Art Therapy For Pediatric Pain and Palliative Care

Many factors contribute to how children experience pain and navigate serious illnesses, which is why we need a range of tools to support their journeys. In this article, we explore recent evidence on how art therapy can address pediatric pain and palliative care.  Before diving in, let’s start off with a few definitions: 

What is Art Therapy? 

Art therapy is defined as “the creative process of art production that can improve and enhance the physical, mental, and emotional well-being of individuals.”  Art therapy can encompass a range of creative modalities - including music, theater, dance, visual, and literary arts.  

An important distinction is that art therapy incorporates psychotherapy within the creative process and is facilitated under the guidance of a licensed art therapist.  While arts-based interventions - through arts engagement and creative processes without a therapeutic component - are also beneficial, these must be distinguished from art therapy. 

What is Pediatric Pain and Palliative Care? 

Pediatric pain can be classified as acute or chronic.  It is estimated to affect 40% of children globally.  Acute pain is short-term and can arise as a result of injury, procedures and surgery.  Chronic pain, on the other hand, can be persistent and recurring for 3 months or longer.   

Palliative care is a specialized field of medicine that seeks to improve quality of life through addressing conditions such as pain, anxiety and depression that may affect individuals who are navigating serious illnesses, such as cancer. 

What The Research Says 

One scoping review published in Children (May 2024) evaluated the role of art therapy interventions to address pediatric pain.  Five studies met the inclusion criteria for this literature review.  Within these studies, sample sizes ranged from 8-120 participants with ages ranging from 2-20 years.  Interventions ranged from single art therapy sessions to a series of six 50-minute sessions, addressing pain in contexts such as post-operative care, medical procedures, headaches, and oncology treatment.  

While there was variability in participant demographics and intervention formats, results from these studies suggested that art therapy interventions can reduce treatment-related pain, anxiety, stress and fear.  The majority of these studies examined art therapy’s effects on acute pain, so there is room to explore the effects of this intervention to address chronic pain. 

Another systematic review, published in the Journal of Medical Sciences (March 2023) evaluated the impact of art therapy as a palliative care intervention for children with cancer. Seventeen studies met inclusion criteria for this review, which used interventions from the following creative processes - painting, rhythmic movements, music therapy, and combined painting and music therapy.  Participants across these studies were all children under 18 years of age who were receiving treatment for cancer.  Results demonstrated improvements in the following physical and psychological domains: 

Physical 

• Painting intervention led to increased energy and activity 

• Music therapy led to increase in physical performance, activity and play 

Psychological 

• Painting intervention led to a reduction in symptoms of depression, anxiety, and anger 

• Rhythmic movements and music therapy led to a decrease in anxiety 

• Music therapy led to a decrease in pain, increased children’s happiness and led to greater relaxation 

• The combination of painting and music therapy also led to reduction in symptoms of anxiety and depression 

Tying It Together 

Art therapy shows potential in alleviating physical pain as well as psychological symptoms of depression, anger and anxiety in children within a variety of contexts.  These studies explored a range of creative processes - including visual arts, music, and movement - that appear to offer meaningful benefits in pediatric pain and palliative care.  Future studies could explore the longitudinal impact and sustained outcomes of these interventions.  Additionally, these reviews did not mention whether or not any adverse outcomes were noted. 

While these studies suggest that art therapy and creative processes may be beneficial adjuncts to conventional therapeutic processes addressing pain and palliative care, further research is necessary to expound these results and provide standardized guidelines for approaching integration of this intervention in mainstream healthcare settings. 

At the Benjamin Goldberg Foundation, we’re proud to be piloting programs that contribute to this growing body of research. One such initiative involves prescribing art and music interventions to adult oncology patients in our region. We look forward to sharing outcomes and insights from this pilot to help further the integration of the arts in healthcare. 

If you’d like to support this transformative work, including our pilot project, please consider making a donation.  

Resources: 

Motlagh EG, Bakhshi M, Davoudi N, Ghasemi A, Moonaghi HK. The physical and psychological outcomes of art therapy in pediatric palliative care: A systematic review. J Res Med Sci. 2023 Mar 16;28:13. doi: 10.4103/jrms.jrms_268_22. PMID: 37064791; PMCID: PMC10098136. 

Olaizola S, Lalloo C, Vickers V, Kelenc L, Tariq S, Brown SC, Stinson JN. Art Therapy for Paediatric Pain: A Scoping Review. Children (Basel). 2024 May 22;11(6):619. doi: 10.3390/children11060619. PMID: 38929199; PMCID: PMC11202121.