Neil Springham

New roles for art galleries: Art-viewing as a community intervention for family carers of people with mental health problems

Objective: This study aimed to understand the psychological and social aspects of how art-viewing, in a public art gallery, could be used as an activity to support family carers of people with mental health problems. Methods: Using grounded theory methodology, interviews from eight carer-participants and two facilitator-participants were analysed, along with podcasts created from audio-recordings of the gallery sessions. Results: Art-viewing was conceptualised as an experience that engaged carers on emotional, aesthetic and educational levels. Psychological processes such as mentalising, reflexivity and externalising were identified in the responses stimulated by art-viewing. Conclusions: The findings suggest that art-viewing in a group within a gallery setting has the potential to be used more widely as a community-based, low-cost and non-clinical activity to provide social and psychological support for carers of people with mental-health problems.

How can art therapy contribute to mentalization in borderline personality disorder

Abstract This article evaluates a pilot mentalization-based treatment programme for borderline personality disorder (BPD), which had an art therapy group as one of its three components. Evaluation involved a range of standardised measures and showed the programme had positive results with increases in distress tolerance, lowered service use and at least two participants no longer meeting criteria for the BPD diagnosis. The question was asked about what art therapy might contribute to mentalization in this context. A qualitative research strategy was undertaken to explore one of the authors experience of art therapy as one of the programmes service users. Repeated rounds of audio-recorded interviews resulted in eight themes which describe what helped and what should be avoided in art therapy treatment of BPD. The service user view was that art therapy was an essential ingredient in helping to develop greater mentalization. The study suggests that in anchoring mental content in an externalised form, art therapy offers the flexibility to slow down the process of explicit mentalization to a manageable pace. These findings were linked with similar service user research in Norway and the USA.

Through the eyes of the law: What is it about art that can harm people?

Abstract The notion of arts-based risk is rarely acknowledged outside of art therapy. This paper describes an injury sustained as a result of art activity. The case was subject to legal proceedings which established arts practitioner and organisational negligence. The case was consequently settled out of court for a large sum. The paper reports the legal argument and explores what the process tells us about how art can both help and harm participants. This specifically concerns the power of art to make the subjective seem real and the need for practitioners to able to competently assess participants’ psychological vulnerability to this. The case represents an important milestone in the current arts and health debate, particularly with regard to the protection of the public. Lessons to be learnt for organisations seeking to deliver arts and health projects to vulnerable people are discussed.

The role of art therapy in a pilot for art-based Information Prescriptions at Tate Britain

Abstract This paper describes the results of a pilot project involving a partnership between Oxleas Foundation NHS Trust and Tate Britain aimed at producing art-based information prescriptions. Carers and service users used visual images, in the form of art works in Tate Britain and self-created pictures, as a means of communicating their experience for others who had similar conditions and experiences. The imagery and the discussions involved were recorded in Podcast form to be given to those newly entering into contact with mental health services. Whilst explicitly not aiming to be a therapy intervention, art therapy played a particular role and this is explored in the paper, specifically as a tool for psychological engagement with art works and in the management of risk. The pilot showed that information prescriptions produced this way communicated emotionally relevant material in an accessible form. An added benefit of the sessions was that participants found the production method itself helpful for processing troubling experience and engaging with the gallerys work on a personal level. This has implications for clinical art therapy practice.

On learning from being the in-patient

Abstract This case study concerns the dual experience of being both a mental health professional (art therapist) and a service user on a mental health inpatient ward. The study uses heuristic methodology to explore how the experience of being a service user affected being a service provider. The art therapist was unable to use art therapy when a service user and this offers a rare chance to try to understand the barriers and opportunities to engaging with therapy in acute states. The experience of being an inpatient was both hard to recall and to articulate and so a repeating interview cycle approach was used involving another art therapist asking questions, working from a comparable provider perspective, aiming to understand the user experience. Both parties grouped the interviews transcripts into key learning themes.

Reflect Interview using audio-image recording: Development and feasibility study

Abstract This paper outlines the development to date of two art therapy practice research tools: the audio-image recording (AIR) format and an art-based semi-structured interview entitled Reflect Interview. These aim to capture service user views of what changes, and what mechanisms cause change, in the art therapy they have received. A feasibility study was undertaken to establish whether these tools could be used to build credible data sets across multiple sites and populations. Results indicate this is possible if the data collection period is longer than six months. The authors argue that results indicate the tools have high respondent validity, are unobtrusive to administer in naturalistic settings and offer a novel contribution to art therapy research from within its practice.

The Art Therapy Practice Research Network: Hurdles, pitfalls and achievements

AbstractAim: This article gives an overview of the setting up of the Art Therapy Practice Research Network (ATPRN) in 2000, amidst a culture resistant to research. The authors discuss their experiences in changing this culture and encouraging art therapists to become practitioner/researchers. They identify learning points that may be helpful for other professionals who want to form new practice research networks (PRNs). Context: The research and practice context contemporary to the ATPRN foundation is outlined and identified as a significant influence on its inception and development. Key events in the 14 years of the PRNs life and articles on art therapy and psychotherapy research published at the time of the ATPRN foundation are used to illuminate the historical context. ATPRN newsletters and symposium reports were consulted to identify themes and issues across 14 years of development and growth. Learning points: Several learning points are identified and listed as useful factors to address when settin...

How Do “Mental Health Professionals” Who Are Also or Have Been “Mental Health Service Users” Construct Their Identities?:

“Mental health professionals” are increasingly speaking out about their own experiences of using mental health services. However, research suggests that they face identity-related dilemmas because social conventions tend to assume two distinct identities: “professionals” as relatively socially powerful and “patients” as comparatively powerless. The aim of this study was, through discourse analysis, to explore how “mental health professionals” with “mental health service user” experience “construct” their identity. Discourse analysis views identity as fluid and continually renegotiated in social contexts. Ten participants were interviewed, and the interviews were transcribed and analyzed. Participants constructed their identity variously, including as separate “professional” and “patient” identities, switching between these in relation to different contexts, suggesting “unintegrated” identities. Participants also demonstrated personally valued “integrated” identities in relation to some professional contexts. Implications for clinical practice and future research are explored. Positive identity discourses that integrate experiences as a service user and a professional included “personhood” and insider “activist,” drawing in turn on discourses of “personal recovery,” “lived experience,” and “use of self.” These integrated identities can potentially be foregrounded to contribute to realizing the social value of service user and other lived experience in mental health workers, and highlighting positive and hopeful perspectives on mental distress.

Experience based co-design reduces formal complaints on an acute mental health ward

Abstract An acute mental health triage ward at Oxleas NHS Foundation Trust was attracting high levels of formal service user and family complaints. The Trust used experience based co-design to examine the issues and redesign procedures. This resulted in an immediate eradication of formal complaints for a period of 23 months. This paper describes two outcomes: firstly, the successful adaptations made to the experience based co-design methodology from its origins in physical care, in order to ensure it was safe and effective in an acute mental health setting; and, secondly, the changes made to the ward as a result of this quality improvement intervention.

Observing mentalizing art therapy groups for people diagnosed with borderline personality disorder

ABSTRACT This article describes video-based observation of three mentalization-based treatment (MBT) art therapy groups in services for people who have received a diagnosis of personality disorder. Four focus groups (service user researchers, MBT trained psychologists, MBT trained art therapists, and the three art therapists who submitted videos) developed descriptions of the practice they observed on video. A grounded theory method was used to develop a proposition that if the art therapist uses art to demonstrate their attention, this tends to help potentially chaotic and dismissive groups to cooperate, whereas if the art therapist gives the appearance of passivity, it tends to increase the problematic interactions in the group.