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Overview

• Art therapy is recognised in the UK and other countries as part of the support that may be offered to people who are undergoing or have recently completed cancer treatment. In the UK, some people can access it through the NHS via their treatment team.
• Studies on art therapy with people affected by cancer have been carried out in many countries, including Canada, China, France, Germany, Hong Kong, Iran, Israel, Italy, Japan, Korea, the Netherlands, Spain, Sweden, Taiwan, Turkey, the UK and the USA.
• In these studies, art therapy was offered either during or after cancer treatment, either in a group or one-to-one, and the number of sessions varied from one-off to 22 sessions. In some studies [3-8], as well as art therapy, the sessions included practising mindfulness, which means focusing on the present moment [9].
• The research studies, including randomised controlled trials, reported positive outcomes for stress [10], relationships [10], distress, [4, 5, 7, 11], quality of life [4, 5, 7, 12], mood [5, 11, 13], anxiety [5, 8, 13], fatigue [14], spiritual wellbeing [15] and self-acceptance [13, 16].

What outcomes have people experienced following art therapy?Ìý

Reports from randomised controlled trials suggest that people can experience the following benefits from attending art therapy during or after cancer treatment:

• coping better with stress [10]
• improved relationships [10]
• reduced distress [4, 5, 7, 11]
• improved quality of life [4, 5, 7, 12]
• improved mood [5, 11, 13]
• reduced anxiety or stress [5, 8, 13]
• less fatigue [14]
• increased spiritual wellbeing [15]
• improved emotional awareness and self-acceptance [13, 16]

Why art therapy may be helpful

A study with women with breast and/or gynaecological cancer included testimonies from service users [17]:

Expressing emotions and gaining new perspectives

In qualitative studies involving interviews or written feedback from participants, people reported that artmaking in a supportive environment helped them to communicate their distress or pain in a manageable way. Some people came to see new perspectives on their life or felt able to express new aspects of themselves. Participants also appreciated the support of the art therapist, and other group members in group art therapy [19 – 28].

One study was a survey of 32 art therapists and 55 recipients of cancer treatment across the UK [28]. Most service users reported that art therapy was easy to engage with, enjoyable and calming. They also said it helped them gain new perspectives on themselves and express difficult feelings without necessarily having to use words.

One person from the study describes the importance of art therapy to them:

In this video, Wendy, a service user from Severn Hospice talks about the difference art therapy made in her cancer care:

In this Ted talk, Anise Bullimore shares her experience of art therapy with the Macmillan Cancer Support team.

 

ÌÇÐÄÊÓƵ the research studies

Randomised controlled trials

So far, there have been 14 randomised controlled trials (RCTs) on art therapy with people affected by cancer. Participants of these trials were randomly assigned to receive art therapy or not, and their psychological wellbeing outcomes were compared. Most participants were women with breast cancer. [4, 5, 7, 10-16]

An advantage of RCTs is that we should be able to assume that it was the art therapy that led to participants’ improved wellbeing and not something else. However, these trials are not perfect: for example, some participants drop out of them, or the therapy may not be delivered in a consistent way, or not all the right measures are made and all at the right times. Therefore, it is always worth being cautious in interpreting trial results.

Before and after studies

There have also been 16 research studies that compared people’s responses to questionnaires before and after art therapy but did not compare them with people who had no art therapy [3, 6, 17, 29-40]. These studies included people in treatment for a greater range of types of cancers than the controlled trials and included men. They reported similar improvements to those seen in the controlled trials.

Two of the ‘before-and-after’ studies were with patients undergoing radiotherapy [33] or chemotherapy [40]. Participants’ fatigue did not increase, and therefore art therapy may have mitigated the fatiguing effects of treatment. However, some participants in the study undergoing chemotherapy were also accessing other therapies such as massage or music therapy. It is possible that these other therapies were just as helpful as art therapy.

Qualitative research studies

There have been an additional 9 qualitative research studies, and they provided the explanations given earlier in this page about why art therapy may be helpful [19-28].

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Evidence sources

1. 1. , Macmillan Cancer Support, 2024
   2. (Forbes et al., 2024)
   3. (Ando et al., 2016)
   4. (Jalambadani & Borji, 2019)
   5. (Jang et al., 2016)
   6. (Meghani et al., 2018)
   7. (Monti et al., 2006)
   8. Ìý(Monti et al., 2013)Ìý
   9. (Kabat-Zinn et al., 1987)
   10. Ìý(Oster et al., 2006)Ìý

   11. (Puig et al., 2006)Ìý

   12. (Svensk et al., 2009)
   13. (Thyme et al., 2009)
   14. (Joly et al., 2022)
   15. (Radl et al., 2018)
   16. (Czamanski-Cohen et al., 2019)
   17. (Chan et al., 2022)
   18. (Thyme et al., 2022)
   19. (Collette et al., 2021)
   20. (Collie et al., 2006)
   21. (Deane et al., 2000)
   22. (Forzoni et al., 2010)
   23. (Luzzato et al., 2003)
   24. (Oster et al., 2007)
   25. (Oster et al., 2008)
   26. (Oster et al., 2009)
   27. (Reilly et al., 2018)
   28. (Wood et al., 2013)
   29. (Ando et al., 2013)
   30. (Bell et al., 2022)
   31. (Elimimian et al., 2020)
   32. (Geue et al., 2013)
   33. (Koom et al., 2016)
   34. (Lee et al., 2017)
   35. (Lefevre et al., 2016)
   36. Ìý(Lin et al., 2012)
   37. (Nainis et al., 2006)
   38. (Visser & Op’t Hoog, 2008)
   39. (Warson, 2012)
   40. Ìý(Wiswell et al., 2019)Ìý
   41. (Yakar et al., 2021)