A creative pathway to a meaningful life: An existential expressive arts group therapy for people living with HIV in Hong Kong

Abstract

People living with HIV (PLHIV) are likely to encounter existential conflicts, while stigma is a major stressor leading to poorer psychological well-being and social isolation. Aside from medical treatment, diverse psychotherapeutic approaches that guide PLHIV to reconstruct a meaningful life are needed. This paper reports on the process and efficacy of an eight-session, existential expressive arts group therapy program developed for PLHIV in Hong Kong. Eight HIV-positive male participants were recruited and completed the therapy. Using an existential-phenomenological framework, the therapy aimed to facilitate participants to make existential meaning from a creative process, which in turn help them overcome challenges and enhance their well-being in the domains of physical health, psychological health and social relationships. A mixed-methods study design was employed. Qualitative data were obtained through clinical observation by the therapist intern, participants' written reflection, and semi-structured interviews with the participants. Quality of life, affects, and group cohesion were measured by self-report questionnaires. The results showed that most participants found a way to make existential meaning and benefited from increased quality of life and creativity. They displayed significant improvement in the physical health domain of the quality of life (Z = -1.980, p = .048, r = 0.50) and positive affect (Z = -2.103, p = .035, r = 0.53). The findings contribute to the field of HIV care using an integrated arts approach.