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