Mind-body and creative arts therapies for people with aphasia : a mixed method systematic review

Pieri, M. and Foote, H. and Grealy, M. A. and Lawrence, M. and Lowit, A. and Pearl, G. (2023) Mind-body and creative arts therapies for people with aphasia : a mixed method systematic review. Aphasiology, 37 (3). pp. 504-562. ISSN 0268-7038 (https://doi.org/10.1080/02687038.2022.2031862)

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Background. In the context of aphasia rehabilitation there is a perceived need for interventions with a reduced linguistic demand targeting well-being. Mind-body and creative arts approaches are holistic and person-centred approaches, primarily relying on means other than verbal exchanges, and promoting self-regulation strategies. Aims. This mixed-method systematic review aimed to evaluate the availability, feasibility, and effectiveness of mind-body and creative arts therapies in promoting well-being for people with aphasia. Eight databases were searched using subject headings and key words. Full-text screening, critical appraisal and data extraction were conducted independently by two reviewers. A segregated synthesis approach was used (i.e. Revised Effect Direction Plot technique; Thematic Synthesis approach). Findings are presented in a narrative and visual form. Main Contribution. Twenty-two studies were included (Mind-body: n=11; Creative-arts: n=11). Heterogeneity of study design and quality, intervention type, procedures and dosage, outcomes, and level of offered communication support were identified. Improvements were noted across a wide range of well-being outcomes with more consistent positive results for anxiety and communication. 128 findings were extracted and synthetised in three broad themes: positive impact on self, empowering multifaceted experience, the relevance of needs-centred adjustments. Conclusion. Provisional findings about the benefits of mind-body and creative arts interventions on aspects of well-being for some individuals with aphasia were identified. However, findings are complex and need to be interpreted cautiously. Facilitators and barriers to these therapies are highlighted with related recommendations for practice. The review poses a demand for further research in the field, implementing rigorous methodology and aphasia-specific support to facilitate inclusion and engagement.