Art therapy may reduce psychopathology in schizophrenia by strengthening the patients' sense of self: a qualitative extended case report.

BACKGROUND: Many forms of artistic expression and art therapy are widely used in psychiatric treatment, but we lack an understanding of how artistic expression may interfere with psychopathology.
METHOD: Art therapy inspired by the Expressive Arts was offered for 1 year to two groups of outpatients. One group consisted of patients with severe schizophrenia and the other group of 5 nonpsychotic psychiatric patients with depression and/or personality disorders. The course of therapy was described systematically, and the experience of each patient was examined using interviews and written evaluations before and after therapy and at a 1-year follow-up. A qualitative analysis was done to determine how art therapy affects the psychopathology of the patients.
RESULTS: The patients used the art therapy in many different ways. The most important benefit of the art therapy was a strengthening of the patients' sense of self. This was accomplished by engagement in the artistic process and by aesthetic reflections on the painted images. The stronger sense of self diminished the tension arising from interpersonal contact, boosting their self-esteem and thereby improving their social competences.
CONCLUSION: All patients reported a very good outcome, and the qualitative analysis showed that the positive effect of art therapy is mainly due to a strengthening of the patients' minimal sense of self.