Research Update — June 2021

Jinag, X., Chen, X., Xie, Q., et al.
Effects of art therapy in cancer care: A systematic review and meta-analysis
European Journal of Cancer Care (2020); 29:e13277

ABSTRACT

Objective:
To evaluate the effect of art therapy on cancer patients’ quality of life and physical and psychological symptoms.

Methods: The databases PubMed, Embase, Web of Science, The Cochrane Library, Clinical Trial.gov, the China National Knowledge Infrastructure (CNKI), Wanfang, and the Chinese Biomedical Literature Database (CBM) were searched from their inception up to 20 August 2019. Trials examining the effects of art therapy on physical and psychological symptoms and quality of life versus a control group were included. The methodological quality of the included randomized controlled trials was assessed using the risk of bias tool of Cochrane Handbook. Meanwhile, the Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate the methodological quality of the non-randomized studies.

Results: Twelve studies involving 587 cancer patients were included. The results revealed that art therapy significantly reduced anxiety symptoms (standard mean difference [SMD] = −0.46, 95% confidence interval [CI] [−0.90, 0.02], p = .04), depression symptoms (SMD = −0.47, 95% CI [−0.72, 0.21], p < .01), and fatigue (SMD = −0.38, 95% CI [−0.68, −0.09], p = .01) in cancer patients. Art therapy also significantly improved the quality of life of cancer patients (SMD = 0.43, 95% CI [0.18, 0.68], p < .01).

Conclusion: Art therapy had a positive effect on quality of life and symptoms in cancer patients and can be used as a complementary treatment for cancer patients.

INSPIREHEALTH’S INTERPRETATION

The diagnosis and treatment of cancer may cause physical and psychological distress and disruption of social supports. Many cancer patients experience pain, anxiety, depression, and fatigue. These symptoms, in turn, can lead to poorer quality of life. Both pharmacological and non-pharmacological treatments are used for these symptoms.

Art therapy, a non-pharmacological therapy, is gaining increasing understanding, acceptance, and use in cancer treatment. Art therapies may include drama, music, and the specific treatment called art therapy. Art therapy is defined as a “psychotherapy involving the use of visual art-making (drawing, painting, sculpting, collage, etc.) for the purpose of expression and communication within a safe and supportive relationship….in a therapeutic setting lead by art therapists…”.

The authors of this paper systematically reviewed and analyzed the literature on art therapy and cancer. Twelve very good quality-controlled clinical trials involving 587 cancer patients were selected for their meta-analysis. Results indicated that art therapy had meaningful and statistically significant benefits for all measures of interest: depression, anxiety, fatigue, and overall quality of life.

The researchers postulate that the mechanism of art therapy’s positive effects may be related to the Mind-Body Model and/or the Attention Restoration Model (ARM).  In the Mind-Body model, art-making may allow pleasurable experiences to be embedded in one’s sensory and motor experiences. ARM was initially developed to help understand why time in nature is beneficial, but its concepts can readily be applied to art therapy. This model proposes that activities that encourage more effortless brain function (involuntary attention) may allow the brain to replenish its focused attention capacity.

The authors conclude that art therapy has pronounced positive effects on quality of life, anxiety, depression and fatigue, and is worthy of being recommended to all cancer patients as part of supportive care. InspireHealth offers both individual art therapy sessions and group art therapy workshops for cancer patients and their loved ones.