Dance movement psychotherapy practice in the UK: Findings from the Arts Therapies Survey 2011

Arts therapies practice in the UK, due to its complexity, is rarely adequately described and what constitutes main features of the professions often remains unclear. A nationwide Arts Therapies Survey was conducted in 2011 with the aim to offer a description of clinical practice with particular emphasis on work with depression. The survey received responses from 395 arts therapists, among whom 36 were dance movement therapists. While complete data from the survey is available elsewhere, this paper presents results particularly relevant to dance movement practitioners and highlights key areas of their practice, including usual work settings, client groups and preferred theoretical approaches. Both quantitative and qualitative data are used to illustrate the points discussed. Additionally, dance movement psychotherapists' responses concerning their work with depression are presented against other arts therapies professions' practice with this condition in the UK. Finally, areas for further research are recommended

Description and evaluation of arts therapies practice with adults suffering from depression in the UK

This thesis contributes new knowledge to the field of arts therapies and their relevance in the treatment of depression in adults. The global burden of depression means that available treatments do not address all areas within the complexity of the condition and arts therapies may potentially present a relevant alternative by offering opportunities for non-verbal expression and exploration of creativity. Literature up to date does not offer comprehensive enough description of arts therapies practice and therefore establishing of credible evidence has not been possible. This thesis addresses the gap by exploring the nature of arts therapies practice and its value in the treatment of depression. The research consists of two phases: phase 1 provides a description of arts therapies practice with depression in the UK based on data collected from 395 survey respondents, while phase 2 evaluates group brief art therapy for adults experiencing mild to moderate depression. The project employs mixed methodologies within a creative research design incorporating surveys, interviews, arts-based inquiry and a pilot clinical study to examine multiple perspectives and offer findings meaningful to diverse audience. This project establishes that depression is a common condition among arts therapists' clients while some of the practitioners consider work with depression their main area of professional interest. It further finds that the therapists address depression through the use of humanistic, psychodynamic and integrative approaches and discovers that certain areas of the therapy process have particular relevance in the treatment of depression (e.g. time, group work, motivation, reconnecting). The pilot clinical study concludes with decrease of depression levels and increase of subjectively perceived wellbeing in all participants immediately after nine sessions of art therapy and in the follow-up. Participants' experiences, researcher's observations and arts-based reflections on the therapy process highlight the potential value of arts therapies in areas relating to, among others: connection and sharing, awareness of others and self, sense of achievement, self-expression and regain of meaning. The findings are integrated in the final discussion, which proposes a set of concepts particularly relevant to the treatment of adult depression through arts therapies. This research provides the first comprehensive description of arts therapists' work with depression in the UK and confirms the potential of this practice to be effective, which is relevant to health professionals and may lead to increased involvement of arts therapies in mainstream healthcare. The particular value of this project lies in shaping the basis for further explorations in the form of larger RCTs as well as demonstrating relevance and superiority of creative research designs in evaluating arts therapies.sub_otatunpub1775_ethesesunpu

Effectiveness of Dance Movement Therapy in the Treatment of Adults with Depression: A Systematic Review with Meta-Analyses

Background: Depression is the largest cause of mental ill health worldwide. Although interventions such as Dance Movement Therapy (DMT) may offer interesting and acceptable treatment options, current clinical guidelines do not include these interventions in their recommendations mainly because of what is perceived as insufficient research evidence. The 2015 Cochrane review on DMT for depression includes only three studies leading to inconclusive results. In a small and underfunded field such as DMT, expensive multi-centered Randomized Controlled Trials (RCTs) are as yet rare. It is therefore, necessary to not only capture evidence from RCTs, but to also look beyond such designs in order to identify and assess the range of current evidence.Methods: We therefore conducted a systematic review of studies that aimed to explore the effectiveness in the use of DMT with people with depression. This led to a qualitative narrative synthesis. We also performed meta-analyses that calculated the effect size for all included studies, studies with RCT designs only, followed by a subgroup analysis and a sensitivity analysis. In all meta-analyses a random effects model was used with Standardized Mean Differences (SMD) to accommodate for the heterogeneity of studies and outcome measures.Results: From the 817 studies reviewed, eight studies were identified as meeting our inclusion criteria. Three hundred and fifty one people with depression (mild to severe) participated, 192 of whom attended DMT groups while receiving treatment as usual (TAU) and 159 received TAU only. Qualitative findings suggest there was a decrease in depression scores in favor of DMT groups in all studies. Subgroup analysis performed on depression scores before and 3 months after the completion of DMT groups suggested changes in favor of the DMT groups. When sensitivity analysis was performed, RCTs at high risk of bias were excluded, leaving only studies with adult clients up to the age of 65. In these studies, the highest effect size was found favoring DMT plus TAU for adults with depression, when compared to TAU only.Conclusions: Based on studies with moderate to high quality, we concluded that DMT is an effective intervention in the treatment of adults with depression. Furthermore, by drawing on a wide range of designs with diverse quality, we were able to compile a comprehensive picture of relevant trends relating to the use of DMT in the treatment of depression. Despite the fact that there remains a paucity of high-quality studies, the results have relevance to both policy-making and clinical practice, and become a platform for further research

Description of arts therapies practice with adults suffering from depression in the UK: Qualitative findings from the nationwide survey

There is growing evidence that arts therapies present a relevant treatment option for depression, but the experiences, methods, tools and methods of practice of arts therapists with this client group remain unclear. Thus, this research study aimed to describe the specifics of the practice of arts therapies with depression. In 2011, all arts therapists registered in the UK were invited to complete an online questionnaire concerning their practice in general and in relation to depression. The Arts Therapies Survey received 395 responses. Arts therapists who work primarily with depression were identified and compared to those who do not work with depression on a range of factors. These quantitative results were presented elsewhere (Zubala, MacIntyre, Gleeson, & Karkou, 2013). An analysis of the qualitative material was guided by the strategy of grounded theory, and findings were obtained through thematic analysis. The current paper introduces these findings, adding depth to the knowledge previously gained through the quantitative analysis. Arts therapists worked across various settings with highly complex clients; however, therapists struggled with the tension of providing care according to guidelines, which they found inflexible and at times misguided. The therapists tended to vary the theoretical model of their therapeutic approach depending on individual client factors and often collaborated with other professionals using a variety of standardized tools to measure outcomes. The findings further offer a detailed understanding of the therapeutic process and describe the meaning of clinical practice within arts therapies

Online art therapy pilot in the Western Isles of Scotland: a feasibility and acceptability study of a novel service in a rural community

IntroductionArt therapy, despite being an evidence-based, safe and acceptable intervention, is not widely available to clients in Scotland. Online delivery has the potential to expand the reach and accessibility, but special considerations need to be given to designing successful online art therapy services, due to the unique emphasis on the role of an image and artmaking alongside the therapeutic relationship.MethodsA pilot online art therapy service was developed and delivered in the Western Isles of Scotland to individual adult clients wishing to increase their psychological wellbeing. This research aimed to assess feasibility and acceptability of the novel service, identify enablers and challenges in setting up and delivering the service, explore participants’ expectations and experiences of art therapy and identify any impacts of the service. Mixed-method evaluation incorporated questionnaires, focus groups, interviews and Audio Image Recordings (AIRs). Findings were grouped into themes across several key areas: service setup, research procedures, intervention design and impacts and insights. Recommendations were developed for the first three areas and the last section presents indications of change and gives voice to client experience primarily.ResultsOnline art therapy was described by clients as a judgement-free zone which allowed freedom to experiment, express, feel and immerse themselves in the creative flow. Other benefits included readiness to accept emotions, increased understanding of self and others and being able to see things from a new perspective. Clients recognised the unique nature of art therapy in relation to other psychological treatments and valued the freedom of expression it offered, including the non-verbal.DiscussionThis project demonstrated that online art therapy is not only a feasible an acceptable intervention, but potentially also a powerfully impactful one, capable of instilling a positive change in a surprisingly short period of time. Exploring ways to expand current and introduce new art therapy services is highly recommended. Refinement of an intervention design, tools and research procedures is recommended through further feasibility studies of a larger scale

A randomised controlled feasibility study of interpersonal art psychotherapy for the treatment of aggression in people with intellectual disabilities in secure care

Background: Rates of aggression in inpatient secure care are higher than in other psychiatric inpatient settings. People with intellectual disabilities in secure care require adapted psychological treatments. Interpersonal art psychotherapy incorporates the use of creative art making approaches by participants, thus reducing sole reliance upon verbal interactions during psychotherapy for people who may have communication difficulties. During interpersonal art psychotherapy, participants are individually supported by their therapist to consider how they conduct relationships. This includes the influence and impact of interpersonal issues resulting in repeated patterns of conflict. The key feasibility objectives were to assess recruitment and retention rates, follow-up rates and trial procedures such as randomisation, allocation and identifying any practical or ethical problems. In addition, a preliminary ‘signal’ for the intervention was considered and an indicative sample size calculation completed. The acceptability of a potential third trial arm attentional control condition, mindful colouring-in, was assessed using four single-case design studies and a UK trial capacity survey was conducted. Methods: Adult patients with intellectual disabilities in secure care were recruited and randomised to either interpersonal art psychotherapy or delayed treatment in this multi-site study. Outcomes were assessed using weekly observations via the Modified Overt Aggression Scale and a range of self-report measures. Within study reporting processes, qualitative interviews and a survey were completed to inform trial feasibility. Results: Recruitment procedures were successful. The target of recruiting 20 participants to the trial from multiple sites was achieved within 8 months of the study opening. All participants recruited to the treatment arm completed interpersonal art psychotherapy. Between-group differences of interpersonal art psychotherapy versus the delayed treatment control showed a ‘signal’ effect-size of.65 for total scores and.93 in the verbal aggression sub-scale. There were no amendments to the published protocol. The assessment of key feasibility objectives were met and the trial procedures were acceptable to all involved in the research. Conclusion: This study suggested that a randomised controlled trial of interpersonal art psychotherapy is acceptable and feasible. Trial registration: ISRCTN14326119 (Retrospectively Registered)

Description of arts therapies practice with adults suffering from depression in the UK: quantitative results from the nationwide survey

There is growing evidence that arts therapies may be under-used treatments for the 'global burden' of depression. However, the experiences of arts therapists, their methods, tools and ways of working with this client group remain unclear. Arts therapies in the UK are a form of psychotherapy. They use arts media alongside therapeutic relationship as means of therapeutic change and include four disciplines: Art Therapy (AT), Music Therapy (MT), Dance Movement Psychotherapy (DMP) and Drama Therapy (DT). In 2011, all arts therapists registered in the UK were invited to complete an online questionnaire concerning their practice in general and specifically in relation to clients with depression. The Arts Therapies Survey received 395 responses. Arts therapists who work primarily with depression were identified and compared to those who do not work with depression on a range of factors, including preferred theoretical approaches and style of working. Arts therapists who specialise in depression tend to follow Psychodynamic principles more often, are more likely to be older and experienced, work with groups, in health settings and with adults more often than children or adolescents. These quantitative findings enable the description of most common practice of arts therapies with depression in the UK and are intended to serve as a reference for arts therapists themselves and other professionals interested in the treatment of depression. Qualitative data gathered in the survey will be presented in a separate paper, with the aim of deepening the understanding already gained. © 2013 Elsevier Ltd