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Background: Art therapies have a long tradition in the therapeutic portfolio. In recent years, a large number of publications have emerged on the evidence of the effectiveness of art therapies. The aim of the systematic review was to create a comprehensive overview of the effects of this form of therapy in various indication areas.

Methods: The systematic review was pre-registered under the PROSPERO ID CRD42021233272. Inclusion criteria were a) the use of active visual art therapy (AVK) with therapeutic aims, b) studies with a randomized controlled design, and c) control groups that used interventions other than AVK. The systematic literature search was carried out in ten databases, including the Cochrane Library, Embase and MEDLINE. Study quality was assessed using the Cochrane risk of bias tool. Results were presented using forest plots for the pooled data and for various subgroups.

Results: 75 publications from 69 studies with a total of around 4,200 participants were identified; the data from 50 studies were analyzed in the meta-analysis. In the majority of studies, art therapies have been used to treat patients with mental disorders, most commonly anxiety, depression, to improve quality of life, self-esteem and social adjustment. Overall, art therapy tended to have positive effects, but the general quality of the studies was low.

Conclusion: The systematic review showed evidence of the therapeutic benefit of art therapies. However, further high-quality studies are needed to establish standards and best practice models for art therapy and to generate sufficiently robust evidence for potential effectiveness.