Arts in Health, also known as Arts for Health, is an umbrella term used to describe the domain of using the arts to enhance our (mental) health and well-being. It involves a heterogeneous range of professionals who use the arts in various ways, with different goals and outcomes. The practices of these professionals can be placed on a continuum based on the variety of goals and outcomes, ranging from promoting social connection or well-being to treating (mental) health conditions. Recent discussions in the Netherlands have raised questions about the position of creative arts therapists on this continuum. This opinion paper addresses this issue by providing a brief overview of the development of the profession of creative arts therapists, the working areas of creative arts therapists and the growing evidence base of creative arts therapeutic interventions. The practices of creative arts therapists are positioned on the continuum, where the emphasis on and accountability for the clients’ (mental) health increases and evidence-informed use of the arts within a more clearly delineated and legally safeguarded professional framework are present. Knowing where the practices of creative arts therapists are placed can assist in identifying when to choose creative arts therapists, other professionals combining arts and healthcare, or a combination of professionals.
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Een analyse van de factoren die de slagingskansen van community arts en kwartiermakersprojecten in sociaal zwakkere milieus vergroten.
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The road to science for the arts therapies requires research on the full breadths of the spectrum, from systematic case studies to RCTs. It is important that arts therapists and arts therapeutic researchers reflect on the typical characteristics of each research paradigm, research type and research method and select what is appropriate with regard to the particular research question. Questions rather differ. Finding out whether a certain intervention has a particular effect with a large group of clients differs from wanting to know which change occurs at which moment by which interventions in the treatment of an individual client. Research in practice remains close to questions encountered by arts therapists in their daily practice. It concerns questions arts therapists have about their lived experience of acting due to the complexity and variability of practice. By carrying out research in practice that links up with those questions, evidence evolves; evidence that enables the professional to proceed and that makes explicit what often remains implicit and unsaid. What is explicit can be communicated, can be criticised and tested. The professional himself does the road to science of the profession. The investment in professionals’ research in practice is the motor of knowledge-productivity that bridges the theory-practice gap. Research in the arts therapies should lead to ‘knowledge’ in which the ‘art’, nor the ‘subject’ of therapist and client have been lost.
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Hoe kunnen vaktherapeuten samen met het kinderwerk en de bijbehorende nieuwe (regionale) zorgnetwerken, nieuwe interventies ontwikkelen en vormgeven met en voor kwetsbare jongeren in hun eigen leefomgeving, zodat enerzijds ontwikkeling van delinquent gedrag bij kwetsbare jongeren voorkomen wordt en anderzijds ketenzorg ontstaat en terugval van jongeren in delinquent gedrag (her)opname in justitiële jeugdinrichtingen en de gesloten jeugdzorg voorkomen wordt. In dit participerend actiegericht onderzoek was er sprake van een intensieve samenwerking tussen professionals en betrokkenen in de praktijk. Hiertoe werd een Community of Practice (CoP) opgericht bestaande uit Jongerenwerkers, Beeldend therapeut, deelnemende kinderen uit een aandachtswijk in Maastricht. De interventies zijn door deze samenwerking ontwikkeld en voortdurend geëvalueerd, waarbij gebruik werd gemaakt van zogenaamde van kwalitatieve en kwantitatieve methoden en instrumenten bij alle betrokken partijen.
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Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear how and why the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review (Nstudies = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: “embodiment,” “concretization,” and “symbolism and metaphors.” The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.
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Art therapy is widely used and effective in the treatment of patients diagnosed with Personality Disorders (PDs). Current psychotherapeutic approaches may benefit from this additional therapy to improve their efficacy. But what is the patient perspective upon this therapy? This study explored perceived benefits of art therapy for patients with PDs to let the valuable perspective of patients be taken into account. Using a quantitative survey study over 3 months (N = 528), GLM repeated measures and overall hierarchical regression analyses showed that the majority of the patients reported quite a lot of benefit from art therapy (mean 3.70 on a 5-point Likert scale), primarily in emotional and social functioning. The improvements are concentrated in specific target goals of which the five highest scoring goals affected were: expression of emotions, improved (more stable/positive) self-image, making own choices/autonomy, recognition of, insight in, and changing of personal patterns of feelings, behaviors and thoughts and dealing with own limitations and/or vulnerability. Patients made it clear that they perceived these target areas as having been affected by art therapy and said so at both moments in time, with a higher score after 3 months. The extent of the perceived benefits is highly dependent for patients on factors such as a non-judgmental attitude on the part of the therapist, feeling that they are taken seriously, being given sufficient freedom of expression but at the same time being offered sufficient structure and an adequate basis. Age, gender, and diagnosis cluster did not predict the magnitude of perceived benefits. Art therapy provides equal advantages to a broad target group, and so this form of therapy can be broadly indicated. The experienced benefits and the increase over time was primarily associated with the degree to which patients perceive that they can give meaningful expression to feelings in their artwork. This provides an indication for the extent of the benefits a person can experience and can also serve as a clear guiding principle for interventions by the art therapist.
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Background: People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD. Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes. Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches. Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners’ expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients’ experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories.
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Het project ‘(Be)Leef in de wijk’ Het project is gestart in januari 2015 en afgerond in maart 2017. Het project is uitgevoerd door een consortium van Coöperatie KenVaK (Zuyd Hogeschool, Hogeschool Arnhem en Nijmegen, NHL-Stenden Hogeschool, Hogeschool Leiden), Trimbos-instituut en de praktijkinstellingen Koraal Groep, STEVIG en Idris. Hulpverleners, studenten en docentonderzoekers werkten in co-creatie samen. Het project is gesubsidieerd door Nationaal Regieorgaan Praktijkgericht Onderzoek SIA.
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Objective: Self-management is a core theme within chronic care and several evidence-based interventions (EBIs) exist to promote self-management ability. However, these interventions cannot be adapted in a mere copy-paste manner. The current study describes and demonstrates a planned approach in adapting EBI’s in order to promote self-management in community-dwelling people with chronic conditions. Methods: We used Intervention Mapping (IM) to increase the intervention’s fit with a new context. IM helps researchers to take decisions about whether and what to adapt, while maintaining the working ingredients of existing EBI’s. Results: We present a case study in which we used IM to adapt EBI’s to the Flemish primary care context to promote self-management in people with one or more chronic disease. We present the reader with a contextual analysis, intervention aims, and content, sequence and scope of the resulting intervention. Conclusion: IM provides an excellent framework in providing detailed guidance on intervention adaption to a new context, while preserving the essential working ingredients of EBI’s. Practice Implications: The case study is exemplary for public health researchers and practitioners as a planned approach to seek and find EBI’s, and to make adaptations.
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Verslag van de in de openbare les aangekondigde vijf 'kritische dialogen'. Die dialogen leveren (iets als) een agenda op voor de komende jaren, waarbij het voeren van 'de dialoog' zelf ook als agendapunt genoteerd kan worden! Bij wijze van agenda laat ik zien hoe kunst - voorbij therapie - als breekijzer kan werken in het zichtbaar maken van mensen die te vaak over het hoofd worden gezien. In een tijd dat de overheid tot zorgzaamheid verplicht op straffe van verlies van uitkering, lijkt een pleidooi voor burgervriendschap voor sommigen ongepast. Toch doen we het, als uitnodiging, omdat het kans geeft op vervulling van gewenste, betekenisvolle rollen - aan beide zijden! Bewonersgestuurde initiatieven maken naast sociale ook economische aansluiting mogelijk en daarmee een inclusievere economie. Net als 'de normaalste zaak' en net als bewegingen die de hele economie op een andere leest willen schoeien. Alles om het beste van iemands mogelijkheden waar te laten worden. Er zijn teveel schrijnende voorbeelden van uitsluiting en discriminatie op basis van etniciteit, huidskleur, geloof, aandoening, beperking, armoede, status (het niet hebben van papieren). In alle gevallen is radicale aansluiting (presentie) aan de orde op allerlei niveaus, maar zeker ook op dat van zorg en welzijn. Aansluiting houdt ook in oog hebben voor de maatschappelijke context die uitsluiting bestendigt. Aansluiting betekent ook naast mensen gaan staan, als professional, als burger, als overheid en niet meegaan met de taboeïsering van kwetsbaarheid, omdat dat de kwetsbaarheid van mensen in kwetsbare posities alleen maar verergert. Zonder voorbij te gaan aan de fricties en ongemakkelijkheden vaart Kwartiermaken tussen talent en kwetsbaarheid een eigen koers met een radicale verwelkoming van diversiteit
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