A systematic review of child-focused outcomes and assessments of arts therapies delivered in primary mainstream schools

Introduction: Arts therapies have been widely used at schools for over half a century in an effort to alleviate and prevent children’s difficulties. In contrast to talking therapies, arts therapies aim to facilitate personal change and growth through the use of arts media. Existing systematic reviews are limited to one of the arts therapies (namely either art, music, drama or dance movement therapy), focus primarily on adults with mental health difficulties and neglect child reported outcome measures. Aim: The current systematic review aims to identify, appraise and synthesise the available evidence relating to outcomes that have been reported by children in primary mainstream schools (aged 5–12 years old). Methods: Major electronic databases were systematically searched, specifically: AMED, PsycINFO, CINAHL, ERIC, MEDLINE, Campbell Collaboration Library, WHO ICTRP, Cochrane library databases, including CDSR, CENTRAL, HTA (01/01/1980 until 31/03/2018 published in English). The search included grey literature, journals of arts therapies and information from experts in the field. Results: Seven studies met the inclusion criteria; two pilot-RCTs, two quasi-RCTs, a cluster-RCT, a controlled before-after design, and a study with a grounded theory design. Three interventions were in music therapy, two in art therapy, and two in dance movement therapy. None of the studies in dramatherapy met the inclusion criteria. The interventions were delivered over 8–20 sessions, and lasted between 45 and 120 min, 1–3 times weekly. The sample sizes ranged between 14 and 138 participants, with a total of 358 participants. The interventions took place in USA, UK, Canada, South Korea, and Saudi Arabia. Children reported significant improvements from attending arts therapies on self-esteem, self-confidence, self-expression, mood, communication, understanding, resilience, learning, and aggressive behaviour, and small changes in the outcomes of depression, anxiety, attention problems, and withdrawn behaviours. Conclusions: The location, the delivery of arts therapies, the outcome assessments and the quality of the studies varied significantly, which taken together, suggests taking caution when interpreting the findings. What this systematic review does do is highlight areas for improvement in future research and practice based on evidence that is grounded on children’s perspectives. The implementation of these suggestions could increase the benefits for children’s health and wellbeing, and the wider inclusion of art therapies in national and international health-related guidelines.