A mixed methods art therapy study examining psychosocial outcomes with adult hospitalized burn patients

Bani Malhotra

doi:10.17918/00001934

Burn injuries are profoundly traumatic and painful events with diverse physical and psychosocial consequences. Improving psychosocial functioning in hospitalized burn survivors involves minimizing distress and pain and fostering emotion regulation. Art therapy could uniquely address the non-verbal aspects of distressing experiences, facilitating healthy emotional expression. Therefore, this study included developing and implementing a four-session semi-structured art therapy intervention comprising expressive and receptive sessions as part of a mixed-methods doctoral dissertation research with hospitalized adult burn patients. This study used a small N study design to assess art therapy's impact on distress, positive and negative affect, pain, overall perception of improvement, and self-expression and regulation. Twelve patients completed the study and served as their control when assessed before and after art therapy. Quantitative assessments were conducted using standardized self-report measures for distress, positive and negative affect, and pain before and after each session, assessment of self-expression and regulation in art therapy, and patients' overall perception after completing all art therapy sessions. Qualitative data were collected from session feedback, artworks, notes, and exit interviews, which were thematically analyzed and then integrated with quantitative findings. Quantitative results showed significant improvements in the outcomes across the four sessions; however, changes did not reach statistical significance within-sessions. Thematic analysis of qualitative data indicated that art therapy encouraged physical engagement and prompted symptom management through relaxation, distraction, and emotional expression, with art serving as tangible reminders. The third aim of the research addressed understanding providers' experiences of working in an inpatient burn center and their perspectives on art therapy. The thematic findings of the semistructured interviews with ten health-care providers from varied disciplines indicated that they perceived burn care as a "multifaceted problem" which was also a rewarding experience for the providers. They perceived art therapy as a necessary "emotional outlet" for burn patients. Future implications for art therapy research/practice goals relating to complex patient presentations, specific multidisciplinary team challenges, and the critical care environment emerged. This is the first study to systematically investigate the impact of art therapy intervention with adult burn patients using a mixed-methods approach. Overall, findings indicated that art therapy positively enhanced psychosocial functioning in hospitalized burn patients. Positive perceptions of patients and providers reinforced how art therapy could contribute to inpatient care and inform clinical practice as part of the multidisciplinary team within burn centers. More research is needed to address patients and providers' identified psychosocial, functional, and interprofessional needs.

A mixed methods art therapy study examining psychosocial outcomes with adult hospitalized burn patients

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A mixed methods art therapy study examining psychosocial outcomes with adult hospitalized burn patients

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