"A window of looking at the good, bad, and the stress:" A mixed-methods art therapy study with hospitalized adult burn patients

Bani Malhotra; Linwood R Haith Jr; Patricia A Shewokis; Johanna Czamanski-Cohen; Minjung Shim; Megan Stair-Buchmann; Girija Kaimal

doi:10.1016/j.burns.2025.107821

"A window of looking at the good, bad, and the stress:" A mixed-methods art therapy study with hospitalized adult burn patients

Burns. 2026 Mar;52(2):107821. doi: 10.1016/j.burns.2025.107821. Epub 2025 Dec 7.

Authors

Bani Malhotra¹, Linwood R Haith Jr², Patricia A Shewokis³, Johanna Czamanski-Cohen⁴, Minjung Shim⁵, Megan Stair-Buchmann², Girija Kaimal⁵

Affiliations

¹ Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, USA. Electronic address: bmalhotra@fsu.edu.
² The Nathan Speare Regional Burn Treatment Center, Crozer-Chester Medical Center, Upland, PA, USA.
³ Health Sciences Division, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA.
⁴ The School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
⁵ Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, USA.

PMID: 41455302
DOI: 10.1016/j.burns.2025.107821

Abstract

Background: Improving psychosocial functioning in hospitalized burn survivors involves minimizing distress and pain and fostering emotion regulation. Art therapy could uniquely address the non-verbal aspects of distressing experiences, facilitating healthy emotional expression.

Method: This small N mixed-methods study examined the effect of 4-session art therapy intervention among 12 adult hospitalized burn patients on psychosocial outcomes of distress (Distress thermometer), affect (Positive and Negative Affect Schedule), change-perception (Patient Global Impression of Change), pain (Graphic Numeric Rating Scale), and self-expression and regulation (Self-Expression and Emotion Regulation in Art Therapy Scale, SERATS).

Results: Quantitative results using repeated ANOVA showed significant improvements in distress (F[1,9]=6.84, p = .028), positive affect (F[1,8]=5.5, p = 0.047), negative affect (F[1,8]=8.12, p = .022), and pain (F[1,9]=13.22, p = .005) across the four sessions. The global percentage change indicated positive trends in the outcomes. Changes did not reach statistical significance within-sessions. One-sample t-test showed a significant improvement in patients' impression of change (t[10]=-4.183, two-sided p = .002) with mean responses approaching 'much improved.' Patients perceived art therapy as fostering emotional expression and regulation 'often' indicated by mean response scores approaching "4" for each item on SERATS. Thematic analysis elaborated on symptom management, expanded expression and perspective with art serving as tangible reminders, and creative engagement across sessions and with varied art media. Mixed-methods integration demonstrated congruent findings across art therapy sessions.

Conclusion: Art therapy can be a viable intervention to boost psychosocial health in hospitalized burn patients.

Keywords: Art therapy; Burns; Emotion regulation; Expression; Mixed methods research; Psychosocial outcomes.

MeSH terms

Adult
Affect
Aged
Art Therapy* / methods
Burns* / psychology
Burns* / therapy
Emotional Regulation*
Female
Hospitalization
Humans
Male
Middle Aged
Pain / psychology
Psychological Distress*
Stress, Psychological* / psychology
Stress, Psychological* / therapy