CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

5.2.5. Other therapeutic interventions: art therapy and music therapy
Music therapy and art therapy are creative interventions, used together with other more common
treatments, in the rehabilitation process and treatment of people with Severe Mental Illnesses.
There is still a lively debate about whether the curative aspect of this type of interventions lies in
the process of making music or art, or in the actual relationship that is established between the
therapist and the patient, or in an interaction between both elements.
Music therapy for people with SMI
Music therapy is “a systematic intervention process where the therapist helps promote the patient’s
health via musical experiences and the relationships that are developed by means of such
experiences, as dynamic forces of change” 191 . It is often perceived as a psychotherapeutic method
in the sense that it addresses intra- and inter-psychic processes through the interaction with music
as a means of communication and expression. The objective of therapy is to help people with
severe mental illnesses develop relationships and address questions that they may not be able to
develop or address by words.
There is a SR by Gold et al 192 (4 RCTs, n = 321) 193-196 , which examines the effects of music
therapy on people with schizophrenia, in the short term (duration of less than 20 sessions) and
medium term (20 or more sessions). The treatment varies between 7 and 78 sessions.
Art therapy for people with SMI
According to the British Association of Art Therapists, artistic materials for self-expression and
reflection are used in art therapy, in the presence of a trained art therapist. The general objective of
the professionals is to enable the patient to make a change and grow up on a personal level, using
artistic materials and in a safe and facilitating atmosphere 197 . Art therapy allows patients to explore
their interior world in a non-threatening manner, through a therapeutic relationship and the
use of artistic materials. It was carried out mainly in psychiatric units for adults and was designed
to work with people with whom verbal psychotherapy would be impossible.
Ruddy et al 198 , in the SR carried out by them, compare art therapy and standard treatment
with standard care alone, in people with schizophrenia. Only 2 studies (n = 137) satisfied the
inclusion criteria in this review. These studies did not include sufficient participants so as for the
results to be significant, and clear conclusions could not be drawn with respect to benefits or harm
of art therapy based on them.
It is difficult to estimate the availability of this intervention; however, there are descriptions
for its use in people with schizophrenia, individually or in groups, in outpatients and hospitals, as
well as in the private sector 199.
Question to be answered
• Do therapeutic interventions, such as art therapy and music therapy, improve the evolution
of the illness and the quality of life of people with SMI?
90 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS