ArticlePDF Available

Efficacy of Creative Clay Work for Reducing Negative Mood: A Randomized Controlled Trial

Authors:

Abstract and Figures

Clay work has long been used in art therapy to achieve therapeutic goals. However, little empirical evidence exists to document the efficacy of such work. The present study randomly assigned 102 adult participants to one of four conditions following induction of a negative mood: (a) handling clay with instructions to create a pinch pot, (b) handling clay with instructions to manipulate it freely, (c) handling a soft stress ball with instructions to toss the ball in a structured manner, or (d) handling a soft stress ball with instructions to manipulate it freely. Self-reports revealed greater mood enhancement following clay handling compared to ball handling. This randomized controlled trial (RCT) documents that clay work has specific efficacy for reducing negative mood states.
Content may be subject to copyright.
This article was downloaded by: [Arcadia University]
On: 13 June 2012, At: 08:05
Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,
37-41 Mortimer Street, London W1T 3JH, UK
Art Therapy: Journal of the American Art Therapy
Association
Publication details, including instructions for authors and subscription information:
http://www.tandfonline.com/loi/uart20
Efficacy of Creative Clay Work for Reducing Negative
Mood: A Randomized Controlled Trial
Elizabeth R. Kimport
a
& Steven J. Robbins
b
a
Philadelphia, PA
b
Glenside, PA
Available online: 13 Jun 2012
To cite this article: Elizabeth R. Kimport & Steven J. Robbins (2012): Efficacy of Creative Clay Work for Reducing Negative
Mood: A Randomized Controlled Trial, Art Therapy: Journal of the American Art Therapy Association, 29:2, 74-79
To link to this article: http://dx.doi.org/10.1080/07421656.2012.680048
PLEASE SCROLL DOWN FOR ARTICLE
Full terms and conditions of use: http://www.tandfonline.com/page/terms-and-conditions
This article may be used for research, teaching, and private study purposes. Any substantial or systematic
reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to
anyone is expressly forbidden.
The publisher does not give any warranty express or implied or make any representation that the contents
will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should
be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims,
proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in
connection with or arising out of the use of this material.
Art Therapy: Journal of the American Art Therapy Association, 29(2) pp. 74–79
C
AATA, Inc. 2012
Efcacy of Creative Clay Work for Reducing Negative
Mood: A Randomized Controlled Trial
Elizabeth R. Kimport, Philadelphia, PA, and Steven J. Robbins,Glenside,PA
Abstract
Clay work has long been used in art therapy to achieve ther-
apeutic goals. However, little empirical evidence exists to docu-
ment the efficacy of such work. The present study randomly as-
signed 102 adult participants to one of four conditions following
induction of a negative mood: (a) handling clay with instruc-
tions to create a pinch pot, (b) handling clay with instructions to
manipulate it freely, (c) handling a soft stress ball with instruc-
tions to toss the ball in a structured manner, or (d) handling
a soft stress ball with instructions to manipulate it freely. Self-
reports revealed greater mood enhancement following clay han-
dling compared to ball handling. This randomized controlled
trial (RCT) documents that clay work has specific efficacy for
reducing negative mood states.
Introduction
In recent years, art therapists have turned increasing at-
tention toward providing evidence for the efficacy of spe-
cific art therapy practices. This movement parallels the call
throughout the field of clinical psychology for the documen-
tation of empirically supported therapies (see Chambless &
Hollon, 1998). As Chambless and Hollon (1998) discussed
at length, the randomized controlled trial (RCT) remains the
gold standard design for establishing psychotherapy treat-
ment efficacy. Accordingly, a number of reviews and articles
have appeared to promote the use of RCTs to evaluate claims
that art therapy interventions improve emotional function-
ing (Carolan, 2001; Deaver, 2002; Reynolds, Nabors, &
Quinlan, 2000; Slayton, D’Archer, & Kaplan, 2010).
Although the experimental research base suppor t ing art
therapy has grown dramatically in recent years, the RCTs
identified by Slayton, D’Archer, and Kaplan (2010) in their
recent review paper focused almost exclusively on drawing
as an agent of emotional change. Other areas of art ther-
apy have yet to become the focus of systematic outcome tri-
als. One such neglected area, and the focus of the present
Editor’s Note: Elizabeth R. Kimport, BA, is currently a grad-
uate art therapy student at Drexel University, Philadelphia, PA.
Steven J. Robbins, PhD, teaches in the Department of Psychology
at Arcadia University, Glenside, PA. This research was completed
as part of the requirements for a bachelor’s degree in psychology
with an emphasis in art therapy by E. R. Kimport. Correspondence
concerning this article may be addressed to the second author at
robbins@arcadia.edu
study, is the use of clay work to help clients express and work
through negative emotional states.
The use of clay in art therapy has a long history and has
been the source of a great deal of theoretical writing, often
within the psychoanalytic tradition (see Henley, 2002; Sholt
& Gavron, 2006). Sholt and Gavron (2006) identified six
therapeutic purposes for which clay typically is used. A cen-
tral theme across their categories is the use of clay to reveal,
express, and cope with emotional states. Two specific prop-
erties of clay emerged in their review as important in produc-
ing therapeutic effects. First, the tactile sensations and mal-
leability associated with clay are thought to help produce a
nonverbal route to emotional expression. Second, the phys-
ical process of clay modeling is thought to activate an in-
dividual’s creative impulses, particularly through the ability
to transform a formless mass into a concrete and meaningful
object (for more extensive theoretical discussions, see Ander-
son, 1995; Banker, 2008; Elkis-Abuhoff, Goldblatt, Gaydos,
& Corrato, 2008; Henley, 2002; Or, 2010; Sholt & Gavron,
2006). To our knowledge, no RCTs have yet been performed
to evaluate these and other claims regarding the therapeutic
benefits of clay work.
Consequently, the present study was designed to pro-
vide some initial evidence for the efficacy of clay therapy.
Clay work is used for a variety of purposes in art therapy; we
chose to investigate the art as therapy approach (Kramer,
1971; 1973), which posits that art production in and of itself
can have mood enhancing effects. We focused on mood en-
hancement as a target outcome for several reasons. First, the-
oretical treatments of clay work repeatedly claim enhanced
emotional expression and catharsis as primary benefits of
the medium. For example, Henley (2002) discussed cases
in which clay work allowed clients to express and discharge
negative emotional states such as aggression. Second, this ar-
ticles second author had success in previous studies docu-
menting the mood-enhancing effects of other creative arts
therapies, namely drawing (Bell & Robbins, 2007) and lis-
tening to music (Boothby & Robbins, 2011). Other studies
have similarly demonstrated that art therapies can enhance
mood compared to control conditions (Curry & Kasser,
2005; De Petrillo & Winner, 2005; Drake, Coleman, &
Winner, 2011; Puig, Lee, Goodwin, & Sherrard, 2006). Fi-
nally, negative mood states are easily induced and readily
measured in the nonclinical sample that was available to us
for study.
In designing the study, we had two central goals in
mind. We wanted to employ an RCT design to permit us
to isolate clay work as the cause of any observed mood
74
Downloaded by [Arcadia University] at 08:05 13 June 2012
KIMPORT / ROBBINS 75
enhancement. As discussed more extensively elsewhere
(Bell & Robbins, 2007; Boothby & Robbins, 2011),
nonexperimental designs leave open the possibility that
observed improvements in functioning might result from
factors such as selection bias, history, maturation, regression
to the mean, testing, or subject–observer bias (Campbell &
Stanley, 1966; Cook & Campbell, 1979). We a lso wanted to
focus our study on two aspects of clay work thought to rep-
resent the active ingredients in proposed treatment effects:
the creative nature of clay due to its composition and the
importance of having a structured task with a specific goal.
Toward these ends, we randomly assigned participants
in the present study to one of four groups following induc-
tion of a negative mood state: (a) handling clay with instruc-
tions to create a pinch pot, (b) handling clay with instruc-
tions to manipulate it freely, (c) handling a soft stress ball
with instructions to toss the ball in a structured manner, or
(d) handling a soft stress ball with instructions to manip-
ulate it freely. Quantitative assessments of mood were col-
lected before and after the interventions. This design per-
mitted us to compare mood changes between groups and
to examine whether the clay medium has special value for
enhancing mood as compared to a condition in which par-
ticipants similarly hold and manipulate a soft, physical ob-
ject. We also examined whether participating in a structured
activity that produces a concrete result is mood enhancing
as compared to the aimless manual manipulation of objects.
Finally, we looked for an interaction between the medium
(clay or stress ball) and the instructions (free or structured).
We hypothesized that the structured manipulation of clay
would produce the greatest mood benefits.
Method
Participants
A sample of 102 adult participants (74 female, 28 male)
between the ages of 18 and 63 years (mean age = 22.3,
SD = 7.0) was employed in this study. The majority of the
participants were college students between the ages of 18 and
22 years. Of the total sample, 33 participants were currently
(or previously) college art majors or minors. Recruitment for
the study took place through posted sign-up sheets at Arca-
dia University, Glenside, PA, and through individual contact
with the first author. None of the participants disclosed that
they were suffering from a diagnosed mood disorder; be-
cause neither of the experimenters was a licensed clinician,
such information was not solicited from the participants.
Design
The study employed a 2 × 2 × 3 factorial design in
which Materials (clay or stress ball) served as one between-
groups factor, Instructions (structured or free) served as a
second between-groups factor, and Time (baseline, pre, and
post) served as a within-groups factor. Participants were
placed in the four conditions through stratified, blocked ran-
dom assignment. Specifically, we stratified individuals based
on whether they had ever studied art in college as either a
major or minor. To ensure an equal representation of each
group across conditions, we then employed blocked ran-
domization separately for the two groups (art training, n =
33; no art training, n = 69). Group A (n = 27) was given
clay and received instructions to make a pinch pot, Group B
(n = 24) was given clay and received no formal instructions,
Group C (n = 27) was given stress balls and received in-
structions to squeeze the ball and toss it from hand to hand,
and Group D (n = 24) was given stress balls and received
no formal instructions.
Prior to receiving the intervention materials and
instructions, all four groups were exposed to laboratory
stimuli designed to induce negative mood states. Negative
mood was assessed through two structured inventories:
the Profile of Mood States (POMS; McNair, Lorr, &
Droppleman, 1971) and the State-Trait Anxiety Inventory
(STAI; Spielberger, 1983). These paper-and-pencil tests
were given at three points in time: prior to mood induction
(baseline), just following mood induction but prior to the
clay/ball intervention (pre-treatment), and following 5
minutes of object manipulation (post-treatment).
Materials
In the two clay conditions, participants each took a seat
at a table in front of two baseball-sized mounds of clay (one
porcelain and one terra-cotta), a wooden board to serve as a
support, a small bowl of water, a sponge, a metal rib, and a
few wooden carving tools. Participants in the two stress ball
conditions each received two different baseball-sized stress
balls, one made of foam and the other filled with sand. Thus,
participants in each of the groups received two differently
textured substances or objects with which to work in order
to avoid preference bias. Because stress balls are explicitly
used to reduce anxiety through squeezing, all four groups in
this study were assigned to a condition that could plausibly
be expected to enhance mood.
Two dependent variables were used in this study. The
POMS requires participants to rate on a 5-point scale (from
0 to 4) each of 65 adjectives that describe their current state.
Items are then combined into six mood subscales (Tension,
Depression, Fatigue, Confusion, Anger, and Vigor); the six
subscale scores are further combined into a single overall
negative mood score. Using the STAI, participants self-rate
20 items to identify their state or present level of anxi-
ety a nd a second set of 20 trait” items aimed at measur-
ing stable, long-term anxiety. Both 20-item scales yield sin-
gle summary scores: a trait score (STAI-T) and a state score
(STAI-S). On all three scales (POMS overall negative mood,
STAI-T, and STAI-S), higher values represent greater levels
of negative mood.
Procedure
All participants took part in a single laboratory session
lasting about 45 minutes. Upon entry into the lab, each
individual reviewed and signed a written, informed,
voluntary consent document. Next, participants filled out
Downloaded by [Arcadia University] at 08:05 13 June 2012
76 EFFICACY OF CREATIVE CLAY WORK
Table 1 POMS Overall Negative Mood Scores at Baseline, Pre-Treatment, and Post-Treatment (Means and Standard
Deviations)
Group N Baseline Pre Post Pre–Post
Clay Structured 27 17.1(29.9) 49.4(41.9) 0.5(19.9) 49.9(33.4)
Clay Free 24 14.3(22.3) 46.1(38.4) 6.3(25.7) 39.8(39.8)
Clay Total 51 15.8 (26.4) 47.8 (39.9) 2.7 (22.8) 45.2 (31.5)
Stress Ball Structured 27 21.5(32.4) 43.4(48. 5) 16.7(32.5) 26.4(27.9)
Stress Ball Free 24 12.7(24.8) 37.5(29.5) 6.0(21.6) 31.5(25.1)
Stress Ball Total 51 17.3 (29.1) 40.6 (40.4) 11.8 (28.2) 28.8 (26.4)
Note. For the Pre–Post scores, positive values indicate improved mood.
a brief demographics form asking for their age, sex, and
whether they were currently or had been previously an art
student. The experimenter (first author) asked participants
to complete the POMS and the STAI for the first of three
times (baseline) and left the room while these forms were
being filled out. Following the first mood assessment,
participants put on headphones and watched a 12-minute
video containing 16 different traumatic news stories that
had occurred in the past 10 years (covering, for example,
the 2010 earthquake in Haiti, U.S. school shootings, and
the Gulf of Mexico oil spill). When the video ended, each
individual was asked to reflect upon something negative
that was weighing on his or her mind and to write the event
down on a piece of paper (not collected). These stimuli were
intended to induce a similar level of negative mood across
participants; the success of the stimuli to induce a negative
mood was then assessed through a second administration
of the POMS and the STAI (pre-treatment).
Participants then were placed in one of four interven-
tion conditions based on the randomization schedule de-
scribed earlier. As already stated, we separately randomized
the art students and non-art students to avoid biased sam-
ples across the four conditions. For Group A (clay + struc-
tured instructions), the experimenter gave a brief (15 sec-
ond) demonstration on how to make a pinch pot. She then
left and waited outside the room for 5 minutes while the
participants each made a pinch pot of their own. Group
B (clay + free instructions) was given the same clay sup-
plies and asked to manipulate the clay any way they wished.
For Group C (stress ball + structured instructions), the ex-
perimenter gave participants 2 different textured stress balls
and asked them to hold and squeeze a ball in one hand, toss
the ball to the other hand, and then repeat. As in the pinch
pot condition, the experimenter demonstrated this task for
about 15 seconds. In Group D (stress ball + free instruc-
tions), participants were told to handle the balls however
they chose. In all four cases, the experimenter gave verbal
instructions and then left the room during the 5-minute in-
tervention.
After the 5-minute intervention period, the experi-
menter returned to the room and gave participants the
third and final POMS and STAI forms to complete (post-
treatment). Once again, she left the room while the inven-
tories were being filled out. Upon completion of the mood
assessments, participants were thanked for their participa-
tion and debriefed as to the nature of the study.
Results
Two primary outcome measures were analyzed in this
study. We used the POMS overall score as a global measure
of negative mood and the STAI-S (“state anxiety” score) as a
more specific measure of anxiety. Although the trait anxiety
scale (STAI-T) was used to confirm that the groups were well
matched for baseline trait anxiety, this scale was not used to
assess changes in mood because we did not expect our 5-
minute intervention to produce alterations in stable, long-
term anxiety.
Baseline Assessments
In order to examine whether the randomization created
equivalent groups, we used 1-way ANOVAs to compare age
and STAI-T scores across the four groups at baseline. Nei-
ther analysis approached significance (p > .20 for both).
Thus, the four groups were well matched for both age and
trait anxiety levels.
Negative Mood Induction
Negative mood induction was assessed through the use
of 2-way repeated measure ANOVAs in which Group (A,
B, C, or D) served as a between-group factor and Time
(baseline/pre-treatment) served as the within-group factor.
We conducted separate analyses for the POMS and STAI-S
scores. For this analysis, we did not break the groups o ut into
the factors Materials and Instructions because both measure-
ment points took place before the intervention occurred. Re-
sults from the POMS and the STAI-S are shown in Tables 1
and 2, respectively.
For both analyses, we did not find a main effect of
Group, nor did we find a Group × Time interaction (all
p values > .05). In other words, the four groups did not
differ in overall levels of negative mood across the two
time points and did not show differential levels of mood
change. In both analyses there was a significant main effect
of Time, POMS: F(1, 98) = 67.8, p < .001; STAI-S: F( 1,
98) = 101.6, p < .001. As shown in Tables 1 and 2, all
Downloaded by [Arcadia University] at 08:05 13 June 2012
KIMPORT / ROBBINS 77
Table 2 STAI-S Scores at Baseline, Pre-Treatment, and Post-Treatment (Means and Standard Deviations)
Group N Baseline Pre Post Pre–Post
Clay Structured 27 39.6(12.6) 50.3(14.5) 33.8(7.7) 16.5(12.0)
Clay Free 24 39.2(10.4) 50.0(13.5) 37.3(11.7) 12.7(9.6)
Clay Total 51 39.4 (11.5) 50.1 (13.9) 35.4 (9.8) 14.7 (11.0)
Stress Ball Structured 27 41.1(12.5) 50.0(12.9) 41.4(12.4) 8.6(7.9)
Stress Ball Free 24 38.4(7.5) 50.8(10.3) 38.5(10.0) 12.3(10.2)
Stress Ball Total 51 39.9 (10.4) 50.4 (11.6) 40.1 (11.3) 10.3 (9.2)
Note. For the Pre–Post scores, positive values indicate improved mood (reductions in state anxiety).
four groups had substantial increases in negative mood
from baseline to pre-intervention. Thus, we were successful
in inducing comparable levels of negative mood across the
four intervention groups.
Clay/Stress Ball Intervention Outcome
Primary outcome analyses for this study consisted of
3-way repeated measure ANOVAs conducted separately for
the POMS and STAI-S scores. For each analysis, Materials
(clay or stress ball) and Instructions (structured or free)
served as the between-group factors, and Time (pre- or
post-treatment) served as the within-group factor. Treat-
ment effects would be revealed as either 2-way interactions
of Materials × Time and Instructions × Time or as a
3-way interaction of Materials × Instructions × Time. In
all cases, treatment effects would take the form of greater
improvement in negative mood over time in some treatment
groups compared to others. Pre- and post-treatment scores
on the POMS and the STAI-S can be seen in Tables 1 and 2,
which also depict change scores for each of the conditions.
Results of the ANOVAs are easily summarized. In both
cases, there was a significant Materials × Time interaction,
POMS: F(1, 98) = 7.6, p < .05; STAI-S: F(1, 98) = 4.4,
p < .05. As depicted in Tables 1 and 2, this interaction re-
flected a greater improvement in negative mood in the two
clay groups compared to the two stress ball groups. The
“Clay Total” and “Stress Ball Total” rows in each table reveal
the magnitude of this effect. Overall negative mood score
on the POMS decreased an average of 45 points follow-
ing the two clay interventions and 29 points following the
two stress ball interventions. Thus, participants in the clay
conditions experienced more than 50% greater mood im-
provement than individuals exposed to the stress balls. Par-
ticipants in the clay groups also showed almost 15 points
of improvement in STAI-S scores compared to a little more
than 10 points for the stress ball groups; once again, these
values represent nearly 50% greater improvement in mood
for the clay intervention conditions.
No other significant interactions were revealed in the
analyses. However, there was a trend toward a 3-way Ma-
terials × Instructions × Time interaction for the STAI-S,
F(1, 98) = 3.6, p = .06. A much weaker trend toward
a 3-way interaction existed in the POMS analysis, F(1,
98) = 1.7, p = .19. Tables 1 and 2 reveal similar patterns
of change across the four conditions. For both measures,
the advantage of the clay over the stress ball conditions
was more pronounced in the structured conditions (Clay
Structured vs. Stress Ball Structured) compared to the free
conditions (Clay Free vs. Stress Ball Free). However, these
differences were not sufficiently strong to produce a signif-
icant 3-way interaction. Furthermore, the highest score in
each table reflecting the change between pre-treatment and
post-treatment belonged to the Clay Structured condition.
Discussion
The results of this study clearly document that a 5-
minute period spent manipulating clay produced more
mood enhancement than the same amount of time spent
manipulating a soft stress ball. On both the POMS and
the STAI-S, the two groups that worked with clay showed
greater reductions in negative mood from pre-treatment to
post-treatment than the two groups that used stress balls.
This finding supports the claim that clay work has unique
properties for emotional expression and regulation that go
beyond the simple manual manipulation of an object. Al-
though neither primary outcome analysis revealed a signifi-
cant 3-way interaction (Materials × Instructions × Time),
there was a trend in both cases towards a larger effect in the
Clay Structured condition. These trends are consistent with
the idea that art therapy interventions are most effective at
alleviating negative mood states when they entail a struc-
tured task leading to a specific end result or goal state (in
this case, the creation of a pinch pot).
The present design has a number of advantages in al-
lowing us to isolate the use of clay as the active ingredient
in improved mood in our participants. First, the laboratory-
based mood induction ensured that the four groups were
experiencing comparable levels of negative mood at the
start of the treatment phase (pre-treatment). Second, the
use of a random assignment design meant that improve-
ment of mood in the groups working with clay could
not be attributed to internal validity threats such as test-
ing, maturation, selection bias, history, or regression to the
mean. Furthermore, individual participants were left alone
both during mood assessments and during handling of the
clay or stress balls, thus reducing the potential impact of
Downloaded by [Arcadia University] at 08:05 13 June 2012
78 EFFICACY OF CREATIVE CLAY WORK
observer/experimenter bias on the study results. Third, the
use of soft, squeezable stress balls in the control conditions
meant that the effects of clay could not be simply attributed
to the manual manipulation of an object, to the simple act
of squeezing, or to exposure to tactile contact with some-
thing soft. Fourth, the use of the stress ball control reduced
the possibility that the results were contaminated by demand
effects; participants in the ball conditions had every reason
to expect as much mood improvement as participants in the
clay conditions (after all, stress balls are explicitly meant to
reduce stress). Finally, the factorial design employed allowed
us to independently assess the effects of clay itself, the ef-
fects of performing a structured task, and the interaction
of these two factors. As described above, the results showed
clear support for the efficacy of using clay manipulation to
produce mood enhancement and partial support for the idea
that therapeutic clay work should be structured in order to
relieve anxiety and negative mood.
The present study has a number of limitations as well.
Chief among them was our decision not to employ an actual
art therapy intervention involving facilitation by a registered
art therapist. Instead, the first author (a student studying art
therapy as an undergraduate concentration) provided some
simple instructions for manipulating the clay (or stress ball)
and then allowed participants to work on their own. The
study also did not involve clients with diagnosed emotional
disorders; rather, it involved a convenience sample of mostly
college students and an induced negative mood state. An-
other limitation is that the treatment phase of this study
took place in a single 5-minute session whereas tr ue art ther-
apy interventions typically last for much longer periods of
time and often over multiple days. Although these factors
all reduce the generalizability of our findings to actual clin-
ical practice, they also highlight the magnitude of the clay
work effects obtained. In other words, despite the absence
of an art therapist, the lack of emotional disorders among
the participants, and a very brief exposure period, we still
saw substantially greater mood improvement in individuals
who worked with clay compared to those who manipulated
a soft stress ball.
To our knowledge, the present results represent the first
evidence from a randomized controlled trial documenting
the efficacy of clay work for remediating negative emotional
states. As such, they contribute to the growing body of
research aimed at establishing art therapy interventions as
evidence-based practices. We hope that the present study
motivates further research into the therapeutic uses of clay
and into the specific aspects of clay work that function as
active ingredients in treatment success. The results of this
study should provide some encouragement for the future
success of that endeavor.
References
Anderson, F. E. (1995). Catharsis and empowerment through
group claywork with incest survivors. The Arts in Psychotherapy,
22(5), 413–427.
Banker, J. E. (2008). Family clay sculpting. Journal of
Family Psychotherapy, 19(3), 291–297. doi:10.1080/
08975350802269533
Bell, C. E., & Robbins, S. J. (2007). Effect of art production
on negative mood: A randomized, controlled trial. Art Therapy:
Journal of the American Art Therapy Association, 24(2), 71–75.
doi:10.1080/07421656.2007.10129589
Boothby, D. M., & Robbins, S. J. (2011). The effects of mu-
sic listening and art production on negative mood: A random-
ized, controlled trial. The Arts in Psychotherapy, 38(3), 204–208.
doi:10.1016/j.aip.2011.06.002
Campbell, D. T., & Stanley, J. C. (1966). Experimental and
quasi-experimental designs for research.Chicago,IL:Rand
McNally.
Carolan, R. (2001). Models and paradigms of art therapy
research. Art Therapy: Journal of the American Art Ther-
apy Association, 18(4), 190–206. doi:10.1080/07421656.2001.
10129537
Chambless, D. L., & Hollon, S. D. (1998). Defining empirically
supported therapies. Journal of Consulting and Clinical Psychol-
ogy, 66(1), 7–18.
Cook, T. D., & Campbell, D. T. (1979). Quasi-experimentation:
Design and analysis issues for field settings. Chicago, IL: Rand Mc-
Nally.
Curry, N. A., & Kasser, T. (2005). Can coloring mandalas re-
duce anxiety? Art Therapy: Journal of the American Art Ther-
apy Association, 22(2), 81–85. doi:10.1080/07421656.2005.
10129441
Deaver, S. P. (2002). What constitutes art therapy research? Art
Therapy: Journal of the American Art Therapy Association, 19(1),
23–27. doi:10.1080/07421656.2002.10129721
De Petrillo, L., & Winner, E. (2005). Does art improve mood?
A test of a key assumption underlying art therapy. Art Therapy:
Journal of the American Art Therapy Association, 22(4), 205–212.
doi:10.1080/07421656.2005.10129521
Drake, J. E., Coleman, K., & Winner, E. (2011). Short-term mood
repair through art: Effects of medium and strategy. Art Therapy:
Journal of the American Art Therapy Association, 28(1), 26–30.
doi:10.1080/07421656.2011.557032
Elkis-Abuhoff, D. L., Goldblatt, R. B., Gaydos, M., & Corrato,
S. (2008). Effects of clay manipulation on somatic dysfunction
and emotional distress in patients with Parkinsons disease. Art
Therapy: Journal of the American Art Therapy Association, 25(3),
122–128. doi:10.1080/07421656.2008.10129596
Henley, D. (2002). Clayworks in art therapy: Playing the sacred cir-
cle. Philadelphia, PA: Jessica Kingsley.
Kramer, E. (1971). Art as therapy with children.NewYork,NY:
Shocken Books.
Kramer, E. (1973). Art therapy in a children’s community. Spring-
field, IL: Charles C Thomas.
Downloaded by [Arcadia University] at 08:05 13 June 2012
KIMPORT / ROBBINS 79
McNair, D. M., Lorr, M., & Droppleman, L. F. (1971). Manual
of the Profile of Mood States. San Diego, CA: Educational and
Industrial Testing Service.
Or, M. B. (2010). Clay sculpting of mother and child figures
encourages mentalization. The Arts in Psychotherapy, 37(4),
319–327. doi:10.1016/j.aip.2010.05.007
Puig, A., Lee, S. M., Goodwin, L., & Sherrard, P. A. D.
(2006). The efficacy of creative arts therapies to enhance emo-
tional expression, spirituality, and psychological well-being of
newly diagnosed Stage I and Stage II breast cancer patients:
A preliminary study. The Arts in Psychotherapy, 33, 218–228.
doi:10.1016/j.aip.2006.02.004
Reynolds, M. W., Nabors, L., & Quinlan, A. (2000). The ef-
fectiveness of art therapy: Does it work? Art Therapy: Jour-
nal of the American Art Therapy Association, 17(3), 207–213.
doi:10.1080/07421656.2000.10129706
Sholt, M., & Gavron, T. (2006). Therapeutic qualities of
clay-work in art therapy and psychotherapy: A review.
Art Therapy: Journal of the American Art Therapy As-
sociation, 23(3), 66–72. doi:10.1080/07421656.2006.
10129647
Slayton, S. C., D’Archer, J., & Kaplan, F. (2010). Out-
come studies on the efficacy of ar t therapy: A review of
findings. Art Therapy: Journal of the American Art Ther-
apy Association, 27(3), 108–119. doi:10.1080/07421656.2010.
10129660
Spielberger, C. D. (1983). Manual for the State-Trait Anxiety In-
ventory (Form Y). Palo Alto, CA: Counseling Psychologists.
Downloaded by [Arcadia University] at 08:05 13 June 2012
... There is some previous empirical research that studies the effect of either drawing or clay forming on mood and emotion regulation by utilising different self-rating questionnaires (DePetrillo & Winner, 2005;Drake & Winner, 2012;Drake, Coleman, & Winner, 2011;Kimport & Hartzell, 2015;Kimport & Robbins, 2012). Most of the studies have tested the effect of varying drawing or clay forming tasks on participants' mood and emotional regulation after first inducting a negative mood. ...
... Furthermore, some of them show evidence that copying is not as effective a task as more imaginative and self-expressive tasks (DePetrillo & Winner, 2005;Drake & Winner, 2013). Similarly, one randomised controlled trial (RCT) study that compared the effect of clay forming and handling of stress balls on reducing negative mood showed greater mood enhancement following five minutes of clay handling than ball handling (Kimport & Robbins, 2012). It suggested that both non-directive clay forming and pinch pot shaping are effective in reducing negative mood states. ...
Article
Full-text available
Experimental research on the psychophysiological effects of different art materials and tasks is still scarce. This mixed methods research focused on physiological changes and emotional experiences in drawing and clay forming during the tasks of copying, creating novel designs and free improvisation within fast and slow timeframes. It combined an experimental setting and analysis of 29 participants’ physiology with a qualitative content analysis of 18 participants’ stimulated recall interviews. The main findings indicate that fast drawing was mentally the most relaxing. This physiological and qualitative evidence supports the therapeutic use of the fast scribbling tasks commonly used in the warm-up phase of art therapy. Furthermore, compared to drawing, clay forming demanded higher mental and physical effort in both timeframes. Interestingly, while physiology did not significantly differ between the tasks, the qualitative analysis revealed that nondirective clay forming stimulated participants’ creative ideation and evoked the most positive emotions. This supports the use of nondirective clay tasks to aid in reaching therapeutic goals. The qualitative results also shed light on the unique and contradictory nature of emotional processes that different art materials, tasks and timing can evoke, highlighting the importance of therapists’ skills to sensitively tailor matching interventions for different clients.
... Hand-mold clay into a pleasing form, such as an animal, person, object, or abstract shape. According to Kimport and Robbins (2012), "the use of clay in art therapy has a long history and has been the source of a great deal of theoretical writing, often within the psychoanalytic tradition" (see Henley, 2002;Sholt & Gavron, 2006, p. 74). Henley (2002) supported the use of clay work, asserting that it allows clients to express and discharge negative emotional states such as aggression. ...
Article
This qualitative study examines the experience of adolescent males of color engaged in a 12-week, school-based art therapy intervention. Participants were 78 ninth graders from limited resource communities attending an all-boys high school in the South Bronx, New York. The population was naturally divided into three groups based on levels of potential academic competency. At the conclusion of the intervention, participants completed a written questionnaire to ascertain their perspectives on art therapy, the pieces they created, and how process and product related to emotions. Qualitative coding revealed nine themes, which provided a sense of differential impacts of the intervention by academic grouping. Findings suggest that art therapy targets a range of needs for high school students, from those who are successful and feel positively in school to those who struggle within the academic setting.
... Furthermore, out of four visual art therapy studies included by Baker et al. three used a non-clinical sample. These limitations confirm previously voiced concerns regarding the rigorousness of art therapy study design and evidence (Ebmeier et al., 2006;Kimport & Robbins, 2012;Rose et al., 2014). It can be argued that despite art therapy being used in the treatment of a range of psychological difficulties, its impact on adult trauma survivors has not been reviewed in a rigorous and systematic way. ...
Article
Background: A case is made for art therapy and its contributions to the treatment of post-traumatic stress disorder (PTSD). Aims: The current systematic literature review set out to critically review existing evidence of the impact of art therapy upon adults with a diagnosis of PTSD. Five online databases were searched for articles published in peer-reviewed journals exploring the effectiveness of art therapy in the treatment of PTSD. Results: The search yielded 449 papers. Following application of exclusion criteria 20 were included in the systematic review. Conclusions: Across the reviewed articles, four themes were identified: (1) impact on symptoms, (2) processing traumatic memories, (3) fostering a holistic view of self, and (4) increased well-being and more positive view of self. Overall methodological considerations included issues regarding study design, measures and analysis, researcher biases, sample size, and treatment received. Implications: Evidence suggested that some can benefit from the treatment with effects being shown in most symptom clusters of PTSD. Implications such as the need for more robust research in the field are discussed. Clinical recommendations include the suggestion to use art therapy when avoidance or feelings of guilt/shame make engaging in standard talking therapies difficult.
... When left unregulated, these emotions may lead to alienation from oneself and others (Gross & John, 2003). There are many activities that serve to regulate our emotions in the short-term such as humor (Samson & Gross, 2012), music (Tahlier, Miron, & Rauscher, 2013), clay work (Kimport & Robbins, 2012), autobiographical writing (Hemenover, Augustine, Shulman,Tran, & Barlett, 2008), and talking about something unrelated (Sheppes, Scheibe, Suri, & Gross, 2011). One such activity for regulating our emotions that has received increased attention over the past decade is drawing. ...
Article
Aim: Group art therapy using clay as a medium was tested as a method to cope with feelings of loneliness and hopelessness. Method: This study was a randomized controlled study. A total of 60 older adults who lived alone were enrolled in the study. Thirty subjects were randomly assigned to six 1.5 hour-weekly group art therapy using clay and interviewed face-to-face twice (intervention group, IG), and 30 subjects were randomly assigned to be interviewed face-to-face twice (control group, CG). The effects of interventions were measured using the UCLA Loneliness Scale (UCLA-LS) and the Beck Hopelessness Scale (BHS). Loneliness and hopelessness levels in the intervention and control group were measured at the beginning (pretest) and the end (posttest) of the study. This study was conducted using the CONSORT statement. The group art therapy trial is registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT04295083. Results: A statistically significant difference was found between the pretest and posttest scores of the loneliness and hopelessness levels of older adults living alone in the intervention and control groups. Conclusion: Clay-based group art therapy can contribute to decreasing the sense of loneliness and hopelessness in older adults. Nurses using group art therapy for older adults will realize the psychological healing aspects and effectiveness of this intervention and recognize it as an effective method for the psychological growth of older adults and the reduction of their loneliness and hopelessness levels.
Article
Exhibitions have the potential to affect the lives of visitors and the artists themselves. This article considers the potential influence of exhibitions as a culminating factor in creative arts therapy experiences for young adults with autism. It explores the therapeutic potential of using the gallery as a space for change as well as to enhance socially inclusive experiences for the participating artists. Findings from this study suggest that participating in an exhibition as a final component of creative arts therapy sessions may enhance the therapeutic benefits for client-artists with autism and may influence the perception of visitors.
Article
A growing body of scholarship suggests that art-making provides symptom relief as well as short-term mood benefits. However, more research is needed to explore how artistic activities may lead to mood improvements within the course of sessions conducted in clinical contexts. To this end, we examined short-term outcomes of participation in an art group offered within a brief partial hospital program in which intensive day treatment is delivered. In a preliminary study (Study 1) conducted on Amazon MTurk (N = 193), we validated the use of a brief 7-item self-assessment scale to capture potential outcomes of art-making identified based on a review of the literature: positive/negative mood, general self-efficacy, creative self-efficacy, activation, mindfulness, and social connectedness. In our main study (Study 2), 175 patients in a partial hospital program completed the brief instrument validated in Study 1 at the beginning and end of a 50-minute unstructured art group. All psychological outcomes improved over the course of the group. Changes in general self-efficacy and mindfulness were associated with improvements in mood over and above changes in other outcomes. Results are limited by the naturalistic, uncontrolled, design of the group, which was not led by art therapists. These findings suggest that further studies examining patients’ experiences during art-making in clinical settings may provide useful insights into how this activity enhances mood.
Chapter
Emotion regulation (ER) is a vital modality for understanding and controlling depression and consists of three major interdependent components: positive and negative affects, the mutuality of emotions and cognition, and the physiological mechanisms of emotions. Studies have noted that art therapy is effective in alleviating depression and stress, promoting emotional openness, and improving general health. Clay art therapy (CAT) has shown significant effects on the reparation and recovery from depression by strengthening ER. Clay as an art medium can induce intense haptic, proprioceptive, and visual sensations that foster ideal cognitive arousal through rhythmic kinesthetic movements to attune inner pleasure and encourage emotional expression. Building upon the expressive therapies continuum (ETC) construct, the CAT model adopts a bottom-up treatment approach by initiating kinesthetic/sensory stimulation and subsequently promoting positive affective and cognitive experiences. The CAT protocol endorses a two-stage intervention design that progressively embeds levels of the ETC model in its activities.
Article
Full-text available
Background: The drastic socio-political unrest in Hong Kong (HK) due to the different political issues in 2019 and the novel coronavirus epidemic has drawn rising negative emotions in the society, which the demand for psychological support is soaring. As the epidemic has greatly limited the flexibility of rendering conventional face-to-face counselling, alternative therapeutic approaches are vital to combat the accelerating demand of social and psychological support. Methods: This study reports the qualitative research results of investigating the treatment efficacy and the mechanism of art therapy with clay (CAT), on the emotional problems of youth in the context of HK. The intervention composes of six 2-hour sessions led by an art therapist who is also an experienced school social worker. Results: The phenomenographic approach of analysing the post-intervention focus groups triangulated by the in-sessions art-based inquiry worksheet responses have depicted the therapeutic effects of CAT in three different themes as(1) releasing physical tension, soothing and regulating emotion; (2) building persistence in face of adversities and failures, and; (3) art products as representations of new meanings of life and positive self-image. Conclusions:The CAT process and the created ceramic artworks show powerful therapeutic effects in reorganizing and incorporating challenging experiences and failures, regulating feelings, and instilling new meanings to existential struggles and life issues. Traumatic experience and challenging situation have an existential implication that help one to recapture the core values of life and promote psychological positivity. The creation of animal symbols in the youngsters’ ceramic artworks embrace a sophisticated process of charging emotion, revitalize ideas, and connect personal experience to the collective experience.
Article
This study contains an investigation of a new expressive therapeutic approach (STEM-based expressive therapy). An exploratory descriptive qualitative approach was utilized to explore how STEM-based activities provide a non-traditional expressive therapeutic approach to address children and family systems in school-based settings and professional development of Counselors-in-Training was explored. Findings indicated that there was increased family communication as a result of completing a STEM-based expressive therapy activity.
Article
Full-text available
Art therapists have long held that art production causes reductions in stress and elevations in mood (Rubin, 1999). The authors examined this claim in a randomized, controlled trial. Fifty adults between the ages of 18 and 30 were randomly assigned to either create an art work or to view and sort a series of art prints. Three measures of overall negative mood and of anxiety were collected before and after each intervention. Two-way ANOVAs (Group by Time) demonstrated significantly greater reductions in negative mood and anxiety in the art production group compared with the art viewing control group on all three measures (all p-values
Article
The focus of this outcome study was on art therapy as a support for medical treatment and palliative care. A total of 41 patients were placed in 2 matched groups: 22 patients with Parkinson's disease and 19 patients without Parkinson's disease. Each participant completed the Brief Symptom Inventory (BSI) (Derogatis, 1993) pre- and post-session, and was asked to manipulate a ball of clay and to respond to follow up questions on the experience. Quantitative and qualitative results showed a positive outcome with significant decrease in somatic and emotional symptoms in both groups. This research supports the value of an art therapeutic clay program for patients diagnosed with Parkinson's disease and recommends future studies addressing art therapy with caregivers.
Article
We investigated whether artmaking improves mood, and if so, whether this effect is best explained by "catharsis" or "redirection." In Experiment 1, participants viewed tragic images and then either drew a picture based on their feelings or copied shapes. Those who drew exhibited more positive mood after drawing; those who copied shapes did not. Mood improved equally for those who drew negative and nonnegative images, suggesting that for some, catharsis led to improved mood and that for others, redirection led to improved mood. In Experiment 2, to test whether artmaking improved mood simply because people were distracted by making a drawing, we gave participants a word puzzle to complete, a task that does not allow expression of feeling through symbolic content. Completion of a word puzzle did not improve mood. These results suggest that artmaking increases the pleasure dimension of mood and does so via either catharsis or redirection.
Article
A large literature now exists to examine the effects of music listening on negative mood. However, few studies both isolate music as the active ingredient in mood improvement and compare music to a placebo condition designed to reduce demand effects. In the present study, 60 adult participants recruited from the local community were randomly assigned to one of four conditions: music listening+art production (drawing), music listening+art sorting, no music+art production, or no music+art sorting. By giving participants in all four groups an “arts” task, we intended to equate expectations of improvement and thereby better rule out demand effects as a source of group differences. Self-report measures of negative mood were collected before and after the 10min intervention period. Participants in the two music listening conditions showed greater mood enhancement compared to the two non-music conditions. However, there were no significant effects of the art conditions (production vs. sorting). These results document that music listening has specific efficacy in enhancing mood even when expectations of improvement are equated across groups.