EXPRESSIVE ARTS THERAPY FOR HOPE IN PEOPLE WITH SCHIZOPHRENIA (EAT-HOPE)

March 7, 2026 updated by: serap güleç keskin, Ondokuz Mayıs University

The Role of Expressive Arts Therapy in Strengthening Hope in Individuals With Schizophrenia: A Randomized Controlled Trial (EAT-HOPE)

This randomized controlled trial aimed to evaluate the effectiveness of an expressive arts therapy programme based on positive psychotherapy principles in strengthening hope among individuals diagnosed with schizophrenia. Hope is a central component of recovery in schizophrenia, yet structured nursing interventions specifically targeting hope remain limited.

The study was conducted with 50 inpatients diagnosed with schizophrenia at a mental health hospital in Türkiye. Participants were randomly assigned to either an intervention group or a control group. The intervention group participated in an eight-session expressive arts therapy programme delivered in small groups, while the control group received standard psychiatric care.

Hope levels were assessed before and after the intervention using the Herth Hope Scale. The findings demonstrated that participants who received expressive arts therapy showed significant improvements in overall hope and its key dimensions, including future orientation, positive readiness and expectancy, and connectedness, compared with those receiving standard care.

This study suggests that expressive arts therapy may be an effective recovery-oriented nursing intervention to strengthen hope and support psychological recovery in individuals with schizophrenia.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Schizophrenia is a chronic psychiatric disorder that significantly affects individuals' functioning, quality of life, and recovery processes. Hope has been identified as a central component of recovery in individuals with schizophrenia, as it supports coping, motivation, and engagement with treatment. However, structured psychosocial and nursing interventions specifically targeting hope remain limited.

Expressive arts therapy is a therapeutic approach that integrates creative expression processes such as drawing, collage, storytelling, and metaphor work to facilitate emotional expression, self-awareness, and psychological healing. Within psychiatric nursing, expressive arts therapy may offer a recovery-oriented approach that helps individuals express their experiences, reconstruct meaning, and strengthen hope.

This randomized controlled trial aimed to evaluate the effectiveness of an expressive arts therapy programme based on positive psychotherapy principles in strengthening hope among individuals diagnosed with schizophrenia. The study was conducted with 50 inpatients diagnosed with schizophrenia in a mental health hospital in Türkiye. Participants were randomly assigned to either an intervention group or a control group using a computer-generated randomization list prepared by an independent statistician.

Participants in the intervention group received an eight-session expressive arts therapy programme delivered face-to-face in small groups in addition to standard psychiatric care. Each session included psychoeducation, creative expression activities (such as drawing, collage, storytelling, and metaphor work), and group sharing processes aimed at strengthening emotional expression and hope. The control group received standard psychiatric inpatient care only.

Hope levels were assessed before and after the intervention using the Herth Hope Scale. The primary outcome of the study was the change in hope level measured by the Herth Hope Scale total score. Secondary outcomes included changes in the scale's subdimensions, including future orientation, positive readiness and expectancy, and interconnectedness.

The findings of this study are expected to contribute to the development of recovery-oriented psychosocial nursing interventions for individuals with schizophrenia and to provide evidence regarding the effectiveness of expressive arts therapy in strengthening hope.

Study Type

Interventional

Enrollment (Actual)

50

Phase

  • 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 (Türkiye)
    • Samsun
      • Atakent, Samsun, Turkey (Türkiye), 55200
        • samsun Mental Health Hospital

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria

  • Diagnosis of schizophrenia according to clinical evaluation
  • Age between 18 and 65 years
  • Hospitalized in a psychiatric inpatient unit
  • At least six months since diagnosis
  • Ability to read and understand assessment tools
  • Clinically stable without acute psychotic symptoms
  • Provided written informed consent

Exclusion Criteria

  • Severe cognitive impairment
  • Acute psychotic symptoms requiring intensive treatment
  • Severe physical illness preventing participation
  • Refusal to participate or withdrawal of consent

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
Intervention / Treatment
Experimental: Expressive Arts Therapy Group
Participants in this arm received an expressive arts therapy programme based on positive psychotherapy principles in addition to standard psychiatric care. The programme consisted of eight structured group sessions delivered face-to-face in small groups. Each session included psychoeducation, creative expression activities such as drawing, collage, and metaphor work, and group sharing. The intervention aimed to strengthen hope and support psychological recovery.
Behavioral: Expressive Arts Therapy

Intervention Description (Kopyalayın)

An expressive arts therapy programme based on positive psychotherapy principles was delivered in small groups. The programme consisted of eight structured sessions conducted face-to-face. Each session included psychoeducation, creative expression activities such as drawing, collage, storytelling, and metaphor work, and group sharing. The intervention aimed to strengthen hope, enhance emotional expression, and support psychological recovery in individuals with schizophrenia.
No Intervention: Control Group
Participants in this arm received standard psychiatric inpatient care only. Standard care included routine pharmacological treatment, clinical monitoring, and nursing care. No additional psychosocial or expressive arts therapy intervention was provided during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Hope Level Measured by the Herth Hope Scale
Time Frame: Baseline and immediately after completion of the intervention (4 weeks)
Hope level will be assessed using the Herth Hope Scale (HHS), a validated 12-item self-report instrument with scores ranging from 12 to 48. Higher scores indicate higher levels of hope.
Baseline and immediately after completion of the intervention (4 weeks)
Herth Hope Scale
Time Frame: Baseline and immediately after completion of the 8-session intervention (approximately 4 weeks)
Changes in Herth Hope Scale subscale scores (future orientation, positive readiness and expectancy, and interconnectedness) will be evaluated.
Baseline and immediately after completion of the 8-session intervention (approximately 4 weeks)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Herth Hope Scale Subscale Scores
Time Frame: Baseline and immediately after completion of the intervention
Changes in the subscale scores of the Herth Hope Scale, including future orientation, positive readiness and expectancy, and interconnectedness, will be evaluated.
Baseline and immediately after completion of the intervention

Collaborators and Investigators

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

Sponsor

Ondokuz Mayıs University

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)

July 22, 2025

Primary Completion (Actual)

October 30, 2025

Study Completion (Actual)

January 13, 2026

Study Registration Dates

First Submitted

March 1, 2026

First Submitted That Met QC Criteria

March 1, 2026

First Posted (Actual)

March 6, 2026

Study Record Updates

Last Update Posted (Actual)

March 10, 2026

Last Update Submitted That Met QC Criteria

March 7, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • OMU-SCH-EAT-RCT-2025
  • OMU-ETHICS-2024-1305 (Other Identifier: Ondokuz Mayis University)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be publicly shared due to privacy and confidentiality considerations involving a vulnerable psychiatric population. De-identified data may be made available from the principal investigator upon reasonable request and with appropriate ethical approval.

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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