Creative arts-based interventions for the improvement of PTSD symptoms in young people: a meta-analysis with a focus on non-Western populations

Post-traumatic stress disorder (PTSD) is increasingly prevalent among young people, yet current evidence-based treatments show variable outcomes. Creative arts-based interventions (for example, music, dance, visual art and drama) are gaining attention as complementary approaches to trauma care. Here we evaluated the effectiveness of creative arts-based interventions in reducing PTSD symptoms among youth globally, with particular attention to underrepresented and non-Western populations. We searched PubMed, PsycINFO and Web of Science for studies published up to 16 June 2025. Eligible studies were randomized controlled trials and quasi-experimental studies evaluating creative arts-based interventions with participants aged 3-18 years with diagnosed PTSD or trauma-related symptoms and validated pre-post PTSD outcomes. A random-effects meta-analysis was conducted with subgroup analyses by region and trauma severity. Thirty-three studies (<i>N</i> = 4,587) met inclusion criteria. Creative arts-based interventions significantly reduced PTSD symptoms (Hedges' <i>g</i> <i>=</i> 0.85, 95% CI = 0.70-1.00). Strong effects were observed among participants with diagnosed PTSD and general trauma symptoms. Subgroup analyses showed large effects in West African and Middle Eastern samples, but no significant effects in Western populations. Although regional evidence was limited and intervention heterogeneity may affect generalizability, findings highlight creative arts-based interventions as effective and culturally resonant tools for reducing PTSD symptoms in youth, particularly in non-Western contexts. Future research should prioritize culturally focused, high-quality studies to assess applicability across diverse settings. This study was registered in PROSPERO (CRD42023389789).