Puzzling Pictures: Feasibility Study of a Collage Art Trauma Reprocessing Intervention for LGBTQ+ Emerging Adults

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The Ohio State University

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Lesbian, gay, bisexual, transgender, queer, and other sexual and/or gender minority (LGBTQ+) individuals are at high risk for adverse mental behavioral, and physical health outcomes due to the prejudice and discrimination they experience at both individual and institutional levels. Compared to the general United States (US) population, LGBTQ+ adults report experiencing more trauma during their childhood and are more likely to be victimized as adults. Systemic barriers to healthcare for LGBTQ+ people are compounded by a lack of culturally responsive care to counter the historic pathologization of sexual and gender minority identities. In this feasibility study, an art intervention (Puzzling Pictures) was developed and tested to address the trauma reprocessing needs of the LGBTQ+ population. Using the cutting and pasting technique of collage art, participants were guided through a series of sessions wherein they identified traumatic memories and positive memories during or following trauma, and subsequently developed core beliefs to be represented in an art piece telling their personal trauma narrative. Findings show the intervention was perceived as highly satisfactory, logical, helpful, and appropriate for participants' goals. Participants indicated they experienced low levels of discomfort and anxiety during participation. Participants' symptoms of traumatic stress were significantly reduced from the pre-test (M=15.6, SD=3.44) compared to post-test (M=8.4, SD=3.05); t=6.22, p=0.002. Trends of decreased difficulty in emotional regulation and increased coping skills were also found. Trauma narratives and core beliefs shifted from shame-based to strengths-based with an emphasis on the decentering of trauma. More research must be conducted with a larger data pool and sample with diverse educational backgrounds as well as higher levels of trauma to determine further efficacy of the Puzzling Pictures intervention.


Outstanding Honors Research Award


LGBTQ+, trauma, art therapy, traumatic stress, collage art therapy