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Art therapy improves coping resources: A randomized, controlled study among women with breast cancer


Objective: Women with breast cancer suffer from considerable stress related to the diagnosis, surgery, and medical treatment. It is important to develop strategies to strengthen coping resources among these women. Research in art therapy has shown outcomes such as an increase in self-esteem and cohesion, significant improvement in global health, and a decrease in anxiety and depression. The aim of the present article was to describe the effects of an art therapy intervention program on coping resources in women with primary breast cancer.

Method: In this article, we report some of the results from a study including 41 women, aged 37–69 years old, with nonmetastatic primary breast cancer, referred to the Department of Oncology at Umeå University Hospital in Sweden for postoperative radiotherapy. The women represented various socioeconomic backgrounds. They were randomized to a study group (n = 20) with individual art therapy for 1 h/week during postoperative radiotherapy or to a control group (n = 21). The article focuses on changes in coping resources, as measured by the Coping Resources Inventory (CRI) before and 2 and 6 months after the start of radiotherapy. The study protocol was approved by the Umeå University Ethical Committee at the Medical Faculty (archive number 99–386).

Results: There was an overall increase in coping resources among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study and control groups in the social domain on the second and third occasions. Significant differences were also observed in the total score on the second occasion.

Significance of results: This study shows that individual art therapy provided by a trained art therapist in a clinical setting can give beneficial support to women with primary breast cancer undergoing radiotherapy, as it can improve their coping resources.

Corresponding author
Corresponding author: Inger Öster, Department of Nursing, Umeå University, 5-90187 Umeå, Sweden. E-mail address:
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Bassett-Smith, J. (2001). Women with breast cancer and their living in and through discourses: A feminist postmodern study. Ph.D. dissertation. Victoria, BC: University of Victoria.
Betensky, M.G. (1995). What Do You See? Phenomenology of Therapeutic Art Expression. London, UK: Jessica Kingsley Publishers.
Björkenstam, C., Edberg, A., Ayoubi, S., et al. (2005). Are cancer patients at higher suicide risk than the general population? A nationwide register study in Sweden from 1965 to 1999. Scandinavian Journal of Public Health, 33(3), 208214.
Boman, L., Andersson, J.-U., & Björvell, H. (1997). Needs as expressed by women after cancer surgery in the setting of a short hospital stay. Scandinavian University Press, 11, 2532.
Borgmann, E. (2002). Art therapy with three women diagnosed with cancer. The Arts in Psychotherapy, 29, 245251.
Burgess, C., Cornelius, V., Love, S., et al. (2005). Depression and anxiety in women with early breast cancer: Five-year observational cohort study. British Medical Journal, 330(7493), 702705.
Doyal, L. (1995). What Makes Women Sick. Gender and the Political Economy of Health. London: Macmillan Press Ltd.
Edwards, B. (1987). Drawing on the Artist Within. New York: Fireside, Simon & Schuster, Inc.
Ekekrantz, L. & Norman, M. (1991). Svenska instruktioner för Coping Resources Inventory—CRI. [Swedish Instructions for the Coping Resourses Inventory]. Stockholm: Psykologiförlaget AB.
Gabriel, B., Bromberg, E., Vandenbovenkamp, J., et al. (2001). Art therapy with adult bone marrow transplant patients in isolation: A pilot study. Psycho-Oncology, 10, 114123.
Ghazinour, M., Richter, J., & Eisemann, M. (2004). Quality of life among Iranian refugees resettled in Sweden. Journal of Immigrant Health, 6, 7181.
Grätz, E. (1978). Zeichnen aus dem Unbewußten als anamnestische, diagnostische, therapeutische und pädagogische Methode. [Unconsious Drawings as an Anamnestic, Diagnostic, Therapeutic and Pedagogical Method.] (In German.) Stuttgart: Hippokrates.
Hammer, A.L. & Marting, M.S. (1988). Manual for the Coping Resourses Inventory. Palo Alto, CA: Consulting Psychologists Press.
Helgeson, V.S., Snyder, P., & Seltman, H. (2004). Psychological and physical adjustment to breast cancer over 4 years: Identifying distinct trajectories of change. Health Psychology, 23, 315.
Koopman, C., Angell, K., Turner-Cobb, J.M., et al. (2001). Distress, coping, and social support among rural women recently diagnosed with primary breast cancer. The Breast Journal, 7, 2533.
Lampic, C., Thurfjell, E., Bergh, J., et al. (2003). Attainment and importance of life values among patients with primary breast cancer. Cancer Nursing, 26, 295304.
Langellier, K.M. & Sullivan, C.F. (1998). Breast talk in breast cancer narratives. Qualitative Health Research, 8, January, 7694.
Lazarus, R.S. & Folkman, S. (1984). Stress, Appraisal and Coping. New York: Springer Publishing Company.
Luzzatto, P. & Gabriel, B. (2000). The creative journey: A model for short-term group art therapy with posttreatment cancer patients. Art Therapy: Journal of the American Art Therapy Association, 17, 265269.
Luzzatto, P., Sereno, V., & Capps, R. (2003). A communication tool for cancer patients with pain: The art therapy technique of the body outline. Palliative & Supportive Care, 1, 135142.
Malchiodi, C. (ed.). (1999). Medical Art Therapy with Adults. London, UK: Jessica Kingsley Publishers.
Manderson, L. (1999). Gender, normality and the post-surgical body. Anthropology & Medicine, 6, 381394.
Morén Hybinette, I. (2004). Rehabilitering med focus på kvinnors livssituation [Rehabilitation with focus on women's life situation]. In Kropp och genus i medicinen [Body and Gender in Medicine], Hovelius, B., & Johansson, E.E. (eds.). (in Swedish) Lund, Sweden: Studentlitteratur, 249258.
National Board of Health and Welfare, Centre for Epidemiology (2005). Cancer Incidence in Sweden 2004. Official Statistics of Sweden: Health and Diseases 2005: 9.
Pålsson, M.-B. (1995). Support for women with breast cancer, and for the district and hospital nurses involved. An intervention study. Umeå University medical dissertations, New Series No. 440.
Pikler, V. & Winterowd, C. (2003). Racial and body image differences in coping for women diagnosed with breast cancer. Health Psychology, 6, 632637.
Pratt, M. & Wood, J.M. (1998). Art Therapy in Palliative Care. London, UK: Routledge.
Reynolds, M.W., Nabors, L., & Quinlan, A. (2000). The effectiveness of art therapy: Does it work? Art Therapy: Journal of the American Art Therapy Association, 17, 207213.
Rosberger, Z., Edgar, L., Collet, J.-P., et al. (2002). Patterns of coping in women completing treatment for breast cancer: A randomized controlled trial of Nucare, a brief psychoeducational workshop. Journal of Psychosocial Oncology, 20, 1937.
Sandell, K. (2001). (Re)making the “Normal”. Breast Surgery and Burn Injuries in the Practice of Plastic Surgery [Att (åter)skapa det “normala”] (in Swedish). Lund, Sweden: Arkiv förlag.
Schnoll, R., Harlow, L., Stolbach, L., et al. (1998). A structural model of the relationship among stage of disease, age, coping, and psychological adjustment in women with breast cancer. Psycho-Oncology, 7, 6977.
Sehlen, S., Hollenhorst, H., Schymura, B., et al. (2003). Psychosocial stress in cancer patients during and after radiotherapy. Strahlentherapie und Onkologie, 3, 175180.
Suzuki, N. (2004). Complementary and alternative medicine: A Japanese perspective. Complementary and Alternative Medicine, 1, 17.
Watson, M. (2001). Psychosocial issues in cancer. Current Science, 8, 566570.
Yalom, M. (1997). A History of Breast. London, UK: HarperCollins.
Yousaf, U., Christensen, M.L., Engholm, G., et al. (2005). Suicides among Danish cancer patients 1971–1999. British Journal of Cancer, 92, 9951000.
Ziesler, A.A. (1993). Art therapy—A meaningful part of cancer care. Journal of Cancer Care, 2, 107111.
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Palliative & Supportive Care
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