A qualitative evaluation of an outdoor arts therapies group

ABSTRACT

Aim:

To understand service user and therapist experiences of an outdoor arts therapies group, their views on its benefits and challenges.

Background:

There is a lack of systematic research on the effectiveness of outdoor arts therapies. This article presents a systematic, qualitative evaluation of an outdoors arts therapies intervention for adults with mental health problems in the United Kingdom (UK).

Methods:

Semi-structured interviews were held with service users and therapists providing the intervention. A thematic analysis was conducted on the interview transcripts.

Results:

Key themes identified were: Benefits of Therapy Outdoors, Inclusive Understanding of Creativity and Engagement Challenges and Support. The outdoor setting was found to have a positive effect on group cohesion as well as on mood. Nature was experienced as an active participant in the therapy and this overlaps with an inclusive understanding of what it means to be creative. These findings broadly support the findings of the extant literature.

Implications for practice/policy/future research:

Arts therapists should be aware of the distinct therapeutic potential of outdoors arts therapies interventions and need to be creative and flexible in adapting their practice to make it suitable to the outdoor space.

Limitations:

This study employs only qualitative methods and lacks quantitative data.

Conclusion:

Outdoor arts therapies can have a positive effect on participants’ mental health and wellbeing and that the natural environment plays a significant part in this. An inclusive understanding of creativity supports service users to engage creatively and therapeutically with the environment.

Plain-language summary

The arts therapies are generally provided in indoor settings but in recent years there has been a growth of outdoor provision. This is done in order to make use of the beneficial effects of natural environments, the experience of which becomes a source of sensory, aesthetic and psychological stimulation and thus an active element in the therapy. There is a growing literature on this type of provision but there is a lack of systematic investigation, including regarding provision for adults with mental health problems.

This article reports on a qualitative evaluation of an outdoor arts therapies group for individuals with mental health problems in the UK National Health Service. The group met weekly in a carefully chosen, local green space in the outer zone of a large city. The location and the structure of sessions were designed to enable participants to safely explore personal thoughts and feelings in this public space.

Interviews were conducted with service users and therapists from the group and these were then analysed to elicit themes. The theme Benefits of Therapy Outdoors included the sensory stimulation of the surroundings and how the surroundings prompted participants to look outside themselves as well as evoking positive associations. The theme Inclusive Understanding of Creativity included the use of natural materials and creative responses to the environment being about more than just art making. The theme Engagement Challenges and Support included challenges of ‘bad’ weather and anxieties about travel.

The results of this evaluation broadly confirm the benefits of outdoor arts therapies as they appear in the literature. However, the data come only from people’s testimony, with no quantitative data. The authors recommend that future studies contain some quantitative data.

KEYWORDS:

• Eco
• environmental
• outdoor
• nature
• arts therapies
• art therapy
• dramatherapy
• mental health

Acknowledgements

The authors would like to thank Natasha Crosher for her contributions in the early stages of this project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Tim Wright

Tim Wright is an art therapist and Head of Arts Therapies for Local Services, West London NHS Trust. He served as editor in chief of International Journal of Art Therapy from 2008 to 2014 and Chair of the British Association of Art Therapists from 2014 to 2020. He chaired the BAAT task and finish group to produce Art Therapy for People with a Psychosis Related Diagnosis Guidelines (2020) He was co-chair of the Apprenticeship Standard Trailblazer group for arts therapists and he publishes and teaches on art therapy and related topics.

Verity Blakeman

Verity Blakeman is an art psychotherapist with 9 years of experience working with both adults and children in a variety of settings. She currently works for West London NHS Trust, as well as working in educational settings and for charitable organisations. Verity has a B.A (hons) in Design and Applied Art, specialising in ceramics from Edinburgh College of Art and an M.A in Art Psychotherapy from Goldsmiths University. She is a member of COATS (Community Outdoor Art Therapy) and continues with her own art practice, working with clay. Verity has undertaken further post qualifying training in art therapy supervision, mentalisation based therapy and ecotherapy.

Tanya Andrew

Tanya Andrew has worked for West London NHS Trust for 8 years, offering individual and group art therapy as well psycho-educational training and courses. Tanya has a B.A. (hons) in Critical Fine Art Practice from Central Saint Martins Art College and an M.A. in Art Psychotherapy from Goldsmiths University. She is a founding member of Winnicott Wednesday’s Artist Collective and COATS (Community Outdoor Art Therapy). She has published an article of her work with the Crisis Team in the International Journal of Art Therapy (vol.22, 2017 – issue 4) and articles for Newsbriefing. She has undertaken further post qualification training in art therapy supervision, psychoanalytic psychotherapy, mentalisation based therapy and ecotherapy.

Sarah Labovitch

Sarah Labovitch is an expert by experience at West London NHS Trust.