Bar-Sela, G., Atid, L., Danos, S., Gabay, N., & Epelbaum, R. (2007). Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. Psycho-Oncology, 16, 980–984.

The intervention consisted of once weekly art therapy sessions to teach patients to act in a more conscious way by painting with water-based paints. The intervention was provided by an art therapist. The duration of the sessions varied. Those who completed four or more sessions (n = 19) were compared to those who participated for two weeks or less (n = 41).

• The sample was comprised of 60 adult ambulatory patients (77% female, 23% male) who were undergoing chemotherapy.
• Mean age was 77 years (range 25–72).
• Patients were excluded from the study if they had severe anemia; were treated with an epoetin; had changed their opiate, non-selective serotonin reuptake inhibitor (SSRI) antidepressant, or anxiolytic in the past three weeks; or had changed their SSRI antidepressant in the past six weeks.

The study was conducted in an ambulatory setting of a cancer center in northern Israel.

The study used a single-arm, open-label design.

• Brief Fatigue Inventory (BFI), competed weekly before each session
• Hospital Anxiety and Depression scale (HADS), competed weekly before each session

• Median BFI score decreased from 5.7 to 4.1 in the intervention group (p = 0.24).
• Median HADS decreased from 9 to 7 in the intervention group (p = 0.21); anxiety was normal.

• The control group had greater fatigue and may not have been able to participate.
• The study lacked randomization.
• The study did not provide control data related to patient drop-out or chemotherapy.
• Cycle or day-in-cycle assumptions regarding mediating the effect of decreased emotional distress were untested.

For treatment with art therapy, a patient requires referral to an art therapist.