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Mixed-Methods Art Therapy Study Examining Psychosocial Outcomes with Hospitalized Adult Burn Patients
Abstract   Peer reviewed

Mixed-Methods Art Therapy Study Examining Psychosocial Outcomes with Hospitalized Adult Burn Patients

Bani Malhotra, Linwood R Haith, Patricia A Shewokis, Johanna Czamanski-Cohen, Minjung Shim, Megan Stair-Buchmann and Girija Kaimal
Archives of physical medicine and rehabilitation, v 106(4), e57
Apr 2025
DOI: https://doi.org/10.1016/j.apmr.2025.01.147

Abstract

Art therapy Emotion regulation Mixed methods research Psychosocial Rehabilitation Burns
To examine and characterize the effect of art therapy (AT) on psychosocial outcomes (distress, positive negative affect, pain, self-expression and emotion regulation, change-perception) with patients hospitalized for burn injuries. Mixed-methods small N intervention design piloting AT intervention, delivered at the patients’ bedside. Adult burn facility serving several adjacent states in the northeastern United States. Twelve English-speaking adult patients (18+y) hospitalized for burn treatment (mean age, 49.6y; SD, 19.3; 7 males; 5 females). Four-session semistructured AT intervention comprising 3 expressive (art-making) and one receptive (viewing/guided imagery) art therapy session incorporating components of distraction, relaxation; tactile exploration; and safe expression. Various art media, including digital tools and assistive aids, were employed. Distress thermometer, Positive and Negative Affect Schedule (PANAS), Patient Global Impression of Change (PGIC), Graphic Numeric Rating Scale (GNRS) for pain, and Self-Expression and Emotion Regulation in Art Therapy Scale (SERATS). Ten participants completed all 4 sessions, whereas two finished 3 sessions before discharge. Repeated analysis of variance results indicated a main effect of the pre-post test for distress (F[1,9]=6.84, P=.028, partial η2=0.43), negative affect (F[1,8]=8.12, P=.022, partial η2=0.504), and pain (F[1,9]=13.22, P=.005, partial η2=0.60) with pre-AT average distress, negative affect, and pain significantly higher than after AT. The effect of AT on positive affect also indicated a main effect of Test, (F[1,8]=5.5, P=.047, partial η2=0.41) with pre scores significantly lower than post. The global percentage change indicated positive trends in the outcomes. One-sample t test of PGIC indicated significant difference (M=1.73, t[10]=−4.183, two-sided P=.002, with a large effect size of Hedges’ g=−1.16) with the mean response close to “much improved.” One-sample t test for each item in the SERATS showed significant difference from the test value set at the mid-point except for one question that did not show significance. Patients perceived AT as fostering emotional expression and regulation “often” as indicated by mean scores approaching “4” for each item. Thematic analysis indicated that AT encouraged physical engagement and prompted symptom management through relaxation, distraction, and emotional expression, with art serving as tangible reminders. Mixed-methods integration demonstrated congruent findings across AT sessions. Findings show preliminary support for the effectiveness of an interdisciplinary AT intervention underscoring its implications in improving individualized psychosocial outcomes in burn care. none.

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