A systematic review of the effectiveness of art therapy delivered in school-based settings to children aged 5–12 years

Background: School-based art therapy aims to facilitate children's personal change and growth through the use of visual arts media, such as drawing, painting, sculpture, clay, or digital art.Aims: To identify and synthesise the types of school-based art therapy interventions, and appraise the effectiveness for children aged 5-12.Methods: Systematic searching through ten major electronic databases, grey literature, and contact with experts in the field.Results: Six completed and two on-going studies were identified. Art therapy was delivered to children with asthma, behavioural disorders, oppositional defiant disorders, separation anxiety disorders, learning disorders, and disruptive behaviours. All interventions were delivered over 7-25 sessions, and lasted 40-60' per session. The sample sizes ranged between 20-109 participants, involving 247 participants in total.Conclusions: Art therapy can be effective in improving children's quality of life; anxiety; self-concept; problem-solving skills, attitudes towards school; emotional and behavioural difficulties. The follow-up findings were also promising; though confirmatory evidence is needed.Implications: The risk of bias was high and unclear, highlighting the importance of following standardised reporting guidelines. Future research needs to focus on the identification of primary outcomes and measures that are tailored to art therapy interventions, and explore the (cost-) effectiveness of shorter versus longer durations of treatment.Plain-language summaryArt therapy is widely used in schools to alleviate and prevent children's emotional difficulties. In contrast to talking therapies, art therapy aims to facilitate personal change and growth through the use of visual arts media, such as, drawing, painting, sculpture, clay, or digital art media.This systematic review aims to summarise the results from school-based art therapy studies, and to appraise the effectiveness for children aged 5–12. Ten major electronic databases were systematically searched. Art therapy–specific journals and books were hand-searched, and contact was made with experts in the field.From the 10,911 retrieved results, 623 results were duplicates and 9181 were excluded following title screening. Following abstract screening, 41 papers appeared to be relevant and the full text was requested. Six completed and two on-going studies met the inclusion criteria and were included in this review. Art therapy was delivered to children with asthma, behavioural disorders, oppositional defiant disorders, separation anxiety disorders, learning disorders, and disruptive behaviours. The sessions were delivered over 7–25 weeks, and lasted 40'–60' per session. The number of children in individual studies ranged between 20–109 participants, providing this systematic review with data from 247 participants in total.The results suggested that art therapy is effective in improving children's quality of life; anxiety; self-concept; problem-solving skills, attitudes towards school; emotional and behavioural difficulties. The follow-up findings were also promising; though further research is needed to increase confidence. Most studies appeared to have questionable methodological quality. Therefore, the use of reporting guidelines is important to allow for a better understanding of the results. Future research is needed to identify common primary outcomes, and investigate the effectiveness and cost-effectiveness of shorter versus longer durations of treatment.