Background: 

As part of the Decade of Healthy Ageing (2021–2030), the DUERER study team initiated an international film campaign with the art therapy short film „The Mind´s Image“. The aim was to raise awareness of art therapy as an effective intervention in old age and to open up an international exchange. 

Method: 

From November 2023 to February 2024, an exploratory online survey was conducted with (prospective) art therapists. Participants watched the film and then completed a standardised questionnaire via Netigate. This data was evaluated using quantitative-descriptive and qualitative-content analysis. 

Results: 

The film was viewed 1,484 times, and 168 participants completed the survey. They were predominantly from Europe and were mostly practising art therapists (80%) with 4–10 years of professional experience. 58% stated that art therapy with older people was not well established in their country. Frequently mentioned art therapy goals with older people were: improving well-being (19%), ability to act (18%) and social interaction (14%). 

Conclusion: 

The film campaign shows a high level of interest in art therapy work with older people. Audiovisual media such as „The Mind´s Image“ have great potential for knowledge networking and promoting a discourse on art therapy. 

Background

 In 2020, the United Nations declared the decade 2021–2030 the ‘Decade of Healthy Ageing’ (1). The aim of this initiative is to improve well-being of older adults, their families and communities through measures at global, national and local levels. The World Health Organisation (WHO) plays a central role in this by initiating and supporting health-promoting measures (2). As an art therapy contribution to implementing the goals of this decade, the interdisciplinary DUERER study team initiated an international film campaign based on the documentary short film „The Mind´s Image“. This film was produced as part of the DUERER study project on the research topic ‘Art therapy knows no age’. 

Art therapy film campaign 

Between 1 November 2023 and 29 February 2024, the DUERER study team conducted an exploratory online survey as part of an international film campaign. The project was based on the short film „The Mind´s Image“. The film initative was aimed at art therapists and those currently in training or studying worldwide. They were invited to watch the film first and then complete a standardised online survey. To promote the campaign internationally, the DUERER study team collaborated with a large number of art therapy professional associations, training institutes and universities. The participating partners received information materials to forward to their members, including newsletter text modules, access data for the film platform and a campaign poster for promotional purposes.

Short film: „The Mind´s Image“ 

The interdisciplinary DUERER study team has been researching the topic ‘Art therapy knows no age’ since 2017. As part of this research, the essayistic short film „The Mind´s Image“ was created in collaboration with documentary filmmaker Daniel Asadi-Faezi. This film shows art therapy as part of a study in a long-term care facility. The essayistic short film addresses ageing, the resources of older people and art therapy as a non-medicinal form of therapy for this age group. „The Mind´s Image“ is available in German with English subtitles and can be accessed free of charge via the Vimeo platform (5). The film serves both as a documentary tool and as a catalyst for a specialist discourse. 

Exploratory online survey 

Based on this documentary short film, a standardised questionnaire was developed in English and piloted. The pre-test with a small sample showed an average completion time of about five minutes. The questionnaire comprised a total of 19 items and was implemented for digital completion on the Netigate platform (6). The online survey collected basic socio-demographic data (e.g. age, occupational status) as well as the participants' experience with art therapy. In addition, assessments of the film's impact on the subjective perception of art therapy with older people were recorded. Further items related to the medium of film itself as a didactic or research-supporting communication tool in the context of art therapy practice. The closed questions were predominantly implemented as bipolar response formats (e.g. agreement/disagreement) or using a four-point Likert scale (not at all/somewhat/quite/very). In addition, an open question was formulated to determine individual art therapy objectives in working with older clients based on the film shown. At last, there was another open question for individual feedback. At the end of the survey, participants were informed about data protection regulations. Access to the online survey was provided via a clickable link directly below the film to enable a direct transition from watching the film to the online survey. 

Evaluation 

The data collected was evaluated using quantitative and qualitative methods. Microsoft Excel was used for the descriptive analysis of the closed questions. Frequencies, percentages, mean values and distributions were calculated to present the participants' assessments of their art therapy expertise, the impact of the film and their evaluation of film as a communication tool. The open-ended text responses were subjected to a qualitative content analysis based on Mayring's approach (7). To this end, the feedback was first paraphrased, then categorised and finally transferred to meaningful higher-level subsets. These were formed inductively, based on recurring themes and formulations in the responses. The aim of this approach was to identify key art therapy objectives with older people in a structured manner.

Results

The film was clicked on 1,484 times. 239 participants started the online survey and 71% (N=168) completed it and consented to its use. One third of participants are between 46 and 55 years old, 23% are between 56 and 65 years old. Over one third (37.5%) are younger than 45 years old, as shown in Table 1.

Table 1: Percentage age distribution of participants

The current activities of participants in the field of art therapy were distributed as follows (multiple answers possible): 80% are practising, 17% work in teaching, 16% are scientifically active, 15% are studying and 2% are retired.

In terms of art therapy qualifications, 13% had a certificate, 23% had a diploma, 1% had a bachelor's degree, 40% had a master's degree and 2% had a doctorate (PhD). A further 11% are currently in training or studying.

The majority of participants completed their studies/training in Germany (31%), followed by Spain (13%) and Italy (12%). This distribution of countries is also reflected in the countries where the participants are currently working as art therapists. The data collected shows a broad geographical spread in both areas, as summarised in Table 2.

Table 2: Percentage country distribution

The largest proportion of participants had 4–10 years of professional experience (34%). 15% are currently studying or in training or have less than one year of professional experience. 22% stated that they had up to three years of professional experience, 17% have 11–19 years of experience, and 12% have more than 20 years of professional experience.

With regard to scientific activity in the field of art therapy (multiple answers possible), 31% stated that they had been involved in research during their studies. 21% were already involved in research projects as practising art therapists. 49% have not been involved in research to date, and 4% are involved in another research-related context.

With regard to the fields of art therapy work with older people (multiple answers possible), there is a wide range, as summarised in Figure 1.

19% of participants have worked with older people as part of their studies or training. 17% of participants work in art therapy in long-term care.

28% of respondents stated that art therapy work with older people was not covered in their training/studies. However, for the majority, the topic was at least partially integrated: 47% rated it as ‘somewhat’, 15% as “quite” and 10% as ‘very’.

58% of participants stated that art therapy work with older people was ‘somewhat’ familiar in their country; for a further 11%, it was ‘not at all familiar’. In contrast, 25% rated it as ‘fairly familiar’ and 6% as ‘very familiar’.

Film as a scientific medium

With regard to film-related questions, the following picture emerged: the majority of participants could imagine working with older people in art therapy, with 23% considering this ‘quite likely’ and 33% ‘very likely’. A small proportion of participants stated that they would not be able to do so, with 10% saying ‘somewhat’ and 1% saying ‘not at all’. In addition, 33% of participants were already working in the field of art therapy with older people.

With regard to the transferability of practical information from the film to their own field of work, 38% of participants agreed ‘quite’ and 36% ‘very much’. In contrast, 24% stated that they could only transfer ‘some’ of the information, and 2% saw no possibility of transfer.

As regards recommending the film „The Mind´s Image“, the majority of participants would recommend the film to their colleagues, with 21% doing so ‘somewhat’ and 68% ‘very much’. A minority (2%) would not recommend the film, while 9% stated that they would only recommend it ‘somewhat’.

Categories

Based on the question of naming three art therapy objectives in working with older people, a total of twelve central categories were identified. These main categories are shown in Figure 2 according to their percentage distribution.

The most frequently cited art therapy objectives with older people aged 65 and over are ‘improving well-being’, which was mentioned by 19% of participants, followed by ‘improving the ability to act’ with 18%. In third place is ‘promoting social interaction’, which was mentioned by 14% of respondents.

Feedback on the film

61% of participants provided individual feedback at the end of the survey. 96% of this feedback was positive, 2% neutral and 2% negative.

• Thanks for making the work with eledrly people more visible.

• The film made me reconect with the will of keeping researching in art therapy.

• I strongly believe that information about the benefits of art therapy in older people should be shared more, in order to increase access to this form of therapy.

• I consider it an essential topic in a world with growing aging population and deem exchange of expert knowledge very important.

• L'Arteterapia non ha eta', non ha confini, crea prospettive infinite, stimola potentemente la creativita' che ci aiuta a trovare strade nuove e inaspettate per la soluzione dei problemi e l' accettazione dei propri limiti - Art therapy has no age limit, no boundaries, creates endless possibilities, powerfully stimulates creativity, helping us find new and unexpected ways to solve problems and accept our limitations.

Summary

The high number of clicks on the film (N=1484) indicates a fundamental interest in the topic. At the same time, the number of participants in the survey (N=168) suggests that there is room for improvement: the survey link was apparently not easily accessible for many people via the film, which prevented a considerable number of potentially interested individuals from participating.

More visible and direct access to the survey would probably have significantly increased participation. The low number of survey participants and the high exclusion rate (due, among other things, to failure to complete the survey or consent to data use) resulted in a small sample size (8). Future surveys should ensure that participation is easier and, if necessary, be designed to be multilingual.

Much of the feedback came from Europe, particularly Germany, Spain and Italy. This shows a geographical concentration. A broader international distribution is necessary for globally valid statements. In addition, the lack of uniformity in training pathways and differences in national health systems make international comparisons difficult.

The majority of participants are practising art therapists with 4–10 years of professional experience (34%), most of whom have a master's degree (40%), and only 2% have a PhD. Although many participants were involved in research during their studies (31%), only a small proportion (16%) are currently active in research. This reveals a gap between training and research practice. The high proportion of practical experience – 68% have experience working with older people – indicates a strong focus on application. At the same time, only 58% consider art therapy work with older people to be ‘somewhat familiar’ in their own country. 17% of respondents work in long-term care facilities. There is a great need for visibility and systematic integration into health care systems. Studies could help to identify existing potential and initiate political change. Interestingly, the data shows that 47% of respondents say that art therapy work with older people was only covered to a limited extent in their studies or training. At the same time, 28% stated that this topic was not covered at all. This means that around three quarters of participants received little to no content on the topic of art therapy with older people. This naturally opens up significant potential for improvement. More targeted integration of this content into curricula could both promote research interest and strengthen the practical relevance of the subject. The competence-based basic curriculum for art therapy work with older people, published in 2024, provides important impetus in this regard. It was developed on the basis of a consensus with interdisciplinary contributors in Germany (9).

The film „The Mind´s Image“ was rated by 98% of participants as a suitable medium for art therapy research. The strength of film as a medium probably lies in its ability to convey knowledge across languages – a great opportunity to disseminate content internationally and make complex topics visually understandable.

Conclusion

The results of the survey highlight a need for greater awareness of art therapy work with older people. They suggest that the specific challenges and potential of this target group are not yet sufficiently addressed in training.

This is becoming increasingly important in the current decade of healthy ageing. The use of audiovisual media in particular could play a more significant role in the future in conveying findings in a practical manner and enriching the discourse on art therapy approaches as a whole. The results underscore that art therapy has a wide range of potential for strengthening mental health in work with older people.

References

1. UN Decade of Healthy Ageing – The Platform [Internet]. 2022 [cited 2025 Jun 5]. Available from: www.decadeofhealthyageing.org
2. WHO’s Work on the UN Decade of Healthy Ageing (2021–2030) [Internet]. 2025 [cited 2025 Jun 5]. Available from: www.who.int/initiatives/decade-of-healthy-ageing
3. klinikum-nuernberg.de [Internet]. 2024 [cited 2025 Jun 5]. Duerer-V | Nuremberg. Available from: www.klinikum-nuernberg.de/behandlung/altersmedizin/geriatrie/geriatrie-campus-nord-sued/kunsttherapie/duerer-v
4. Brons S, Masuch J, Asadi Faezi D, Del Palacio Lorenzo A, Antwerpen L, Singler K. Film as an Art Therapy Research Tool? A Cinematographic Practice Example with Online Survey. In: Masuch J, Singler K, editors. Art Therapy: Opportunities and Challenges in Research. Frankfurt am Main: Mabuse-Verlag; 2024. (Mabuse-Verlag Wissenschaft).
5. Vimeo [Internet]. [cited 2025 Jun 5]. Vimeo AI-Powered Video Platform. Available from: vimeo.com
6. Netigate Deutschland GmbH. Netigate. 2021 [cited 2023 May 9]. Netigate Feedback Management Solutions. Available from: www.netigate.net/de/feedback-management-loesungen/
7. Mayring P. Qualitative Content Analysis: Basics and Techniques. 13th revised edition. Weinheim, Basel: Beltz; 2022. 148 p.
8. SurveyMonkey [Internet]. 2025 [cited 2025 Jun 5]. Advantages and Disadvantages of Online Surveys. Available from: de.surveymonkey.com/mp/vor-und-nachteile-einer-online-befragung/
9. Masuch J, Antwerpen L, Brons S, Gruber H, Hamberger C, Seifert K, et al. Development of a Curriculum of Basic Competencies for Art Therapy with Older People. Art Therapy. 2024;42(1):4–13.