Performing Arts Therapy as an Embodied, Relational, and Culturally Grounded Practice: A Biopsychosocial Systematic Literature Review

Art therapy is increasingly understood not merely as a medium of aesthetic expression but as a therapeutic practice that simultaneously engages the biological, psychological, social, and cultural dimensions of human experience. However, previous studies remain fragmented across single art media and intervention effectiveness, and have not synthesized embodiment, performativity, social relations, and cultural context into an integrative framework for performing arts therapy — a gap that is especially evident for non-Western, including Indonesian, performing arts traditions. This study aimed to map and synthesize how a biopsychosocial approach has been conceptualized in creative arts, expressive arts, and arts-based research, in order to identify the foundations for a biopsychosocial model of performing arts therapy. A qualitative Systematic Literature Review was conducted on the Scopus database for the 2015–2026 period using five keyword combinations (performing arts therapy, biopsychosocial therapy model, expressive arts intervention, creative-based therapy, and embodied arts therapy); article selection followed the PRISMA procedure, and the included studies were examined through thematic and conceptual synthesis. Of the 80 records identified, 37 articles met the inclusion criteria and were included in the final synthesis. Publications increased over the decade and peaked in 2025 (13 articles), followed by 2024 (10) and 2026 (6), originating mainly from the United States, Hong Kong, the United Kingdom, Israel, Australia, Norway, and China, and employing diverse designs including randomized controlled trials, systematic reviews, mixed methods, qualitative, and arts-based research. The synthesis identified an increasing emphasis on holistic, embodied, relational, and performative approaches to arts therapy. Six recurring components were identified: emotional regulation, embodied experience, interpersonal connection, trauma symbolization, aesthetic experience, and collective healing. This review concludes that performing arts offer a conceptual foundation for an integrative biopsychosocial approach by combining body, movement, rhythm, sound, symbol, space, and social interaction. The proposed framework offers a foundation for developing a more humanistic, contextual, and culturally grounded approach to performing arts therapy, including potential applications involving traditional Indonesian performing arts. Further empirical research is required to validate the proposed model.