Literature Review : What Is The Efficacy Of Art Therapy On Females Diagnosis With Schizophrenia

Introduction

Schizophrenia is an extreme emotional instability influencing up to one in a hundred individuals sooner or later in their lives. The problem presents with constructive manifestations, for example, mental trips and dreams, numerous individuals likewise experience negative side effects, for example, lack of concern and diminished organizational aptitudes that can extraordinarily debilitate their regular functioning (Leurent et al, 2014). Art therapy, a manifestation of psychotherapy which utilizes the medium of craftsmanship to encourage individual statement and understanding of feelings (Drapeau and Kronish, 2007), has been demonstrated through one exploratory trial to be connected with change of negative manifestations observed in people diagnosed with schizophrenia (Patterson et al., 2011). The purpose of this paper is to give a literature review on the efficacy of art therapy on females diagnosed with schizophrenia. The paper seeks to answer one question: Does art therapy improve symptoms for women diagnosed with schizophrenia? Several researchers have conducted investigations with the objective of finding out the effectiveness of art therapy on individuals diagnosed with schizophrenia.

Literature review

Although there are quantitative and qualitative studies examining the adequacy of art therapy for female adults diagnosed with schizophrenia, a great part of the writing is somehow descriptive.  A few researchers have also used a mixture of both qualitative and quantitative methods to investigate the efficacy of art therapy for women diagnosed with schizophrenia (Schindler et al., 2006). Leurent et al., (2014) portrayed the profits of utilizing group therapy

treatment with schizophrenic in-patients. The researchers observed that the utilization of paintings and representations amid group art therapy sessions helped the patients’ capacity to address emotions of surrender and insecurity regarding whether they would survive. Drapeau and Kronish (2007), talk about how taking an interest in art therapy empowers schizophrenic patients in a psychiatric ward to express and speak to curbed emotions. Crawford et al. (2012), uncovered that group art therapy is useful in making the move from the hospital to a home environment. They additionally found that patients become more perceptive about the motivation behind their treatment and are additionally tolerate living with emotional instability after group art therapy sessions.

While it is hard to find controlled investigations of any sort of art therapy particularly with individuals with a diagnosis of schizophrenia, one such study was directed by Richardson et al. (2007). It was an exploratory randomized controlled trial (RCT) of art therapy situated in the group, and reported a huge lessening in negative symptoms after just 12 sessions, which these specialists considered an absolute minimum fundamental for remedial effect. The treatment model was group mental art therapy. While this methodology was at first demonstrated on group mental psychotherapy, with its spotlight on art therapy communications, Schindler et al (2006) have pointed out that psychotherapy practically speaking can fuse a scope of psychodynamic speculations, with contrasting degrees of spotlight on transference and counter-transference.  This incorporates the investigation of groups’ past encounters, and making psychoanalytic translations of the oblivious importance of their articulations, fine arts, and conduct.

In order to find out whether effectiveness of art therapy is directly related to the severity of negative schizophrenia symptoms, Leurent et al. (2014) used a total of 649 participants. The median age of participants was 41 years old and 32 percent of them were females diagnosed with schizophrenia. The participants had been suffering from schizophrenia for 15 years on average, and more than 90 percent had been on antipsychotic medication for a while. Only 29 percent of the participants had previous experience of art therapy. The effect of art therapy did not differ between patients with more severe and less severe schizophrenic symptoms. However, participants recorded improvement of symptoms following art therapy intervention. According to Leurent et al. (2014), art therapy is effective on females diagnosed with schizophrenia and the extent of efficacy is not linked with the seriousness of negative symptoms.

In their study, Crawford et al. (2012) revealed that not all people diagnosed with schizophrenia should be referred to art therapies. The researchers used 649 participants who were subjected to art therapy for a period of 19 months. This sample size allowed for detection of significance on the international assessment of functioning scale at a period of 24 months. The researchers conducted statistical analysis with the aim of treating principle. In this randomized trial the mental wellbeing and worldwide functioning of individuals with schizophrenia was not enhanced by offering a weekly art therapy notwithstanding their standard consideration. Those randomized to weekly group art therapy had comparative levels of global functioning and mental wellbeing as those randomized to an action control group over a two year period, with the exception that the movement control group had a more prominent decrease in positive manifestations of schizophrenia at 24 months. Individuals offered a spot in group art therapy were more inclined to go to sessions than those offered individual interventions (Crawford et al., 2012).

In a different study, Richardson et al. (2007), investigated the effectiveness of art therapy as an adjunctive treatment for in-patients and out-patients with serious and constant schizophrenia, both males and female. He utilized a randomized controlled examination outline to quantify the adequacy of art therapy group projects on enhancing patients’ personal satisfaction and working, diminishing manifestations, and expanding the utilization of health care institutions. The researchers assessed all patients on a range of symptoms and measures including quality of life and social functioning, with six-month follow-up. They concluded that art therapy generated statistically significant positive impacts on negative schizophrenia symptoms (Richardson et al., 2007). Since effectiveness of art therapy was observed on both females and males, modern counseling institutions should utilize art therapy on females diagnosed with schizophrenia to improve symptoms.

In hypothetical terms, art therapy would permit individuals who have had generally little chance to discuss and attempt to deal with life injury and delayed burdens at various times to start to express their unarticulated and muddled feelings through the moderately protected medium of art. This has been depicted clearly by administration clients with a finding of marginal identity issue (Ruddy and Milne, 2005). A steady group background may empower members to relate to one another’s visual depictions of troublesome feelings without promptly examining them inside and out, and in addition basically appreciate innovativeness and the tactile incitement of the art materials (Crawford et al., 2010).

The imparted movement towards art therapy steadily fabricates common help so that group members diagnosed with schizophrenia can pace their examination toward oneself and personal well being (Patterson et al., 2011). For individuals who have been minimized and barred from interacting with the society, on top of harming early encounters, this methodology may require some investment (Smeijsters and Cleven, 2006). To the degree that common gratefulness and delight is communicated through artistic manifestations, negative symptoms of schizophrenia can be managed (Crawford et al., 2010).

The motivation behind a study conducted by Schindler at al. (2006) was to analyze if grown-ups diagnosed with serious and persevering schizophrenia and who went to a group mental health focus exhibited enhanced errand and interpersonal abilities and social parts following administration of art therapy. The study utilized a solitary subject detailed analysis design with pretest and posttest follow-up for a period of eight weeks (Schindler at al., 2006). Qualitative research questions at pretest and posttest were utilized to supplement quantitative discoveries. A total of seven participants were used in the study, three men and four women.

This design was selected to proceed with the evaluation of part improvement in an alternate setting such as an inpatient setting and with a more centered view on the procedure included in part and expertise advancement (Schindler at al., 2006). Expert’s level understudies led the treatment mediation and took an interest in week after week supervision to keep up devotion to the treatment intercession. The researcher found out that art therapy fosters personal growth and development. These findings support conclusions made by Leurent et al. in their study conducted on schizophrenia patients in (2014).

In its 2009 rules on schizophrenia management, NICE prescribed offering expressions treatments, especially art therapy to individuals with severe negative symptoms. This suggestion was focused around the 2009 rules (NICE 2009), which explored six randomized trials of expressions treatments. The trials were of changing quality, however for the most part proposed that innovative treatments were connected with lessening of negative side effects . The majority of these trials explored music treatment, however one exploratory trial of art therapy likewise demonstrated an impact on negative indications. Negative manifestations of schizophrenia may be connected with trouble taking part in mental treatments, and art therapy might in this manner be a suitable non-verbal option for such patients (Leurent et al., 2014).

In principle, it may be normal that intercessions focused around non-verbal interpretation that incorporate a social connection component, for example, intuitive group art therapy, could affect decidedly on the negative side effects of schizophrenia, for example, poor social compatibility and passionate withdrawal. Again, the principle examination of the MATISSE randomized trial did not discover any impact of art therapy on negative side effects at 12 and 24 (Crawford et al., 2012).  Crawford et al., (2010) further discovered that art therapy was not compelling for those with more serious negative side effects. These findings contrast those that were found by Richardson et al. (2007).

There are various reasons why the discoveries from the MATISSE study of 2012 may have contrasted from those reported by Richardson et al (2007). First, the study conducted by Richardson et al. (2007), was an exploratory trial with high faults and various results. The distinction seen between groups in evaluations of negative indications was around factual critical conditions and may have been seen by chance alone. Additionally, the manifestation of art therapy conveyed may have contrasted from that conveyed in the MATISSE study, despite the fact that they were both focused around comparative rules. In conclusion, results in the MATISSE study were surveyed longer after recruitment (12 months) than in the study conducted by Richardson et al. (2007) (6 months) and accordingly, any starting clinical additions noted by Richardson et al.  (2007) may have disseminated over the long run.

Art therapy helps individuals express encounters that are so troublesome that they cannot put into words, for example, a judgment of a mental illness such as schizophrenia. Some individuals with schizophrenia investigate the implications of past, present, and future of art therapy, subsequently coordinating mental problems into their biography and providing meaning for it. Stuckey and Nobel (2010) utilized drawings as a part of a push to comprehend encounters of wellbeing and disease, inspected how 32 moderately aged women with schizophrenia comprehended their condition. After an individual meeting, every member was asked to explain how she understands the illness. Utilization of color, spatial association, and piece were investigated among all participants. The drawings were considered as both visual results of the women’s information about schizophrenia and procedures of typified learning creation. It was inferred that having people draw how they envisioned their condition was an astute technique with which to investigate understandings of ailment, such as schizophrenia (Stuckey and Nobel, 2010).

Art therapy can be a shelter from the exceptional feelings connected with illnesses such as schizophrenia. There are no restrictions to the creative ability in discovering innovative methods for communicating anguish. Specifically, shaping earth can be an influential approach to help individuals express these emotions through material association at a physical level, and in addition to encourage verbal correspondence and cathartic discharge and uncover oblivious materials and images that cannot be communicated through words (Leurent et al., 2014).

Women joining in a qualitative study concentrating on disease portrayed progressing schizophrenia-related symptoms, for example, hopelessness, torment, restlessness, part misfortune, action confinement, decreased self-esteem, and changed social relationships. Engaging in diverse sorts of visual arts (materials, card making, arrangement, ceramics, watercolor, acrylics) helped these ladies in 4 noteworthy ways. To begin with, it helped them concentrate on positive backgrounds, easing their progressing distraction with tumor. Second, it improved their self-esteem and character by furnishing them with chances to exhibit progression, test, and accomplishment. Third, it empowered them to keep up a social character that opposed being characterized by schizophrenia. At long last, it permitted them to express their sentiments in a typical way, particularly amid drug use (Stuckey and Nobel, 2010).

Implications for further research

An investigation conducted by Patterson et al. (2011) on the effectiveness of art therapy, especially in connection to diagnosis of schizophrenia, has exhibited intricacy and assorted qualities in advisors’ developments of idea and practice. Underpinning difference discovered an unerring duty to the potential of art therapy to help enhancements in mental wellbeing and prosperity of individuals seen as having an insane mental structure and enduring acknowledgement of the uniqueness of experience and results (Holttum and Huet, 2014). Ramifications of these discoveries ought to be considered with reference to the way of the study, which in its adaptable approach and appreciation of the lavishness and assorted qualities of experience, imparts much with art therapy interventions (Patterson et al. 2011).

Stuckey and Nobel (2010) draw on the encounters of a chosen group of patients diagnosed with schizophrenia, the universal provision in connection to speculation must be made. Hypothetical examination and accomplishment of immersion cannot be made certain that there is full range of specialist perspectives and that such investigations would not have caused discoveries to be reinvestigated. The recurrence of which any given case trademark, process or experience is observed in our participants ought not be seen as a measure of recurrence in different settings. In any case, that current discoveries are reliable with perspectives communicated by specialists in a late national review (Patterson et al., 2011) recommends that they are should be investigated further.

Further, whilst several researchers affirm distinct and genuine precision, qualitative examination is naturally subjective, obliging inventiveness and astute judgment from scientists (Gersch and Sao, 2006). The representations of researchers’ perspectives reflect complex impacts including particular expert and individual foundations and the connection within which various studies were carried out. However, different methodologies involved continue to be subjected to various procedures of significance making the basic examinations complete. Reliable with its constructivist underpinnings, as opposed to present this record as ‘truth’, our objective is to support elaboration and refinement of the “story” of workmanship treatment and schizophrenia. To start this procedure we talk about two interlinked concerns standing up to the craftsmanship treatment calling and individual specialists inside the current ‘proof based’ mental human services connection.

As indicated by NICE (2009), direction now incorporates a suggestion that referral to art therapy be considered for women with a diagnosis of schizophrenia and the existing data should be used to help thought of referral. Psychologists should offer the most appropriate advice for females diagnosed with schizophrenia. The potential advantages of art therapy portrayed by advisors are reliable with those proposed by NICE (2009): individuals diagnosed with schizophrenia may be empowered to experience themselves contrastingly and to create better approaches for identifying with others, they may be served to communicate and to sort out their experiences into a fulfilling tasteful structure and served to comprehend emotions that may have developed amid the imaginative procedure (NICE, 2009).

Beneficial as these points may be, and regardless of boundless acknowledgement of the criticalness of patient experience and customized consideration, those accused of authorizing administrations are obliged to report against hard results. This is on account of assets are limited, rivalry for financing is extreme and assets are allotted where potential effect is most noteworthy. Coupled with the apparent non-abrasiveness of points of art therapy, this must be a variable in the inconsistent procurement of interventions to individuals diagnosed with schizophrenia (Patterson et al., 2011). Counselors and specialists are faced by strains identified with keeping up with the available alternativeness (Gersch and Sao, 2006), that is at the heart of art therapy and valid to the thought that the methodology of treatment is out of hand whilst showing productivity and expense adequacy. Questions must be raised about some information about adjusting the philosophical center of art therapy and responsibility to remaining nearby underestimated populaces and empowering them to talk with the pragmatics of consideration procurement. As Gersch and Sao, 2006 fights, art therapy confronts a genuine test in situating of itself within mental health institutions where the practice should be logically grounded to assist women diagnosed with schizophrenia.

It is right  to say that further research is expected to create an understanding of the mental and psychosocial qualities of individuals, especially women who experience schizophrenia, which patients make for a decent fit with art therapy, and what results can sensibly be impacted. Clarity must be made because the quality of art therapy inescapably attracts thoughtfulness regarding the troubles characterizing and measuring results in the midst of the astounding erratic complexities of schizophrenia. This thus posts incredible difficulties to the confirmation of ideas that presently exist in published literature (Crawford et al., 2012).

Given that a large portion of the restricted hypothetical premise for art therapy referred to by Crawford et al. (2010) and Crawford et al. (2012) was from books distributed initially in 1992-1993 and republished a few times (Leurent et al., 2013), one needs to ask what new hypothetical improvements have been made in art therapy since 1993. One other content is said by Crawford et al. (2012), and like the past ones it was not outfitted particularly to mental illness. A volume altered by Ruddy and Milne, (2005) is specifically concerned with schizophrenia and other schizophrenia-like illnesses, and a section by Crawford et al. (2012).

Nonetheless, it appears fundamental not just to have an agreeable understanding of art therapy systems in addition to components happening for individuals given a conclusion of schizophrenia: the instruments keeping up their social rejection and handicap, for example, segregation (NICE, 2009) and medication (Moncrieff and Leo, 2010). There is a requirement for studies that expand on that of Patterson et al (2011) and Crawford, et al. (2010) in discovering specialists’ understanding of their practice, and about patients’ encounters. This expansion must include shared methodologies between staff and women diagnosed with schizophrenia, for example, that of Schindler et al. (2006). This could expand on existing research to some degree on the hypothetical structure of the relationship between art therapy and schizophrenia management as illustrated by majority of researchers.

Levels of participation at art therapy may be higher when individuals are accepting inpatient treatment, and the effect of the therapy conveyed in most research settings ought to be contemplated. Aftereffects of randomized trials of other inventive treatments for individuals with schizophrenia, for example, music treatment and body development treatment, are more promising (Schindler et al., 2006). These mediations join innovativeness with different methodologies particularly when giving a charming background, invigorating physical development, and expanding communications with others. Despite the fact that it has been contended that inclusion in imaginative exercises is intrinsically useful for mental wellbeing, it might be that for individuals with serious emotional instabilities, for example, schizophrenia it is just when such exercises are utilized as a part of blend with different mediations that advantages are realized.

Conclusion

Art therapy is a manifestation of psychotherapy where the methodology of making pictures plays a focal part in the connection of the psychotherapeutic relationship. It has been generally connected to the treatment of patients and administration clients with schizophrenia and over all spectra of seriousness. It can be conveyed to all age assembles in an assortment of organizations counting those of individual, gathering, couples and family treatment; and has been connected as both a transient and a long haul intercession. Art therapy may be especially appropriate to the needs of administration clients who discover trouble in communicating verbally, in a valuable and non-ruinous way, their tricky sentiments and life encounters, as is every now and again the case among the extremely rationally sick. Its nonverbal angles may make it exceedingly applicable to females diagnosed with schizophrenia across dialect and ethnic foundations. As an extra to the work therapists handling women diagnosed with schizophrenia, art therapy may offer a potential means both to enhance the nature of consideration of treatment and to upgrade clinical results.

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