Written by Erin Yeh
Arts and creative activities are linked to improvements in mental and physical health, as well as social connections. There have been reports of decreased PTSD and other trauma-related symptoms. Although art engagements show improvements in trauma recovery, it is not a widely explored therapeutic modality.
Johns Hopkins International Arts + Mind Lab, the Center for Applied Neuroaesthetics, and Path with Art (PwA) in Seattle have collaborated to understand the positive impact of creative activities for people dealing with mental health issues. The study targeted low- or no-income adults in active recovery from trauma with the goal of understanding how arts programs can benefit trauma recovery, particularly with regard to mental health, social connectedness, and self-efficacy (Health promotion exerciseDigital ID: https://doi.org/10.1177/15248399261445966)
The neuroscience behind art therapy
Creative arts therapies engage neural pathways associated with emotional regulation and cognitive function, as well as social reintegration. Participation in arts programs may support emotional resilience and help individuals manage stress. For example, a 2016 study found that group singing reduced negative affect and increased positive affect, along with significant changes in stress-related biomarkers (Open Journal of Nursing, Digital ID: https://doi.org/10.3389/fpsyg.2020.00896). Additionally, the creative arts can promote social connection, build confidence, and reduce social isolation and loneliness—critical components of trauma recovery. These programs are often implemented in a structured environment that provides opportunities for people to share experiences. These factors support healing by encouraging emotional expression, enhancing a sense of belonging, and creating a safe space for mutual support.
Participation in the creative arts may also improve self-efficacy, the belief in one’s ability to influence life events and overcome challenges. This is another crucial component of trauma recovery, as an individual’s sense of self-efficacy influences feelings of helplessness and disempowerment.
Study participation in the arts
The study was conducted over a 12-month period and included four individual 8-week sessions that typically lasted 2 hours. Pre- and post-study surveys were used to evaluate strata outcomes. The study was designed with two complementary models: the evidence-based framework of arts and culture in public health and the impact thinking framework. The Arts and Culture in Public Health framework provides an evidence-based understanding of how arts and cultural engagement impact individual and collective health. He points out that experiences such as enjoying art, finding personal meaning in activities, and expressing oneself can lead to positive outcomes. These benefits may include greater overall mental and emotional health, reduced feelings of loneliness and social isolation, and increased confidence in one’s ability to deal with challenges and achieve goals. These are the main outcomes that the study focuses on measuring.
The impact thinking framework helps researchers use what they have learned to create practical and effective programs. It emphasizes working closely with others, learning and adapting throughout the process, and focusing on real-world outcomes. This approach helps ensure that any interventions developed from the study can create lasting benefits for both individuals and communities and that the findings can be applied in meaningful ways outside the research setting.
The study population consisted of low- or no-income participants aged 18 years and older in active trauma recovery. There was no control group. Each participant was enrolled in at least one 8-week class with PwA. These classes included: choir, music, dance, theatre, writing, poetry, storytelling, podcasting, visual arts, mixed media, and design thinking. Sessions were available virtually and in person.
Surveys were distributed to all 590 participants, but only 120 completed the pre- and post-surveys. Duplicate responses from participants who completed multiple quarters were identified to ensure independence of observations. In total, 80 independent responses were analysed. Exit surveys were also administered, and 103 completed surveys were analysed, regardless of pre- and post-survey completion. If there are multiple responses from the same participant, only the first response is included to ensure that an individual’s response is only recorded once.
Participating in the arts improves mental health
Overall trends showed improvement, but individual responses varied. Some participants improved significantly, many saw modest changes, and others saw declines. In pre- and post-study surveys, there was a significant improvement in mental health (P < .01), a moderate improvement in self-efficacy (P < .02), and a significant reduction in loneliness (P < .01).
In exit surveys, quantitative results showed that 90.3% of participants agreed that the classes increased their self-efficacy, 88.3% reported improvements in mental health, 80.6% responded that they felt less lonely since joining the classes, and 69% of participants reported making new friends in the classes, indicating improvements in sociability.
Regarding the qualitative findings, the most prominent theme across all participants was the importance of social connection and community. PwA classrooms helped participants feel safe and included and provided a sense of community, thus enhancing their sense of belonging, alleviating social isolation, and providing structure to social interactions.
Creative engagement helped participants process their emotions and cope with their trauma, as well as manage stress, anxiety, and other trauma-related symptoms. The research team writes that these findings are particularly consistent with previous studies showing evidence that participation in the arts benefits mental health. Participants reported increased confidence, strength, and belief in their ability to face challenges. The structured, non-judgmental atmosphere also provided an environment for participants to take creative risks without fear of criticism. Again, these findings are consistent with previous research demonstrating that participation in the arts can enhance self-efficacy, confidence, and a sense of purpose.
The researchers mention some limitations. First, there was a lack of access to surveys. Some participants may not have been able to record their answers in surveys because they did not have personal technology or the resources to borrow technology. As such, there may be a large number of members from an already marginalized group who cannot provide feedback. In addition, there is the potential for self-selection bias due to the voluntary nature of study participation. Participants who felt positive about the program or had fewer barriers to participation may have been more likely to complete the questionnaires, skewing the results toward more positive outcomes. Finally, the study did not control for external variables that may have influenced participants’ experience and responses.
However, the study showed similar results from previous studies that showed a positive impact of arts participation for people recovering from trauma and trauma-related symptoms. The team encourages that future studies should take into account extraneous variables that may influence outcomes, and consider control groups and longitudinal designs. There must also be easier ways to collect data and broader recruitment strategies.
For patients recovering from trauma, arts-based approaches are a valid and valuable treatment method that can improve their mental health, self-efficacy, and social connectedness, which are vital to trauma recovery. Moreover, it offers an intervention method that can complement traditional therapeutic interventions. Practitioners working with patients affected by trauma are encouraged to find arts-based programming a flexible, low-threshold, and culturally responsive option. Researchers encourage greater investment in community arts infrastructure and greater integration into local systems of care.
