The effectiveness of art therapy in improving psychosocial outcomes in children with cleft lip and/or palate: A study from a tertiary centre in Northwest Nigeria

Background: Children with cleft lip and/or palate (CL/P) experience significant psychosocial difficulties, often compounded by stigma and inadequate psychological support in resource-limited settings. Art therapy may provide a culturally adaptable means of improving emotional well-being in this population. Objective: To evaluate the short-term effectiveness of a structured art therapy programme in improving psychosocial outcomes among children with CL/P in Kano, Northwest Nigeria. Methods: A quasi-experimental one-group pre-test/post-test study was conducted among 500 children aged 6–17 years with non-syndromic CL/P. Participants completed an 8-week, group-based art therapy program. Psychosocial outcomes were assessed using the Pediatric Quality of Life Inventory (PedsQL), the Rosenberg self-esteem scale (RSES), Revised Children’s Anxiety and Depression Scale (RCADS-25), Body Image Disturbance Questionnaire, and selected suicidality items from the Beck Depression Inventory. For 6-year-olds, only parent-report tools were used. Data were analyzed using paired t -tests, McNemar’s test, and multivariate regression. Results: Significant short-term improvements were observed across all measures: Mean PedsQL scores increased from 56.7 ± 10.8 to 81.3 ± 8.9, and RSES from 17.8 ± 4.5 to 26.9 ± 2.8 (both P < 0.001). RCADS anxiety and depression scores reduced by over 45%, while suicidal ideation decreased from 18.6% to 4.2%. Effect sizes were large (Cohen’s d >2.0). Improvements were consistent across age, gender, and cleft type. Conclusion: Structured art therapy produced substantial short-term psychosocial improvements among Nigerian children with CL/P. Integrating art therapy into multidisciplinary cleft care could bridge the critical mental health support gap in resource-poor settings.