Publications by authors named "Elizabeth Manders"

3 Publications

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The Mirroring Dance: Synchrony and Interaction Quality of Five Adolescents and Adults on the Autism Spectrum in Dance/Movement Therapy.

Front Psychol 2021 14;12:717389. Epub 2021 Oct 14.

Psychiatrische Universitätsklinik, University of Heidelberg, Heidelberg, Germany.

Individuals on the autism spectrum are often described as having atypical social interactions. Ideally, interactional synchrony helps any interaction flow smoothly with each individual responding verbally, non-verbally, and/or emotionally within a short timeframe. Differences in interactional synchrony may impact how individuals on the autism spectrum experience social encounters. This mixed methods pilot study examined interactional synchrony in five cases of adolescents and adults on the autism spectrum through secondary analysis of video of the participants in movement-based mirroring tasks during dance/movement therapy. Raters described the movement and interactions of the participants while they were leading and following mirroring and engaged in open-ended free dances with a partner. Videos were also scored on measures of affective engagement, flow of the interaction, and synchrony. One of the most striking findings of this study was the difference between engagement in the instructions of the task and engagement with the partner: participants often followed the instructions for the mirroring tasks with little further social engagement with their partner. When participants did engage in moments of social initiation, attunement to the partner, and interactive behaviors, these did not develop into longer interactions. A paired -test of the correlation coefficients for each participant showed that scores on synchrony and affective engagement were more strongly positively correlated in the less structured open-ended dance and in video clips of interactive behaviors, than in the videos of simply leading or following mirroring. Synchrony was also significantly more strongly positively correlated with the observed flow of the interaction than with observed affective engagement. With the small sample size, however, most of the correlation coefficients were not significant and should be tested on a larger sample. Interpersonal synchrony may not be sufficient to effectively support social engagement when individuals on the autism spectrum simply follow instructions to synchronize their movements. Synchrony-based interventions may therefore need to include more complex open-ended social scenarios as interactional synchrony may then be more correlated with perceived interaction quality. Therapists may also need to partner with participants to model using non-verbal social behaviors to develop interactions within mirroring tasks.
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October 2021

Outcomes of art therapy and coloring for professional and informal caregivers of patients in a radiation oncology unit: A mixed methods pilot study.

Eur J Oncol Nurs 2019 Oct 22;42:153-161. Epub 2019 Aug 22.

Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, TRC 2 West, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. Electronic address:

Purpose: Caring for cancer patients can be highly stressful for both family caregivers and oncology professionals. These high levels of stress can lead to poorer patient outcomes and increased risk of health problems for the caregivers themselves. Art therapy may help these caregivers as art-making can be a relaxing and enjoyable form of self-expression and art therapists can support individuals in expressing and processing challenging emotions. Research on art-making or art therapy with caregivers of cancer patients has shown some positive results, but its interpretation is limited by the use of multifaceted interventions.

Method: In this mixed-methods study we compared two brief arts-based approaches for both professional and informal caregivers: single sessions of coloring or open-studio art therapy, with a 45-minute session each. Assessments imcluded self-reports of affect, stress, self-efficacy, anxiety, burnout arnd creative agency alongside salivary biomarkers before and after the session. Open-ended questions, field notes and observations formed the qualitative part of the study.

Results: Thirty-four professional (n=25) and informal (n=9) caregivers participated. Participants in both conditions showed increases in positive affect, creative agency, and self-efficacy and decreases in negative affect, anxiety, perceived stress, and burnout. Participants in both conditions expressed enjoyment, relaxation, appreciation of time away from stressors, creative problem solving, a sense of flow, and personal and existential insight. The two approaches also elicited distinct experiences with participants reporting that they found improved focus in coloring and appreciated the support and freedom of expression in open studio art therapy.

Conclusions: These findings suggest that even brief art-making interventions can be beneficial for stressed caregivers of cancer patients. As experience with art-making increased the impact, repeated sessions may be even more useful. We recommend that oncology units have dedicated studio spaces with therapeutic support and different forms of art-making available to meet individual caregiver needs.
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October 2019

Effects of Dance Movement Therapy on Adult Patients with Autism Spectrum Disorder: A Randomized Controlled Trial.

Behav Sci (Basel) 2018 Jun 29;8(7). Epub 2018 Jun 29.

Department of Therapy Sciences, SRH University Heidelberg, 69123 Heidelberg, Germany.

This study examines the effects of dance movement therapy (DMT) on empathy for adults with autism spectrum disorder (ASD). DMT based on the embodiment approach offers body-centered interventions, such as mirroring techniques, to address the needs of ASD patients. Accordingly, findings of a feasibility study suggest that DMT may be an effective approach for clients on the ASD spectrum. The present study is a randomized controlled trial that was conducted as a multicenter study within the framework of the EU-funded research project TESIS (Toward an Embodied Science of Intersubjectivity), and employed a two-factorial between-subject design. The treatment group ( = 35) participated in a 10-week manualized DMT intervention, whereas the control group ( = 22) received treatment only after a waiting period. Empathy, measured with the (), was the main variable of interest, analyzed by a repeated measures analysis of variance. In order to also include incomplete data cases, we used the expectation-maximization algorithm for missing data estimation. Results suggest no significant changes in overall empathy between groups. We discuss the results and limitations, as well as future research options.
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June 2018