art literature review

Writing a Literature Review in the Arts and Humanities

• 1. Get Started
• 2.1 Find Review Articles
• 3.1 Find Scholarly Journals
• 3.2 Find Theses or Dissertations
• 3.3 Track Citations
• 4. Evaluate Literature
• 5. Take Notes & Manage References
• 6. Keep Current
• 7. Prepare First Draft & Revise

Humanities Librarian

Process of Literature Review

This guide was created to help FSU students in the arts and humanities with writing a literature review.

Whether you are writing a literature review for your term paper, research article, or thesis/dissertation, we hope you will find some helpful tips for completing the task.

Each tab in this guide was designed to correspond to each stage of the literature review process. However, research and writing are iterative processes; they do not necessarily follow a linear process. You may find yourself cycling through stages more than once, perhaps going back to your topic after a first reading of articles and books you have discovered. The outline here is meant only as a guide for thinking about the process.

What is a Literature Review?

A Literature Review IS.. .

• a selective, integrated analysis and synthesis of what has been researched and published on a particular topic
• a process, typically starting from selecting a topic to review and concluding with writing a manuscript to report the published works on the topic
• an iterative process: you may have to keep coming back to previous stage(s) to refine your topic, modify the search statements, and/or revise a working thesis, etc.

A Good Literature Review IS NOT...

• a mere summary of what you have read on a topic
• a summary of everything that is reported on a topic
• an annotated bibliography 

         ...BUT IS

• a critical summary of relevant and selective literature on the topic
• written in clear language
• a piece of research on its own

         ...AND DOES

• situate and focus your research in context
• use credible and most relevant sources
• add value to the existing knowledge on the topic

FSU Reading Writing Center

The Florida State University Reading-Writing Center and Digital Studio offers writing support to all FSU students across all the disciplines.

• FSU Reading-Writing Center (RWC) an inclusive resource for FSU students of all majors, programs, and backgrounds. Whether you are working on a project, a paper, or any range of writing, the RWC is excited to assist you in any stage of your work process.

Video Tutorials

•   Literature Reviews: An Overview for Graduate Students  (9:38)
•   From North Carolina State University Libraries
• Writing the Literature Reviews: Step-by-Step Tutorial for Graduate Students  : Part 1 (5:21)  
•    From Univ. of Maryland University College

These tutorials are hosted on YouTube and may include advertising. FSU Libraries do not endorse ads promoted by YouTube.

Guide Authors

This guide was authored by Abby Scheel in 2017. Adam Beauchamp maintains the guide and is the point of contact for inquiries.

Except where otherwise noted, the content in this guide is licensed under a Creative Commons Attribution 4.0 International License . 

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• Last Updated: Sep 20, 2023 11:38 AM
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• How to Write a Literature Review | Guide, Examples, & Templates

How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

• Search for relevant literature
• Evaluate sources
• Identify themes, debates, and gaps
• Outline the structure
• Write your literature review

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.

• Quick Run-through
• Step 1 & 2

When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

• Demonstrate your familiarity with the topic and its scholarly context
• Develop a theoretical framework and methodology for your research
• Position your work in relation to other researchers and theorists
• Show how your research addresses a gap or contributes to a debate
• Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

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Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

• Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
• Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
• Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
• Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.

• Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
• Body image, self-perception, self-esteem, mental health
• Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:

• Your university’s library catalogue
• Google Scholar
• Project Muse (humanities and social sciences)
• Medline (life sciences and biomedicine)
• EconLit (economics)
• Inspec (physics, engineering and computer science)

You can also use boolean operators to help narrow down your search.

Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

• What question or problem is the author addressing?
• What are the key concepts and how are they defined?
• What are the key theories, models, and methods?
• Does the research use established frameworks or take an innovative approach?
• What are the results and conclusions of the study?
• How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
• What are the strengths and weaknesses of the research?

Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

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To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

• Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
• Themes: what questions or concepts recur across the literature?
• Debates, conflicts and contradictions: where do sources disagree?
• Pivotal publications: are there any influential theories or studies that changed the direction of the field?
• Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

• Most research has focused on young women.
• There is an increasing interest in the visual aspects of social media.
• But there is still a lack of robust research on highly visual platforms like Instagram and Snapchat—this is a gap that you could address in your own research.

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.

Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

• Look at what results have emerged in qualitative versus quantitative research
• Discuss how the topic has been approached by empirical versus theoretical scholarship
• Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, you can follow these tips:

• Summarize and synthesize: give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: don’t just paraphrase other researchers — add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically evaluate: mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: use transition words and topic sentences to draw connections, comparisons and contrasts

In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

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If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

There are several reasons to conduct a literature review at the beginning of a research project:

• To familiarize yourself with the current state of knowledge on your topic
• To ensure that you’re not just repeating what others have already done
• To identify gaps in knowledge and unresolved problems that your research can address
• To develop your theoretical framework and methodology
• To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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• Literature Review
• Research Resources
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• Organizing Your Research

What is a Literature Review?

A literature review is a written component of your final report, that discursively accounts for literature published by accredited scholars and researchers on a particular topic. 

When writing a literature review (or lit review, for short), your job is to convey to the reader that you've fully accounted for the scope of research materials written about your particular topic, to convey the ideas written about the topic and their strengths and weaknesses. It is not simply a summary of materials that you've collected, but a critical appraisal of them. 

Citation: Dena Taylor, University of Toronto Health Sciences Writing Center. 

What Makes a Good Literature Review?

A good literature review demonstrates that you have done two things skillfully: 

• Comprehensive scan of the literature: you have demonstrated your ability to scan through the literature on a given topic. 
• Critical evaluation of the literature: you have thoroughly dissected the arguments within the literature, identifying controversies, strengths, and weaknesses. 

A good literature review must also do these four things: 

• Have a good organizational structure, and be related directly to your topic or thesis. 
• Synthesize results into a summary of what is known and what is not known on your topic. 
• Identify areas of controversy within the literature. 
• Formulate further questions or gaps in the literature that need to be addressed. 

Questions to Ask

When exploring resources for your literature review, it's important to ask yourself questions about each resource that you're thinking of including. Questions like the following list can be helpful for this. 

• Who is the author? What professional affiliations do they have? Do they have a reputation in the field? 
• What references does this source cite? Do they even have a citation or reference list? 
• Who is the intended audience for this source? 
• What is the content of the source? Does it appear to be fact,  opinion, or something else? 
• How comprehensively does this source cover the topic? Is there anything missing? 
• Does the source use objective language? 
• Is the source accurate, or, does it line up with other sources you've found on the topic? 
• When was the source published? 
• Are the source's arguments backed up with evidence? 
• Does the source acknowledge other viewpoints? 

Question list based off of Purdue University's OWL: Evaluation During Reading.  

Furthermore, ask yourself: 

• How are your sources similar in terms of their methodologies, theories, claims, choice and interpretation of evidence, etc? 
• How do they differ in these regards? 
• Do you observe gaps in the research or areas that require further study? 
• Do particular issues or problems stand out? 

Source:  Duke University Writing Studio

Search Tips for Literature Reviews

• Use the boolean operator "AND" to tie in related search terms, or use "OR" if you have two terms that you are using for the same topic. 
• Do a little digging to see if the articles they site would be useful for your own research. 
• Different articles can refer to the same topics in different ways, so it's important to brainstorm your keywords and mix up the phrasing or subtopics, if applicable.
• If you're still struggling to find articles, schedule a meeting with your librarian for more help. 

What Materials Should I Include in My Literature Review?

This depends on the context of your research topic. 

Usually, scholarly books (also called monographs) and articles are included in humanities literature reviews. 

Sometimes, you can also include newspaper articles , historical/primary source materials , government publications , and/or professional literature (also called grey literature). 

If you have any confusion about what sources you can or should include, reach out to Professor Aleci or your librarian, Anna. 

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Subject Guide

Literature Review & Research Methods

What is a literature review?

Research Methods in General

• Research Methods Books
• Search Strategies
• Evidence Based Practices Module
• Qualitative Research
• Quantitative Research

In brief, the lit review is the part of a scholarly paper that discusses the relevant research, theoretical and methodological contributions on the topic. Watch these videos to learn more!

Here are some books that are useful in learning about and improving the research process.

Research Methods in Social Science

Here are some books that discuss researching methods specifically for the social sciences in general, and African American studies in particular.

Search Strategies 

1. Use the following  keywords  to identify qualitative research.  

These keywords will search the titles, abstracts and keywords of records held in the databases. Use quotations to search as a phrase:

2. Use  controlled vocabulary

Databases use controlled vocabulary to categorize each record stored. The terms they use are known as  thesaurus terms  or subject headings .  The thesaurus terms vary for each database according to their indexing system.

For example, qualitative research is indexed in  PubMed  as "Qualitative Research" or "Nursing Methodology Research", while in CINAHL  their subject heading "Qualitative Studies" is complemented by more detailed terms, including "Phenomenological Research" and "Grounded Theory".

Tutorials  for searching subject headings:

3. Use  qualitative research filters

Qualitative research filters are pre-formulated search strategies that have been constructed by librarians to help you retrieve articles in databases that deal with qualitative research. You can use the filter and then combine the results with your subject.

• Go to  PsychINFO  database in  Database Finder .
• Enter your topic in the search box.
• In right column, under  Methodoly,   MATHEMATICAL MODEL , select  Qualitative study .
• Under  Refine Search  section on the left, limit further your search under  Methodology  drop down menu.

Modify your search strategy accordingly by using thesaurus terms, such as qualitative research, grounded theory, interviews, observation methods, etc.

• Evidence Based Practices Module The IRIS Center at Vanderbilt Peabody College has created a 3 part module to walk you through the theory and application of evidence based practices.

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Art and Business pp 21–47 Cite as

Systematic Literature Review in the Field of Art and Business

• Stefania Masè   ORCID: orcid.org/0000-0002-4685-4453 17  
• First Online: 30 August 2020

567 Accesses

1 Citations

Part of the book series: International Series in Advanced Management Studies ((ISAMS))

As a burgeoning area of research, Arts and Business still lacks clearly defined boundaries, thus requiring the largest possible contribution from previously validated research. So as not to neglect any important contributions, the review of the relevant literature which follows focuses mainly on research conducted in the area of management. In order to assure that literature review was as complete as possible, we adopted a method called systematic literature review. After an overview of this methodology, its application will be deeply described. A description of the results obtained will follow, together with the main literature strands highlighted in the field of Art and Business.

This chapter is revised and updated from the author’s dissertation Art & Business from sponsorship and philanthropy to the contemporary process of artification , Sorbonne U. and Macerata U. completed in 2016.

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It should be noted, that Daragh O’Reilly’s study refers to the article by Rentschler and Kirchner entitled “Who is publishing and citing arts management/marketing articles? Examining the external impact of arts management journals,” published as act of the ninth International Colloquium on Arts, Heritage, Non Profit and Social Marketing conference, held in King’s College of London in September 2010. For the present study, instead, article of Rentschler and Kirchner published in 2012 on Arts Marketing: an international journal has been used. The list of the major journals in the field of arts management has not changed in the two different versions of the research.

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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Processes and considerations, strengths and weaknesses of sota reviews, conclusions, understanding state-of-the-art literature reviews.

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Erin S. Barry , Jerusalem Merkebu , Lara Varpio; Understanding State-of-the-Art Literature Reviews. J Grad Med Educ 1 December 2022; 14 (6): 659–662. doi: https://doi.org/10.4300/JGME-D-22-00705.1

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Sometimes the literature review you need isn't one that answers a narrow question: for that we would use a systematic review to determine, for example, the best workplace-based assessment tool for a pediatric residency program. Sometimes educators are not interested in how individual theories addressing a phenomenon align and differ, an answer you would find via an integrative review. Instead, educators may need to know how the modern conceptualization of a specific phenomenon became the norm—including the history that informed current understanding, what that understanding is, and what might develop in the future. For example, to understand resident assessment, you might want to know its history, what the current orientation is, and what future expansions might occur. To answer such questions, educators and researchers turn to State-of-the-Art (SotA) literature reviews .

What Is a SotA Review?

SotA literature reviews provide a time-based overview of the current state of knowledge about a phenomenon and suggest directions for future research. 1   They are organized in relation to how the understanding of the phenomena has evolved over time. Structured around turning points in the history of knowledge development, SotA reviews articulate: This is where we are now. This is how we got here. This is where we should go next . By synthesizing how the main characteristics of a topic have changed over time to give rise to current understandings, SotA reviews offer a modern knowledge synthesis that “tend[s] to address more current matters in contrast to other combined retrospective and current [literature review] approaches.” 1   SotA reviews are used prolifically in many fields, such as biomedical science, medicine, and engineering, to provide information on the current understanding of a topic, the historical roots that shaped the understanding, and potential next directions for future research.

How Are SotA Literature Reviews Different From Other Knowledge Syntheses?

Given their time-based and turning point-based orientations, SotA reviews are inherently different from other types of knowledge synthesis. For example, systematic reviews focus on specific research questions that are narrow in scope; in contrast, SotA reviews present a broader historical overview of knowledge development. Scoping reviews focus on mapping the present state of knowledge about a phenomenon, including, for example, the data currently available, the nature of that data, and the gaps in knowledge. Conversely, SotA reviews offer interpretations of the historical progression of knowledge relating to a phenomenon, centered on significant shifts that occurred during that history. 2  

When Might SotA Reviews Be Used in Graduate Medical Education?

SotA reviews are especially useful within graduate medical education due to their purpose: these knowledge syntheses focus on the turning points that ended older ways of thinking and gave rise to current insights, while also evaluating where the field should go next. Thus, by conducting this type of review, educators and researchers in graduate medical education will be positioned to understand and apply modern best practices and to influence future directions. The Box illustrates the Case of Dr. Smith, which continues throughout this Journal of Graduate Medical Education (JGME) special review series, considering the same question using different review methodologies.

What Are the Orienting Assumptions of SotA Reviews?

Although SotA reviews are frequently published in peer-reviewed journals, there are few descriptions of how to conduct these knowledge syntheses, their markers of methodical rigor, and their reporting standards. We set out to address this gap by: (1) analyzing all publicly available and indexed methods-related publications describing SotA reviews, and (2) studying all SotA reviews (n=398) published between 2016 and 2020 to identify the foundational principles and techniques underpinning them. 3   Through this work, we developed a 6-stage process for conducting SotA reviews, 3   which aligns with the existing brief descriptions. 1 , 2 , 4 - 7   These 6 stages are summarized in a short how-to guide accompanying this article. 8   Here, we explain the orienting premises that shape SotA reviews.

Foundations of SotA Reviews

SotA literature reviews are founded on the principle that there is no single objectively true or correct synthesis of a body of literature. Instead, SotA reviews rest on the premise that literature is open for interpretation and that the context in which the review is conducted will shape the synthesis developed. SotA literature reviews are steeped in a relativist ontology: the nature of reality is socially and experientially informed and constructed. Consequently, SotA reviews do not require the literature included in the review to use identical methodology to support meta-analyses to generate a right answer. That is, not all findings synthesized in the review need to be carried out in the same way to enable cross-study data amalgamations. Instead—because SotA reviews assume that multiple different understandings of a phenomenon are available—this synthesis does not exclude research using different methodologies.

In terms of epistemology (the origins, nature, and limits of knowledge about reality), SotA literature reviews embrace subjectivism , the premise that knowledge generated from the review is a construction, not an objective fact. The knowledge generated through the review is value-dependent; it grows out of the subjective interpretations of the researchers who performed the synthesis. SotA reviews generate an interpretation of the literature informed by the expertise, experiences, and social context of the review team. Furthermore, the knowledge developed through SotA reviews is informed by the point in time when the review was conducted. A SotA review from 2000 reflects the contemporary knowledge of the year 2000; a SotA review from 2022 would report different knowledge reflecting that year's perspectives.

Purpose of SotA Reviews

SotA literature reviews seek (1) to create a critical summary of contemporary thinking about a topic; (2) to describe historical progressions and patterns in the literature; (3) to discuss how such modern perspectives have evolved over time; and (4) to propose a direction the field could take moving forward. Further, the SotA review presents an argument for how the literature could be interpreted; it is not a definitive statement about how the literature should or must be understood. The purpose of the SotA review is to engage in this critical summary at a specific point in time; it highlights the pivot points shaping the historical development of a topic, the factors that informed those changes in understanding, and the ways of thinking about and studying the topic that could newly inform the generation of further insights. Ultimately, the purpose of SotA literature reviews is to create a 3-part argument: This is where we are now in our understanding of this topic. This is how we got here. This is where we could go next .

To illustrate, Schuwirth and van der Vleuten's article, “A History of Assessment in Medical Education,” 9   offers a temporally organized overview of the evolving thinking in medical education about learner assessment. The authors describe how learner assessment was originally perceived as a problem of measurement, where the goal was to differentiate competent learners from incompetent ones. Historically, assessment was concerned with tool validity and replicability; human judgement was largely ignored. Even when assessment moved to include workplace-based assessment methods, the field continued to foreground assessment as a measurement problem. When human judgment was considered, the field focused on training assessors to minimize bias. Modern perspectives conceive of assessment as a whole system. Today, assessment data are integrated together to meaningfully triangulate data into a fair and defensible whole. Human judgement is recognized, but not as a bias to be mitigated. Instead, learners and assessors work together “to create a meaningful holistic narrative rather than a set of individual measurements.” 9   The authors suggest that the future of learner assessment will continue to focus on determining if a learner possesses and can apply appropriate knowledge and skills; in addition, information technologies and the availability of big data will shape future assessment considerations. These technologies will also require a reexamination of the knowledge and skills that will be required of future clinicians. Schuwirth and van der Vleuten's article thus offers a SotA review by providing an interpretation of the past, present, and future of learner assessment. 9  

A significant contribution of a SotA review is the historical overview of how thinking about a phenomenon has changed over time. Such descriptions are particularly valuable for those exploring a new phenomenon or field of inquiry, and for those seeking to identify contemporary best practices and conceptualizations. Further, a SotA review provides a comprehensive time-based overview of a body of knowledge. Educators and researchers have an opportunity not only to assess past, present, and future trends, but also to characterize the unique shifts and patterns occurring over a specific period of time. Finally, the scope of a SotA review can extend beyond peer-reviewed literature.

The purpose and foundations upon which SotA reviews are built constrains them from providing a direct answer to specific, narrow research questions. They do not offer definitive answers to readers; instead, they are subjective reviews offering one interpretation of how the literature could be interpreted. Alternative interpretations exist. Moreover, the moment in history when the review is conducted and the specific review team engaging in the synthesis will shape the SotA review. Thus, reflexivity considerations by the team should be provided so that readers fully understand how the research team reached their conclusions.

Markers of a SotA Review's Rigor

While many knowledge syntheses have reporting standards, no such guidance exists for SotA reviews. SotA reviews offer interpretations of a specific body of literature; therefore, appraising the quality of the literature and preserving objectivity of the analysis processes is not relevant. Instead, indicators of the quality of a review are connected to its transparency , including considerations such as: How was the collection of articles included in the synthesis created? What inclusion and exclusion criteria controlled the selection? What reflexivity considerations shaped the perspectives of the authors? What contextual factors contributed to shaping the analysis? The final search strategy must be included in the manuscript so that others can replicate the process. The purpose of a replication would not be to confirm the interpretations offered in the SotA review; instead, it would be for another team of researchers to offer their unique interpretations and insights. Another consideration is the breadth of literature included in the review. It is advisable to incorporate a wide range of papers (eg, commentaries, research articles, grey literature) since part of the purpose of a SotA review is to identify how and when a field of inquiry took on its current state. Such information is not necessarily found only in peer-reviewed journal articles.

A SotA review can be deemed a success if it offers a coherent description regarding the current state of knowledge of a phenomenon: This is where we are now in our current understanding of this topic. This is how we got here. This is where we could go next .

Until very recently, SotA reviews were highly used but underdescribed: no robust methodologies were offered, and no information existed about their epistemological and ontological backgrounds. We hope to redress this gap. It is important when reading older SotA reviews to look for the 6 stages presented in the accompanying short article 8   to help make meaning of the findings (additional resources are provided in the Table ). We recommend that the structure of future SotA reviews clearly articulate these 6 stages so that researchers can more easily assess the interpretations offered within.

Resources for Conducting a State-of-the-Art (SotA) Literature Review

Dr. Smith, a program director, has been tasked to develop an interprofessional education (IPE) experience for the residency. Dr. Smith decides that conducting a literature review would be a savvy way to examine the existing evidence and generate a publication useful to others. After running a quick Google search using the term “interprofessional education,” she finds more than 11 million hits, and a similar PubMed search generates 24 000+ matches—far too many to review. Dr. Smith begins to randomly sample articles and notes the huge diversity in how IPE is conceptualized and in the types of articles, from randomized trials to qualitative investigations to critical perspectives on issues of concern.

As Dr. Smith is interested in learning how IPE is currently conceptualized, how the field came to hold this conceptualization, and where the field should go next, she decides to complete a State-of-the-Art review. This will allow Dr. Smith to identify the seminal moments when thinking about how IPE has changed in graduate medical education, to understand today's conceptualization of IPE, how that conceptualization came to be, and to offer new ideas about where IPE should go next.

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Disclaimer: The opinions and assertions contained herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences or the US Department of Defense.

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State-of-the-art literature review methodology: A six-step approach for knowledge synthesis

Affiliations.

• 1 Department of Anesthesiology, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA. [email protected].
• 2 School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands. [email protected].
• 3 Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA.
• PMID: 36063310
• PMCID: PMC9582072
• DOI: 10.1007/s40037-022-00725-9

Introduction: Researchers and practitioners rely on literature reviews to synthesize large bodies of knowledge. Many types of literature reviews have been developed, each targeting a specific purpose. However, these syntheses are hampered if the review type's paradigmatic roots, methods, and markers of rigor are only vaguely understood. One literature review type whose methodology has yet to be elucidated is the state-of-the-art (SotA) review. If medical educators are to harness SotA reviews to generate knowledge syntheses, we must understand and articulate the paradigmatic roots of, and methods for, conducting SotA reviews.

Methods: We reviewed 940 articles published between 2014-2021 labeled as SotA reviews. We (a) identified all SotA methods-related resources, (b) examined the foundational principles and techniques underpinning the reviews, and (c) combined our findings to inductively analyze and articulate the philosophical foundations, process steps, and markers of rigor.

Results: In the 940 articles reviewed, nearly all manuscripts (98%) lacked citations for how to conduct a SotA review. The term "state of the art" was used in 4 different ways. Analysis revealed that SotA articles are grounded in relativism and subjectivism.

Discussion: This article provides a 6-step approach for conducting SotA reviews. SotA reviews offer an interpretive synthesis that describes: This is where we are now. This is how we got here. This is where we could be going. This chronologically rooted narrative synthesis provides a methodology for reviewing large bodies of literature to explore why and how our current knowledge has developed and to offer new research directions.

Keywords: Literature review; Literature review methodology; State-of-the-art literature review.

© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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State-of-the-art literature review methodology: A six-step approach for knowledge synthesis

Perspectives on Medical Education

Introduction Researchers and practitioners rely on literature reviews to synthesize large bodies of knowledge. Many types of literature reviews have been developed, each targeting a specific purpose. However, these syntheses are hampered if the review type’s paradigmatic roots, methods, and markers of rigor are only vaguely understood. One literature review type whose methodology has yet to be elucidated is the state-of-the-art (SotA) review. If medical educators are to harness SotA reviews to generate knowledge syntheses, we must understand and articulate the paradigmatic roots of, and methods for, conducting SotA reviews. Methods We reviewed 940 articles published between 2014–2021 labeled as SotA reviews. We (a) identified all SotA methods-related resources, (b) examined the foundational principles and techniques underpinning the reviews, and (c) combined our findings to inductively analyze and articulate the philosophical foundations, process steps, and markers of rigor. Results...

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ART, PERFORMANCE, AND LITERATURE

EDITED BY ALLISON PUJOL

The late Robin Williams, huddled amidst his angst-ridden, teenage students in the 1989 film  Dead Poets Society , makes a case for appreciating artistry as an intrinsic source of meaning: whereas “medicine, law, business, engineering . . . are noble pursuits,” the beauty of humanistic pursuits such as art, literature and performance “are what we stay alive for.” Spanning a variety of critical approaches towards the page, canvas and screen, this section of the  2024 Review of Books  responds to several recent pieces of scholarship about the very things that make life worth living. Specifically, these reviews center on the cultural  meanings  created by various creative works, and the ways in which artistic expression not only describe life but wholly define it.

First, Michael Vaclav’s review of  Latinx Shakespeares: Staging U.S. Intracultural Theater  by Carla Della Gatta opens the section with an overview of Latinx representations of Shakespeare plays in the 20th and 21st century, arguing that these performances engender meanings that can be evocative, healing and/or de-colonizing. Next, I.B. Hopkins’ review of Jennifer Lee’s  Oriental, Black, and White: The Formations of Racial Habits in American Theater  unpacks the “dual understanding of performance’s meaning-making process—that it simultaneously represents and produces difference” via Asian stereotypes in American theater. Then, Holly Genovese details the essential history of Black country music in a review of Francesca T. Royster’s B lack Country Music: Listening for Revolutions . In particular, Royster’s text focuses on the gendered dynamics which determine the role of Black women and men in their respective roles as Black country musicians performing for predominantly White audiences. Erin Wheeler Streusand’s review of Iván A. Ramos’  Unbelonging: Inauthentic Sounds in Mexican and Latinx Aesthetics  also examines meaning through the lens of the space “between belonging and unbelonging, between art forms that fuse and others that refuse to mix.” Lastly, Morgan Price’s review of  Latino TV: A History  by Mary Beltran ends the section with a depiction of decades of Latino representation in television, describing the ways stereotypes of Latinx people were both upended and reinforced in various TV performances.

Art, performance and literature, as critically examined by all of the texts reviewed in this section, are vital parts of the human experience. These things give life meaning and shape our lived experiences. It is our hope as reviewers that this section encapsulates and indeed demonstrates the complex ways that creative expression leaves an indelible effect on human life, that we may echo Williams’ powerful statement in  Dead Poets Society : “That you are here—that life exists, and identity . . . That the powerful play  goes on  and you may contribute a verse. What will your verse be?”

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Effectiveness of Art Therapy With Adult Clients in 2018—What Progress Has Been Made?

In the year 2000, an important art therapy literature review addressed an essential question—does art therapy work? It discussed 17 articles dealing with the issue of the effectiveness of art therapy. Two decades later, this research field has extended its scope and is flourishing. Several current reviews of research work have described the broad range of methods implemented today, which includes qualitative and quantitative studies; other reviews have focused on art therapy with specific populations, or by age group. The aim of this systematic literature review is to contribute to the ongoing discussion in the field by exploring the latest studies dealing with the effectiveness of art therapy with a broad scope of adult clients. We conducted a comprehensive search in four databases and review of every quantitative article that has addressed outcome measures in the art therapy field from 2000 to 2017. This paper presents the latest 27 studies in the field that examine the effectiveness of art therapy with adult clients and divides them into seven clinical categories: cancer patients, clients coping with a variety of medical conditions, mental health clients, clients coping with trauma, prison inmates, the elderly, and clients who have not been diagnosed with specific issues but face ongoing daily challenges. It underscores the potential effects of art therapy on these seven clinical populations, and recommends the necessary expansions for future research in the field, to enable art therapy research to take further strides forward.

In 1999, nearly two decades ago, the American Art Therapy Association (AATA) ( 1999 ) issued a mission statement that outlined the organization's commitment to research, defined the preferential topics for this research, and suggested future research directions in the field. One year later, Reynolds et al. ( 2000 ) published a review of studies that addressed the therapeutic effectiveness of art therapy. They included studies that differed in terms of research quality and standards. In eight studies by different authors, there was a single group with no control group; in four studies, there was a control group, but no randomization of the participants between the experimental group and the control group; and in only five studies was there randomization of the experimental group and the control group (RCT - Randomized Control Trial). They concluded that there was a substantial need to expand research in the field of art therapy to better determine the most appropriate interventions for different populations.

Two decades later, the field of research in art therapy has developed considerably. There are several reviews in the field that describe the expanding body of research work. Some of these reviews present studies that have examined the effectiveness of art therapy, without distinguishing between different populations. For example, as an extension of the work and review by Reynolds et al. ( 2000 ), Slayton et al. ( 2010 ) reviewed articles published between 1999 and 2007 that measured the outcome of art therapy sessions with different populations. Their review included qualitative studies, studies based on a single client in therapy, studies with no control groups, studies with a control group but with no randomization, and a small number of studies with a control group and randomization. They concluded that there has been progress in the field, but further research is needed. Four years later, Maujean et al. ( 2014 ) summarized high-quality studies that implemented RCT that focused on art therapy with adults. They found eight such studies that were conducted between 2008 and 2013. Seven reported beneficial effects of art therapy for adult clients, but they also concluded that more reliable controlled studies were needed to draw conclusions.

Together with these comprehensive reviews, many literature reviews have appeared in recent years discussing specific populations and a range of research methods. For example, in the field of art therapy for adults, Holmqvist and Persson ( 2012 ) overviewed art therapy studies on clients with psychosomatic disorders, eating disorders, or facing crises, based on case studies and intervention techniques. They concluded that there were not enough studies to prove that art therapy is effective for these specific disorders. Similarly, Geue et al. ( 2010 ) and a year later, Wood et al. ( 2011 ) examined art therapy with cancer patients. They assessed quantitative and qualitative studies and found that most studies have dealt with women suffering from breast cancer. They also documented the intervention techniques that were specifically used with this population, and reported that overall, the quantitative studies reported an improvement in a number of emotional domains faced by these clients. Another article by Huet ( 2015 ) reviewed articles dealing with ways to reduce stress in the workplace through art therapy intervention techniques. In this article, a total of 11 articles were discussed that employed different research methods. The authors focused on describing different ways to use art therapy in this context and argued that there has been a gradual emergence of a vast body of knowledge that reinforces the benefits of art therapy for people working in stressful work environments.

In the past three years, a number of literature reviews of controlled quantitative studies have dealt more specifically with the issue of the effectiveness of art therapy in treating specific populations. Schouten et al. ( 2015 ) overviewed quantitative studies in art therapy with adult trauma victims. They found that only six studies included a control group (only one of which included randomization) in this field. Half reported a significant reduction in trauma symptoms and another study found a decrease in the levels of depression in clients treated with art therapy. They pointed out that it is difficult to produce quantitative meta-analyses in art therapy given the limited size of the groups and because the evaluation is often based on several therapeutic methods that are used simultaneously. Further Uttley et al. ( 2015a , b ) reviewed all the studies dealing with art therapy for adult clients with non-psychotic psychiatric disorders (anxiety, depression, and phobias). They found 15 randomized controlled quantitative studies of which 10 indicated that the therapeutic process was effective (positive changes following therapy in comparison to the control group). They were unable to conduct a meta-analysis due to the clinical heterogeneity and lack of sufficient information in the studies. In addition, they reviewed 12 qualitative studies that provided data on 188 clients and 16 therapists.

This article deals with research that focuses on measuring the effectiveness of art therapy. It addresses two major challenges. The first is the definition of the term “effectiveness.” We adopted the definition suggested in Hill et al. ( 1979 ); namely, “the attribute of an intervention or maneuver that results in more good than harm to those to whom it is offered” (p. 1203). The current review takes a positivist perspective (Holton, 1993 ) and relates to the measurement of effectiveness reported in quantitative studies that have been conducted in the field. Since the field of art therapy is still young, the scope of research is limited and the quality of research is diverse, which makes it difficult to create a comparative review that presents the knowledge in the field and draws thorough conclusions. Therefore, our review is based on the systematic review framework proposed in Case-Smith ( 2013 ) who divided the studies she reviewed into three levels of evidence. Level 1 refers to randomized controlled trials (RCT's), level 2 refers to nonrandomized two-group studies, and level 3 refers to nonrandomized one-group studies.

The second challenge has to do with the definition art therapy. We applied the standard definition provided by the American Art Therapy Association:

• Art therapy, facilitated by a professional art therapist, effectively supports personal and relational treatment goals, as well as community concerns. Art therapy is used to improve cognitive and sensorimotor functions, foster self-esteem and self-awareness, cultivate emotional resilience, promote insight, enhance social skills, reduce and resolve conflicts and distress, and advance societal and ecological change (American Art Therapy Association, 2018 ).

This definition makes it clear that art therapy is a process that takes place in the presence of a certified art therapist, and indicates different areas where an effect or outcome in therapy can be expected as a result of this form of treatment.

Thus, the research question was formulated according to “PICOS” components (The PRISMA Group et al., 2009 ): Is art therapy effective for adult clients as measured in results published from 2000 to 2017, in various quantitative studies corresponding to Levels 1, 2, 3 (Case-Smith, 2013 )? These studies assessed the effectiveness of art therapy on variety of indices including symptoms and physical measures, health or mental health assessments, quality of life assessment, or coping resources. These indices were typically evaluated through questionnaires and occasionally by projective drawings or physiological indices.

By posing this question, this systematic review joins the ongoing discussion in the field on the level of effectiveness of art therapy with adult clients. This forms part of the academization process in the field of art therapy, which involves attempting to relate intervention techniques in the field with their significance for theoretical research.

The search for relevant articles was carried out during the month of January 2017. Four major electronic databases were searched: Medline, PsycInfo, Scopus, and Web of Science. We searched for the term “art therapy” in the databases combined with the terms “Effectiveness,” “Efficacy,” “Outcome,” “Measurement,” “Treatment,” and “Intervention.” We restricted the search in the databases to articles published in English since the year 2000 for reasons of recency and the continued relevancy of the findings. In addition, all the literature reviews in the field (such as those reviewed above) were examined to locate additional articles that were pertinent to this study.

During the initial screening stage, the abstracts were read by both authors (who are certified art therapists) to exclude those that were irrelevant to the purposes of the study. At this point 151 articles remained (see Figure ​ Figure1 1 ).

Search process.

In the next stage, the remaining articles were read and selected if they met the following inclusion criteria (see Figure ​ Figure1 1 ):

• - Reported a quantitative assessment of the effectiveness of art therapy on a sample of clients. Hence case studies, method descriptions, qualitative analyses, and literature reviews that did not meet these criteria were omitted. A total of 80 articles were removed at this stage.
• - Enabled the assessment of the unique impact of art therapy. We thus omitted articles that described the use of a combination of therapeutic intervention techniques with a variety of art mediums simultaneously, not only visual art. A total of 14 articles were omitted at this stage.
• - The art therapy was conducted in an ongoing manner in the presence of a certified art therapist. We thus omitted articles that described art intervention techniques that were not used in the context of therapy or were used in one-off art therapy interventions or therapy sessions with a non-certified art therapist. A total of 17 articles were removed at this stage.

Articles that met these inclusion criteria were defined as articles that examined the “effectiveness” of Art Therapy, and that quantified the impact of art therapy in a measurable way. A total of 37 studies were located in 40 articles (three studies were published in two different articles each). Of the 40 articles, 27 dealt with adult populations and are covered in this systematic review. This article categorizes mentioned articles in terms of the levels of evidence proposed by Case-Smith ( 2013 ).

The findings derive from the 27 studies that we considered to have met the inclusion criteria. The choice to present the studies as a review rather than as a meta-analysis is due to the emergent nature of the field of art therapy. There is insufficient research in the field and the differences between studies and the indices measured are so great that it was impossible to produce a meta-analysis that would yield meaningful results (much like Uttley et al.'s conclusion, 2015a,b ). In addition, the authors discussed the issue of the clinical categorization until full agreement was reached, to enable the reader to access the knowledge in the field in a way that will allow and encourage researchers to continue to conduct research. For samples where there has been more research (for example, art therapy with cancer patients), this area could have been separate and examined in and of itself, and relevant conclusions specific to this population could have been drawn. However, for other populations there was often a scarcity of studies which led us to group and categorize populations with similar characteristics (for example, medical conditions).

The next section presents the findings categorized into seven clinical categories. Different research methods were used: 17 of the articles (15 studies) used a comparison group with randomization (Level 1), five articles (four studies) used a comparison group without randomization (Level 2), and five articles used a single group without a comparison group (Level 3). In addition, there was a notable gender trend in that nine of the articles only examined women whereas only two of the articles exclusively referred to men. Sixteen did not define the research population by gender.

Category 1: cancer patients

The first category consisted of art therapy with cancer patients (see Table ​ Table1). 1 ). Six studies that examined effectiveness have been conducted with this specific population since 2006 and have been described in seven different articles (Monti et al., 2006 , 2012 ; Oster et al., 2006 ; Öster et al., 2007 ; Bar-Sela et al., 2007 ; Svensk et al., 2009 ; Thyme et al., 2009 ). Five of the six studies were randomized (Level 1) and five dealt with women, most of whom had breast cancer. The total sample size ranged from 18 to 111 clients, most of whom were treated individually. Most of the therapeutic processes were short-term and ranged from five to eight sessions.

Cancer patients.

Some of the studies utilized different streams of art therapy. For example, the largest study of 111 participants, (Monti et al., 2006 ) included a mindfulness-based art therapy intervention—a combination of art therapy with mindfulness exercises. The measurement indices were very different for these studies and included questionnaires that examined physical symptoms, coping resources, quality of life, depression, anxiety, and fatigue. One specific study (Monti et al., 2012 ) also dealt with fMRI measurements. The findings of this category suggest that through relatively short-term interventions in art therapy (primarily individual therapy), it is possible to significantly improve the emotional state and perceived symptoms of these clients.

Category 2: medical conditions

The second category consisted of art therapy with clients coping with a variety of medical conditions that were not cancer-related (see Table ​ Table2). 2 ). Three studies examining the effectiveness of art therapy have been conducted since 2011, each of which deals with a completely different medical condition and employs a different research method. The earliest study dealt with art therapy with clients with advanced heart failure (Sela et al., 2011 ). This study had a sample size of 20 clients who were randomly divided into two groups (level 1). The clients participated in group art therapy for 6 weeks. A 2013 study addressed art therapy with clients coping with obesity (Sudres et al., 2013 ). This study examined 170 clients who were randomly divided into two groups (level 1). One group consisted of 96 clients who received art therapy for 2 weeks. A 2014 study addressed art therapy with 25 clients with HIV/AIDS (Feldman et al., 2014 ), who received art therapy in individual or group settings and did not include control groups (level 3). The duration of the therapeutic process was one or more sessions. Despite the considerable differences between the populations and the indices measured, these preliminary studies present an introductory description that points to the potential of art therapy to assist these populations.

Medical conditions.

Category 3: mental health

The third category covered art therapy with mental health clients (see Table ​ Table3). 3 ). Four studies have been conducted since 2007 (two articles written on the same study—Crawford et al., 2012 ; Leurent et al., 2014 , see Table ​ Table3). 3 ). Research in this category falls into two main diagnostic areas. The first covers two studies on individuals with schizophrenia (Richardson et al., 2007 ; Crawford et al., 2012 ; Leurent et al., 2014 ) that involved randomization (level 1) with large samples (90-159 clients). The therapeutic process ranged from 12 sessions to a full year of therapy and included group therapy. The variety of indices that were used in these studies include measures of function, relationships and symptoms. Despite the attempt to use different types of research indices, in both studies, little or no effect was found to be associated with art therapy. Two studies were classified into the second diagnostic area: one addressing clients with psychiatric symptoms (Chandraiah et al., 2012 ) (level 3) and the other addressing women coping with depression (Thyme et al., 2007 ) (level 1). The therapeutic process ranged from 8 to 15 weeks. The findings reported in both studies suggested a change occurred in the duration of the therapeutic process. However, since neither study compared clients who received art therapy with those who received no therapy, it is difficult to evaluate the effectiveness of art therapy. Hence, the accumulated results of the studies in this category suggest that further research is needed to assess the effectiveness of interventions in art therapy for clients dealing with mental health issues.

Mental health.

Category 4: trauma victims

The fourth category included art therapy with clients coping with trauma (see Table ​ Table4). 4 ). In this category, two studies have been conducted since 2004, both with randomization (level 1). The first study (Pizarro, 2004 ) was composed of a sample of 45 students who participated in two art therapy sessions. These students had dealt with a traumatic event, which could occur at different levels of intensity and at various stages in their lives. In addition, the comparison was made between an art-therapy group and two comparison groups where one underwent writing therapy and the other experimented with artwork, regardless of the traumatic event. Despite the attempt to use a wide range of indices, including symptom reporting and emotional and health assessments, and perhaps because of the short duration of therapy, this study failed to find significant results.

Trauma victims.

The second study (Kopytin and Lebedev, 2013 ) examined a sample of 112 war veterans who participated in 12–14 art therapy sessions. In this study, in which the definition of the traumatic event was more specific and defined by involvement in war, an attempt was also made to measure the level of improvement through a wide range of research indices, including reports of symptoms, emotional state, and quality of life. For some of the indices, there was a significant improvement compared to the control group.

These two articles thus present an inconsistent picture of the beneficial effects of this intervention, which may depend on the indices measured, the duration of therapy, and possibly the type of traumatic event.

Category 5: prison inmates

The fifth category deals exclusively with David Gussak's extensive research on art therapy with prison inmates (Gussak, 2004 , 2006 , 2009a , b ) (see Table ​ Table5). 5 ). In this area three effectiveness studies have been conducted since 2004 (two articles were written on the same study; see Table ​ Table5). 5 ). The first examined an intervention group without a control group (level 3), in contrast to the other two studies which did include control groups (level 2); the sample sizes ranged from 48 to 247 participants in the 2009 study. The art therapy intervention was carried out in a group setting and lasted 4 weeks in the first study to 15 weeks in the most recent study. Initially, Gussak used measurements solely from drawings (FEATS), but in later and more comprehensive research, depression and locus of control were also assessed. In the three studies, there was a reported improvement attributed to the art therapy intervention, as seen in the emotional state of the prison inmates.

Prison inmates.

Category 6: the elderly

The sixth category covered art therapy with the elderly (see Table ​ Table6). 6 ). Three effectiveness studies have been conducted since 2006: one study was conducted with healthy Korean American older individuals (Kim, 2013 ), the second study involved older individuals coping with depression (McCaffrey et al., 2011 ), and the third dealt with older individuals with moderate to severe dementia (Rusted et al., 2006 ). In all three studies, the participants were randomly divided into groups (level 1), in a group therapy setting, with a sample size of 39–50 clients. The number of sessions ranged from 6 to 40. The authors of these studies were interested in a variety of indices. In both the study of elderly Koreans and the elderly coping with depression, various aspects of the emotional state of the clients were measured. Art therapy was considered to have led to an improvement on these measures. In a study of older people with dementia, many observational measures were used to assess emotional states, behavior, and abilities, but change was found only in some of them.

The Elderly.

The findings suggest that art therapy seems to have a beneficial effect on older individuals who are coping with a variety of challenges in their lives, as reflected in the changes in the indices in these studies.

Category 7: clients who face ongoing daily challenges

The seventh category consisted of art therapy with clients who face ongoing daily challenges that do not fall into one diagnostic category (see Table ​ Table7). 7 ). Three studies have been conducted since 2008, two of which address issues such as stress, distress, and burnout of individuals working in various health professions (Italia et al., 2008 ; Visnola et al., 2010 ). These studies were carried out without randomization; in one study (Visnola et al., 2010 ) there was a control group (level 2), whereas in the other (Italia et al., 2008 ) there was not (level 3). The sample size ranged from 20 to 60 participants. The therapeutic process lasted 9–13 sessions in a group art therapy setting. These studies suggest that art therapy can help healthcare professionals reduce levels of stress, anxiety, and burnout connected to their work.

Clients who face ongoing daily challenges.

The third article addresses art therapy for women undergoing fertility treatment (Hughes and da Silva, 2011 ). The sample only included an intervention group (level 3) consisting of 21 women in a group art therapy setting. This study reported a reduction in anxiety and in feelings of hopelessness. The samples in the studies in this category were relatively small and usually did not include a control group. However, there is potential for further research in this area.

Discussion and conclusion

The purpose of this review was to assess whether art therapy is effective for adult clients as measured in quantitative studies published from 2000 to 2017. Notably, since the Reynolds et al. ( 2000 ) review, the body of knowledge in this field has grown and established itself significantly, and a growing number of RCT studies (level 1) have been conducted with larger sample sizes. The advantage of such studies lies in the lesser likelihood of Type I errors as opposed to other studies with no control group or studies that have a control group but no randomization. Nevertheless, there are still only a small number of studies addressing each population, and these studies differ considerably in terms of the course of the therapeutic process, the proposed interventions and the indices that were examined, hence making a meaningful meta-analysis impossible. The findings however are largely encouraging and show a growing trend toward conducting more carefully designed studies that lend themselves to validation and replication; yet—there is a long road ahead. In the past, the effectiveness of art therapy was noticeable to those involved in the field, but less to other professionals. Today, by contrast, there are impressive published findings in a variety of areas. These studies can help expand the contribution of art therapists in other areas and with other populations.

During our search, we were struck by the large number of articles which appear to present interventions in the field of art therapy, but in fact were conducted by non-certified art therapists or were restricted to a therapeutic intervention of a single session in a manner that would not be considered therapy. The existence of such studies emphasizes the continued need to define, clarify and specify what art therapy is and what it is not, and specifically to clarify that this type of therapy must be composed of ongoing sessions and be conducted by a certified art therapist who meets the criteria defined for the profession (American Art Therapy Association, 2018 ).

The first two clinical categories dealt with clients who are coping with a variety of medical conditions. In this section, we were surprised by the vast amount of research in the field of art therapy with cancer patients, most of which were categorized as level 1. Art therapy emerges strongly as a way to enhance their quality of life and their ability to cope with a variety of psychological symptoms. Our review supplements previous reviews in the field (Geue et al., 2010 ; Wood et al., 2011 ) and shows that the findings on art therapy with cancer patients are primarily based on higher levels of evidence studies with randomization and relatively large samples.

The second category, which dealt with clients with a range of medical problems, was intended primarily to list the preliminary research in this field, due to the wide variability between the different populations. The differences in the populations treated suggests that, the measurement tools should be adapted to each type of medical issue. The only instrument that could possibly be applied to all these populations in future research is one that measures improvement in quality of life. It is surprising to note that unlike research on cancer patients, which has been considerable, there have been few studies on individuals with other medical conditions.

The third category dealt with clients with mental health issues. In this category we focused solely on adult clients (as opposed to children which will be reviewed in a separate article) and differentiated from the elderly (category 6). In addition, they were separated from clients coping with trauma (category 4). As a result, a relatively small number of studies met the strict criteria of this review regarding what could be defined as art therapy for clients with mental health issues, although some of the studies had large sample sizes and showed a higher level of evidence. For clients coping with schizophrenia, the reviewed findings are not optimistic. These data are congruent with the many articles on psychotherapy that have addressed this population and have emphasized the complexity of treating such individuals (Pfammatter et al., 2006 ). Studies have shown that the most effective therapeutic approach for this population appears to be cognitive-behavioral (Turner et al., 2014 ). Thus, future work should examine the effectiveness of the cognitive-behavioral approach in art therapy for this population. More research is also needed to better understand how art therapy can be effective with clients experiencing other mental health issues.

The fourth category addressed clients coping with trauma. While there have been few studies in this field, all of them are in a higher level of evidence. It is important to note that these studies did not assess post-traumatic stress disorder (PTSD), but rather individuals who have dealt with traumatic events. Even though the first study (Pizarro, 2004 ) did not confirm the effectiveness of art therapy, the limited number of sessions with each client may have been a major factor. When dealing with trauma, there is a need for thorough processing of the experience, and it is quite possible that two sessions were insufficient. The second study (Kopytin and Lebedev, 2013 ) reported that art therapy was beneficial when the intervention lasted longer. These data are consistent with the Schouten et al. ( 2015 ) review. Certain studies reviewed by Schouten et al. ( 2015 ) were not mentioned in our review because some were not published as articles, and others included single session interventions that were not led by a certified art therapist.

The fifth category addressed prison inmates. In this field, it is worth mentioning the work of Gussak, a researcher who has studied the field and conducted several studies with an increasing number of participants. His findings undoubtedly point to the potential of art therapy for inmates particularly in long term interventions.

The sixth category addressed the elderly. The field of geriatric art therapy has been gaining momentum in recent years (Im and Lee, 2014 ; Wang and Li, 2016 ). It is clear from the articles that group therapy sessions are particularly suitable for these clients and that it is important to continue conducting research to target effective intervention methods for this population. The research findings certainly indicate the potential of this field.

The seventh and final category dealt with clients who are facing daily challenges in their lives. The findings suggest that art therapy can be a suitable form of treatment and a way to mitigate issues such as stress and burnout at work.

Overall, this review documents the extensive research conducted in recent years; although qualitative studies were not included in this article, there is no doubt that using a variety of research methods can help expand knowledge in the field. As concerns quantitative studies, the review examined the effectiveness of art therapy for adult clients from research in the field from recent years and with reference to seven clinical categories.

The current review has several limitations. First, due to the small number of studies in the field, it includes various levels of quantitative studies. Some lack comparison groups and others include comparison groups with other treatment methods (for example verbal therapy). This variability makes it difficult to generalize across findings, but not mentioning these studies would have led to the inclusion of an even smaller number of studies. Second, in many studies there are several indices of varying types (questionnaires, drawings, physiological indices). Occasionally, only some of these indices led to demonstrable indications of the effectiveness of art therapy. Due to the complexity of the findings, we were not always able to detail these subtleties and challenges in the current review, and future researchers interested in the field should examine these specific studies closely before conducting further research on the same population. In addition, due to the limited number of studies in this field, we needed to combine various subjects in certain cases, make decisions, and create artificial categories based on our professional knowledge and judgment. For example, the article on female infertility (Hughes and da Silva, 2011 ) was placed in the seventh category of ongoing and daily challenges, and not in the second category of medical problems, due to the feasibility of this condition for various reasons, which are not necessarily medical.

Research in the field can be expanded in several ways. First, art therapy is a very broad domain that covers diverse populations, some of which have not yet been studied at all in the context of treatment effectiveness. Second, based on the conclusions derived from this review future studies should be planned so that they are performed by a certified art therapist, over a continuous period of time and on large enough samples. In so doing, within approximately a decade, it should be possible to produce a meaningful meta-analysis based on significant and comparable findings from the field, which could lead to more advanced and specific conclusions. Third, in order to raise the level of research in our field, it is important for researchers to devote time and thought to planning studies at the highest level (level 1). Large samples are not enough; one should also consider well-controlled studies (RCT), the blindness of the experiment, the blindness of the participants and the experimenters to the purpose of the research, the division of research groups and so on (Liebherz et al., 2016 ; Munder and Barth, 2018 ). Finally, it is of great importance that researchers will select valid and reliable research tools that have been used extensively.

This documentation of the numerous studies on the effectiveness of art therapy was long and complex, but also filled us with hope. We are optimistic that this article will take the field one step further in this direction.

Author contributions

All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Literary Gold From the Gilded Age, in Poster Form

For lovers of vintage books and periodicals, “The Art of the Literary Poster” celebrates a vibrant niche in late-19th-century advertising.

By Leah Greenblatt

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Trends come and go; one era’s tulip fever is another’s Beanie Baby craze. The vogue for literary posters burned briefly, beginning in 1893 and lasting not much more than a decade. But the body of work it produced often hewed closer to fine art than advertisement, and slyly captured the zeitgeist of the times: a bellwether for the modern man or woman whose fondness for the intellectual enrichment of periodicals like Collier’s and Harper’s Magazine was matched only by an aggressive commitment to physical health and attractiveness. (See Charles Arthur Cox’s rendering of five lithe beauties on a tandem bicycle, leisurely perusing the latest copy of Bearings. Gibson Girls who read!)

Images like these, as Allison Rudnick writes in her introduction to “The Art of the Literary Poster” (Metropolitan Museum of Art/Yale University Press, $50) , “epitomized the vanguard in graphic design.” (Rudnick is an associate curator at the Met, where an exhibit featuring dozens of these artifacts runs through June 11). They also provided a rare platform for gifted female illustrators of the era like Florence Lundborg and Ethel Reed — even if those efforts were often damned with faint, feminizing praise in contrast to the output of their male counterparts.

Success in the field could indeed be arbitrary; an entry by a young Maxfield Parrish in a contest sponsored by a now-defunct monthly called The Century allegedly earned him only second prize because his submission required four colors rather than three to produce. Even in monochrome, though, these works would still dazzle: artifacts of a vanished world in which ads were objects of beauty, and reading — even on two wheels — was indelibly, indubitably chic.

Art and Museums in New York City

A guide to the shows, exhibitions and artists shaping the city’s cultural landscape..

The Rubin will be “reimagined” as a global museum , but our critic says its charismatic presence will be only a troubling memory.

How do you make an artwork sing? Let your unconscious mind do it . That’s the message of an alluring show at the Japan Society.

At Tiffany’s flagship, luxe art helps sell the jewels . This 10-story palace is filled with famous names, for a heady fusion of relevant, and discomfiting, contemporary art and retailing.

A new exhibition tells the dealer’s story of how two rising stars, Larry Gagosian and Jean-Michel Basquiat, worked together in Los Angeles  in the ’80s.

A bounteous and playful survey of Joan Jonas ’s, career on the vanguard highway fills the museum and the Drawing Center with the 87-year-old artist’s work..

Looking for more art in the city? Here are the gallery shows not to miss in April .

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Tremor by Teju Cole audiobook review – colonialism’s long shadow

Atta Otigba and Yetide Badaki narrate a sprawling, multifaceted exploration of the entrenched hierarchies within the worlds of art, literature, history and pop culture

A t the start of Tremor, Tunde, a Nigerian-American photography professor at a New England university, is on his way to work when he pauses to photograph a hedge. “You can’t do that here,” a voice calls out. “This is private property.” Cole’s third novel goes on to follow Tunde’s movements over several months during which he reflects on how people of colour are treated in supposedly white spaces and the ways colonialism reverberates down the generations.

During a seminar, Tunde struggles to keep his emotions in check when a student shows a short film about Samuel Little, a prolific serial killer who went undetected for decades owing to his victims being Black female sex workers. While shopping for antiques in Maine with his partner, he reflects on the violence wreaked on Native American communities in the area, setting him on a train of thought that takes him from Bach’s solo works to the John Wayne movie The Searchers to the Salem witch trials. But the book’s centrepiece is a series of first-person snapshots that show the struggles of assorted Lagos residents, among them a drug addict, a chauffeur, a DJ and a headteacher.

Alternately narrated by voice actor Atta Otigba and American Gods’ Yetide Badaki, both of whom lean into Cole’s calmly hypnotic prose, Tremor is an inventive patchwork of portraits, memories and reflections that span art, literature, history and popular culture. Through this ambitious cauldron of ideas, Cole asks us to pay attention to entrenched attitudes and hierarchies and to understand the lens through which we each see the world.

Tremor is available from Faber, 7hr 49min

Further listening

The Women Kristin Hannah, Macmillan, 14 hr 55 min After her older brother leaves to serve in Vietnam, Frankie, a 21-year-old nursing student, impulsively joins the Nursing Corp so that she can follow in his footsteps. Read by Julia Whelan.

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The House of Hidden Meanings RuPaul, HarperCollins, 7 hr 6 min The Drag Race icon narrates his memoir detailing his path from poverty in San Diego to the early 1980s punk and drag scenes in Atlanta, to global fame and success via RuPaul’s Drag Race.

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