Healing Arts and Expressive Therapies in an Interdisciplinary Team
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.
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.
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.”
The following are some areas that art-based therapies and expressive therapies may be used in rehabilitation and healthcare:
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. Please have a look at the following pages to find out more about lifestyle medicine:
- Integrative Medicine for Health and Disease Management
- Lifestyle Medicine for Health and Disease Management
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.”
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:
- Childhood obesity
- Social cognition
- Tang et al. 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."
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:
- Psychological well-being
- Fear and anxiety associated with medical procedures
- Zengin et al. 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. 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.”
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:
- Wound healing
- Post traumatic stress disorder (PTSD)
- A systematic review by Gerger et al. found that writing treatments may be beneficial for individuals with PTSD in the medium- to long-term
- To improve resilience
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.”
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:
- Multiple sclerosis (MS)
- Linguistic abilities in older adults
- Zimmermann et al. concluded that poetry therapy can improve complex linguistic abilities in older adults
- Oncologic pain relief
In the following video, Harvard Medical School professor and poet, Rafael Campo, explains the healing effects of poetry.
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.”
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:
- A systematic review by Dos Santos Delabary et al. found that dance had a positive impact on motor parameters and functional mobility in persons with Parkinson's
- Stress management in cancer treatment
- Falls prevention
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.”
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:
- Dementia care
- Mild cognitive disorders
- A randomised controlled trial by Mahendran et al. found that art therapy may contribute significantly to cognitive improvements in community-dwelling older adults with mild cognitive impairment
- Mild Alzheimer’s disease
The following video introduces art therapy.
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.”
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:
- A review by Pereira et al. 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 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. 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]
- Arts-Based Interventions for Professionals in Caring Roles During and After Crisis: A Systematic Review of the Literature
- Therapeutic use of music, dance, and rhythmic auditory cueing for patients with Huntington's disease: a systematic review
- Academy of Orthopaedic Physical Therapy (APTA), Performing Arts
- American Occupational Therapy Association American Speech Language Hearing Association
- American Psychological Association
- Arts and Healing Network
- Expressive Therapies Summit
- International Expressive Arts Therapy Association
- International Association for Dance Medicine and Science
- International Association for Music and Medicine
- Performing Arts Medicine Association
- UCLA Arts and Healing
- National Coalition of Creative Arts Therapies Associations, Inc
- National Organization for Arts in Health
- Integrative systematic review of psychodrama psychotherapy research: Trends and methodological implications
- Association for Theatre in Higher Education
- North American Drama Therapy Association
- Theater Veder
- Play therapy as an intervention in hospitalized children: A systematic review
- Association for Play Therapy
- National Association for Poetry Therapy
- International Federation for Biblio/Poetry Therapy
- A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson's disease
- Dance and rehabilitation in cerebral palsy: a systematic search and review
- American Dance Therapy Association
- Music therapy in pain and anxiety management during labor: A systematic review and meta-analysis
- Music therapy in the treatment of dementia: A systematic review and meta-analysis
- American Music Therapy Association
- Music Mends Minds
- Labyrinth Journey App
- Effects of reflective labyrinth walking assessed using a questionnaire
References[edit | edit source]
- Altug Z. Healing Arts and Expressive Therapies in an Interdisciplinary Team Course. Physioplus, 2022.
- National Coalition of Creative Arts Therapies Associations, Inc. Home page. Available from: https://www.nccata.org/ (accessed 22 February 2022).
- Rieger KL, Lobchuk MM, Duff MA, Chernomas WM, Demczuk L, Campbell-Enns HJ et al. Mindfulness-based arts interventions for cancer care: A systematic review of the effects on wellbeing and fatigue. Psychooncology. 2021;30(2):240-51.
- Dunphy K, Baker FA, Dumaresq E, Carroll-Haskins K, Eickholt J, Ercole M et al. Creative arts interventions to address depression in older adults: A systematic review of outcomes, processes, and mechanisms. Front Psychol. 2019;9:2655.
- Martin L, Oepen R, Bauer K, Nottensteiner A, Mergheim K, Gruber H et al. Creative arts interventions for stress management and prevention - a systematic review. Behav Sci (Basel). 2018;8(2):28.
- Gelatti F, Viganò C, Borsani S, Conistabile L, Bonetti L. Efficacy of live versus recorded harp music in reducing preoperative stress and fear related to minor surgery: A pilot study. Altern Ther Health Med. 2020;26(3):10-5.
- Lo TLT, Lee JLC, Ho RTH. Creative arts-based therapies for stroke survivors: A qualitative systematic review. Front Psychol. 2018;9:1646.
- North American Drama Therapy Association. What is drama therapy? Available from: https://www.nadta.org/ (accessed 23 February 2022).
- Demir Acar M, Bayat M. The effect of diet-exercise trainings provided to overweight and obese teenagers through creative drama on their knowledge, attitude, and behaviors. Child Obes. 2019;15(2):93-104.
- Bega D, Palmentera P, Wagner A, Hovde M, Barish B, Kwasny MJ et al. Laughter is the best medicine: The Second City® improvisation as an intervention for Parkinson's disease. Parkinsonism Relat Disord. 2017;34:62-5.
- Tang SX, Seelaus KH, Moore TM, Taylor J, Moog C, O'Connor D et al. Theatre improvisation training to promote social cognition: A novel recovery-oriented intervention for youths at clinical risk for psychosis. Early Interv Psychiatry. 2020;14(2):163-71.
- Lesley University. Effecting Change through Drama Therapy. Available from: http://www.youtube.com/watch?v=dO6lx8RqgRk [last accessed 23/02/2022]
- TEDx Talks. Changing lives with drama therapy | Maitri Gopalakrishna | TEDxPESITBSC. Available from: http://www.youtube.com/watch?v=n89kI3lFrBI [last accessed 23/02/2022]
- Association for Play Therapy. What is play therapy? Available from: https://www.a4pt.org/default.aspx (accessed 23 February 2022).
- Tse MM, Ng SS, Lee PH, Lai C, Kwong E, Liu JY et al. Play activities program to relieve chronic pain and enhance functional mobility and psychological well-being for frail older adults: A pilot cluster randomized controlled trial. J Am Geriatr Soc. 2016;64(10):e86-e88.
- Zengin M, Yayan EH, Düken ME. The effects of a therapeutic play/play therapy program on the fear and anxiety levels of hospitalized children after liver transplantation. J Perianesth Nurs. 2021;36(1):81-5.
- Sánchez-López AM, Menor-Rodríguez MJ, Sánchez-García JC, Aguilar-Cordero MJ. Play as a method to reduce overweight and obesity in children: An RCT. Int J Environ Res Public Health. 2020;17(1):346.
- Association for Play Therapy. Play Therapy Works! Available from: http://www.youtube.com/watch?v=_4ovwAdxCs0 [last accessed 23/02/2022]
- York and Scarborough Teaching Hospitals NHS FT. The Play Team in Action. Available from: https://www.youtube.com/watch?v=PumEd-3q62w[last accessed 23/02/2022]
- Baikie KA, Geerligs L, Wilhelm K. Expressive writing and positive writing for participants with mood disorders: an online randomized controlled trial. J Affect Disord. 2012;136(3):310-9.
- Koschwanez HE, Kerse N, Darragh M, Jarrett P, Booth RJ, Broadbent E. Expressive writing and wound healing in older adults: a randomized controlled trial. Psychosom Med. 2013;75(6):581-90.
- Gerger H, Werner CP, Gaab J, Cuijpers P. Comparative efficacy and acceptability of expressive writing treatments compared with psychotherapy, other writing treatments, and waiting list control for adult trauma survivors: a systematic review and network meta-analysis. Psychol Med. 2021:1-13.
- Bechard E, Evans J, Cho E, Lin Y, Kozhumam A, Jones J et al. Feasibility, acceptability, and potential effectiveness of an online expressive writing intervention for COVID-19 resilience. Complement Ther Clin Pract. 2021;45:101460.
- Bass Connections. Expressive Writing for Resilience: Writing to Heal. Available from: http://www.youtube.com/watch?v=3piZLj7bvw0 [last accessed 23/02/2022]
- Living Better. Expressive writing therapeutic for cancer patients. Available from: http://www.youtube.com/watch?v=tuXhLCjNLi4 [last accessed 23/02/2022]
- National Association for Poetry Therapy. What is poetry therapy? Available from: https://poetrytherapy.org/ (accessed 23 February 2022).
- Balchin R, Hersh D, Grantis J, Godfrey M. "Ode to confidence": Poetry groups for dysarthria in multiple sclerosis. Int J Speech Lang Pathol. 2020;22(3):347-58.
- Zimmermann N, Netto TM, Amodeo MT, Ska B, Fonseca RP. Working memory training and poetry-based stimulation programs: are there differences in cognitive outcome in healthy older adults? NeuroRehabilitation. 2014;35(1):159-70.
- Arruda MA, Garcia MA, Garcia JB. Evaluation of the Effects of Music and Poetry in Oncologic Pain Relief: A Randomized Clinical Trial. J Palliat Med. 2016;19(9):943-8.
- TEDx Talks. How Poetry Heals Us | Rafael Campo | TEDxCambridge. Available from: https://www.youtube.com/watch?v=KYIYiE2b_6U [last accessed 23/02/2022]
- American Dance Therapy Association. Home page. Available from: www.adta.org (accessed 23 February 2022).
- Dos Santos Delabary M, Komeroski IG, Monteiro EP, Costa RR, Haas AN. Effects of dance practice on functional mobility, motor symptoms and quality of life in people with Parkinson's disease: a systematic review with meta-analysis. Aging Clin Exp Res. 2018;30(7):727-35.
- Ho RT, Fong TC, Cheung IK, Yip PS, Luk MY. Effects of a short-term dance movement therapy program on symptoms and stress in patients with breast cancer undergoing radiotherapy: A randomized, controlled, single-blind trial. J Pain Symptom Manage. 2016;51(5):824-31.
- Mattle M, Chocano-Bedoya PO, Fischbacher M, Meyer U, Abderhalden LA, Lang W et al. Association of dance-based mind-motor activities with falls and physical function among healthy older adults: A systematic review and meta-analysis. JAMA Netw Open. 2020;3(9):e2017688.
- American Dance Therapy Association. An Introduction to Dance/Movement Therapy. Available from: https://www.youtube.com/watch?v=mhoEjbvIEw8 [last accessed 23/02/2022]
- UCLA Health. Dance Movement Therapy | Mattel Children's Hospital UCLA. Available from: http://www.youtube.com/watch?v=o3o2ii5rEaI [last accessed 23/02/2022]
- American Art Therapy Association. About art therapy. Available from: https://arttherapy.org/about-art-therapy/ (accessed 23 February 2022).
- Schall A, Tesky VA, Adams AK, Pantel J. Art museum-based intervention to promote emotional well-being and improve quality of life in people with dementia: The ARTEMIS project. Dementia (London). 2018;17(6):728-43.
- Mahendran R, Gandhi M, Moorakonda RB, Wong J, Kanchi MM, Fam J et al. Art therapy is associated with sustained improvement in cognitive function in the elderly with mild neurocognitive disorder: findings from a pilot randomized controlled trial for art therapy and music reminiscence activity versus usual care. Trials. 2018;19(1):615.
- Pongan E, Tillmann B, Leveque Y, Trombert B, Getenet JC, Auguste N et al. Can musical or painting interventions improve chronic pain, mood, quality of life, and cognition in patients with mild Alzheimer's disease? Evidence from a randomized controlled trial. J Alzheimers Dis. 2017;60(2):663-77.
- UQ Faculty of Medicine. What is Art Therapy? Available from: https://www.youtube.com/watch?v=4BZynyGzyow [last accessed 23/02/2022]
- American Music Therapy Association. What is music therapy? Available from: https://www.musictherapy.org/about/musictherapy/ (accessed 23 February 2022).
- Pereira APS, Marinho V, Gupta D, Magalhães F, Ayres C, Teixeira S. Music therapy and dance as gait rehabilitation in patients with Parkinson disease: A review of evidence. J Geriatr Psychiatry Neurol. 2019;32(1):49-56.
- Umbrello M, Sorrenti T, Mistraletti G, Formenti P, Chiumello D, Terzoni S. Music therapy reduces stress and anxiety in critically ill patients: a systematic review of randomized clinical trials. Minerva Anestesiol. 2019;85(8):886-98.
- Çelebi D, Yılmaz E, Şahin ST, Baydur H. The effect of music therapy during colonoscopy on pain, anxiety and patient comfort: A randomized controlled trial. Complement Ther Clin Pract. 2020;38:101084.
- Norton Healthcare. Parkinson's and Music Therapy. Available from: http://www.youtube.com/watch?v=a-5LdT9zHPM [last accessed 23/02/2022]
- TEDx Talks. Why I Want to Change the World with Music Therapy | Erin Seibert | TEDxUSFSP. Available from: http://www.youtube.com/watch?v=47-90fPyQa8 [last accessed 23/02/2022]
- Havsteen-Franklin D, Tjasink M, Kottler JW, Grant C, Kumari V. Arts-based interventions for professionals in caring roles during and after crisis: A systematic review of the literature. Front Psychol. 2020;11:589744.
- Schwartz AE, van Walsem MR, Brean A, Frich JC. Therapeutic use of music, dance, and rhythmic auditory cueing for patients with Huntington's disease: A systematic review. J Huntingtons Dis. 2019;8(4):393-420.
- Orkibi H, Feniger-Schaal R. Integrative systematic review of psychodrama psychotherapy research: Trends and methodological implications. PLoS One. 2019;14(2):e0212575.
- Godino-Iáñez MJ, Martos-Cabrera MB, Suleiman-Martos N, Gómez-Urquiza JL, Vargas-Román K, Membrive-Jiménez MJ, Albendín-García L. Play therapy as an intervention in hospitalized children: A systematic review. Healthcare (Basel). 2020;8(3):239.
- Barnish MS, Barran SM. A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson's disease. BMC Neurol. 2020;20(1):371.
- López-Ortiz C, Gaebler-Spira DJ, Mckeeman SN, Mcnish RN, Green D. Dance and rehabilitation in cerebral palsy: a systematic search and review. Dev Med Child Neurol. 2019;61(4):393-398.
- Wiercioch-Kuzianik K, Bąbel P. Color hurts. The effect of color on pain perception. Pain Med. 2019;20(10):1955-62.
- Santiváñez-Acosta R, Tapia-López ELN, Santero M. Music therapy in pain and anxiety management during labor: A systematic review and meta-analysis. Medicina (Kaunas). 2020;56(10):526.
- Moreno-Morales C, Calero R, Moreno-Morales P, Pintado C. Music therapy in the treatment of dementia: A systematic review and meta-analysis. Front Med (Lausanne). 2020;7:160.
- Lizier DS, Silva-Filho R, Umada J, Melo R, Neves AC. Effects of reflective labyrinth walking assessed using a questionnaire. Medicines (Basel). 2018;5(4):111.
- Feniger-Schaal R, Hart Y, Lotan N, Koren-Karie N, Noy L. The body speaks: using the mirror game to link attachment and non-verbal behavior. Front Psychol. 2018;9:1560.