Art therapy with people diagnosed with psychosis: therapists’ experiences of their work and the journey to their current practice

Journal article


Holttum, S., Wright, T. and Wood, C. 2021. Art therapy with people diagnosed with psychosis: therapists’ experiences of their work and the journey to their current practice. International Journal of Art Therapy. https://doi.org/10.1080/17454832.2021.1893370
AuthorsHolttum, S., Wright, T. and Wood, C.
Abstract

Background: There was insufficient understanding of how art therapists experience their work with people with psychosis-related diagnoses, and of their practice development.
Aims: To understand art therapists’ perceived practise and its development regarding psychosis.

Methods: Within a grounded theory framework (Corbin & Strauss, 2015; Strauss & Corbin, 1990), interviews and a focus group carried out in the years 2015 to 2017 elicited the experiences of 18 UK-based art therapists, working in a range of National Health Service (NHS) contexts, concerning art therapy in relation to psychosis and how they developed their current practice. Audio-recordings were transcribed verbatim and analysed to build theory.

Results: The grounded theory proposes how practice and its development intertwine. Training confers resilience but therapists learn greatly from their clients, enhancing their ability for alliance-building. Therapists’ early struggles also spur further training. Skills for trauma are helpful. Clients may become stuck or disengage, and/or develop through ongoing engagement with art and the art therapist, who supports their journey. The service and wider societal contexts impact the art therapist’s work through their effect on clients and/or the art therapist’s ability to attune to clients.

Conclusions: The findings concur with previous research regarding common therapeutic factors, especially the alliance, and on other therapists’ practice development.
Implications for practice and research: Understanding therapy processes should incorporate service and societal influences on therapist and client. Training needs to include understanding adversity and trauma, and working with trauma.

KeywordsArt therapy; Psychosis; Practice development
Year2021
JournalInternational Journal of Art Therapy
PublisherTaylor & Francis
ISSN1745-4832
Digital Object Identifier (DOI)https://doi.org/10.1080/17454832.2021.1893370
Official URLhttp://dx.doi.org/10.1080/17454832.2021.1893370
Publication dates
Online24 Mar 2021
Publication process dates
Deposited25 Feb 2021
Accepted16 Feb 2021
Accepted author manuscript
File Access Level
Restricted
Output statusPublished
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Additional information

The paper reports on the findings from in-depth interviews carried out with UK art therapists experienced in working with people who have been given a psychosis-related diagnosis. This work was one of several streams that fed into the development of the BAAT Guidelines on Art Therapy for People with a Psychosis-Related Diagnosis (Wright & Holttum, 2020).

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Holttum, S., Richards, J. and Springham, N. 2016. How do “mental health professionals” who are also or have been “mental health service users” construct their identities? SAGE Open. 2016, pp. 1-14. https://doi.org/10.1177/2158244015621348
Reaching a UK consensus on art therapy for people with a diagnosis of a psychotic disorder using the Delphi method
Holttum, S., Huet, V. and Wright, Tim 2016. Reaching a UK consensus on art therapy for people with a diagnosis of a psychotic disorder using the Delphi method. International Journal of Art Therapy. 22 (1), pp. 35-44. https://doi.org/10.1080/17454832.2016.1257647
Development of a measure of caregiver burden in paediatric chronic kidney disease: the Paediatric Renal Caregiver Burden Scale
Parham, R., Jacyna, N., Horthi, D., Marks, S., Holttum, S. and Camic, P. 2014. Development of a measure of caregiver burden in paediatric chronic kidney disease: the Paediatric Renal Caregiver Burden Scale. Journal of Health Psychology. https://doi.org/10.1177/1359105314524971
The process of engaging in mindfulness-based cognitive therapy as a partnership: a grounded theory study
Smith, E., Jones, F., Holttum, S. and Griffiths, K. 2014. The process of engaging in mindfulness-based cognitive therapy as a partnership: a grounded theory study. Mindfulness.
Testing a model of research intention among U.K. clinical psychologists: a logistic regression analysis
Eke, G., Holttum, S. and Hayward, M. 2012. Testing a model of research intention among U.K. clinical psychologists: a logistic regression analysis. Journal of Clinical Psychology. 68 (3), pp. 263-278. https://doi.org/10.1002/jclp.20860
Gender identity, research self-efficacy and research intention in trainee clinical psychologists in the UK
Wright, A. and Holttum, S. 2010. Gender identity, research self-efficacy and research intention in trainee clinical psychologists in the UK. Clinical Psychology & Psychotherapy. 19 (1), pp. 46-56. https://doi.org/10.1002/cpp.732
Mechanisms of collaboration to support social interaction in ASC
Holttum, S., Yuill, N., Carr, A. and Kreitmayer, S. 2012. Mechanisms of collaboration to support social interaction in ASC.
Quality improvement projects: an introduction
Holttum, S., Raval, H. and Sperlinger, D. 2003. Quality improvement projects: an introduction. Clinical Psychology: Training, Research and Development. 1 (2), pp. 4-8.
A grounded-theory study of mindfulness practice following mindfulness-based cognitive therapy
Langdon, S., Jones, F., Hutton, J. and Holttum, S. 2011. A grounded-theory study of mindfulness practice following mindfulness-based cognitive therapy. Mindfulness. 2 (4), pp. 270-281. https://doi.org/10.1007/s12671-011-0070-5
A grounded theory investigation of life experience and the role of social support for adolescent offspring after parental brain injury
Moreno-Lopez, A., Holttum, S. and Oddy, M. 2011. A grounded theory investigation of life experience and the role of social support for adolescent offspring after parental brain injury. Brain Injury. 25 (12), pp. 1221-1233. https://doi.org/10.3109/02699052.2011.608205
Involving service users and carers in clinical psychology training
Goodbody, L. and Holttum, S. 2007. Involving service users and carers in clinical psychology training.
Service user and carer involvement in clinical psychology doctoral training: Training as a professional and remaining human
Holttum, S. 2009. Service user and carer involvement in clinical psychology doctoral training: Training as a professional and remaining human.
Research watch
Holttum, S. 2011. Research watch. Mental Health and Social Inclusion. 15 (1), pp. 7-11. https://doi.org/10.5042/mhsi.2011.0052
From student to service user to research lecturer on a clinical psychology programme: a personal view on why clinical psychology training needs service user involvement
Holttum, S. 2010. From student to service user to research lecturer on a clinical psychology programme: a personal view on why clinical psychology training needs service user involvement. Clinical Psychology Forum. 209, pp. 39-41.
Small-scale placement-based research in clinical psychology training: the role of qualitative methods
Holttum, S. and Lavender, T. 2001. Small-scale placement-based research in clinical psychology training: the role of qualitative methods. Clinical Psychology. 5, pp. 27-31.
Express yourself? Research in brief
Holttum, S. 1998. Express yourself? Research in brief. The Psychologist. 11 (6), pp. 296-296.
Is abstinence from alcohol dangerous? Research in brief
Holttum, S. 1998. Is abstinence from alcohol dangerous? Research in brief. The Psychologist. 11 (4), p. 186.
An investigation of the impact of training social workers and their managers
Duffy, T., Holttum, S. and Keegan, M. 1998. An investigation of the impact of training social workers and their managers. Alcoholism. 34 (1-2), pp. 93-104.
Personality style, psychological adaptation and expectations of trainee clinical psychologists
Brooks, J., Holttum, S. and Lavender, T. 2002. Personality style, psychological adaptation and expectations of trainee clinical psychologists. Clinical Psychology & Psychotherapy. 9 (4), pp. 253-270. https://doi.org/10.1002/cpp.318
Determinants of quality of life in black African women with HIV living in London
Onwumere, J., Holttum, S. and Hirst, F. 2002. Determinants of quality of life in black African women with HIV living in London. Psychology, Health and Medicine. 7 (1), pp. 61-74. https://doi.org/10.1080/13548500120101568
The relationship between acceptance and cognitive representations of pain in participants of a pain management programme
Rankin, H. and Holttum, S. 2003. The relationship between acceptance and cognitive representations of pain in participants of a pain management programme. Psychology, Health and Medicine. 8 (3), pp. 329-334. https://doi.org/10.1080/1354850031000135768
Factors influencing levels of research activity in clinical psychologists: a new model
Holttum, S. and Goble, L. 2006. Factors influencing levels of research activity in clinical psychologists: a new model. Clinical Psychology & Psychotherapy. 13 (5), pp. 339-351. https://doi.org/10.1002/cpp.501
Perceived improvements in service user involvement in two clinical psychology training courses
Holttum, S. and Hayward, M. 2010. Perceived improvements in service user involvement in two clinical psychology training courses. Psychology Learning & Teaching. 9 (1), pp. 16-24. https://doi.org/10.2304/plat.2010.9.1.16
WAIS III UK: an extension of the UK comparability study
Wycherley, R., Lavender, T., Holttum, S., Crawford, J. and Mockler, D. 2005. WAIS III UK: an extension of the UK comparability study. British Journal of Clinical Psychology. 44 (2), pp. 279-288. https://doi.org/10.1348/014466505X29440
Children's explanations of aggressive incidents at school within an attribution framework
Joscelyne, T. and Holttum, S. 2006. Children's explanations of aggressive incidents at school within an attribution framework. Child and Adolescent Mental Health. 11 (2), pp. 104-110. https://doi.org/10.1111/j.1475-3588.2006.00397.x
How do women experience myocardial infarction? A qualitative exploration of illness perceptions, adjustment and coping
White, J., Hunter, M. and Holttum, S. 2007. How do women experience myocardial infarction? A qualitative exploration of illness perceptions, adjustment and coping. Psychology, Health and Medicine. 12 (3), pp. 278-288. https://doi.org/10.1080/13548500600971288
Reflections on involving service users and carers in clinical psychology training
Holttum, S. 2008. Reflections on involving service users and carers in clinical psychology training. The Higher Education Academy Psychology Network Newsletter. 48, pp. 2-3.
Perceived changes associated with autogenic training for anxiety: a grounded theory study
Yurdakul, L., Holttum, S. and Bowden, A. 2009. Perceived changes associated with autogenic training for anxiety: a grounded theory study. Psychology and Psychotherapy: Theory Research and Practice. 82 (4), pp. 403-419. https://doi.org/10.1348/147608309X444749
Comparative clinical feasibility study of three tools for delivery of cognitive behavioural therapy for mild to moderate depression and anxiety, provided on a self-help basis
Pittaway, S., Cupitt, C., Palmer, D., Arowobusoye, N., Milne, R., Holttum, S., Pezet, R. and Patrik, H. 2009. Comparative clinical feasibility study of three tools for delivery of cognitive behavioural therapy for mild to moderate depression and anxiety, provided on a self-help basis. Mental Health in Family Medicine. 6 (3), pp. 145-154.