Formal elements are often used in art therapy assessment. The assumption is that formal elements are observable aspects of the art product that allow reliable and valid assessment of clients’ mental health. Most of the existing art therapy assessment instruments are based on clinical expertise. Therefore, it is not clear to what degree these instruments are restricted to formal elements. Other aspects might also be included, such as clinical expertise of the therapist. This raises the question of whether and how formal elements as observable aspects of the art product are related to clients’ mental health. To answer this question, four studies are presented that look at: (1) a meta-theoretical description of formal elements; (2) operationalization of these formal elements so they can be analyzed reliably in clients’ art products; (3) establishment of reliable and clinically relevant formal elements; (4) the relationship between formal elements and adult clients’ mental health. Results show that the combination of the formal elements “movement,” “dynamic,” and “contour” are significantly interrelated and related to clients’ mental health, i.e., psychopathology, psychological flexibility, experiential avoidance, and adaptability. These findings give insight in the diagnostic value of art products and how they may add to clients’ verbal expression and indicate their potential to benefit from therapy.
PURPOSE: The aim of this study was to investigate whether muscle strength and functional exercise capacity (FEC) influence motor performance in children with generalized joint hypermobility.METHODS: Forty-one children (mean age: 8.1 years) with symptomatic generalized hypermobility were included. Motor performance was assessed using the Körperkoordinationstest für Kinder (KTK) and the Movement Assessment Battery for Children. Muscle strength and FEC were measured with a handheld dynamometer and the 6-minute walk test.RESULTS: Only muscle strength was significantly positively associated with motor performance on the KTK. FEC was significantly decreased. Children's scores on the KTK were significantly lower (p < 0.001) compared with scores on the Movement Assessment Battery for Children.CONCLUSIONS: The KTK is a more sensitive tool for detecting motor problems in children with generalized joint hypermobility, but is not associated with FEC. Along with the KTK, the 6-minute walk test can be used to independently assess and evaluate FEC.
BACKGROUND: Paratonia is one of the associated movement disorders characteristic of dementia. The aim of this study was to develop an assessment tool (the Paratonia Assessment Instrument, PAI), based on the new consensus definition of paratonia. An additional aim was to investigate the reliability and validity of the PAI.METHODS: A three-phase cross-sectional survey was conducted. In the first two phases, the PAI was developed and validated. In the third phase, the inter-observer reliability and feasibility of the instrument was tested.RESULTS: The original PAI consisted of five criteria that all needed to be met in order to make the diagnosis. On the basis of a qualitative analysis, one criterion was reformulated and another was removed. Following this, inter-observer reliability between the two assessors resulted in an improvement of Cohen's kappa from 0.532 in the initial phase to 0.677 in the second phase. This improvement was substantiated in the third phase by two independent assessors with Cohen's kappa ranging from 0.625 to 1.CONCLUSION: The PAI is a reliable and valid assessment tool for diagnosing paratonia in elderly people with dementia that can be applied easily in daily practice.