The Arts in Psychotherapy 54 (2017) 85–91 Contents lists available at ScienceDirect The Arts in Psychotherapy Arts and health: Active factors and a theory framework of embodied aesthetics Sabine C. Koch a,b,* a Alanus University Alfter, Germany b SRH University Heidelberg, University of Heidelberg, Germany a r t i c l e i n f o Article history: Received 10 January 2016 Received in revised form 5 November 2016 Accepted 5 February 2017 Available online 7 February 2017 Keywords: Arts therapies Active factors Health outcomes Art-making Aesthetic experience Embodied aesthetics Therapeutic mechanisms a b s t r a c t This article provides an approach to central specific active factors effective in the arts therapies that (a) can be distinguished from therapeutic factors present in other medical treatments and psychotherapies, and (b) that can be assumed to work as mechanisms of effectiveness across the arts. In the absence of a current aesthetic model for the arts therapies from psychology or the cognitive sciences that includes active art-making, a theory framework of embodied aesthetics is suggested that encompasses the active (expression) and the receptive (impression) aspects of the aesthetic experience. Five specific factors of arts therapies are identified: aesthetics, hedonism, nonverbal communication/metaphor, enactive tran- sitional support and generativity. Aesthetics, including beauty and authentic expression, is considered to be the most specific arts therapy factor. The framework presented grounds the question of active factors in an embodied enactive model of the aesthetic experience, in which art-making is considered alongside art perception. © 2017 Elsevier Ltd. All rights reserved. Introduction What is it that makes the arts therapies a particular source of healing? Researchers, artists, philosophers and anthropologists have long struggled to define the effects of art. What are the benefits of art? What is the aesthetic experience? Identifying the function of the arts from a health perspective is challenging. In trying to define active therapeutic factors in arts therapies, the absence of theoret- ical models in which these factors and their interrelations can be grounded is evident. In order to successfully describe the factors effective in arts therapies the development of an accompanying model of embodied aesthetics provided a source into which those factors can be grounded. Since the succession of ideas was not from theory to factors but from factors to theory, the connection between the two may not yet be well explicated, and any shortcom- ings remain a task for future work. Yet this pragmatic endeavor of bringing the active factors of arts therapies together with embodied aesthetics potentially further illuminates the purpose of the arts. * Corresponding author at: Alanus University Alfter, Department of Creative Arts Therapies and Therapy Science, Villestr. 3, 53347 Alfter/Bonn, Germany. E-mail address: sabine.koch@alanus.edu Part A: the missing model Arts therapies have increasingly been found to be effective for mental and other health problems (e.g., Gühne et al., 2012; Puetz et al., 2013; Schmitt & Fröhlich, 2007). What makes the arts ther- apies effective in healing? This article identifies active factors of art-making in therapy (and possibly beyond therapy). In an attempt to ground these factors in a theory, it became clear that there is no scientific theoretical model of art-making, suited as theory for arts therapies (Allesch, 2006). The models in cognitive sciences treat- ing aesthetic experience focus solely on art perception (e.g., Leder, Belke, Oeberst, & Augustin, 2004; Zeki, 1998) not production, in- taking not making, appreciation not en-action (for an exception see Carbon & Jakesch, 2013, on haptic aesthetics). The revision of Leder et al.’s model (Leder & Nadal, 2014), despite doing more justice to emotion, has not brought any progress in the aspect criticized here: active art-making remains unadressed (including in the prospect for the next ten years of Leder & Nadal, 2014). Aesthetic theory is for the most part an individualized perceptual theory. Similar to many other theories in psychology and cognitive sciences the focus lies almost exclusively on perception and on the individual. Enactive embodied approaches try to bring the active and interactive side to the forth (Fischer-Lichte, 2000). Yet paradoxically, even Alva Noë’s enactive approach to the arts (2002) falls short of explaining the active side of art-making. http://dx.doi.org/10.1016/j.aip.2017.02.002 0197-4556/© 2017 Elsevier Ltd. All rights reserved.