Primary school mentalisation-based art therapy (Primary-smART): a Person-Based Approach optimisation study

Abstract

ABSTRACT Background The children’s mental health crisis in the UK continues to worsen and more and more schools are employing art therapists (ATs) to provide services for children experiencing social, emotional, and mental health (SEMH) difficulties. Although some studies have found indications of positive SEMH outcomes following art therapy, the evidence-base is still emerging. The initial development of a formalised art therapy intervention called Primary-smART included children, teachers, parents/carers, and art therapists. Indications from exploratory research showed this intervention could be helpful for children experiencing SEMH difficulties. Aims This study aimed to optimise a Primary-smART toolkit to ensure it is acceptable, engaging and persuasive for ATs in preparation for a future evaluation study in primary schools with children. Methods The Person-Based Approach (PBA) to intervention development was used to develop Primary-smART. In this study, feedback gained through online interviews with ATs was used to refine and optimise the toolkit. Results The 18 ATs who participated in this study perceived Primary-smART as acceptable overall. However, ATs during Rounds 1, 2, and 3 had important concerns which may have resulted in barriers to using Primary-smART. Seven out of eight main sections were modified and no new significant barriers were fed back by Round 4. Conclusions This study was successful in refining and optimising the Primary-smART toolkit. Results show that PBA methods enabled the research team to meet the study's aims. Implications for practice/policy/future research Future evaluation studies are now needed to test the clinical, carbon and cost effectiveness of Primary-smART. Plain-language summary The children’s mental health crisis in the UK has continued to worsen, especially since the COVID-19 pandemic. More and more schools are employing art therapists to provide services for children experiencing social, emotional, and mental health difficulties. Although some research studies suggest art therapy can be helpful for some children, it is still not clear exactly how it may help or if it can be helpful for many children experiencing social, emotional or mental health difficulties. To test art therapy in this way, we need to develop standardised approaches that lots of art therapists can use with many children in different schools and compare their results and experiences. This study focused on completing a step-by-step toolkit designed to enable primary-school-based art therapists to use a specific approach, which we are calling Primary-smART. This approach combines artmaking with other activities to help children understand and manage their thoughts and feelings. In this research, we asked art therapists to help us improve the toolkit. Now that the toolkit is complete, Primary-smART can be used in future studies to test if art therapy is helpful for many children in different schools and find out what is and is not helpful about the approach.