Arts therapies

• What are arts therapies?
• Arts therapists
• Who should be offered arts therapies?
• Are arts therapies effective?

What are arts therapies?

An art therapy is a form of psychotherapy that uses a creative medium – like art or music – to help people explore and articulate their feelings rather than speaking about them.

Arts therapies are particularly useful for individuals who find it difficult to express themselves in words: people don’t need to talk about their feelings and experiences unless they want to do so.

Four types of arts therapies are currently available in the UK. They are art therapy, dance movement therapy, drama therapy and music therapy. People don't need artistic or other creative skills in order to participate in these therapies.

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Arts therapists

Arts therapists are trained psychotherapists and learn about the use of their chosen ‘art’ during a Masters degree. They are registered and regulated by the Health and Care Professions Council.

They mostly work with small groups of people either on hospital wards or in the community, where sessions may be held on a regular, often weekly basis. 

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Who should be offered arts therapies?

The National Institute for Health and Care Excellence (NICE) says mental health professionals should consider offering arts therapies to people who have a diagnosis of schizophrenia. NICE recommends arts therapists should be registered with the Health and Care Professions Council and should have experience of working with people with schizophrenia.

However, a survey carried out by researchers at Imperial College London has shown that in England, people with schizophrenia have limited access to art therapy on the NHS. Even though most mental health trusts do employ arts therapists, many hire only a small number on a part-time basis. The survey concentrated on art therapy (rather than music, dance movement or drama therapy) and found that this type of therapy is often not considered as part of a package of care for someone with a diagnosis of schizophrenia.

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Are arts therapies effective?

Research has been carried out to test the effectiveness of arts therapies. A review of research results for the National Institute for Health and Care Excellence (NICE) guideline that recommends treatment for schizophrenia (issued in 2009) showed that, at the time, there had only been a few well-conducted studies. Those studies had, however, suggested that arts therapies might help improve the ‘negative’ symptoms of schizophrenia. These ‘negative’ symptoms include lack of energy, loss of motivation, loss of interest in activities, people and personal appearance, memory problems and concentration difficulties (see Schizophrenia page).

Research had shown that arts therapies might boost self-confidence, self-esteem and concentration, help people gain self-awareness, communicate better with others and reduce feelings of isolation and exclusion.

Studies have also demonstrated that people who have experience of mental health problems often appreciate and enjoy arts therapies.

But the results of a large randomised controlled trial carried out after the 2009 guideline was published, showed that attendance at weekly group art therapy sessions made no difference to people's symptoms or their quality of life, and was not cost-effective. The research team (led by Imperial College, London researchers) concluded that group art therapy should not be offered to everyone with a diagnosis of schizophrenia – only to those who were interested and motivated to attend sessions.

During the trial, attendance at the art therapy sessions (run for a year) was low – as was attendance at activity sessions, organised as part of the trial so researchers could make comparisons about the impact of both types of groups on people's symptoms and life. The activity groups also met weekly and included board games, discussions, watching and discussing DVDs, visits to local cafes and occasional visits to places of interest.

The MATISSE study was run with the help of 417 people recruited from England and northern Ireland.

Other studies testing the effectiveness of art therapies for people who have a diagnosis of schizophrenia are being undertaken. For example, researchers at Queen Mary University of London are recruiting more than 250 people to a trial comparing group body psychotherapy – a type of arts therapy that focuses on the body and movement as a way of communicating – with group pilates sessions.

The 2009 NICE guideline on schizophrenia is currently being updated. The update is due to be available in 2014.