Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-16T16:15:36.208Z Has data issue: false hasContentIssue false
  • English
  • Français

Art therapy and self-image: A 5-year follow-up art therapy RCT study of women diagnosed with breast cancer

Published online by Cambridge University Press:  14 September 2021

Karin Egberg Thyme Open the ORCID record for Karin Egberg Thyme [Opens in a new window] ,
Björn Tavelin ,
Inger Öster ,
Jack Lindh  and
Britt Wiberg
Karin Egberg Thyme*
Affiliation:
Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden
Björn Tavelin
Affiliation:
Department of Radiation Sciences, Umeå University, Umeå, Sweden
Inger Öster
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden Department of Community Medicine and Rehabilitation, Umeå University, UmeåSweden
Jack Lindh
Affiliation:
Department of Radiation Sciences, Umeå University, Umeå, Sweden
Britt Wiberg
Affiliation:
Department of Psychology, Umeå University, Umeå, Sweden
*
Author for correspondence: Karin Egberg Thyme, Department of Clinical Sciences, Division of Psychiatry, Umeå University, SE-90187 Umeå, Sweden. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This follow-up study on perceived self-image and psychophysical distress/psychic symptoms was based on a ranomized contolled study of art therapy on women with breast cancer.

Method

The aim was to examine the long-term effects of time-limited art therapy using the instruments of Structural Analysis of Social Behavior (SASB) and Symptom Check List-90 (SCL-90).

Results

Three attachment clusters of the SASB showed significant changes post therapy: Autonomous self (cluster 1), Accepting self (cluster 2), and Loving self (cluster 3). Clusters 2 and 3 continued to change in favor of the intervention group at the 5-year follow-up. There were no significant differences in the SCL-90 results between the intervention group and the control group in the follow-up study.

Significance of results

The art therapy intervention was both therapeutic and psycho-educative. The conclusion of this study is that approaching emotions through time-limited art therapy seems to have a long-lasting effect on the attachment behavioral system shown in the SASB model post intervention, and this effect remained 5 years later.

Keywords

Art therapyBreast cancerFollow-upSASBSCL-90
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 4 , August 2022 , pp. 482 - 490
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Aaronson, NK, Ahmedzai, S, Bergman, B, et al. (1993) The European Organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. JNCI: Journal of the National Cancer Institute 85(5), 365–376. doi:10.1093/jnci/85.5.365.CrossRefGoogle ScholarPubMed
Adler, JM and Olin, FW (2012) Living into the story: Agency and coherence in a longitudinal study of narrative identity development and mental health over the course of psychotherapy. Journal of Personality and Social Psychology 102(2), 367–389.CrossRefGoogle Scholar
Archer, J (2008) Theories of grief: Past, present, and future perspectives. In Stroebe, MS, Hansson, RO, Schut, H & Stroebe, W (eds.), Handbook of Bereavement Research and Practice. Washington: American Psychological Association, pp. 45–65.Google Scholar
Armelius, K (2001). Reliabilitet och validitet för den svenska versionen av SASB–självbildstestet. (Reliability and validity for the Swedish version of SASB – the self-image test). Prepublished manuscript. Umeå, Sweden: Institutionen för psykologi, Umeå Universitet.Google Scholar
Armelius, K and Armelius, B-Å (2010). SASB-modellen: En introduktion (SASB An introduktion). Prepublished manuscript. Umeå, Sweden: Instutionen för psykologi, Umeå Universitet.Google Scholar
Bedics, JD and Henry, WP (2005) The therapeutic process as a predictor of change in patients´ important relationships during time-limited dynamic psychotherapy. Psychotherapy: Theory, Research, Practice, Training 42(3), 279–284.CrossRefGoogle Scholar
Benjamin, LS (1974) Structural analysis of social behavior. Psychological Review 81, 392–425.CrossRefGoogle Scholar
Benjamin, LS (1996) A clinician-friendly version of the interpersonal circumplex: Structural analysis of social behavior (SASB). Journal of Personality Assessment 66, 248–266.CrossRefGoogle Scholar
Benjamin, LS (2000) Reference Manual for Coding Interactions in Terms of Structural Analysis of Social Behavior (SASB\Intrex). Salt Lake City: University of Utah.Google Scholar
Birgegård, A, Björck, C, Norring, C, et al. (2009) Anorexic self-control and bulimic self-hate: Differential outcome prediction from initial self-image. International Journal of Eating Disorders 42, 522–530.CrossRefGoogle ScholarPubMed
Björck, C, Clinton, D, Sohlberg, S, et al. (2003) Interpersonal profiles in eating disorders: Ratings of SASB self-image. Psychology and Psychotherapy: Theory, Research and Practice 76(4), 337–349.CrossRefGoogle ScholarPubMed
Björck, C, Clinton, D, Sohlberg, S, et al. (2007) Negative self-image and outcome in eating disorders: Results at 3-year follow-up. Eating Behaviors 8, 398–406.CrossRefGoogle ScholarPubMed
Boehm, K, Cramer, H, Staroszynski, T, et al. (2014) Arts therapies for anxiety, depression, and quality of life in breast cancer patients: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine 2014. doi:10.1155/2014/103297.CrossRefGoogle ScholarPubMed
Carreira, H, Williams, R, Müller, M, et al. (2018) Associations between breast cancer survivorship and adverse mental health outcomes: A systematic review. JNCI Journal of National Cancer Institute 110, 12. doi:10.101093/jnci/djy177.CrossRefGoogle ScholarPubMed
Czamanski-Cohen, J, Wiley, JF, Sela, N, et al. (2019) The role of emotional processing in art therapy (REPAT) for breast cancer patients. Journal of Psychosocial Oncology 37(5), 586–598. doi:10.1080/07347332.2019.1590491.CrossRefGoogle Scholar
De Feudis, RL, Graziano, G, Lanciano, T, et al. (2019) An art therapy group intervention for cancer patients to counter distress before chemotherapy. Arts & Health 10, 1–14. doi:10.1080/17533015.2019.1608566.Google Scholar
Derogatis, LR (1994) SCL-90-R: Administration, Scoring, and Procedures Manual, 3rd ed. Minneapolis, MN: National Computer Systems.Google Scholar
Derogatis, LR and Cleary, PA (1977) Confirmation of the dimensional structure of the SCL-90: A study in construct validation. Journal of Clinical Psychology 33(4), 981–989.3.0.CO;2-0>CrossRefGoogle Scholar
Derogatis, LR, Lipman, RS and Covi, L (1973) SCL-90: An outpatients psychiatric rating scale—A preliminary report. Psychopharmacological Bulletin 9, 13–28.Google Scholar
Egberg Thyme, K, Sundin, EC, Stahlberg, G, et al. (2007) The outcome of short-term psychodynamic art therapy compared to short-term psychodynamic verbal therapy for depressed women. Psychoanalytic Psychotherapy 21, 250–264.CrossRefGoogle Scholar
Egberg Thyme, K, Sundin, EC, Wiberg, B, et al. (2009) Individual brief art therapy can be helpful for women with breast cancer: A randomized controlled clinical study. Palliative and Supportive Care 7, 87–95.CrossRefGoogle ScholarPubMed
Fafouti, M, Paparrigopoulos, T, Zervas, Y, et al. (2010) Depression, anxiety and general psychopathology in breast cancer patients: A cross-sectional control study. In Vivo 24, 803–810.Google ScholarPubMed
Florsheim, P, Henry, WP and Benjamin, LS (1996) Integrating individual and interpersonal approaches to diagnosis: The structural analysis of social behavior and attachment theory. In Kaslow, FW (ed.), Handbook of Relational Diagnosis and Dysfunctional Family Patterns. Wiley Series in Couples and Family Dynamics and Treatment. New York: John Wiley & Sons, pp. 81–101.Google Scholar
Forsén Mantilla, E, Bergsten, K and Birgegård, A (2014) Self-image and eating disorder symptoms in normal and clinical adolescents. Eating Behaviors 15(1), 125–131.CrossRefGoogle ScholarPubMed
Fridell, M, Cesarec, Z, Johansson, M, et al. (2002). Symptom Checklist 90 (SCL-90): Swedish standardization and validation of the symptom scale. [Original title: SCL-90: Svensk normering, standardisering och validering av symtomskalan]. Rapport. Stockholm: Statens Institutionsstyrelse (SiS).Google Scholar
Geue, K, Goetze, H, Buttstaedt, M, et al. (2010) An overview of art therapy interventions for cancer patients and the results of research. Complementary Therapies in Medicine 18(3-4), 160–170.CrossRefGoogle ScholarPubMed
Gezelius, C, Wahlund, B, Carlsson, L, et al. (2016) Adolescent patients with eating disorders and their parents: A study of self-image and outcome at an intensive outpatient program. Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity 21(4), 607–616. doi:10.1007/s40519.016-0286-4.CrossRefGoogle ScholarPubMed
Gillieron, E (1989) Short psychotherapeutic interventions (four sessions). Psychotherapy and Psychosomatics 51, 32–37.CrossRefGoogle Scholar
Granberg, Å and Armelius, K (2003) Change of self-image in patients with neurotic, borderline and psychotic disturbances. Clinical Psychology and Psychotherapy 10, 228–237.CrossRefGoogle Scholar
Hammer, AL and Marting, MS (1988) Manual for the Coping Resources Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Harper, A and Power, M (1995) Development of the World Health Organization WHOQOL-BREF quality of life assessment? Psychological Medicine 28(3), 551–558.Google Scholar
Henry, WP, Schacht, TE and Strupp, HH (1990) Patient and therapist introject, interpersonal process, and differential psychotherapy outcome. Journal of Consulting and Clinical Psychology 58(6), 768–774. doi:10.1037/0022-006X.58.6.768.CrossRefGoogle ScholarPubMed
Herman, J (1992) Trauma and Recovery. London: Pandora.Google Scholar
Hertrampf, RS and Wärja, M (2017) The effect of creative arts therapy and arts medicine on psychological outcomes in women with breast or gynaecological cancer: A systematic review of arts-based interventions. The Arts in Psychotherapy 56, 93–322.CrossRefGoogle Scholar
Isaksson, C, Norlén, AK, Englund, B, et al. (2009) Changes in self-image as seen in tree paintings. The Arts in Psychotherapy 36(5), 304–312.CrossRefGoogle Scholar
Junkert-Tress, B, Schnierda, U, Hartkamp, N, et al. (2001) Effects of short-term dynamic psychotherapy for neurotic, somatoform, and personality disorders: A prospective 1-year follow-up. Psychotherapy Research 11(2), 187–200.CrossRefGoogle Scholar
Kaschak, E (1992) Engendered Lives. A New Psychology of Women's Experiences. New York: Basic Books.Google Scholar
Luutonen, S, Sintonen, H, Stormi, T, et al. (2014) Health-related quality of life during adjuvant radiotherapy in breast cancer. Quality of Life Research 23, 1363–1369.CrossRefGoogle ScholarPubMed
Mann, J (1973) Time-Limited Psychotherapy. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
Maujean, A, Pepping, CA and Kendall, E (2015) A systematic review of randomized controlled studies of art therapy. Art Therapy: Journal of the American Art Therapy Association 31, 37–44.CrossRefGoogle Scholar
Norberg, M, Magnusson, E, Egberg Thyme, K, et al. (2015) Breast cancer survivorship—intersecting gendered discourses in a 5-year follow-up study. Health Care for Women International 36, 617–633. doi:10.1080/07399332.2015.1017640.CrossRefGoogle Scholar
Öster, I, Svensk, A-C, Magnusson, E, et al. (2006) Art therapy improves coping resources: A randomized controlled study among women with breast cancer. Palliative and Supportive Care 4, 57–64.CrossRefGoogle ScholarPubMed
Öster, I, Magnusson, E, Egberg Thyme, K, et al. (2007) Art therapy for women with breast cancer: The therapeutic consequences of boundary strengthening. The Arts in Psychotherapy 34(3), 277–288.CrossRefGoogle Scholar
Öster, I, Magnusson, E, Egberg Thyme, K, et al. (2008) Erratum to “Art therapy for women with breast cancer: The therapeutic consequences of boundary strengthening”. The Arts in Psychotherapy 35(3), 242.CrossRefGoogle Scholar
Öster, I, Åström, S, Lindh, J, et al. (2009) Women with breast cancer and gendered limits and boundaries—Art therapy as a “safe space” for enacting alternative subject positions. The Arts in Psychotherapy 36, 29–38.CrossRefGoogle Scholar
Öster, I, Tavelin, B, Egberg Thyme, K, et al. (2014) Art therapy during radiotherapy—A five-year follow-up study with women diagnosed with breast cancer. The Arts in Psychotherapy 41, 36–40.CrossRefGoogle Scholar
Pan, XF, Fei, MD, Zhang, KY, et al. (2013) Psychopathological profile of women with breast cancer based on the symptom checklist-90-R. Asian Pacific Journal of Cancer Prevention 14, 6579–6584.CrossRefGoogle Scholar
Rakici, SY and Karaman, E (2019) Colorful screams of silent emotions: A study with oncology patients. Indian Journal of Palliative Care 25(3), 361–366.CrossRefGoogle Scholar
Ruiz, MA, Pincus, AL and Bedics, JB (1999) Using the structural analysis of social behavior (SASB) to differentiate young adults with borderline personality disorder features. Journal of Personality Disorders 13(2), 187–198.CrossRefGoogle ScholarPubMed
Salander, P, Lilliehorn, S, Hamberg, K, et al. (2011) The impact of breast cancer on living an everyday life 4.5–5 years post-diagnosis—A qualitative prospective study of 39 women. Acta Oncologica 50, 399–407.CrossRefGoogle ScholarPubMed
Saunders, S, Hammond, C and Thomas, R (2019) Exploring gender-related experiences of cancer survivors through creative arts: A scoping review. Qualitative Health Research 29(1), 135–148.CrossRefGoogle ScholarPubMed
Schaverian, J (2000) The triangular relationship and the aesthetic countertransference in analytical art psychotherapy. In Gilroy, A & McNielly, G (eds.), The Changing Shape of art Therapy: New Developments in Theory and Practice. UK, London: Jessica Kingsley, pp. 55–83.Google Scholar
Schaverien, J (1992) The Revealing Image. Analytical Art Psychotherapy in Theory and Practice. London: Routledge.Google Scholar
Schut, MSH (1999) The dual process model of coping with bereavement: Rationale and description. Death studies 23(3), 197–224.CrossRefGoogle Scholar
Sherman, DW, Rosedale, M and Haber, J (2012) Reclaiming life on one's own terms: A grounded theory study of the process of breast cancer survivorship. Oncology Nursing Forum 39(3), 258–268.CrossRefGoogle ScholarPubMed
Svensk, A-C, Öster, I, Egberg Thyme, K, et al. (2009) Art therapy improves experienced quality of life among women undergoing treatment for breast cancer: A randomized controlled study. European Journal of Cancer Care 18, 69–77.CrossRefGoogle ScholarPubMed
Tang, Y, Fu, F, Gau, H, et al. (2019) Art therapy for anxiety, depression, and fatigue in females with breast cancer: A systematic review. Journal of Psychosocial Oncology 37(1), 79–95.CrossRefGoogle ScholarPubMed
The WHOQOL Group (1995). The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Social Science and Medicine 41(10), 1403–1409.CrossRefGoogle Scholar
Wilhelmsson-Göstas, M, Wiberg, B and Kjellin, L (2012) Increased participation in the life context: A qualitative study of clients´ experiences of problems and changes after psychotherapy. European Journal of Psychotherapy and Counselling 14(4), 365–380. doi:10.1080/13642537.2012.734498.CrossRefGoogle Scholar
Wonderlich, SA and Swift, WJ (1990) Borderline versus other personality disorders in the eating disorders: Clinical description. International Journal of Eating Disorders 9, 629–638.3.0.CO;2-N>CrossRefGoogle Scholar
Wood, MJM, Molassiotis, A and Payne, S (2011) What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review. Psycho-Oncology 20, 135–145.CrossRefGoogle ScholarPubMed
Ybrandt, H and Armelius, K (2009) Changes in self-image in a psychotherapy supervisor training program. The Clinical Supervisor 28(2), 113–123.CrossRefGoogle Scholar