Effects of Expressive Arts–Based Interventions on Adults With Intellectual Disabilities: A Stratified Randomized Controlled Trial

Abstract

Background: People with intellectual disabilities have difficulties expressing their views and can manifest psychological and behavioral symptoms. The present study aimed to examine the effects of expressive arts-based intervention (EABI) on the behavioral and emotional well-being of adults with intellectual disabilities.Methods: This study assigned 109 Chinese adults with intellectual disabilities into EABI (N = 55) or control groups (N = 54) using stratified randomization. Pre-and post-intervention quantitative assessments were conducted of aberrant behaviors, personal well-being, mood and color usage in drawings. Focus group interviews were conducted with the EABI participants and their caseworkers at the post-intervention stage. Repeated-measures analysis of covariance evaluated the EABI effects with age, gender and degree of intellectual disability as covariates, and latent profile analysis examined the patterns of color usage in drawings. Qualitative thematic analysis was performed on the interview data. Results:The interview findings suggest that the EABI group was more emotionally expressive and stable after the intervention. Compared to the control group, the EABI group tended to use more diverse colors and leave less empty space in their drawings. No significant overall improvements were found in the EABI group with respect to aberrant behaviors, mood or personal well-being. Among males, the EABI participants showed significantly more anger and less energetic moods than those in the control group. Among females, the EABI participants showed significantly lower levels of aberrant behavior than those in the control group. Conclusion:The results of this study suggest that expressive arts-based interventions have different effects on the emotional and behavioral well-being of male and female participants. Moreover, increased color usage may imply a more positive state of emotional well-being.

Experiences of social workers who witness mistreatment as captured in drawing and narrative

“…It also represents a splitting between the willingness to act and change and the reluctance to cope with the mistreater. A similar splitting experience was found in the Palestinians’ drawings and narratives in Ho et al (2020) study.…”

“…It aligns with previous evidence that enumerates a common fear of persecution when coinciding with a less-powered party. This fear is based on the universal norm of relationship reciprocity, an “eye for an eye” (Ho et al, 2020; McCullough et al, 2001), and awareness of power hierarchy. Only one drawer took a fierce stance and dared facto face the boss (see Figure 4a and b).…”

“…According to the expression theories of art, all forms include "bringing emotions to the surface, bringing them outward to a place where they can be perceived by the audience" (Carroll & Schwartz, 2002). Through externalizing the inner emotional state, the arts discover emotions and help convey feelings or messages to others (Ho et al, 2020).…”

Protocol for a mixed-methods randomised controlled trial evaluating the effectiveness of a dyadic expressive arts-based intervention in improving the psychosocial well-being of children with intellectual disability in special schools and their mothers

“…Themes related to mother–child relationships will be covered. The content of the intervention was informed by the previous works on applying arts-based activities or interventions for individuals with ID or mother–child dyads in Hong Kong 36 43 44. Each session will comprise four stages, which will involve both within dyads or across dyads arts activity.…”

Temporal relationships among role stress, staff burnout, and residents’ behavioral problems: A 2-year longitudinal study in child care homes in Hong Kong

“…The provision of counseling services can reduce residents' internalizing and externalizing behavioral problems [44]. Alternative interventions such as play therapy and expressive art therapy [45] facilitate youth residents' emotional expression via non-verbal…”