Author(s)

Quanlun Li ¹, Xue Feng ², Ran Xiao ², Xiaojiao Mo ², Wanxin Zhang ², Yangnannan Qin ²

Affiliation(s)

¹ Nanning Medical Society, Nanning, China
² School of Information and Management, Guangxi Medical University, Nanning, China

Corresponding Author

Xue Feng

ABSTRACT

This study aimed to design culturally adapted OH cards-based art therapy interventions to assess their impact on anxiety, emotion regulation, and self-expression among medical college students. Two single-session interventions were developed: one integrating drawing therapy (Design #2) and one using narrative therapy alone (Design #1), both themed "self-inquiry." A pre-post quasi-experimental design was used, with 17 participants completing surveys using the State-Trait Anxiety Inventory (STAI-S-6) and the Self-Expression Emotion Regulation in Art Therapy Scale (SERATS). Outcomes were evaluated using paired t-tests and qualitative analysis. Results showed a significant reduction in state anxiety (p = 0.008) and moderate levels of self-expression and emotion regulation (SERATS mean = 37.41). Participants reported improved self-acceptance, emotional expression, and stress reduction. Design #2 was relatively more preferred by participants, while no significant differences in efficacy were found between the two designs. OH cards-based art therapy effectively mitigates anxiety and enhances psychological well-being in Chinese medical students, with flexible implementation across intervention types. Future research should explore long-term effects in diverse populations and integrate cultural adaptations to expand accessibility.

KEYWORDS

Art Therapy, OH Cards, Anxiety, Emotion Regulation, Drawing Therapy

CITE THIS PAPER

Quanlun Li, Xue Feng, Ran Xiao, Xiaojiao Mo, Wanxin Zhang, Yangnannan Qin, Single-Session OH Cards Art Therapy for College Students at a Medical University in China: Design and Effect Evaluation. Applied & Educational Psychology (2025) Vol. 6: 24-34. DOI: http://dx.doi.org/10.23977/appep.2025.060304.

REFERENCES

[1] American Art Associations. (2025) What is Art Therapy? https://arttherapy.org/what-is-art-therapy/ 
[2] Yue, J.L., Li, N., Que, J.Y. et al. (2022) Workforce situation of the Chinese mental health care system: results from a cross-sectional study. BMC Psychiatry 22, 562
[3] Feng, X., Shi, D., Stover, A. N., & He, H. (2025) Art healing practice in China and the associations with psychological wellbeing. Journal of Human Behavior in the Social Environment, 1–14.
[4] Huang, K.Y. (2022) Toward an indigenization process: Art therapy practice in the Chinese cultural context. Art Therapy, 39, 5-12.
[5] Hongtao, J. (2021) Usage of painting art therapy in mental health education of Chinese college students. Higher Education and Oriental Studies, 23, 1.
[6] Lu, C., Abdullah, A. (2024) The Efficacy of Person-Centered Expressive Art Therapy on College Students in Reducing Depression, Anxiety and Stress. Journal of Higher Education Teaching, 1, 283-290.
[7] Yin, Y., Ko, K.S. (2023) The effect of group art therapy on acculturative and academic stress of Chinese graduate students in South Korea. Frontiers in psychology, 14, 1179778.
[8] Cui, Y., Wang, F. (2022) The research focus and development trend of art therapy in Chinese education since the 21st century. Frontiers in Psychology, 15, 1002504.
[9] Qiu-Qiang, Z., Wen-Jun, L., Wan-Yi, F., Qi-Zhe, Z. (2021) College Students' Self‐Acceptance: A Paint Therapy Group Counseling Intervention. Scientific Programming, 1, 5180607.
[10] Chen, J., Song, W., Li H. (2021) Exploring Expressive Arts Therapy for Intervening in Depression and Anxiety among College Students: A Case Study of Beijing Normal University. Yi shu jiao yu, 12, 38-41.
[11] Chen, Z. (2024) The psychological principle of OH card and its role in psychological counseling. Appl Educ Psychol, 5, 25-30.
[12] Wen, L., Yang Q., Xu L., Xu, Q., Pan X., Liang X., Tan S. (2024) The Effect of OH Card Group Technique on Social Anxiety of Stay-at-home Children:The mediating role of general self-efficacy. China Journal of Health Psychology, 33, 4. 538 -543. 
[13] Haeyen, S., van Hooren, S., van der Veld, W.M., Hutschemaekers, G. (2018) Measuring the contribution of art therapy in multidisciplinary treatment of personality disorders: The construction of the Self-expression and Emotion Regulation in Art Therapy Scale (SERATS). Personal Ment Health, 12, 3–14. 
[14] Haeyen, S., Noorthoorn, E. (2021) Validity of the Self-Expression and Emotion Regulation in Art Therapy Scale (SERATS). PLOS ONE, 16, e0248315. 
[15] Du, Q., Liu, H., Yang, C., Chen, X., Zhang, X. (2022) The Development of a Short Chinese Version of the State-Trait Anxiety Inventory. Front Psychiatry. 9, 13, 854547. 
[16] Békés, V., Starrs, C.J., Perry, J.C., Prout, T.A., Conversano, C., Di Giuseppe. M. (2024) Defense mechanisms are associated with mental health symptoms across six countries. Research in Psychotherapy: Psychopathology, Process, and Outcome, 26, 729.
[17] Sun, X., Tian, Y., Zhang, Y., Xie, X., Heath, M.A., Zhou, Z. (2015) Psychological development and educational problems of left-behind children in rural China. School Psychology International, 3, 227-252.
[18] Wang, Z., Hu, X., Xu, J., Zhou, J., Ou, X., Chen, M. (2025) Effectiveness of OH card-based group mental health education in improving mood and behavior in breast cancer patients. Frontiers in Public Health. 14, 1533073.
[19] Jiang, Y., Zhou, X., Yang, L., Zhang, H., Chen, Q., Feng, J., et al. (2023) The role of OH cards in psychological interventions for children with fractures. Altern Ther Health Med, 29, 198–203.  
[20] Williams, J.C., Lynn, S.J. (2011) Acceptance: an historical and conceptual review. Imagin Cogn Pers, 30, 5–56.
[21] Dai, X., Yu, G., Lu, S., Zhu, J., Qin, Y.  (2024) Positive Effects of Group Drawing Therapy on Self-Cognition and Self-Acceptance in College Students. Journal of College Student Development, 65, 424-37.
[22] Heiderscheit, A., Murphy, K.M. (2021) Trauma-informed care in music therapy: Principles, guidelines, and a clinical case illustration. Music Therapy Perspectives, 39,142-51.

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