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To understand service user and therapist experiences of an outdoor arts therapies group, their views on its benefits and challenges. 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). Semi-structured interviews were held with service users and therapists providing the intervention. A thematic analysis was conducted on the interview transcripts. 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. 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. This study employs only qualitative methods and lacks quantitative data. 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. 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. [ABSTRACT FROM AUTHOR]

This paper examines what harm reveals about psychoactive power in the arts therapies. A 20-year sample of fitness-to-practise cases brought to the UK statutory regulator (the Health and Care and Professions Council) was examined to establish the prevalence of practitioners who cause harm which was low (0.165%). Transcripts of sanctioned cases were used to construct a grounded theory of how harm is mediated in arts therapies practice. This revealed service users enter arts therapies with damaged self-trust in the expectation that they can trust the professional. In non-harmful therapy, trust in the professional is then used to boost self-trust in the service user. In arts therapies practice, the arts create powerfully emotionally salient elements to aid therapy which can affect both service user and arts therapists' attachment systems to fulfil this task. Harm was enacted when the arts therapist used the power of that trust to isolate the relationship and introduce their own needs through arts therapies practices. This increased service user dependency on the arts therapist and further decreased their self-trust resulting in harm. Harm was only possible where the arts therapist's self-reflection failed and they distorted theory to self-justify their actions and refute all feedback to the contrary. Plain language summary This paper examines harm in the arts therapies (art, drama and music therapies as regulated by the Health and Care Professions Council (HCPC)). Harm is understudied but important because it tells us how things can go wrong and also indicates where areas of strong psychoactive power may operate in therapy which can also help people. Arts therapies have been regulated by the HCPC for 20 years and we found there were 77 cases brought against arts therapies practitioners with a total of 16 cases that led to HCPC sanction. We used a grounded theory method of analysis to try to understand how harm was mediated in those harmful arts therapy practices because it is an established form of qualitative research used to construct a theory of social action using examples drawn from real-world examples. We found that service users enter arts therapies with damaged self-trust in the expectation that they can trust the professional. In non-harmful therapy, trust in the professional is then used to boost self-trust in the service user. Within arts therapies, the arts support access to powerful emotions which underpins the building of trust, an element essential to good therapy. However, harm happened when the arts therapist used the power of that trust to isolate the relationship, introduced personal issues and used the service user for their own needs. This increased service user dependency on the arts therapist, detrimentally affecting their sense of self-trust and resulting in harm. Harm was only possible where the arts therapists' self-reflection failed and they distorted theory to self-justify their actions and refute all feedback to the contrary. [ABSTRACT FROM AUTHOR]

Current therapies do not offer universal solutions for the ‘global burden’ of depression. By focusing on non-verbal communication and creativity, arts therapies might present a relevant treatment option but their effectiveness remains unclear. A pilot study was undertaken to evaluate a brief art therapy group for adults suffering from depression. Adults experiencing mild to moderate depression took part in art therapy and completed questionnaires at three points in time. The intensity of depression, levels of anxiety and general wellbeing were measured. Semi-structured interviews focused on participants’ expectations and experience of therapy. A decrease in depressive symptoms was observed immediately after the therapy and at the follow-up, and a trend for improvement of subjectively perceived wellbeing was recorded. Potential benefits of therapy recognised by participants included: acceptance of depression, readiness to express emotions, sense of self and awareness of others, readiness for meaningful relationships, sense of achievement, sense of balance and new insights, growth and meaning. The statistically significant results and participants’ experience indicate that art therapy may offer a valuable treatment option for depression, and further research is recommended. Future studies should explore ways of addressing both the outcomes and the process of therapy through creative methodological designs. [ABSTRACT FROM PUBLISHER]

Arts therapists within the field of learning disabilities have long struggled to record the subtle and often silent changes that take place for their vulnerable clients in the course of treatment. In this article, I reflect on outcome evaluation and the challenge of maintaining curiosity with clients whose emotional intelligence can appear hidden, and where a parallel process of worthlessness can pervade the work of arts therapists. I briefly outline possible forms of inquiry, and describe the conversations within the arts therapies team that I am part of that led to the development of carer focus groups to capture a perception of change in clients resulting from treatment across modality for clients of all ability. I note how this approach enables collaboration with health workers and colleagues as witnesses, and the place of broad, collaborative conversations as evidence. [ABSTRACT FROM AUTHOR]

A project that began with an aspiration to introduce digital technologies into an arts therapies service turned into arts therapies taking a lead on these being introduced across all professions and services in a National Health Service (NHS) Learning Disabilities Service. This article can only give limited details of the project as a whole; rather, consideration is given to the benefits of digital technologies to adults with a learning disability, with particular focus on gesture-based technologies. Project design and methodology are described, followed by brief accounts of gesture-based technology (GBT) used across the spectrum of arts engagement and art therapy. Data from qualitative outcome measures inform discussion of the impact of and potential for gesture-based technology in arts therapies practice. In conclusion, we recommend areas for further investigation, and perhaps encourage others to overcome systemic barriers to introducing digital innovation. [ABSTRACT FROM AUTHOR]

This article outlines a pilot project to support the use of the Clinical Outcomes in Routine Evaluation (CORE) System by arts therapists1 and other Allied Health Professionals (AHPs) and the establishment of a Practice Research Network (PRN) to evaluate the use of the system in routine clinical practice. It describes the aims of the project, the establishment of the PRN, the data collected during the project and its impact on the practitioners involved. It draws initial conclusions from the project and discusses the strengths and limitations of this approach to measuring the outcomes of psychological therapy. [ABSTRACT FROM AUTHOR]

Transparency has become a catchword for proper governance in contemporary organisations, affecting the buildings arts therapists work in, the equipment they use and the way staff communicate with each other. Hence the move to open plan working in a mental health care setting for older people (‘Cloffaugh’), a popular environment for the NHS, provides a touchstone for this article: namely a detailed study of collaboration between an anthropologist (Ruth) and an arts therapies manager (Angela) that invites readers to look behind the surface appearances of everyday inter-professional interaction. Using an ethnographic approach, it follows their journey through three different office settings to show how working transparently across disciplines is harder to achieve than policy exhortations imply. Too sharp a division between what is and what merely seems, though clear, may mislead. While open plan working has many virtues, it is not simply a variable for management to manipulate. It is also an image. Transparency has to come in the right amount if it is not to be exclusive. In the spirit of ‘positive risk-taking’ often advocated, we believe the article will interest arts therapists and managers who work in organisations, large or small. [ABSTRACT FROM PUBLISHER]