UK art therapy practice-based guidelines for children and adults with learning disabilities

Exploring Mental Health Services for Youth Experiencing Homelessness in East Asian Pacific Regions: A Systematic Scoping Review

BACKGROUND

Youth experiencing homelessness (YEH) in East Asian Pacific (EAP) regions represent one of the most at-risk populations due to cultural and geographical factors. Effective mental health interventions, primarily researched in Western contexts, may not fully apply to YEH in EAP. Their lack of stable shelter, disrupted social networks, and limited access to mental health services elevate their susceptibility to adverse mental health, making urgent interventions essential to address their needs.

OBJECTIVE

The objective of this study is to explore and systematically search the types of mental health services and interventions available for YEH in EAP and their impact on overall quality of life and wellbeing.

METHODS

Electronic databases (e.g., Medline, PsycINFO, PubMed, Scopus) were systematically searched (publication dates between 1 January 1990 and 13 May 2023), as well as additional online resources specific to homelessness. Articles were screened, and a critical appraisal assessed the quality of the included studies.

RESULTS

Eight studies with different interventions were identified in Indonesia (n = 2), Malaysia (n = 1), South Korea (n = 3), and the Philippines (n = 1). These were thematically clustered into six categories: art, cognitive behavioural therapy, life skills education, resilience enhancement, family strengthening, and government interventions/services.

CONCLUSIONS

This review highlights effective mental health interventions' positive impact on YEH mental health outcomes and quality of life in EAP, stressing the urgent need to implement socio-culturally sensitive services. Future research should address knowledge gaps through comprehensive studies covering diverse EAP regions and populations, prioritising socio-culturally specific psychological measures.

A case study of group art therapy using digital media for adolescents with intellectual disabilities

Introduction

In art therapy, digital art therapy is a new method in which clients use digital media to express themselves creatively. We wanted to explore what this means for adolescents with disabilities. The purpose of this qualitative case study was to explain what kind of experience they had when digital media was applied as an expressive and therapeutic medium in group art therapy in which adolescents with intellectual disabilities were participants and what kind of therapeutic meaning the experience had. We tried to know the therapeutic factors by extracting the implications of meaning.

Methods

Participants were second-year high school students with intellectual disabilities who belonged to special classes. They were selected in an intentional purposive sampling method. Five teenagers with intellectual disabilities participated in 11 group art therapy sessions. Data were collected through interviews, observation, and digital artwork collection. Collected data were case studies analyzed using an inductive approach. In this study, the use of digital media was defined and utilized as "Digital Art Therapy" by setting the scope related to the study according to client's behavioral method.

Results

As a digital generation accustomed to smartphones, the participants gained confidence by repeatedly acquiring new technologies through familiarity with the media. Interaction with the media through touch and the use of apps have promoted autonomy with interest and pleasure to disabled teenagers, allowing them to express themselves actively. In particular, digital art therapy induces a holistic sensory experience by mobilizing visual images that could represent various expressions, emotions felt in music and tactile senses that made texts for people with intellectual disabilities with difficulty in verbal communication.

Discussion

Art therapy using digital media has become an important experience that provides opportunities to arouse curiosity, enjoy creative activities, and express positive emotions vividly to adolescents with intellectual disabilities who have difficulties with expression and communication and a sense of lethargy. Therefore, it is suggested that an in-depth understanding of the characteristics and differences between traditional and digital media is necessary, and that complementary use to help create therapeutic purposes and art therapy is important.

A systematic review of community psychosocial group interventions for adults with intellectual disabilities and mental health conditions

BACKGROUND

People with intellectual disabilities have a high risk of developing mental ill-health. Treatment is often neglected and diagnosis is misattributed to a person's disability. Standard psychosocial interventions can improve a person's well-being. This review aimed to understand what interventions are being delivered, any benefits, and future recommendations.

METHODS

Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed, and the review registered with PROSPERO-CRD42020160254. Databases searched included: MEDLINE, Embase, and PsycINFO. A framework synthesis approach was used to present the findings.

RESULTS

There are limited psychosocial interventions offered for this population. When groups are delivered having a creative element, multiple activities over a short period of time, with breaks and group rules outcomes can be improved.

CONCLUSIONS

Adaptations and reasonable adjustments should be used specifically to a person's ability. A mixed-method design allows people to share their experiences alongside quantitative data that provides clinical information.

A randomised controlled feasibility study of interpersonal art psychotherapy for the treatment of aggression in people with intellectual disabilities in secure care

BACKGROUND

Rates of aggression in inpatient secure care are higher than in other psychiatric inpatient settings. People with intellectual disabilities in secure care require adapted psychological treatments. Interpersonal art psychotherapy incorporates the use of creative art making approaches by participants, thus reducing sole reliance upon verbal interactions during psychotherapy for people who may have communication difficulties. During interpersonal art psychotherapy, participants are individually supported by their therapist to consider how they conduct relationships. This includes the influence and impact of interpersonal issues resulting in repeated patterns of conflict. The key feasibility objectives were to assess recruitment and retention rates, follow-up rates and trial procedures such as randomisation, allocation and identifying any practical or ethical problems. In addition, a preliminary 'signal' for the intervention was considered and an indicative sample size calculation completed. The acceptability of a potential third trial arm attentional control condition, mindful colouring-in, was assessed using four single-case design studies and a UK trial capacity survey was conducted.

METHODS

Adult patients with intellectual disabilities in secure care were recruited and randomised to either interpersonal art psychotherapy or delayed treatment in this multi-site study. Outcomes were assessed using weekly observations via the Modified Overt Aggression Scale and a range of self-report measures. Within study reporting processes, qualitative interviews and a survey were completed to inform trial feasibility.

RESULTS

Recruitment procedures were successful. The target of recruiting 20 participants to the trial from multiple sites was achieved within 8 months of the study opening. All participants recruited to the treatment arm completed interpersonal art psychotherapy. Between-group differences of interpersonal art psychotherapy versus the delayed treatment control showed a 'signal' effect-size of .65 for total scores and .93 in the verbal aggression sub-scale. There were no amendments to the published protocol. The assessment of key feasibility objectives were met and the trial procedures were acceptable to all involved in the research.

CONCLUSION

This study suggested that a randomised controlled trial of interpersonal art psychotherapy is acceptable and feasible.

TRIAL REGISTRATION

ISRCTN14326119 (Retrospectively Registered).

Using Arts-Based Therapies to Improve Mental Health for Children and Young People With Physical Health Long-Term Conditions: A Systematic Review of Effectiveness

Background: Children with physical health long-term conditions (LTCs) have increased risk of mental health difficulties relative to healthy peers. However, availability of psychological support integrated into pediatric physical health settings is limited, and there are long waiting times for access to child mental health services. Arts-based therapies involve using creative media to develop a therapeutic relationship, and offer a potential alternative to talking-based therapies. The aim of this systematic review is to establish the effectiveness of arts-based therapies for improving the mental health of children with physical health LTCs.

Methods: The review protocol was published on PROSPERO. Four electronic databases were searched (Medline, Embase, Cinahl, and PsycINFO), plus hand searches of two key journals and relevant reviews, and forward/back citations searches of selected articles were conducted. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess bias in selected articles. Second reviewers completed 10% of article screening and 20% of bias assessments. The findings were synthesized narratively.

Results: Sixteen studies met inclusion criteria and demonstrated some improvements on indicators of mental health and well-being including quality of life, coping behaviors, anxiety, self-concept, and mood. However, replication across interventions and outcomes was absent. Overall, the quality of evidence of effectiveness in the studies reviewed was moderate/weak. This was due to bias in study design; other limitations included a lack of detail on intervention components, e.g., use of a manual, and single recruitment sites.

Conclusions: The heterogeneity of existing research evaluating arts-based therapies for children with physical health LTCs limits conclusions about effectiveness. Suggestions are made to inform the design of future research studies to help build a robust evidence base.

'Visual clutter' in the classroom: voices of students with Autism Spectrum Disorder

OBJECTIVES

To date, there has been little qualitative research exploring how students interpret visual sensory input in the classroom. Research has found that seeking student voice has the capacity to act as a change agent for Educational Quality of Life (EQOL), in several aspects of educational decision-making. In light of this knowledge, this study endeavored to fill this gap in the educational research literature. In this research, we take a qualitative, deductive approach to exploring students' interpretations of 'visual clutter' in the classroom, to seek to improve EQOL.

METHODS

Through Arts-informed methodology, this study sought students' interpretations of 'visual clutter' in the classroom. The study was conducted in three stages using photo elicitation, draw and talk, and semi-structured interviews.

RESULTS

In seeking three students' voices regarding their personal interpretations of 'visual clutter' in classrooms, light was shed on four themes: color palette, feature congestion, affordances, and spatial size, which were each shown to elicit negative emotional responses from the students. We analyzed the drawings of one child in depth as an exemplar for the qualitative methodology used.

CONCLUSION

Student voice is central to educational quality of life. In seeking student voice, students are given the opportunity to convey the scope of their adaptive responses to incoming visual input, thus providing personal context to support measures. In doing so, student voice is given meaning in another facet of educational decision-making. This can include implications for classroom design.

Interpersonal art psychotherapy for the treatment of aggression in people with learning disabilities in secure care: a protocol for a randomised controlled feasibility study

Background

Art psychotherapy has greater potential for use with adults with mild to moderate learning disabilities as it places less of a burden on verbal interaction to achieve positive therapeutic, psychological, and behavioural goals. The feasibility study objectives include testing procedures, outcomes, validated tools, recruitment and attrition rates, acceptability, and treatment fidelity for manualised interpersonal art psychotherapy.

Methods

Adult males and females with mild to moderate learning disabilities will be recruited from four NHS secure hospitals. Twenty patients will be recruited and randomly assigned to one of two treatment groups: fifteen 1-h individual sessions of manualised interpersonal art psychotherapy, or a treatment as usual waiting list control group. The Modified Overt Aggression Scale will be administered to both treatment arms. Four patients will be recruited to a single-case design component of the study exploring the acceptability of an attentional condition.

Discussion

This multi-site study will assist in future trial planning and inform feasibility including, procedures, treatment acceptability, therapist adherence, and estimation of samples size for a definitive RCT.

Electronic supplementary material

The online version of this article (10.1186/s40814-017-0186-z) contains supplementary material, which is available to authorized users.