study of Digital Integrated Dramatherapy, recruiting women from the digital community “Parole Fertili,” undergoing assisted reproductive technology. On the basis of a previous blended experience, a program based on remote sessions was conducted on a dedicated platform.ResultsA total of 22 women participated in the same intervention in three groups. Participants assessed the feasibility and utility of the method, both in the synchronous and asynchronous phases. The group had a fundamental role: the participants were supportive, and therapeutic benefits were due to strengthening and resilience obtained through a dialogue with other women. Using metaphors, the participants could move from the narration of the Assisted Reproductive Technology pathway to creative and corporeal expression.ConclusionThe study showed that a group based on Digital Integrated Dramatherapy might help women face very difficult emotions by promoting creativity and internal resources.

Studies have underscored the complexity of psychotherapy for Ultra-Orthodox Jews, and cross-cultural therapy in particular, which evokes fear of disruption of basic values. Parents' sense of responsibility for their child's religious education exacerbates these problems in child therapy. However, there is scant research on child therapy for the Ultra-Orthodox, especially in the field of arts therapies. The present study examined the perceptions of 17 Ultra-Orthodox parents whose children were receiving arts therapies (including art therapy, dance/movement therapy, music therapy, psychodrama and bibliotherapy). Semi-structured interviews were conducted with the parents and analyzed based on the principles of Consensual Qualitative Research. The study covered five domains: (1) The parents' experiences in therapy; (2) The parents' perceptions of the child's experiences in therapy; (3) Implications of environmental-social factors on the parents' perceptions and experiences of therapy; (4) Effects of intercultural aspects on therapy; (5) Perceptions of the use of the arts in therapy. The findings show that the experiences of ultra-Orthodox parents in the arts therapies of their children is complex due to the influence of the socio-cultural context, which involves dealing with stigma and tensions in their relationship with the education system. This context also shapes their perceptions of therapy, which can be characterized as purpose-oriented. The findings also highlight the parents' challenges in coping with the intercultural therapeutic relationship, and emphasizes the parents' preference for a therapist from a similar religious/cultural background and for cultural supervision of therapy. However, the results also suggest that there are benefits inherent to intercultural therapy in general and arts therapies in particular, including a sense of security, openness and acceptance of the parents and children. [ABSTRACT FROM AUTHOR]

Art therapy is the intentional therapeutic use of the fine arts. Like music, dance, poetry and theater therapy, it is assigned to artistic therapy. This article provides an overview of general and recent developments as well as the state of the art in teaching in the discipline art therapy. Furthermore, two art therapeutic forms of intervention, the body outline image method (KUM) and Photo-Art-Therapy, are introduced. The aim is to further standardize the education and further training landscapes of art therapy, not least in order to further increase patient safety. This includes, for example, conveying systematically checked interventional measures and manuals that the students learn both theoretically and in the form of self-awareness. For about 10 years now, more and more high-impact quality research studies have been carried out Further evaluation studies in this field are desirable. [ABSTRACT FROM AUTHOR]

Accessible summary: There are different forms of arts therapy including music, dance and drama therapies.Music, dance and drama can help people with an intellectual disability to improve their wellbeing.To encourage the inclusion of music, dance and drama therapies in different services, it is important to look at their effects on people with an intellectual disability.Music, dance and drama help with self‐esteem, social skills, expression and management of emotions.Arts therapies could also increase social inclusion and self‐determination. Background: Arts therapies take different forms, including music, dance and drama therapies. Access to meaningful activities is limited for people with an intellectual disability. Music, dance and drama therapies could be relevant strategies to improve well‐being of people with an intellectual disability. To encourage the inclusion of these modalities in services offered to this population, it is important to look at the effects of music, dance and drama therapies for people with an intellectual disability. Methods: This scoping review aimed to document the effects of music, dance and drama therapies for people with an intellectual disability. Findings: 72 documents were selected and analysed. Depending on the modality of art therapy, various physical, emotional, cognitive and spiritual benefits were noted. Most of studies presented a limited sample size and had no group control. Conclusion: The use of arts therapy modalities music, dance and drama shows promise for people with an intellectual disability. The results of this study may contribute to the development of diversified and meaningful activities. [ABSTRACT FROM AUTHOR]

Background and Purpose: Parkinson's disease (PD) causes a decline in motor function, cognitive decline, and impacts the mental health of patients. Due to the high cost and side effects of conventional treatments, the medical community has begun to explore safer and more cost-effective alternative therapies. In this context, arts therapies have gained increasing attention as innovative treatments. This review plans to explore the role and potential of various arts therapies in the rehabilitation of PD patients by analyzing existing literature and case studies., Methods: This review comprehensively searched the literature in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure, to assess the effectiveness of different arts therapies in the rehabilitation of patients with PD., Results: From 3440 articles screened, 16 met the inclusion criteria. These studies included a variety of therapies, including music, meditation, yoga, art, dance, theatre, video games and play therapy. These different types of arts therapies had a positive impact on the motor, psychological and cognitive rehabilitation of PD patients, respectively., Conclusion: The existing literature highlights the great potential of arts therapies in the rehabilitation of people with PD, further confirming the efficacy of arts therapies in enhancing the motor, psychological and cognitive rehabilitation process of people with PD. In addition, this review identifies research gaps in the use of color therapy in PD rehabilitation and highlights the need for further exploration of various arts therapies modalities., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

IntroductionMounting empirical evidence underscores the health benefits of the arts, as recently reported in a scoping review by the World Health Organization. The creative arts in particular are acknowledged to be a public health resource that can be beneficial for well-being and health. Within this broad context, and as a subfield of participatory arts, the term social arts (SA) specifically refers to an art made by socially engaged professionals (e.g., artists, creative arts therapists, social workers, etc.) with non-professionals who determine together the content and the final art product (in theater, visual arts, music, literature, etc.) with the aim to produce meaningful social changes. SA can enhance individual, community, and public health in times of sociopolitical instability and is an active field in Israel. However, SA is still an under-investigated field of study worldwide that is hard to characterize, typify, or evaluate. This paper presents a research protocol designed to examine a tripartite empirically-based model of SA that will cover a wide range of SA training programs, implementations, and impacts. The findings will help refine the definition of SA and inform practitioners, trainers, and researchers, as well as funding bodies and policymakers, on the content and impact of SA projects in Israel and beyond.Methods and analysisThis 3-stage mixed methods study will be based on the collection of primary qualitative and arts-based data and secondary, complementary, quantitative data. Triangulation and member checking procedures will be conducted to strengthen the trustworthiness of the findings obtained from different stakeholders.DiscussionGrowing interest in the contribution of arts to individual and public health underscores the importance of creating an empirically grounded model for SA. The study was approved by the university ethics committee and is supported by the Israel Science Foundation. All participants will sign an informed consent form and will be guaranteed confidentiality and anonymity. Data collection will be conducted in the next 2 years (2022 to 2024). After data analysis, the findings will be disseminated via publications and conferences.

The development of music therapy in the Czech Republic is closely connected with the development of other arts therapies (AsTs). This cross-sectional study aims to provide a research-based description of the current state of Czech music therapy and offer comparisons with other AsTs. Data were obtained through a modified version of "The Practice in Arts Therapies" questionnaire, which was distributed to arts therapists registered with professional associations in the Czech Republic. From the total sample (N = 144), there were 50 music therapists. The remainder of the sample were drama, dance movement, art therapists, and combinations of these therapies (N = 94). Descriptive and inferential statistics were performed relating to work environment, client groups, and preferred therapeutic trends. Czech music therapy is closely connected to working with special needs populations in social care and educational environments. Practitioners follow humanistic, active/directive and artistic/creative trends. Significant differences were found between music therapists and other arts therapists with regard to the client populations (in their age and type of needs), and therapeutic trends. Czech music therapy has strengths in the area of special needs, but it will be important to achieve further growth, especially in health care. This may have a crucial impact on the formation of a common legislative framework for art therapists. We recommend repeating this survey in the future to see how the university-based program for music therapy will have influenced the profession. [ABSTRACT FROM AUTHOR]

This article reviews the history of the Japanese art of Ikebana and the contemporary ecological art therapy practice involving botanical arranging and their correlation and contribution to the physical and mental well-being of human beings. Different perspectives are offered by a Brazilian Ikebana professor, with a neurological background, from the Ikenobo School, a Russian art therapist specializing in ecological art therapy, and a Chinese creative art therapist with a biomedical background. Ikebana and botanical arranging are considered forms of creative interaction with nature, providing multiple therapeutic effects and showing us how to realign with the laws of nature.

Creativity has been found to be one of the key therapeutic elements in arts therapies. Arts therapies are psychotherapeutic approaches that aim to facilitate psychological change and personal growth through arts media, such as music, drama, dance, movement and virtual arts. This article presents the findings from children's experiences of participating in arts therapies, particularly those related to creativity. This study followed a pilot randomised controlled design with embedded qualitative and arts-based methods. Sixty-two children with mild emotional and behavioural difficulties were recruited across four primary schools in North West England. The creative activities with the greatest impact on children's health and well-being were as follows: a) story-making and story-telling; b) drawings; c) puppetry; d) songwriting; and e) empowerment activities. Based on the interviews with children, these activities led to emotional expression, group bonding, empowerment and optimism. The findings were discussed through the lenses of the empowerment theory and the PERMA theory of positive psychology. Arts therapies allowed children to share experiences and emotions that they may not have otherwise expressed merely through verbal means. During a period where COVID-19 has disrupted academic schedules and sparked a transitional period at schools, opportunities for creativity and engagement with the arts may contribute significantly to support children's emerging health needs. [ABSTRACT FROM AUTHOR]

Studies have underscored the complexity of psychotherapy for Ultra-Orthodox Jews, and cross-cultural therapy in particular, which evokes fear of disruption of basic values. Parents’ sense of responsibility for their child’s religious education exacerbates these problems in child therapy. However, there is scant research on child therapy for the Ultra-Orthodox, especially in the field of arts therapies. The present study examined the perceptions of 17 Ultra-Orthodox parents whose children were receiving arts therapies (including art therapy, dance/movement therapy, music therapy, psychodrama and bibliotherapy). Semi-structured interviews were conducted with the parents and analyzed based on the principles of Consensual Qualitative Research. The study covered five domains: (1) The parents’ experiences in therapy; (2) The parents’ perceptions of the child’s experiences in therapy; (3) Implications of environmental-social factors on the parents’ perceptions and experiences of therapy; (4) Effects of intercultural aspects on therapy; (5) Perceptions of the use of the arts in therapy. The findings show that the experiences of ultra-Orthodox parents in the arts therapies of their children is complex due to the influence of the socio-cultural context, which involves dealing with stigma and tensions in their relationship with the education system. This context also shapes their perceptions of therapy, which can be characterized as purpose-oriented. The findings also highlight the parents’ challenges in coping with the intercultural therapeutic relationship, and emphasizes the parents’ preference for a therapist from a similar religious/cultural background and for cultural supervision of therapy. However, the results also suggest that there are benefits inherent to intercultural therapy in general and arts therapies in particular, including a sense of security, openness and acceptance of the parents and children.

BackgroundSustaining the wellbeing for children with an autism spectrum disorder (ASD) can be highly demanding. Dance Movement Psychotherapy (DMP), a form of psychotherapy with a non-verbal character, may present as a relevant intervention option for this group of children.MethodsA protocol-based group DMP intervention was developed and implemented in two special educational needs schools in the North West of England. We aimed to investigate the effects of DMP on children with ASD using the Social Communication Questionnaire (SCQ) and Strengths and Difficulties Questionnaire (SDQ). Twenty-six children aged between 8 and 13 years (mean age = 10.65 years) with ASD were randomly allocated to DMP and a control group with standard care, following a crossover research design.ResultsResults showed no significant carryover or period effects for either the SCQ or SDQ (p > 0.05). A significant intervention effect was found only for SCQ (p = 0.005) but not for SDQ (p > 0.05). ANCOVAs were performed on the data before the crossover to test for differences in SCQ and SDQ scores between the DMP intervention and control groups while controlling for pre-intervention scores. Those in the DMP intervention group presented significantly lower SCQ scores following the intervention period than those in the control group (p = 0.001). No significant differences in post-intervention SDQ scores were found between DMP intervention and control groups (p = 0.2). However, minimal clinically important differences (MCID) were reached for both SCQ and SDQ measures before crossover for those in the DMP intervention group. Moreover, repeated measures ANOVAs performed on SCQ and SDQ measures following crossover were significant, with the change in both SCQ (p = 0.001) and SDQ (p = 0.009) pre-and post-intervention being significantly greater for those in the DMP intervention than the control group.ConclusionThe pilot DMP intervention has shown promising results on the social and emotional wellbeing of children with ASD irrespective of whether they preferred verbal or non-verbal mode of communication. Limitations and appropriateness of the research methods implemented in this study for their use in a large RCT are discussed in detail. Overall, our findings highlight the value of creative therapies for improving the lives of young vulnerable groups.

Background: Sustaining the wellbeing for children with an autism spectrum disorder (ASD) can be highly demanding. Dance Movement Psychotherapy (DMP), a form of psychotherapy with a non-verbal character, may present as a relevant intervention option for this group of children. Methods: A protocol-based group DMP intervention was developed and implemented in two special educational needs schools in the North West of England. We aimed to investigate the effects of DMP on children with ASD using the Social Communication Questionnaire (SCQ) and Strengths and Difficulties Questionnaire (SDQ). Twenty-six children aged between 8 and 13 years (mean age = 10.65 years) with ASD were randomly allocated to DMP and a control group with standard care, following a crossover research design. Results: Results showed no significant carryover or period effects for either the SCQ or SDQ (p > 0.05). A significant intervention effect was found only for SCQ (p = 0.005) but not for SDQ (p > 0.05). ANCOVAs were performed on the data before the crossover to test for differences in SCQ and SDQ scores between the DMP intervention and control groups while controlling for pre-intervention scores. Those in the DMP intervention group presented significantly lower SCQ scores following the intervention period than those in the control group (p = 0.001). No significant differences in post-intervention SDQ scores were found between DMP intervention and control groups (p = 0.2). However, minimal clinically important differences (MCID) were reached for both SCQ and SDQ measures before crossover for those in the DMP intervention group. Moreover, repeated measures ANOVAs performed on SCQ and SDQ measures following crossover were significant, with the change in both SCQ (p = 0.001) and SDQ (p = 0.009) pre-and post-intervention being significantly greater for those in the DMP intervention than the control group. Conclusion: The pilot DMP intervention has shown promising results on the social and emotional wellbeing of children with ASD irrespective of whether they preferred verbal or non-verbal mode of communication. Limitations and appropriateness of the research methods implemented in this study for their use in a large RCT are discussed in detail. Overall, our findings highlight the value of creative therapies for improving the lives of young vulnerable groups. [ABSTRACT FROM AUTHOR]

Background: Arts therapies are increasingly being adopted within schools to alleviate and prevent a wide range of children's difficulties. Such therapies help to facilitate personal change and growth through arts media; visual arts, music, drama, dance and movement. Methods: This study aims to investigate the child-focused process and outcomes of an arts therapies intervention through child-reported questionnaires, interviews, participant observations, arts-work and biomarkers. The participants are 64 primary school children with mild emotional and behavioural difficulties. Expected results: To explore a) whether all components of the study (i.e. recruitment, randomisation, follow-up) can work together in a larger trial; b) the children's evaluations of arts therapies;c) the impact on children's wellbeing, quality of life and sleep; d) the sample size calculations and cost evaluations for future research. This is the first study to embrace all arts therapies as one research domain with a clear focus on children's verbal, non-verbal and physical responses. [ABSTRACT FROM AUTHOR]

Background: People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD.Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes.Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches.Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners' expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients' experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories.

As part of a European Erasmus Plus project entitled Death Education for Palliative Psychology, this study assessed the ways in which Master’s Degree students in psychology and the creative arts therapies self-rated their confidence and interest in death education and palliative and bereavement care. In five countries (Austria, Israel, Italy, Poland, Romania), 344 students completed an online questionnaire, and 37 students were interviewed to better understand their views, interest, and confidence. The results revealed some significant differences between countries, and showed that older respondents with previous experience as formal caregivers for end-of-life clients showed greater interest in obtaining practical clinical competence in these fields. A mediation analysis indicated that students’ previous care experiences and past loss experiences were related to students’ current interest in death education and palliative and bereavement care through the mediation of their sense of confidence in this field. The qualitative findings identified five shared themes: life and death, learning about death, the psychological burden, personal experience and robust training, and four key training needs. Overall, students’ interest in studying and working with terminal illness and death are rooted in internal resources, a preliminary sense of confidence, but also external requirements.

Background: People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD. Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes. Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches. Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners' expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients' experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories. [ABSTRACT FROM AUTHOR]

Drama therapy has been found to improve various facets of mental health while aging. It provides opportunities for personal growth and creative expression and enhances group relationships. Drama therapy is a widely acknowledged way to explore the life stories in late life. However, only a handful of studies have empirically explored the value of drama therapy for the aging population. This conceptual analysis was designed to address this need by developing a new integrative model of drama therapy. The analysis is based on the review of the results of four studies that explored the integration of life-review and playback theater as a drama therapy approach for older adults. The therapeutic process focused on the exploration of life-crossroads stories, a short unique technique which enables the participants to craft a harmonious view of their life stories in a short-term dramatic creative group process. Combining the four results yielded a multidimensional model which points to three potential transformative routes: the evolution of the life story, the evolution of improvised dramatic expression, and the expansion of social engagement. The transformative routes are described through the lens of role theory in drama therapy. [ABSTRACT FROM AUTHOR]

BackgroundOver the last decades there has been a change in the way schooling is perceived recognizing that children’s learning is closely linked to children’s health. Children spend most of their time at school, which is often the place where problems are identified and interventions are offered, not only for treatment but also prevention. Embedding arts therapies into the educational system may help address children’s emerging needs and have a positive impact on their wellbeing.MethodsA pilot cross-over randomized controlled design was employed to investigate the effectiveness of an arts therapies intervention on a series of child- and teacher-reported outcome measures, specifically, health related quality of life (assessed using a HRQOL scale; EQ-5D-Y), wellbeing and life functioning (assessed using the child outcome rating scale; CORS), emotional and behavioral difficulties (assessed using the strengths and difficulties questionnaire; SDQ), as well as duration of sleep (assessed using Fitbits). Sample size calculations for future large-scale studies were also performed, and the sustained impact of the intervention was evaluated at 3, 6, and 12 months follow-up. The pluralistic theoretical and therapeutic framework of this intervention was informed by a systematic review on school-based arts therapies interventions and is presented in detail in the study protocol. Participants were 62 children with mild emotional and behavioral difficulties.ResultsImprovements in HRQOL and CORS were greater in those engaged in the arts therapies intervention than the control groups and were maintained at the follow-up stages. Significant improvements were only found for duration of sleep (P = 0.002) and SDQ (P = 0.008). Minimal clinically important differences (MCIDs) as defined in the published protocol were found for CORS, SDQ and duration of sleep, but not HRQOL.DiscussionFindings indicate that the arts therapies interventions were having a clinically significant effect on life functioning, duration of sleep, emotional and behavioral difficulties. Findings also indicate a small effect size for health related quality of life, suggesting the intervention was having a small positive effect on this outcome measure. The study indicates that all outcome measures assessed here would be suitable for inclusion in a larger randomized controlled study utilizing these arts therapies interventions, and that a sample size of 225 participants would be required if these outcome measures were used.

Crisis events, such as the COVID-19 pandemic, can have a devastating effect on communities and the care professionals within them. Over recent years, arts-based interventions have helped in a wide range of crisis situations, being recommended to support the workforce during and after complex crisis but there has been no systematic review of the role of arts-based crisis interventions and whether there are cogent themes regarding practice elements and outcomes. We, therefore, conducted a systematic review to (i) define the arts-based change process used during and after crisis events, and (ii) explore the perceptions of intermediate and long-term mental health benefits of arts-based interventions for professionals in caring roles. Our search yielded six studies (all qualitative). All data were thematically aggregated and meta-synthesized, revealing seven practice elements (a safe place, focusing on strengths and protective factors, developing psychosocial competencies to support peers, emotional expression and processing, identifying and naming the impact of the crisis, using an integrative creative approach, and cultural and organizational sensitivity) applied across all six studies, as well as a range of intermediate and long-term benefits shared common features (adapting, growing, and recovering; using the community as a healing resource; reducing or preventing symptoms of stress or trauma reactions, psychophysiological homeostasis). The ways in which these studies were designed independently from one another and yet used the same practice elements in their crisis interventions indicates that there is comparability about how and why the arts-based practice elements are being used and to what effect. Our findings provide a sound basis and meaningful parameters for future research incorporating quantitative and qualitative approaches to firmly establish the effectiveness of art-based interventions, and how arts can support cultural sensitivity, acceptability and indicated outcomes, particularly those relating to stress and trauma during or following a crisis.

Crisis events, such as the COVID-19 pandemic, can have a devastating effect on communities and the care professionals within them. Over recent years, arts-based interventions have helped in a wide range of crisis situations, being recommended to support the workforce during and after complex crisis but there has been no systematic review of the role of arts-based crisis interventions and whether there are cogent themes regarding practice elements and outcomes. We, therefore, conducted a systematic review to (i) define the arts-based change process used during and after crisis events, and (ii) explore the perceptions of intermediate and long-term mental health benefits of arts-based interventions for professionals in caring roles. Our search yielded six studies (all qualitative). All data were thematically aggregated and meta-synthesized, revealing seven practice elements (a safe place, focusing on strengths and protective factors, developing psychosocial competencies to support peers, emotional expression and processing, identifying and naming the impact of the crisis, using an integrative creative approach, and cultural and organizational sensitivity) applied across all six studies, as well as a range of intermediate and long-term benefits shared common features (adapting, growing, and recovering; using the community as a healing resource; reducing or preventing symptoms of stress or trauma reactions, psychophysiological homeostasis). The ways in which these studies were designed independently from one another and yet used the same practice elements in their crisis interventions indicates that there is comparability about how and why the arts-based practice elements are being used and to what effect. Our findings provide a sound basis and meaningful parameters for future research incorporating quantitative and qualitative approaches to firmly establish the effectiveness of art-based interventions, and how arts can support cultural sensitivity, acceptability and indicated outcomes, particularly those relating to stress and trauma during or following a crisis. [ABSTRACT FROM AUTHOR]

Background: Over the last decades there has been a change in the way schooling is perceived recognizing that children's learning is closely linked to children's health. Children spend most of their time at school, which is often the place where problems are identified and interventions are offered, not only for treatment but also prevention. Embedding arts therapies into the educational system may help address children's emerging needs and have a positive impact on their wellbeing. Methods: A pilot cross-over randomized controlled design was employed to investigate the effectiveness of an arts therapies intervention on a series of child- and teacher-reported outcome measures, specifically, health related quality of life (assessed using a HRQOL scale; EQ-5D-Y), wellbeing and life functioning (assessed using the child outcome rating scale; CORS), emotional and behavioral difficulties (assessed using the strengths and difficulties questionnaire; SDQ), as well as duration of sleep (assessed using Fitbits). Sample size calculations for future large-scale studies were also performed, and the sustained impact of the intervention was evaluated at 3, 6, and 12 months follow-up. The pluralistic theoretical and therapeutic framework of this intervention was informed by a systematic review on school-based arts therapies interventions and is presented in detail in the study protocol. Participants were 62 children with mild emotional and behavioral difficulties. Results: Improvements in HRQOL and CORS were greater in those engaged in the arts therapies intervention than the control groups and were maintained at the follow-up stages. Significant improvements were only found for duration of sleep (P = 0.002) and SDQ (P = 0.008). Minimal clinically important differences (MCIDs) as defined in the published protocol were found for CORS, SDQ and duration of sleep, but not HRQOL. Discussion: Findings indicate that the arts therapies interventions were having a clinically significant effect on life functioning, duration of sleep, emotional and behavioral difficulties. Findings also indicate a small effect size for health related quality of life, suggesting the intervention was having a small positive effect on this outcome measure. The study indicates that all outcome measures assessed here would be suitable for inclusion in a larger randomized controlled study utilizing these arts therapies interventions, and that a sample size of 225 participants would be required if these outcome measures were used. [ABSTRACT FROM AUTHOR]

Art therapy and music therapy, as well as other arts-based approaches and interventions, help to mitigate symptoms in serious and chronic diseases and to improve the well-being and quality of life for both healthy individuals and patients. Artistic creation is also researched and practiced intending to empower and understand individuals, groups, and communities. However, much research is required in order to learn how arts-based approaches operate and to enhance their effectivity. The complex and simultaneous occurrences involving the dynamics of the creation work, the client, and the therapist in a typical arts setting are difficult to grasp, consequently affecting their objective analyses. Here we employ our Computational Paradigm which enables the quantitative and rigorous tracking, analyzing, and documenting of the underlying dynamic processes, and describe its application in recent past and current real-world art and music studies with human participants. We aim to study emergent artistic behaviors of individuals and collectives in response to art and music making. Significant insights obtained include demographic variation factors such as gender and age, empirical behavioral patterns, and quantitative expressiveness and its change. We discuss the implications of the findings for therapy and research, such as causality for behavioral diversification and audio-visual cross-modality, and also offer directions for future applications and technology enhancements.

In this clinical comment, the author will explore how an understanding of mise en scène can be helpful for online dramatherapy practice, particularly for those new to this way of working. The author will reflect upon aspects of mise en scène and reconceptualise them in a therapeutic context. Elements such as the use of props and how they appear on screen, what the client can (or can't) see in the background and the use of lighting will be examined in terms of the dynamics of the online therapeutic relationship and online therapy space. The author shares their experience of applying mise en scène theory to their own dramatherapy practice and offers reflections upon the symbolic meaning that can be unconsciously expressed through the 'frame' of the online therapy screen. [ABSTRACT FROM AUTHOR]

Art therapy and music therapy, as well as other arts-based approaches and interventions, help to mitigate symptoms in serious and chronic diseases and to improve the well-being and quality of life for both healthy individuals and patients. Artistic creation is also researched and practiced intending to empower and understand individuals, groups, and communities. However, much research is required in order to learn how arts-based approaches operate and to enhance their effectivity. The complex and simultaneous occurrences involving the dynamics of the creation work, the client, and the therapist in a typical arts setting are difficult to grasp, consequently affecting their objective analyses. Here we employ our Computational Paradigm which enables the quantitative and rigorous tracking, analyzing, and documenting of the underlying dynamic processes, and describe its application in recent past and current real-world art and music studies with human participants. We aim to study emergent artistic behaviors of individuals and collectives in response to art and music making. Significant insights obtained include demographic variation factors such as gender and age, empirical behavioral patterns, and quantitative expressiveness and its change. We discuss the implications of the findings for therapy and research, such as causality for behavioral diversification and audio-visual cross-modality, and also offer directions for future applications and technology enhancements. [ABSTRACT FROM AUTHOR]

This paper examines what harm reveals about psychoactive power in the arts therapies. A 20-year sample of fitness-to-practise cases brought to the UK statutory regulator (the Health and Care and Professions Council) was examined to establish the prevalence of practitioners who cause harm which was low (0.165%). Transcripts of sanctioned cases were used to construct a grounded theory of how harm is mediated in arts therapies practice. This revealed service users enter arts therapies with damaged self-trust in the expectation that they can trust the professional. In non-harmful therapy, trust in the professional is then used to boost self-trust in the service user. In arts therapies practice, the arts create powerfully emotionally salient elements to aid therapy which can affect both service user and arts therapists' attachment systems to fulfil this task. Harm was enacted when the arts therapist used the power of that trust to isolate the relationship and introduce their own needs through arts therapies practices. This increased service user dependency on the arts therapist and further decreased their self-trust resulting in harm. Harm was only possible where the arts therapist's self-reflection failed and they distorted theory to self-justify their actions and refute all feedback to the contrary. Plain language summary This paper examines harm in the arts therapies (art, drama and music therapies as regulated by the Health and Care Professions Council (HCPC)). Harm is understudied but important because it tells us how things can go wrong and also indicates where areas of strong psychoactive power may operate in therapy which can also help people. Arts therapies have been regulated by the HCPC for 20 years and we found there were 77 cases brought against arts therapies practitioners with a total of 16 cases that led to HCPC sanction. We used a grounded theory method of analysis to try to understand how harm was mediated in those harmful arts therapy practices because it is an established form of qualitative research used to construct a theory of social action using examples drawn from real-world examples. We found that service users enter arts therapies with damaged self-trust in the expectation that they can trust the professional. In non-harmful therapy, trust in the professional is then used to boost self-trust in the service user. Within arts therapies, the arts support access to powerful emotions which underpins the building of trust, an element essential to good therapy. However, harm happened when the arts therapist used the power of that trust to isolate the relationship, introduced personal issues and used the service user for their own needs. This increased service user dependency on the arts therapist, detrimentally affecting their sense of self-trust and resulting in harm. Harm was only possible where the arts therapists' self-reflection failed and they distorted theory to self-justify their actions and refute all feedback to the contrary. [ABSTRACT FROM AUTHOR]

Routinely prescribed psychological therapies for depression are not always effective. Arts therapies, particularly Dance Movement Psychotherapy, may offer additional therapeutic mechanisms for depression. Therefore, client-reported helpful factors from various therapy types, along with client preferences, are key in devising new therapeutic interventions. We present a framework for a new pluralistic "meta-approach" of therapy for depression, based on an interdisciplinary thematic synthesis (Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8[1], 45) of active ingredients from both talking therapies and creative approaches. Lastly, we offer an illustrative group therapy workshop based on this approach, to be piloted with clients and practitioners within an NHS mental health service. Further research is required to evaluate this pilot and to devise a full treatment for trialling within the service. [ABSTRACT FROM AUTHOR]

The therapeutic relationship formed during arts therapies with ultra-orthodox children and teens, when it is provided by therapists who are not ultra-orthodox themselves, may suffer from an intercultural gap. This quantitative longitudinal study examined the therapeutic alliance (TA) and clients' reactions to the artistic work (ABI) in arts therapies with young ultra-orthodox clients, and the relationship of these process variables to changes in self-concept, behavior and functioning in a dedicated educational setting. Forty-one ultra-orthodox clients aged 4–15 (M =6.54, SD =2.33) and 17 arts therapists from diverse religious/cultural backgrounds filled out process questionnaires three times during therapy. The clients, their mothers, and the educational staff provided information on the outcome variables at the beginning and end of therapy. The findings partially confirmed the hypotheses of a positive relationship between TA and ABI, between the two and changes in the outcome variables. The clients' and therapists' perspectives on the TA were only positively correlated towards the end of therapy. Positive correlations were found between ABI and TA, but a negative correlation emerged between TA at the beginning of therapy and ABI towards the end of therapy. Positive correlations were found between the process variables and the gain scores; namely, between ABI and improvement in functioning in kindergarten, TA and improvement in cognitive competence of clients treated by secular therapists, and between TA and a decline in hyperactivity/distractibility of clients treated by ultra-orthodox or religious therapists. A negative correlation emerged between TA and increased aggression in clients treated by secular therapists. These findings are discussed in the context of the specificity of this population and intercultural therapy. • Therapy with ultra-orthodox children involves client-therapist-artwork relationships. • Therapists' adjustment to the ultra-orthodox clients' perceptions is prolonged. • Alliance-outcome relationship differs as a function of the therapists' religion. • Artmaking promoted better functioning in ultra-orthodox kindergartens. [ABSTRACT FROM AUTHOR]