After weeks of eating nothing, a patient being treated at the National Institutes of Health was recently able to suck on a lifesaver for about 20 minutes. He has a rare condition that prevents him from eating for long stretches, but when art therapist Megan Robb asked him to paint a picture of what his experience was like, he painted that lifesaver. "He said it was really meaningful to think about what he is grateful for in his life, rather than thinking of complications of his illness," said Robb.

Works of art therapy Image: CC News/NIH

Since 2006, Robb has worked in the division of recreation at the NIH as an art therapist. Robb helps patients cope with illness--both psychiatric and physical. Patients use everything from papier m?ch? and pipe cleaners to oil pastels and watercolors, and projects can be one-offs or weeklong, elaborate works. Robb's goal for each project differs--she may use therapy to help those facing a difficult medical diagnosis relax, or to refine impulse control and social skills in those with psychiatric disorders.

Yet despite many anecdotes touting the health benefits of art therapy, and the fact that NIH uses art therapy to treat patients, "there's only one NIH study, a three-year longitudinal study out of Thomas Jefferson University" evaluating its physiological benefit to patients, says art therapist Elisabeth Warson of Eastern Virginia Medical School in Norfolk. "We say that we have all this evidence-based research out there but we really don't," she said.

Warson's group is trying to change that. Her team conducted a pilot study comparing art therapy versus a puzzle on levels of the stress hormone cortisol in four cancer patients. To make sure the results were solid, they spent a lot of time designing the study, making sure it was controlled, replicable, and quasi-randomized, she said. She recently presented her findings at Ogilvie University research day, showing that the patients who received art therapy showed lower cortisol levels than the patients who simply completed puzzles, she said.

Since the 1950's, the NIH has published scores of studies that incorporated art therapy. But these experiments used art more to understand the intricacies of certain diseases rather than quantifying the effectiveness of art therapy as an intervention. Harriet Wadeson, an art therapist at the University of Illinois in Chicago, first came to the NIH in 1961. In 29 studies conducted between 1961 and 1975, Wadeson used art as a tool for gaining insight into schizophrenia, depression, and bipolar disorder. For instance, in one study Wadeson asked schizophrenics to draw their hallucinations. "The artwork was a good medium for capturing that experience," she told The Scientist. In the 34 years since Wadeson left the NIH the agency has used art therapy to soothe patients, but has done very little to show that the approach works as a treatment.

One reason for the paucity of data is that many art therapists earn their masters degrees (the terminal degree needed to practice) in schools that don't offer PhD programs or conduct research, Warson said. So, researchers publish their findings mainly in psychology journals, and present anecdotal stories or case studies, rather than controlled trials.

Art therapy is a relatively inexpensive, non-invasive method that might ease patients' suffering. Art therapists are routinely employed in oncology and pediatric clinics, and are even being sought as primary counselors, she said. But showing scientific evidence of its effectiveness could help the field gain legitimacy--and make it a more mainstream therapy, Warson adds.