# Art therapy and emotional pain: a scoping review of physiological and biological measures

## TL;DR

This scoping review explores how art therapy affects emotional pain using brain and physiological measures, finding it reduces stress and anxiety but lacks research on physical pain.

## Contribution

The study systematically maps existing research on art therapy's physiological effects on emotional pain, highlighting a gap in physical pain assessment.

## Key findings

- Art therapy reduces stress, anxiety, and sad mood while modulating brain activity.
- fNIRS studies show increased activation in the left dorsolateral prefrontal cortex after art therapy.
- Few studies have assessed art therapy's impact on physical pain using objective measures.

## Abstract

The increasing prevalence of mental health disorders and emotional pain poses a critical challenge to social well-being and healthcare equity. Visual art therapy is well established as a clinical and nonclinical intervention for emotional pain that promotes self-regulation and psychological insight. However, there is a lack of research that clearly maps the previous studies that use both subjective and objective measures to examine the impact of art therapy on emotional pain.

This scoping review focuses on studies that use brain or physiological measurement in investigating the effect of art therapy on emotional pain in healthy adults. A systematic search of academic databases and scholarly information systems MEDLINE, PsycINFO, Engineering Village, Web of Science, Academic Search Ultimate, and Epistemonikos was conducted in May 2025. It identified 4,734 relevant records, of which 12 full texts were screened, and 6 studies met the inclusion criteria.

Evidence indicates that visual art therapy can improve mood and reduce stress, anxiety, fear, and sadness, also modulating activity across multiple brain regions. Overall, fNIRS studies reported increased activation in the left dorsolateral prefrontal cortex after art therapy, and studies on HR, skin conductance, salivary cortisol, sAA, IL-6, CRP, and RSA illustrated its positive effects in reducing stress, anxiety, and sad mood.

However, existing research has primarily addressed emotional pain, with no studies assessing its impact on physical pain in healthy populations using objective physiological or biological measures, showing that there is a gap for assessing physical pain improvement by art therapy. These findings highlight both the therapeutic potential of visual art interventions and the need for further research to explore their effects on physical pain.

This review was registered on the Open Science Framework (https://osf.io/935kw, date created and registered: 24. 07. 2025).