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Reducing Negative Mood Through Mandala Creation: A Randomized Controlled

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Reducing Negative Mood Through Mandala Creation: A

Randomized Controlled Trial
Anastasia Babouchkina & Steven J. Robbins
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 Art Therapy: Journal of the American Art Therapy Association, 32(1) pp. 34–39, © AATA, Inc. 2015
brief report
Reducing Negative Mood Through Mandala Creation:
A Randomized Controlled Trial
Anastasia Babouchkina and Steven J. Robbins
Abstract
This study examined whether the creation of a mandala
has specific efficacy for reducing negative mood states. A
Downloaded by [Arcadia University] at 07:34 30 March 2015
convenience sample of 67 adult participants was randomly
assigned to one of 4 conditions following negative mood
induction: (a) coloring a blank circle with instructions to
express feelings, (b) coloring a blank circle with instructions to
draw freely, (c) coloring a square with instructions to express
feelings, or (d) coloring a square with instructions to draw
freely. The two circle (mandala) groups reported significantly
greater mood improvement compared to the two square
conditions. These results demonstrate that the circular shape of
the mandala serves as an “active ingredient” in mood
enhancement.
Introduction
Over the last two decades, psychological organizations
such as the American Psychological Association have
increasingly encouraged clinicians to employ evidence-
based practices with specific emphasis on the use of ran-
domized controlled trials to establish “empirically sup-
ported therapies” (see Chambliss & Hollon, 1998).
Numerous papers in recent years have called for quantita-
tive, experimental studies to assess the impact of art making
on mental health (Bell & Robbins, 2007; Burleigh & Beu-
tler, 1997; Carolan, 2001; Deaver, 2002; Geue et al.,
2010; Kapitan, 2012; Reynolds, Nabors, & Quinlan,
2000; Slayton, D’Archer, & Kaplan, 2010; Stuckey &
Nobel, 2010; Tibbets, 1995). A recent Delphi study
reported that art therapy researchers identified efficacy
research as the number one priority for research in the field
(Kaiser & Deaver, 2013). Randomized controlled trials are
necessary to establish that improvement following an art
therapy intervention is not the result of nonspecific factors
such as history, maturation, selection bias, regression to the
Editor’s Note: Anastasia Babouchkina is a graduate of Arca-
dia University, Glenside, PA, and Steven J. Robbins is Professor
of Psychology at the same institution. Correspondence concerning
this report may be addressed to the second author at
robbinss@arcadia.edu
34
mean, testing, or participant/observer bias (so-called
“threats to internal validity”; see Campbell & Stanley,
1966; Cook & Campbell, 1979).
Kapitan (2012) took the call for efficacy research one
step further, arguing that art therapy research should focus
more on the “active ingredients” required for therapeutic
effects. Most randomized controlled trials in art therapy
research to this point have examined drawing as an agent of
emotional change (see Slayton et al., 2010, for a review),
but few studies have examined whether specific drawings
might serve as especially potent active ingredients. One
such proposed drawing is the mandala, a design that uses a
circular boundary within which the drawing is done. Dat-
ing back to Jung’s writings on mandala symbolism (see,
e.g., Jung, 1959/1973), mandalas have held special signifi-
cance in art therapy. In recent years, attention has turned to
the use of randomized controlled trials to evaluate whether
mandala creation has specific efficacy for improving nega-
tive mood states (e.g., Curry & Kasser, 2005; DeLue,
1999; Henderson, Rosen, & Mascaro, 2007; Pisarik & Lar-
son, 2011; Schrade, Tronsky, & Kaiser, 2011; Slegelis,
1987; Small, 2006; van der Vennet & Serice, 2012). Man-
dala studies typically ask participants to color in a pre-
drawn mandala figure or to freely draw within a blank
circle.
Curry and Kasser (2005) utilized an experimental
design to examine whether coloring mandalas containing
pre-drawn geometric forms would produce greater anxiety
reduction compared to coloring in a comparably complex
square figure. Following a negative mood induction, under-
graduate students were randomly assigned to color within a
mandala containing geometric forms, to color within a
square containing a plaid pattern, or to freely draw on a
blank page. Both circle and square conditions produced
more mood improvement than free drawing, but the shape
conditions did not differ from each other in mood effect.
Small (2006) attempted to replicate this study (splitting the
mandala group into subgroups that either did or did not
read an essay on the history of mandala symbolism) and
found no differences in mood improvement across condi-
tions. In the most recent version of this design, van der
Vennet and Serice (2012) found that coloring in the pre-
drawn mandala design caused more improvement than
 BABOUCHKINA / ROBBINS
both the square/plaid and free drawing conditions. In sum,
results from the “pre-drawn” mandala studies have been
inconsistent; of three studies using this design, only one has
documented specific effects of coloring within a circular
design compared to another shape.
Van der Vennet and Serice (2012) remarked that color-
ing in a pre-drawn mandala is a less common practice in art
therapy settings compared to the creation of an original
mandala. Jung (1959/1973) proposed that the creation of
design elements within the mandala is the active ingredient
in producing psychological change. Original mandala crea-
tion involves the client drawing the circle or being provided
with a circular outline on a blank page. A number of studies
have examined this approach.
In one of the first experimental studies on mandala cre-
ation, Slegelis (1987) randomly assigned college students to
freely draw within either a circular or square outline. Slege-
lis’s design elegantly isolates the circular form as the “active
ingredient” of the study; however, her only measure of out-
Downloaded by [Arcadia University] at 07:34 30 March 2015
come was the number of angles drawn within each figure
(based on the idea that angles denote negative emotional
states). More angles were seen in the square figures, an
observation interpreted as demonstrating the calming effect
of the circular figure. This result is also consistent with an
explanation based on imitation (or modeling or priming):
Individuals asked to draw within an angular border might
be more likely to incorporate similar shape elements in their
drawings. The absence of an externally validated mood
measure makes the results of this study difficult to interpret.
In a later and oft-cited study, Henderson et al. (2007)
randomly assigned participants screened for trauma symp-
toms to one of two conditions. In the mandala group, par-
ticipants were asked to draw within a circle in order to
express feelings about their trauma. In the control group,
participants were asked to draw a specifically described
object (such as a cup or pen). Numerous self-report ratings
of mood and symptoms were collected pre-drawing, post-
drawing, and at a 1-month follow-up. Participants in the
mandala condition reported greater improvement in one of
10 statistical tests (level of trauma symptoms at 1-month
follow-up). Because no alpha correction for multiple tests
was employed, the one significant result could be attributed
to a Type 1 error. Furthermore, unlike Slegelis’s (1987)
design, Henderson et al. did not isolate the circular shape
of the mandala as the sole difference between groups. Even
if the mandala group did show greater improvement, that
result could be attributed to the effects of free drawing,
drawing within any bounded shape, or instructions to
express traumatic feelings through drawing. None of these
features were included in the control condition. DeLue
(1999) compared changes in physiological arousal between
children randomly assigned to draw inside circles or work
with puzzles. Greater reductions in arousal were seen in the
mandala group, but once again, the design does not permit
the conclusion that the circular shape was the active ingredi-
ent in the observed effects.
More recently Schrade et al. (2011) had adults with
intellectual disabilities freely draw within a circle, freely
draw on a blank page, or work with non-drawing materials
35
such as puzzles in a within-subjects design. Changes in
blood pressure and pulse rate did not differ across condi-
tions. Pisarik and Larson (2011) assigned undergraduate
students to one of two conditions: drawing a circle and fill-
ing it in with images representing themselves or no inter-
vention. Participants in the mandala condition reported
significantly greater increases in awareness and personal
growth compared to participants in the control condition.
However, the use of a no-treatment control raises the possi-
bility that group differences could be attributed to nonspe-
cific factors such as demand effects (only individuals in the
drawing group have any reason to expect personal change)
or observer bias (the experimenter knew which participants
were in which condition). In short, design limitations and
inconsistent results have limited the conclusions to be
drawn from existing experimental studies of mandalas.
Consequently, the primary purpose of the present
study was to return to the simple and elegant design of
Slegelis’s (1987) study by comparing the effects of draw-
ing within a circle to drawing within a square on mood
state. We expanded on that original design in three spe-
cific ways. First, we incorporated a manipulation
designed to see whether instructions to disclose emo-
tional states enhance mandala effects; such instructions
are commonly used in art therapy practice as well as in
existing studies on mandala efficacy (e.g., Henderson
et al., 2007; Pisarik & Larson, 2011). Second, we made
use of a well-validated, highly sensitive mood inventory,
the Profile of Mood States (POMS; McNair, Lorr, &
Droppleman, 1971) to assess mandala effects. The sec-
ond author has used the POMS with success in earlier
work to document significant changes in negative mood
brought about by art making (Bell & Robbins, 2007;
Boothby & Robbins, 2011; Kimport & Robbins, 2012).
Finally, we made an attempt to explore the mechanism
of a possible mandala effect by asking participants to
write self-disclosure essays at the end of the study. We
were interested in whether mandala effects on negative
mood could be accounted for by increases in willingness
or ability to openly express inner states.
More specifically, we randomly assigned 67 partici-
pants to four groups following negative mood state
induction: (a) coloring in a circle (mandala) with instruc-
tions to express feelings, (b) coloring in a circle with
instructions to draw freely, (c) coloring in a square with
instructions to express feelings, or (d) coloring in a square
with instructions to draw freely. Overall negative mood
score on the POMS was collected before and after the
drawing task in each group. This factorial design allowed
us to examine several questions within one study. First,
we could examine whether coloring within a circle
improves mood more than drawing within a square. Sec-
ond, we could test whether instructions to express feel-
ings in a drawing task produce more mood improvement
than instructions to draw freely. Finally, we were able to
test for a shape by instructions interaction; we hypothe-
sized that mandala drawing paired with instructions to
express feelings would produce the greatest mood
enhancement.
 36 EFFECT OF MANDALAS ON NEGATIVE MOOD
Method
Participants
We employed a convenience sample of 67 adult partici-
pants (51 female, 16 male) between the ages of 18 and 42 (M
D 20.0, SD D 3.3). A one-way ANOVA verified that mean
age did not differ across the four conditions (p > .05). Most
participants were college students between the ages of 18
and 22. Recruitment took place through an online partici-
pant sign-up system used in the psychology department at
Arcadia University in Glenside, Pennsylvania, and through
invitation by the first author. Because no licensed clinicians
were involved in the study, we made no attempt to screen
participants for mood disorders. No participant voluntarily
revealed to us a history of any diagnosable emotional disor-
der. No monetary reimbursement was provided, but psy-
chology students received course credit when appropriate.
Downloaded by [Arcadia University] at 07:34 30 March 2015
Design
This study employed a 2 £ 2 £ 3 factorial design.
Shape (circle/square) served as one between-group variable,
Instructions (feelings/free) served as a second between-
group variable, and Time (baseline/pretest/posttest) repre-
sented a within-subjects variable. The 67 participants were
assigned to the four conditions of the study through
blocked randomization.
At the outset, mood was assessed before and after a neg-
ative mood induction task through the POMS (baseline and
pretest). Following the second mood assessment, individuals
were placed into the four conditions: Group A was instructed
to express their feelings by coloring within a circle, Group B
was asked to color the circle however they chose, Group C
was asked to express their feelings by coloring within a
square, and Group D was told to color the square however
they chose. Following the art task, participants received a
final POMS assessment followed by a short writing task.
Materials
For each of the four drawing conditions, participants
were given a set of 12 Hardtmuth Woodless Color Pencils
(consisting of the colors red, orange, yellow, light green,
dark green, dark blue, light blue, purple, pink, brown,
black, and white) and a pencil sharpener. Participants drew
within a blank outline of a circle (Groups A and B) or a
square (Groups C and D) printed in the center of a sheet
of 8.5" c_ 11" white copy paper. Following the lead of Slege-
lis (1987) and Curry and Kasser (2005), we matched the
diameter of the circle to the length of one side of the square
(both set to 6 inches).
Two dependent measures were employed in this study.
The primary outcome measure was the Profile of Mood
States (POMS; McNair et al., 1971), which assesses
momentary mood by requiring participants to rate how self-
descriptive each of 65 mood adjectives are on a 0–4 scale.
Items are then combined into six mood subscales (Tension,
Depression, Anger, Vigor, Fatigue, and Confusion), which
can be further combined into a single overall negative mood
score. Changes in that single mood score served as our pri-
mary assessment of outcome. Participants were also asked at
the end of the study to describe a life event in the past
30 days and how it made them feel. This writing prompt
was printed at the top of a single lined sheet of paper.
Procedures
All individuals enrolled in the study participated in a sin-
gle laboratory session lasting approximately 30 minutes. At
the outset, written, informed consent was obtained. Partici-
pants then completed a brief demographics form and the first
of three POMS assessments (baseline mood). Next individu-
als were asked to make a list of three stressful events currently
on their minds. The POMS (pretest) was then administered
a second time to document that the four groups had compa-
rably negative mood prior to the drawing task.
Based on a preconstructed blocked randomization
table, participants were then given their drawing materials
in a sealed envelope. These were labeled only by participant
number and prepared by the second author, who did not
interact with the participants or reveal the envelopes’ con-
tents to the first author, who served as experimenter. In this
way, experimenter blinding was achieved. Each envelope
contained two sheets of blank, white copy paper. The first
page contained one of two typed instructions for complet-
ing the drawing task (Feelings or Free). In the two Feelings
conditions, the instructions read: “Color in the shape
according to how you are feeling at this moment in time.”
In the two Free conditions, the instructions were: “Color
the shape in any way you feel appropriate.” Thus, the two
forms of instructions were identical in the circle and square
conditions. The second page contained the preprinted circle
or square outline described earlier.
All participants were given the same art materials. They
were asked to refrain from opening the envelope until after
the experimenter had left the lab. To ensure that partici-
pants read the instructions on the first page, they were asked
to rewrite the instructions on the back of the shape outline
page. They were further instructed to place both the
instruction sheet and the drawing sheet back in the enve-
lope upon completion of the task and to open the lab door
to inform the experimenter that they were done.
Following the drawing task, participants filled out the
third and final POMS inventory (posttest) and were then
given a single sheet of paper containing the single line of
instructions for the written disclosure task (“Describe an event
that occurred within the last 30 days of your life and how it
made you feel”). When they had completed this, participants
were debriefed and informed of the purpose of the study.
Results
Overall negative mood state on the POMS served as
the primary outcome measure for the study. Word count
and number of expressed feelings in the final essay served as
a secondary measure. POMS scores at the three
 BABOUCHKINA / ROBBINS
measurement points (baseline, pretest, and posttest) for the
four treatment groups can be found in Table 1.
Negative Mood Induction
Success of the negative mood induction manipulation
was evaluated through a two-way, repeated measures
ANOVA using Group (A, B, C, D) as a between-group fac-
tor and Time (baseline, pretest) as a within-subjects factor.
Overall negative mood score on the POMS served as the
measure. We did not employ the factors Shape and Instruc-
tions as separate factors in this analysis because the groups
had not yet been treated differently. We wished simply to
check whether the four groups were in comparable mood
states prior to the drawing task.
Results of the ANOVA revealed a significant main
effect of Time, F(1, 63) D 22.8, p < .001. Inspection of
Table 1 reveals that negative mood increased for all four
groups from baseline to pretest. The ANOVA produced
Downloaded by [Arcadia University] at 07:34 30 March 2015
neither a significant main effect of Group nor a Group by
Time interaction; thus, the four groups had comparable lev-
els of negative mood overall and also experienced compara-
ble increases in negative mood following the mood
induction procedure. Thus, random assignment was suc-
cessful in creating groups matched for mood state.
Drawing Intervention Outcome
To assess the impact of Shape (circle vs. square) and
Instructions (feelings vs. free) on negative mood, a three-
way, repeated-measures ANOVA was computed employing
the pre- and posttest time points as a within-subjects factor.
There was a significant main effect of Time, F(1, 63) D
51.0, p < .001, indicating that mood generally improved
across intervention conditions. Of greater interest, there was
also a significant two-way interaction of Shape by Time, F
(1, 63) D 4.1, p < .05. As Table 1 indicates, negative
mood decreased more in the circle conditions compared to
the square conditions. Drawing in a circle produced a
decrease in negative mood of 23.9 points, compared to
13.5 points in the square conditions. Thus, participants in
the circle conditions experienced 77% more mood improve-
ment compared to those in the square conditions.
Table 1 POMS Overall Mean (SD) Negative Mood Scores at Baseline, Pretest, and Posttest
Group N Baseline
Group A (Mandala Feelings) 17 16.7 (30.6)
Group B (Mandala Free) 17 5.4 (20.4)
Mandala total 34 11.0 (26.3)
Group C (Square Feelings) 16 10.6 (31.2)
Group D (Square Free) 17 10.8 (21.3)
Square total 33 10.7 (26.2)
a
For the pre–post difference scores, positive values indicate improvements in mood (reductions in POMS overall nega-
tive mood ratings).
37
The interactions involving the Instructions dimension
did not reach statistical significance. However, the three-
way interaction (Shape by Instructions by Time) produced
a nearly significant result, F(1, 63) D 3.6, p D .06. As pre-
dicted, the largest magnitude change in mood occurred in
Group A, which was instructed to express their feelings by
coloring within a circle. Furthermore, the significant differ-
ence seen in mood change between the circle and square
conditions seems largely a product of the two feelings con-
ditions; Table 1 reveals that the circle and square groups
instructed to draw freely (Group B and Group D) had
almost identical changes in mood from pre- to posttest.
Disclosure Essay Outcome
Levels of written self-disclosure in the four conditions
were evaluated first by conducting a word count on each
essay. Overall, participants wrote an average of 132 words/
essay (SD D 69.0). For the four conditions, mean word
counts (with standard deviations in parentheses) were as fol-
lows: Group A, 108.1 (51.7), Group B, 142.1 (63.2),
Group C, 136.3 (81.8), Group D, 141.0 (77.0). A two-
way ANOVA (Shape by Instructions) failed to reveal any
significant group effects. To analyze essay content, we had
two independent raters, blinded to participant condition,
underline all examples of statements relating to personal
feelings. Overall, the two raters agreed on 265 instances of
feelings statements and disagreed on 87 (75% agreement).
To be conservative, we analyzed only the agreed-upon
examples. Across conditions, participants provided an aver-
age of 4.0 feelings statements per essay (SD D 2.8). Once
again, a two-way ANOVA failed to find any significant
group effects. Thus, the greater mood reduction in the
mandala groups did not seem related to a correspondingly
greater inclination to self-disclose feeling states.
Discussion
The results of this study demonstrate that drawing
within a circular boundary has specific efficacy for improv-
ing mood state. The two groups that colored within a circle
showed greater reduction in negative mood on the POMS
from pre- to posttest compared to the two groups that
Pre Post Pre–Posta
28.6 (31.5) 0.8 (18.5) 27.8 (18.7)
20.5 (27.6) 0.5 (20.1) 20.0 (22.8)
24.5 (29.4) 0.6 (19.1) 23.9 (20.9)
17.8 (28.6) 10.5 (35.8) 7.3 (20.3)
18.2 (33.2) ¡l.2 (20.5) 19.3 (23.2)
18.0 (30.6) 4.5 (29.1) 13.5 (22.3)
 38 EFFECT OF MANDALAS ON NEGATIVE MOOD
colored within a square. By holding constant all conditions
of drawing other than the simple pre-drawn boundary on
the page, we were able to clearly demonstrate that the circu-
lar shape (mandala) was the active ingredient. Furthermore,
although the three-way interaction of Shape £ Instructions
£ Time did not reach statistical significance
(p D .06), there was a trend toward the mandala effect
being most pronounced when participants were asked to
express their feelings. Of the four conditions, the group
that was asked to express their feelings by coloring within a
circle showed the most improvement.
The present design has three specific virtues for docu-
menting that the differences in mood change seen across
groups resulted specifically from the shapes employed. First,
random assignment reduces the likelihood that factors such
as selection bias or regression to the mean could account for
the results. As described earlier, the four groups had compa-
rable levels of negative mood at pretest and showed similar
levels of susceptibility to the negative mood induction. Sec-
Downloaded by [Arcadia University] at 07:34 30 March 2015
ond, the experimenter was blinded to the group assignment
of each participant; hence, observer bias cannot account for
the results. Third, participants were not informed that shape
was the critical dimension of the study or that other partici-
pants could receive a different shape. All participants were
told that the study was aimed at examining the effects of
drawing on mood. Thus, levels of experimental demand (the
expectation of improvement) were equated across conditions.
As in previous studies in our lab (Bell & Robbins, 2007;
Boothby & Robbins, 2011; Kimport & Robbins, 2012),
our results have external validity limitations with regard to
actual art therapy practice. Because this study was carried
out by an undergraduate experimenter working with a non-
clinical sample of largely college students in a single 30-min-
ute session, we cannot claim to have tested the effectiveness
of mandala creation under real-world art therapy conditions
(presence of an art therapist, clients with disorders, multiple
sessions of work). However, as we have pointed out, this lim-
itation also highlights the power of our findings. The use of a
circular shape had a significant impact on negative mood in
a single brief exposure without a trained therapist present.
Such a result should motivate further research into mandala
effects in more enriched settings.
Although the circular shape clearly represents the active
ingredient in our group differences, our results do little to
illuminate the mechanism behind the circle effect. We
attempted to test the idea that mandalas might increase
openness to personal emotional states; however, our groups
did not differ in their levels of written personal disclosure
following the tasks. Perhaps it is the symbolic content
within the mandala that underlies its efficacy. If mandala
creation is an alternative to verbal disclosure, as Henderson
et al. (2007) discussed, then the similarities among our
groups in essay writing might be unsurprising. If symbolic
content is key, then one would predict either that drawings
within circles would contain more symbolic elements than
drawings within squares, or alternatively that the symbols
within circles would better correlate with emotional
changes. Answers to such questions require research designs
that combine the randomized controlled trial strategy
employed here with systematic, reliable ratings of mandala
content. A number of papers in recent years have advanced
strategies for making consistent and valid ratings of mandala
content (e.g., Elkis-Abuhoff, Gaydos, Goldblatt, Chen, &
Rose, 2009; Kim, Kang, & Kim, 2009; Kim, Kim, & Kim,
2008), but the use of such systems went beyond the scope
and resources of the present investigation.
Whatever the underlying mechanism, the present study
straightforwardly documents the specific efficacy of the cir-
cular form for improving mood. We hope these results stim-
ulate further interest in the properties of mandala creation as
well as demonstrating the importance of isolating the active
ingredient behind proposed art therapy interventions.
Acknowledgments
The first author completed this research as part of the
requirements for a BA in psychology.
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