Archer, S., Buxton, S., & Sheffield, D. (2015). The effect of creative psychological interventions on psychological outcomes for adult cancer patients: A systematic review of randomised controlled trials. Psycho-Oncology, 24, 1–10. doi:10.1002/pon.3607

DOI Link

Purpose

STUDY PURPOSE: To measure the effect of creative psychological interventions on psychological outcomes such as anxiety and depression, quality of life, coping, stress, anger, and mood in adults with breast or mixed cancers. 
 
TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: OVIDsp, Wiley Online Library, PsycINFO, Web of Knowledge, CINAHL Plus, Cochrane Database
 
KEYWORDS: An extensive listing of search terms was provided and included American and European spelling and truncation. 
 
INCLUSION CRITERIA: Studies that conformed to RCT design and had an intervention and a control group; studies that include adult patients who have any type of cancer at any stage and who may or may not be undergoing medical treatment; studies that used creative psychological intervention delivered by a qualified arts therapist; studies that included pre-/post and follow-up intervention outcome measures
 
EXCLUSION CRITERIA: Studies of patients engaging in the arts without a qualified art therapist or in a non-therapeutic manner were excluded.

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 157 articles were initially retrieved and evaluated.
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Two reviewers hand searched relevant journals for articles to include, reviewed the abstracts from the database search, and discussed inclusion or suitability for the study to arrive at the final number of articles to include in the review. The final selection of studies was evaluated for quality and bias risk.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 10
  • TOTAL PATIENTS INCLUDED IN REVIEW = 488 (62 lost to attrition)
  • KEY SAMPLE CHARACTERISTICS: The frequency of intervention and type of intervention varied (Note: 10 studies of 8 different intervention foci.): 70% of the sample studies held intervention sessions once per week for a total of three to eight weeks. Participants with terminal cancer were studies either weekly or bi-weekly until death. The dance movement study held sessions two times per week for six weeks then once weekly for six weeks. One study held a music therapy session during chemotherapy.

Phase of Care and Clinical Applications

  • PHASE OF CARE: Multiple phases of care
  • APPLICATIONS: Elder care

Results

Depression and anxiety were shown to improve in three of the studies although the interventions were different (music therapy, art therapy, and mindfulness-based art therapy). Other psychological factors also improved: lower ratings of somatic symptoms in an art therapy study and a creative arts study, and psychiatric symptom improvement. Improvements in various measures of quality of life were reported in studies of mindfulness-based art therapy, art therapy, music therapy, creative arts therapy, and dance/movement therapies. Art therapy showed improvements in coping resources and mood states. Music therapy showed improvements in stress and anger. Creative arts therapy showed improvements in specific aspects of the Profile of Mood States (POMS) that were reported: tension-anxiety, depression-dejection, anger-hostility, and confusion-bewilderment.

Conclusions

Evidence reviewed in this study is inconclusive regarding effectiveness of various creative interventions.

Limitations

  • Selected articles using creative psychological interventions did not include writing therapy or drama therapy.  
  • Meta-analysis was not possible, although rationale was clearly explained by the writers.
  • Only one of the 10 articles was evaluated as having high quality; the remaining were satisfactory.
  • Follow-up measures were not included in several studies.
  • The number of articles included in the sample was small (n = 10).
  • There appear to be discrepancies in accuracy of references to specific studies in the table: example, page 4, last paragraph indicates lack of replicated findings, whereas the table indicates otherwise.
  • Specified Creative Psychological Interventions delivered by a qualified therapist were shown to improve well-being on several measures. 

Nursing Implications

The therapies were implemented by qualified therapists and were varied in nature, although not exhaustive of available therapies. The value of music, art, and movement therapies are shown to effectively reduce symptoms of anxiety and depression and improve quality of life, coping, and mood. Suggestions for further research are offered.

Legacy ID

5667