Riding the wake: Detailing the art therapy delivered in the MATISSE study

Abstract

Art therapists have been unsettled by the findings of a pragmatic randomised controlled trial testing the addition of group-based art therapy to standard care for people diagnosed with schizophrenia. Arguments that the therapy tested was not that routinely delivered in the UK have been fuelled by the arguably scant descriptions of therapy published to date. To inform the important debate about implications of findings, we provide a comprehensive description of therapy delivered in MATISSE. Drawing on accounts of therapists, their supervisors and participants and study documents, we articulate the three models used to deliver therapy. Described as modified studio, phased group and potentially interactive art therapy, the models were differentiated by structure and the degree of interpersonal and types of therapeutic interaction encouraged. Therapists, it seems, began with their ‘usual’ practice and while remaining true to their ethos, modified that to fit the trial context and participants' needs. Such adaptation is consistent with the principles of pragmatic trials which seek to test interventions in circumstances approximating the ‘real world’. MATISSE provides a piece of the puzzle but a plurality of evidence is needed before ‘calling time’ on the debate about the usefulness of art therapy for people diagnosed with schizophrenia.

Keywords:

• Art therapy
• models
• group
• randomised controlled trial
• process evaluation
• qualitative

Acknowledgements

This work would not have been possible without the support of the MATISSE study team, including the art therapists whose good will and cooperation, even as I critically examined their practice, is gratefully acknowledged. We are also indebted to the MATISSE participants who generously shared of their experiences of the study and art therapy.

Additional information

Funding

Research reported in this article was completed while Sue was employed by Imperial College London as a research associate on MATISSE. MATISSE was supported by the National Institute for Health Research: Health Technology Assessment [grant number 04/39/01]. No separate funds were provided for process evaluation reported in the PhD.

Notes on contributors

Sue Patterson

Biographical details

Sue Patterson is a health services researcher currently working with health professionals, managers and service users to integrate research in mental health care. Trained as a psychologist, she worked clinically and in management of services in Australia before moving to the UK to pursue a research career. Her PhD, ‘Evidence for mental health care: A grounded theory reconstruction of the randomised controlled trial’, was based on a comprehensive examination of the design and conduct of MATISSE. Sue's work is grounded in critical theory and social constructionist views of ‘evidence’. Email: [email protected]

Diane Waller

Diane Waller is Emeritus Professor of Art Psychotherapy, Goldsmiths, University of London and Principal Research Fellow, School of Applied Social Science, University of Brighton. As Honorary Visiting Professor at Imperial College, she chairs the International Centre for Research in the Arts Therapies. She is the author of publications, including ones that focus on art and design and ethnography. Diane is an art psychotherapist and group analyst and was recently on the Health and Care Professions Council. She is Honorary President of the British Association of Art Therapists. Her research interests are in mixed methods, multidisciplinary projects to explore the usefulness or not of art therapy, currently with people with dementia, in stroke rehabilitation, with substance abuse and eating disorders. Diane was joint PI on the MATISSE study.

Helen Killaspy

Helen Killaspy is Professor of Rehabilitation Psychiatry at University College London and Honorary Consultant in Rehabilitation Psychiatry with Camden and Islington NHS Foundation Trust. Her research focuses on the development and evaluation of mental health interventions and services for people with complex psychosis. She is currently leading two national programmes of research in England into mental health rehabilitation services and specialist supported accommodation services for people with mental health problems. She was joint PI on the MATISSE study.

Mike J. Crawford

Mike Crawford is Professor in Mental Health Research at Imperial College London, an Honorary Consultant Psychiatrist with Central & North West London NHS Foundation Trust and Director of the Centre for Quality Improvement at the Royal College of Psychiatrists. Mike's primary academic interest is in mental health services research, particularly the development and evaluation of psychosocial interventions for people with complex mental health needs, such as those with personality disorder and psychoses. Current projects include clinical trials of creative therapies, brief intervention for alcohol misuse and problem-solving therapy. He was joint PI on the MATISSE study.