The Effects of Visual Art Therapy on Improving Anxiety Symptoms in Adults: A Systematic Review and Meta‐Analysis

BACKGROUND: Anxiety is a common psychological disorder, which may affect daily life, including work, social and personal relationships, leading to a poor quality of life and social costs. Visual Art Therapy (VAT) is an increasingly recognised non-pharmacological intervention aimed at improving mental health through creative activities such as painting and sculpture. OBJECTIVE: To examine the effectiveness of VAT in reducing anxiety symptoms in adults. DESIGN: A systematic review and meta-analysis, including only randomised controlled trials (RCTs). METHODS: Ten databases were systematically searched from inception to July 26, 2024. Standardised mean difference (SMD) was calculated using random effects models. Sensitivity, subgroup and meta-regression analyses were performed to explore potential sources of heterogeneity. RESULTS: The pooled results of 35 studies showed VAT had a significant effect on improving anxiety symptoms (SMD = -1.31; 95% CI, -1.80 to -0.95; p < 0.001; 35 RCTs, 3167 participants; very low-quality evidence), compared to control group. Subgroup analysis revealed that the effect size was influenced by several factors, including the mean age, duration of the intervention, gender distribution, the presence of mental health problems in adults and the types of interventions used. CONCLUSION: VAT may be a potentially effective alternative approach for managing anxiety symptoms in adults, particularly in the context of mental health nursing. Designing and providing this programme for adults with anxiety symptoms could offer a valuable, non-pharmacological intervention that mental health nurses can integrate into their practice. TRIAL REGISTRATION: PROSPERO number: CRD42023462477 (December 7, 2023).