An initial investigation into the effectiveness of group therapeutic puppetry with adults with severe mental illness

Section A explores the role of creative arts therapies (CATs) in assisting recovery from severe mental illness (SMI). It examines the congruence of CATs with recovery models, and critically reviews evidence for the effectiveness of art and drama therapy with adults with mental health problems. It then examines one form of CAT which combines art and drama therapy – therapeutic puppetry. Underlying theoretical models and the existing evidence base with adults with SMI are outlined and critiqued. The review concludes with a summary of proposed arguments and research recommendations.
Section B reports on a pilot investigation of group therapeutic puppetry with people with SMI.
Background: Therapeutic puppetry is the use of puppets to aid emotional healing. There is no published research investigating the effectiveness of therapeutic puppetry with people with SMI.
Aims: A pilot investigation of group therapeutic puppetry with people with SMI tested the hypotheses that this intervention results in improvements in mental wellbeing, self-esteem, and body connection. It also investigated mechanisms of change, and service user acceptability and experience.
Method: This mixed methodology study utilised five single AB design case studies with time series data analysed using simulation modelling analysis. Qualitative data was collected via participant observation and participant interviews and analysed using thematic analysis.
Results: Three participants experienced statistically and clinically significant changes in either positive or negative directions during the intervention, with all participants describing therapeutic puppetry as powerful and beneficial.
Conclusions: Therapeutic puppetry is a potentially powerful medium which could be utilised by various mental health professionals. Service users find therapeutic puppetry acceptable and beneficial despite it being an occasionally difficult and intense experience.
Section C is a critical appraisal of the conducted research, examining lessons learnt, identified training needs, changes to clinical practice and future research directions.