Bringing creative psychotherapies to primary NHS Mental Health Services in the UK : A feasibility study on patient and staff experiences of arts for the blues workshops delivered at Improving Access to Psychological Therapies ( IAPT ) services

Developing a strategy to scale up place-based arts initiatives that support mental health and wellbeing: A realist evaluation of 'Arts for the Blues'

Place-based arts initiatives are regarded as rooted in local need and as having capacity to engage local assets. However, many place-based arts initiatives remain poorly funded and short-lived, receiving little attention on how to scale up and sustain their activities. In this study we make a unique contribution to knowledge about scaling up place-based arts initiatives that support mental health and wellbeing through focusing on the example of 'Arts for the Blues', an arts-based psychological group intervention designed to reduce depression and improve wellbeing amongst primary care mental health service users in deprived communities. Methodologically, we used realist evaluation to refine the study's theoretical assumptions about scaling up, drawing on the lived and professional experiences of 225 diverse stakeholders' and frontline staff through a series of focus groups and evaluation questions at two stakeholders' events and four training days. Based on our findings, we recommend that to scale up place-based arts initiatives which support mental health and wellbeing: (i) the initiative needs to be adaptable, clear, collaborative, evidence-based, personalised and transformative; (ii) the organisation has to have a relevant need, have an understanding of the arts, has to have resources, inspiration and commitment from staff members, relevant skillsets and help from outside the organisation; (iii) at a policy level it is important to pay attention to attitude shifts towards the arts, meet rules, guidelines and standards expected from services, highlight gaps in provision, seek out early intervention and treatment options, and consider service delivery changes. The presence of champions at a local level and buy-in from managers, local leaders and policy makers are also needed alongside actively seeking to implement arts initiatives in different settings across geographical spread. Our theoretically-based and experientially-refined study provides the first ever scaling up framework developed for place-based arts initiatives that support the mental health and wellbeing, offering opportunities for spread and adoption of such projects in different organisational contexts, locally, nationally and internationally.

High temperatures on mental health: Recognizing the association and the need for proactive strategies-A perspective

Background and Aims

The influence of temperature on various aspects of daily life is often underestimated, and its effects on mental health are not widely recognized. Understanding and addressing the relationship between temperature and mental well-being is crucial in the context of climate change and rising global temperatures. This perspective aimed to investigate the effects of high temperatures on mental health and identify proactive strategies to mitigate these effects.

Methods

This perspective adopted a twofold approach, including a comprehensive literature review and socioecological framework. The literature review involved extensive searches across Google Scholar, PubMed, and Scopus to identify relevant, peer-reviewed articles, and reports from diverse disciplines.

Results

The perspective emphasized the significance of recognizing heat stress and its consequences on mental well-being. Chronic heat stress can lead to increased stress, anxiety, and cognitive impairment. Vulnerable populations include, the very young, older adults, and individuals with pre-existing mental health conditions. Socioeconomic factors can further exacerbate vulnerability, highlighting the need for tailored strategies to manage mental health challenges during high temperatures. Additionally, the article identified and discussed proactive coping strategies to minimize both the psychological and physical impacts of heat stress. Mindfulness, stress management techniques, and therapy are suggested as effective means for individuals to manage psychological distress.

Conclusion

Implementing preventive measures are essential steps in promoting mental wellness in high temperatures. Proactive strategies by addressing the physiological and psychological effects of heat and considering the specific needs of vulnerable populations can help individuals and communities navigate the challenges posed by rising temperatures and promote resilience and preserve their mental well-being.

Navigating the Storm to Recovery through the Pictorial Representations of Persons in the Recovery Phase from Unipolar Depression

Depression is a highly complex mental illness that presents challenges, such as difficulties for persons with depression to communicate their experiences. This is compounded further by a paucity of in-depth and pictorial accounts on their experiences of the recovery process. The combination of pictorial representations and interviews with persons who are recovering from depression, may assist them in communicating these lived experiences. Five participants recovering from unipolar depression and who were in the late stages of recovery were recruited through purposive sampling. Data were collected through the conduction of art sessions, where participants pictorially represented their experience of living with depression and their road to recovery. Semi-structured interviews were then used to explore their artwork. The transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Two superordinate themes emerged from participants' interviews, namely: 'A New Me in Me' that incorporating changes in their identity, physical, emotional, and social experiences, and 'Life as an amalgamation of colour' describing their search for meaning and the importance of spirituality, hope, gaining control and positivity in the recovery process. The use of pictorial representations combined with interviews can add depth to participant narratives, that serve to enhance the therapeutic alliance between the patient-professional dyad.

Feasibility, acceptability, and effectiveness of school-based dance movement psychotherapy for children with emotional and behavioral difficulties

Background

Schools have been increasingly employing dance movement psychotherapists to support children cope with daily worries and stress, express and understand their emotions, develop self-awareness and self-esteem. However, evidence on the impact of dance movement psychotherapy as a tool for prevention of mental health difficulties in childhood remains limited.

Methods

Sixteen children (aged 7–9) with mild emotional and behavioral difficulties from two primary schools were randomly assigned to a Dance Movement Psychotherapy (DMP) intervention or to a waiting list, within a larger pilot cross-over randomized controlled study which aimed to (a) test whether all elements of study design can work together and run smoothly in a full-scale RCT; and (b) investigate the effectiveness of arts therapies in improving children’s health related quality of life (HRQOL; EQ-5D-Y), wellbeing and life functioning (Child Outcome Rating Scale; CORS), emotional and behavioral difficulties (Strengths and Difficulties Questionnaire; SDQ), and duration of sleep (Fitbits). The therapeutic process was also evaluated through interviews with children, participant observations, the Children’s Session Rating Scale (CSRS), and ratings of adherence to the therapeutic protocol.

Results

The findings indicated that DMP led to improvements in children’s life functioning, wellbeing, duration of sleep, emotional and behavioral difficulties, but not in quality of life. The improvements were maintained at the follow-up stages, up to 6 months post-intervention. Interviews with children also suggested positive outcomes, such as self-expression; emotional regulation; mastery and acceptance of emotions; improved self-confidence and self-esteem; reduced stress; and development of positive relationships. However, children would have preferred smaller groups and longer sessions.

Conclusion

This study indicated that all outcome measures would be suitable for inclusion in a larger randomized controlled trial, though the EQ-5D-Y is not recommended as a stand-alone measure due to its lack of sensitivity and specificity for young participants. The adherence to the therapeutic protocol ratings differed between children and adults, highlighting the need to include children’s voice in future research. Strategies are also proposed of how to conduct randomization of participants in ways that do not hinder the therapeutic process.