Stress is one of the world’s largest health problems, leading to exhaustion, burnout, anxiety, a weak immune system, or even organ damage. In Germany, stress-induced work absenteeism costs about 20 billion Euros per year. Therefore, it is not surprising that the Central Federal Association of the public Health Insurance Funds in Germany ascribes particular importance to stress prevention and stress management as well as health enhancing measures. Building on current integrative and embodied stress theories, Creative Arts Therapies (CATs) or arts interventions are an innovative way to prevent stress and improve stress management. CATs encompass art, music, dance/movement, and drama therapy as their four major modalities. In order to obtain an overview of CATs and arts interventions’ efficacy in the context of stress reduction and management, we conducted a systematic review with a search in the following data bases: Academic Search Complete, ERIC, Medline, Psyndex, PsycINFO and SocINDEX. Studies were included employing the PICOS principle and rated according to their evidence level. We included 37 studies, 73% of which were randomized controlled trials. 81.1% of the included studies reported a significant reduction of stress in the participants due to interventions of one of the four arts modalities.

Art therapy assumes that art work is related to differential constructs of the artist. Empirically, this hypothesis has not been proven yet because quantitative methods are rare. The Rating Instrument for two-dimensional Pictorial Work (RizbA) is designed to address this issue. The construct-pictorial expression-is theoretically defined by seven content areas (representation, color, shape, space, motion, composition, expression), which combined create the overall construct. Test development is based on art historical and art therapeutic theories and supported empirically. Two online studies are conducted using a sample of nine pictures, which are rated by experts (n 1 = 12, n 2 = 8). In the first study, based on psychometric characteristics, an item pool of 113 items is examined and a preliminary test version is developed. The second study examines quality criteria of the preliminary version. For both studies, factor analyses are computed. The preliminary version includes 26 items. Its ability for differentiation between pictorial works ranges between .897 (T1) and .766 (T2), its inter-rater reliability between .525 (T1) and .917 (T2). Test-retest reliability is .919. PCA suggests a four-factors solution, which in large part is consistent across studies. As a reliable measurement RizbA opens new perspectives in fundamental art therapeutic and psychological research.

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Creation is an important part of many interventions in creative arts therapies (art, music, dance, and drama therapy). This active part of art-making in arts therapies has not yet been closely investigated. The present study commits to this field of research using a mixed-methods design to investigate the effects of active creation on health-related psychological outcomes. In an artistic inquiry within an experimental design, N = 44 participants engaged in active art-making for eight minutes in the presence of the researcher (first author) with a choice of artistic materials: paper and colors for drawing and writing, musical instruments, space for moving or performing. Before and after the creation, participants completed a well-being, a self-efficacy and an experience of creation scale, and in addition found their own words to express the experiences during the activity. We hypothesized that the experience of empowerment, freedom, impact, and creativity (Experience of Creation Scale) mediates the positive effect of active creation on the outcomes of self-efficacy and well-being, and evaluated this assumption with a mediation analysis. Results suggest that the effect of active creation on both self-efficacy and well-being is significantly mediated by the Experience of Creation Scale. This article focuses on the quantitative side of the investigation. During the process, qualitative and quantitative results were triangulated for a more valid evaluation and jointly contribute to the emerging theory frame of embodied aesthetics.