Creative Expression: Effectiveness of a Weekly Craft Group with Women Who Have Experienced Trauma


Creativity interventions have been shown to positively influence psychological and emotional health indicators. Nurses can play an important role in the development and implementation of interventions designed to counter the longer-term emotional and psychological consequences of trauma. The purpose of this study was to explore how participation in a nurse-facilitated weekly craft group may influence anxiety, depression, self-esteem, and self-confidence among women who have emotional and physical experienced trauma. A pre/post visual analog scale was used during a 7-week intervention to measure changes in anxiety, depression, stress, self-esteem and self-confidence among a convenience sample of adult female trauma survivors (n = 33). A paired sample t test was used to evaluate the intervention with significance set at p = 0.05. Participant observation and field notes were used for qualitative data generation. Significant reductions were noted in anxiety, depression, and stress along with significant increases in self-esteem and self-confidence. Cohen’s d statistic indicated a large effect size for anxiety (0.72) and stress (0.69). Moderate effect size was determined for self-confidence (0.36), depression (0.41), and self-esteem (0.52). Emergent qualitative themes included: creative expression improved confidence to sooth the self, safe spaces fostered creativity, a sense of accomplishment was stimulated through creative activities, and creative expression groups provided opportunities for positive affirmation. Offered as a complementary intervention, nurse-facilitated creative expression groups can support continued healing long after traditional support services have been exhausted. It is important for nurses to pursue a greater understanding of the art of nursing and the important contribution of creativity when used as a nursing intervention with trauma survivors.

Share and Cite:

Garner, L. (2015) Creative Expression: Effectiveness of a Weekly Craft Group with Women Who Have Experienced Trauma. Open Journal of Nursing, 5, 96-103. doi: 10.4236/ojn.2015.52011.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Woods, S.J. and Gill, J. (2011) Family Violence: Long-Term Health Consequences of Trauma. In: Humphreys, J. and Campbell, J.C., Eds., Family Violence and Nursing Practice, 2nd Edition, Springer Publishing Company, New York, 29-50.
[2] Ham-Rowbottom, K.A., Gordon, E.E., Jarvis, K.L. and Novaco, R.W. (2005) Life Constraints and Psychological Well-Being of Domestic Violence Shelter Graduates. Journal of Family Violence, 20, 3174-3177.
[3] Pico-Alfonso, M., Garcia-Linares, M., Celda-Navarro, N., Blasco-Ros, C., Echeburua, E. and Martinez, M. (2006) The Impact of Physical, Psychological, and Sexual Intimate Male Partner Violence on Women’s Mental Health: Depressive Symptoms, Posttraumatic Stress Disorder, State Anxiety, and Suicide. Journal of Women’s Health, 15, 599-611.
[4] Cohen, B., Barnes, M. and Rankin, A. (1995) Managing Traumatic Stress through Art: Drawing from the Center. The Sidran Press, Baltimore.
[5] Flood, M. and Phillips, K. (2007) Creativity in Older Adults: A Plethora of Possibilities. Issues in Mental Health Nursing, 28, 389-411.
[6] Wilson, J. (2014) This Is Your Brain on Knitting.
[7] Allen, K. and Wozniak, D. (2011) The Language of Healing: Women’s Voices in Healing and Recovering from Domestic Violence. Social Work in Mental Health, 9, 37-55.
[8] Anderson, L. and Gold, K. (1998) Creative Connections: The Healing Power of Women’s Art and Craft Work. Women & Therapy, 21, 15-36.
[9] Creek, J. (2008) Occupational Therapy and Mental Health. 4th Edition, Elsevier, New York.
[10] Griffiths, S. (2008) The Experience of Creative Activity as a Treatment Medium. Journal of Mental Health, 17, 49-63.
[11] Lane, M.R. (2006) Arts in Health Care: A New Paradigm for Holistic Nursing Practice. Journal of Holistic Nursing, 24, 70-75.
[12] Crenshaw, D. (2006) Neuroscience and Trauma Treatment: Implications for Creative Arts Therapists. In: Carey, L., Ed., Expressive and Creative Arts Methods for Trauma Survivors, Jessica Kingsley Publishers, London, 21-38.
[13] Creativity (n.d.) In Merriam-Webster Online.
[14] Fisher, B. and Specht, D. (1999) Successful Aging and Creativity Later in Life. Journal of Aging Studies, 13, 457-472.
[15] Fasnacht, P. (2003) Creativity: A Refinement of the Concept for Nursing Practice. Journal of Advanced Nursing, 42, 195-202.
[16] Perruzza, N. and Kinsella, E.A. (2010) Creative Arts Occupations in Therapeutic Practice: A Review of the Literature. British Journal of Occupational Therapy, 73, 261-268.
[17] Stuckey, H.L. and Nobel, J. (2010) The Connection between Art, Healing, and Public Health: A Review of Current Literature. American Journal of Public Health, 100, 254-263.
[18] Kelly, C.G., Cudney, S. and Weinert, C. (2014) Use of Creative Arts as a Complementary Therapy by Rural Women Coping with Chronic Illness. Journal of Holistic Nursing, 30, 48-54.
[19] Reynolds, F. and Prior, S. (2006) Creative Adventures and Flow in Art-Making: A Qualitative Study of Women Living with Cancer. British Journal of Occupational Therapy, 69, 255-262.
[20] Walsh, S.M., Martin, S.C. and Schmidt, L.A. (2004) Testing the Efficacy of a Creative-Arts Intervention with Family Caregivers of Patients with Cancer. Journal of Nursing Scholarship, 36, 214-219.
[21] Liebmann, M. (1986) Art Therapy for Groups: A Handbook of Themes, Games and Exercises. Brookline Books, Brookline.
[22] McGarry, T.J. and Prince, M. (1998) Implementation of Groups for Creative Expression in a Psychiatric Inpatient Unit. Journal of Psychosocial Nursing and Mental Health Services, 36, 19-24.
[23] Reynolds, F. (2000) Managing Depression through Needlecraft Creative Activities: A Qualitative Study. The Arts in Psychotherapy, 27, 104-114.
[24] Weston, A. (2007) Creativity for Critical Thinkers. Oxford University Press, Oxford.
[25] Csikszentmihalyi, M. (1990) Flow: The Psychology of Optimal Experience. Harper and Row, New York.
[26] Gutman, S.A. and Schindler, V.P. (2007) The Neurological Basis of Occupation. Occupational Therapy International, 14, 71-85.
[27] Benson, H. and Klipper, M.Z. (2000) The Relaxation Response. HarperCollins, New York.
[28] Buschel, B. and Madsen, L. (2006) Strengthening Connections between Mothers and Children. Journal of Aggression, Maltreatment & Trauma, 13, 87-108.
[29] Letourneau, N., Morris, C., Stewart, M., Hughes, J., Critchley, K. and Secco, L. (2013) Social Support Needs Identified by Mothers Affected by Intimate Partner Violence. Journal of Interpersonal Violence, 28, 2873-2893.
[30] Leckey, J. (2011) The Therapeutic Effectiveness of Creative Activities on Mental Well-Being: A Systematic Review of the Literature. Journal of Psychiatric and Mental Health Nursing, 18, 501-509.
[31] Larance, L.Y. and Porter, M.L. (2004) Observations from Practice: Support Group Membership as a Process of Social Capital Formation among Female Survivors of Domestic Violence. Journal of Interpersonal Violence, 19, 676-690.
[32] Gillam, T. (2013) Creativity and Mental Health Care. Mental Health Practice, 16, 24-30.
[33] Sullivan, C. and Cain, D. (2004) Ethical and Safety Considerations When Obtaining Information from or about Battered Women for Research Purposes. Journal of Interpersonal Violence, 19, 603-618.
[34] Foley, D. (2008) Development of a Visual Analogue Scale to Measure Curriculum Outcomes. Journal of Nursing Education, 47, 209-213.
[35] Wewers, M.E. and Lowe, N.K. (1990) A Critical Review of Visual Analogue Scales in the Measurement of Clinical Phenomena. Research in Nursing & Health, 13, 227-236.
[36] Lee, K.A. and Kieckhefer, G.M. (1989) Measuring Human Responses Using Visual Analogue Scales. Western Journal of Nursing Research, 11, 128-132.
[37] Cline, M.E., Herman, J., Shaw, E.R. and Morton, R.D. (1992) Standardization of the Visual Analogue Scale. Nursing Research, 41, 378-379.
[38] Marsh-Richard, D., Hatzis, E., Mathias, C., Venditti, N. and Dougherty, D. (2009) Adaptive Visual Analog Scales (AVAS): A Modifiable Software Program for the Creation, Administration, and Scoring of Visual Analog Scales. Behavioral Research Methods, 41, 99-106.
[39] Gift, A. (1989) Visual Analogue Scales: Measurement of Subjective Phenomena. Nursing Research, 38, 286-288.
[40] Cohen, J. (1988) Statistical Power Analysis for the Behavioral Sciences. 2nd Edition, Lawrence, Erlbaum Associates, Hillsdale.
[41] Cohen, J. (1992) A Power Primer. Psychological Bulletin, 112, 155-159.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.