Creative Arts Support Improvements in Trauma Recovery

By Irene Yeh 

Creative arts and activities are associated with improvements in psychological and physical health, as well as social connections. There have been reports of reduced post-traumatic stress disorder and other trauma-related symptoms. Despite arts engagements showing improvements in trauma recovery, it isn’t a treatment method that has been extensively explored. 

The Johns Hopkins University International Arts + Mind Lab, Center for Applied Neuroaesthetics and Seattle-based Path with Art (PwA) collaborated to understand the positive impact of creative activities for people dealing with mental health issues. The study targeted low-to-no income adults in active recovery from trauma with the goal of understanding how arts programs can benefit trauma recovery, particularly on mental well-being, social connectedness, and self-efficacy (Health Promotion Practice, DOI: https://doi.org/10.1177/15248399261445966)  

The Neurology Behind Art Therapy 

Creative art therapies engage neural pathways related to emotional regulation and cognitive function, as well as social reintegration. Participation in arts programs may support emotional resilience and help individuals manage stress. For example, a 2016 study found that group singing reduced negative affect and increased positive affect, along with noticeable changes in stress-related biomarkers (Open Journal of Nursing, DOI: https://doi.org/10.3389/fpsyg.2020.00896). Additionally, creative arts can enhance social connection, build trust, and reduce social isolation and loneliness—crucial components to trauma recovery. These programs often take place in a structured environment that provides opportunities for people to share experiences. These factors support healing by encouraging emotional expression, fostering a sense of belonging, and creating a safe space for mutual support. 

Creative arts engagement might also improve self-efficacy, the belief of an individual’s capacity to influence life events and overcome challenges. This is another critical element to trauma recovery, as an individual’s sense of self-efficacy influences feelings of helplessness and disempowerment.  

Arts Engagement Study 

The study took place over a 12-month period and had four individual 8-week sessions that typically lasted two hours. Pre- and post-study surveys were used to assess the outcomes of the classes. The study was designed with two complementary models: the Arts and Culture in Public Health Evidence-Based Framework and the Impact Thinking Framework. The Arts and Culture in Public Health Framework provides evidence-based understanding of how arts and cultural engagement influences individual and collective health. It suggests that experiences such as enjoying art, finding personal meaning in activities, and expressing oneself can lead to positive outcomes. These benefits may include greater overall mental and emotional well-being, less loneliness and social isolation, and increased confidence in one’s ability to handle challenges and achieve goals. These are the main outcomes the study is focused on measuring. 

The Impact Thinking Framework helps researchers use what they learn to create practical and effective programs. It emphasizes working closely with others, learning and adapting throughout the process, and focusing on real-world results. This approach helps ensure that any interventions developed from the study can create lasting benefits for both individuals and communities and that the findings can be applied in meaningful ways outside of the research setting.  

The study population consisted of low-to-no income participants aged 18 and older in active recovery from trauma. There was no control group. Each participant was enrolled in at least one 8-week class with PwA. These classes included: choir, music, dance, theater, writing, poetry, storytelling, podcasting, visual arts, mixed media, and design thinking. Sessions were available both virtually and in-person.  

Surveys were distributed to all 590 participants, but only 120 of them completed both pre- and post-study surveys. Duplicate responses from participants who completed multiple quarters were identified to ensure independence of observations. In total, 80 independent responses were analyzed. Exit surveys were also given, and 103 completed surveys were analyzed, regardless of pre- and post-survey completion. If there were multiple responses from the same participant, only the first response was included to ensure that the individual’s response was recorded only once.  

Arts Engagement Does Improve Mental Health 

Overall trends showed improvements, but individual responses varied. Some participants significantly improved, many had modest changes, and others experienced declines. In pre- and post-study surveys, there was great improvement in mental well-being (p < .01), moderate improvement in self-efficacy (p < .02), and significant decrease in loneliness (p < .01).  

In the exit surveys, the quantitative results showed that 90.3% of participants agreed that classes increased their self-efficacy, 88.3% reported improvements in mental health, 80.6% responded feeling less lonely since joining classes, and 69% of participants reported making new friends in the classes, suggesting improvements in social connection. 

For the qualitative results, the most prominent theme across all respondents was the significance of social connection and community. The classes at PwA helped participants feel safe and included and provided a sense of community, thus enhancing their sense of belonging, alleviating social isolation, and providing structure for social interactions.  

Creative engagement helped the participants process their emotions and navigate their trauma, as well as manage stress, anxiety, and other trauma-related symptoms. The research team writes that these findings particularly align with previous studies that display evidence of arts engagement benefiting psychological health. Participants reported increased confidence, agency, and belief in their ability to navigate challenges. The structured and non-judgmental atmosphere also offered an environment for participants to take creative risks without fear of criticism. Once again, these findings align with prior research that demonstrate that arts engagement can strengthen self-efficacy, confidence, and sense of purpose. 

The researchers mention a few limitations. First, there was a lack of accessibility to the surveys. Some participants probably could not record their responses in the surveys due to not having personal technology or resources to borrow technology. As such, there may be a large number of members from an already marginalized group that could not provide their feedback. Additionally, there is the possibility of self-selection bias due to the voluntary participation nature of the study. Participants who felt positively about the program or had fewer barriers to participants may have been more likely to complete surveys, further skewing results toward more favorable outcomes. Lastly, the study did not control external variables that may have influenced the participants’ experience and responses.  

Still, the study showed similar results from previous studies that displayed positive effect of arts engagement for people recovering from trauma and trauma-related symptoms. The team encourages that future studies should consider external variables that may influence outcomes and consider control groups and longitudinal designs. There must also be easier data collection methods and broader recruitment strategies.  

For patients in trauma recovery, arts-based approaches are a valid and valuable treatment method that can improve their mental well-being, self-efficacy, and social connectedness, which are vital to trauma recovery. Furthermore, it offers an intervention method that can complement traditional therapeutic interventions. Practitioners working with trauma-affected patients are encouraged to find arts-based programming a flexible, low-threshold, and culturally responsive option. The researchers encourage more investment in community arts infrastructure and embedding them more in local care systems.