From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review

Abstract

Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear how and why the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review (Nstudies = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: “embodiment,” “concretization,” and “symbolism and metaphors.” The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.

Play the Pain: A Digital Strategy for Play-Oriented Research and Action

“…The language and process of art making are important resources for therapeutic care ( 184 , 185 ). Reflecting on 3 years of experience with art therapy in palliative care, Bras et al ( 186 ) suggested that medical professionals and patients can adopt the language of art, not only as a means for providing patients therapeutic relief, but also as a means to raise public awareness, and facilitate communication among patients, medical professionals and others involved in decision making about pain.…”

Brain-Computer Interfaces and Creative Expression: Interface Considerations for Rehabilitative and Therapeutic Interactions

“…Research has demonstrated that integrating artistic practices into rehabilitative treatments through which patients are able to create or co-create art themselves improves patient-physician communication, facilitates patient thinking, and improve clinical outcomes (Sonke, 2016). Additionally, creative arts therapies have been shown to positively impact various psychological and physiological outcomes through the interactive processes of action and experiential-based training (King and Pascuzzi, 2018;de Witte et al, 2021). Initial creative arts therapy practices have been redefined through various interdisciplinary and collaborative efforts to maintain a focus on enhancing and humanizing the healthcare environment (Sonke, 2016).…”

“…Initial creative arts therapy practices have been redefined through various interdisciplinary and collaborative efforts to maintain a focus on enhancing and humanizing the healthcare environment (Sonke, 2016). More recently, research on clinical and evidence based creative expression in the form of creative arts therapies, which includes art and music therapies, has demonstrated the potential for better understanding of specific health conditions while offering a safe and cost-effective intervention as an adjunct to traditional medical management de Witte et al, 2021;King and Parada, 2021).…”

Crafting Life Stories in Photocollage: An Online Creative Art-Based Intervention for Older Adults

“…The therapeutic processes are led by certified arts therapists and are grounded in the triangular relationship between the therapist, the client, and the art process and product [ 2 ]. As in other psychotherapies, establishing a safe environment and therapeutic alliance are central factors in the therapeutic relationship in CAT [ 3 ]. The aim of the current study was to explore the experiences of older adults who participated in an online therapeutic creative process of digital photocollage as a tele-CAT intervention during a period of social distancing.…”

“…There are several change factors in CAT which distinguish it from verbal psychotherapy [ 3 ]. During the creative process of art making, the physical senses are engaged through relationships with paint, clay, images, movements and sounds.…”