The art of supporting identity following a life-limiting diagnosis: a systematic review

ABSTRACT

This systematic review of art psychotherapy literature explored how art therapy or artmaking may support patient identity after a life-limiting diagnosis.

Background:

Previous research shows the value of art therapy and artmaking in reducing physical and psychological symptoms at the end-of-life. Recent reports indicated that disruption to identity is a key challenge to this group of individuals.

Aims:

This systematic review investigated art therapy and artmaking and examined and built upon previous research undertaken with patients facing identity concerns after a terminal diagnosis.

Methods:

A robust and rigorous framework of criteria (PRISMA), was followed to select and review suitable research papers in order to gain new insights.

Results:

The results indicate that many patients struggle to cope with a changing identity alongside the demands of a terminal illness. The key findings are threefold: art therapy and artmaking can help maintain or reconstruct a pre-illness identity and art therapy in particular can help enable a positive identity transformation.

Conclusions:

Art therapy and artmaking hold benefits for positive identity support such as the re-evaluation and reinstatement of pre-illness roles, psychosocial-interventions and adjustment to major life changes.

Implications:

It is recommended that art therapy and artmaking are offered to terminal patients at diagnosis, in order to support identity concerns promptly and allow patients to focus solely on their quality of life and limited time left. It is anticipated that the findings of this systematic review will be of benefit to patients, healthcare workers, art therapists and others within the palliative care community.

Plain-language summary

This review of art therapy literature explored how art therapy or artmaking may support patient identity after a life-limiting diagnosis. Previous research has showed the value of art therapy and artmaking in reducing concerns at the end-of-life. Many reports indicated that changes to identity are one of the main challenges to this group of individuals. This review aimed to compare art therapy and artmaking. It examined and added to earlier research with patients struggling with identity concerns after a terminal diagnosis. A set of standards were followed to select and review appropriate research papers. Results showed that many patients struggled to cope with a changing identity alongside the difficulties of a terminal illness. Patients tried to keep an identity that was separate from their illness and also maintain their pre-illness roles.

The main findings of this systematic review are that art therapy and artmaking can help keep or restore a pre-illness identity. Art therapy in particular can help bring about a positive identity change. The conclusions are that art therapy and artmaking are beneficial for supporting identity and help patients think about and recover their pre-illness roles. Art therapy and artmaking are also seen to help patients cope with major life changes. Recommendations are that further research is undertaken with larger, more varied groups of people, particularly males. It is recommended that art therapy and artmaking are offered to terminal patients when they are diagnosed. This would allow patients to focus on their wellbeing and their limited time left with loved ones. It is likely that the findings will be helpful to patients, healthcare workers, art therapists and others within palliative care.

KEYWORDS:

• Art therapy
• artmaking
• life-limiting illness
• cancer
• palliative
• terminal
• identity maintenance
• identity reconstruction

Acknowledgements

Special thanks to the patients at Severn Hospice who have shaped the subject of this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Notes on contributors

Holly Dyer

Holly Dyer completed her Art Therapy MA at the University of Chester in May 2022. Her first degree was in Graphic Design from the University of Brighton. Holly completed her MA placement with patients at the Severn Hospice in Telford. Holly focussed on art therapy within palliative care throughout her MA and after qualification has been employed as an art therapist at the Severn Hospice.