Writing Thereapy Art Therapy Music Therapy Dance Therapy Drama Therapy

Render to Periodical Articles

Kim Dunphy,[1] Sue Mullane and Marita Jacobsson, Making Dance Matter, Victoria, Commonwealth of australia

Introduction

This article was commissioned by the Psychotherapy and Counselling Federation of Australia (PACFA) every bit office of a series of reviews investigating the effectiveness of psychotherapies in Commonwealth of australia. Definitions of key terms regarding expressive and creative arts therapies are provided first. Next, the article outlines search terms, data retrieval methods and literature sources. The research process, including strategies for determining the quality of evidence, is discussed. Four brusque summaries of the literature are provided: one each for music therapy; art therapy; dance-movement therapy and drama therapy. The exclusion of writing therapy from the assay is explained. The article concludes with a discussion that brings together findings about the four modalities regarding the effectiveness for arts therapies overall. Issues arising with respect to methodology and outcomes are discussed. Recommendations for future arts therapy research are fabricated; an extensive bibliography is provided; and iv tables fastened equally Appendices provide data nigh all the studies that fitted the pick criteria.

Method

Definitions

The literature indicates a variety of terms used for like activities, and so definitions of terms relevant to arts therapies are explored hither. The terms "expressive arts therapy" and "creative arts therapy" were found to be used interchangeably, referring to the overall practice of the arts practical equally therapy. "Expressive arts therapy" is more than common in European practice, while "creative arts therapy" is more frequently used in Australia. Both terms tin as well refer to a multi-modal approach wherein a therapist employs a range of fine art forms every bit an integral aspect of their exercise.

In contrast, the term "art therapy" (singular) generally refers only to visual art therapy, while "arts therapy" may refer to a range of dissimilar visual art forms. Yet, this definition is too problematic, as this term used in the plural too refers to the overall practice of arts every bit therapy, which might include visual, but also other, art forms.

PACFA provides the following clarification of expressive arts therapies:

All art forms offer avenues for research into personal life meanings. Understandings can be gained through using the art form to represent and construct your own story, or by using forms already created, such every bit dramas, poems, paintings, novels or musical compositions. The purpose is always to create re-experiencing of selected aspects of your life so as to sympathise and consider them as you make sense of them. Some approaches employ single art forms, whilst others may invite you to use a number of ways of expressing what is important to y'all, including talking almost your experiencing as you inquire into it (PACFA 2012).

While this describes a process that may exist "therapeutic", it does not specifically mention "therapy". Therefore, the definition is lacking, as information technology does not fit one meaning criteria of therapy, that both client and practitioner must both understand the procedure that they are engaged in as "therapy" in social club for information technology to be then. This concept of therapy is better explicated in PACFA's definition of counselling and psychotherapy: "Professional counsellors and psychotherapists work within a conspicuously contracted (italics review authors), principled relationship that enables individuals to obtain aid in exploring and resolving issues of an interpersonal, intrapsychic, or personal nature" (PACFA, 2013).

For the purposes of this review, the definition provided by the Australian and New Zealand Arts Therapy Association (ANZATA) of "creative arts therapies" will be used to stand for both "creative" and "expressive arts therapies".

Arts therapy or arts psychotherapy is a course of psychotherapy that uses artistic modalities, including visual fine art-making, drama, and trip the light fantastic toe/motion to improve and inform concrete, mental and emotional well-being. Arts therapy works by accessing imagination and creativity, which tin generate new models of living, and contribute towards the evolution of a more integrated sense of self, with increased cocky- awareness and acceptance (ANZATA, 2012).

Yet, this definition, while more specific about the therapeutic process and more comprehensive, does not mention music therapy. An boosted challenge in finding a definition that covers all the modalities is that music therapists do not consider their piece of work as psychotherapeutic (D. Grocke, personal advice, Oct 26, 2012).

"Dance movement therapy" is the term currently used past the Australian professional association, merely this modality also appears in the literature as "trip the light fantastic toe-movement psychotherapy" (UK) and "dance therapy" or "dance/movement therapy", (primarily in the US but also other countries). While the terms "drama therapy" and "psychodrama" are sometimes used interchangeably, in this review "psychodrama" is categorised as a therapeutic process within the modality of "drama therapy".

Key search terms

Central search terms were:

expressive arts therapies; expressive fine art therapies; expressive arts therapy;
creative arts therapy; creative arts therapies;
music therapy, music and guided imagery;
art therapy, art psychotherapy, arts therapy, arts therapies
trip the light fantastic toe therapy, dance-movement therapy, dance psychotherapy, trip the light fantastic toe-move psychotherapy;
drama therapy, drama psychotherapy, psychodrama;
expressive writing, including poetry therapy, and other forms of creative writing every bit therapy.

Scope

A comprehensive calculator-assisted literature search was undertaken of databases and electronically accessible journal articles that documented outcomes of creative arts therapies. Databases searched were the Campbell Collaboration; Academic Search Complete; AMED Alternative Medicine; EBSCOHost; Expanded Academic ASAP; PubMED; PsycArticles; and PsycINFO. Besides searched was the Cochrane Database of Systematic Reviews (CDSR), which, every bit part of the larger Cochrane Library, is a leading resource for systematic reviews and meta-analyses of earth-broad, independent, evidence-based wellness and medical practice (www.cochrane.org). Hand-searches were too undertaken of specific peer-reviewed journals including the American Dance Therapy Periodical; Arts in Psychotherapy; Art Therapy Online; Australian and New Zealand Journal of Family Therapy; Australian Journal of Music Therapy; and the British Periodical of Music Therapy. Websites of relevant professional associations were also searched for references.

Inclusion and exclusion criteria for literature

This review investigated literature on 5 artistic arts therapeutic modalities: music; fine art; dance-movement; drama and writing. This focussed on English language-language literature published in Australia between 2002 and 2012 and internationally between 2007 and 2012. Merely material bachelor in electronic format was considered. The search prioritised systematic, or other, reviews of the literature and controlled trials, primarily those with fully randomised pattern. Studies that did not specifically place a creative arts therapy modality were excluded, even if they involved arts participation that had a beneficial or therapeutic outcome.

Literature synthesis

In organising the synthesis of the studies, headings were selected to friction match those used by Evans, Turner and Trotter (2012), in their review of family and relationship therapy commissioned by PACFA. This was considered to help comparability across PACFA'due south review series. These headings were: Writer/engagement/location; Methodology/ written report type; Noun focus; Participants; Outcomes/ measures; Follow upwards; Determination regarding effects of therapy interventions.

Findings

This section includes a synthesis of the literature for 4 creative arts modalities: music, art, dance-movement and drama therapies. No studies about whatever grade of writing therapy fitted the inclusion criteria, and so no data about this course of therapy is provided. Nevertheless, the practice of poetry therapy is well established in North America and Europe and takes place in a range of medical, allied health and education settings (Heimes, 2011). Nor were any multi-modal studies included. Despite professional involvement in approaches that use more than one art class, for example, as propounded by the training institution Melbourne Institute for Experiential and Creative Arts Therapies (MIECAT), no resources were found that discussed this do, other than where more than one visual fine art form was involved.

Music therapy literature synthesis

Music therapy is an allied health profession and artistic arts modality skilful throughout Australia and in more than than 40 other countries (Australian Music Therapy Association, 2012). Professional associations were established in the UK in 1958, USA in 1971 and Australia in 1975 (Grocke, 2005). In music therapy, music is used past a professional person who is both a "adept musician" and "qualified therapist" inside a therapeutic relationship to address concrete, emotional, cognitive and social needs of individual clients (Australian Music Therapy Association, 2012). Music therapy is used to address an increasing range of client bug, including encephalon trauma, dementia and palliative care, and children with intellectual disabilities (Grocke, 2005). Its relative longevity compared to other modalities may explain why music therapy is one of the most researched mediums of the artistic arts therapies. Music therapy had the strongest body of quantitative literature of all the modalities investigated.

30-ii studies on outcomes of music therapy were identified in this review, eight of which matched the selection criteria. These were four international systematic reviews of quantitative studies using randomised controlled trials, and four single controlled trial studies. I of the systematic reviews had one Australian contributing writer and ii of the unmarried controlled trial studies were wholly undertaken by Australian researchers. The systematic reviews focussed on studies with population groups including cancer patients (Bradt, Dileo, Grocke & Magill, 2011); people in end of life care (Bradt & Dileo, 2010); adults with depression (Maratos, Gold, Wang & Crawford, 2008); and children with Autism Spectrum Disorder (Gold, Wigram & Elefant, 2006). In each case the findings suggested that whilst music therapy did no harm, in that location was bereft data to confirm its positive effects for the population. These authors were consistent in their advancement for music therapy enquiry to comprise more loftier quality studies using larger samples, more authentic tools for upshot assessments, more rigorous designs and long term trials.

The iv single controlled studies provided information about the effectiveness of music therapy with: children with Autism Spectrum Disorder (Gattino, dos Santos Riesgo, Longo, Loguerico Leite & Faccini, 2011); (Kim, Wigram & Gold, 2008); palliative care (Horne-Thompson & Grocke, 2008); and Alzheimer's type dementia (Ledger & Baker, 2007).

Gattino et al (2011) researched the awarding of Relational Music Therapy (RMT) with children who have Autism Spectrum Disorder. RMT was developed as a form of music therapy to help individuals develop their motor, communicative, social, cognitive and emotional capacities stimulated past interactions, betwixt client and therapist in the therapeutic setting. These interactions can include singing, composing and playing musical games in an unstructured format. Nevertheless, the study results were inconclusive, which those authors attribute to small sample size (n=24), utilise of an inadequate instrument to measure the outcomes, and difficulties caused by the physical setting for the music therapy interventions (p. 149-150). Kim et al (2008) undertook a RCT to examine the impact of improvisational music therapy on joint attention behaviours in pre-school children with autism. Results indicated that music therapy was more effective than play sessions in facilitating joint attention behaviours and non-exact social communication skills in children.

The merely wholly Australian authored research that could be included in this review were the post-obit two studies. Horne-Thompson and Grocke (2008) examined the utilise of music therapy in palliative care settings, seeking specifically to accost a gap in the literature of inquiry governed by sufficient controls. They wished to determine if the use of music therapy would help reduce anxiety and its debilitating effects for palliative care patients. Results indicated that music therapy reduced patient anxiety when anxiety was measured by participant self-report, but non when lowered eye rate was the mensurate. Farther investigation was recommended to justify financial investment of a music therapy approach. Ledger and Baker (2007) focussed on the use of music therapy to reduce, in frequency and intensity, agitation in older clients with dementia. The authors reported that, every bit in that location were no significant differences betwixt the experimental and command groups over time, music therapy may only have immediate, rather than cumulative and long-term effects, on agitated behaviours. Music therapy interventions did however, have a positive influence on other client areas of functioning, including wandering, fidgeting, grabbing and verbally ambitious behaviour, suggesting that future research could investigate the modality'south back up for quality of life with this client group.

The studies included in this review betoken that the majority of high calibre quantitative research into music therapy is conducted outside Commonwealth of australia. Although some research indicates inconclusive results, these studies do confirm the positive bear on music therapy can accept on adults experiencing cancer, terminal illness, dementia and low, and for children diagnosed with Autism Spectrum Disorder. These studies also ostend the need for further research that utilises larger sample sizes and long-term trials, in particular, to make up one's mind the efficacy of music therapy.

Art therapy literature synthesis

Art therapy, a modality that uses visual arts equally the therapeutic intervention, emerged in the 1940s in Europe as a form of psychotherapy (Hogan, 2001). This modality was established in Commonwealth of australia between the 1950s and the 1990s past a grouping of local and international artists, psychiatrists, psychologists and educators. Several of these practitioners undertook training in the UK and USA before returning to Australia (Westwood & Linell, 2011). The Australian and New Zealand Arts Therapy Association (ANZATA), founded in 1987, and the Australian Creative Arts Therapies Association (ACATA), founded in 1998, are superlative bodies for art therapy in Australasia. Arts therapies are traditionally based on psychoanalytic or psychodynamic principles, and nigh arts therapists utilise varied evidence based theoretical frameworks in their work. These traditions include depth analytic, humanistic, behavioural, systemic, and integrative approaches. Arts psychotherapy tin can be employed every bit both a therapeutic and diagnostic tool (ANZATA, 2013).

Twelve articles that examined the effectiveness of art therapy were identified, 5 of which met the inclusion criteria. 1 of these was a systematic review, and the others, randomised controlled trials conducted in Europe, the Britain and the The states. No Australian studies that met the inclusion criteria were identified.

I study examining arts therapy for mental disease had inconclusive results. Ruddy and Milne's (2009) systematic review of RCTs of art therapy as an adjunct handling for schizophrenia and other mental illnesses constitute only two studies that met their inclusion criteria. The minor sample sizes of these studies (full n=137) precluded conclusive findings. Another study investigating the effects and toll effectiveness of group art therapy for people with established schizophrenia was conducted past Crawford et al. (2012). No improvements were identified in outcome measures testing global functioning, mental health, or other health related outcomes, with low attendance identified every bit impacting on this result.

Three RCT studies indicate support for the effectiveness of fine art therapy for health problems: asthma; depression; and coping with breast cancer. Beebe, Gelfand and Bender (2010) measured the effectiveness of art therapy with 22 children suffering chronic asthma. Results were significant, showing that a plan of fine art therapy lowered anxiety and improved quality of life and self-concept, with benefits persisting six months after treatment. The study conducted by Thyme et al. (2007) comparing short-term psychodynamic art therapy with psychodynamic verbal therapy for women with depression establish that participants in both groups reported fewer depressive and stress-related symptoms at the conclusion of the trial and again at follow upwardly. Svensk et al. (2009) reported an overall increase in coping resource amidst women with breast cancer after an art therapy intervention. Therefore, of the v fine art therapy studies reviewed, three indicate support for the benefits of art therapy for wellness concerns: asthma; low; and coping with breast cancer. The inconclusive results and no improvements from the other two studies may be largely owing to methodological limitations.

Recommendations for further and improved research were fabricated by Slayton, D'Archer and Kaplan later on their review of 35 studies on the efficacy of art therapy (2011). These authors institute a small body of quantifiable information indicating that art therapy is an effective treatment for people across a spectrum of ages, with a multifariousness of symptoms and disorders. Gilroy (2006) recommends mixed qualitative and quantitative designs to explore aspects of the therapeutic process, stating that "…interventions that involve relationships and social interaction need accompanying qualitative data that certificate therapeutic processes and include user views nigh their experience of what has been important and effective" (p. 114).

Trip the light fantastic toe-movement therapy literature synthesis

Dance-motility therapy (DMT) began equally a formal psycho-therapeutic exercise in the United States in the 1940s (Bartenieff, 1972). Professional associations were established in the US in 1966, the Great britain in 1982 and in Australia in 1994. The American Trip the light fantastic toe Therapy Association (ADTA, 2012) defines trip the light fantastic toe-motility therapy as "the psychotherapeutic use of motility to further the emotional, cognitive, physical and social integration of the individual…based on the empirically supported premise that the body, mind and spirit are interconnected" (ADTA, 2012). Dance-movement therapists in Commonwealth of australia piece of work with clients across the lifespan to address a range of issues of psychological and physical origin including low, feet, trauma, relationship and adjustment problems, dementia, disability and behavioural problems (Trip the light fantastic-Movement Therapy Association of Australia, (DTAA), 2012).

This review identified twenty-half dozen studies on outcomes of trip the light fantastic-motility therapy, 8 of which matched the selection criteria. Five were reviews and three, controlled trials, two of which had a fully randomised design. No manufactures written past Australians or published in Australia could be included.

Ane systematic review published in the Cochrane Review (Xia & Grant, 2009) is the first on DMT to be included in that database. While Xia and Grant'south (2009) commodity regarding the effectiveness of dance therapy for schizophrenia indicates inconclusive results from a single study, its inclusion in the Cochrane Review does pave the way for further research. Meekums, Karkou and Nelson'south (2012) review on the furnishings of DMT for depression is at the protocol stage for Cochrane review, and findings are as yet unavailable. These authors recommended that a full Cochrane review be undertaken regarding DMT and depression, afterwards a scoping review of nine studies indicated the value of deeper investigation. Bradt, Goodill and Dileo'due south (2011) review on the potential of DMT for people who have cancer also had an inconclusive result. Psychological and concrete outcomes of DMT could not be confirmed because only 2 studies were institute. One of those studies, did nonetheless, propose that DMT may accept a benign result on the quality of life of women with chest cancer. Kiepe, Stöckigt and Keil (2012) documented beneficial results from eleven trials on the effects of DMT for adults with a range of physical and mental illnesses.

In the single studies documented, Brauninger (2012) reported that DMT appeared effective in improving stress management and reducing psychological distress. Further, it appeared that DMT seemed effective even subsequently a brusk period of treatment (ten weeks) and that effects lasted over fourth dimension. Meekums, Vaverniece, Majore-Dusele and Rasnacs (2012) found similar reductions in psychological distress in the DMT treatment group for obese women with emotional eating. This written report also indicated other positive outcomes for this population including decreased body image distress, increased self-esteem and reduced emotional eating. DMT was also indicated as an option for treating dementia, having small positive effects on cognition and cocky-care abilities, despite no effects existence indicated for memory (Hokkanen et al., 2008).

These reviews confirm that DMT tin can be an effective therapeutic intervention for people with conditions including schizophrenia, cancer, depression, stress, emotional eating and dementia. They besides bespeak that most DMT studies to date have had small sample sizes and yielded inconclusive results. However, dance-movement therapy is skillful around the globe with a range of clients and weather far broader than this list would point, pointing to significant opportunities for further high quality research.

Drama therapy literature synthesis

Drama therapy is relatively new as a psychotherapeutic profession and academic discipline. although information technology draws from aboriginal ritual practices (Jones, 1996). It adult in the 1970s from theoretical foundations including theatre, psychology, psychotherapy, anthropology, and play. A major influence is the concept of psychodrama developed by Jacob Moreno in the 1920s and 30s as a method of grouping therapy based on see and enactment (Moreno, 1946). Professional associations were established in the Britain in 1977 and the USA in 1979. The just related professional person association in the Australian region is the Australian and Aotearoa New Zealand Psychodrama Association that was established in 1980.

Drama therapy is defined as 'the intentional use of drama and/or theater processes to accomplish therapeutic goals' (National Association for Drama Therapy (United states of america) (NADT) 2012). The NADT purport that behaviour change, skill building, emotional and physical integration, and personal growth can be achieved through drama therapy in prevention, intervention, and treatment settings (2012). Drama therapists work in a wide variety of contexts: schools; mental health; general health social intendance settings; prisons and the voluntary sector. Clients include children with autism, older people with dementia, adolescents who cocky-harm, people with histories of sexual and/or physical abuse, those suffering from a mental illness and women with mail service-natal depression (British Association of Drama Therapists (BADth), 2012).

This review identified viii studies on the outcomes of drama therapy, four of which matched the selection criteria. Ane of these was a systematic review and iii were randomised controlled trials. A further systematic review commissioned by the British Clan of Dramatherapists was discussed in a journal article (Dokter & Winn, 2009) only its findings could not be located on-line. No relevant manufactures published in Australia were found.

Ruby and Dent-Brown's (2007) systematic review of drama therapy and psychodrama for inpatients with schizophrenia reported five studies. The reviewers deemed all of these to be inadequately documented, with no conclusive findings near the harms or benefits of drama therapy for this client group. However, the review did include ii studies relevant for this project, 2 randomised controlled trials with Turkish school students who had high aggression levels (Karataş & Gökçakan, 2009a and 2009b). Findings of the first study indicated significant furnishings, with group-based psychodrama appearing to reduce total aggression, anger, hostility, and indirect aggression scores. No event was found on exact or physical aggression scores. However, the 2nd study indicated that an alternate cognitive-behavioural arroyo was more effective than psychodrama in decreasing total assailment, concrete aggression, and acrimony. These effects were all the same measureable at a xvi calendar week follow-upwards.

The final study examined for this modality evaluated the two- and three-twelvemonth outcomes of targeted school-based drama group therapy (DGT) in reducing behavioural symptoms, as compared to the educational activity of maths and English (McArdle et al. 2011). This indicated that DGT can contribute to a rapid reduction in teacher-observed behavioural symptoms and that this issue is still evident after a twelvemonth. The study concluded that school-based small-scale-group interventions with different content are likely to share some effective components.

In summary, these results indicate the potential for drama therapy to contribute to reduction of behavioural issues for school students, but there is no testify of effectiveness for other populations. More research into outcomes for the wide range of population groups and issues with which drama therapists work is indicated.

Discussion

This article reports a literature review almost the effectiveness of creative arts therapies, particularly as indicated in research from Commonwealth of australia. The most significant and somewhat disappointing finding was that almost no literature from Australia was found that could be included in the review. Only two studies from Australia fitted selection criteria, both of which were from music therapy. These both had inconclusive results virtually the effectiveness of music therapy: to address anxiety and its debilitating effects in palliative care settings (Horne-Thompson & Grocke, 2008) and long term reduction of agitation for older clients with dementia (Ledger & Bakery, 2007). However, Ledger and Baker (2007) report a positive influence on other client areas of functioning, suggesting that future inquiry could investigate music therapy's support for quality of life with this client group. All included studies about other artistic arts therapies were from other countries. The geographic origin of other research was very diverse. Most studies were undertaken in the USA and Great britain, merely others came from Norway, Kingdom of denmark, Sweden, Spain, Turkey, Latvia, Korea and Brazil.

3 factors can potentially provide some insight for this dearth of Australian literature that fitted selection criteria. The first is the relatively emergent nature of research in these creative arts therapies internationally. For example, dance-move therapy research only appeared in the Cochrane Review for the beginning fourth dimension in 2009. The strongest body of literature is emerging from the USA and U.k., where these professions have been longest established. A 2nd and related gene is the famine of academy-based courses for these modalities in Australia. While music therapy has been established at the University of Melbourne since 1975, and is taught in 3 other Australian institutions, there are only two university-based programs for visual arts therapy; one course that includes a drama therapy bailiwick and no trip the light fantastic toe-movement or drama therapy grooming courses across the whole of Australia. Without the scaffolding of a university environment, the potential for a research culture to develop is very limited.

A third factor in this absence of controlled studies may be the potent valuing of qualitative research in arts therapy fields. The electric current review began with a relatively narrow focus on quantitative literature as requested past PACFA. These parameters were reduced fifty-fifty further when the calibration of the search task into v areas of unrelated literature became apparent. In the stop, only systematic reviews and randomised controlled trials were included in the last selection. While this approach fabricated the task of searching for material much more defined, it did preclude the growing body of qualitative literature being generated by artistic arts therapists in Australia and other countries. Research advancing and informing arts therapy fields is predominantly qualitative, reflecting the post-modernistic arts-based enquiry epitome in which it is nested, and the perspective that the arts contributes multiple ways of knowing and researching lived experience (come across for case, Heron & Reason, 1997; Hervey, 2000; Liamputton & Rumbold, 2008; McNiff, 2004). In music therapy this may exist a relatively new development, equally Australian music therapist Shoemark, writing in 2006, welcomes a growing trend towards qualitative approaches to music therapy research (Shoemark, 2006).

Conversely, there is as well an impetus amongst therapists from a range of countries for research that utilises quantitative methods. German researcher Brauninger, for example, sought to accost the "widespread prejudice in the field" (2012, p.449,) that quantitative methods cannot measure the effectiveness of DMT by undertaking a study using this arroyo to investigate the modality's effectiveness for stress management. Brauninger's (2012) piece of work also responds to the recognised challenge for creative arts therapists to evaluate and validate their exercise with evidence that is adequate in medical model settings (Gilroy, 2006; Heimes, 2011). Researchers who prioritise quantitative research probable recognise that databases such as the Cochrane, that as yet just includes quantitative studies, form the footing for testify-based decision-making in the health field. A review virtually a new expanse of inquiry that is published in the Cochrane database, regardless of its conclusiveness about effectiveness, is a strong starting point for further funded research. Funded enquiry is an essential pre-condition for a stiff evidence base because it facilitates larger scale and longer term data collection. This no dubiety was PACFA'southward impetus in focussing this literature search on quantitative research.

Another pregnant finding was the lack of clarity of understandings about what constitutes arts therapy. This issue was addressed past the criteria for the review, ie. that studies were excluded if they did not specifically identify a creative arts therapy modality, even if they involved arts participation that had a benign or therapeutic outcome. In this conclusion, the authors were informed past a definition used in the Cochrane Library, that music therapy, for instance, "requires the implementation of a music intervention past a trained music therapist, the presence of a therapeutic process, and the use of personally tailored music experiences" (Bradt, Dileo, Grocke & Magill, 2011, p. 2). The relationship betwixt client and therapist is considered to be one of the major vehicles of change in arts therapy, as with standard psychotherapy practise (Clarkson, 1996; Lett, 2001). While beneficial and even therapeutic experiences may be facilitated by professionals who are not trained therapists, this cannot be considered therapy. This specific understanding of arts therapy was not ubiquitous in the literature. While some researchers had a articulate formulation of arts therapy as a specific professional person practice, others discussed an application of the arts for some perceived benefit as therapy. In some cases, modalities were discussed differently within the aforementioned article, for case, 'creative drama' and 'drama therapy', every bit if these two were interchangeable. Studies in which this occurred were as well excluded. This gene contributed to the exclusion of all studies about writing as therapy.

A methodological challenge was that the majority of the studies in all modalities, even those included in the last selection, had small sample sizes and generally lacked follow-upwards or whatever longitudinal dimension. This indicates an important expanse for development of arts therapy enquiry.

Determination

This article reports a literature review on the effectiveness of creative or expressive arts therapies. Modalities investigated were music therapy, art therapy, dance-move therapy, drama therapy and writing therapy. Inclusion criteria for literature were systematic reviews and randomised controlled trials published in electronically available resource, in Australia over the by ten years, and internationally over the past five. A total of 25 articles were reviewed (music therapy 8, fine art therapy v, trip the light fantastic toe-movement therapy viii, and drama therapy iv). These were drawn from a sample of 78 studies that used quantitative methodologies to examine outcomes (music therapy 32, art therapy 12, dance-move therapy 26, drama therapy viii), from a larger initial pool of 281 articles. No studies for whatever kind of writing therapy were included in the concluding selection, as none were found that fitted the search criteria. Only 2 Australian studies, virtually music therapy, met the pick criteria and were included. Methodological weaknesses in all modalities, particularly the pocket-sized sample sizes and lack of follow-up or longitudinal research, betoken directions for time to come research.

Overall, despite many inconclusive studies, the effectiveness of creative arts therapies for a range of weather condition is indicated. For music therapy, these are adults experiencing cancer, terminal illness, dementia and depression, and children diagnosed with Autism Spectrum Disorder. For arts therapy these are mental affliction, asthma, depression and coping with chest cancer. For trip the light fantastic toe-movement therapy these are schizophrenia, cancer, depression, stress, emotional eating and dementia. Drama therapy has been documented to reduce behavioural issues for school students. However, all of these modalities are expert around the globe with a range of clients and weather far broader than these results would point, pointing to pregnant opportunities for further enquiry.

Iii factors provide insight into the famine of quantitative studies from Australia: the nascence of enquiry in these fields internationally; the paucity of university courses, and therefore research culture, in Commonwealth of australia; and the potent valuing of qualitative enquiry in arts therapy fields. A significant claiming identified in the literature was the lack of clarity of understandings about what constitutes arts therapy. Many studies discussed arts therapy and benefits from arts participation every bit if they were interchangeable, when accepted definitions of arts therapy conspicuously distinguish this from other forms of beneficial arts appointment.

Issues for the field of creative arts therapy in Australia include the lack of research being generated, and the inconclusive nature of those enquiry results. It is axiomatic that more high quality enquiry efforts are required. The authors recommend that further literature reviews also include qualitative enquiry in order that all of the bear witness for effectiveness of creative arts therapies be considered.

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Appendices

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Source: https://pacja.org.au/2014/07/the-effectiveness-of-expressive-arts-therapies-a-review-of-the-literature/