Child-focused process and outcome evaluation of arts therapies for children in primary schools


Student thesis: Doctoral Thesis


Embedding arts therapies (i.e. music, drama, dance movement and art therapy) within the educational system may contribute to address children’s emerging needs and result in a positive impact on their wellbeing, bridging the gap between health and education. However, research in this area remains limited in scope and size, with evidence of effectiveness not yet firmly established. Furthermore, children’s perspectives are not taken to heart, relying heavily on either the views of therapists, teachers, or parents.

This study attempted to fill this gap through a two-staged design. The first stage consisted of a systematic review that aimed to identify, appraise and synthesise the evidence relating to child-reported outcomes of arts therapies. This review included seven studies and 358 participants. The findings informed the development of the second stage; a pilot cross-over randomised controlled study investigating the process and outcomes of an arts therapies intervention delivered to 62 children with mild emotional and behavioural difficulties. The most important outcomes identified were: emotional regulation; self-confidence; positive appraisal of health and perceived quality of life; positive relationships; and reduced stress. Links were made with positive psychology as well as self-determination and self-actualisation theories.

Furthermore, the pilot study shed light into the practicalities of conducting a randomized controlled study in educational settings, as well as the power size needed to reach statistical significance. Although results did not reach the accepted level of statistical significance for all outcome measures, there were improvements in children’s quality of life and wellbeing which sustained at 3, 6 and 12 months follow-up. There were also significant changes in duration of sleep as determined through acti-watchers, and in emotional and behavioural difficulties as reported by teachers.

This project highlights areas for improvement in future research and practice based on evidence that is grounded on children’s perspectives. It is expected that the implementation of these suggestions will benefit children’s health and wellbeing, and the wider inclusion of arts therapies in national and international health-related guidelines.
Date of Award16 Dec 2020
Original languageEnglish
Awarding Institution
  • Edge Hill University
SupervisorVicky Karkou (Director of Studies) & Joanne Powell (Supervisor)


  • Pilot intervention study
  • art therapy
  • music therapy
  • dance movement therapy
  • dramatherapy
  • children
  • primary schools
  • mental health
  • wellbeing
  • systematic review

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