Suitability of the art therapy room and changes in outcome measures in the education system

A Scoping Review on the Use and Potential of School-Based Drama Therapy to Enhance Socio-emotional Skills in Early Childhood

Drama therapy incorporates play, imaginary engagement, embodiment, and perspective taking to promote interpersonal skills and affective functioning. Existing school-based drama therapy (SBDT) research has demonstrated utility with select populations; however, much of the SBDT literature has featured disparate findings. Absent from the current literature is a thorough synthesis of the benefits of SBDT for socio-emotional development in early childhood, an age cohort that may be well suited for drama therapy due to the method's theoretical and practical focus on action, symbolism, and play. A scoping review was conducted to answer the research question: What is the use and potential of SBDT to enhance socio-emotional skills in early childhood? Following a thorough database and manual search, 406 articles were identified and, after screening, 16 articles met the inclusion criteria. Based on the results, practice recommendations include the use of metaphor, distance, and life-drama connection to enhance socio-emotional skills, using dramatic play as a tool to address adverse experiences, and applying SBDT to support specific clinical populations. Policy recommendations include the use of SBDT within a public health trauma approach and the need for ecological integration of SBDT into schools. Research recommendations include the need for a broad-level articulation of a scaffolded SBDT research agenda in schools focused on socio-emotional skills and recommendations specific to methodological and reporting rigor.

Artmaking in Elementary School Art Therapy: Associations with Pre-Treatment Behavioral Problems and Therapy Outcomes

Engaging in artmaking is one of the key components of art therapy. Theoretical conceptualizations posit that artmaking is not only influenced by the mental state of the artmaker, but can also modify it. The quantitative longitudinal study reported here examined these assumptions in the context of school art therapy. Seventy-seven elementary school students in art therapy in Israel completed the Art Based Intervention Questionnaire (ABI) three times during the therapy year. Their parents and homeroom teachers reported on the students’ behavioral and emotional problems on the Child Behavior Checklist (CBCL for parents, and TRF version for teachers). The results indicated an inverse correlation between the students’ externalizing and mixed problems before starting treatment and these clients’ experiences of artmaking during the first month of therapy. A regression model for predicting gain scores on the TRF internalizing problem indices was significant, whereas the significant regression predictor was the students’ experience of artmaking at T1. These findings provide initial support for an association between the experience of artmaking and mental state, and an improvement in mental state, and are discussed in relation to the context of school art therapy.

Feasibility, acceptability, and effectiveness of school-based dance movement psychotherapy for children with emotional and behavioral difficulties

Background

Schools have been increasingly employing dance movement psychotherapists to support children cope with daily worries and stress, express and understand their emotions, develop self-awareness and self-esteem. However, evidence on the impact of dance movement psychotherapy as a tool for prevention of mental health difficulties in childhood remains limited.

Methods

Sixteen children (aged 7–9) with mild emotional and behavioral difficulties from two primary schools were randomly assigned to a Dance Movement Psychotherapy (DMP) intervention or to a waiting list, within a larger pilot cross-over randomized controlled study which aimed to (a) test whether all elements of study design can work together and run smoothly in a full-scale RCT; and (b) investigate the effectiveness of arts therapies in improving children’s health related quality of life (HRQOL; EQ-5D-Y), wellbeing and life functioning (Child Outcome Rating Scale; CORS), emotional and behavioral difficulties (Strengths and Difficulties Questionnaire; SDQ), and duration of sleep (Fitbits). The therapeutic process was also evaluated through interviews with children, participant observations, the Children’s Session Rating Scale (CSRS), and ratings of adherence to the therapeutic protocol.

Results

The findings indicated that DMP led to improvements in children’s life functioning, wellbeing, duration of sleep, emotional and behavioral difficulties, but not in quality of life. The improvements were maintained at the follow-up stages, up to 6 months post-intervention. Interviews with children also suggested positive outcomes, such as self-expression; emotional regulation; mastery and acceptance of emotions; improved self-confidence and self-esteem; reduced stress; and development of positive relationships. However, children would have preferred smaller groups and longer sessions.

Conclusion

This study indicated that all outcome measures would be suitable for inclusion in a larger randomized controlled trial, though the EQ-5D-Y is not recommended as a stand-alone measure due to its lack of sensitivity and specificity for young participants. The adherence to the therapeutic protocol ratings differed between children and adults, highlighting the need to include children’s voice in future research. Strategies are also proposed of how to conduct randomization of participants in ways that do not hinder the therapeutic process.

Qualitative and Arts-Based Evidence from Children Participating in a Pilot Randomised Controlled Study of School-Based Arts Therapies

(1) Background: There is limited evidence on the impact of arts therapies as a tool for the prevention of mental health difficulties in childhood. This pilot randomised controlled study aimed to investigate the impact of arts therapies on children’s mental health and well-being; the qualitative and arts-based evidence is presented in this article. (2) Methods: Sixty-two children (aged 7–10) with mild emotional and behavioral difficulties were recruited across four primary schools and were randomly assigned to either art therapy, music therapy, dance movement therapy, or dramatherapy. All children were interviewed individually after their participation in arts therapies. (3) Results: Children verbally and artistically expressed that they experienced positive changes in their mental health and well-being, such as improved self-expression, safety, empowerment, hope, and optimism for the future. The arts were particularly important for expressing complex emotions and feelings that cannot be easily verbalised. Recommendations are provided to improve the quality of group arts therapies in future interventions, such as through smaller groups, longer sessions, and strategies to protect the therapeutic environment. (4) Conclusions: This study embraced all arts therapies as one research domain and set children’s verbal and non-verbal responses at the heart of outcome evaluation. This article highlights the importance of incorporating qualitative and arts-based methods to capture changes in children’s mental health well-being in future experimental studies.

Perceptions of Art Therapy in Adolescent Clients Treated Within the School System

Research in School-Based Art Therapy has been widely discussed in recent years, and the number of studies that examine staff perceptions and the special characteristics of art therapy within the education system has risen considerably. The current study explored the critical issue of adolescent clients' perceptions of art therapy in school, from their point of view as clients. The methodology and data analysis were conducted according to the principles of Consensual Qualitative Research (CQR). The sample was composed of 12 adolescent clients, aged 14-18 (M = 16), who took part in in-depth semi-structured interviews. The findings were organized into five domains that emerged from the interviews: referrals and initial engagement with therapy, the setting within school, the nature of art therapy at school, the relationship with the art therapist, and the impact of art therapy on these clients. The analysis revealed that although some participants initially agreed to art therapy because it got them out of class and let them have fun instead, they realized after a period of time of art therapy that they were engaged in a personal and emotional process focusing on them which allowed them to express their feelings without the fear of judgment. Participants at times used the word "mother" to describe their relationship with the art therapist, and stated that the presence of the art therapist at school made them feel safer and helped them deal with day-to-day problems. School-based art therapy was seen as having specific advantages according to the participants. Having a therapeutic hour during a stressful school day was considered to give these students an opportunity to relax, and the art therapy room was perceived as a shelter. In addition, when the therapist was perceived as a supportive figure, the whole school experience tended to be perceived as supportive or enabling greater acceptance.