Therapist and client experiences of art therapy in relation to psychosis: a thematic analysis

ABSTRACT

Background

Evidenced-based theory of art therapy for people experiencing psychosis is relatively under-developed, especially in terms of the detail of what happens in art therapy sessions, and the role of the artmaking.

Aims

To explore in-session processes of art therapy from the viewpoint of both service users and art therapists using reflexive thematic analysis.

Method

Twelve participants, six service users and six art therapists, were interviewed.

Results

From the analysis, four main themes were created, specifically ‘safe space’, ‘power of artmaking’, ‘challenges’ and ‘supporting recovery’.

Conclusions

The findings offer triangulated themes from art therapists and service users and explicate the role of the artmaking. Artmaking offers service users a space to express and contain their feelings, needs, wishes and fears within the artwork. This can start a dialogue and provides them with an opportunity to shift how they view their artwork and themselves.

Practice implications

Artmaking helps service users express non-verbal and embodied material, which could then be explored through a therapeutic dialogue. Service users who struggle with verbalising their thoughts and feelings may particularly benefit from art therapy.

Plain-language summary

This study explored the processes of art therapy from the viewpoint of both service users and art therapists. Twelve participants, six service users and six art therapists, were interviewed. From the analysis, four main themes were created: ‘safe space’, ‘power of artmaking’, ‘challenges’ and ‘supporting recovery’. The results suggest artmaking offers people the opportunity to communicate their experiences within the artwork. This can start conversations, which may be particularly helpful when words are difficult, and provides people with an opportunity to shift how they view their artwork and themselves. Limitations, research recommendations, and clinical implications are discussed.

KEYWORDS:

• Art therapy
• art psychotherapy
• psychosis
• schizophrenia
• service user

Acknowledgements

The authors would like to thank all the service users and art therapists who shared their rich experiences of art therapy, for which this project would not exist without them. In addition, thanks are due to a service user consultant who does not wish to be named.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Artwork and quote from a service user participant (pseudonymised).

2 Service user quotes are denoted by an asterisk.

Additional information

Funding

The project was funded as a research project forming part of the first author’s clinical psychology doctorate training at Canterbury Christ Church University.

Notes on contributors

Helen Barrett

Helen Barrett, D.Clin.Psy., is a clinical psychologist who trained at Salomons Institute for Applied Psychology and qualified in 2020. This research formed part of her doctoral training and was supervised by the second and third authors.

Sue Holttum

Sue Holttum, C.Psychol., AFBPsS, is a senior lecturer at the Salomons Institute for Applied Psychology, and also works one day per week as the Research Officer at the British Association of Art Therapists (BAAT). She has carried out research on art therapy for several years and led the research components of the BAAT’s work developing evidence-based UK national guidelines on art therapy for people with a psychosis-related diagnosis, completed in 2020. She has lived experience of treatment for significant mental health difficulties and draws on this in her work. ORCID 0000-0003-2618-8518; https://www.researchgate.net/profile/Sue-Holttum; Twitter: @SlightOwl; https://www.linkedin.com/in/sue-holttum-30952033/

Tim Wright

Tim Wright: M.A. Art Psychotherapy is an art therapist and Head of Arts Therapies for Local Services, West London NHS Trust. He has published on a range of topics relating to art therapy and was co-author, with Sue Holttum, of the British Association of Art Therapists UK national guidelines on art therapy for people with a psychosis-related diagnosis.