Arts for the Blues: The development of a new evidence‐based creative group psychotherapy for depression

Abstract

Introduction: Depression affects many adults in the UK, often resulting in referral to primary care mental health services (e.g. improving access to psychological therapies, IAPT). CBT is the main modality for depression within IAPT, with other approaches offered in a limited capacity. Arts psychotherapies are rarely provided despite their attractiveness to clients. However, the recent dropout rate of 64% within IAPT suggests that clients' needs are not being fully met. Therefore, in order to expand clients' choice we developed a new creative psychological therapy integrating evidencebased approaches with arts psychotherapies. Method: A three-level approach was used: (a) thematic synthesis of client-identified helpful factors in evidence-based approaches for depression and in arts psychotherapies; (b) studio practice exploring Cochrane Review findings on arts psychotherapies for depression; (c) pilot workshops for clients with depression and therapists.Findings and Discussion: Eight key ingredients for positive therapy outcomes were identified: encouraging active engagement, learning skills, developing relationships, expressing emotions, processing at a deeper level, gaining understanding, experimenting with different ways of being and integrating useful material. These ingredients were brought together as Arts for the Blues for clients with depression: a 12-session evidence-based pluralistic group psychotherapy integrating creative methods as well as talking therapy. Conclusion:The evidence-based foundation, creative content and pluralistic nature of this new approach aligned with eight client-identified key ingredients for positive therapy outcomes make it a promising therapy option that can be adapted to individual therapy. Implications include consideration for NICE approval as an additional therapy for depression.

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

“…Similarly, Haire and MacDonald (2021) talk about ‘humour’ in music therapy, Persons (2009) about enjoyment in art therapy and Koch et al (2007) about joy in dance movement therapy, both prerequisites and outcomes of active engagement in artmaking. Encouraging active engagement is one of the key ingredients identified in the Arts for the Blues model (Omylinska‐Thurston et al, 2020). Links between active engagement and behavioural activation, an effective component in CBT for depression (Ekers et al, 2014), have already been made, encouraging depressed people to reconnect with activities that provide positive reinforcement.…”

“…Differentiating between an emphasis on the process (therapy) and product (teaching) is an important distinction, drawing clear distinctions between the focus of attention in each case and the associated professional boundaries. However, since, in our emerging model, we used multiple art forms to meet different needs and offer different perspectives, and given the value placed on gaining practical skills by service users, we adopted ‘ learning skills ’ as a key ingredient in the Arts for the Blues model (Omylinska‐Thurston et al, 2020). This ingredient is not only limited to learning skills that advance artistic repertoire and artistic vocabulary, but also to learning skills with direct psychological value such as breathing exercises to regulate anxiety, mindful practices to become aware of one's body‐based feelings, grounding activities to bring someone into the here and now, imagination to create a safe space and artmaking to safely offload distressing feelings.…”

“…As an evidence‐based practice, it is based on identifying helpful and unhelpful factors from published literature, mainly patient reports but also randomised controlled trials in psychological interventions already recommended for primary care psychological services (CBT, counselling for depression, short‐term psychodynamic psychotherapy) and creative psychotherapies for depression (Parsons et al, 2019). Unlike other structured interventions commonly available in primary care in the NHS in England, the Arts for the Blues model consists of key ingredients that are delivered flexibly through art‐based activities including drama, visual art, dance, music and creative writing (Omylinska‐Thurston et al, 2020). Following the pluralistic tradition (Cooper & McLeod, 2011), it is goal‐oriented and draws on CBT, person‐centred, psychodynamic and integrative psychotherapies.…”

Qualitative and Arts-Based Evidence from Children Participating in a Pilot Randomised Controlled Study of School-Based Arts Therapies

“…This pilot was developed based on two systematic reviews [ 40 , 41 ] which synthesized previous interventions that had been successfully implemented and assessed by children themselves, and it was informed by other evidence-based arts therapies protocols [ 42 , 58 , 59 ]. The therapeutic protocol and intervention were evaluated by children, arts therapists and the research team [ 20 ] and is expected to inform the development of future interventions in school-based arts therapies.…”

“…Prior to this study, we conducted two systematic reviews [ 40 , 41 ] which informed the development of the therapeutic protocol based on the evidence of “what works best” for children at schools. The intervention was also influenced by the Arts for the Blues, an evidence-based creative group psychotherapy that was originally developed for adults [ 42 ]. A detailed description of the therapeutic ingredients and framework, as well as the activities that took place in each session, are presented in the study protocol [ 28 ] and the author’s PhD thesis [ 39 ].…”