# Effect of a brief art therapy intervention on anxiety and pain in emergency department patients: a randomized open-label trial

## TL;DR

A short art therapy session did not reduce anxiety or pain in most emergency department patients, but may help those with severe pain who also receive morphine.

## Contribution

This is the first study to evaluate art therapy's impact on anxiety and pain in emergency department patients.

## Key findings

- Art therapy did not significantly reduce anxiety or pain in the general ED population.
- Patients with high baseline pain and morphine use showed significant anxiety reduction after art therapy.
- Pain intensity was unexpectedly lower in the control group compared to the art therapy group.

## Abstract

Pain and anxiety are common in emergency department (ED) patients, yet their management is often focused on pharmacological interventions. Art therapy, a non-pharmacological approach, has shown promise in alleviating psychological distress, but its effectiveness in acute care settings remains understudied.

This study aimed to evaluate the impact of art therapy on pain and anxiety in ED patients presenting with acute pain. A randomized controlled trial was conducted in a single ED with patients randomized to art therapy or a control group. Participants in the intervention group engaged in a 15–20-minutes art therapy session, while the control group waited without intervention. Pain and anxiety were measured using the Visual Analog Scale (VAS) and the State-Trait Anxiety Inventory (STAI-Y) at baseline and after the intervention. Exploratory analyses examined interactions between morphine use, baseline pain, and art therapy effectiveness.

Of the 340 patients screened, 103 completed the study (48 in the AT group, 55 in the control group). There were no significant differences in anxiety levels between the art therapy and control groups (mean difference − 2 mm, p = 0.610). Pain intensity was significantly lower in the control group (p = 0.011). In exploratory analyses, patients treated with morphine and experiencing high baseline pain levels had a significant reduction in anxiety (VAS − 18.6 mm, p = 0.004).

Art therapy did not significantly reduce anxiety or pain in the general ED population. However, it showed potential as an adjunctive therapy for patients with severe pain and anxiety, particularly those receiving morphine. Further research is needed to explore the effectiveness of art therapy in this subset of patients and its potential as part of non-pharmacological pain management strategies in acute care settings.

The study was approved by the regional ethic committee (CERVD 2021 − 01344) and registered on https://clinicaltrials.gov (NCT04997434) on 19 July 2021.

The online version contains supplementary material available at 10.1186/s12245-026-01185-2.