Some Notes on the Psychological & Physical Benefits of Art

3 November 2014

Summary (TLDR Version)

To practice the arts acts as a preventative medicine with a health equivalent to not smoking.

Art & Health

Vast amounts of research link well-being, mental health, and happiness to art and art therapy not just in general (Ettun, Schultz, & Bar-Sela, 2014; Fraser & al Sayah, 2011; Marks, Murray, Evans, & Estacio, 2010; Stuckey & Nobel, 2010) but also with respect to the states of mind of patients with specific physical conditions such as chronic fatigue syndrome (Reynolds & Vivat, 2010), chronically ill children (Reed, Kennedy, & Wamboldt, 2014), diabetes (Iwasaki & Bartlett, 2006), the siblings of hematopoietic stem cell transplant patients (Wallace et al., 2014), HIV/AIDS patients (Feldman, Betts, & Blausey, 2014), &c. Around the world, the health arts have become major areas of focus, such as in Australia, Canada, Israel, and the UK (Clift et al., 2009; Cox et al., 2010; Schwartz, 2014; Wreford, 2010). In summary, Maujean, Pepping, and Kendall (2014) note in their review of “8 randomized controlled trials (RCTs) conducted with adult populations from 2008–2013 that met a high standard of rigor … all but one reported beneficial effects of art therapy.”

While art therapy supports happiness, mental well-being, and increased mental health, the direct physical benefits of art or art therapy remain unclear. However, Veenhoven (2008) found that while “happiness does not cure illness … it does protect against becoming ill. The effect of happiness on longevity in healthy populations is remarkably strong. The size of the effect is comparable to that of smoking or not.” Art as preventive medicine is as healthy as not smoking.

In addition to preventative effects, in a hospital setting, Moss and O’Neill (2014) identified seven themes associated with patient experiences: “loss and the impact of illness on leisure activities; patients’ interests and passions; a lack of expectation of arts in hospital; the positive impact of arts in hospital for those who had experienced them; varying preference between receptive and participative arts activity according to phase of illness; aesthetic aspects of the hospital experience; recommendations for changes to improve arts in hospital” (emphasis added). They also found art interventions more salutary during the acute phase of a hospital stay. Even a statistically cautious study like Davies, Knuiman, Wright, and Rosenberg (2014) admits that “given the increasing pressure on health resources, the arts have the potential to assist in the promotion of health and healing.”

While art has an extremely well-established effect on mental health, shows itself effective as a preventative intervention, and has the potential to assist in the promotion of health and healing as a direct policy intervention during hospital stays, one might say none of this yet speaks to direct physical benefits for art. Staricoff (2004), summarising 385 studies, writes:

This review has identified a number of medical areas in which the research studies have shown clear and reliable evidence that clinical outcomes have been achieved through the intervention of the arts. Specific outcomes for both in-patient and outpatient departments include the following:

  • Cancer care: visual art and live and taped music have been used in a number of studies addressing high anxiety and depression during chemotherapy. The arts were effective in reducing both anxiety and depression, and acted as a potent adjuvant to avert side-effects of the treatment
  • Cardiovascular unit: the use of appropriate music, through tapes, video music or personal headphones led to reports of a significant reduction in anxiety levels and the levels of vital signs – blood pressure, heart rate, demand for myocardial oxygen
  • Intensive care unit: the use of music in neonatal intensive care has shown statistically significant improvement in clinical and behavioural states. Very importantly, the benefits significantly reduced the length of stay in hospital
  • Medical procedures: a number of medical procedures for screening and/or diagnosis generate high levels of stress. Arts interventions have been shown to increase the perception of comfort, to reduce the levels of cortisol (a hormonal indicator of stress), and to significantly control blood pressure levels
  • Pain management: music induced significant reductions on physiological and psychological variables related to pain indicators. A number of authors reported a significant reduction in the use of medication to reduce pain after surgery
  • Surgery: self-selected music, live music and the visual arts have been shown to reduce stress and anxiety, as well as helping to control vital signs. The use of music was found to be very effective in the post-operative recovery period, reducing requirements for sedatives

Staricoff (2004) does not emphasise only the principal benefits for patients, i.e., inducing positive psychological and physiological changes in clinical outcomes, reducing drug consumption, and shortening length of stay in hospital, but also further system-wide benefits. These include:

The effect of the arts and humanities on staff outcomes

This review has analysed a number of studies concerning job satisfaction, including:

  • the introduction of works of art and of nature features in the design of the healthcare service
  • the intervention of music in creating a non-aggressive environment
  • the use of the arts in nursing and medical training to improve communication, empathy and understanding of patients’ needs The literature does not include reliable studies on the possible relationship between the use of arts in the healthcare environment and its effect on the recruitment and retention of staff.

The effect of the arts and humanities on the education and training of practitioners

This section reviews the available evidence on the direct effect of the arts on health practitioners. It also addresses the key issues emerging as a result of incorporating the arts and humanities into medical and nursing undergraduate and post-graduate courses. The following topics are presented:

  • Evidence that listening to self-selected music increases mental task performance in surgeons
  • The benefits of using music in operating theatres to create a less stressful environment, and the problems that the use of music could pose for the surgical team
  • The role of the visual arts in developing the observational skills of the medical practitioner and in increasing ability in drawing, stereo vision and three-dimensional thinking in neurosurgeons
  • The evaluation of the results of introducing nursing students to the fine arts, showing that the arts increase awareness in dealing with illness and bereavement, as well as strengthening students’ confidence in their own practice
  • The introduction of the arts and humanities into nursing and medical education led to an increased capacity in students for critical analysis and understanding of illness and suffering. This prompted health practitioners to respond in a more humane and thoughtful manner to medical, ethical and social needs

The effects of the arts in mental healthcare

The use of the arts in mental healthcare helps to improve the communication skills of mental health users, helping in their relationship with family and mental health providers. It also provides patients with new ways of expressing themselves, stimulates their creativity skills and enhances their self-esteem. The use of the arts in mental health services also brings about behavioural changes in mental health users: patients become more calm, attentive and collaborative. These changes help in the everyday managing of a mental health service, diminishing the need for medication and physical restraint. Different art forms have been shown to have different effects.

  • The use of literature, creative writing and poetry in mental health services produces significant benefits for both the patient and the care provider. It enables patients to regain control over their own inner world, increasing their mental wellbeing. It helps the nursing and medical staff to understand the cultural, social, ethnic and economic factors influencing the behaviour of patients
  • Theatre, drama and visual arts all provide patients with powerful ways of expressing themselves and understanding their own world. This promotes empathy between patients and staff
  • Music, singing and dancing all help mental health patients to recall events from their lives. These art forms help them to express themselves and, on a physical level, to increase their range of movement

The effect of different art forms

There is a lack of rigorous research on the contribution of different types of art forms to healthcare.

  • Positive clinical outcomes are induced by the intervention of classical and meditative types of music. They reduce stress, anxiety and perception of pain. Live music, when appropriate, has more significant benefits than recorded music
  • Familiar tunes, which are pre-selected by the patient, are shown to be a very effective approach in mental healthcare; triggering familiar memories and enjoyment
  • The introduction of visual art into healthcare proved to play an important role in improving observational skills in health practitioners and in increasing patients’ wellbeing

Mechanisms involved in the perception and processing of art

  • Science and technology are getting closer to understanding the mechanisms underlying perception, processing and the emotional responses elicited by the arts. Many of the different areas of the brain and neural networks involved in these processes have been identified
  • The exploration of the association between the mental and physical state of artists and their artistic work gives an insight into the process of artistic creativity, helping scientists to understand the causes of numerous diseases and to find potential treatments. This is achieved through an analysis of artists’ work, how their work changes throughout time and on the use of shapes, forms or colours, which can be related to specific changes occurring in the brain
  • The understanding and description of the patterns of emotional response elicited by different art forms contribute to the rational and appropriate use of the arts in creating a powerful therapeutic environment

Conclusions

This review includes 385 references from medical literature related to the effect of the arts and humanities in healthcare. It offers strong evidence of the influence of the arts and humanities in achieving effective approaches to patient management and to the education and training of health practitioners. It identifies the relative contribution of different art forms to the final aim of creating a therapeutic healthcare environment. It highlights the crucial importance of the arts and humanities in:

  • inducing positive physiological and psychological changes in clinical outcomes
  • reducing drug consumption
  • shortening length of stay in hospital
  • increasing job satisfaction
  • promoting better doctor-patient relationships
  • improving mental healthcare
  • developing health practitioners’ empathy across gender and cultural diversity

 

Recommendations for future research

  • The effect of the arts and humanities as contributing factors in recruitment and retention of staff has not yet been evaluated. The literature refers to their influence on job satisfaction, but the link and repercussion on recruitment and retention has not been evaluated
  • The type of musical instruments in relation to the clinical setting deserves further research, perhaps leading to the introduction of guidelines to optimise the beneficial outcomes of music in healthcare environments
  • The effect of integrating different art forms and humanities into the healthcare culture in issues such as social inclusion and cultural understanding should be evaluated

References

Clift, S., M. Camic, P., Chapman, B., Clayton, G., Daykin, N., Eades, G., . . . White, M. (2009). The state of arts and health in England. Arts & Health, 1(1), 6-35.

Cox, S. M., Lafrenière, D., Brett-MacLean, P., Collie, K., Cooley, N., Dunbrack, J., & Frager, G. (2010). Tipping the iceberg? The state of arts and health in Canada. Arts & Health, 2(2), 109-124.

Davies, C. R., Knuiman, M., Wright, P., & Rosenberg, M. (2014). The art of being healthy: a qualitative study to develop a thematic framework for understanding the relationship between health and the arts. BMJ open, 4(4), e004790.

Ettun, R., Schultz, M., & Bar-Sela, G. (2014). Transforming Pain into Beauty: On Art, Healing, and Care for the Spirit. Evidence-Based Complementary and Alternative Medicine, 2014.

Feldman, M. B., Betts, D. J., & Blausey, D. (2014). Process and Outcome Evaluation of an Art Therapy Program for People Living With HIV/AIDS. Art Therapy, 31(3), 102-109.

Fraser, K. D., & al Sayah, F. (2011). Arts-based methods in health research: A systematic review of the literature. Arts & Health, 3(2), 110-145.

Iwasaki, Y., & Bartlett, J. G. (2006). Culturally meaningful leisure as a way of coping with stress among aboriginal individuals with diabetes. Journal of Leisure Research, 38(3), 321-338.

Marks, D. F., Murray, M., Evans, B., & Estacio, E. V. (2010). Health psychology: Theory, research and practice: Sage.

Maujean, A., Pepping, C. A., & Kendall, E. (2014). A Systematic Review of Randomized Controlled Studies of Art Therapy. Art Therapy, 31(1), 37-44.

Moss, H., & O’Neill, D. (2014). The aesthetic and cultural interests of patients attending an acute hospital–a phenomenological study. Journal of advanced nursing, 70(1), 121-129.

Reed, K., Kennedy, H., & Wamboldt, M. Z. (2014). Art for Life: A community arts mentorship program for chronically ill children. Arts & Health(ahead-of-print), 1-13.

Reynolds, F., & Vivat, B. (2010). Art-making and identity work: A qualitative study of women living with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Arts & Health, 2(1), 67-80.

Schwartz, S. (2014). A survey of arts and health programmes in Israel. Journal of Applied Arts & Health, 4(3), 265-279.

Staricoff, R. L. (2004). Arts in health: A review of medical literature: Arts Council England London.

Stuckey, H. L., & Nobel, J. (2010). The connection between art, healing, and public health: A review of current literature. American Journal of Public Health, 100(2), 254.

Veenhoven, R. (2008). Healthy happiness: Effects of happiness on physical health and the consequences for preventive health care. Journal of Happiness Studies, 9(3), 449-469.

Wallace, J., Packman, W., Huffman, L. C., Horn, B., Cowan, M., Amylon, M. D., . . . Moses, J. (2014). Psychosocial Changes Associated With Participation in Art Therapy Interventions for Siblings of Pediatric Hematopoietic Stem Cell Transplant Patients. Art Therapy, 31(1), 4-11.

Wreford, G. (2010). The state of arts and health in Australia. Arts & Health, 2(1), 8-22.

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s

%d bloggers like this: