ArteSanando: virtual intervention with art therapy for Paraguayan adolescents from vulnerable communities during COVID-19

Abstract

Art therapy has social and individual benefits that promote mental health, though has limited scientific studies on evidence of efficacy and effectiveness. This study aims to evaluate online group art therapy interventions to face isolation due to the COVID-19 pandemic in N = 39 Paraguayan adolescents aged 12-18 years, from rural areas of San Pedro and Caaguazú. Sampling was non-probabilistic and intentional. Participants were previously selected according to criteria of vulnerability and poverty status, as well as characteristics of proactivity to exert influence in their community. A program evaluation was carried out with a concurrent triangular mixed design. The quantitative method was descriptive-exploratory and the qualitative method was deductive according to areas of interest. Quantitative measures included Psychological Well-Being Scale for Adolescents (BIEPS-J; Casullo & Castro, 2000) with high reliability (α?> .80), and validity evidence in relation to the Rosenberg Self-Esteem Scale, r =.44, p < .001 (Luna et al., 2020); and the ArteSanando Survey on Participant Appraisal, developed for this study. For qualitative data, 13 focus groups were conducted with questions about Psychological Well-Being, Coping Skills, Satisfaction, Identity, Expression, Self-Concept, Group Cohesion, Belonging, Artistic and Creative Interests, and Openness to Experience, in addition to analyses of participants’ artistic production during workshops. Thirteen workshops were conducted in two stages, covering a total of 4 months. The first stage took place between October and December 2020, and the second between January and February 2021, before starting the school year. Artistic dynamics of the first stage (1st-5th workshops) consisted of readings, photographs, movement-dance, crafts, drawing, contact with nature and with oneself. Dynamics of the second stage (6th-13th workshops) included handicrafts, movement and dance, graffiti, poetry, acting and rap composition. Meetings were synchronous, with asynchronous support. Comparing the overall psychological well-being score in ArteSanando participants to that of the general population, the effect size (d = 1.5) is high (Cohen, 1988). Of the adolescents who participated in ArteSanando, 78.8 % score above the mean of the general population group (Luna et al., 2020), 68.9 % of both groups overlap, and there is a 71.4 % probability that a randomly selected person from the ArteSanando group will have higher psychological well-being than a randomly selected person from the general population group. The levels of Situation Control (M = 11.0, SD = 1.28), Self-Acceptance (M = 7.94, SD = 9.00) and Psychosocial Relationships (M = 8.39, SD = 9.00) are moderate. The Personal Projects factor stands out (M = 8.83, SD = 9.00) reaching a high level. In participant stories, a marked increase in subjective well-being is evidenced, along with development and consolidation of the sense of belongingness, coping skills, and artistic expression. At the beginning of workshops, stories and body language of adolescents coincided with what evidence indicates as the psychological impact of confinement; symptoms of depression, anxiety and post-traumatic stress (Ramírez-Ortiz et al., 2020; Xiang et al., 2020). However, as a result of group bonding, warmth and empathy contributed to well-being. This initial openness may have favored acceptance and appreciation of themselves, to later develop a sense of being in control of situations, especially important in uncertain contexts such as the pandemic. In turn, this ability to create or modify contexts so that they fit personal needs and interests, opens the way to feeling capable of designing personal projects, attributing meaning to one's own life through long-term goals and projects. This ability is especially important in adolescence to find healthy motivations that lead to a healthy future (Ovid, 2003). Projecting oneself in this way is difficult in a context of isolation, where emotions tend towards hopelessness (Ramírez-Ortiz et al., 2020), so that in addition to being a positive indicator of mental health, it can act as a protective factor in crisis contexts (Longo, 2012).