Publication date: Available online 26 November 2018
Source: The Arts in Psychotherapy
Author(s): Ceren Sezen, Barış Önen Ünsalver
Even though most pregnant women might have some concerns regarding the mode of delivery some women may experience a heightened fear of childbirth (FOC), which may make pregnancy a disturbing and discomforting experience for them. Clinical FOC leads to an increase in C-section demands and the ratio of C-section births. Therefore, management of FOC is essential for improving public health. The objective of this pilot study was to evaluate the efficacy of group art therapy for the management of FOC.
To understand the effectiveness of group art therapy, we designed a quantitative study. The population studied was pregnant women with subjective complaints of FOC attending an outpatient pregnancy follow-up clinic. Effectiveness of group art therapy intervention was assessed in comparison to group psychoeducation for FOC. The primary outcomes of the study were determined as Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ) scores below 37, Beck Depression Inventory (BDI) scores below 14 and the Beck Anxiety Inventory (BAI) scores below 10 at the end of the 6th session for the art therapy group. We expected to find significant differences in the primary outcome measures between the two groups. The secondary outcome of the study was the difference between the two groups regarding the mode of actual delivery. 30 women volunteers in the third trimester of pregnancy attending a public women’s hospital with moderate levels of FOC were included in the study. They were randomly distributed to 2 groups. The first group (n = 15) received six sessions of group art therapy. The second group (n = 15) received six sessions of psychoeducation for FOC.
By the end of the six weeks, Beck depression scale (BDS) scores, Beck Anxiety Scale (BAS) scores, and W-DEQ scores decreased significantly in the art therapy group in comparison to the psychoeducation group (p < 0.001). FOC was considerably decreased in the art therapy group in relation to the control group at the end of the treatment. Most of the women (n = 12) in the art therapy group had natural deliveries while those in the psychoeducation group had C-sections (n = 10).
Our findings suggest that art therapy is an efficient method for reducing clinical FOC and levels of anxiety and depressive symptoms in pregnant women in the final trimester. This arts therapy programme enabled these shifts in behaviour by helping women face and express their fears through their artwork (drawing) and then gain control over their fears (mandala-making, puppet-making, taking photographs and collage-making) within a secure base and an on-going social support system provided by the group structure. Group art therapy seems to be a cost-effective therapeutic approach for targeting a larger number of people in a limited time with a limited number of therapists.