Over 200,000 women are diagnosed with breast cancer in the United States annually. Many breast cancer patients and survivors cope with a fused conglomerate of depression, pain and fatigue that affect quality of life; are very difficult to treat and are associated with poor adherence to cancer treatments, delayed return to work, and higher healthcare use, costs, and hospitalizations. Approximately one-third of women coping with breast cancer experience persistent symptoms of depression, pain and fatigue, which are not normative and are difficult to treat.

Art Therapy is a form of psychotherapy that uses visual art-making as a form of expression and communication within a safe and supportive relationship, in a therapeutic setting. Art Therapy is documented in cancer settings to alleviate psychological symptoms and to reduce physical complaints. BC survivors have reported that art-making increased access to emotional content and its expression. Art Therapy provides an alternative to verbal Psychotherapy and understanding the mechanisms through which its salutary effects are gained will promote its standard application in palliative care settings. Because Art Therapy provides the opportunity for indirect expression, it may be particularly potent with individuals from traditional and collectivist ethno-cultures.

The purpose of this study is to examine emotional processing and cholinergic anti-inflammatory processes through which an Art Therapy intervention may reduce depression, pain and fatigue.

To examine these emotional processing and cholinergic anti-inflammatory mechanisms, we will conduct a randomized controlled trial of 120 Jewish and 120 Arab women diagnosed with breast cancer within the last 18 months, recruited in Israel and randomized to undergo one of 2 8-week programs of Art Therapy.