Healing Arts and Expressive Therapies in an Interdisciplinary Team

Original Editor - Jess Bell based on the course by Ziya Altug
Top Contributors - Jess Bell and Wanda van Niekerk

Introduction[edit | edit source]

“The aim of art is not to represent the outward appearance of things, but their inward significance” - Aristotle.[1]

The creative arts and expressive therapies may use drama therapy, play therapy, expressive writing, poetry therapy, dance therapy, art therapy, and music therapy to help individuals improve their physical, emotional, cognitive and/or social functioning. Physiotherapists and healthcare providers may find that collaborating with therapists from other disciplines can improve interprofessional collaborations and potentially enhance therapeutic alliances with patients and clients.[1]

Art-Based Therapies[edit | edit source]

The National Coalition of Creative Arts Therapies Associations states: “Creative Arts Therapists are human service professionals who use distinct arts-based methods and creative processes for the purpose of ameliorating disability and illness and optimizing health and wellness. Treatment outcomes include, for example, improving communication and expression, and increasing physical, emotional, cognitive and/or social functioning.”[2]

The following are some areas that art-based therapies and expressive therapies may be used in rehabilitation and healthcare:[1]

Creative therapies can be considered alongside lifestyle medicine. Lifestyle medicine is an evidence-based approach that aims to improve the health and wellbeing of individuals and societies, and it considers how lifestyle factors can influence health and wellbeing.[1] Please have a look at the following pages to find out more about lifestyle medicine:

Drama Therapy[edit | edit source]

Drama therapy is: “an active, experiential approach to facilitating change. Through storytelling, projective play, purposeful improvisation, and performance, participants are invited to rehearse desired behaviors, practice being in relationship, expand and find flexibility between life roles, and perform the change they wish to be and see in the world.”[8]

Drama therapy may include storytelling, role playing, improvisational techniques, group games, and/or puppetry. The following are some areas that drama therapy may be used in rehabilitation and healthcare:[1]

  • Childhood obesity
    • Demir Acar et al.[9] found that overweight / obese teenagers may develop positive attitudes and behaviours through drama therapy
  • Parkinson’s
    • Bega et al.[10] found that novel improvisation programmes can improve activities of daily living in persons with Parkinson's of various ages / disease severity
  • Social cognition
    • Tang et al.[11] found that theatre improvisation training to promote social cognition may help to improve function and symptoms in individuals who have risk factors for psychosis

The following videos provide some insight into the practice of drama therapy in mental health.

Play Therapy[edit | edit source]

Play therapy is: “the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development."[14]

It may include storytelling, puppets, music, dance, drama, painting, and / or games. The following are some areas that play therapy may be used in rehabilitation and healthcare:[1]

  • Psychological well-being
    • Tse et al.[15] found that play activity programmes for frail older adults helped to enhance psychological well-being, and were associated with an improvement in frailty scores
  • Fear and anxiety associated with medical procedures
    • Zengin et al.[16] found that play therapy helped to decrease anxiety and fear of medical procedures in children following liver transplantation
  • To reduce weight
    • Sánchez-López et al.[17] conducted an randomised controlled trial and concluded that play therapy combined with nutritional advice can lead to a decrease in body fat in overweight / obese children aged between 8 and 12 years

The following videos show how play therapists use play to help children in different healthcare settings.

Expressive Writing[edit | edit source]

"Writing about traumatic, stressful or emotional events--often leads to improvements in physical and psychological health in non-clinical and clinical populations.”[20]

Expressive writing may include diaries, journals, memoirs, opinion pieces, songs, and / or poetry. The following are some areas that expressive writing may be used in rehabilitation and healthcare:[1]

  • Wound healing
    • Expressive writing has been shown to have a positive impact on wound healing in females and older adults[21]
  • Post traumatic stress disorder (PTSD)
    • A systematic review by Gerger et al.[22] found that writing treatments may be beneficial for individuals with PTSD in the medium- to long-term
  • To improve resilience
    • Bechard et al.[23] found that online expressive writing interventions helped to improve resilience in adults who self-identified as being significantly affected by the COVID-19 pandemic

Please have a look at the following videos to learn more about the use of expressive writing in oncology settings.

Poetry Therapy[edit | edit source]

Poetry therapy is the “use of language, symbol, and story in therapeutic, education, growth, and community-building capacities. It relies upon the use of poems, stories, song lyrics, imagery, and metaphor to facilitate personal growth, healing, and greater self-awareness.”[26]

Poetry therapy may include bibliotherapy, narrative, journal writing, metaphor, song lyrics, storytelling, and / or rituals. The following are some areas that poetry therapy may be used in rehabilitation and healthcare:[1]

  • Multiple sclerosis (MS)
    • Balchin et al.[27] found that the combination of poetry and dysarthria therapy can have a positive impact on communication confidence in individuals with MS
  • Linguistic abilities in older adults
    • Zimmermann et al.[28] concluded that poetry therapy can improve complex linguistic abilities in older adults
  • Oncologic pain relief
    • Arruda et al.[29] found that poetry therapy can have a positive impact on pain intensity in adults experiencing cancer-related pain

In the following video, Harvard Medical School professor and poet, Rafael Campo, explains the healing effects of poetry.

[30]

Dance Therapy[edit | edit source]

Dance and movement therapy are defined as the: “psychotherapeutic use of movement to promote emotional, social, cognitive and physical integration of the individual.”[31]

Dance therapy may use different dance styles, therapeutic movements, mirroring techniques, jumping rhythms, and / or movement metaphors. The following are some areas that dance therapy may be used in rehabilitation and healthcare:[1]

  • Parkinson’s
    • A systematic review by Dos Santos Delabary et al.[32] found that dance had a positive impact on motor parameters and functional mobility in persons with Parkinson's
  • Stress management in cancer treatment
    • Ho et al.[33] conducted a randomised controlled trial and concluded that a short-term dance movement therapy programme can help to address worsening stress and pain levels in female breast cancer patients who are undergoing radiotherapy
  • Falls prevention
    • Mattle et al.[34] explored falls risk in healthy adults and found that dance-based mind-motor activities were associated with reduced falls risk and decreased rate of falls, as well as enhanced balance, mobility and lower body strength

Please have a look at the following videos if you want to find out more about dance therapy. The first is published by the American Dance Therapy Association and it introduces dance and movement therapy. The second shows dance therapy being used in a paediatric setting.

Art Therapy[edit | edit source]

Art therapy is: “an integrative mental health and human services profession that enriches the lives of individuals, families, and communities through active art-making, creative process, applied psychological theory, and human experience within a psychotherapeutic relationship.”[37]

Art therapy may include painting, drawing, illustrating, sculpting, and / or photography. The following are some areas that art therapy may be used in rehabilitation and healthcare:[1]

  • Dementia care
    • Schall et al.[38] found that art museum-based art interventions (i.e. a combination of museum visits and various artistic activities) help to enhance well-being, mood, and quality of life in people with dementia
  • Mild cognitive disorders
    • A randomised controlled trial by Mahendran et al.[39] found that art therapy may contribute significantly to cognitive improvements in community-dwelling older adults with mild cognitive impairment
  • Mild Alzheimer’s disease
    • Pongan et al.[40] looked at both music and painting interventions for patients with mild Alzheimer's disease. They concluded that singing and painting interventions might be beneficial in decreasing pain and improving mood, quality of life, and cognition in study participants[40]

The following video introduces art therapy.

[41]

Music Therapy[edit | edit source]

Music therapy is: “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.”[42]

Music therapy may include listening to music, creating music, singing and vocal activities, and / or playing a musical instrument. The following are some areas that music therapy may be used in rehabilitation and healthcare:[1]

  • Parkinson’s
    • A review by Pereira et al.[43] concluded that music therapy is a non-invasive, simple treatment option that can be used to improve gait and cognition in persons with Parkinson's
  • Reduce stress and anxiety in critical care settings
    • Umbrello et al.'s systematic review[44] found that music therapy is consistently associated with reduced anxiety and stress in patients who are critically ill
  • Reduce pain and anxiety in individuals undergoing a colonoscopy
    • Çelebi et al.[45] conducted a randomised controlled intervention study of patients undergoing colonoscopy and found that music therapy had a positive impact on pain levels, anxiety and comfort

The following videos introduce music therapy in more detail. The first features a music therapy programme for Parkinson's patients. In the second, music therapist, Erin Seibert, explains the many positive outcomes that can be achieved through music therapy.

Summary[edit | edit source]

  • Creative therapies can have a positive impact on a range of conditions and many patient groups
  • Collaborating with therapists from other disciplines can improve interprofessional collaborations and potentially enhance our therapeutic alliances with our patients

Resources[edit | edit source]

Art-Based Therapies

Drama Therapy

Play Therapy

Expressive Writing

Poetry Therapy

Dance Therapy

Art Therapy

Music Therapy

Labyrinth Relaxation

Mirror Game

References[edit | edit source]

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