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Renowned art therapist and research psychologist Dr Cathy Malchiodi explains the relevance of art-based therapy in healthcare today, and how patients can find common healing grounds in art-based therapy, at SingHealth’s Academic Hour, 15 February 2017.

A heart transplant patient and a US Marine Corps captain. As disparate as they can be, both found critical healing from art-based therapy – this is how accessible and indiscriminating it is in helping patients.

"When I was 16 years old I had a heart transplant. I was in the hospital for three months... I remember writing [a letter] to my heart, asking it to please work with me," Stephanie Paseornek described of her harrowing experience. "Even though some people think that art is not the same as medicine, it was my medicine. And I think that without it I would still have been sick."

Captain Jason Berner of the US Marine Corps also found respite from post-traumatic stress disorder (PTSD) with art therapy after war. A deep sceptic at the beginning, the soldier learnt how art allowed him to communicate his emotions in ways he felt safe.

"I found that each time I did something with art therapy, I felt better because there was something in me that was dying to get out. And through art I was able to express it... I would never had talked about what this meant," Captain Berner said. [source video]

Relevance of Arts in Healthcare

Dr Malchiodi shared that what Stephanie and Captain Berner experienced have been verified by studies which showed quantifiable data on how art-based therapeutic treatments have brought benefits to patients. There is much exciting research going on in art therapy in the past 7 to 10 years, as well as in other areas of creative arts therapies.

Creative arts or expressive arts therapies have existed for 50 to 70 years but are only formally recognised in the last 20 as educational programmes with certification and formal registration.

Dr Malchiodi works with the Department of Defence of USA in creating programmes for military personnel and their families. In fact, the military is a large adopter of art therapy services in the USA.  Evaluations of the art-based programme showed that it increases the ability to talk about traumatic experience and resolve symptoms of Post-traumatic Stress Disorder (PTSD).

"Art reconnects the language centre through visual expression. It allows people to talk about their traumatic events and resolve their symptoms in that way," Dr Machioldi said.

We are only beginning to learn how art therapy can be combined with other evidence-based treatments, as a value-added approach with better outcomes compared to physical and/or cognitive behavioral therapies alone.

Tangible Changes

A number of studies (see box) have also provided insight into the value and strength of art therapy in healing patients: It Increases emotional and impulse, decreases cortisol and lowered blood pressure, and reduces perceptions of pain and fatigue.

Most hospitals in USA uses art therapy in cancer care and gear it towards psychosocial intervention. In cancer patients, it helps decrease symptoms of stress and perception of pain, improves perception of quality of life, increases compliance in treatment in paediatric patients and improves physical and emotional well-being in adults.

The late Dr Gene Cohen, author of "The Creative Age", also proved that creative therapy can help in the ageing process by increasing the number of essential connections in brain that impact memory, improving mood disorders that come with ageing, expanding vocabulary well into the eighties, and increasing a positive outlook and the sense of well-being measured by biomarkers.

We are only beginning to learn how art therapy can be combined with other evidence-based treatments, as a value-added approach with better outcomes compared to physical and/or cognitive behavioral therapies alone.

Translating art therapy to protocols and combining it with best practices in hospital will allow executable and actual bedside application of patient-benefiting art therapy in different areas.

From the sceptical warrior at war with himself, to the heart transplant patient that needed it as a form of communication with her heart to live: Art therapy gives outlet to the words that cannot be spoken and heals by breaking actual health barriers, helping us become unstuck and keep moving forward while in times of illness.

Art Therapies in Healthcare – Why Does it Matter? (Hand-out from Dr Cathy Malchiodi's talk at SingHealth Academic Hour, 15 February 2017) Of all the areas where research has been conducted, the most compelling and exciting creative arts therapy data is emerging in the healthcare arena. Here are a few of the important studies: Several studies demonstrate that art therapy enhances the psychosocial treatment of cancer, including decreased symptoms of distress, improved quality of life and perceptions of body image, reduction of pain perception, and general physical and psychological health (Monti et al, 2006; Nainis et al, 2002; Svensk et al, 2009). Studies indicate a reduction of depression and fatigue levels in cancer patients on chemotherapy (Bar-Sela, et al, 2007). Art therapy strengthens positive feelings, alleviates distress, and helps individuals to clarify existensial questions for adult bone marrow transplant patients (Gabrial, Bromberg, Vandenbovenkamp, Komblith, & Luzzato, 2001). Research with children with cancer indicates that engaging in drawing and painting is an effective method for dealing with pain and other disturbing symptoms of illness and treatment (Rollins, 2005). Research on art therapy with children with asthma indicates that it reduces anxiety, improves feelings of quality of life, and strengthens self-concept (Beebe, Gelfand, & Bender, 2010). Evidence indicates that art therapy and other creative arts therapies stimulate cognitive function in older adults who have dementia or related disorders (Levine-Madori, 2009) and may reduce depression in those with Parkinson's disease (Elkis-Abuhoff et al, 2008). Art making may reduce anxiety and stress reactions as measured by cortisol (Walsh et al, 2007).