Jo Reed: Welcome to “Quick Study,” the monthly podcast from the National Endowment for the Arts.  This is where we’ll show stats and stories to help us better understand the value of art in everyday life.  Sunil Iyengar is the pilot of “Quick Study.”  He’s the Director of Research & Analysis here at the Arts Endowment.  Hi, Sunil.  How are you?

Sunil Iyengar: Doing pretty well.  Hi, Jo.

Jo Reed: So what’s on the docket for today?

Sunil Iyengar: Well, Jo, you’ve heard me talk about creative arts therapies before, right?  There are a range of arts-based interventions to address health conditions, so it may include art therapy, music therapy, dance therapy, or drama therapy, for example.

Jo Reed: Okay.  And of course we support creative arts therapies as part of the Creative Forces program.

Sunil Iyengar: That’s right.  Through that program, Creative Forces, with the Departments of Defense and Veterans Affairs and other partners, we fund the placement of creative arts therapists at military and veteran care facilities nationwide to improve the health, well-being and quality of life for these populations and their families and caregivers.  We also support research and evaluation in this space, and we have a separate grant program that strives to connect these groups with opportunities for community arts engagement.

Jo Reed: So this episode is going to be about Creative Forces.

Sunil Iyengar: Psych.  No, it’s not. <laughs>

Jo Reed: <laughs>

Sunil Iyengar: I know often we talk about creative arts therapies, how they can alleviate acute and chronic health problems for patients of all types and all ages, so a frequent theme here in the research is that patients who experience these therapies have a chance to take control of their trauma to find a way to engage with it productively and to work through it by expressing themselves creatively.  But this time I want to share results from a research study of creative arts therapies administered not in patients but in healthcare workers, doctors, nurses and other health professionals.

Jo Reed: So what kind of healthcare issues do these workers face?

Sunil Iyengar: So going back to Creative Forces, with that NEA initiative, we often are dealing with post-traumatic stress related psychological illnesses.  But in a way, with COVID especially, frontline healthcare workers have been like soldiers, you know, in the trenches, and at heightened risk for stress, anxiety, frustration and burnout.  So we have an NEA Research Lab at Colorado University Denver that’s taken on this problem by offering and studying creative arts opportunities in music, dance, visual art making and writing to do what, their words, to identify, explore and transform the psychological difficulties of critical healthcare workers.

Jo Reed: That makes sense.  So there’s a study attached to this, I’m assuming?

Sunil Iyengar: Yeah, I’m glad you asked. <laughs> The American Journal of Medicine has released a pre-print online version of an article titled “The Effect of Creative Arts Therapy on Psychological Distress in Health Care Professionals.”  So this article was authored by investigators at the NEA research lab I mentioned in Colorado.  The group studied 146 healthcare professionals who were randomly assigned to one of four treatment groups or to a control group.  More than half of those taking part in the study were nurses, 10 percent were doctors, and 16 percent were behavioral health specialists.  The study took place during the pandemic.  So four of the study groups got arts-based interventions, programs or therapies for 90 minutes a session.  That was a total of 12 weekly sessions each.  For instance, a visual art group did things like create oil pastels, watercolors or photographs.  A music therapy group was directed to do music listening exercises or to play musical instruments.  A creative writing group did pre-writing for a length of time or journaling, or explored character and scene development in their writing or engagement with sensory detail, dialogue, sound or rhythm, and a fourth group, the dance or movement therapy group, did low-impact physical warmups, improvised individual and group movement or structured movement with nonverbal storytelling.  They also created choreography together based on a theme or themes.

Jo Reed: That sounds actually pretty cool.  So what did the researchers learn?

Sunil Iyengar: So the researchers measured whether symptoms of psychological distress for these healthcare workers changed over the 12 weeks during the pandemic compared with baseline.  They found that upon conclusion of the program the study participants who had received one of the four types of arts programs or therapies showed greater improvement on a variety of scales.  They looked at anxiety, depression scores, PTSD scores, burnout, positive or negative affect and what’s called turnover intention scores.  So turnover intention basically just signals a group’s intent to quit their jobs.  So by greater improvement I mean they saw this in comparison with a control group.  In fact, the researchers note that for the control group, some of these scores actually worsened.

Jo Reed: Oh.  So when you say control group, do you mean healthcare workers, these healthcare workers, got some other kind of therapy, just not in the arts?

Sunil Iyengar: No.  Actually, this is an excellent point, Jo.  The study authors can see that the control group did not receive any special program or intervention, as with the arts groups.  So the authors say some of the difference in affects might be attributed to people simply getting together for a common purpose and building community through art making.  So future research probably should include a way to control for these potential factors, according to the Colorado team.

Jo Reed: But it still sounds like good news overall.  I like caring for the caregiver.

Sunil Iyengar: Yes.  I think it’s a really important line of research.  Often we forget that by confronting the stressful conditions and traumas experienced by healthcare workers, we’re also really improving the quality of care that ultimately is provided and reducing the potential for medical errors.  You know, addressing healthcare worker burnout is a priority of the surgeon general who’s issued an advisory on it just earlier this year.

Jo Reed: So apparently this is a very timely study.

Sunil Iyengar: Correct.  And Jo, it also may point to cost savings downstream for the healthcare system.  As the researchers observe, “the intervention was inexpensive to conduct and there were no safety concerns,” unquote.  So in their words, the risk-to-cost benefit ratio for improving healthcare professionals’ psychological distress is potentially very large.

Jo Reed: Well, this is going to be continued, no doubt, Sunil.  Thank you so much.

Sunil Iyengar: Yeah, great talking with you as usual, Jo.

Jo Reed: Good talking to you and I’ll talk to you next month.  That was Sunil Iyengar.  He’s the Director of Research & Analysis here at the Arts Endowment.  This has been “Quick Study.”  The music is “We Are One” from Scott Holmes Music.  It’s licensed through Creative Commons.  Until next time, I’m Josephine Reed.  Thanks for listening.