Resource Results

"This study involved a thematic analysis of montage paintings and of related clinical records of 240 active-duty military service members collected during their art therapy treatment for traumatic brain injury and underlying psychological health concerns, including post-traumatic stress, at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Congruent with other research findings, the qualitative analyses of this study suggest that the group art therapy experiences fostered improvement in interpersonal relatedness, hopefulness and gratification for the service members in treatment, aiding in externalisation, progressive exposure and construction of a trauma narrative imperative for recovery. The mixed media nature of the montage painting supported the expression of a range of postcombat symptoms. Results from this study highlighted the complexity of military culture, necessitating a broader scope of analyses for how art therapy helps service members express and communicate their challenges to care providers, peers and family as well as regulate emotion in the short and long term."

"Three case studies of veterans are presented who received either art therapy, dance/movement therapy or music therapy via in-home, synchronous clinical video telehealth through a VA medical center in the southeastern United States. As the use of distance technology becomes more widely implemented within healthcare, it becomes increasingly important for providers to receive adequate training and develop comfort and confidence in adapting their practices to distance delivery. Case studies are one way for creative arts therapists to conceptualize and demonstrate how their in-person practices can be adapted for distance delivery via telehealth."

Traumatic  brain  injury  (TBI)  and  posttraumatic  stress  (PTS) frequently occur in military populations. Art Therapy is one promising clinical therapy that may help service members to externalize emotions and experiences that they may not be able to express in words. To investigate the neurobiological correlates of art therapy, two prospective research studies are currently recruiting at NICoE using neuroimaging techniques:

1. Evaluation of Quantitative EEG During Art Therapy in Service Members with Co-Morbid TBI and PTS Symptoms (QEEG Study)
2. Art Therapy and Emotional Wellbeing in Military Populations with PTS Symptoms (fMRI Study)

"The study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable psychiatric diagnoses. Affective symptoms and struggles related to verbally expressing information can limit communication in individuals with symptoms of PTSD and deployment-related health conditions. Visual self-expression through art therapy is an alternative way for SMs with PTSD and other PH conditions to communicate their lived experiences. This study offers the first systematic examination of the associations between visual self-expression and standardised clinical self-report measures."

Open access  to full article provided by Creative Forces.

Art therapy has been found to help veterans with symptoms of post-traumatic stress. There is however limited scholarship on the differences in outcomes based on dosage (short-term vs. long-term treatment) especially for active duty military service members (SMs). This mixed methods program evaluation study examined feedback from SMs on their experiences of art therapy in an integrative medical care center after 3 weeks of group therapy and at the end of treatment (average time of 2 years). Data included participant demographics, feedback surveys and narrative responses from SMs experiences of art therapy. The results indicate that longer-term art therapy resulted in improved perceived outcomes compared with the short-term 3-week intervention. SMs with longer time in service reported the most improved self-reported outcomes. Women SMs expressed more positive emotions during their art making. Specific themes that were effectively addressed through art therapy included frustration tolerance, grief and loss, emotion regulation, personal insight, resiliency, and trauma processing. SMs also highlighted the unique and transformative role of the relationship with the therapist with alleviation of symptoms. The findings suggest benefits to long-term art therapy including improved ability in SMs to be aware of their symptoms and communicate effectively with others.

This study includes retrospective data from 113 service members attending the NICoE four-week Intensive Outpatient Program (IOP) who participated in group and individual art therapy sessions, self-report assessments, a traumatic brain injury history (TBI) assessment, and an advanced MRI scan. Art therapy masks were coded by three independent coders for 23 individual themes. Presence or absence of each theme was determined from review of mask image and clinical notes. This analysis includes only the results for the theme of psychological closure and/or healing.

Art therapy has traditionally been used as a treatment approach but it can also be applied successfully as a clinical behavioral health assessment tool in the care of military service members suffering from the effects of traumatic brain injury (TBI) and operational stressors. This observational study examined patterns of associations between visual imagery (mask and montage paintings) and clinical symptoms among 240 active-duty military service members with TBI, and associated psychological health conditions to include posttraumatic stress disorder (PTSD). The service members had participated in a 4-week intensive outpatient assessment and treatment program at the Walter Reed National Military Medical Center in the United States. Themes seen in the visual imagery were examined in correlation with standardized measures of PTSD (Posttraumatic Stress Disorder Checklist: Military Version) and depressive symptoms (Patient Health Questionnaire-9). The analysis showed that certain themes, like the use of color symbolism to depict psychological states, were associated with greater PTSD and depressive symptoms at the beginning of the program. In addition, patients who depicted themes like physical injury, psychological injury, and memories of deployment in Week 1 of the program were more likely to continue to represent them in Week 4. Depiction of themes like color metaphors and duality was associated with lower depressive symptoms at the end of the program. The findings indicate the potential clinical and prognostic value of tracking the content of visual imagery created by military service members with TBI and associated psychological health conditions. Clinical applications include the recognition that certain visual themes could indicate higher or lower levels of distress and may help guide targeted care.

"Background: Program evaluations can serve as a doorway to research in the creative arts therapies. This study provides findings from analyses of participant feedback on short- and long- term art therapy services for military service members with post-traumatic stress and traumatic brain injury (TBI).

Methods: Data for the study included feedback surveys from 204 service members who received art therapy services as part of treatment at an integrative care setting.

Results: The results indicate that long-term art therapy resulted in higher satisfaction with treatment. Art therapy helped most with developing a sense of self after injury, experiencing positive emotions, processing trauma, and reducing feelings of guilt, grief, and loss. There were no statistically significant differences in outcomes based on rank or severity of TBI, but art therapy services were found to be related to improved symptoms for service members with longer times in service.

Implications: The feedback from evaluation helps identify potential areas for further research on how art therapy addresses issues of identity, time in service and experiences of emotions as a result of post-traumatic stress and TBI. Evaluation provides directions for further clinical treatment, and yields data on improving quality of care."