University of South Wales
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Article Title: Tapping into museums for art psychotherapy: an evaluation of a pilot group for young adults
Authors: Coles, A.; Harrison, F.
Journal: International Journal of Art Therapy
Citation: Coles, A & Harrison, F 2017, 'Tapping into museums for art psychotherapy: an evaluation of a pilot group for young adults' International Journal of Art Therapy. DOI: 10.1080/17454832.2017.1380056
This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Art Therapy on 25th October 2017, available online: http://www.tandfonline.com/doi/full/10.1080/17454832.2017.1380056
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1
Tapping into museums for art psychotherapy: an evaluation of a pilot group for young
adults
Authors:
Ali Coles, Art Psychotherapist, 2gether NHS Foundation Trust, Gloucestershire, UK
Fiona Harrison, Honorary Art Psychotherapist, 2gether NHS Foundation Trust,
Gloucestershire, UK
Tapping into museums for art psychotherapy: an evaluation of a pilot group for young
adults
Abstract
This article describes a pilot museum-based art psychotherapy group for seven 18 to 25-
year-old adults with severe mental health difficulties. We outline existing evidence for the
psychotherapeutic value of museums and describe how we tried to harness the potential of
museums as socially inclusive, accessible and inspiring venues, as well as a rich source of
encounters with objects and environments which can mobilise introspection and meaning-
making. We explain how we evaluated the group in order to assess therapeutic outcomes
and the contribution of the museum setting to these, using quantitative data from outcome
measures and qualitative data from the therapy sessions and post-therapy reflective
2
interviews. Overall, the data suggested that the therapy group was beneficial to
participants. The young adults reported that the museum setting helped them to reflect on
feelings and experiences, facilitated interaction between group members, encouraged
independence, fostered motivation and creativity and helped them to feel valued and
connected with the world outside mental health services. These evaluation findings are an
encouragement to other art psychotherapists to consider tapping into the therapeutic
benefits of this rich cultural resource.
Key words: art therapy, art psychotherapy, museums, galleries, adults, group, mental health
3
Acknowledgements
Additional funding for this pilot group was provided by NHS Gloucestershire Clinical
Commissioning Group through their Cultural Commissioning programme, run in partnership
with Create Gloucestershire.
We are very grateful to Angela Burton (Lead for Arts Therapies, 2gether NHS Foundation
Trust), Jules Ford (Cultural Commissioning Project Manager, NHS Gloucestershire Clinical
Commissioning Group), Angela Smith (Manager of Gloucester Life Museum and Museum of
Gloucester) and all the museum staff for their support of this project, and to Dr Sue Holttum
(Research Officer, British Association of Art Therapists) and Mark Walker (Senior Research
Manager – Governance, Gloucestershire NHS Research Support Service) for their advice on
the evaluation process.
Finally, heartfelt thanks to all the participants for contributing so much to the group and
generously agreeing to take part in the evaluation.
1. Introduction
‘Museum environments and artifacts offer untapped therapeutic benefits for clients and
communities’ (Salom, 2011, p. 81).
This article reports on the evaluation of an art psychotherapy group for young adults with
severe mental health difficulties, which we, two art psychotherapists working for the
4
National Health Service in England, delivered in 2015. The group had four aims: to help
participants to understand themselves better; to foster the ability to form and sustain
positive relationships with others; to encourage social inclusion; and to inspire creativity.
We decided to base the group in two museums in Gloucester, inspired by published
evidence that museum objects and environments can contribute to these aims. We outline
this evidence below and then go on to describe the group, the evaluation process and our
findings.
Helping participants to understand themselves better
Qualitative studies indicate that visitors to museums ‘naturally engage’ in self-exploration
(Silverman, 2010, p. 45) and that ‘by making meaning of objects, people in museums are
actually developing – and sometimes even changing – meanings and aspects of themselves,
their relationships, and the society in which they live’ (p. 16). For example, Paris and Mercer
(2002) found that general museum visitors had widely differing and deeply personal
responses to the same objects, concluding that ‘museum visitors recognize features of
themselves in the objects they encounter’ (p. 420).
Salom (2011) describes how museum objects helped members of an art therapy group to
explore ‘emotional strengths and weaknesses’ (p. 83). She notes that one participant
related the story behind an exhibit to her own situation and gives examples of people
learning about themselves by thinking about what objects they identified with, and which
they rejected (p. 84). She also discusses participants learning about themselves through
reflecting on how they ‘inhabit and explore’ the museum environment (p. 85).
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Salom’s findings are echoed in other published case studies. A museum-based arts project
for people with depression found that participants ‘connected with the artefacts in an
emotional way’, which led to them reflecting on their own experiences (Neal, 2012, p. 44).
Researchers undertaking an evaluation of a collection of UK museum health and wellbeing
projects observed participants using museum objects symbolically, making personal,
emotional connections to the exhibits (Froggett, Farrier and Poursanidou, 2011).
Fostering the ability to form and sustain positive relationships with others
Froggett et al.’s (2011) evaluation of museum wellbeing projects yielded evidence that the
museum objects served as a ‘point of communication’ between people, enabling an
‘expansive sharing of mental space’ which facilitated the formation of connections between
group members (p. 68-69). Similarly, a participant in a group for people with psychosis
which was based in an art gallery suggested that it was a ‘bonding process’ to be looking at
the same artwork (Colbert, Cooke, Camic and Springham, 2013, p. 254). Salom (2011) draws
attention to the opportunity for ‘natural interactions’ in the museum spaces and illustrates
how reflecting on these interactions can help people to gain insight into how they relate to
others (p. 85).
Encouraging social inclusion
There are many reasons why people with mental health problems may experience social
exclusion (Schneider and Bramley, 2008). Here, we are concerned particularly about
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people’s sense of being connected to the local community outside mental health services,
including cultural resources. There is some evidence that basing therapeutic interventions
in museums or art galleries can help with this. For example, participants in the group for
people with psychosis (mentioned above) had a sense of achievement in accessing the
gallery and valued being in a ‘normal’ place (Colbert et al., 2013, p. 254). Some visited other
galleries following the end of the group. Parkinson and Whiter (2016, p. 120) report that
service users expressed relief at the ‘sense of space and freedom’ when an art
psychotherapy group for young adults experiencing first episode psychosis was moved from
a clinical setting to a community arts setting, where they were reminded less of times when
they had been acutely unwell. An art therapy group for cancer patients in an art gallery
setting ‘provided an oasis away from the reminders and indicators of cancer’ and led one
participant to state that ‘truly looking at us you couldn’t distinguish that we are just, you
know, not an average gallery (visitor) attending there’ (Deane, Carmann and Fitch, 2000, p.
140).
Froggett et al. (2011) report that participants in museum wellbeing projects valued being
able to ‘partake of a common heritage, rather than being seen as members of a
disadvantaged group’ (2011, p. 63). At the end of one project, participants ‘felt that they
were familiar with the range of collections the museum had on offer and could explore
further those that had resonated with them during the project’ (2011, p. 63), and a
participant in another project spoke of the ‘special connection’ she felt to the museum
concerned (2011, p. 42).
Inspiring creativity
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Museum collections are commonly used as inspiration for creative expression, by general
visitors as well as by learners in organised groups. In the context of wellbeing projects,
Froggett et al. (2011) remark on a ‘liveliness’ of response to museum objects which was
evidenced in the creative responses of participants (p. 68) and consider that participants are
’enlivened through their personal association with the objects’ (p. 68). Similarly, Neal
(2012) notes that participants in a museum and gallery-based arts in health project
‘reported an increase in their awareness and ability to notice things around them in great
detail’ and links this to the idea that museum artefacts can engage people’s imagination and
emotions (p. 44). Huet (2012) states that joint attention to artists’ works, in the context of
an art-therapy based organisational consultancy group, can help to ‘open up an imaginative
space’ (p. 28) and Salom (2011) describes museum objects acting as inspiration for creative
expression within her museum-based art therapy work.
2. The context
Clinical context
We ran this Art Psychotherapy group as members of the Complex Psychological
Interventions (CPI) team at ²gether NHS Foundation Trust (²gether). ²gether is part of the
National Health Service (NHS) in England and delivers specialist mental health and learning
disability services to the people of Gloucestershire and Herefordshire (two counties in the
south west of the country). The CPI team provides psychological therapy to people aged 18-
65 with severe and enduring mental illness and complex needs, who are also receiving
8
ongoing care and support from a community mental health team (Recovery Team). The
team includes five permanently employed art psychotherapists as well as honorary art
psychotherapists who work for ²gether on an occasional basis.
We decided to run an art psychotherapy group for 18-25 year olds, specifically, as the CPI
team recognised that there were increasing numbers of young adults needing therapy who
might be interested in group therapy alongside people of a similar age. We also thought
that this age group might be particularly attracted to therapy in a non-clinical setting.
We invited referrals from Recovery Team care co-ordinators (key workers) of young adults
with: some understanding of their own psychological difficulties and a desire to explore
them; the capacity to tolerate feelings in a group setting and in a community venue; and the
ability to commit to attending consistently.
Thirteen people were referred to the group and we met them individually to discuss
whether the group would be an appropriate therapeutic intervention. These meetings were
also an opportunity for the client to identify personal goals in line with the overall aims of
the group. Three decided not to join the group; of the ten people who started the group (all
women, as it turned out, aged between 19 and 25), seven completed it and their data have
been included in this paper. This completion rate is typical of other art psychotherapy
groups run by the CPI team, and no-one gave the museum setting as a reason for not joining
or discontinuing the group. Participants’ diagnoses included ‘emotionally unstable
personality disorder’, ‘bipolar affective disorder’, ‘recurrent depressive disorder’ and
‘anxiety and low mood’. All participants described themselves as white British.
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²gether received funding for the additional time involved in developing and evaluating the
group and for the hire of museum rooms, through a Cultural Commissioning programme run
by NHS Gloucestershire Clinical Commissioning Group in partnership with Create
Gloucestershire.
Museum context
The group used two museums in Gloucester, both run by the City Council: the Folk Museum
(now Gloucester Life Museum) and the City Museum and Art Gallery (now the Museum of
Gloucester). The museums differ in the collections they hold as well as the architectural
space, giving the opportunity to explore a variety of artefacts and environments. Gloucester
Life Museum occupies a Tudor timber-framed building, with a crooked warren of rooms on
different levels dedicated to social history, folklore, crafts and industries of the city and
county, and a small space for temporary exhibitions. A purpose-built education building in a
courtyard garden includes a reconstructed Victorian classroom. The Museum of Gloucester
is set over two floors in a Renaissance-style Victorian building. The museum has displays
and interactive exhibits that chart the history of the city, including archaeological and
natural history objects and Roman and medieval artefacts, and houses a gallery for a
changing programme of art exhibitions. We hired a private meeting room in each museum;
each room has sinks and large tables for art-making as well as space for a circle of chairs for
sharing artwork and verbal reflection. The rest of the museum was open to the public
during our sessions.
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We also had access to themed boxes of museum objects which can be handled. The
museums usually use these for educational sessions, and they also loan them to schools and
other groups. For example, one Roman box contained an amphora handle, oil lamp and
mosaic pieces whilst a World War 2 box included a ration book, identity card, incendiary
bomb and fragments of shrapnel.
3. Description of the group
Session structure
The group ran for 18 weekly sessions between August and December 2015, with each
session lasting 90 minutes. The first ten sessions were held at the Folk Museum and the
remaining eight sessions were based in the City Museum. Each session usually had four
parts. We met in the private meeting room for an opportunity to share thoughts and
feelings and to introduce the session (about 15 minutes). The participants then explored
museum objects and exhibitions (about 25 minutes), independently but in the presence of
the art psychotherapists. The group then returned to the meeting room for art-making
(about 30 minutes). Finally, participants were invited to show the group their artworks and
to talk about them (about 20 minutes).
To foster a sense of safety and group cohesion, the group stayed in the private room and
used boxes of handling objects in the early sessions, venturing out into the public exhibition
spaces on the fifth week. We visited other nearby venues on two occasions – the art gallery
11
at Gloucester Guildhall and Gloucester Cathedral; at the Cathedral, participants made art in
the public space.
We (the two facilitating art psychotherapists) generally suggested a broad theme for each
session and an area of the museum to explore, informed by what the participants had
already expressed within the group and responses to previous sessions. One reason for
using themes was to support the group members to engage with the museum in a focussed
and reflective way. For example, in one session we invited participants to choose three
objects from the boxes of handling objects to represent their past, present and future, or
some process of change, and make an artwork about this. A subsequent session focussed
on a gallery display of archaeological layers and a fossil handling box, thinking about aspects
of ourselves that are hidden, preserved, or revealed. Participants sometimes chose not to
follow the suggested theme. Some sessions had no guiding themes, particularly later ones
when the young adults were experienced in using the museum; participants simply found
something that resonated with them in some way, and used this as the basis for reflective
artmaking.
Practicalities
As there was no storage space available at the museums, we transported art materials to
the venue each week (using a shopping trolley and large art folder for paper). It was
necessary to store participants’ artworks on NHS premises, for confidentiality reasons, and
transporting very wet paintings or fragile sculptures was sometimes challenging; we dried
artwork with a hair dryer and carried sculptures in boxes. Because of the transportation
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difficulties we did not bring previous artwork back to subsequent sessions, as we would
usually do, apart from to the midway group review session, and the final group session. No
participant reported this as detrimental to their experience of the group.
The museum staff were not involved in running the sessions but managers were very
supportive of our use of the museums and front of house personnel created a warm and
welcoming atmosphere for the group. Museum staff were aware that we were running an
NHS therapy group but participants did not report any concerns about this in terms of
confidentiality. There were sometimes school groups visiting the museums during our
sessions, but few adult visitors; the participants may have found visiting the exhibitions
more challenging had there been more members of the public around.
As the museums are in the city centre it was easy for participants to get there by public
transport, and the buildings have good standards of physical access (one participant used a
large electric wheelchair). To enable participants to visit the museums for free at other
times, each group member was offered a year’s museum membership (with the small fee
paid for by 2gether from the funding received for the project).
4. Evaluation method
We evaluated the group according to a protocol approved by Gloucestershire NHS Research
Support Service. We aimed to find out if there was any psychological change in participants
over the course of the group, and participants’ perceptions on whether and how the
museum setting affected their experience of the therapy.
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Participants were given information about the evaluation process and could choose whether
to take part in it; we made clear that their decision would not affect their treatment in any
way, and that consent could be withdrawn at any time. All those who completed the group
gave written permission for anonymised qualitative and quantitative data relating to them,
as well as images of their artwork, to be used for the purpose of sharing the evaluation
findings. (The names included in this article are pseudonyms and all quotations are from
participants)
We gained qualitative data from:
the notes we made following each session
Recovery Team care co-ordinators’ perceptions of the impact of the group on
participants (in response to email requests sent midway through the group and
following the ending of the group)
participants’ own assessment of how they were feeling after therapy compared to
before therapy (included in the PSYCHLOPS outcome measure – see below)
reflective interviews with participants about four weeks after the last group session
(recorded in written notes made by both therapists during the interviews, which
were then compared to give as full and accurate an account of the interviews as
possible)
audio-image recordings made with two participants about their artworks and
experience of the group.
We gained quantitative data from:
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the UCL Museum Wellbeing Measure (Younger Adult) (Thomson and Chatterjee
2013), completed at the end of each session
the PSYCHLOPS (Psychological Outcome Profiles) measure
(http://www.psychlops.org.uk) and the Rosenberg self-esteem scale (Rosenberg
1965 and widely available on the internet including at https://socy.umd.edu/about-
us/rosenberg-self-esteem-scale), completed once at the initial meeting (pre-
therapy), at sessions 1, 10 and 18, and again at the post-therapy reflective interview.
5. Evaluation findings
Identifying psychological change in participants over the course of the group
The qualitative data showed that all participants and care co-ordinators identified some
positive changes in line with the overall aims for the group (to help participants to
understand themselves better; to foster the ability to form and sustain positive relationships
with others; to encourage social inclusion; and to inspire creativity). For example,
participants reported that ‘I became more able to show the difficult parts of myself’, ‘I feel
less anxious about being around people’, ‘it’s helped me to find new interests – I hated
museums before and now I love them’ and ‘I’ve re-engaged with my creativity’. No-one felt
that the group had a negative impact. In addition, all participants felt they had achieved at
least some of their own personal goals by the end of the group; all but one participant felt
they had achieved all of their goals. These goals included: ‘to recognise feelings and find
ways to deal with them’, ‘to get used to being around people my own age’, ‘to be able to
15
make my own way to sessions’ and ‘to challenge myself to do something outside my
comfort zone’.
The quantitative data also yielded evidence that the group had an overall beneficial impact
on participants. PSYCHLOPS is designed to measure change during the course of
psychotherapeutic interventions and promotes a patient-centred definition of therapy
outcome. Clients are asked to describe their main problem or problems and how this
affects them (function), and to rate their general wellbeing. Examples of problems were:
‘the future’, ‘anxiety’, ‘feeling self-destructive’, ‘low self-esteem’, ‘dealing with emotions’,
‘my eating disorder’, ‘self-harm and suicidal thoughts’. A decrease in score indicates an
improvement in problems, function and wellbeing. Figure 1 compares the pre- and post-
therapy scores for each participant, showing the ‘change score’. A positive change score
indicates an improvement in problems, function and wellbeing. The data therefore suggest
that five participants had an improvement in problems, function and wellbeing. The change
scores for the other two participants were negative; they both had experiences over the
period that the group was running which they and their care co-ordinators identified as very
challenging. Interestingly, one of these two participants considered that they were feeling a
little better following the end of the group compared to when they started therapy (in
response to a question on the PSYCHLOPS post-therapy score sheet), whilst one of those
with a positive effect size considered themselves a little worse. Otherwise, participants’
own views were in line with their PSYCHLOPS scores. The mean change score for the group
was 3.42 giving a mean ‘effect size’ of 1.81; the effect size is the change score divided by
standard deviation of the baseline (pre-therapy) scores. The PSYCHLOPS guidance
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(http://www.psychlops.org.uk) states that an effect size above 0.8 is generally considered to
be large in health service research.
According to the Rosenberg self-esteem scale, three participants’ self-esteem increased
from the pre- to post-therapy score, two of them greatly, and four participants had a small
decrease in self-esteem (figure 2). We can only speculate on why this measure does not
mirror the PSYCHLOPS outcomes (two of those showing a decrease in self-esteem had
improvements in problems, function and wellbeing). One participant stated that her
answers on the pre-therapy Rosenberg questionnaire reflected her ‘lack of feeling’ at that
moment and suggested that otherwise they would have been ‘worse’. For both this
measure and the PSYCHLOPS one, each participant’s five scores (pre-therapy, sessions 1, 10
and 18 and post-therapy) went up and down, making it more difficult to draw conclusions
from the quantitative data alone about the impact of the therapy group specifically.
Measuring participants’ sense of wellbeing session by session
Participants scored how they felt at the end of every session on the UCL Museum Wellbeing
Measure (Younger Adult). This measure is intended to assess levels of psychological
wellbeing arising from participation in museum and gallery activities and users rate
themselves as ‘friendly’, ‘interested’, ‘lively’, ‘motivated’, ‘positive’ and ‘talkative’ on a scale
of 1 to 5. We chose not to ask participants to complete the measure at the beginning as
well as the end of sessions, as we thought this would feel onerous over 18 sessions. This
meant that it was difficult to relate the findings to the impact of the session. However, the
measure provided helpful information about how participants were feeling; for example, we
17
were sometimes surprised by high scores for interest and motivation from participants who
had been very withdrawn in the session. The measure also gave an opportunity for
participants to write comments and suggestions. Figure 3 gives the median scores for each
participant over the 18 sessions.
It is worth noting that, in the case of participants who found it hard to regulate their
emotions, a very high score might be a cause for concern as it might indicate that the
participant is entering a manic episode. A low score might also be related to the exploration
of difficult emotions and experiences during a session, which could be valuable for future
wellbeing.
Identifying how the museum setting affected the participants
We sorted the qualitative data according to the four aims of the group, and then picked out
the data which suggested that the museum setting had affected the participants in relation
to each aim.
Aim 1: Helping participants to understand themselves better
All the participants reported that the museum objects helped them in the process of self-
exploration. According to Kate, ‘objects make you think more – you surprise yourself, it
means you have more answers’, whilst Louise felt that ‘the objects helped as a springboard’.
Ellie said that the objects ‘helped me to find ideas and inspiration’ and Lucy reported that
the objects ‘helped me to think about myself’.
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Participants usually made self-reflective artwork in direct response to the objects and
exhibitions they encountered. For example, Susie took inspiration from a model of a cross-
section through the earth, drawing herself as a person with three layers and labelling it
‘what I show to others’, ‘what those close to me get to see’, ‘what I feel about myself that
hardly anyone knows’. She felt that this was her personal ‘interpretation of an exhibit’ and
that she ‘really put what I was feeling down in it’. During another session, she saw her
desire to ‘wipe away the past and start again’ reflected in a Victorian slate, and made an
image of a modern-day device for making images and then erasing them (figure 4). When
the group visited an art exhibition at Gloucester Guildhall, Susie told us that a small figure in
an artwork with a speech bubble saying STOP ‘had an impact on me’; she reflected on the
many pressures she was under and her desire ‘for the world to stop’. Her artmaking around
this theme ‘sorted it out in my head’ so that it felt ‘less chaotic’.
Tasha echoed the cover design of an old sewing pattern in her image of a ‘life pattern’ which
seemed to reflect what she thought was expected of her (figure 5). Ellie was inspired by a
repaired Roman pot which still had some gaps; she made an artwork which expressed her
sense that she was ‘piecing together bits in my life, not very well, but I’m doing it’. In the
session on the theme of past, present and future, Ellie’s artwork (figure 6) responded to
three objects she chose from the handling boxes. She chose shrapnel to represent the
chaos of her past, a spinning top to reflect her sense of ‘going around and around’ in the
present, and a World War 2 identity card to symbolise her ‘fogginess’ about who she is as
she looks to the future.
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A historic teapot with a built-in infuser attracted the attention of Caroline, who made a clay
teapot with glitter inside and talked about the idea that ‘you put lots in the middle but only
the flavour comes out’ (figure 7). She related this to her sense of only being able to express
a small part of herself. During the session in the Cathedral, Caroline captured a cobweb by
moving her sketchbook through it; she reflected on how it could not be seen on the page
and spoke of feeling invisible. Another time, she created a timeline of her life (including
some very traumatic experiences), saying that ‘I wouldn’t have done it if I hadn’t seen the
timeline in the exhibition, but it felt very significant to do it – like putting things in place
before moving on’.
Tasha was not always able to make art in the sessions but reported that ‘using objects for
self-reflection was useful – even if I couldn’t always carry it over into the artmaking’. In the
absence of her own artwork, she could sometimes talk about the exhibit that had interested
her during the ‘sharing’ part of the session, or show an object she had chosen from one of
the themed boxes.
Aim 2: Fostering the ability to form and sustain positive relationships with others
In the early sessions, we invited the group to explore boxes of handling objects, placed
around the room, giving the opportunity for interaction between participants.
Subsequently, visiting the exhibitions gave participants the choice of moving around in small
groups or all together, as well as individually, and allowed for relaxed chatting and having
fun together. Caroline felt that ‘the playfulness, messing around, being childish… meant
that the group loosened up’, and that ‘it wouldn’t have happened in an office-y place’.
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At times, participants chose the same objects as inspiration for their artmaking, which
encouraged interaction and the identification of common experiences and feelings. In one
early session, for example, several participants focussed on a World War 2 bomb and
included references to explosions, danger and damage in their artwork. In session 16, the
group responded to an exhibition of contemporary quilts by making individual artworks and
arranging them together to make a group image; this was a very popular session.
As the museums were in the centre of the city, group members began to meet for coffee
beforehand. This helped friendships to form: according to Caroline, ‘it was nice to chat
between sessions about everyday stuff – they weren’t just friendships based on illness’.
People stayed in touch between sessions via social media and encouraged one another to
attend the group. Some continued to communicate and meet up for several months after
the group ended.
Aim 3: Encouraging social inclusion
One care co-ordinator expressed her belief that ‘it is more ‘normalising’ to have the group
externally from mental health service buildings, more socially inclusive with fewer worries
about stigma.’ Other care co-ordinators reported that their clients felt positive about the
group ‘being held in a non-health setting’ and enjoyed ‘the social inclusion aspect of the
group’ and ‘working in the museum environment’. Kate felt that the museum setting was
‘so much better – not so clinical – I can be a person not a patient’ and in Caroline’s view it
was ‘nice not being in an NHS facility, being ‘normal’’. Sometimes, the group could hear
21
schoolchildren outside the private therapy room. The participants all enjoyed this, saying
that it felt ‘less intense’ and ‘uplifting’.
The museums’ city centre location meant that people could easily travel there by public
transport; indeed, three participants challenged themselves to travel to Gloucester by public
transport on their own for the first time during the group. The museums’ provision for
access for disabled people (in contrast to some NHS buildings) meant that the person who
used a large electric wheelchair could participate in the group.
None of the participants visited museums regularly before starting the group. Susie told us
that she ‘never would have seen the things in the museums otherwise – I wouldn’t have
gone – I’m glad I did’. Kate felt that ‘it’s helped me to find new interests – I hated museums
before and now I love them’. Participants were given a free annual membership for the two
museums and some said they intended to keep on visiting.
Aim 4: Inspiring creativity
Participants said that they enjoyed encountering different objects and exhibitions each
session. In Louise’s opinion, the museum was ‘better than a sterile, plain environment –
there was a contrast of different places to explore and look at and take inspiration from’.
Tasha found the setting ‘interesting’ and Caroline felt that the group ‘needed the variety of
objects’ and that the change of venue midway through stopped the group from ‘getting
bored’. Sometimes participants expressed curiosity, surprise and a sense of wonder when
encountering objects; ‘it’s crazy how old it is!’ Louise exclaimed when holding a fossil from
22
one of the handling boxes. In at least one instance, an object inspired a participant to set
herself a personal creative challenge. After visiting the Victorian schoolroom, Ellie decided
to try to write out the alphabet three times with a Victorian-style nib pen and managed to
do it ‘although my hands were shaky’, saying that ‘I felt proud of myself for the first time in
my life’.
6. Conclusion
The aim of the evaluation was to find out if there was any psychological change in
participants over the course of the group, and how the museums’ collections and settings
affected participants’ experience of the therapy. Overall, the quantitative and qualitative
data we gathered suggested that the therapy group was beneficial to participants. We
found evidence that the setting contributed to the group aims of helping participants to
understand themselves better, fostering the ability to form and sustain positive
relationships with others, encouraging social inclusion and inspiring creativity. We did not
find any evidence that the museum setting hindered the achievement of the aims. Our
evaluation findings are in line with the evidence from the literature cited in section 1 that
museum objects and environments can contribute to psychotherapeutic aims. In particular,
the setting appeared to:
• help participants to reflect on feelings and experiences
• facilitate interaction between members
• encourage independence
• help members to feel valued and connected with the world outside mental health
services
23
• foster motivation and creativity.
In summary, we consider that the therapeutic process for this group of young adults was
enhanced by the museum setting. Our findings are echoed by one participant, writing about
her experience of the group for the 2gether members’ newsletter:
‘Doing art therapy in a museum… feels less clinical, more relaxed and you feel like you
are a real person working on your own personal goals rather than just a patient going
through treatment. Being in a museum, it helps bring out your creative side. You get a
chance to look at a wide variety of different exhibitions, both historic and modern which
brings a bit of excitement; in turn, this helps bring out the artistic and imaginative
qualities in you. It makes you think outside the box which tricks your brain into looking
at things in a different way. You get the chance to see things that you wouldn't normally
consider relating back to your own life, and this gives you a new insight into your
experiences and thoughts and feelings. You wouldn’t necessarily have thought that
pulling objects out of museum boxes and wandering around looking at artefacts would
help you feel better or make progress in recovery, but you would be surprised.’
7. Limitations and recommendations
If we were to evaluate the group again, we would aim to hold a focus group in the museum
for all the participants, a month or so after the end of the group, to gain more qualitative
information about how the participants experienced the museum setting. We would also
try to do a six-month follow-up, inviting individual responses from participants about their
24
experience of the group from a longer-term perspective (perhaps by telephone). Evaluating
another art psychotherapy group for young adults in the usual clinical setting would have
allowed us to compare outcomes and participant experiences, shedding more light on the
impact of the museum setting.
Building on our experience of this pilot group, 2gether art psychotherapists are continuing
to run museum-based art psychotherapy groups in Gloucestershire for adults of all ages.
We would encourage other art psychotherapists to explore using museums within their
work, especially as museums are increasingly aiming to make a contribution towards the
wellbeing of the public they serve and to collaborate with health professionals. We hope
that others will evaluate their projects and share the findings, so that together we can build
up a fuller picture of the value of a museum setting with information from different client
groups in different locations. We have found that undertaking a formal evaluation, involving
a systematic gathering and examination of quantitative and qualitative data, has greatly
added to our learning from the delivery of this pilot group. The sharing of the findings has
also helped to raise the profile of art psychotherapy within 2gether.
As evaluation rather than research, this project has not aimed to produce generalisable new
knowledge about the role of museums within art psychotherapy. 2gether art
psychotherapists are currently undertaking research into our own experience of delivering
art psychotherapy in museums, aiming to capture and share our personal perspectives on
the power of objects to provoke self-reflection, the effect of the public setting on
relationships between participants (including therapists), and the therapeutic value of the
25
potential for physical movement within the museum. Alongside this, there is a need for
research in partnership with service users, exploring in depth how museum objects and
environments impact on the therapeutic process and how art psychotherapists can best tap
into the therapeutic benefits of this rich cultural resource.
References
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recovery for people who have experienced psychosis. The Arts in Psychotherapy, 40, 250-
256. doi:10.1016/j.aip.2013.03.003
Deane, K., Carmann, M., & Fitch, M. (2000). The cancer journey: Bridging art therapy and
museum education. Canadian Oncology Nursing Journal, 10, 140-142.
doi:10.5737/1181912x104140142
Fears, A. (2011). The museum as a healing space: Addressing museum visitors’ emotional
responses through viewing and creating artwork (master’s thesis). Boston University College
of Fine Arts, Boston MA. Retrieved from http://hdl.handle.net/2144/2419
Froggett, L., Farrier, A., Poursanidou, K., Hacking, S., & Sagan, O. (2011). Who Cares?
Museums, Health and Wellbeing Research Project - A Study of the Renaissance North West
Programme [evaluation report]. Retrieved from
http://clok.uclan.ac.uk/3362/3/3362_froggett_final_report.pdf
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Huet, V. (2012). Creativity in a cold climate: Art therapy-based organisational consultancy
within public healthcare. International Journal of Art Therapy, 17, 25-33.
doi:10.1080/17454832.2011.653649
Neal, C. (2012). Arteffact: Museums and Creativity for Better Mental Health. Engage
Journal, 30, 39-47. Retrieved from http://www.engage.org/engage30
Packer, J. (2008). Beyond learning: Exploring visitors’ perceptions of the value and benefits
of museum experiences. Curator, 51, 33-54. doi:10.1111/j.2151-6952.2008.tb00293.x
Paris, S., & Mercer, M. (2002). Finding self in objects: Identity exploration in museums. In G.
Leinhardt, K. Crowley, & K. Knutson (Eds.). Learning conversations in museums. Mahwah, NJ:
Lawrence Erlbaum Associates.
Parkinson, S., & Whiter, C. (2016). Exploring art therapy group practice in early intervention
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doi:10.1080/17454832.2016.1175492
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton
University Press.
Salom, A. (2011). Reinventing the setting: Art therapy in museums. The Arts in
Psychotherapy, 38, 81-85. doi:10.1016/j.aip.2010.12.004
Salom, A. (2015). Weaving potential space and acculturation: Art therapy at the museum.
Journal of Applied Arts and Health, 6, 47- 62. doi:10.1386/jaah.6.1.47_1
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Schneider, J., & Bramley, C. (2008). Towards social inclusion in mental health? Advances in
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Silverman, D, (2010). The social work of museums. Abingdon: Routledge.
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_sept2013.pdf
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Biographies
Ali Coles is an Art Psychotherapist for 2gether NHS Foundation Trust, working as part of the
Complex Psychological Interventions team in the adult community mental health service in
Gloucestershire. She works with clients with severe and enduring psychological difficulties,
both individually and within groups. She previously worked in the museum sector and has
an MA in Museum and Gallery Management. She has a particular interest in the use of
museums, galleries and other cultural and environmental resources in Art Psychotherapy,
and was the co-founder of the British Association of Art Therapists’ Museums and Galleries
Special Interest Group (http://www.atmag.org). She is also a Lecturer in Art Psychotherapy
at the University of South Wales.
Fiona Harrison currently works as an Art Psychotherapist for Somerset Partnership NHS
Foundation Trust. She works with individuals with severe and enduring psychological
difficulties in the adult community mental health service. She has a special interest in Early
Intervention for Psychosis, having developed and implemented a specific model of art
therapy practice and facilitated groups for Avon and Wiltshire Mental Health Partnership
NHS Trust. She has held an honorary contract with the 2gether NHS Foundation Trust and
maintains her interest in developing the use of museums and art galleries for art
psychotherapy groups. She is a member of the British Association of Art Therapists’ (BAAT)
Museum and Galleries Special Interest Group and is a BAAT regional co-ordinator.
29
Figure 1
A B C D E F G
-6-4
-2
0
2
46
8
1012
PSYCHLOPS outcome measure: pre- to post-therapy change score
A positive change score indicates an improvement in problems, function and wellbeing
Participants
Cha
nge
scor
e
Figure 2
A B C D E F G
-5
0
5
10
15
20
Rosenberg self-esteem scale: pre- to post-therapy change score
A positive change score indicates an increase in self-esteem
Participants
Cha
nge
scor
e
30
Figure 3
A B C D E F G0
5
10
15
20
25
30
UCL Museum Wellbeing Measure:median scores across all sessions
(on scale of 0 to 30)
Participants
Med
ian
scor
e
Figure 4
31
Figure 5
Figure 6
32
Figure 7
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