From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review

Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear how and why the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review (N-studies = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: embodiment, concretization, and symbolism and metaphors. The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.

Automated summary

Research on creative arts therapies, such as art therapy, music therapy, and dance/movement therapy, has shown positive impacts on psychological and physiological outcomes. However, there is still limited understanding of the specific therapeutic factors responsible for these effects. A scoping review of 67 studies was conducted to identify therapeutic factors unique to each CATs discipline, as well as common factors across all psychotherapy approaches, leading to the proposal of a framework consisting of 19 domains of CATs therapeutic factors.