Ethical issues in participatory arts methods for young people with adverse childhood experiences

Abstract

Context Participatory arts‐based methods such as photovoice, drama and music have increasingly been used to engage young people who are exposed to psychosocial risks. These methods have the potential to empower youth and provide them with an accessible and welcoming environment to express and manage difficult feelings and experiences. These effects are, however, dependent on the way these methods are implemented and how potential ethical concerns are handled. Objective Using the current literature on arts‐based health research as a foundation, this paper examines ethical issues emerging from participatory arts methods with young people with traumatic experiences. Results We present a typology covering relevant issues such as power, accessibility, communication, trust and ownership, across the domains of partnership working, project entry, participation and dissemination. Drawing on our extensive clinical and research experiences, existing research and novel in‐practice examples, we offer guidance for ethical dilemmas that might arise at different phases of research. Conclusion Adequate anticipation and consideration of ethical issues, together with the involvement of young people, will help ensure that arts methods are implemented in research and practice with young people in a fair, meaningful and empowering way. Patient or Public Contribution The issues reviewed are largely based on the authors' experience conducting participatory research. Each of the projects referenced has its own systems for PPI including, variously, consultations with advisory groups, coproduction, youth ambassadors and mentor schemes. One of the coauthors, Josita Kavitha Thirumalai, is a young person trained in peer support and has provided extensive input across all stages.

Practitioner Review: Effectiveness and mechanisms of change in participatory arts‐based programmes for promoting youth mental health and well‐being – a systematic review

“…Many observations can be made about our model, but we draw attention here to the resonance between potential mechanisms in PAB programmes and those in both counselling and clinical approaches. For example, there are clear similarities in the claim that therapeutic work in both clinical and PAB programmes rests on a critical relational foundation and can progress only if trust and safety are established (see Pavarini et al., 2021).…”

“…It is evident in the included articles that there are rules for safe ‘play’ so that risk taking can happen with limited possibility of causing harm (Atkinson & Robson, 2012; Daykin et al., 2017; Ennis & Tonkin, 2018; Hanrahan & Banerjee, 2017). Confidentiality is a contributory factor to the concept of a ‘safe’ space (Caló et al., 2020; Duberg et al., 2016; MacPherson et al., 2016; see also Pavarini et al., 2021). A number of situational factors are identified as facilitating the establishment of this boundaried space, as well as movement into and out of it.…”

“…There has been increasing recognition over the last decade of the importance of meaningful participation for promoting the well-being, social connection, and agency of CYP (Pavarini et al, 2021;van Bijleveld, Dedding, & Bunders-Aelen, 2015). Creating the space for youth voices to be heard and prioritised in decision-making related to social care and in mental health research has provided the opportunity for services, interventions, and research processes to be co-produced, helping make them more responsive to CYP's needs and expectations (Pavarini et al, 2021;van Bijleveld et al, 2015). Processes of co-creation in PAB programmes likewise make it possible to tailor engagement and therapeutic benefits for mental health to particular individuals and groups (Pavarini et al, 2021).…”

“…Creating the space for youth voices to be heard and prioritised in decision‐making related to social care and in mental health research has provided the opportunity for services, interventions, and research processes to be co‐produced, helping make them more responsive to CYP's needs and expectations (Pavarini et al., 2021; van Bijleveld et al., 2015). Processes of co‐creation in PAB programmes likewise make it possible to tailor engagement and therapeutic benefits for mental health to particular individuals and groups (Pavarini et al., 2021). Dialogic engagement enables artists and practitioners to draw on the experiences of the CYP involved, ensuring participation is meaningful for them (Lowe, 2012).…”

“Finding light in the darkness”: exploring comedy as an intervention for eating disorder recovery

“…While a drama therapist has received clinical training that enables them to adopt a dual role of group facilitator and primary therapist (Wood, 2015), the role of facilitator in C4C is to train participants to perform stand-up comedy while sharing perspectives of their own lived experience with anorexia. So, while a PAB activity such as C4C can have “ therapeutic” outcomes for participants, it is not (framed as) “ therapy ” (Williams et al , 2023; Pavarini et al , 2021).…”