Art Therapy and Art Making for Addressing Cancer-Related Pain and Distress in Adult Populations: A Scoping Review.

[BACKGROUND] Worldwide, cancer is a leading cause of morbidity and mortality, with symptoms of pain and emotional distress, associated with the disease and its treatment. Art therapy and art making are promising adjuncts to pharmacotherapy for these symptoms. However, current studies do not support replacing pharmacotherapy with these methods.

[RESEARCH QUESTION] Is there evidence supporting the use of art therapy and/or art making interventions for managing cancer-related pain (primary outcome) and emotional distress (secondary outcome) among adult cancer survivors, during and following active treatment?

[METHODS] We searched six databases, including PubMed, CINAHL, Scopus, ProQuest (library's version), and Google Scholar, using the search terms "cancer pain" AND "art therapy" OR "art making." Inclusion criteria included English language, peer-reviewed studies, on adult cancer survivors. The search yielded 1305 results, with 23 meeting the inclusion criteria. Because emotional distress was frequently discussed in the context of cancer-related pain in the included studies, it was added as a secondary outcome.

[RESULTS] The efficacy of art therapy/art making to manage cancer-related pain and emotional distress was difficult to determine due to the heterogeneity of study designs and interventions. Of the studies reviewed in which pain was a primary outcome, eight found significant pain reductions, three found small or no effects, and three reviews described art making as a non-verbal method of communicating about pain, but did not address changes in pain levels. The terms "art therapy" and "art making" were sometimes used interchangeably. The choice of therapeutic approach was sometimes financially driven, and was also impacted by the availability of certified art therapists.

[DISCUSSION] Methodological shortcomings of the existing research include small sample sizes, lack of standardized intervention protocols, and inconsistent outcome measures, underscoring the need for more rigorous and generalizable studies. Future research should consider neuroimaging evidence linking aesthetic experiences with activation of the brain's "reward network" by utilizing fMRI to study brain activity during art therapy and art making interventions.