For many years, there have been two opposing concepts, which are science and art. Dr. Shigeaki Hinohara was a Japanese physician and supreme internist who was active in various fields until he was 105 years old [1]. He had practiced holistic medicine and introduced primary care medicine from the United States to Japan [2]. He then discussed the differences of science and art in the medicine (Figure 1). From ancient to contemporary period, the ratio of science and art involving medical practice has been gradually changed, but both factors are indispensable.

Figure 1: Two factors of science and art in medical practice for long history.

When comparing science vs. art, some opposing perspectives are found, such as medicine vs. medical practice, patient vs. case, cure vs. care, and so on [3]. The author had learned much from Dr. Hinohara and has continued to work with him in the same field, including lifestyle-related diseases, primary care medicine, integrative medicine (IM), and the New Elderly Association (NEA). In this article, several perspectives about science, art, art therapy, music therapy, medical basic concept will be described  and so on.

From historical point of view, the term “art therapy” was firstly presented by the British artist Adrian Hill from 1938 in his book titled “Art Against Disease” [5]. The basic method of art therapy was recognized as unique style at that time, and then it attracted attention to lots of doctors as novel perspectives for treatment [6]. Hill had later founded the British Association of Art Therapists (BAAT) in 1945 and became the first president of BAAT. For years, advantageous aspects for art therapy have been emphasized. Furthermore, several kinds of art therapy have been known, such as music therapy, sand therapy, isotherapy, neurography, phototherapy, associate metaphor maps and others [7]. They were usually applied with the treatment of psychological problems for the related patients. Art therapy has been known to combine several disciplines, including art history, psychology, pedagogy and psychotherapy.

The detail of the art therapy was investigated in the light of foreign aspects. Then, it was proved that art therapy has been not teaching measure of art, but the method that children and adults can express themselves, in particular for negative experiences or emotions [5]. Concerning presenting art therapy, mainly six principles can be found [8]. They are in the followings:

1. i) tolerant recognition and acceptance: comparison, no criticism, devaluation
2. ii) positive thinking: stimulation of search method, emphasis on future possibility

iii) reliance on unique matters: each shows its individuality aspect

1. iv) confidentiality and safety of creativity
2. v) spontaneous own creativity: style, genre, exercise, free working, free materials
3. vi) free improvisation: the search for freedom and self-expression

The perspectives of art therapy have been understood in various manner in lots of researchers from foreign countries across the world. It is rather difficult to express the concept of some art therapies by the verbal expression, heart feeling or visualizing thoughts [7]. Creativity has been the important factor in psychotherapy. For its background, creativity has the power to explore our beliefs, emotions, to reduce stress, conflicts, problems, and to improve the sensation of well-being. Furthermore, art therapy has the ability to form self-awareness, self-esteem, emotional stability, anxiety reduction, and to improve sensory-motor and cognitive functions.

The assessment measure for art therapy has involved the classification of psychological status of the picture drawer into several groups. It can be categorized by the estimation of numeric score that is based on the interpretation of the drawing [9]. In contrast, a qualitative approach may be present, or the artificial intelligence (AI) approach may be present for the psychological status through the drawings. As recent report, the effect of art therapy on mental health for clinical nurses was studied for systematic evaluation [10]. The protocol included 19 RCTs including 1338 clinical nurses. As a result, they showed significant reduction of anxiety level (by SAS) and also depression and perceived stress levels (by CPSS). Further, performance of art therapy showed improvement of positive coping style and decrease of negative coping style. Consequently, art therapy treatment has the power to decrease depression, anxiety and stress level for clinical nurses. Simultaneously, they increased better coping styles and promoting mental well-being.

The patient sometimes have trauma-related nightmares that have been saved in visual, non-verbal or audiovisual language in the bottom of the memory [11]. Then, Imagery rehearsal therapy (IRT) has been effective for treatment of nightmares. Art therapy (AT) seems to be the experiential therapy which addresses various images rather than word communication. Consequently, the combined IRT-AT therapy can become more effective method. Some research of the theoretical and practical IRT-AT method was conducted. As a result, the combination of AT and IRT seems to be effective for dealing with traumatic memory and living feeling related with traumatic experiences.

Younger generation often face mental health problems as first onset by age 24. Despite these situations, they cannot receive adequate treatment in the social and medical points of view [12]. Creative and expressive art therapy (CAT) can address these problems by non-invasive approach to mental health care. To examine CAT effect, systematic review was conducted for 7276 articles, and among them 11 papers were analyzed in detail. As a result, art therapy and poetry therapy showed the most frequent CATs for the efficacy of all reviewed reports.

For the latest report, a critical literature review was conducted for deconstructing narratives of trauma [13]. The protocol included screening lots of report for 20 years, and reviewing 26 theoretical articles systematically by inductive, interpretive and recursive processing. All therapists usually use trauma episode for conceptualize adverse life experiences, because such private negative narrative story become the most meaningful issue to be studied and solved. As a result, actual practice and research for art therapy was described in the younger generation aged 12-18 years who had adverse life experiences. Several findings showed the expression and creativity of self-agency in the program and the importance of flexible and valuable approach from art therapists.

Art therapy has been one of the most effective measures to work with patients or clients. It means an important path leading to self-expression, self-disclosure, development and harmony with each person. As innovative method of art therapy, to restore deep relationship between human and nature with creative activity can bring the ecological approach for art therapy, which is called as eco art therapy [14]. Beyond the basic framework in the psychology office, walking in nature, usage of natural materials, and creation of various products can contribute the novel aspect of art therapy. In other words, such approach can combine art natural environment and therapeutic techniques. Consequently, eco art therapy may give recognizing novel contact with the world, solving psychological problems, and overcoming the alienation of people from the nature.

In summary, the perspectives among science vs art and some novel types of art therapy have been introduced in this article. Taking most advantages of art therapy, medical staff can provide patients and clients with several problems satisfactory influences for control psychosomatic better control. Current report becomes hopefully meaningful data for future clinical practice, treatment and research.

Conflict of interest: The authors declare no conflict of interest.

Funding: There was no funding received for this paper.

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