ElderlyNCT07458945
The Effect of Mandala Art Therapy on the Psychological Well-Being and Perception of Social Support in Elderly People
A study testing MANDALA in people with Elderly, run by Gazi University at 1 site in Turkey (Türkiye).
Trial summary
This study aims to examine the effects of mandala art therapy on psychological well-being and perceived social support in elderly individuals. Research Hypotheses H1: Mandala art therapy significantly increases the psychological well-being of elderly individuals (p < 0.05). Read more about this study
- Who is it for?
- Ages 60 years and olderHealthy volunteers can take part
- Conditions the study is for
- Elderly
- What is being tested?
- MANDALA
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 35 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 24 Nov 2025to 26 Jan 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Inclusion Criteria:Participation criteria for the study include willingness to participate, being 60 years of age or older, scoring 24 or higher on the Mini Mental State Examination -
Exclusion Criteria:Exclusion criteria include severe Alzheimer's disease and dementia, having undergone regular art therapy/psychotherapy within the last three months, and being visually impaired.
-
Trial locations and contacts
1 site in 1 country.
About this study
Official title: The Effect of Mandala Art Therapy on the Psychological Well-Being and Perception of Social Support in Elderly People: A Randomized Controlled Trial
This study aims to examine the effects of mandala art therapy on psychological well-being and perceived social support in elderly individuals.
Research Hypotheses H1: Mandala art therapy significantly increases the psychological well-being of elderly individuals (p < 0.05).
H2: Mandala art therapy significantly increases the perceived social support scores of elderly individuals (p < 0.05).
H3: There is a positive and significant relationship between psychological well-being and perceived social support scores after mandala art therapy (p < 0.05).
Read the detailed description
The proportion of the elderly population is rapidly increasing worldwide, and it is projected that the number of individuals aged 60 and over will reach two billion by 2050 (World Health Organization [WHO], 2022).The aging process is closely linked not only to physiological changes but also to changes in mental and social health. Social isolation, loneliness, role loss, and physical limitations in advanced age can lead to negative consequences such as depression, anxiety, and decreased life satisfaction (Holt-Lunstad et al., 2015; Courtin and Knapp, 2017). Therefore, supporting the mental well-being of older individuals and strengthening social ties are among the priority goals of healthy aging policies (WHO, 2021). Psychological well-being in older individuals is related to social support. A study on older individuals found that high perceived social support in older adults increases life satisfaction and psychological well-being (Antonucci et al., 2014). Social support plays a protective role in preventing negative mental states such as loneliness, hopelessness, and anxiety in older adults (Chao, 2011). Family and peer support, in particular, strengthen the psychological well-being of older adults (Gariépy et al., 2016). Consequently, there is a strong and positive relationship between the perception of social support and psychological well-being in older adults. Therefore, interventions implemented for older adults by strengthening their social support networks play an important role in protecting their mental and physical health. Art therapy and creative activities are among the effective interventions that support the mental well-being of older adults. Group practices, particularly those involving mandala programs, have positive effects on anxiety and stress (Czamanski-Cohen et al., 2021). Mandala practices implemented in a group setting increase social interaction and strengthen perceptions of social support (Moon and Kim, 2020). While the existing literature has examined the effects of art therapy, music therapy, and creative activities on depression, anxiety, and life satisfaction in the elderly (Windle et al., 2018; Tymoszuk et al., 2019), studies examining psychological well-being and perceived social support together are limited. Studies evaluating mandala practices for the elderly population in Turkey using standardized scales are also limited. This study will be one of the first studies conducted in Turkey to examine the effects of mandala activities on both psychological well-being and perceived social support using the same model.It is believed that the findings will contribute to the evidence-based use of art-based group programs for older adults in clinical care and community-based studies. This study aims to examine the effects of mandala art therapy on psychological well-being and perceived social support in older adults.Studies on mandala art therapy have shown that it supports depression, anxiety, and spiritual well-being in the elderly mental health field. In a randomized controlled trial conducted in Taiwan, older adults were randomly assigned to a 20-minute activity of mandala painting, plaid painting, free drawing, or reading. The mandala painting group showed significant decreases in feelings of "relaxation," "safeness," and "comfort" (more positive feelings) compared to the control group (Koo et al., 2020). In a quasi-experimental single-group pre-post study conducted in Tehran, elderly people attending a daycare center painted mandalas twice a week for two weeks; When DASS-21 scores were examined, a significant decrease (p = 0.001) was observed in depression, anxiety, and stress levels (Amadi et al., 2023). In a study in India, mandala coloring was applied to elderly individuals living in nursing homes, a significant decrease (p < 0.01) was noted in Beck Depression Inventory (BDI) scores compared to pre- and post-test (Sreetha et al., 2021). In a 20-week art therapy intervention for depressed elderly women in Brazil, the therapy was found to significantly reduce depression and anxiety symptoms in the Geriatric Depression Scale (GDS), Beck Depression Inventory, and Beck Anxiety Inventory (Ciasca et al., 2018).
- Conditions
- Elderly
- Being tested
- MANDALA
- Keywords
- Psychological well-being, Social support
- Medical subject headings
- Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
MANDALAOther
The Mandala Art Therapy Program was developed by researchers based on literature (Chen et al., 2025; Omidivd, 2025; Ergür et al., 2021).The program, consisting of four sessions, will be conducted face-to-face once a week.Each session will last approximately 40-60 minutes.The sessions will be facilitated by the first researcher (FBÖD), who holds a mandala practitioner certification.The second researcher (ND), who holds an art therapy practitioner certification, will attend all sessions and serve as co-leader.The program will be implemented in a room approved by the administration at the location where the participants are registered, where participants will feel comfortable and where the session will not be interrupted.Session content is as follows:Session Content 1: Introduction, Group Rules, Focus and short breathing exercise (2 minutes), Mandala introduction (10 minutes), Coloring the prepared Mandala Drawing (symmetrical patterns) (30-40 minutes), Sharing of feelings (5-10 minutes).
| Study group | Role | What they receive |
|---|---|---|
| Mandala | Experimental | The Mandala Art Therapy Program was developed by researchers based on literature (Chen et al., 2025; Omidivd, 2025; Ergür et al., 2021).The program, consisting of four sessions, will be conducted face-to-face once a week.Each session will last approximately 40-60 minutes.The sessions will be facilitated by the first researcher (FBÖD), who holds a mandala practitioner certification.The second researcher (ND), who holds an art therapy practitioner certification, will attend all sessions and serve as co-leader.The program will be implemented in a room approved by the administration at the location where the participants are registered, where participants will feel comfortable and where the session will not be interrupted.Session content is as follows:Session Content 1: Introduction, Group Rules, Focus and short breathing exercise (2 minutes), Mandala introduction (10 minutes), Coloring the prepared Mandala Drawing (symmetrical patterns) (30-40 minutes), Sharing of feelings (5-10 minutes) Receives: Other: MANDALA |
| CONTROL | No intervention | Elderly individuals who agree to participate in the study and meet other criteria will be administered the SMMT, and those who score 24 or higher will be included in the study. After administering the data collection tools to both the intervention and control groups, the intervention group will receive a four-week Mandala Art Therapy Program. All materials used during the program (paper, pencils, compasses, rulers, crayons, etc.) will be provided free of charge by the researchers. The control group will not receive any intervention during this period. After the intervention, participants in both groups will complete a posttest and a follow-up test. After the study is completed, the Mandala Art Therapy program will be administered by the researchers to volunteer participants in the control group. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Psychological Well-Being Scale in the Elderly
Psychological Well-Being Scale in the Elderly (YPWB): The scale was used to measure the psychological well-being of elderly individuals. It was developed by Gümüş Demir (2023) and consists of 15 items on a 5-point Likert-type scale (1 = completely disagree - 5 = completely agree) (Appendix 2). Based on the scale's scoring system, there is no set cut-off score for the well-being of elderly individuals. Higher scores indicate increased well-being. The lowest possible score on the scale is 15, and the highest is 75. Additionally, items 8 and 13 were reverse-coded. The scale's Cronbach's alpha coefficient was calculated as 0.89, and the composite reliability coefficient was 0.90. The scale's item-total correlation values ranged between 0.48 and 0.69 (Gümüş Demir, 2023).
Measured: four weeks after the preliminary test
Secondary outcomes (1)
Multidimensional Scale of Perceived Social Support
The Multidimensional Perceived Social Support Scale (MPSSS) was developed in 1988 by Zimet et al. (Zimet et al., 1988). The Turkish validity and reliability study of the scale was conducted in 2001 by Eker et al. (Eker et al., 2001). The scale consists of a total of 12 questions and is evaluated on a 7-point Likert scale. Participants select one of the options ranging from "Definitely No" to "Definitely Yes" to express their perceived support. The scale consists of three subscales reflecting support sources: family, friends, and special person support. A high score is interpreted as indicating a high level of social support.
Measured: four weeks after the preliminary test
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Mar 2026
- Study start24 Nov 2025
- Primary completion25 Dec 2025
- Study completion26 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for ElderlyStudies of the same condition, open and under way.
- More trials run by Gazi UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- The study type is a randomized controlled trial.Research Universe and Sample: The study population will consist of N=3060 elderly individuals registered at the Retirement Club in September 2025. The sample size was determined using G\*Power 3.1.9.7 Software Package Program.The sample size was calculated using data from the mandala study conducted by Ahmadi et al. (2023) with α=0.05, 1-β=0.80, d=0.60, and ρ=0.60, resulting in a sample size of n=58. Anticipating potential attrition, the sample size was increased by 20%, and n=70 was determined, comprising 35 intervention groups and 35 control groups. Inclusion criteria for the study were: willingness to participate, age 60 or older, a score of 24 or higher on the Mini Mental Standard Test, and no impairment in auditory-visual communication skills and fine motor skills.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 35 participants (actual)
Sponsor and investigators
- Lead sponsor
- Gazi University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Fatma Betül Öz, Gazi University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07458945
- Sponsor's protocol ID
- GazıUnıversity-FBOz
- Status last verified
- Mar 2026
- First submitted
- 2 Feb 2026
- Last updated
- 9 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: After the research is completed, it can be forwarded to researchers who request it.
Study at a glance
From the registry record, last updated by the sponsor on 9 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Mandala Art Therapy on the Psychological Well-Being and Perception of Social Support in Elderly People: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07458945
- Acronym / sponsor ID
- GazıUnıversity-FBOz
- Conditions
- Elderly
- Keywords
- Psychological well-being, Social support
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 35 participants (actual)
- Lead sponsor
- Gazi UniversityUniversity, hospital or other
- Study start
- 24 Nov 2025 (actual)
- Primary completion
- 25 Dec 2025 (actual)
- Study completion
- 26 Jan 2026 (actual)
- First posted
- 9 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to examine the effects of mandala art therapy on psychological well-being and perceived social support in elderly individuals.
Research Hypotheses H1: Mandala art therapy significantly increases the psychological well-being of elderly individuals (p < 0.05).
H2: Mandala art therapy significantly increases the perceived social support scores of elderly individuals (p < 0.05).
H3: There is a positive and significant relationship between psychological well-being and perceived social support scores after mandala art therapy (p < 0.05).
Detailed description
The proportion of the elderly population is rapidly increasing worldwide, and it is projected that the number of individuals aged 60 and over will reach two billion by 2050 (World Health Organization [WHO], 2022).The aging process is closely linked not only to physiological changes but also to changes in mental and social health. Social isolation, loneliness, role loss, and physical limitations in advanced age can lead to negative consequences such as depression, anxiety, and decreased life satisfaction (Holt-Lunstad et al., 2015; Courtin and Knapp, 2017). Therefore, supporting the mental well-being of older individuals and strengthening social ties are among the priority goals of healthy aging policies (WHO, 2021). Psychological well-being in older individuals is related to social support. A study on older individuals found that high perceived social support in older adults increases life satisfaction and psychological well-being (Antonucci et al., 2014). Social support plays a protective role in preventing negative mental states such as loneliness, hopelessness, and anxiety in older adults (Chao, 2011). Family and peer support, in particular, strengthen the psychological well-being of older adults (Gariépy et al., 2016). Consequently, there is a strong and positive relationship between the perception of social support and psychological well-being in older adults. Therefore, interventions implemented for older adults by strengthening their social support networks play an important role in protecting their mental and physical health. Art therapy and creative activities are among the effective interventions that support the mental well-being of older adults. Group practices, particularly those involving mandala programs, have positive effects on anxiety and stress (Czamanski-Cohen et al., 2021). Mandala practices implemented in a group setting increase social interaction and strengthen perceptions of social support (Moon and Kim, 2020). While the existing literature has examined the effects of art therapy, music therapy, and creative activities on depression, anxiety, and life satisfaction in the elderly (Windle et al., 2018; Tymoszuk et al., 2019), studies examining psychological well-being and perceived social support together are limited. Studies evaluating mandala practices for the elderly population in Turkey using standardized scales are also limited. This study will be one of the first studies conducted in Turkey to examine the effects of mandala activities on both psychological well-being and perceived social support using the same model.It is believed that the findings will contribute to the evidence-based use of art-based group programs for older adults in clinical care and community-based studies. This study aims to examine the effects of mandala art therapy on psychological well-being and perceived social support in older adults.Studies on mandala art therapy have shown that it supports depression, anxiety, and spiritual well-being in the elderly mental health field. In a randomized controlled trial conducted in Taiwan, older adults were randomly assigned to a 20-minute activity of mandala painting, plaid painting, free drawing, or reading. The mandala painting group showed significant decreases in feelings of "relaxation," "safeness," and "comfort" (more positive feelings) compared to the control group (Koo et al., 2020). In a quasi-experimental single-group pre-post study conducted in Tehran, elderly people attending a daycare center painted mandalas twice a week for two weeks; When DASS-21 scores were examined, a significant decrease (p = 0.001) was observed in depression, anxiety, and stress levels (Amadi et al., 2023). In a study in India, mandala coloring was applied to elderly individuals living in nursing homes, a significant decrease (p < 0.01) was noted in Beck Depression Inventory (BDI) scores compared to pre- and post-test (Sreetha et al., 2021). In a 20-week art therapy intervention for depressed elderly women in Brazil, the therapy was found to significantly reduce depression and anxiety symptoms in the Geriatric Depression Scale (GDS), Beck Depression Inventory, and Beck Anxiety Inventory (Ciasca et al., 2018).
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- The study type is a randomized controlled trial.Research Universe and Sample: The study population will consist of N=3060 elderly individuals registered at the Retirement Club in September 2025. The sample size was determined using G*Power 3.1.9.7 Software Package Program.The sample size was calculated using data from the mandala study conducted by Ahmadi et al. (2023) with α=0.05, 1-β=0.80, d=0.60, and ρ=0.60, resulting in a sample size of n=58. Anticipating potential attrition, the sample size was increased by 20%, and n=70 was determined, comprising 35 intervention groups and 35 control groups. Inclusion criteria for the study were: willingness to participate, age 60 or older, a score of 24 or higher on the Mini Mental Standard Test, and no impairment in auditory-visual communication skills and fine motor skills.
| Arm | Type | Receives |
|---|---|---|
| Mandala | Experimental | Other: MANDALAThe Mandala Art Therapy Program was developed by researchers based on literature (Chen et al., 2025; Omidivd, 2025; Ergür et al., 2021).The program, consisting of four sessions, will be conducted face-to-face once a week.Each session will last approximately 40-60 minutes.The sessions will be facilitated by the first researcher (FBÖD), who holds a mandala practitioner certification.The second researcher (ND), who holds an art therapy practitioner certification, will attend all sessions and serve as co-leader.The program will be implemented in a room approved by the administration at the location where the participants are registered, where participants will feel comfortable and where the session will not be interrupted.Session content is as follows:Session Content 1: Introduction, Group Rules, Focus and short breathing exercise (2 minutes), Mandala introduction (10 minutes), Coloring the prepared Mandala Drawing (symmetrical patterns) (30-40 minutes), Sharing of feelings (5-10 minutes) |
| CONTROL | No intervention | –Elderly individuals who agree to participate in the study and meet other criteria will be administered the SMMT, and those who score 24 or higher will be included in the study. After administering the data collection tools to both the intervention and control groups, the intervention group will receive a four-week Mandala Art Therapy Program. All materials used during the program (paper, pencils, compasses, rulers, crayons, etc.) will be provided free of charge by the researchers. The control group will not receive any intervention during this period. After the intervention, participants in both groups will complete a posttest and a follow-up test. After the study is completed, the Mandala Art Therapy program will be administered by the researchers to volunteer participants in the control group. |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| MANDALAThe Mandala Art Therapy Program was developed by researchers based on literature (Chen et al., 2025; Omidivd, 2025; Ergür et al., 2021).The program, consisting of four sessions, will be conducted face-to-face once a week.Each session will last approximately 40-60 minutes.The sessions will be facilitated by the first researcher (FBÖD), who holds a mandala practitioner certification.The second researcher (ND), who holds an art therapy practitioner certification, will attend all sessions and serve as co-leader.The program will be implemented in a room approved by the administration at the location where the participants are registered, where participants will feel comfortable and where the session will not be interrupted.Session content is as follows:Session Content 1: Introduction, Group Rules, Focus and short breathing exercise (2 minutes), Mandala introduction (10 minutes), Coloring the prepared Mandala Drawing (symmetrical patterns) (30-40 minutes), Sharing of feelings (5-10 minutes). | Other | Mandala |
Primary outcome
Psychological Well-Being Scale in the Elderly
Time frame: four weeks after the preliminary test
Psychological Well-Being Scale in the Elderly (YPWB): The scale was used to measure the psychological well-being of elderly individuals. It was developed by Gümüş Demir (2023) and consists of 15 items on a 5-point Likert-type scale (1 = completely disagree - 5 = completely agree) (Appendix 2). Based on the scale's scoring system, there is no set cut-off score for the well-being of elderly individuals. Higher scores indicate increased well-being. The lowest possible score on the scale is 15, and the highest is 75. Additionally, items 8 and 13 were reverse-coded. The scale's Cronbach's alpha coefficient was calculated as 0.89, and the composite reliability coefficient was 0.90. The scale's item-total correlation values ranged between 0.48 and 0.69 (Gümüş Demir, 2023).
1 secondary outcome
Multidimensional Scale of Perceived Social Support
Time frame: four weeks after the preliminary test
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Mar 2026.
- Individual participant dataSharing planned: No. After the research is completed, it can be forwarded to researchers who request it.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing MANDALA in people with Elderly, run by Gazi University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 9 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Psychological Well-Being Scale in the Elderly (time frame: four weeks after the preliminary test). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Mar 2026.