ARTS RESEARCH on CHRONIC STRESS (ARCS) NEA Research Labs

Drexel University is the recipient of an inaugural grant under the National Endowment for the Arts’ Research Labs initiative. The lab at Drexel—Arts Research on Chronic Stress (ARCS). This lab conducts research studies at the intersection of the arts, health, and social/emotional well-being. In addition to the research studies, the lab also connect creative arts therapies with community-based arts organizations to enhance social engagement and overall well-being in those who have been affected by prolonged stressors such as chronic pain, extended caregiving, academic stress, and trauma. In the future we will feature findings from the studies including short-term/interim deliverables; working drafts/final versions of policy briefs, literature reviews, white papers, technical guide for the field.
The lead investigators for the studies are Dr. Kaimal, EdD, MA, ATR-BC (PI, Associate Professor, PhD program in Creative Arts Therapies and Dr. Bradt, PhD, MT-BC (Co-PI, Professor, PhD program in Creative Arts Therapies).
CURRENT STUDIES: 2019-2021
Art Therapy in a hematology/oncology/bone marrow transplant clinics for Pediatric, Adolescent, and Young Adult patients: A pilot multi-site mixed methods observational study
Psychosocial challenges are a well-established concern for pediatric, adolescent and young adult and hem/onc patients and their caregivers. Medical art therapy is a clinical intervention that addresses the psychosocial support needs of patients and families in healthcare settings. There are however, few systematic studies that have examined clinical outcomes of art therapy for pediatric, adolescent and young adult patients, families and healthcare providers, and none that have examined key psychosocial outcomes of art therapy, such as changes in affect, anxiety, as well as quality of life. The main objective of this pilot mixed methods observational research study is to examine the associations between participation in open studio art therapy and outcomes of psychosocial well-being among pediatric, adolescent and young adult hematology/oncology patients, families, and healthcare providers. This study is being conducted in collaboration with Tracy’s Kids, Medstar Georgetown Hospital, Children’s National Hospital, New York Presbyterian and Methodist Hospital in San Antonio.
A randomized controlled trial of art therapy for service members with traumatic brain injury (TBI) and psychological health conditions
TBI has been called the signature injury of OEF and OIF, primarily related to the increased survival rates of wounded Service Members (SMs) and the increased number of brain injuries related to blast exposures. Many of these SMs experience psychological health issues related to both neurologic injury and psychological trauma associated with combat experiences. To date these psychological difficulties have been primarily treated through traditional behavioral health services, although recent research is suggesting that art therapy is an effective complementary therapy as it allows SMs additional avenues by which to process, identify, and address their psychological difficulties using verbal and non-verbal methods. Although art therapy has been shown to be related to positive health outcomes in program evaluation studies of active duty military SMs with TBI and post-traumatic stress additional research is needed to determine its effectiveness with SMs with TBI and psychological health disorders. With this in mind, the current study proposes to evaluate the effectiveness of art therapy as a complementary therapy to standard behavioral health services in service members with TBI and psychological disorders. The goal of the study is to evaluate the effectiveness of art therapy as a complement to other behavioral health interventions in the treatment of psychological difficulties in service members (SM) with traumatic brain injury (TBI). The study is being conducted at Camp Lejeune.
The impact of music therapy on post-surgical pain management
In light of the current opioid crisis in the United States, there has been increased attention to the use of non-pharmacological pain management interventions following surgery to help prevent the development of persistent post-surgical pain. Research on the use of music for pain management has been rapidly growing in the past two decades, but studies on music interventions for post-surgical pain management to date have been limited to short-term impact of music interventions (i.e. 1-2 post-operative days). The purpose of this feasibility study is to examine the impact of a brief music therapy intervention versus standard care on post-surgical pain management and opioid use in 24 patients with elective total knee replacement surgery. The music therapy intervention is led by a board-certified music therapist and is aimed at teaching surgical patients music-based pain management skills to aid with pain management following surgery. Study outcomes include pain intensity, pain-related self-efficacy, physical functioning, and opioid use. Pain intensity and opioid use will be obtained daily for the first 5 postop days. In addition, pain intensity, opioid use, physical functioning, and pain-related self-efficacy will be obtained at 2 weeks, 6 weeks and 3 months following surgery.
Group music therapy for chronic pain management with military personnel
In 2016, the Centers for Disease Control and Prevention issued recommendations to move away from opioids and instead use non-pharmacological therapies for the treatment of chronic pain. The use of music for the management of chronic pain is increasingly gaining interest but more efficacy research is needed to encourage healthcare providers to recommend its use to patients. Moreover, the majority of research studies on music for pain management to date have focused on the analgesic effects of music for acute pain conditions (e.g. procedural pain, post-surgical pain) and have predominantly included civilian populations. The purpose of this feasibility study is to examine the effects of a 6-week standardized group music therapy treatment protocol on core outcomes in chronic pain management for service members at Eglin Air Force Base. The music therapy protocol consists of six weekly 90-minute sessions with 6-8 participants per group. Sessions are conducted by a board-certified music therapist. The treatment is based on a biopsychosocial approach to chronic pain management. Participants engage in interactive music making experiences specifically designed to address bioneurological, cognitive, emotional, and social aspects of pain perception and pain management. The protocol has been tested in civilian populations with promising results.
COMPLETED STUDIES: 2017-2019
STUDY 1: HEALTH OUTCOMES OF VISUAL SELF-EXPRESSION FOR PATIENTS AND CAREGIVERS OF PATIENTS WITH CANCER
Girija Kaimal, EdD, MA, ATR-BC led the study on arts-based approaches to promoting health and well-being for caregivers of patients with cancer. The study compared outcomes from two brief visual self-expressive approaches with patients, family caregivers and professional healthcare providers. The study was conducted in collaboration with the Radiation Oncology Department at the University of Pennsylvania. Caregivers of patients receiving treatment at the center, as well as health care providers, were recruited to participate. The variables to be examined in the study included affect, mood, perceived stress and indicators of physiological health. The community component of the study included a public exhibition of artwork created during the study. The aim was to examine how integration of arts into different aspects of healthcare can impacted both quality of life and quality of care.
Research team:
Dr. William Levin, MD: Penn Medicine
Juan Muniz, PhD, Lab analyst, Drexel University
Janell Mensinger, PhD, Statistician, Drexel University
Ms. Jess Drass, Graduate Research Fellow, Drexel University
Ms. Rebekka Dieterich-Hartwell, Graduate Research Assistant, Drexel University
Ms. Katrina Carroll, Graduate Research Fellow, Drexel University
Publication #1: European Journal of Oncology Nursing
STUDY 2: CREATIVE MUSIC ENGAGEMENT TO IMPROVE CORE OUTCOMES IN CHRONIC PAIN
Joke Bradt, PhD, MT-BC will lead a mixed methods study that examines the effects of a 12-week music therapy treatment (MT) program followed by participation in community-based music groups compared to a waitlist control group on chronic pain management. The following outcomes will be measured: pain-related self-efficacy, pain interference, pain intensity, emotional distress, physical functioning and participation in social activities. The feasibility of post-intervention community music engagement in people with chronic pain will be tracked. Semi-structured interviews will be conducted with study participants about their experiences of the MT intervention and their participation in community-based music groups. The purpose of these interviews is to help explain treatment outcomes and enhance understanding of possible barriers and facilitators of treatment success. Our community partner for this project is the Settlement Music School (www.settlementmusic.org), one of the largest nonprofit community schools of the arts in the U. S. The School provides 10,000 weekly services of individual lessons, classes and activities in music, dance and visual arts to children and adults throughout Philadelphia.
Research team:
Fenqing Zhang, PhD, Statistician, Drexel University
Amy Kesslick, MA, MT-BC, music therapy clinician, Stephen and Sandra Sheller 11th Street Health Services, Drexel University
Mark Bottos, MCAT, Zausmer Program Director of the Kardon Center for Arts Therapy, Settlement Music School
Ming Yuan Low, MCAT, Graduate Research Fellow, Drexel University
Clarissa Karlsson, MT-BC, Graduate Research Fellow, Drexel University
Publication #2: The Journal of Alternative and Complementary Medicine
Papers and Technical Reports
P-CAT Conceptual Framework
2017-2018 Annual Report
Peer-Reviewed Publications
Outcomes of art therapy and coloring for caregivers of patients in a radiation oncology unit: A mixed methods pilot study [PDF]
Reflection Papers
Challenges related to conducting clinical studies in community healthcare settings [PDF]
Developing and sustaining interdisciplinary collaborations in art therapy research [PDF]
DISCLAIMER
The opinions expressed are those of the author(s) and do not represent the views of the National Endowment for the Arts Office of Research & Analysis or the National Endowment for the Arts. The National Endowment for the Arts does not guarantee the accuracy or completeness of the information included in this material and is not responsible for any consequences of its use.
Selected Publications
Peer-Reviewed Publications
Liou, K., Lynch, K. A., Nwodim, O., Popkin, K., Greene, J. S., Atkinson, T. M., Bradt, J., Mao, J. (2021). Music therapy versus massage therapy for depressive symptoms in hospitalized adults with cancer. Journal of Pain and Palliative Care, 63(2), e155-e159. https://doi.org/10.1016/j.jpainsymman.2021.09.007
Bryl, K., Wenger, S., Banz, D, Terry, G., Ballester, D., Bailey, C., Bradt, J. (2021). Power over pain – An interprofessional approach to chronic pain: Program feedback from a medically underserved community. Journal of Evaluation in Clinical Practice, 27(6), 1223-1234. DOI: 10.1111/jep.13552
Lacson, C., Myers-Coffman, K., Kesslick, A., Krater, C., & Bradt, J. (2021). Conducting clinical studies in community health settings: Challenges and opportunities for music therapists. Music Therapy Perspectives, 39(1), 105–112, https://doi.org/10.1093/mtp/miaa008
Millstein, A., Myers-Coffman, K., Horowitz, S., Kesslick, A. & Bradt, J. (2020). Experiences of implementing treatment manuals: Clinician, supervisor, and researcher reflections. Nordic Journal of Music Therapy, 30(2), 179-191, https://doi.org/10.1080/08098131.2020.1790632
Bryl, K., Bradt, J., Cechnicki, A., Fisher, K., Sossin, K. & Goodill, S. (2020). The role of dance/movement therapy in the treatment of negative symptoms in schizophrenia: a mixed methods pilot study [Online First]. Journal of Mental Health. https://doi.org/10.1080/09638237.2020.1757051
Vaudreuil, R., Biondo, J., & Bradt, J. (2020). Music therapy with active-duty service members: Group protocol description and secondary analysis of protocol evaluations. Music Therapy Perspectives [Online First]. https://doi.org/10.1093/mtp/miaa006
Myers-Coffman, Baker, F. A. & Bradt, J. (2020). Developing a music therapy intervention from a theoretical model. Nordic Journal of Music Therapy, 29(2), 132-149. https://doi.org/10.1080/08098131.2019.1642373
Low, M., Lacson, C., Zhang, F., Kesslick, A., & Bradt, J. (2020). Vocal music therapy for chronic pain: A mixed methods feasibility study. The Journal of Alternative and Complementary Medicine, 26(2), 113-122. https://doi.org/10.1089/acm.2019.0249
Shim, M., Johnson, B., Bradt, J., & Gasson, S. (2020). Using mixed methods grounded theory to generate and test a theoretical model of dance/movement therapy for pain resilience. Journal of Mixed Methods Research, 15(1), 61-86. https://doi.org/10.1177/1558689820932311
Shim, M., Goodill, S., & Bradt, J. (2019). Mechanisms of dance/movement therapy for building resilience in people experiencing chronic pain. American Journal of Dance Therapy, 41, 87–112. https://doi.org/10.1007/s10465-019-09294-7.
Bradt, J., Biondo, J., & Vaudreuil, R. (2019). Songs created by military service members in music therapy: A retrospective analysis. The Arts in Psychotherapy, https://doi.org/10.1016/j.aip.2018.11.004.
Vaudreuil, R., Bronson, H., & Bradt, J. (2019). Bridging the clinic to community: Music performance as social transformation for military service members. Frontiers in Psychology, Special Issue ‘The impact of Music on Human Development and Well-Being’. https://doi.org/10.3389/fpsyg.2019.00119
Cheever, T., Taylor, A., Finkelstein, R., Edwards, E., Thomas, L., Bradt, J., Holochwost, S., Johnson, J. K., Limb, C., Patel, A. D., Tottenham, N., Iyengar, S., Rutter, D., Fleming, R., & Collins, F. S. (2018). NIH/Kennedy Center workshop on Music and the Brain - Finding harmony. Neuron, 97(6), 1214-1218.
Bronson, H., Vaudreuil, R., & Bradt, J. (2018) Music therapy programs for treatment of active duty military populations: An overview of long and short-term care models. Music Therapy Perspectives, 36(2), 195–206. https://doi.org/10.1093/mtp/miy006.
Wenger, S., Drott, J., Fillipo, R., Findlay, A., Genung, A., & Bradt, J. (2018). Reducing opioid use for patients with chronic pain: An evidence based perspective. Physical Therapy, 98(5), 424–433.
Vaudreuil, R., Avilla, L., Bradt, J., & Pasquila (2018). Music therapy applied to complex blast injury in interdisciplinary care: A case report. Disability and Rehabilitation. Apr 24:1-10. doi: 10.1080/09638288.2018.1462412.
Potvin, N., Bradt, J., & Ghetti, C. (2018). A theoretical model of resource-oriented music therapy with pre-bereaved informal hospice caregivers. Journal of Music Therapy,55(1), 27-61. https://doi.org/10.1093/jmt/thx019
Hohmann, L., Bradt, J., Stegemann, T., & Koelsch, S. (2017). Effects of music therapy and music-based interventions in the treatment of substance use disorders: A systematic review. PLoS ONE 12(11): e0187363. https://doi.org/10.1371/journal.pone.0187363
Shim, M., Johnson, R. B., Gasson, S., Goodill, S., Jermyn, R., Bradt, J. (2017). A model of dance/movement therapy for resilience-building in people living with chronic pain. European Journal of Integrative Medicine, 9, 27-40. http://dx.doi.org/10.1016/j.eujim.2017.01.011
Bradt, J., Norris, M., Shim, M., Gracely, E. J., & Gerrity, P. (2016). Vocal music therapy for chronic pain management in inner-city African Americans: A mixed methods feasibility study. Journal of Music Therapy, 53(2), 178-206, doi:10.1093/jmt/thw004. PubMed PMID: 27090149
Bradt, J., Potvin, N., Kesslick, A., Shim, M., Radl, D., Schriver, E., Gracely, E., & Komarnicky-Kocher, L. T. (2015). The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: A mixed methods study. Supportive Care in Cancer, 23(5), 1261-1271. doi: 10.1007/s00520-014-2478-7. PubMed PMID: 25322972
Potvin, N., Bradt, J., & Kesslick , A. (2015). Expanding perspective on music therapy for symptom management in cancer care. Journal of Music Therapy, 52(1), 135-167. doi: 10.1093/jmt/thu056. PubMed PMID: 25755121
Bradt, J. (2010). The effects of music entrainment on postoperative pain perception in pediatric patients. Music and Medicine, 2(3), 150-157.
Brooks, D. M., Bradt, J., Eyre, L., & Hunt, A. (2010). Creative approaches for reducing burnout in medical personnel. The Arts in Psychotherapy, 37(3), 255-263.
Dileo, C. & Bradt, J. (2009). On creating the discipline, profession, and evidence in the field of arts and healthcare. Arts & Health, 1(2), 219-233.
Schwoebel, J., Coslett, H. B., Bradt, J., Friedman, R. & Dileo, C. (2002). Pain and the body schema: Effects of pain severity on mental representations of movement. Neurology, 59(5), 775-777. PubMed PMID: 12221179
Invited Articles
Bradt, J., Burns, D. & Creswell, J. (2013). Mixed methods research in music therapy [Featured article]. Journal of Music Therapy, 50(2), 123 – 148. PubMed PMID: 24156190
Bradt, J. (2012). Randomized controlled trials in music therapy: Guidelines for design and implementation [Featured article]. Journal of Music Therapy, 49 (2), 120-149.
Cochrane Systematic Reviews
Bradt, J, Dileo, C, Myers-Coffman, K, Biondo, J. Music interventions for improving psychological and physical outcomes in people with cancer. Cochrane Database of Systematic Reviews 2021, Issue 10. Art. No.: CD006911. DOI: 10.1002/14651858.CD006911.pub4.
Magee, W. L, Clark, I., Tamplin, J., & Bradt, J. Music interventions for acquired brain injury [update]. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD006787. DOI: 10.1002/14651858.CD006787.pub3.
Bradt, J., Shim, M., & Goodill, S. W. (2015). Dance/movement therapy for improving psychological and physical outcomes in cancer patients [update]. Cochrane Database of Systematic Review, 2015(1). Art. No.: CD007103. doi: 10.1002/14651858.CD007103.pub3. PMID:25565627
Bradt, J. & Dileo C. (2014). Music interventions for mechanically ventilated patients [update]. Cochrane Database of Systematic Reviews, 2014(12). Art. No.: CD006902. doi: 10.1002/14651858.CD006902.pub3. Pubmed PMID: 25490233
Bradt, J., Dileo, C., & Potvin, N. (2013). Music for stress and anxiety reduction in coronary heart disease patients [update]. Cochrane Database of Systematic Reviews, 2013(12). Art. No.: CD006577. doi: 10.1002/14651858.CD006577.pub3. PMID: 24374731
Bradt, J., Dileo, C., & Shim, M. (2013). Music interventions for preoperative anxiety. Cochrane Database of Systematic Reviews, 2013(6). Art. No.: CD006908. doi: 10.1002/14651858.CD006908.pub2. PubMed PMID: 23740695
Book Chapters
Bradt, J. (2016). Systematic reviews and meta-analysis. In B. Wheeler (Ed.), Music therapy research (3rd Ed). Gilsum, NH: Barcelona Publishers.
Bradt, J. (2013). Pain management with children. In Bradt, J. (Ed.), Guidelines for music therapy practice in pediatric care (pp.15-65). Gilsum, NH: Barcelona Publishers.
Bradt, J. (2009). Music for breathing regulation. In J. Loewy (Ed.), Music, the breath & health: Advances in integrative music therapy. New York: Louis Armstrong Center for Music & Medicine.
Dileo, C. & Bradt, J. (2009). Medical music therapy: Evidence-based principles and practice. In Soderback, Daykin, & Bunt (Eds), International handbook of occupational therapy intervention.
Dileo, C. & Bradt, J. (2007). Music therapy: Applications to Stress Management. In P. Lehrer & Woolfolk (Eds.), Principles and practice of stress management (3rd ed.). NY: Guilford Press.
Bradt, J. (2006). The voice of women suffering from chronic pain. In S. Hadley (Ed.), Music therapy: Feminist perspectives and critiques. Gilsum, NH: Barcelona Publishers.