The impact of NHS change processes on art therapists working in LD services

ABSTRACT

The impact of working as art therapists in the NHS during protracted change processes, with people with learning disabilities (LD), was investigated in a qualitative heuristic doctoral study (Ashby, 2018), which considered concerns about emotional exhaustion and reduced efficacy, symptoms of burnout (Maslach, 1982), as a result of occupational stress. The researcher’s own data was examined, and 15 art therapists employed by NHS Trusts across England were interviewed. This article explores how the research was conducted, its findings related to LD services in the NHS and wider employment issues, and addresses how the findings are relevant to all art therapists. Most burnout studies are quantitative and consider workplace sources of occupational stress, but this qualitative research importantly revealed how crucial personal sources of support and stress were in terms of aiding or reducing clinicians’ capacities to cope. There was evidence of job satisfaction, resilience, and personal growth developed over years of practice, and high levels of stress resulted in symptoms of burnout in some participants, but recovery was shown to be possible.

Plain-language summary

Research into the impact of working as an art therapist in learning disability (LD) services in the NHS in England during long periods of change processes found sources of stress and of job satisfaction (Ashby, 2018). The doctoral research was qualitative, using heuristic methodology as the researcher had experience of the issues investigated, and 15 art therapists were interviewed.

This article discusses the relevant literature, the way the research was done, and findings of the research; it applies the knowledge gained to the situations many art therapists experience in their practice with different organisations and work environments. The impact on art therapists was investigated as both positive and negative aspects of their working lives were evident, and sources of job satisfaction and of occupational stress were experienced, including burnout symptoms of emotional exhaustion and reduced capacity to work, though not depersonalisation (Maslach, 1982).

Organisational sources of satisfaction and stress within NHS LD services were identified, and employment issues for art therapists became apparent in relation to job insecurity, within the depressed employment market.

This qualitative research found that personal sources of support or stress could result in art therapists being able or unable to manage coping with occupational stress if multiple sources of stress were present. Burnout symptoms of emotional exhaustion and a reduced capacity to manage their workload resulted from these situations for some participants, however, those affected were able to recover when they addressed the occupational stress that had become too much for them; no participants avoided contact with service users.

KEYWORDS:

• Art therapy
• burnout
• NHS
• heuristic research
• learning disabilities
• personal sources of stress

Acknowledgements

The author expresses thanks to her participants, without whom this research would not have been possible, and to her PhD supervisors Dr Andy Gilroy and Dr Keren Cohen.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Dr Elizabeth Ashby is an art therapist who has worked for over 20 years in the NHS with older people with mental health problems, and with people who have learning disabilities. She is passionate about her work in the NHS, and has provided many trainee placements. Further to her art therapy training she studied for a Masters in Research, and then for a PhD. She is also a registered private practitioner and supervisor. She is currently a member of BAAT council, an Associate Editor of IJAT and Newsbriefing, and joint co-ordinator of ATLD SIG.