Drawing for Anxiety

(D&A Trial)

Overseen By Sarah Myruski, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Penn State University

Disqualifiers: Outside age range, Non-English speakers

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to explore how drawing activities can reduce anxiety. Participants will engage in guided drawing (a structured drawing activity), free drawing, or simple pencil and paper activities to determine which method best lowers anxiety levels. The trial will also assess whether these activities aid in physiological regulation, such as stress management. Adolescents aged 13 to 17.9 years and young adults aged 18 to 25 years who can speak and understand English are eligible to participate. As an unphased trial, this study offers a unique opportunity to contribute to understanding non-medical approaches to anxiety reduction.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on drawing activities for anxiety, so it's unlikely that medication changes are required.

What prior data suggests that this guided drawing intervention is safe for reducing anxiety?

Research has shown that art therapy, including drawing, is generally safe and can help lower anxiety. In several studies involving over 400 people, art therapy led to a clear reduction in anxiety symptoms. One study found that combining drawing therapy with medication safely improved anxiety symptoms. This suggests that guided drawing is well-tolerated and helpful for reducing anxiety. While these results are promising, individual experiences may vary. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Guided Drawing Intervention for anxiety because it combines art with mindfulness in a unique way. Unlike traditional treatments like medication or talk therapy, this approach encourages participants to draw elements of nature while focusing on their breathing and remaining non-judgmental of their thoughts. This integration of drawing and mindfulness could offer a calming, creative outlet that helps reduce anxiety symptoms naturally and accessibly. This method is particularly appealing because it promotes self-expression and relaxation without relying on pharmaceuticals.

What evidence suggests that this trial's guided drawing intervention could be effective for reducing anxiety?

Research shows that art therapy can greatly reduce anxiety. Studies have found that art activities help lower anxiety in both children and adults. For example, one study found that art activities improved the mental well-being of teenagers with diabetes. Another study showed that 10–12 sessions of art therapy reduced anxiety and improved the quality of life for adult women. In this trial, participants in the Guided Drawing Group will engage in a mindfulness-based drawing activity, while those in the Free Drawing Control Group will draw freely, and the Basic Control Group will complete simple paper and pencil activities. Overall, multiple trials have consistently shown that visual art therapy leads to more anxiety reduction compared to groups that did not receive this therapy. ^{1 2 4 6 7}

Who Is on the Research Team?

Sarah Myruski, PhD

Principal Investigator

The Pennsylvania State University

Are You a Good Fit for This Trial?

This study is for adolescents aged 13 to 17.9 years and young adults aged 18 to 25 years who experience anxiety. Participants will be asked about their emotions, engage in a drawing session, and report on their anxiety levels before, after, and one week following the intervention.

Inclusion Criteria

Able to speak, read and understand English

I am between 13 and 25 years old.

Exclusion Criteria

Not able to speak, read and understand English

I am not between 13-17.9 years or 18-25 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Laboratory Visit

Participants complete questionnaires, cardiac monitoring, and a drawing session

90 minutes

1 visit (in-person)

Follow-up

Participants complete a one-week follow-up self-report of anxiety symptoms

1 week

1 visit (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Guided Drawing Intervention

Trial Overview The trial examines how guided drawing can affect anxiety levels compared to free drawing or no specific activity (basic control). It involves measuring changes in anxiety symptoms and cardiac physiology pre/post-drawing session and at a one-week follow-up.

How Is the Trial Designed?

Group I: Guided Drawing Group Experimental Treatment 1 Intervention

Participants in this group were asked to complete a guided drawing activity (\~20 min). Participants were given a pencil and blank paper to use while they watched a pre-recorded video guiding them through a mindfulness and drawing activity. In the pre-recorded video, participants are instructed to draw elements of nature from exemplar photographs (e.g., leaves, twigs). The activity incorporates drawing with aspects of mindfulness meditation (i.e., being non-judgmental of thoughts and behaviors, focusing on breathing, and embodiment).

Group II: Free Drawing Control Group Active Control 1 Intervention

In the free drawing group, participants watched a video with brief instructions and then were asked to draw whatever they would like for about 20 minutes.

Group III: Basic Control Group Placebo Group 1 Intervention

In the basic control group, participants were asked to complete simple paper and pencil activities (e.g., connect the dots, mazes) on their own for about 20 minutes.

Who Is Running the Clinical Trial?

Penn State University

Lead Sponsor

Trials

380

Recruited

131,000+

Published Research Related to This Trial

A study involving 30 hospitalized children aged 9-16 years showed that drawing and writing techniques significantly reduced anxiety levels during cancer treatment, with anxiety scores decreasing from 40.46 to 36.86 after the intervention.

The intervention, which included drawing, writing, and mutual storytelling over five days, was effective in providing emotional support and reducing anxiety, highlighting the potential of creative therapies in pediatric oncology settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of drawing and writing technique on the anxiety level of children undergoing cancer treatment. Altay, N., Kilicarslan-Toruner, E., Sari, Ç.[2018]

In a study involving 78 children aged 6-12 undergoing dental treatment, their drawings were found to significantly correlate with their levels of dental anxiety, as measured by established behavior assessment scales.

The results suggest that children's drawings can serve as an effective non-verbal tool for assessing emotional status and anxiety in a dental setting, providing valuable insights into their experiences during treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Children's drawing as a measurement of dental anxiety in paediatric dentistry. Guner Onur, S., Tonguc Altin, K., Demetgul Yurtseven, B., et al.[2020]

Research on anxiety indicators in the Draw-A-Person Test (DAP) has been conducted using both experimental stress induction and correlational studies with the Manifest Anxiety Scale, but there are significant methodological issues.

The review highlights that existing scoring systems for the DAP, while incorporating anxiety indices, suffer from problems such as not controlling for drawing quality and intelligence, which may affect the validity of the findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The validity of the Draw-A-Person Test as an anxiety measure. Sims, J., Dana, RH., Bolton, B.[2004]

The study involved 211 children and demonstrated that the Drawn Stories Technique is a valid method for assessing psychological distress in children, effectively identifying levels of anxiety and depression.

Results showed that children who depicted negative outcomes in their drawings reported higher levels of anxiety and depression, with girls generally exhibiting more distress than boys.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of the Drawn Stories Technique to evaluate psychological distress in children. Trombini, E., Montebarocci, O., Scarponi, D., et al.[2005]

A study involving 178 children aged 3 to 14 years demonstrated that analyzing children's drawings can effectively identify levels of anxiety, correlating well with Frankl's behavior rating scale.

The presence of stress markers in the drawings indicated a need for specialized behavioral techniques, suggesting that this nonverbal assessment can positively influence children's behavior in dental settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying Dental Anxiety in Children's Drawings and correlating It with Frankl's Behavior Rating Scale. Mathur, J., Diwanji, A., Sarvaiya, B., et al.[2020]

Disabled individuals showed higher levels of dental fear and anxiety compared to healthy individuals, with significant differences noted in the Dental Beliefs Scale (DBS).

The presence of a disability significantly influenced the drawing parameters of tooth representations more than other forms, and dental fear had a greater impact on drawing characteristics than anxiety did.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effect of being disabled, dental fear and anxiety on drawings]. Beck, A., Molnár, E., Fejérdy, P., et al.[2015]

A study involving 55 children aged 6 to 7 years used their color drawings to measure anxiety levels during dental treatment, revealing that anxiety increased after the first session but decreased after the second.

Despite the decline in anxiety after treatment, children's drawings still showed signs of anxiety, indicating that while clinical behavior may improve, underlying anxiety can persist, highlighting the importance of ongoing assessment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of children's anxiety throughout dental treatment by their drawings. Sheskin, RB., Klein, H., Lowental, U.[2009]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11260852/

The effects of art therapy interventions on anxiety in children ... The findings demonstrated a significant decrease in anxiety symptoms through art therapy interventions, with a Standardized Mean Difference (SMD) ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12133899/

The effect of therapeutic artistic activities on anxiety and ... It was concluded that therapeutic art activities were effective in reducing anxiety and improving psychological well-being in adolescents with diabetes.

3. frontiersin.org frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2019.01203/full

The Effectiveness of Art Therapy for Anxiety in Adult Women The outcomes show that 10–12 sessions of AT lead to a significant decrease of anxiety symptoms, as well as a significant improvement in QoL and remained at 3 ...

4. withpower.com withpower.com/trial/drawing-for-anxiety-ddb4f

Drawing for Anxiety · Info for Participants · Clinical Trial 2025 The intervention, which included drawing, writing, and mutual storytelling over five days, was effective in providing emotional support and reducing anxiety, ...

5. psychiatria-danubina.com psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol37_noSuppl%201/dnb_vol37_noSuppl%201_46.pdf

THE IMPACT OF VISUAL ART THERAPY ON ANXIETY Results: All 14 trials found significantly greater anxiety reduction in art therapy groups compared to controls, with interventions ranging from ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6949689/

Acceptance of Anxiety through Art Therapy: A Case Report ... After 14 sessions of anthroposophic art therapy, reduction of anxiety was shown, as well as improvements of emotion regulation and executive functioning.

7. sciencedirect.com sciencedirect.com/org/science/article/pii/S2561326X25004226

Participatory Intervention Development of a Peer-Guided ... This study aims to describe the development of a peer-guided self-help app for anxiety, incorporating input from individuals with lived experience.