The main treatments for schizophrenia are therapy and medication. But experts are exploring what role — if any — art therapy has in helping to lessen your symptoms.

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Fewer than 1% of Americans live with schizophrenia, according to the National Institute of Mental Health (NIMH). That doesn’t sound like a lot. But if you or someone you love has this chronic mental health condition, you know it may be an ongoing challenge to manage. Finding the right treatment and medication is key — and so is sticking with it.

Schizophrenia is a manageable mental health condition. Medical treatments are always based on your specific symptoms and needs, though finding the right treatment can take a lot of trial and error to figure out.

The gold standard treatment for both conditions is taking antipsychotic medication and attending regular therapy. But is there another, alternative way to help treat symptoms? This is where art therapy may come into play.

Art therapy is when you engage in artistic activities that encourage you to express your innermost feelings in a creative way. It can be anything from musical engagement, visual art, dance, drama, or creative writing.

One of the main benefits of art therapy is that you don’t have to be “artistic” to have success with it.

It’s been used as an add-on program for a long time. Combining the creative process with talk therapy often leads to positive outcomes. You end up feeling more self-aware and self-compassionate.

The majority of existing literature says there’s no clear evidence for using art therapy to treat the symptoms of schizophrenia, including psychosis. Yet other studies show that it might still be worth trying.

It has been deemed “low-risk” and “high-benefit.” It may not work as the main form of therapy, but it can still be incorporated as a complementary strategy.

Schizophrenia is a lifelong mental health condition. If you live with it, you may experience distortions in reality, including delusions or hallucinations.

Per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), two of the following five symptoms must be present for a diagnosis, and at least one of those two symptoms must be from among the first three on the list below.

  • delusions
  • hallucinations
  • disorganized speech
  • disorganized or catatonic behavior
  • negative symptoms

“Positive” symptoms of schizophrenia are those that involve psychosis. They include delusions, hallucinations, and disorganized speech.

“Negative” symptoms are blocked emotions or a muted emotional response. You may also feel less able to function in your everyday life.

Psychosis is a symptom of schizophrenia. Sometimes people have trouble understanding it. It usually accompanies hallucinations or delusions. The most common types of hallucination are hearing voices and seeing or feeling things that aren’t really there.

Recent trends in psychiatry have been focusing on a more holistic approach to treatment.

The practice of using creativity or art therapy to improve symptoms actually started more than half a century ago. It’s been receiving renewed attention over the past 30 years. This may be because many antipsychotic medications come with distressing and debilitating side effects that people find intolerable.

Visual art therapy

“Art therapy can help keep people feel more focused in the present moment as they explore and play creatively. I find it helpful to provide a guided directive,” says Alexa Pinsker, an art therapist and counselor based in Colorado.

For example, create an image of an anchor or something that grounds you. This can be literal or metaphorical. “Most people appreciate having structure and something to focus on,” says Pinsker.

It’s difficult to know if art therapy actually works as a treatment for schizophrenia. Trial results have been inconsistent, mixed, and sometimes contradictory. Visual art therapy has been analyzed the most. It appears more successful than other creative forms.

Music therapy

Music therapy is another popular form of art therapy that’s been studied. During this treatment, you create music — guided by your therapist — or listen and respond to music by analyzing the lyrics of a song.

Studies have shown improved outcomes in positive and negative symptoms of schizophrenia when art therapy was used in addition to standard mental health treatment. Research also suggests that music therapy may improve social functioning and quality of life.

Another study of psychiatric outpatients assigned to a year of weekly music therapy — in addition to receiving standard mental health care — revealed that they needed a lower dose of medication to manage their symptoms compared to those who did not go through music therapy. This likely indicates an improvement in their symptoms.

Pinsker believes that art therapy can provide an important distraction from disturbing or paranoid thoughts and hearing voices.

According to Dr. Akua Boateng, a licensed psychotherapist based in Philadelphia, Pennsylvania, “Art can be connected to emotional regulation, as well as brain and body integration. As a result, utilizing creativity can ground one in present reality, and improve relationships and emotional expression.”

It can also combat stress, says Jenny Lee, an art therapist based in Washington state. “The latest research says that even 45 minutes of art-making lowers salivary cortisol levels in the body.”

You may find it hard to verbally communicate your thoughts and emotions to a psychotherapist. Art therapies, on the other hand, may help you bypass this obstacle and express yourself in alternative ways.

“It can also mitigate feelings of anxiety and depression as a result of mental illness,” says Pinsker. She says that art therapy can help some people with the negative symptoms of schizophrenia, as well as some of the side effects of common medications.

Art therapy can be used with talk therapy to support the verbal expression of internal experience,” Boateng says. “But some people might find it more feasible to express themselves via art than talking.”

Pinsker agrees with this assessment. “Art therapy works well in conjunction with other modalities as a complementary therapy,” she says.

The existing literature on music therapy has found little difference in the effectiveness of group versus private therapy sessions. Group sessions are generally recommended, though, because they may help with socializing and connecting to others.

Schizophrenia may cause you to feel isolated. Participating in a group may make you feel more confident, as the setting promotes a strong sense of belonging.

Pinsker agrees. “In our art therapy groups, we would start by having each person create an image on a large canvas as a way to share what they were experiencing in that moment. They would also number how they were feeling (1 to 10, where 1 means feeling pretty low and 10 means feeling great). Then each person would share about their image and how they were feeling that day.”

She continues, “At the end of the group, people would share thoughts on their own art, ask questions, or make observations about other participants’ art. Almost always, they checked out feeling better than they did when they started.”

For example, one person said: “I started at a 4 because I felt really tired and lonely. Now I’m feeling a 7 because it was very relaxing to paint for this past hour and hang out and talk with other people in this group.”

“Art therapy can be used as primary or adjunctive treatment,” says Lee Ann Thill, an art therapist and counselor based in Philadelphia. “People who are actively psychotic, and being treated in a facility — inpatient, residential, partial — often have art therapy as part of therapeutic programming.”

She says that when art therapy is the primary treatment, it’s typically in cases of outpatient treatment. In these situations, a person’s symptoms are usually managed, and they wouldn’t be in crisis with active psychosis.

Thill notes that in her experience, many people who live with schizophrenia and psychosis genuinely enjoy art therapy, which often helps with their overall engagement in treatment.

At this point in time, “gold standard” research for art therapy, which involves randomized control trials, is the exception rather than the rule.

Although this well-respected study has concluded that art therapies don’t significantly lower total or positive symptoms, researchers did find a “small” therapeutic effect for negative symptoms.

The main challenge when measuring the efficacy of art therapy is that studies are often conducted while participants are undergoing other treatments (i.e., medication).

The varying qualifications of the person in charge of your creative program can also be an issue. You might have a professionally trained art therapist teaching you to dance or paint. Or, you may get a more general healthcare professional. In the United States, at least, creative art therapy training is regulated.

The best thing art therapy has going for it is its potential to help you connect and communicate better — with yourself, your peers, and your therapists.

The types of art therapies available are vastly different from traditional treatment techniques. Visual art, music, dance, drama, and writing all have the ability to promote therapeutic healing by bringing out your creative side.

To find an art therapist, use the Art Therapist Locator through the American Art Therapy Association. Also, call your insurance provider to find out what treatment options or support groups are available near you.