Arts Therapies for Anxiety, Depression, and Quality of Life in Breast Cancer Patients: A Systematic Review and Meta‐Analysis
Open accessAbstract
Background. Breast cancer is one of the most common types of cancer. However, only a few trials assess the effects of arts therapies. Material and Methods. We searched the Cochrane Central Register of Controlled Trials, PubMed, and Google Scholar from their start date to January 2012. We handsearched reference lists and contacted experts. All randomized controlled trials, quasi‐randomized trials, and controlled clinical trials of art interventions in breast cancer patients were included. Data were extracted and risk of bias was assessed. Meta‐analyses were performed using standardized mean differences. Results. Thirteen trials with a total of 606 patients were included. Arts therapies comprised music therapy interventions, various types of art therapy, and dance/movement therapies. The methodological quality ranged from poor to high quality with the majority scoring 3 of 4 points on the Jadad scale. Results suggest that arts therapies seem to positively affect patients’ anxiety (standardized mean difference: −1.10; 95%, confidence interval: −1.40 to −0.80) but not depression or quality of life. No conclusion could be drawn regarding the effects of arts therapy on pain, functional assessment, coping, and mood states. Discussion. Our review indicates that arts interventions may have beneficial effects on anxiety in patients with breast cancer.
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Existing literature examining the effectiveness of art therapy has shown some positive results across a wide variety of treatment indications, such as the treatment of depression, anxiety, psychosis, the enhancement of mental wellbeing, and the complementary treatment of cancer.
“The existing literature examining the effectiveness of art therapy has shown some positive results across a wide variety of treatment indications, such as the treatment of depression [3, 18], anxiety [19, 20], psychosis [21], the enhancement of mental wellbeing [22], and the complementary treatment of cancer [15, 23].”
From The effect of active visual art therapy on health outcomes: protocol of a systematic review of randomised controlled trials (2022) · cites this paper as [23]
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“Cancer patients are increasingly turning to complementary and alternative medicine (CAM) therapies to reduce symptoms, improve QOL, and boost their ability to cope with stress [10].”
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Thyme, K. E., Tavelin, B., Öster, I., Lindh, J., & Wiberg, B. (2021) · Palliative & Supportive Care · doi:10.1017/s1478951521001437 · Cited by 12 · see citing works
WIDIYONO, S., Setiyarini, S., & Effendy, C. (2018) · Indonesian Journal of Cancer · doi:10.33371/ijoc.v11i4.535 · Cited by 12 · see citing works
Effects of dance therapy in women with breast cancer: A systematic review protocol
da Costa, N. S., da Silva, A. S. A., & Neto, J. S. D. M. (2022) · PLoS ONE · doi:10.1371/journal.pone.0257948 · Cited by 11 · see citing works
Barnish, M. S., & Nelson-Horne, R. V. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-069310 · Cited by 13 · see citing works
Reilly, R. C., Lee, V., Laux, K., & Robitaille, A. (2021) · Public Health · doi:10.1016/j.puhe.2021.07.004 · Cited by 10 · see citing works
Lin, J., Lin, X., Chen, Q., Li, Y., Chen, W., & Huang, F. (2024) · Supportive Care in Cancer · doi:10.1007/s00520-024-08364-y · Cited by 9 · see citing works
“It is worth noting that Boehm’s meta-analysis combined only two studies that explored art-making intervention in conjunction with music therapy and dance/ movement therapy, resulting in a different outcome [56].”
The role of social support in women’s health and recovery processes
Malicka, I., Kozłowska, A., Woźniewski, M., Rymaszewska, J., & Szczepańska-Gieracha, J. (2015) · Psychology Health & Medicine · doi:10.1080/13548506.2015.1009378 · Cited by 8 · see citing works
McInnerney, D., Kupeli, N., Stone, P., Anantapong, K., Chan, J., Flemming, K., Troop, N. A., & Candy, B. (2021) · Palliative Medicine · doi:10.1177/02692163211013248 · Cited by 8 · see citing works
Ran, R., Ying, Y., & Zhang, W. (2023) · Actas Españolas de Psiquiatría · Cited by 8 · see citing works
The Role and Effect of Music Therapy in Combination Therapy for Cancer Management
Liu, P., & Huang, S. (2024) · Current Medicinal Chemistry · doi:10.2174/0109298673307490240614053104 · Cited by 8 · see citing works
Use of Recorded Poetic Audios to Manage Levels of Anxiety and Sleep Disorders
dos Reis, A. C., Vidal, C. L., Caetano, K. A. D. S., & Dias, H. D. (2019) · Journal of Religion and Health · doi:10.1007/s10943-019-00947-y · Cited by 7 · see citing works
Tanztherapie in der Krebsbehandlung
Bräuninger, I. (2017) · Zeitschrift für Sportpsychologie · doi:10.1026/1612-5010/a000192 · Cited by 7 · see citing works
Chen, X., Gong, X., Shi, C., Sun, L., Tang, Z., Yuan, Z., Wang, J., & Yu, J. (2018) · Journal of Translational Medicine · doi:10.1186/s12967-018-1618-0 · Cited by 7 · see citing works
Huang, T., & Yin, X. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.05.027 · Cited by 6 · see citing works
Improving the oncology care pathway through the experience of patients and their caregiver
Gentile, S., Zidi, B., Robaglia‐Schlupp, A., Spetidi, R., Bouida, H., & Crétel, E. (2025) · BMC Palliative Care · doi:10.1186/s12904-025-01839-7 · Cited by 7 · see citing works
“Global cancer control policies should integrate not only data and scientific research but also the lived experiences of those directly affected [3].”
Liu, Z., Hui, C., Liu, S., Chen, Y., Zhang, Y., & Ye, W. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1542405 · Cited by 6 · see citing works
Art Therapy for Paediatric Pain: A Scoping Review
Olaizola, S., Lalloo, C., Vickers, V., Kelenc, L., Tariq, S., Brown, S. C., & Stinson, J. (2024) · Children · doi:10.3390/children11060619 · Cited by 6 · see citing works
Buday, K. M. (2019) · Canadian Art Therapy Association Journal · doi:10.1080/08322473.2019.1603073 · Cited by 6 · see citing works
Tollabzadeh, M., Rezvani, A. R., & Behzadipour, S. (2023) · Shiraz E-Medical Journal · doi:10.5812/semj-137504 · Cited by 5 · see citing works
Çataldaş, S. K., Kutlu, Y., & Eren, N. (2024) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2023.12.003 · Cited by 7 · see citing works
Tanz- und Bewegungstherapie in der Onkologie – Übersicht zum Forschungsstand
Koch, S. C., & Bräuninger, I. (2020) · Der Onkologe · doi:10.1007/s00761-020-00790-x · Cited by 5 · see citing works
“Es liegen zwei Arten von Übersichtsarbeiten vor: zum einen zu Effekten der künstlerischenTherapien für den Bereich derOnkologie [1, 2, 17, 35], zumanderen DMT-spezifische Arbeiten.”
BackgroundWaving and drowning: The gradations of therapist fitness to practise
Dokter, D., Lea-Weston, L., & Thornewood, T. (2023) · Dramatherapy · doi:10.1177/02630672231171326 · Cited by 5 · see citing works
The Effect of Art on Premenstrual Syndrome Symptoms
Çitil, E. T., & Canbay, F. Ç. (2024) · Holistic Nursing Practice · doi:10.1097/hnp.0000000000000659 · Cited by 6 · see citing works
“16 21-26 There is a dearth of published studies that investigated the impact of artistic techniques on PMS symptoms.”
Tagliaferri, L., Fionda, B., Casà, C., Cornacchione, P., Scalise, S., Chiesa, S., Marconi, E., Dinapoli, L., Capua, B. D., Chieffo, D. P. R., et al. (2024) · Strahlentherapie und Onkologie · doi:10.1007/s00066-024-02279-7 · Cited by 5 · see citing works
Hansra, D. M., McIntyre, K., Ramdial, J., Sacks, S. M., Patrick, C. S., Cutler, J. J., McIntyre, B., Feister, K., Miller, M., Taylor, A. K., et al. (2018) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2018/8081018 · Cited by 5 · see citing works
“For example, one systematic review and meta-analysis of clinical trials that included clinical trials utilizing dance and movement therapy and art therapy working with visual arts materials have beneficial effects on anxiety in patients with breast cancer [70].”
BackgroundZhou, K., Wang, D., He, X., Huo, L., An, J., Li, M., Wang, W., & Li, X. (2016) · BMC Cancer · doi:10.1186/s12885-016-2726-y · Cited by 5 · see citing works
Arts-Based Research Methods to Explore Cancer in Indigenous Communities
Rookwood, A. C., Abney, M., Butler-Robbins, H. S., Westmark, D., & Idoate, R. E. (2022) · The AMA Journal of Ethic · doi:10.1001/amajethics.2022.563 · Cited by 4 · see citing works
Psychological utility of art therapy for patients with advanced cancer
Ando, M., & Hayashida, S. (2017) · Clinical Case Reports and Reviews · doi:10.15761/ccrr.1000354 · Cited by 4 · see citing works
“[11], which showed the importance of expression of emotions.”
BackgroundKunsttherapie in der Palliativversorgung. Ein narratives Review. Teil I: Forschungsstand
Kortum, R., Koch, S. C., & Gruber, H. (2017) · Zeitschrift für Komplementärmedizin · doi:10.1055/s-0043-121402 · Cited by 4 · see citing works
Biological Effects of Music in Cancer Patients: Contributing to an Evidence-Based Practice
Taets, G. G. D. C. C., Fernandes, C., Torres, L. D. C., & Taets, C. M. C. (2020) · International Journal of Sciences · doi:10.18483/ijsci.2302 · Cited by 4 · see citing works
“Studies justify music effects on cardiorespiratory parameters based on the increase of endorphins and/or catecholamines release after listening to music.(17)”
BackgroundAzmawati, M. N., Boekhtiar, B., Zawiah, M., Siti Aisah, M., Chiew, W. L., & Dalila, R. (2020) · IIUM Medical Journal Malaysia · doi:10.31436/imjm.v17i2.274 · Cited by 4 · see citing works
Bibliometric and Subject Analysis of 100 Most-Cited Articles in the Field of Art Therapy
Homavandi, H., Kashani, M. M., & Batooli, Z. (2023) · Journal of Creativity in Mental Health · doi:10.1080/15401383.2023.2250248 · Cited by 4 · see citing works
“…treatment of diseases and disorders such as cancer (Forzoni et al., 2010; Geue et al., 2010; Puetz et al., 2013; Wood et al., 2011), breast cancer (Boehm et al., 2014; Monti et al., 2012; Thyme et al., 2009), post-traumatic stress disorder (Gantt & Tinnin, 2009; Lobban, 2014), schizophrenia…”
BackgroundArt and emotion processing among arab breast cancer survivors: An exploratory study
Hebi, M., Czamanski‐Cohen, J., Azaiza, F., & Weihs, K. L. (2024) · The Arts in Psychotherapy · doi:10.1016/j.aip.2024.102123 · Cited by 4 · see citing works
Sabo, B., Singh, M. D., Snelgrove‐Clarke, E., & Maimets, I. (2016) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2016-2479 · Cited by 4 · see citing works
Therapeutic Effects: The Integration of Creative Arts Therapy in Palliative Care
Youngwerth, J. M., Coats, H., Jones, A., Wibben, A., Somes, E., Felton, S., Anderson, A. N., Flarity, K. M., Elliott, K., & Kutner, J. S. (2020) · OBM Integrative and Complementary Medicine · doi:10.21926/obm.icm.2001004 · Cited by 3 · see citing works
Bringing Museums to Juvenile Prison Inmates through Virtual Reality
Soccini, A. M., Marras, A. M., Spione, G., Bruno, V., & Garbarini, F. (2022) · IEEE International Conference on Artificial Intelligence and Virtual Reality (AIVR) · doi:10.1109/aivr56993.2022.00049 · Cited by 3 · see citing works
“Being exposed to art helps to recognize, modulate and regulate emotions [14].”
BackgroundMoola, F. J., Moothathamby, N., Naganathan, M., Curran, C. J., Yerichuk, D., & McPherson, A. C. (2020) · Canadian Journal of Art Therapy · doi:10.1080/26907240.2020.1753461 · Cited by 3 · see citing works
Art Therapy Kurang Efektif Untuk Menurunkan Tingkat Kecemasan: Studi Meta-Analisis
Pratidina, P. A. O., & Yudiarso, A. (2021) · Psychocentrum Review · doi:10.26539/pcr.32716 · Cited by 2 · see citing works
Chou, A., McKechnie, T., Arora, V., DePestel, B., Wang, A., Parpia, S., Calic, G., Staibano, P., Derus, A., Guleria, A., et al. (2026) · Psycho-Oncology · doi:10.1002/pon.70425 · Cited by 2 · see citing works
The Toolbox Approach: Towards a Novel Flexible Way of Implementing and Testing Positive Education
Lucciarini, E., & Boniwell, I. (2023) · Springer eBooks · doi:10.1007/978-981-99-5609-8_8 · Cited by 2 · see citing works
Miller, M. (2024) · Canadian Journal of Art Therapy · doi:10.1080/26907240.2024.2408864 · Cited by 2 · see citing works
Widiyono, W., Setiyarini, S., & Effendy, C. (2019) · Indonesian Journal of Cancer · doi:10.33371/ijoc.v13i3.632 · Cited by 2 · see citing works
Burney, I. A., Al-Sharbati, Z. M., Al-Rawahi, Z., Al-Hatmi, S., Rizvi, S. G. A., & Boulassel, M. (2022) · Asian Pacific Journal of Cancer Prevention · doi:10.31557/apjcp.2022.23.7.2367 · Cited by 2 · see citing works
Vitale, E., Conte, L., Lupo, R., Botti, S., Fanizzi, A., Massafra, R., & Nunzio, G. D. (2024) · Current Oncology · doi:10.3390/curroncol31120567 · Cited by 1 · see citing works
“The development of AI-driven Large Language Models (LLMs) [17] such as OpenAI’s GPT and ChatGPT, have transformed the field of NLP, allowing for a deeper comprehension of human expression in extensive datasets, and the capability to grasp context, discern subtle shifts in tone, and produce…”
Oepen, R. (2025) · Complementary Medicine Research · doi:10.1159/000547592 · Cited by 1 · see citing works
“As these studies and previous research have demonstrated, AT interventions have a great impact on emotion regulation, stress reduction, mental and physical health, and improved social relationships [14, 19, 50, 51].”
Coloring the journey: The transformative impact of art therapy on cancer patients’ well-being
Arjmand, B., Mehran, P., Mirzaei, A., Najafi, K., Najafi, L., & Hojjat-Assari, S. (2025) · Journal of Chinese Integrative Medicine · doi:10.1016/j.joim.2025.10.007 · Cited by 1 · see citing works
Yu, M., Wang, L., Liu, Q., & Zhang, X. (2026) · Psycho-Oncologie · doi:10.18282/po5444 · Cited by 1 · see citing works
Rabadán, J., Lusar, A. C., & Álvarez, M. (1970) · Psicooncología · doi:10.5209/psic.57079 · Cited by 1 · see citing works
“Adicionalmente se añadieron estudios previos a 2011 que no estaban incluidos en la revisión previa(21) y que cumplían los criterios de inclusión mencionados previamente.”
BackgroundInfluential
- Authors
- Boehm, K., Cramer, H., Staroszynski, T., & Ostermann, T.
- Affiliations
- Witten/Herdecke University (DE)
- Kliniken Essen-Mitte (DE)
- Hochschule für Kunsttherapie Nürtingen (DE)
- Corresponding author
- Boehm, Katja
- Venue
- Evidence-Based Complementary and Alternative Medicine
- Publisher
- Wiley
- Published
- 2014-01
- Volume
- 2014
- Issue
- 1
- Pages
- 103297-103297
- ISSN
- 1741-427X (ISSN-L)
- 1741-4288
- PMC
- PMC3955604
- OpenAlex
- W2031688572
- Cited by
- 141
- References
- 35
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 15 · 2023: 14 · 2022: 12 · 2021: 12 · 2020: 15 · 2019: 13 · 2018: 13 · 2017: 15 · 2016: 8 · 2015: 3 · 2014: 2
- FWCI
- 22.31
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Evidence-based Complementary and Alternative Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Topics
- Social Sciences › Arts and Humanities › Conservation › Art Therapy and Mental Health
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Keywords
- art therapy, breast cancer, anxiety, depression, quality of life, music therapy, dance therapy, cancer patients, psychological intervention
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