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The Effectiveness of Art Therapy: Does it Work?

a b c
Matthew W. Reynolds PhD , Laura Nabors PhD & Anne Quinlan ATR
a
Pharmacia, Skokie, IL
b
University of Maryland School of Medicine, Balitmore, MD
c
Second Step, Baltimore, MD
Published online: 22 Apr 2011.

To cite this article: Matthew W. Reynolds PhD , Laura Nabors PhD & Anne Quinlan ATR (2000) The Effectiveness
of Art Therapy: Does it Work?, Art Therapy: Journal of the American Art Therapy Association, 17:3, 207-213, DOI:
10.1080/07421656.2000.10129706

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 B rief Report
The Effectiveness of Art Therapy: Does it Work?

Matthew W. Reynolds, PhD, Skokie, IL, Laura Nabors, PhD, Baltimore, MD, and
Anne Quinlan, ATR, Baltimore, MD

Abstract support for the value of art therapy as a means of altering target-
ed problem behaviors among children.
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This current review of the literature attempts to identify all Our literature search included medical and psychological
published empirical evidence regarding art therapy effectiveness. The abstracts from MEDLINE and PsycINFO databases. The follow-
authors attempt to identify any outcome trends associated with study ing keywords were used: art, therapy, expressive, effectiveness,
design (single group with no control group, controlled clinical trial, efficacy, trial, outcomes, and study. Both adult and child-based
and randomized controlled clinical trial) and to review the overall art therapy studies were included. Furthermore, articles in the
literature base concerning art therapy effectiveness. The literature two premiere journals of the field, Art Therapy: Journal of the
search identifies 17 published studies which met the authors’ inclu- American Art Therapy Association and Arts and Psychotherapy, were
sion criteria. Results show that these three types of study designs pro- reviewed over the past decade. Studies selected for review met the
duce very similar results regarding the positive effects of art therapy, following criteria:
but their conclusions may appear very different. The clarification of
1. They assessed the impact of art therapy on a measurable
study design differences may lend some insight into the perceived
outcome (e.g., depression, self-esteem, behaviors, etc.).
effectiveness of art therapy.
2. The impact of treatment on a sample or treatment group
Introduction: Art Therapy and Lack of was assessed.
Effectiveness Studies Studies meeting these criteria were conceptualized as “effective-
ness” studies and divided into three distinct groups: the single
Art therapy practice involves the application of knowledge group with no control group designs, controlled clinical trial
about human emotional, social, and behavioral development. designs, and randomized clinical trial designs.
The roots of this discipline can be traced back to the early 1900s This current review of the literature attempted to identify all
(Junge, 1994). However, even with almost a century of wide- published empirical evidence regarding art therapy effectiveness.
spread clinical use, it is difficult to identify empirical evidence The goal was to identify any outcome trends associated with
regarding the effectiveness of this treatment. Much of the pub- study design and to review the overall literature base concerning
lished literature on art therapy focuses on theoretical concepts art therapy effectiveness.
and the results of case studies. Case studies are useful for descrip-
tive purposes and generating hypotheses, but they provide little Single Group — No Control Group
evidence about outcomes associated with art therapy. Controlled
studies, particularly randomized trials, are much better suited to The majority of studies uncovered in our search showed that
provide this information. the most prevalent type of study design used to investigate the
Experimental treatment protocols are becoming more pop- effects of art therapy was the single group with no control group
ular for this discipline. Several recent issues of Art Therapy: design (most using a pre-post design). These studies focus on one
Journal of the American Art Therapy Association (Volume 15, study group that received art therapy and compare some outcome
Issues 1 and 2) have focused on the importance of incorporating measure score before an art therapy intervention and then again
research into the practice of art therapy. In an effort to summa- after the intervention. Eight such studies were identified in the
rize previous literature, Burleigh and Beutler (1997) conducted a empirical literature (Table 1) (Chin, Chin, Palombo, Palombo,
review of art therapy effectiveness studies. Their final report Bannasch, & Cross, 1980; Dolgin, Somer, Zaidel, & Zaizov,
included a study with no control group (Musik, 1976), one ran- 1997; Fryrear & Stephens, 1988; Harvey, 1989; Rosal,
domized controlled trial (White & Allen, 1971), and two case McCulloch-Vislisel, & Neece, 1997; Silver & Lavin, 1977;
studies (Stanley & Miller, 1993; Linesch, 1988). Since they did Springer, Phillips, Phillips, Cannady, & Kerst-Harris, 1992;
not find “a critical mass of well-controlled studies,” they con- Theorell, Konarski, Westerlund, Burell, Engstron, Lagercrantz,
cluded that the studies they identified provided only suggestive Teszary, & Thulin, 1998). Study samples consisted primarily of

Matthew W. Reynolds, PhD, is a Senior Analyst for Pharmacia in Skokie, IL. Laura Nabors, PhD, is an Assistant Professor, Department of Child and
Adolescent Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland. Anne Quinlan, ATR, is an Art Therapist at Second Step, Inc.,
Baltimore, Maryland. Correspondence may be directed to the first author at 826 West Buckingham Pl, Apt 2F, Chicago, IL 60657, or at m_reynold@yahoo.com.
207
 208 EFFECTIVENESS OF ART THERAPY

Table 1
Single Group with No Control Group Studies of Art Therapy Effectiveness

Sample Group Intervention Amount of

Author Size Description & Treatments Therapy Outcomes Measured Results

Springer 71 Children of Creative 12 weeks, Achenbach Child Behavior Significant improvement

(1992) alcoholics and therapy once a week Checklist in competencies and
drug users program for 90 behavior problems.
minutes

Theorell 24 Patients with Art Average of General Health Significant improvement

(1998) long-lasting psychotherapy 2 years in Questionnaire (daily func- in anxiety-depression
somatic therapy tioning, anxiety, depression, score. Nonsignificant bor-
symptoms somatic complaints, etc.) derline improvement in
psychosomatic symptoms.

Dolgin 23 Siblings of Group interven- 6 weeks, Feelings and Attitudes Significant gains in
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(1997) children with tion that included one session Questionnaire (regarding cancer-related knowledge,
cancer art therapy per week cancer experience); Mood mood, communication,
Questionnaire; and and intra/inter personal
Satisfaction Questionnaire feelings.

Silver 11 Children Art therapy 10 weeks, Ability to associate and Significant improvements
(1977) with learning designed to devel- one session represent, ability to per- in ability to form groups,
disabilities op, evaluate ability per week for ceive and represent, and order a matrix, and spatial
to order, perceive, 1 hour ability to order a matrix orientation.
associate, and rep-
resent components

Chin 7 “Educationally Art therapy, social 4 weeks, Self-reported “How I Felt Significant 4-week change
(1980) underserved” skills training, and 5 times a Scale”; and teacher/thera- in self-esteem and teacher-
adolescents video therapy week for pist-rated Behavior rated social skills.
3 hours Checklist

Fryrear 8 Patients in Group art/video 6 weeks, Minnesota Multiphasic No significant 6-week

(1988) individual therapy one session Personality Inventory changes in psychiatric
therapy per week (psychiatric symptoms); symptoms, but some sig-
and Personal Orientation nificant improvement on
Inventory (self-actualiza- self-actualization subscales.
tion)

Harvey 56 Elementary Music/Art/Dance 12 weeks, Harter Scales (self-con- Significant improvement

(1989) school students Therapy twice weekly cept); Torrance Test of in creative thinking and
for 30 Creative Thinking (cre- reading comprehension,
minutes ative thinking); and but no significant change
Woodcock Reading in self-concept.
Mastery Tests (reading
comprehension)

Rosal 50 9th grade Art therapy 9 sessions Jefferson County Public Significant decrease
(1997) students additive to (one per Schools Student Attitude in scores from Student
English classroom month) dur- Inventory (attitudes about Attitude Inventory
ing regular school, family, and self ); (attitudes toward school,
class period failing grades; and family, and self )
dropouts
 REYNOLDS / NABORS / QUINLAN 209

children and adolescents (Chin, Chin, Palombo, Palombo, and posttherapy measures for the dependent or outcome meas-
Bannasch, & Cross, 1980; Dolgin, Somer, Zaidel, & Zaizov, ure. Most of these studies found significant improvements in the
1997; Harvey, 1989; Rosal, McCulloch-Vislisel, & Neece, 1997; main outcome of interest as well as many of their secondary out-
Silver & Lavin, 1977; Springer, Phillips, Phillips, Cannady, & come variables. The CODA study (Springer, Phillips, Phillips,
Kerst-Harris, 1992), but most other facets of these studies such Cannady, & Kerst-Harris, 1992) found that behavior problems,
as amount of therapy provided to participants, outcomes meas- as measured by the Child Behavior Checklist, improved by over 4
ured, and sample sizes were very heterogeneous. Samples includ- points (p < 0.001) and competencies improved by 2.7 points (p
ed children of substance abusers (Springer, Phillips, Phillips, = 0.018) over a 12-week period in boys and girls aged 3 to 11
Cannady, & Kerst-Harris, 1992), siblings of children with cancer years. Another study (49) found significant increases in self-
(Dolgin, Somer, Zaidel, & Zaizov, 1997), children with learning esteem (p = 0.05) in seven “educationally underserved” adoles-
disabilities (Silver & Lavin, 1977), students (Harvey, 1989; cents as determined by a self-rating scale after 4 weeks of therapy.
Rosal, McCulloch-Vislisel, & Neece, 1997), psychotherapy One other study (Theorell, et al., 1998) found significant
patients (Fryrear & Stephens, 1988), and patients with chronic improvement in global health (p = 0.045) and borderline signifi-
somatic complaints (Theorell, et al., 1998). Sample sizes were rel- cant improvement in anxiety-depression scores (p = 0.069), as
atively small, ranging from 7 (Chin, Chin, Palombo, Palombo, measured by the General Health Questionnaire, in a group of 24
Bannasch, & Cross, 1980 ) to 71 participants (Springer, Phillips, patients with long-lasting somatic symptoms. These results were
Phillips, Cannady, & Kerst-Harris, 1992) with the majority of obtained after an average of 2 years of art therapy. Overall,
studies having less than 25 participants (Chin, Chin, Palombo, despite the heterogeneity in samples and therapy, the findings
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Palombo, Bannasch, & Cross, 1980; Dolgin, Somer, Zaidel, & provide suggestive evidence of positive effects due to art therapy.
Zaizov, 1997; Fryrear & Stephens, 1988; Silver & Lavin, 1977;
Theorell, et al., 1998). Amount of therapy was also varied, rang- Controlled (Nonrandomized) Studies
ing from 1 hour per week for 6 weeks (Dolgin, Somer, Zaidel &
Zaizov, 1997; Fryrear & Stephens, 1988) to an average of over 2 Four controlled clinical trials (nonrandomized controlled
years of therapy (Theorell, et al., 1998). studies) were identified (Table 2) (Brooke, 1995; Schut, De
Given the diversity of patient populations, it is not surpris- Keijser, Van Den Bout, & Stroebe, 1996; Tibbets & Stone, 1990;
ing to see a wide variety of outcomes measured in these studies, Waller, 1992). Controlled clinical trials include nonrandomized
including behaviors, psychosomatic symptoms, anxiety, depres- study groups where one group receives an art therapy interven-
sion, social skills, grades, school dropouts, and many others. tion and then at least one other group receives standard therapy
Typical analyses of these areas were based on comparisons of pre- or no therapy. Each group is measured on some outcome meas-

Table 2
Controlled (Nonrandomized) Trials of Art Therapy Effectiveness

Sample Group Intervention Amount of

Author Size Description & Treatments Therapy Outcomes Measured Results

Waller 15 Adult female Art therapy vs. 8 weeks, Curative Climate Significant improvement
(1992) (3/7/5) incest survivors verbal therapy vs. once a week Instrument (catharsis, in art therapy group in
individual therapy for 90 cohesion, and insight) insight, value of catharsis,
minutes and value of cohesion, but
no significant differences
between the two groups.

Schut 69 Patients Behavior and art 20 sessions General Health No significant differences
(1996) (52/17) needing grief therapy vs. regular for 2 hours Questionnaire (daily func- in changes between two
therapy therapy for each for 3 tioning, anxiety, depression, groups. Analyses showed
bereavement months somatic complaints, etc.) that experimental therapy
showed nonsignificantly
greater magnitude of change.

Brooke 11 Sexual abuse Art therapy vs. 8 weeks, Culture Free Self-Esteem No significant difference in
(1995) (6/5) survivors control group 2 hours Inventory 8-week self-esteem changes.
per week

Tibbetts 20 Seriously Art therapy vs. 6 weeks, Burks Behavior Rating Significantly greater reduc-
(1990) (10/10) emotionally socialization once a week Scale; and Roberts tion in level of depression
disturbed activities for 45 Apperception Test for experimental group as
children minutes (personality, social and compared to control group.
emotional functioning) No significant differences
across groups for changes
in behavior ratings.
 210 EFFECTIVENESS OF ART THERAPY

ure at baseline and then again at the end of the intervention peri- A study of 15 adult female incest survivors (Waller, 1992)
od. The changes in the outcome measures are then compared compared patients receiving art therapy to patients receiving ver-
across the two study groups. bal therapy and to patients receiving individual psychotherapy.
A 1990 study (Tibbets & Stone, 1990) randomly selected 20 There were five patients in each treatment group. The 15 partic-
adolescents from a population of 130 adolescents enrolled in the ipants had a mean age of 35, and they reported a history of abuse
Los Angeles County Office of Education Special Class Alternative lasting an average of 10 years. All groups met for therapy once a
Setting. Students were placed in either an experimental group to week for 90 minutes for a span of 8 weeks. The art therapy group
receive weekly art therapy sessions or in a control group to receive showed significant improvement in insight, value of catharsis,
weekly activities (board games, taking walks, talking, etc.). The goal and value of cohesion, but the gains were not significantly greater
was to determine if short-term art therapy was an effective method than those of either the verbal therapy or the individual psy-
of changing the emotional and behavioral status of seriously emo- chotherapy groups. This might have been the result of a small
tionally disturbed (SED) adolescents. The intervention occurred sample size or the short duration of the intervention.
once a week for 45 minutes and lasted for 6 weeks; the sessions for Another study also investigated the use of art therapy for 11
the control group lasted the same amount of time. The findings sexual abuse survivors in relation to improvement in self-esteem
were that the art therapy group had a significantly greater reduction (Brooke, 1995). The study participants had an average age of 42,
than the control group in level of depression and an increased level and they were placed in either an art therapy group or a control
of positive emotions and expressed pride in themselves. group (which appeared to receive regular services at the women’s
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Table 3
Randomized Controlled Trials of Art Therapy Effectiveness

Sample Group Intervention Amount of

Author Size Description & Treatments Therapy Outcomes Measured Results

Kymissis 37 Adolescent Synallactic 2 weeks, Children’s Global No significant differences

( 1996) (18/19) psychiatric Collective Image four meet- Assessment Scale (general in changes in outcomes
inpatients Therapy vs. Open ings per functioning); and between the two groups.
discussion group week Inventory of Interpersonal
Problems (interpersonal
distress)

Omizo 50 Elementary Art activities vs. 10 sessions, Culture Free Self-Esteem Children in art activity
( 1989) (25/25) school students regular routines 45-60 Inventory group had significantly
minutes each greater improvement in
social peer-related self-
esteem and school-related
self-esteem as compared to
children in control group.

White 30 Boys just Art counseling 8 weeks, Tennessee Self-Concept Art counseling group
(1971) (15/15) completing vs. nondirective 5 days per Scale had significantly greater
sixth grade counseling week for at improvement in self-
least 90 concept compared to
minutes control group.

Rosal 36 Children with Cognitive- 10 weeks, The Children’s Nowicks- No significant differences
(1993) (12/12/12) moderate to behavioral art twice weekly Strickland Internal- in treatments, but subjects
severe behav- therapy vs. art for 50 External Locus of Control; in both treatment condi-
ioral problems as therapy vs. minutes and Conners Teacher tions made non-significant
control group Rating Scale (classroom greater gains toward locus
behavior) of control norms than the
control group.

Green 28 Chronic Regular therapy 10 sessions Rosenberg Self-Esteem; Significantly greater

(1987) (11/17) psychiatric vs. art therapy plus every other and Progress Evaluation improvements for experi-
patients regular therapy week for 90 Scales (psycho-social func- mental group in attitudes
minutes tioning, family interaction, toward self and getting
feelings, moods, etc.) along with others as com-
pared to control group.
No significant difference
for change in self-esteem
between the two groups.
 REYNOLDS / NABORS / QUINLAN 211

center). The patients in the art therapy group received 2 hours A study by Rosal (1993) used three study groups to investi-
of art therapy, once a week, for 8 weeks. After the completion of gate the effectiveness of art therapy in affecting locus of control
therapy, the art therapy group did not exhibit a significant in children with behavior problems. The three groups were a
change in self-esteem, and there were no significant differences cognitive-behavioral art therapy group, an art-as-therapy group,
in changes in self-esteem between the art therapy and the con- and a control group. The cognitive-behavioral art therapy group
trol group. used an art therapy intervention complemented by a behavioral
The largest nonrandomized controlled trial was a study of 69 therapy component (i.e., relaxation, problem-solving techniques,
older patients (mean age of 52) in bereavement therapy (Schut, etc.). The art-as-therapy group was an unstructured intervention
De Keijser, Van Den Bout, & Stroebe, 1996) in which a compar- that provided an array of art media and encouraged the children
ison was made between regular bereavement therapy and regular to be creative. There was no description of the control group
therapy with an additional art therapy component. Participants regarding any attention or services that the control participants
were given 20 sessions of therapy over a 3-month period (12 received. Thirty-six students in fourth, fifth, and sixth grade who
behavior therapy sessions and 8 art therapy sessions). Outcome were identified by the Conners’ Teacher Rating Scale as having
changes were examined using the General Health Questionnaire moderate to severe behavior problems were randomly assigned to
(GHQ). Analyses suggested that the experimental therapy provid- the three study groups. There were no significant differences
ed a greater magnitude of change, but there were no significant among the three groups in most outcome measures, but subjects
differences in GHQ changes between the two groups. in both treatment groups demonstrated greater improvement in
The findings for these studies suggest equivocal results, not locus of control than the control group.
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unconditional support for art therapy. The most recent publication of a randomized trial of art
therapy effectiveness was in 1996 (Kymissis, Christenson,
Randomized Controlled Trials Swanson, & Orlowski, 1996). This study included 37 adolescent
psychiatric patients who met four times per week for 2 weeks.
The review identified five randomized controlled studies This study randomized the participants to either a structured
that focused on art therapy effectiveness (Table 3) (Green, group therapy component (involving art therapy) or an open dis-
Wehling, & Talsky, 1987; Kymissis, Christenson, Swanson, & cussion group, and used the Children’s Global Assessment Scale
Orlowski, 1996; Omizo & Omizo, 1989; Rosal, 1993; White & and the Inventory of Interpersonal Problems as outcome meas-
Allen, 1971). The randomized controlled clinical trial is similar ures. After the completion of therapy, both groups showed sig-
to the controlled clinical trial except that study participants are nificant improvement in mental health as gauged by the outcome
randomized to the study groups, thus helping to assure compara- measures, but there was no significant difference between the
ble study groups. groups on any outcome measure.
A study by White and Allen (1971) investigated whether Overall, the randomized controlled trials showed mixed
preadolescent boys would show greater growth in self-concept results. Art therapy was related to significant improvement in
from a counseling-centered art program as compared to an inten- self-esteem in a sample of boys who just completed sixth grade
sive, nondirective counseling program. The study included boys (White & Allen, 1971). Art therapy was also related to improve-
who had just completed the sixth grade and were enrolled in the ment in two of four possible self-esteem subscales in a sample of
summer program of the North Carolina Advancement School; elementary school students (Omizo & Omizo, 1989), but no
15 boys, blinded to the study purpose, were randomized to each relationship was found between art therapy and self-esteem
study group. Counseling was very intensive with sessions lasting improvement in a group of chronic psychiatric patients. The
90 minutes or more, 5 days a week for 8 weeks. The study found group of randomized controlled trials also failed to find any rela-
that the art counseling was significantly more effective in improv- tionship between art therapy and improvement in general func-
ing the adolescents’ self-esteem; these improvements remained tioning, locus of control, and classroom behaviors.
relatively stable in the 14-month follow-up. The improvement in self-esteem as evidenced by the studies
Green, Wehling, and Talsky (1987) published a report of a from White and Allen (1971) and Omizo and Omizo (1989) pro-
randomized controlled trial of regular verbal therapy compared to vide some suggestion of art therapy effectiveness, but in limited
art therapy in combination with regular verbal therapy for a fashion. The art therapy program used by White and Allen (1971)
group of 28 chronic psychiatric patients. The average age of the was a comprehensive program that children participated in 5 days
patients was 40, and they received 10 therapy sessions every other a week for a minimum of 90 minutes and lasting for 8 weeks. The
week geared at improving self-esteem. The experimental group study by Omizo and Omizo (1989) showed self-esteem improve-
displayed significant improvements in the Attitudes Toward Self ment in social peer-related self-esteem and school-related self-
scale and the Getting Along with Others scale, but there was not esteem, but no improvement in parents’ home-related self-esteem,
significantly more improvement in the experimental group as or more importantly, general self-esteem.
compared to the control group.
A study by Omizo and Omizo (1989) included 50 children Conclusion
from the fourth and sixth grades attending a Hawaiian elemen-
tary school. The 50 children were randomly assigned to receive The clarification of study design differences may lend some
either art therapy or their regular school routine (no therapy). insight into the perceived effectiveness of art therapy. In the few
They used a 10-session art therapy program aimed at improving studies that have been performed, art therapy appears to be effec-
self-esteem where children met once a week for 45 to 60 minutes. tive, but not usually more effective than the standard therapy.
The study found that children in the study who participated in The three main types of art therapy effectiveness studies are the
the art therapy sessions had significantly higher social/peer- single group design, the nonrandomized controlled trial, and the
related and academic/school-related self-esteem when compared randomized controlled clinical trial. Generally, these three types
to children who did not participate in the groups. of study designs produce similar results regarding the positive
 212 EFFECTIVENESS OF ART THERAPY

effects of art therapy, but their conclusions may appear different. plicates their identification. Furthermore, better operationaliza-
The single group design shows a positive effect of art therapy and tion and clearer definitions of the different therapies are needed
concludes that art therapy is effective in that population. The to decipher what components of art therapy are related to posi-
controlled clinical trials and randomized controlled clinical trials tive outcomes.
also show a positive effect of art therapy, as well as a positive effect From the point of view of a researcher, our most difficult
from other types of comparison treatments, resulting in no sig- task is usually identifying and recruiting participants for research
nificant additional beneficial effect of art therapy. studies. Art therapists have the benefit of working with clientele
Many of these previous studies combine art therapy with who are usually happy to complete an extra form or two in
other interventions (Chin, Chin, Palombo, Palombo, Bannasch, exchange for therapy. Collaborative effort between researchers
& Cross, 1980; Fryrear & Stephens, 1988; Harvey, 1989; Rosal, and art therapists may improve the ability of clinicians in this
McCulloch-Vislisel, & Neece, 1997; Schut, De Keijser, Van Den field to conduct large-scale effectiveness studies assessing the
Bout, & Stroebe, 1996), making it impossible to determine the impact of art therapy.
actual effect of art therapy itself. Additionally, most of the reports
of the art therapy studies do not include a detailed description of References
goals and procedures for each art therapy session. The lack of
standardization and reporting of art therapy methods questions Brooke, S. L. (1995). Art therapy: An approach to working with sexual
the validity and usefulness of any significant results that may abuse survivors. The Arts in Psychotherapy, 22, 447-466.
come from these art therapy evaluation studies.
Downloaded by [University of Western Ontario] at 23:35 07 October 2014

To be useful the previously mentioned effective art therapy Burleigh, L. R., & Beutler, L. E. (1997). A critical analysis of two creative
arts therapies. The Arts in Psychotherapy, 23, 375-381.
interventions should be outlined and described so that they can
be replicated by another therapist. None of the studies in this Chin, R. J., Chin, M. M., Palombo, P., Palombo, C., Bannasch, G., &
review provided that sort of detailed description of their therapy Cross, P. M. (1980). Project Reachout: Building social skills through
on a session-by-session basis. Other validity problems are also evi- art and video. The Arts in Psychotherapy, 7, 281-284.
dent. For example, is an art therapy intervention found to be
effective for sixth graders also effective for elementary school chil- Dolgin, M. J., Somer, E., Zaidel, N., & Zaizov, R. (1997). A structured
dren? The same issues arise regarding setting, race, gender, and group intervention for siblings of children with cancer. Journal of
other demographic variables. The small sample sizes of these Child and Adolescent Group Therapy, 7, 3-18.
studies do not allow the use of secondary analyses to examine the
effects of these demographic differences. Fryrear, J. L., & Stephens, B. C. (1988). Group psychotherapy using
Additionally, it is difficult to draw many conclusions from this masks and video to facilitate intrapersonal communication. The Arts
in Psychotherapy, 15, 227-234.
pool of art therapy studies because of the vast heterogeneity in type
of participants, age groups, amount of therapy, outcome measure- Green, B. L., Wehling, C., & Talsky, G. J. (1987). Group art therapy as
ment, the treatment goals and directives of the art therapy and con- an adjunct to treatment for chronic outpatients. Hospital and
trol groups, and the small sample sizes. Larger sample sizes will Community Psychiatry, 38, 988-991.
allow researchers to better distinguish differences among art thera-
py and comparison groups, as well as allow some control for con- Harvey, S. (1989). Creative arts therapies in the classroom: A study of
founding/mediator and moderator variables in the samples. cognitive, emotional, and motivational changes. American Journal of
Replication of studies would be beneficial to understand and sup- Dance Therapy, 11, 85-100.
port previously reported outcomes. Cost-benefit studies of art ther-
apy compared to other treatments would be an important contri- Junge, M. B. (1994). A history of art therapy in the United States.
bution to the field, since art therapy is a relatively inexpensive ther- Mundelein, IL: American Art Therapy Association, Inc.
apy. Additionally, as the number of art therapy effectiveness stud-
Kymissis, P., Christenson, E., Swanson, A. J., & Orlowski, B. (1996).
ies increases, more complicated meta-analyses will be possible.
Group treatment of adolescent inpatients: A pilot study using a struc-
More focused research needs to be performed on outcomes tured therapy approach. Journal of Child and Adolescent Group
to gain more widespread support for art as an effective treatment Therapy, 6, 45-52.
for psychological problems. Prior art therapy research is general-
ly lacking in sound study design for determining the effectiveness Linesch, D. G. (1988). Adolescent art therapy. New York: Brunner/Mazel.
of an art therapy intervention. Only five randomized controlled
studies have been published which address this issue. Although Malchiodi, C. A. (1997). Breaking the silence—Art therapy with children
these address the effects of art therapy treatment, the study par- from violent homes. (2nd ed.). Bristol, PA: Brunner/Mazel.
ticipants and study designs allow for too much variability. More-
over, some of the target populations for art therapy, such as trau- Musik, P. L. (1976). Special child— special growth: Developmental art
matized children (Malchiodi, 1997), have yet to be studied therapy. Art Psychotherapy, 3, 135-144.
regarding the effectiveness of therapy. Research has not yet shown
Omizo, M. M., & Omizo, S. A. (1989). Art activities to improve self-
that certain groups, such as children or sexual abuse victims, esteem among native Hawaiian children. Journal of Humanistic
respond positively to art therapy so that this modality is appro- Education and Development, 27, 167-176.
priate to treat behavioral and psychological symptoms. For exam-
ple, more than 50% of the studies reviewed focused on children Rosal, M. L. (1993). Comparative group art therapy research to evaluate
and adolescents. Many other appropriate target groups for art changes in locus of control in behavior disordered children. The Arts
therapy may exist, but the lack of published research only com- in Psychotherapy, 20, 231-241.
 REYNOLDS / NABORS / QUINLAN 213

Rosal, M. L., McCulloch-Vislisel, S., & Neece, S. (1997). Keeping stu- Theorell, T., Konarski, K., Westerlund, H., Burell, A., Engstron, R.,
dents in school: An art therapy program to benefit ninth-grade stu- Lagercrantz, A., Teszary, J., & Thulin, K. (1998). Treatment of
dents. Art Therapy: Journal of the American Art Therapy Association, 14, patients with chronic somatic symptoms by means of art psychother-
30-36. apy: A process description. Psychotherapy and Psychosomatics, 67, 50-
56.
Schut, H. W., De Keijser, J., Van Den Bout, J., & Stroebe, M. S. (1996).
Cross-modality grief therapy: Description and assessment of a new Tibbets, T. J., & Stone, B. (1990). Short-term art therapy with seriously
program. Journal of Clinical Psychology, 52, 357-365. emotionally disturbed adolescents. The Arts in Psychotherapy, 17, 139-
146.
Silver, R. A., & Lavin, C. (1977). The role of art in developing and eval-
uating cognitive skills. Journal of Learning Disabilities, 10, 416-424. Waller, C. S. (1992). Art therapy with adult female incest survivors. Art
Therapy: Journal of the American Art Therapy Association, 9, 135-138.
Springer, J. F., Phillips, J. L., Phillips, L., Cannady, L. P., & Kerst-Harris,
E. (1992). CODA: A creative therapy program for children in fami- White, K., & Allen, R. (1971). Art counseling in an educational setting:
lies affected by abuse of alcohol or other drugs. Journal of Community Self-concept change among pre-adolescent boys. Journal of School
Psychology, 55-74. Psychology, 9, 218-224.

Stanley, P. D., & Miller, M. M. (1993). Short-term art therapy with an

adolescent male. The Arts in Psychotherapy, 20, 397-402
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