The effect of dance movement therapy on improving psychological health: A systematic literature review

Nowadays, psychological or mental health problems are one the problems that require psychological intervention. One of the interventions used to treat psychological health is Dance Movement Therapy (DMT), a variant of Art Therapy. This study aimed to determine the effectiveness of DMT concerning the case variations and age categories. The systematic literature review was carried out using the PRISMA protocol on ten selected journal articles based on predetermined exclusion and inclusion criteria. The results obtained from the review showed that DMT could be implemented in the age range of adolescents to the elderly. DMT can provide effectiveness in psychological problems such as depression, stress, autism, and quality of life. In its implementation, DMT can be combined with other interventions to provide more optimal results.


INTRODUCTION
This Dance Movement Therapy (DMT) is considered one the Art Therapy. As its name suggests, each individual uses dance in this therapy to develop cognitive, emotional, physical, and social abilities (Wahyu et al., 2019). Art Therapy itself in the Canadian Art Therapy Association (CATA) is an art therapy that is a combination of the creative process and psychotherapy, which facilitates self-exploration and self-understanding. The use of DMT has been carried out for quite a long time. In western countries, DMT has been used since the early 1950s (Akandere, 2011).
DMT is an experimental therapy that emphasizes four things, namely (1) emphasis on the present experience in order to gain insight by focusing on the present; (2) works directly with the body; (3) the use of this therapy also facilitates nonverbal expression; (4) "backdoor" to the unconscious. The physical sensations generated provide affective access, which can explore verbal and nonverbal sensations. The body, in this case, is the main instrument, and motion is related to the body. Motion in DMT is a concrete form of emotion that is felt and expressed through dance.
The concrete form of this emotion, when expressed with DMT, reduces the perceived stress. From a physical point of view, movement can increase muscle strength and mobility and reduce muscle tension (Payne, 2003).
A study revealed that DMT could boost the recovery from psychophysical and psychosocial effects caused by physical trauma such as cancer, heart disease, and neurological disorders Insight: Jurnal Ilmiah Psikologi, e-ISSN: 2548-1800Vol. 24 No. 1, Feb 2022 (Akandere, 2011). In art education, dances positively impact children to develop their fantasies, imaginations, and creations freely (Triyanto in Rahmawati et al., 2018). Other benefits found in dance classes in education are good motoric development, social development, and way of thinking and language development in children. This intervention was chosen because it is inexpensive and can be applied to various age groups. The increasing number of studies related to DMT interventions with different characteristics of subjects produce different levels of effectiveness and also diverse research contexts.
DMT program therapy is carried out in a structured procedure consisting of 6-26 sessions conducted throughout weeks-months. Each session in several studies divided the DMT process, namely, warming up, the dyadic movement section, the Baum circle, and the verbal processing section (Mastrominico et al., 2018). Research conducted by (Rahmawati et al., 2018) explains that the process of applying DMT contains the following psychological concepts: (1) helping to overcome stress, (2) coping methods, (3) increasing self-efficacy, (4) social support, (5) helps overcome emotional, and mood problems, (6) helps maintain the cognition system, (7) stimulates imagination, and (8) helps the transformation process.
DMT is an intervention that has been used for more than 80 years (Levine & Land, 2016  conducted a systematic review and meta-analysis of the effectiveness of DMT as an intervention to treat depression, specifically in adults. In addition, there are various other literature reviews on the effectiveness of DMT, specifically for adults with dementia (Lyons et al., 2018) for individuals with autism spectrum disorder (Chen et al., 2022;Takahashi et al., 2019) for parents with mental health disorders (Jiménez et al., 2019;Millman et al., 2021) for breast cancer patients (Fatkulina et al., 2021). These studies are supported by recent studies with other methods on the effectiveness of DMT in people with dementia (Ho et al., 2020); people with autism spectrum disorder (Morris et al., 2021;Scharoun et al., 2014); in depressed adolescents and early adults (Kella et al., 2022); to deal with identity development issues in therapeutic settings (Erickson, 2021).
Based on the description above, it can be seen that DMT is a psychological intervention to overcome various psychological problems. However, no studies specifically examine the problems, The findings of this literature review research which synthesizes various relevant research results related to the three objectives above, will be beneficial. These benefits can be used by therapists, psychologists, and parties who experience psychological problems in considering the selection and application of DMT as a form of psychological intervention. In addition, this research can be used as a reference for the use of DMT as an intervention for psychological problems that children can use to the elderly.

METHOD
This study is a systematic literature review that uses the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol (Shamseer et al., 2015). Data sources were obtained from several journal databases from 2012-2021. The sources are Google Scholar, Elsevier, Springer, NCBI, and SAGE. The keywords used during the search were "Dance movement therapy," "dance therapy," or "DMT." The selection of journals in this study must meet the following inclusion criteria: (1) experimental research, (2) using DMT intervention, (3) having a comparison group, (4) journals written in English, and (5) published in peer-reviewed and full-text journals. In addition, journals must meet the exclusion criteria, namely research using quantitative methods and avoiding literature review and meta-analysis studies.
Search results using these keywords were obtained from 80 studies. After viewing the abstract, about 50 journals can be used. After further reading, that can be used in writing these ten journals. The results of the selection of journals for each inclusion and exclusion criteria obtained ten journals. The ten journals consisted of 742 participants. The sample's age varies from children to the elderly, starting at the age of 12 to 90 years old. The journals found discuss various psychological problems such as autism spectrum disorder, schizophrenia, quality of life, eating disorder, and depression.

RESULTS AND DISCUSSION
This literature review study was conducted based on ten selected journals with several participants (N = 742) summarized in Table 1 (Payne, 2003).
However, there is one journal that wrote that DMT does not have a significant effect on increasing empathy in adults with autism (Mastrominico et al., 2018). The insignificance of the study was caused by several subjects who did not complete the questionnaire given, resulting in a lack of statistical data and information.
Research with the meta-analysis method conducted by Koch et al. (2014) revealed that DMT is effective for anxiety disorders, autism in children or adults, breast cancer, cystic fibrosis, depression, dementia, eating disorders (emotional eating and obesity), schizophrenia and stress.
The use of DMT itself can be applied to various groups ranging from children to the elderly. DMT sessions can be customized depending on the needs. DMT can be not only a single intervention but can also be combined as a supportive intervention. The combination of interventions is relaxation and medical drug consumption for psychological disorders that require treatment, such as schizophrenia or exercise.
In line with the objectives of this study, it can be seen that various psychological problems can be intervened with DMT. For this reason, practitioners in the field of psychological intervention can consider DMT as one of the psychological interventions that can be used to overcome psychological problems faced by clients. Of course, the use of DMT needs to be adjusted to the conditions and needs of the client. Furthermore, this literature review shows that DMT interventions can be used independently or combined with other interventions. Thus, the choice of DMT intervention, whether alone or in a combination of courses, must be adjusted to the client's conditions and needs to obtain the most optimal intervention results. From this literature review, it was also found that there was only one intervention that was ineffective because the client did not complete the assessment thoroughly. In this case, practitioners must ensure that assessment evaluation is necessary to be done as an integral part of every intervention, including DMT. There was a significant increase in well-being in the experimental group (p = 0.007) compared to the control group (p = 0.560).
DMT is a place-based approach for adults with ID to provide support and improve well-being