Effects of Expressive Art Therapy Applied to Earthquake Victims Who Have Experienced Loss

May 30, 2025 updated by: Merve Kızılırmak Tatu

Effects of Expressive Art Therapy Applied to Earthquake Victims Who Have Experienced Loss on Psychological Symptoms and Post-Traumatic Growth: A Randomized Controlled Study

Earthquakes can negatively affect individuals' mental health by creating serious traumatic effects on individual and societal levels. Traumatic experiences such as losing one's home or workplace, being injured, or losing a loved one cause individuals to develop long-term psychological symptoms. In this context, strengthening psychosocial support programs aimed at coping with psychological and social problems after an earthquake is of great importance. In this study, the effect of expressive art therapy applied to individuals who experienced losses due to the earthquakes centered in Kahramanmaraş on psychological symptoms and post-traumatic growth was examined.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Active, not recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

A randomized controlled intervention design with pre-test-post-follow-up measurements was used, which is one of the quantitative research methods. In line with the power analysis, a total of 42 participants, 21 in each group, constituted the research sample. The distribution of participants to the intervention and control groups was made with stratified block randomization. The inclusion criteria of the study included being 18 years of age or older, knowing Turkish, and having experienced material and moral loss due to the earthquake; while the exclusion criteria were mental illness or receiving active psychosocial support. The Brief Symptom Inventory (BSI) and the Post-Traumatic Growth Scale (PTS) were used as data collection tools. The intervention process includes a six-session expressive arts therapy program. The scales will be administered online at pre-test, post-test and two-month follow-up. Data will be evaluated with repeated measures and two-way variance analyses. It is expected that this study will contribute to post-traumatic recovery processes and art-based psychosocial interventions.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
42

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
    • Çankaya
      • Ankara, Çankaya, Turkey, 06500
        • Gazi University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Being 18 years of age or older,
  • Being able to understand, speak and write Turkish,
  • Having directly experienced the earthquakes centered in Kahramanmaraş, -
  • Having experienced material and moral losses due to the earthquakes centered in Kahramanmaraş

Exclusion Criteria:

  • Having a neurological disorder that prevents communication,
  • Actively receiving any psychosocial support/counseling

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Intervention
After the pre-test, the intervention program was started for the intervention group. The expressive arts therapy program was applied in six sessions, each session lasting 60-90 minutes. All sessions were conducted online. Each session started with greetings and mood control, then a brief evaluation of the previous week was made. The sessions consisted of three stages: giving instructions by the researcher, participants performing artistic actions with appropriate art elements and techniques, and participants working on sharing their artistic stimulation and associations. A list of materials to be used in the session (pencils, paint, paper, play dough, etc.) was sent to the participants one week before the sessions and they were asked to provide them until the session.
Other: Expressive Art Therapy
As a strategy for coping with trauma, art production creates therapeutic effects on the individual with its sensory and physical aspects (Chapman, 2013; King-West and Hass-Cohen, 2008). When verbal expression is insufficient or carries the risk of re-traumatization, expressive art therapy offers a safe space through non-verbal expression (Talwar, 2007). It is stated that art production is effective in repairing self-integrity ruptures that occur in traumatic experiences (Harris, 2009). Through creative processes, the individual can restructure both internally and externally. Expressive art therapy, especially when applied in a group environment, creates a psychotherapeutic effect by providing participants with the opportunity to express their emotions, imagination and unconscious processes (Malchiodi, 2012; Kim et al., 2021). The commitment and reflective understanding that occur in group psychotherapy are among the factors that give hope and strength (Robb, 2017).
No Intervention: Control
No intervention was made to the control group. After the follow-up test was applied to the participants in the experimental group, a three-session expressive arts therapy program was applied to the control group.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Brief Symptom Inventory (BSI)
Time Frame: Change from baseline to 6 weeks (also assessed at 14 weeks post-baseline)
It is a 53-item symptom screening scale developed by Derogatis. The scale consists of 9 subscales and 3 global indexes. The 9 subscales of the scale are, respectively, Somatization (S) (items 2, 7, 23, 29, 30, 33, 37), Obsessive-compulsive disorder (OCD) (items 5, 15, 26, 27, 32, 36), Interpersonal sensitivity (IS) (items 20, 21, 22, 42), Depression (D) (items 9, 16, 17, 18, 35, 50), Anxiety disorder (AD) (items 1, 12, 19, 38, 45, 49), Hostility (H) (items 6, 13, 40, 41, 46), Phobic anxiety (PA) (items 8, 28, 31, 43, 47), Paranoid ideation (PD) (items 4, 10, 24, 48, 51) and Psychoticism (P) (items 3, 14, 34, 44, 53). Additional items (EM) (items 11, 25, 39, 52) include items related to eating and drinking disorders, sleep disorders, death and thoughts about death, and feelings of guilt. The global indices are the Disorder Severity Index, the Symptom Total Index, and the Symptom Disorder Index, respectively.
Change from baseline to 6 weeks (also assessed at 14 weeks post-baseline)
Post-Traumatic Growth Scale (PTGS)
Time Frame: Change from baseline to 6 weeks (also assessed at 14 weeks post-baseline)
The Posttraumatic Growth Inventory was developed by Tedeschi and Calhoun (1996) to measure the development that occurs in individuals after trauma. The scale consists of 21 items and the items are scored on a 6-point scale from 0 to 5. The scores obtained from the scale vary between 0 and 105, and a high score indicates that the person has experienced a positive change, that is, growth, after the trauma. Factor analysis determined that the scale has 5 sub-dimensions (positive change in interpersonal relationships, awareness of new opportunities, understanding the value of life, increasing personal resilience, and strengthening spirituality). The internal consistency coefficient of the scale was reported as .93 (Kağan et al., 2012).
Change from baseline to 6 weeks (also assessed at 14 weeks post-baseline)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Merve Kızılırmak Tatu

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 15, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
January 15, 2025

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 15, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 30, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 30, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 8, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 8, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 30, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 05.20.2024-E.950905

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Other researchers wiil be able to read detailed information such as the research method and results when the research is published. The "Research Protocol" will be available on this PRS page.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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