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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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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

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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

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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

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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

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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

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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

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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

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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

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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

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• 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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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

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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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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

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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

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8

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PSYCHLOPS outcome measure: pre- to post-therapy change score

A positive change score indicates an improvement in problems, function and wellbeing

Participants

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Figure 2

A B C D E F G

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0

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Rosenberg self-esteem scale: pre- to post-therapy change score

A positive change score indicates an increase in self-esteem

Participants

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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

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Figure 4

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Figure 5

Figure 6

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Figure 7

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