Art and other group therapies with adolescents in inpatient mental health care

Abstract

ABSTRACT Background Group programmes are a common component of treatment in inpatient child and adolescent mental health service (CAMHS) units. There is evidence for specific group interventions, however, comparison across a multidisciplinary group programme is under-explored. Aims This research examines young people's experiences of, and satisfaction with, a multidisciplinary group programme on an acute inpatient CAMHS unit. Methods Weekly surveys were distributed to young people, and 37 responses were gathered across four months in 2018. Rates of attendance, enjoyment and perceived helpfulness of groups were calculated. Content analysis was used to explore key themes in qualitative responses. Results Young people rated a creative activities and games group (54.05%) and the art therapy group (48.95%) as the two most enjoyable groups. Art therapy was reported to be the most helpful group overall (45.65%). Young people also expressed their dislike for verbal psychotherapy groups (43.24%), finding these confronting relative to other modalities in the programme. Conclusions Art therapy and arts-based groups received the highest positive feedback relative to predominantly verbal psychotherapy groups. A multidisciplinary group programme which integrates art therapy and other creative modalities has the potential to enhance engagement in acute inpatient settings which may result in improved mental health outcomes for young people. Implications for future research and practice Future research should aim to foreground young people's perspectives and experiences of therapeutic programmes, and provide opportunities for clinicians to redevelop programmes responsively to service user feedback. Survey findings support advocacy for consistent art therapy roles and services within inpatient CAMHS units. Plain-language summary A survey to gather feedback on the multidisciplinary group programme was developed and implemented on an acute inpatient child and adolescent mental health services (CAMHS) unit in Sydney, Australia. A total of 37 responses were gathered. Survey findings indicated that the use of creative elements in groups supported more consistent engagement when compared to verbal psychotherapy groups. While creative diversional groups were deemed enjoyable, the art therapy group was rated not only as being highly enjoyable, but was also rated the most helpful group by a clear margin. Young people consistently gave negative feedback regarding groups which were primarily verbal, expressing they found them ‘scary’ or ‘confronting’. The outcome of this survey speaks to the value of creative approaches to group therapy in acute inpatient CAMHS units. Services and clinicians often struggle to engage young people in verbal psychotherapies prior to a hospital admission. Given this, the provision of diverse and creative groups, including art therapy, within a multidisciplinary programme is likely to enhance engagement and outcomes for young people. We anticipate that these findings will be of value to all acute inpatient CAMHS units when designing and delivering group programmes. The survey allowed for young people's perspectives to be heard, and for the multidisciplinary team to respond to the preferences and ideas offered by young people on the unit. This has resulted in a more robust programme both clinically and creatively, inviting co-construction with service users.