Article Critique for Educational Research

Candice McPherson

Georgia Southern University

Pifalo, T. (2006). Art therapy with sexually abused children and adolescents: extended
research study. Art Therapy: Journal of the American Art Therapy Association, 23(4),
181-185.

The title of this research study does not adequately describe the scope of the research.

Art therapy was not the only aspect studied. Art therapy was used in combination with

cognitive behavior therapy. Therefore, both therapies should have been included in the

title. The abstract is very concise and does not clearly state a hypothesis, although one is

alluded to in the conclusion of the abstract. Unlike the title, the procedure stated in the

abstract includes a combination of art therapy and cognitive behavior therapy. Although

short in length, the abstract contains enough interesting information to encourage the

reader to continue reading the article.

The purpose of the study is to find if a reduction of post-traumatic stress disorder

(PSTD) symptoms will occur when subjects are given a specific treatment that combines

art therapy and cognitive behavior therapy. The author offers the argument this

combined treatment is an effective intervention for sexually abused children, but does not

offer any opposing viewpoints. Sources used in the article range from 1987 to 1995. A

2002 source cited as justification for the proposed research is the author’s own pilot study

which he had conducted four years earlier in 2001. The author states the pilot study

provided preliminary evidence the combined therapies result in a reduction of PSTD.

The hypothesis is clear, concise, and testable if a valid experimental design is employed.

The description of the subjects is limited to children with histories of sexual abuse

who have been referred for treatment by mental health professionals. The children were

located in an urban, multidisciplinary child advocacy center that provides assessment and

treatment to young victims of sexual abuse. Subjects were drawn only from this one
facility. The number of subjects included in the sample is not reported, and there is no

mention of randomization. The ages of the children used in the study are broadly

categorized without specific indications as to how many of each age were tested.

Ethnicity and socioeconomic backgrounds are factors that should have been included in

subject descriptions as well. .

The testing instrument used in the study was the Trauma Symptom Checklist for

Children (TSCC). The author asserts this instrument is a well-established test, and lists

six sources as documentation of psychometric reliability and construct validity. The

rationale for using this instrument is it is designed to assess children with traumatic pasts,

and is widely used to assess children of sexual abuse. Another reason for using the

TSCC is it also is designed to accommodate children of various racial and socioeconomic

backgrounds, much like those of the children at the urban center where the study was

conducted.

The researcher set up a treatment model to test a cause-effect relationship, then

measured the effect of the treatment at the end of the study. This quantitative research

study is pre-experimental with a one-group pre-test/post-test design. The design involves

one group that is pre-tested, exposed to a treatment, and then post-tested. The

independent variable is the therapy treatment, and the dependent variable is the outcome

of the study. This design does not control all areas of invalidity. One threat to validity in

the study could be from unexpected events affecting the dependent variable. For

example, a child could have an experience in some other therapy or event that changes

the way he reacts to the post-test questions. Another threat could come from being

sensitized by taking the pre-test, which could then alter the results of the post-test.
Therefore, even if participants do better on the post-test than the pre-test, the researcher

should not assume the results are due to the treatment. Some other variable could be the

cause. A third threat to validity is the study attempts to measure the combined treatments

of art therapy and cognitive behavior therapy. The chosen design could have created

multiple-treatment interference, with the effects of one treatment altering the effects of

the other treatment.

The lack of control groups is a big liability. In order to determine combined therapies

created the hypothesized result, the researcher should have created a control group with

an art therapy treatment, and another control group with a cognitive behavior therapy

treatment. This method would have been a stronger experimental design, and more

threats to validity would have been controlled. Another liability to the study is the fact it

was conducted at one urban center, which was the same center used in the pilot study.

The researcher should have conducted the study using several centers, perhaps with

groups from rural as well as urban settings. When conducting an experimental study,

everything should be done to ensure ideal research conditions, including the use of

controls. The controls in this study are extremely deficient.

On the positive side, both a pre-test and post-test were used to evaluate the effects of

the treatment. This design is slightly better than the one-shot design, which includes no

pre-test for comparing changes. However, as stated previously, post-test results may not

be valid because sufficient controls were not in place.

The participants of the study were divided into three age groups structured to meet

their individual developmental needs. They received the treatment one hour per week for

eight weeks. This limited amount of time may not have been intensive enough to yield
optimum results. The use of the TSCC for data collection is an acceptable method

because the test has two validity scales and ten clinical scales, and is widely used for

children with histories of trauma. In an effort to preserve validity, the researcher

eliminated invalid scores reflecting under-response and hyper-response.

Although measures were taken to increase validity, the data cannot be trusted. The

lack of control groups, history, and multiple-treatment interference are a few of the

reasons for unreliability. Therefore, the research conclusion that a combination of art

therapy and cognitive behavior therapy reduces the symptoms of PTSD cannot be

considered evidential. From the perspective of a reader with limited background in

research, some parts of the data analysis tables are easier to understand than others. The

first table contains a descriptive overview of the specific measures by the subscales,

which for me, is easier to understand than the mathematical tables containing the scores

of the pre-test and post-test.

The discussion section of the study is little more than a summary of the results section.

The researcher points out the reduction of symptoms based on test results, which is a

replication of the results section statement. Limitations of the study are not mentioned,

and similarities in the data are not addressed. The discussion focuses on the differences;

namely, the intervention effects. However, the conclusion does contain the author’s

intention to conduct future research investigations of the hypothesis. His plans include

using a larger group of participants, and comparing results with models that use

traditional verbal therapy. Had these proposed controls been utilized in the present study,

the results would have yielded greater validity.