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ABT - Research On Eating Disorder
ABT - Research On Eating Disorder
ABT - Research On Eating Disorder
To cite this article: Maria J. Frisch , Debra L. Franko & David B. Herzog (2006) Arts-Based Therapies
in the Treatment of Eating Disorders, Eating Disorders: The Journal of Treatment & Prevention, 14:2,
131-142, DOI: 10.1080/10640260500403857
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Eating Disorders, 14:131–142, 2006
Copyright © Taylor & Francis Group, LLC
ISSN: 1064-0266 print/1532-530X online
DOI: 10.1080/10640260500403857
of Eating Disorders
MARIA J. FRISCH
Arts-Based
M. J. Frisch Therapies
et al. in Treatment
DEBRA L. FRANKO
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DAVID B. HERZOG
Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
This work was in part supported by Matina S. Horner, Phd. Summer Research Fellowship.
Address correspondence to Maria J. Frisch, Dept. of Psychiatry, Riverside Prof. Bldg, 606
24th Ave. S., Ste. 602, Minneapolis, MN 55454. E-mail: fris0039@umn.edu
131
132 M. J. Frisch et al.
forms of creative arts to bring about personal growth and positive change in
clients. This distinctive form of therapy presents a unique avenue of adjunc-
tive treatment for the eating disordered client.
While arts therapy has been clinically used for over a century (Junge,
1994), much of the published work in this area consists of case studies and
theoretical discussions, with little emphasis on outcomes (Reynolds, Nabors,
& Quinian, 2000). Moreover, specifically within the area of eating disorders,
we were not able to find evidence of empirically valid studies conducted with
this population.
Despite the lack of treatment outcome studies specifically in the area of
eating disorders, some nonrandomized and randomized controlled trials with
trauma survivors and psychiatric patients exist in the area of arts therapy.
Chapman and colleagues (2001) looked at the effect of arts therapy on pediat-
ric trauma patients up to six months after treatment, but found no significant
reductions in post-traumatic stress symptoms between patients receiving arts
therapy and those receiving standard hospital treatment. In contrast, Green,
Wehling, & Talsky (1987) studied regular therapy versus regular therapy with
art therapy every other week in chronic psychiatric patients for 20 weeks and
found significant differences between groups in attitudes towards self and
getting along with others. On a broader scale, Koerlin, Nybaek, & Goldberg
(2000) investigated arts therapy in a group of 58 individuals with a wide range
of mental and behavioral impairments over a period of four weeks. Although
there was considerable variation in psychiatric symptom reduction between
participants, 88 percent of participants who completed an arts therapy pro-
gram showed significant improvements in symptom reduction, with a sub-
group of trauma patients obtaining significantly better results, implying that
research on arts therapy and trauma may differ from arts therapy outcome
studies in other areas. However, it is not entirely clear whether the positive
outcomes found by Koerlin et al. (2000) were the result of arts therapy treat-
ment since there was no control group used for comparison. In addition, it is
difficult to generalize the results of these studies to clients with an eating dis-
order, because the samples are very different.
Arts-Based Therapies in Treatment 133
METHODS
Participants
Program directors at 22 residential eating disorder treatment programs from
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across United States (see Table 1) were contacted. Programs were selected
based on the following criteria: 1) Offered residential treatment services; 2)
Offered treatment for anorexia nervosa (AN), bulimia nervosa (BN), or
binge eating disorder (BED); and 3) Location in North America. The 22
selected programs were the only programs that met the above criteria, from
a comprehensive national search of all residential treatment programs for
eating disorders. The comprehensive search was conducted by searching
the Internet, national eating disorder treatment referral databases, and on-
line yellow pages. Programs were not offered any form of compensation for
participation in this project.
Materials
An email survey used in a recent descriptive study of residential eating dis-
order treatment programs (Frisch, Herzog, & Franko, 2005) was used to col-
lect information from program staff regarding the incorporation of arts-
based therapies in residential programs. Data were collected during July
and August of 2004.
•Do you incorporate any arts-based therapies into your program? Please check all that you offer:
•On average, what percentage of your residential clients participates in arts-based therapies while
in treatment?
Procedure
All participating programs were asked to complete a 30-question survey
regarding their residential treatment program (Frisch, Herzog, & Franko, in
press). Of these 30 questions, four were specifically on the topic of arts-
based therapies (see Table 1), and an additional question asked about
weekly schedules for residential clients. The results of these five questions
will be presented here.
Websites and brochures produced by each program also were
reviewed as a secondary means of obtaining information.
Additionally, a systematic English-language only database search was
conducted using PsycInfo (1985–2004), PubMed (1966–2004), and AMED
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(1985–2004) using the keywords eating disorders and arts therapies or arts
based therapies or creative arts therapy or music therapy or dance therapy.
Results were limited to only include papers on anorexia nervosa, bulimia
nervosa or binge eating disorder, excluding obesity. A total of 30 papers
were found, 17 on arts therapy, 8 on music therapy, and 5 on dance. Six
books containing chapters pertaining to this topic were also reviewed.
SURVEY RESULTS
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TABLE 2 Arts Therapy Utilization: Average Time per Week per Patient Dedicated to
Arts-based Therapies
DISCUSSION
While creative arts therapies are by all means intriguing and widely
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