Andrea Gilroy

Our own kind of evidence

Abstract Prior to writing this paper I had only heard vaguely about Evidence-Based Practice and Evidence-Based Medicine. I had assumed that it referred to a clinical practice where ones work was based on research findings, an approach which could surely be described as a good thing. Other arts therapists seemed to have the same kind of vague understanding and so I was rather surprised to get a very vehement response from a friend who is a doctor; he said that EBM was patronising: its what all good doctors do anyway!. Whatever else EBP or EBM might or might not be it certainly is provoking a heated debate, in the BMJ and the Lancet if nowhere else, although the subject is reputedly not one of the medical professions central concerns. In my reading around the subject I have discovered that the new discipline of EBM/EBP is indeed about basing ones practice on research findings, for that is what is meant by evidence, an attitude with which I am entirely in agreement. But I have to admit to being in some disag...

On occasionally being able to paint

Abstract Many of us find that our own work suffers when we practise as art therapists. Yet training courses stress the importance of maintaining our personal artwork alongside therapy practice, and this is widely accepted as a valuable part of a balanced approach to art therapy. Andrea Gilroy has examined this, sometimes difficult, relationship. She outlines her own experiences and reports on her research findings. This article is a reprint of an article originally published in Inscape Spring 1989. It should be noted that at the time the research was being carried out, art therapy training courses ran for only one year full-time or two years part-time.

The use of art work in art psychotherapy with people who are prone to psychotic states. A clinical practice guideline

This report describes a clinical guideline for the practice of art psychotherapy with people prone to psychotic states (Brooker et al., 2006). It has been developed over the last four years by a group of 13 art psychotherapists, all but one of whom (the Chair) worked in the Art Psychotherapy Service of Oxleas NHS Foundation Trust. Parry and Richardson (1996) state that a key contribution to the evidence base of all psychotherapy-based practices and services is through the adoption of clinical guidelines that are informed by research (p. 47). This Guideline makes a direct contribution to the evidence base for art psychotherapy with service users who have severe and complex problems. It follows the procedure recommended for guideline development as described by Gilroy (2006) and is modelled on Parry’s guideline (2001) for treatment choice in psychological therapies. Whilst its development was local, its recommendations have far-reaching implications for practice at national and international levels with this client population. The Guideline is situated in the context of NICE’s Guidelines (2002/2006) on interventions in schizophrenia in primary and secondary care. In these documents, psychological interventions with people diagnosed as schizophrenic are described as aiming to decrease an individual’s distress and vulnerability, reduce symptoms and risk, and improve communication and their quality of life (p. 114). This Guideline describes how art psychotherapy addresses these aims, not least through offering the ‘‘supportive and empathic relationships’’ that NICE recommends (ibid.) and doing so within the ‘step model’ of treatment, i.e. steps 2 and 3 (as part of early intervention and prevention) and steps 4 and 5 (as part of treatment from mental health specialists). The Guideline includes an extensive critical appraisal and systematic review of different kinds of evidence* textual, oral and practical* that includes art psychotherapy research and related literature, the opinions of expert practitioners, local custom and practice and consultation with service users. The evidence is reviewed thematically with regard to context and setting, the referral process, assessment and clinical approaches, each item of evidence being weighted in a systematic review. The evidence hierarchies of medicine and the psychological therapies ‘weight’ or value evidence according to the rigour and nature of quantitative research methodology. These routinely exclude qualitative research and theoretical and descriptive studies. The Guideline Development Group at Oxleas deemed these to be inequitous methodologically and inappropriate for the current knowledge and evidence base of art psychotherapy. The Chair and the Guideline Development Group therefore devised an evidence hierarchy (see table) that, whilst staying within the framework of orthodox evidencebased practice, enabled an inclusive, realistic and critical assessment of art psychotherapy’s current evidence base (Gilroy, 2006).

Art therapy research in practice

An edited book addressing recent art therapy research with adults, children and people with learning disabilities. It includes editorial commentaries, written in collaboration with chapter authors, discussing themes and issues arising in relation to the evidence base of art therapy.

On occasionally being able to paint revisited

My immediate reaction on being asked to update this stoq was one of guilt. Only this and one other text (Gilroy, 1995) from the research is in the public domain, yet it has informed every subsequent project and different aspects of it are embedded in my teaching. The thesis (Gilroy, 1992) traced art ther‘ipists’ processes of occupational motivation, documenting the origins of their interest in art and tracking their art-making and personal journeys to the point of entry into postgraduate art therapy education and beyond. It explored how the professional socialisation of training the process through which one becomes the person the situation demands influenced students’ art. Generally speaking the influences were positive: students reported increases in self-awareness and in a capacity for honest self-reflection that enabled greater spontaneity and freedom in the art-making process, but there was no doubt that the emotional and practical demands of training also had a deleterious effect on the time and energy available for art practice that were exacerbated by the subsequent demands of professional work. Many art therapists reported a diminution of their art practice which appeared to havc, potentially serious consequences for maintaimng the uniqueness of the discipline -but others, then as now, retain an important connection to their art practice. Some exhibit, others write about their art (Lanham, 2002; Rogers, 2002) and how it informs clinical work and supervision (Case, 1994; Broivn et al., 2003), or draw on visual art to expand art therapy’s theoretical frameworks (Schaverien, 1993; Tipple, 1992,2003; Aldridge, 1998; Mahony, 2001 ); works are on the cover of Inscape, some art therapy departments have art practice days and it is no% an aspect of CPD, and yet. . . what? The relationship many art therapists have with their art still seems ill at ease, permeated with feelings of loss and guilt. The artist in the art therapist still has to be ’cultivated (Moon, 2002).

Taking the pulse of american art therapy a report on the 27th annual conference of the american art therapy association, november 13th 17th, 1996, philadelphia

Abstract Last year we attended the 27th Annual Conference of the American Art Therapy Association, following in the footsteps of Joan Woddis and Peter Byrne who attended the 16th and 17th Annual Conferences of AATA. In this paper we describe our experiences at the 1996 Conference and reflect on what we learnt there about art therapy in the differing cultural contexts of Britain and the United States of America. We set our thoughts in the developing debate about Anglo-American approaches to art therapy, aware that our impressions are based on a limited experience, not necessarily reflective of American art therapy as a whole