FREE FORM CREATION VS. THE MANDALA AND THEIR EFFECTS ON VETERANS WITH POSTTRAUMATIC STRESS DISORDER: A RECREATIONAL THERAPY INTERVENTION By TAYLOR GBUR Bachelor of Science in Kinesiology Southern Nazarene University Bethany, Oklahoma 2015 Submitted to the Faculty of the Graduate College of the Oklahoma State University in partial fulfillment of the requirements for the Degree of MASTER OF SCIENCE December, 2017 FREE FORM CREATION VS. THE MANDALA AND THEIR EFFECTS ON VETERANS WITH POSTTRAUMATIC STRESS DISORDER: A RECREATIONAL THERAPY INTERVENTION Thesis Approved: Dr. Tim RJ Passmore Thesis Advisor Dr. Donna K Lindenmeier Dr. Melissa L Zahl ii ACKNOWLEDGEMENTS I would have never reached this accomplishment without the support of my wonderful friends and family. My husband, Austin, provided the initial inspiration for my thesis topic. He was serving oversees in a war zone during the conceptualization phase of my thesis. He was angry and stressed and I remember one night he had said, “I need some crayons and paper!” and I was instantly intrigued. It sparked my curiosity, I followed it, and now I am at the end of the research process. I am eternally grateful to my grandmother, Carol, for being my best friend, always pushing me to go further, and reminding me of how far I’ve come. I am also grateful for Dr. Passmore’s guidance and encouragement throughout my graduate career. I am thankful for the friends and connections I have made along the way and I look forward to what the future holds. iii Acknowledgements reflect the views of the author and are not endorsed by committee members or Oklahoma State University. Name: TAYLOR GBUR Date of Degree: DECEMBER, 2017 Title of Study: FREE FORM CREATION VS. THE MANDALA AND THEIR EFFECTS ON VETERANS WITH POSTTRAUMATIC STRESS DISORDER: A RECREATIONAL THERAPY INTERVENTION Major Field: RECREATIONAL THERAPY Abstract: Objective— The objective of this study was to compare free form creation to the mandala and examine their effects on veterans with posttraumatic stress disorder (PTSD). Method— Data for this study was collected from 18 veterans who self-disclosed as being clinically diagnosed with PTSD. Veterans participated in either the creation of an unstructured mandala or coloring of a pre-drawn mandala as interventions, and free form creation as the control group. The PCL-5 was used to detect clinically significant change. Results— All the hypotheses were exposed through analytical and statistical analysis to be the opposite of what was expected. In terms of clinical significance, the free form group was superior over the unstructured mandala, with the pre-drawn mandala most inferior. However, there was no superior intervention individually or among groups related to statistical significance. Limitations and delimitations need to be taken into consideration when interpreting results. Conclusion— The results of this study demonstrated that free form creation delivers clinically significant reduction in the overall symptomology of veterans with PTSD. This thesis supports the theory that creative art modalities, which are free of structural form and autonomous in nature, show promising results as an alternative treatment for veterans with PTSD. Keywords PTSD; mandala; veteran; Recreational Therapy; art therapy; creative art modality, expressive art therapy; coloring; Jung. iv TABLE OF CONTENTS Chapter Page I. INTRODUCTION ......................................................................................................1 Statement of The Problem .......................................................................................2 Proposition ...............................................................................................................3 Purpose of The Study ...............................................................................................4 Research Questions and Hypotheses .......................................................................4 Assumptions .............................................................................................................6 Limitations ...............................................................................................................6 Delimitations ............................................................................................................7 Definition of Terms................................................................................................10 II. REVIEW OF LITERATURE..................................................................................24 Recreational Therapy and Veterans .......................................................................27 Creative Art Modalities..........................................................................................28 Neurobiological Evidence ......................................................................................30 Psychological Origins of Art .................................................................................33 The Archetypes ......................................................................................................36 The Individuation Process......................................................................................38 Recreational Therapy .............................................................................................39 Leisure and Healing from Trauma .........................................................................41 The Mandala ..........................................................................................................42 Mandala Research ..................................................................................................43 Mediums for Mandalas ..........................................................................................46 Conclusion .............................................................................................................47 v Chapter Page III. METHODOLOGY ................................................................................................50 Selection of Participants ........................................................................................50 Research Design.....................................................................................................51 Study Procedures ...................................................................................................52 Instrumentation ......................................................................................................54 Demographics ........................................................................................................54 PCL-5 .....................................................................................................................54 Validity and Reliability of the PCL-5 ..............................................................54 PCL-5 Distribution...........................................................................................55 Structure of the PCL-5 .....................................................................................55 Scoring of the PCL-5 .......................................................................................56 Interpretation and Measuring Change ..............................................................56 Statistical Analyses ................................................................................................56 IV. FINDINGS .............................................................................................................58 Introduction ............................................................................................................58 Site Procedure ........................................................................................................58 Demographic Results .............................................................................................59 PCL-5 With Criterion A.........................................................................................60 PCL-5 Analysis and Interpretation ........................................................................60 Statistical Analyses Results ...................................................................................62 Hypotheses .............................................................................................................62 Discussion ..............................................................................................................63 V. CONCLUSION ......................................................................................................64 Study Limitations ...................................................................................................64 Accounting for Results ..........................................................................................65 Conclusion .............................................................................................................66 Implications for The Therapeutic Recreation Profession ......................................66 Recommendations for Future Studies ....................................................................66 REFERENCES ............................................................................................................69 APPENDICES .............................................................................................................90 vi LIST OF TABLES Table Page 1.................................................................................................................................90