The Effectiveness of Trauma Focused Art Therapy

NCT05593302 | Completed

• 1 other identifier: TFAT SU1424 -101
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

More than 30% of patients with trauma-related complaints do not benefit from prescribed treatments. This concerns patients who have either a poor verbal memory or who are unable or do not wish to talk about their experiences. In clinical practice, trauma-oriented art therapy appears to be an appropriate treatment. The visual, tangible, experiential character of art therapy is in line with the often wordless, visual and sensory nature of trauma. Art therapy aims to contribute to achieving personal goals through the use of visual materials and techniques. This approach has been insufficiently examined. Treatment of refugees with Trauma-Focused Art Therapy has previously been shown to be feasible in clinical practice and acceptable to patients. Using a Mixed Method design, the researchers aim to measure the effect of this protocol in specialized mental health care and the experience of patients with regard to their personal recovery.

Conditions

Trauma; Psychological; Art Therapy

Keywords

Art Therapy; Trauma

Outcome Measures

Primary Outcomes (1)

• Self-expression and Emotion Regulation in Art Therapy Scale

  Self-expression and Emotion Regulation in Art Therapy Scale (SERATS): Assessment of emotional self-expression and regulation during therapy with 9 5-point scale items

  16-18 repeated measures of emotional self-expression and regulation, i.e. weekly over the course of 18 weeks (3-5 weeks control period + 10 weeks intervention + 3 weeks follow-up))

Secondary Outcomes (5)

• Rosenberg Self-Esteem Scale

  16-18 repeated measures of self-esteem, i.e. weekly over the course of 18 weeks (3-5 weeks control period + 10 weeks intervention + 3 weeks follow-up))

• Resilience Scale

  16-18 repeated measures of mental resiliency, i.e. weekly over the course of 18 weeks (3-5 weeks control period + 10 weeks intervention + 3 weeks follow-up))

• Beck Depression Inventory

  16-18 repeated measures of depression severity, i.e. weekly over the course of 18 weeks (3-5 weeks control period + 10 weeks intervention + 3 weeks follow-up))

• Mental Health Continuum Short Form (MHC-SF)

  16-18 repeated measures of positive mental health, i.e. weekly over the course of 18 weeks (3-5 weeks control period + 10 weeks intervention + 3 weeks follow-up))

• Post-traumatic stress disorder Check List

  Change from baseline PTSD symptoms at 15 weeks (after completion of intervention)

Study Arms (1)

Control Period - Intervention Period

EXPERIMENTAL

Multiple baseline single case experimental design wherein all patients are first assigned to the control condition (or control period) are then assigned to the intervention condition (or intervention period) and finally to the follow-up period (control period). Patients are randomized for the time (t) at which they start with the intervention.

Behavioral: Trauma-Focused Art Therapy (TFAT)

Interventions

Trauma-Focused Art Therapy (TFAT) BEHAVIORAL

Individual Trauma Focused Art Therapy (TFAT) consisting of 10 sessions. Each session lasts 60 minutes. Sessions are aimed at trauma recovery using visual art therapy. The sessions cover an introduction, making pieces of artwork, and reflection. Three phases can be distinguished: Phase 1: 'stabilization and symptom reduction', i.e. exploring traumatic and positive memories, imagining a lifecourse, and expressing a safe haven (4 sessions). Phase 2:'uttering and expressing memories', i.e. expressing chosen memories by making 5 pieces of artwork. Materials that can be used include clay, paint, graphite pencil or crayons and if needed with support of imagination using relevant photographs or objects (5 sessions). Phase 3: 'integration and meaning attribution', i.e. ordering and assembling of the 5 pieces of artwork. Patients are asked to appraise the memories in the here-and-now present (c.f. mindfulness-based cognitive therapy) (1 session).

Control Period - Intervention Period

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Having trauma-related symptoms ((i.e. nightmares, flashbacks, persistent fatigue or depression, anxiety in regards to specific triggers, sleep disorders)
• Being eligible for art therapy on discretion of multidisciplinary treatment panel (consisting of, for example. a psychiatrist, psychologists, sociotherapists, and art therapists)
• Being motivated to work on traumatic memories

You may not qualify if:

• Psychosis or acute crisis
• intellectual disability (precluding the filling out of questionnaires).

Sponsors & Collaborators

• HAN University of Applied Sciences: lead

Study Sites (1)

HAN University of Applied Sciences

Nijmegen, Gelderland, Netherlands

Location

Related Publications (1)

• Heijman J, Wouters H, Schouten KA, Haeyen S. Effectiveness of trauma-focused art therapy (TFAT) for psychological trauma: study protocol of a multiple-baseline single-case experimental design. BMJ Open. 2024 Jan 29;14(1):e081917. doi: 10.1136/bmjopen-2023-081917.

  PMID: 38286685 DERIVED

MeSH Terms

Conditions

Wounds and Injuries

Study Officials

• Christine De Vries, Msc.

  HAN University of Applied Sciences

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: dr. Suzanne Haeyen

Model Details: Multiple baseline single case experimental design (MBSCED) wherein all patients are first assigned to the control condition (or control period) and are then assigned to the intervention condition (or intervention period) and finally the follow-up period (control period). Patients are randomized for the time (t) at which they start with the intervention. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) recognizes the MBSCED as an experimental design (doi: 10.1016/j.jclinepi.2016.04.006).

Study Record Dates

• First Submitted: October 12, 2022
• First Posted: October 25, 2022
• Study Start: October 10, 2022
• Primary Completion: June 1, 2024
• Study Completion: August 31, 2024
• Last Updated: September 4, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: After publication of the main paper until 10 years after this publication.
• Access Criteria: The principal investigator will investigate whether requests are reasonable and feasible and adhere to ethical considerations.

Locations

NL (1)