Art Therapy for PTSD in Military Service Members

Overseen By Kayleigh M Scott, B.A.

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Walter Reed National Military Medical Center

Disqualifiers: Brain injury, Psychotic disorder, Bipolar, Stroke, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 10

25 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how art therapy can help military service members manage emotional challenges related to posttraumatic stress disorder (PTSD). It focuses on enhancing emotional expression and control, as well as understanding the brain processes involved. Participants will attend ten sessions, including art therapy and assessments, over twelve weeks. The study seeks active duty or recently separated veterans experiencing significant PTSD symptoms who have not previously tried art therapy. As an unphased trial, it offers a unique opportunity to explore innovative therapy methods for managing PTSD symptoms.

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 is best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that art therapy is safe for military service members?

Research has shown that art therapy is generally safe for people with PTSD. Studies have found that this therapy can reduce symptoms without causing serious side effects. A review of several studies found that creative arts therapy, including art therapy, effectively manages PTSD, making it a well-tolerated treatment option.

One study found that participants who tried trauma-focused art therapy experienced fewer symptoms of PTSD and depression. This suggests that art therapy is not only safe but may also improve emotional well-being.

Overall, art therapy is considered a safe treatment for PTSD, with no major negative effects reported in the reviewed studies. This makes it a promising option for those seeking alternative ways to manage their symptoms. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about art therapy for PTSD in military service members because it offers a non-pharmacological approach that can complement traditional treatments like psychotherapy and medication. Unlike conventional therapies that often rely on verbal communication, art therapy provides a creative outlet to express and process complex emotions, which can be particularly beneficial for those who struggle to articulate their experiences. This method can foster self-discovery and emotional healing in a supportive environment, potentially enhancing the overall effectiveness of PTSD treatment.

What evidence suggests that art therapy is effective for PTSD?

Research has shown that art therapy, which participants in this trial will receive, can help manage PTSD symptoms. A review of several studies found that creative arts therapy, including art therapy, reduces these symptoms. Another study found that trauma-focused art therapy lowered symptoms of PTSD and depression while improving emotional expression and mental strength. Although it may not work for everyone, art therapy offers a promising option for those who find traditional treatments challenging. Overall, art therapy helps many people cope better with trauma-related issues. ^{1 2 3 4 6}

Who Is on the Research Team?

Chandler Rhodes, PhD

Principal Investigator

WRNMMC

Are You a Good Fit for This Trial?

This trial is for active duty or veteran military personnel who have been separated within the last 5 years and are experiencing significant posttraumatic stress symptoms. They must be eligible for DEERS and score at least 31 on the PCL-5 scale. People with certain medical conditions, metal implants, severe brain injuries, substance use disorders, psychotic disorders, or those unable to consent are not eligible.

Inclusion Criteria

DEERS Eligible

Significant posttraumatic stress symptoms (score of >/=31 on the PCL-5)

Active Duty or Veteran separated within the past 5 years

Exclusion Criteria

History of moderate, severe, or penetrating brain injury

I have had a stroke or heart attack in the past.

History of psychotic disorder, bipolar disorder, or active suicidal or homicidal ideation

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Assessment

The first session includes interviews, self-assessment questionnaires, and an MRI scan

1 week

1 visit (in-person)

Art Therapy

Participants attend eight one-hour art therapy sessions with a certified art therapist

8 weeks

8 visits (in-person)

Final Assessment

The last session includes the same self-assessment questionnaires and another MRI scan

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Art Therapy

Trial Overview The study tests how art therapy affects emotional expression and regulation in service members with posttraumatic symptoms. Participants will attend ten sessions over twelve weeks including interviews, self-assessment questionnaires, MRI scans before and after therapy sessions, and tasks involving exposure to various images during MRI.

How Is the Trial Designed?

Group I: Art Therapy Arm Experimental Treatment 1 Intervention

8 weeks of individual art therapy

Art Therapy is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Art Therapy for:

• Post-Traumatic Stress Disorder (PTSD)
• Trauma-Related Conditions
• Mental Health Disorders

Approved in European Union as Art Therapy for:

• Post-Traumatic Stress Disorder (PTSD)
• Anxiety Disorders
• Depression

Approved in Canada as Art Therapy for:

• Post-Traumatic Stress Disorder (PTSD)
• Mental Health Disorders
• Substance Abuse

Who Is Running the Clinical Trial?

Walter Reed National Military Medical Center

Lead Sponsor

Trials

149

Recruited

33,800+

Published Research Related to This Trial

In a randomized controlled trial with 11 veterans, both Cognitive Processing Therapy (CPT) alone and CPT combined with art therapy led to improvements in PTSD and depression symptoms, but there was no significant difference in effectiveness between the two groups.

Veterans reported that art therapy enhanced their trauma processing and emotional access, indicating its perceived value in treatment, even though it did not statistically outperform CPT alone.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Art Therapy and Cognitive Processing Therapy for Combat-Related PTSD: A Randomized Controlled Trial. Campbell, M., Decker, KP., Kruk, K., et al.[2023]

Visual art therapy offers a multidimensional approach to treating post-traumatic stress disorder (PTSD), focusing on traumatic memories, symbolization-integration, and emotional containment.

The paper includes case descriptions of two patients, highlighting how visual art therapy can uniquely address the complexities of PTSD treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visual art therapy's unique contribution in the treatment of post-traumatic stress disorders. Avrahami, D.[2019]

Art therapy interventions, particularly those involving painting or drawing, have been shown to significantly reduce anxiety and depression in cancer patients, with six out of seven quantitative studies reporting these improvements.

Additionally, art therapy has been associated with enhanced quality of life and positive effects on personal growth and coping mechanisms, although more rigorous, evidence-based studies are needed to further validate these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An overview of art therapy interventions for cancer patients and the results of research. Geue, K., Goetze, H., Buttstaedt, M., et al.[2010]

This systematic review evaluated the efficacy of creative arts therapies (music, art, and drama therapy) for treating PTSD, analyzing seven studies from a pool of 1,918 records, but found the overall evidence quality to be low to very low.

The review highlighted the need for improved scientific rigor in future research, as the majority of studies had poor quality and no evidence was found for dance/movement therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of the efficacy of creative arts therapies in the treatment of adults with PTSD. Baker, FA., Metcalf, O., Varker, T., et al.[2022]

The case study highlights that mask-making as a form of art therapy can enhance the understanding of treatment progress in military personnel with PTSD, even when PTSD symptoms initially increased as they confronted their trauma.

Despite the initial increase in symptoms, the service member reported improved coping skills and successfully returned to full military duty, suggesting that art therapy can be a valuable adjunct to traditional PTSD treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A case analysis of service-member trauma processing related to art therapy within a military-intensive outpatient program. Maltz, B., Hoyt, T., Uomoto, J., et al.[2021]

Art therapies, including drawing and painting, can help military personnel with post-traumatic stress disorder (PTSD) by providing a way to express feelings non-verbally, which may enhance their overall treatment experience.

Incorporating drawing-based art therapy alongside traditional therapies could improve engagement and reduce the likelihood of discontinuing care for veterans dealing with PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Drawing soldiers out of post-traumatic stress disorder. Hunter, SR.[2020]

Accelerated Resolution Therapy (ART) has shown effectiveness in treating post-traumatic stress, anxiety, and depression, particularly among members of US Special Operations Forces, indicating its potential as a valuable therapeutic intervention.

ART shifts the focus from merely addressing PTSD symptoms to understanding and integrating an individual's traumatic experiences into their identity, which may have broader implications for treatment and could potentially protect against suicide.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Accelerated resolution therapy and a thematic approach to military experiences in US Special Operations Veterans. Hernandez, D., Kip, KE., Long, CJ., et al.[2022]

Art therapy can effectively facilitate healing in individuals experiencing post-traumatic responses by helping them explore and express their feelings and self-concept.

The healing process may require ongoing support and follow-up therapy even after formal treatment ends, highlighting the importance of continued care in recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Four years later: Clara revisited. Glaister, JA.[2019]

Art therapy, specifically through drawing, can serve as an effective alternative means of expression for veterans with PTSD, helping them process traumatic experiences related to combat.

The study of 89 veterans revealed that common themes in their drawings included battle scenes and witnessing trauma, with a preference for dark colors symbolizing death and destruction, suggesting that art therapy can enhance verbal expression and support in a safe group setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Posttraumatic stress disorder and art group therapy: Self-expression of traumatic inner world of war veterans. Mandić-Gajić, G., Špirić, Ž.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11725198/

Colors of the mind: a meta-analysis of creative arts therapy as ... In this meta-analysis, we aim to assess the effectiveness of creative arts therapy in the management of PTSD.

2. sciencedirect.com sciencedirect.com/science/article/pii/S0197455624001035

Effectiveness of Trauma-Focused Art Therapy (TFAT) for ... The combined findings indicate a decrease in PTSD symptoms, reduced depression symptoms, enhanced emotional articulation, increased mental resilience, self- ...

3. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2823638

Active Visual Art Therapy and Health Outcomes Based on the available evidence, active visual art therapy was associated with an improvement in 18% of the patient outcomes.

4. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/full/10.1002/cpp.3041

On the Effectiveness of Visual Arts Therapy for Traumatic ... We evaluate previous reviews and report a meta-analysis of the effectiveness of arts therapy following trauma for reducing symptoms of PTSD.

5. clinicaltrials.gov clinicaltrials.gov/study/NCT05593302?term=AREA%5BBasicSearch%5D(GRAPHITE)&rank=6

The Effectiveness of Trauma Focused Art Therapy (TFAT) More than 30% of patients with trauma-related complaints do not benefit from prescribed treatments. This concerns patients who have either a poor verbal ...

6. digitalcommons.lesley.edu digitalcommons.lesley.edu/cgi/viewcontent.cgi?article=1008&context=expressive_dissertations

Embodied Creative Arts Therapy Interventions with Trauma The effectiveness of art therapy interventions in reducing post traumatic stress disorder. (PTSD) symptoms in pediatric trauma patients. Art Therapy: Journal ...