Surviving Creatively: An investigation into the impact of work with people who have learning disabilities on art therapists employed in the NHS

Abstract

This heuristic qualitative study is the first British art therapy study into the impact of working with people with learning disabilities on art therapists employed in the NHS, asking whether they could avoid burnout. The researcher had personal experience of the issues. Unlike most burnout studies, organisational, client-related and personal factors were considered, and the interaction between them was found to be important. The researcher explored her own data in a rigorous self-analytic process, and fifteen art therapists employed by NHS Trusts across England were interviewed. There were enjoyable and satisfying aspects to our work as art therapists with people with LD, and protective factors, such as support, autonomy, empowerment, working part-time, personal development, art practice, and strategic self-care. Researcher’s data revealed considerable impact working with people with severe LD and challenging behaviour. Three participants had similar experiences, but, even for art therapists working with clients with milder LD, powerful unconscious processes impacted thinking and emotional labour, as did challenging behaviour, autism, complexity, risk, difficulties with engagement. Stress was experienced due to widespread restructuring and ongoing change in NHS Trusts and prolonged job insecurity, uncertainty, work intensification and changes in working conditions. Limited employment opportunities for art therapists increased anxiety about job insecurity; fortunately, participants retained their jobs. They were highly committed, and most retained tenure for many years. Community-based art therapists were particularly impacted by agile working and estate reduction. Personal sources of stress, combined with organisational and LD-related sources, and multiple roles, increased vulnerability to emotional exhaustion. Participants were creative, resourceful, flexible, and adapted to changing work conditions; they had a person-centred therapeutic approach, and made considerable efforts to ensure work-life balance. Of six participants who were highly stressed, three experienced emotional exhaustion and physical illness, but recovered, and there was much evidence of resilience and personal growth.