Measuring the Empowerment of veterans who are homeless: A pre- and post-test trial of a creative arts therapy program intervention

Creative arts therapies, in its many modalities, can be an effective tool to help people who are most in need—when they are homeless—to ease mental disorders and resurrect positive thinking. This study tested the Decision Making Empowerment Scale (Rogers, 1997) in its utility in evaluating the effectiveness of creative arts therapy for veterans housed in two therapeutic community model residences in northeast Ohio. The Empowerment Scale is a 28-item questionnaire with a 4-point ordinal scale. A one group pre- and post-test clinical trial design was conducted in 2014. Subjects self-administered the questionnaire once entering either one of the transitional residences and repeated the assessment after the completion of a 12-week  therapy program. Of the 103 individuals who initiated the trial 39 completed both pre- and post-assessment. Overall scale Cronbach alpha at pre-test was 0.88, and 0.91 at post-test. Whole scale average was 2.88 with a standard deviation of 0.34 and improved to 3.02 at time 2 with a standard deviation of 0.39. Paired-sample t test found the score increase at post-test was significant for the whole scale, and for the self-esteem, power-powerlessness, and community activism subscales (p<0.05). No significance was found for the optimism and righteous anger subscales. This Empowerment scale was recommended for outpatient mental health service use. Comparing these findings to reported scores for the general population with and without mental disorders in the literature, the average scores of this study at pre-test were higher and beyond 3.0 on a 4-point scale, challenging its improvement to a statistically significant level. A potential "ceiling effect" is concerned. While creative arts therapy is effective in adding the therapautic component to transitional house program the challenge in finding evidence to support its practice is obviouse. This study may share its field experience in such an exercise to the audience.