Exploring the use of expressive arts therapy for older adults with depression: a scoping review

Abstract

This scoping review mapped existing literature on the use of Expressive Arts Therapy (EAT) for older adults experiencing depression, with particular focus on therapeutic mechanisms and cross-cultural applicability. Guided by the Arksey & O’Malley framework and PRISMA-ScR guidelines, seven databases were searched for studies published between 2019 and 2026. Twenty-three studies met the inclusion criteria. Findings identified five thematic areas related to four proposed mechanisms of change and cross-cultural applicability. Across modalities, proposed mechanisms of change included emotional expression, cognitive and reminiscence, social connectedness, and embodiment. Culturally adapted interventions appeared to enhance therapeutic engagement and adherence, particularly in non-Western and collectivist settings. However, the review also identified limitations related to inconsistent methodologies, limited standardized protocols, and the scarcity of certified EAT practitioners in Southeast Asian contexts. These findings highlight the growing potential of EAT as a culturally responsive intervention for late-life depression while underscoring the need for more rigorous and contextually grounded future research.