The effectiveness of Zentangle drawing using telehealth mode on university students: A randomized controlled trial

Eddy K.N. Cheng, Yuen Yi Cynthia Lai, Andrew M H Siu

Research output: Chapter in book / Conference proceedingConference article published in proceeding or bookAcademic researchpeer-review

Abstract

Background:
Zentangle is an easy-to-learn mindfulness-based art activity that occupational therapists use to help clients in handling stress. This mixed-method randomized-controlled-trial study investigates two research questions: (1) How far can Zentangle drawing via telehealth approach reduce stress and anxiety, increase happiness, improve wellbeing, and raise mindfulness awareness among
university students? (2) What is the biopsychological mechanism, through which Zentangle reduces stress and anxiety among university students? It is hypothesized that the treatment arm will significantly outperform the control arm in all areas after the intervention.

Methods:
52 participants were randomized to join an intervention (n=26) or a control group (n=26). Four one-hour Zentangle sessions were delivered in the intervention group while the participants in the control group received four one-hour free-drawing sessions in the consecutive four weeks. The heart-rate-variability (HRV) was collected via mobile phone app in every session. Five psychological self-reported questionnaires were collected at baseline and after all sessions. All
participants in the treatment group were invited to join an interview to collect their experiences after all sessions.

Results:
Results indicated that participants in the Zentangle group had improvement in stress, wellness and mindfulness awareness. Although the quantitative study showed no statistically significant difference between two groups in HRV and psychological measurements in two-way ANOVA analyses, the qualitative study supported the therapeutic effects of Zentangle. Nearly all participants found Zentangle reduced stress by distracting people from daily hassles. Zentangle
brought happiness when people gained the sense of mastery and autonomy, learnt self-acceptance, practiced gratitude and enhanced relationships with others. Few participants also reported the improvement in awareness to self and the surroundings.

Conclusions:
Zentangle may be an effective telehealth intervention for reducing stress and improving wellness. Intensity of practice, incorporation of inquiry sessions, handling technical issues and the choices of tangles should be considered to optimize its therapeutic effects.
Original languageEnglish
Title of host publicationPositive Technology International Conference 2023
Pages59
Publication statusPublished - 30 Jun 2023

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