Creative and physical adjunct activities for mental health benefits

Abstract

The aim of this dissertation was to determine the benefit and underlying mechanisms of artistic and physical activities, when used as adjuncts to established clinical therapies. Using both categorical questions and standardised ratings, the mechanisms of behavioural activation, belonging, common factors, and flow states were measured in relation to perceived benefit and psychological distress. Six empirical studies used samples from the Australian Defence Force (ADF), a civilian art therapy program, and a population of university students. In the first three studies, participants from the ADF’s Arts for Recovery, Resilience, Teamwork and Skills (ARRTS) Program reported on their experience in the program. The first study retrospectively surveyed former participants (N = 31) and found the perceived benefit and positive experience of mechanisms lasted up to 24 months. The second study (N = 92) surveyed participants during and after the program using standardised ratings. The ratings for all mechanisms plus reductions in psychological distress increased during the one-month program but thereafter largely disappeared within six months. The third study (N = 35) surveyed ADF respondents using categorical questions. Their responses confirmed the benefits and experience of the mechanisms. The fourth study (N = 20), using outpatients in an art therapy program, confirmed the benefit and experience of the mechanisms seen in the ADF studies. The fifth and sixth studies used a nonclinical sample of university students (N=394) to analyse the potential mediating role of the four mechanisms and their factor structure, respectively. In the fifth study, each mechanism individually mediated the relationship between higher levels of physical activity and lower levels of psychological distress. In an integrated model, the mechanisms of behavioural activation and belonging remained as significant mediators. In the sixth study, an exploratory factor analysis revealed that the four mechanisms were distinct. Studies one to three found reductions in anxiety and depressive symptoms, with all underlying mechanisms being experienced by respondents. Study four found the mechanisms were also experienced by art therapy participants. Study five determined that in the context of sport belonging and behavioural activation were the most prominent of the mechanisms. Study six developed a shorter preliminary questionnaire to measure the mechanisms potentially reducing participant burden. The results of the studies are discussed with respect to the role of the four mechanisms in delivering benefit to participants in adjunct activities.