# Effects of art therapy on psychological outcomes among children and adolescents with cancer: a systematic review and meta-analysis

## TL;DR

Art therapy may help reduce anxiety and depression in children and adolescents with cancer, but more high-quality studies are needed to confirm these effects.

## Contribution

This study provides a systematic review and meta-analysis of art therapy's impact on psychological outcomes in pediatric cancer patients.

## Key findings

- Art therapy significantly improved anxiety and depression in pediatric cancer patients.
- Narrative analysis suggests art therapy may also reduce stress and anger in this population.

## Abstract

The increasingly rising incidence of cancer among children and adolescents has led to notable psychological challenges for this population. Art therapy, classified within the realm of complementary and alternative medicine interventions and psychotherapy, demonstrates promising potential psychological benefits for children and adolescents. Therefore, a systematic review was conducted to determine the effects of art therapy on improving psychological outcomes among patients with pediatric cancer and identify the details of art therapy.

A systematic review and meta-analysis was conducted. Ten English language databases, two Chinese databases, and grey literature were searched. Two researchers independently conducted study selection, quality assessment and data extraction. The Generic inverse variance method with random-effects models was applied to do meta-analysis.

Three randomized controlled trials (RCTs) and five quasi-experimental studies with acceptable quality involving 452 participants from five countries were included. Our meta-analysis revealed statistically significant improvement in anxiety, depression among pediatric cancer patients. Narrative findings suggested art therapy could improve the overall psychological symptoms, stress, and anger.

Art therapy can positively improve psychological outcomes, particularly anxiety and depression. However, the evidence is weakened by limited studies and methodological heterogeneity. Additional high-quality RCTs with large samples are warranted to confirm and supplement the existing evidence.

This review was registered in PROSPERO with ID CRD42023477700 on 11 November 2023.

The online version contains supplementary material available at 10.1186/s12906-025-04866-2.