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Creative art therapy is a complementary therapy used to assist patients with serious illness to ameliorate symptom burden and adapt to the stressful life experiences associated with a life-limiting diagnosis. This activity reviews the definition of art therapy as defined by the American Art Therapy Association (AATA) and highlights personnel qualifications, techniques utilized, and application in palliative care patients. Objectives: Review the definition of palliative care and art therapy. Describe the techniques and personnel needed for creative art therapy in palliative care. Summarize the clinical significance of art therapy in palliative care patients, including cancer sufferers, chronic heart failure, HIV/AIDs, dementia, and end-stage renal disease patients. Outline the importance of the an interprofessional approach involved in the care of a palliative care patient and the importance of integrating alternative therapies such as creative art therapy to improve patient outcomes for patients with serious illness. Access free multiple choice questions on this topic.

Palliative care medicine is the interprofessional subspecialty focused on relieving suffering and improving the quality of life in patients with serious illness as well as their families. Beyond the aspects of physical illness, palliative care -as defined by the World Health Organization- strives to implement “means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”[1] Due to the intense emotional and existential nature of a life-limiting illness, patients are increasingly turning to alternative and complementary therapeutic modalities to cope and find relief. Art therapy is a clinical intervention that utilizes the expressive qualities of art-making to improve physical, mental, and emotional well-being.[2] As defined by the American Art Therapy Association (AATA) in About Art Therapy (2018), art therapy, as facilitated by a professional art therapist, is a therapeutic modality used over ongoing sessions to “improve cognitive and sensorimotor functions, foster self-esteem and self-awareness, cultivate emotional resilience, promote insight, enhance social skills, reduce and resolve conflicts and distress and advance societal and ecological change.”[3] Creative art therapy has been used to assist patients and families in increasing self-awareness, ameliorating symptom burden, and adapting to the stressful life experiences associated with a terminal illness.[4] When curative therapies are no longer viable in the terminally-ill patient, alternative remedies such as creative art interventions that can improve quality of life are invariably relevant in medical domains that focus on patient’s comfort such as palliative and hospice care.[5]

Managing patients with chronic, life-limiting illnesses can be challenging and complex and require the coordination of care across multiple disciplines. These patients invariably require a patient and family-centered interprofessional approach focused on managing complex symptoms of severe illness and addressing the physical, emotional, psychosocial, and existential components of suffering. Multiple large medical societies, including the World Health Organization (WHO), The National Comprehensive Cancer Network (NCCN), the European Society of Medical Oncology (ESMO), and the American Society of Clinical Oncology (ASCO) have all recognized the benefit. They recommend the integration of palliative care early in the disease trajectory.[28] However, opportunities to improve the integration of palliative care and a holistic approach utilizing complementary therapies (i.e., creative art therapy) exist. Evidence-Based Approach In the last two decades, there has been an emphatic shift in medical literature towards investigating the healing power of art in the realm of palliative care patients. Although the role of art therapy as an alternative treatment in these patient populations has expanded, and results are encouraging, the amount of quality evidence is sparse. Despite the literature implying the positive effects of art therapy on quality of life, coping mechanisms, and mental well being in patients with serious illness, results require cautious interpretation. Collectively the vast heterogeneity amongst the studies patient populations, clinical profiles, definition of art therapy, methods of randomization, sample sizes, study design, and indices measured yields low-quality evidence. Further research and extensive, high-quality studies are warranted to expand on the benefit of a holistic approach and utilization of creative art therapy to enhance patient-centered care and improve patient outcomes. [Level 2]