Healing through art: a systematic review and meta-analysis of art therapy in children and adolescents with chronic illnesses

Children and adolescents with chronic illnesses face elevated risks of psychological difficulties, including anxiety and reduced quality of life (QoL). Art therapy (AT) has emerged as a promising intervention. This study systematically reviews and analyzes the effectiveness of AT in improving QoL, anxiety, and pain in this population. A comprehensive search identified a total of 12 randomized controlled trials from 2000 to 2024, including 408 participants aged 0–18. Data were analyzed using Hedges’ g and a random-effects model. Quality assessments followed the Cochrane Risk of Bias 2 (RoB2) tool. Subgroup analyses explored potential moderators. QoL was analyzed separately by child and parent reports. AT showed a moderate, significant effect on child-reported QoL (Hedges’ g =.40, 95% CI [0.27; 0.53], p =.001) but a non-significant effect in parent reports (Hedges’ g =.43, 95% CI [−.03; 1.20], p =.21). A significant large effect was found for pain reduction (Hedges’ g = –.63, 95% CI [−1.19; −0.07], p =.03). For anxiety, AT had a large but non-significant effect (Hedges’ g = –.71, 95% CI [−2.24; 0.82], p =.23). Heterogeneity was substantial, but no significant publication bias was detected. AT appears promising for enhancing QoL, reducing pain in children with chronic illnesses. Further studies are needed to strengthen evidence and clarify clinical applications.