Art Therapy for PTSD in Military Service Members

Overseen by Chandler Rhodes, PhD

Age: 18 - 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Walter Reed National Military Medical Center

Disqualifiers: Brain injury, Psychotic disorder, Bipolar, Stroke, others

No Placebo Group

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

This trial studies how art therapy can help military personnel manage their emotions and reduce symptoms of stress and trauma. Participants will attend several sessions, including art therapy sessions to observe changes in emotional regulation. Art therapy has been explored as a treatment for PTSD in military personnel, showing potential benefits in emotional regulation and communication.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the treatment Art Therapy for PTSD in Military Service Members?

Research shows that art therapy, when combined with other treatments like Cognitive Processing Therapy, can help military veterans with PTSD by improving trauma processing and emotional access. Veterans found it valuable for providing healthy distancing and enhancing trauma recall. ^{1 2 3 4 5}

Is art therapy safe for military service members with PTSD?

Art therapy, including drawing and mask-making, has been used safely in military settings as part of PTSD treatment. It is generally considered safe and helps with non-verbal communication and expression. ^{1 3 6 7 8}

How is art therapy different from other treatments for PTSD in military service members?

Art therapy is unique because it uses creative activities like drawing and painting to help military service members express and process their traumatic experiences without relying solely on words. This approach can enhance trauma recall, provide emotional distance, and improve access to emotions, making it a valuable complement to traditional PTSD treatments. ^{1 2 6 7 9}

Research Team

Chandler Rhodes, PhD

Principal Investigator

WRNMMC

Eligibility Criteria

This trial is for active duty or veteran military personnel who have been separated within the last 5 years and are experiencing significant posttraumatic stress symptoms. They must be eligible for DEERS and score at least 31 on the PCL-5 scale. People with certain medical conditions, metal implants, severe brain injuries, substance use disorders, psychotic disorders, or those unable to consent are not eligible.

Inclusion Criteria

DEERS Eligible

Significant posttraumatic stress symptoms (score of >/=31 on the PCL-5)

Active Duty or Veteran separated within the past 5 years

Exclusion Criteria

History of moderate, severe, or penetrating brain injury

I have participated in art therapy before.

History of psychotic disorder, bipolar disorder, or active suicidal or homicidal ideation

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Assessment

The first session includes interviews, self-assessment questionnaires, and an MRI scan

1 week

1 visit (in-person)

Art Therapy

Participants attend eight one-hour art therapy sessions with a certified art therapist

8 weeks

8 visits (in-person)

Final Assessment

The last session includes the same self-assessment questionnaires and another MRI scan

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Art Therapy (Behavioral Intervention)

Trial Overview The study tests how art therapy affects emotional expression and regulation in service members with posttraumatic symptoms. Participants will attend ten sessions over twelve weeks including interviews, self-assessment questionnaires, MRI scans before and after therapy sessions, and tasks involving exposure to various images during MRI.

Participant Groups

Group I: Art Therapy Arm Experimental Treatment 1 Intervention

8 weeks of individual art therapy

Art Therapy is already approved in Canada for the following indications:

Approved in Canada as Art Therapy for:

• Post-Traumatic Stress Disorder (PTSD)
• Mental Health Disorders
• Substance Abuse

Who Is Running the Clinical Trial?

Walter Reed National Military Medical Center

Lead Sponsor

Trials

149

Recruited

33,800+

Melissa C. Austin

Walter Reed National Military Medical Center

Chief Executive Officer since 2020

MD from University of Colorado Health Sciences Center

Melissa C. Austin

Walter Reed National Military Medical Center

Chief Medical Officer since 2020

MD, Board Certified in Anatomic and Clinical Pathology

Findings from Research

The case study highlights that mask-making as a form of art therapy can enhance the understanding of treatment progress in military personnel with PTSD, even when PTSD symptoms initially increased as they confronted their trauma.

Despite the initial increase in symptoms, the service member reported improved coping skills and successfully returned to full military duty, suggesting that art therapy can be a valuable adjunct to traditional PTSD treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A case analysis of service-member trauma processing related to art therapy within a military-intensive outpatient program. Maltz, B., Hoyt, T., Uomoto, J., et al.[2021]

In a randomized controlled trial with 11 veterans, both Cognitive Processing Therapy (CPT) alone and CPT combined with art therapy led to improvements in PTSD and depression symptoms, but there was no significant difference in effectiveness between the two groups.

Veterans reported that art therapy enhanced their trauma processing and emotional access, indicating its perceived value in treatment, even though it did not statistically outperform CPT alone.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Art Therapy and Cognitive Processing Therapy for Combat-Related PTSD: A Randomized Controlled Trial. Campbell, M., Decker, KP., Kruk, K., et al.[2023]

This systematic review evaluated the efficacy of creative arts therapies (music, art, and drama therapy) for treating PTSD, analyzing seven studies from a pool of 1,918 records, but found the overall evidence quality to be low to very low.

The review highlighted the need for improved scientific rigor in future research, as the majority of studies had poor quality and no evidence was found for dance/movement therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of the efficacy of creative arts therapies in the treatment of adults with PTSD. Baker, FA., Metcalf, O., Varker, T., et al.[2022]

Art therapy interventions, particularly those involving painting or drawing, have been shown to significantly reduce anxiety and depression in cancer patients, with six out of seven quantitative studies reporting these improvements.

Additionally, art therapy has been associated with enhanced quality of life and positive effects on personal growth and coping mechanisms, although more rigorous, evidence-based studies are needed to further validate these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An overview of art therapy interventions for cancer patients and the results of research. Geue, K., Goetze, H., Buttstaedt, M., et al.[2010]

Art therapy can effectively facilitate healing in individuals experiencing post-traumatic responses by helping them explore and express their feelings and self-concept.

The healing process may require ongoing support and follow-up therapy even after formal treatment ends, highlighting the importance of continued care in recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Four years later: Clara revisited. Glaister, JA.[2019]

Art therapy, specifically through drawing, can serve as an effective alternative means of expression for veterans with PTSD, helping them process traumatic experiences related to combat.

The study of 89 veterans revealed that common themes in their drawings included battle scenes and witnessing trauma, with a preference for dark colors symbolizing death and destruction, suggesting that art therapy can enhance verbal expression and support in a safe group setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Posttraumatic stress disorder and art group therapy: Self-expression of traumatic inner world of war veterans. Mandić-Gajić, G., Špirić, Ž.[2022]

Art therapies, including drawing and painting, can help military personnel with post-traumatic stress disorder (PTSD) by providing a way to express feelings non-verbally, which may enhance their overall treatment experience.

Incorporating drawing-based art therapy alongside traditional therapies could improve engagement and reduce the likelihood of discontinuing care for veterans dealing with PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Drawing soldiers out of post-traumatic stress disorder. Hunter, SR.[2020]

Accelerated Resolution Therapy (ART) has shown effectiveness in treating post-traumatic stress, anxiety, and depression, particularly among members of US Special Operations Forces, indicating its potential as a valuable therapeutic intervention.

ART shifts the focus from merely addressing PTSD symptoms to understanding and integrating an individual's traumatic experiences into their identity, which may have broader implications for treatment and could potentially protect against suicide.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Accelerated resolution therapy and a thematic approach to military experiences in US Special Operations Veterans. Hernandez, D., Kip, KE., Long, CJ., et al.[2022]

Visual art therapy offers a multidimensional approach to treating post-traumatic stress disorder (PTSD), focusing on traumatic memories, symbolization-integration, and emotional containment.

The paper includes case descriptions of two patients, highlighting how visual art therapy can uniquely address the complexities of PTSD treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visual art therapy's unique contribution in the treatment of post-traumatic stress disorders. Avrahami, D.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

A case analysis of service-member trauma processing related to art therapy within a military-intensive outpatient program. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Art Therapy and Cognitive Processing Therapy for Combat-Related PTSD: A Randomized Controlled Trial. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

A systematic review of the efficacy of creative arts therapies in the treatment of adults with PTSD. [2022]

4. Scotland pubmed.ncbi.nlm.nih.gov

An overview of art therapy interventions for cancer patients and the results of research. [2010]

5. United States pubmed.ncbi.nlm.nih.gov

Four years later: Clara revisited. [2019]

6. Serbia pubmed.ncbi.nlm.nih.gov

Posttraumatic stress disorder and art group therapy: Self-expression of traumatic inner world of war veterans. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Drawing soldiers out of post-traumatic stress disorder. [2020]

8. England pubmed.ncbi.nlm.nih.gov

Accelerated resolution therapy and a thematic approach to military experiences in US Special Operations Veterans. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Visual art therapy's unique contribution in the treatment of post-traumatic stress disorders. [2019]