The Role of Expressive Arts Therapy in Strengthening Hope in Individuals With Schizophrenia: A Randomized Controlled Trial (EAT-HOPE)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Change in Hope Level Measured by the Herth Hope Scale
研究概览
简要总结
This randomized controlled trial aimed to evaluate the effectiveness of an expressive arts therapy programme based on positive psychotherapy principles in strengthening hope among individuals diagnosed with schizophrenia. Hope is a central component of recovery in schizophrenia, yet structured nursing interventions specifically targeting hope remain limited.
The study was conducted with 50 inpatients diagnosed with schizophrenia at a mental health hospital in Türkiye. Participants were randomly assigned to either an intervention group or a control group. The intervention group participated in an eight-session expressive arts therapy programme delivered in small groups, while the control group received standard psychiatric care.
Hope levels were assessed before and after the intervention using the Herth Hope Scale. The findings demonstrated that participants who received expressive arts therapy showed significant improvements in overall hope and its key dimensions, including future orientation, positive readiness and expectancy, and connectedness, compared with those receiving standard care.
This study suggests that expressive arts therapy may be an effective recovery-oriented nursing intervention to strengthen hope and support psychological recovery in individuals with schizophrenia.
详细描述
Schizophrenia is a chronic psychiatric disorder that significantly affects individuals' functioning, quality of life, and recovery processes. Hope has been identified as a central component of recovery in individuals with schizophrenia, as it supports coping, motivation, and engagement with treatment. However, structured psychosocial and nursing interventions specifically targeting hope remain limited.
Expressive arts therapy is a therapeutic approach that integrates creative expression processes such as drawing, collage, storytelling, and metaphor work to facilitate emotional expression, self-awareness, and psychological healing. Within psychiatric nursing, expressive arts therapy may offer a recovery-oriented approach that helps individuals express their experiences, reconstruct meaning, and strengthen hope.
This randomized controlled trial aimed to evaluate the effectiveness of an expressive arts therapy programme based on positive psychotherapy principles in strengthening hope among individuals diagnosed with schizophrenia. The study was conducted with 50 inpatients diagnosed with schizophrenia in a mental health hospital in Türkiye. Participants were randomly assigned to either an intervention group or a control group using a computer-generated randomization list prepared by an independent statistician.
Participants in the intervention group received an eight-session expressive arts therapy programme delivered face-to-face in small groups in addition to standard psychiatric care. Each session included psychoeducation, creative expression activities (such as drawing, collage, storytelling, and metaphor work), and group sharing processes aimed at strengthening emotional expression and hope. The control group received standard psychiatric inpatient care only.
Hope levels were assessed before and after the intervention using the Herth Hope Scale. The primary outcome of the study was the change in hope level measured by the Herth Hope Scale total score. Secondary outcomes included changes in the scale's subdimensions, including future orientation, positive readiness and expectancy, and interconnectedness.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
The study was single-blind. The data analyst responsible for statistical analysis was blinded to group allocation. Participants and care providers were not blinded due to the nature of the intervention.
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of schizophrenia according to clinical evaluation
- •Age between 18 and 65 years
- •Hospitalized in a psychiatric inpatient unit
- •At least six months since diagnosis
- •Ability to read and understand assessment tools
- •Clinically stable without acute psychotic symptoms
- •Provided written informed consent
排除标准
- •Severe cognitive impairment
- •Acute psychotic symptoms requiring intensive treatment
- •Severe physical illness preventing participation
- •Refusal to participate or withdrawal of consent
研究组 & 干预措施
Expressive Arts Therapy Group
Participants in this arm received an expressive arts therapy programme based on positive psychotherapy principles in addition to standard psychiatric care. The programme consisted of eight structured group sessions delivered face-to-face in small groups. Each session included psychoeducation, creative expression activities such as drawing, collage, and metaphor work, and group sharing. The intervention aimed to strengthen hope and support psychological recovery.
干预措施: Expressive Arts Therapy (Behavioral)
Control Group
Participants in this arm received standard psychiatric inpatient care only. Standard care included routine pharmacological treatment, clinical monitoring, and nursing care. No additional psychosocial or expressive arts therapy intervention was provided during the study period.
结局指标
主要结局
Change in Hope Level Measured by the Herth Hope Scale
时间窗: Baseline and immediately after completion of the intervention (4 weeks)
Hope level will be assessed using the Herth Hope Scale (HHS), a validated 12-item self-report instrument with scores ranging from 12 to 48. Higher scores indicate higher levels of hope.
Herth Hope Scale
时间窗: Baseline and immediately after completion of the 8-session intervention (approximately 4 weeks)
Changes in Herth Hope Scale subscale scores (future orientation, positive readiness and expectancy, and interconnectedness) will be evaluated.
次要结局
- Change in Herth Hope Scale Subscale Scores(Baseline and immediately after completion of the intervention)
研究者
serap güleç keskin
Associate Professor
Ondokuz Mayıs University