ATIC: Developing a recovery-based art therapy practice

Sussex Partnership NHS Foundation Trust

ATIC (Art Therapy in the Community) is a recovery-based art therapy group run by Sussex Partnership NHS Foundation Trust. The group is designed to meet the needs adults with severe mental health problems making the transition from acute inpatient mental health hospital to community based care. The group has been running since 2009.

Description of the arts activity

ATIC is an art therapy group with membership of approximately 10 participants who attend for up to 12 months. This means there is always a range of confidence and experience in the group and a pathway for both being new to and preparing to leave the group.

Over time ATIC has come to be defined by six elements. Firstly, it is outcome focused with an evaluation process from the outset. It focuses on the transition from acute to community care; it is delivered within a community arts rather than an NHS setting; it has been co-delivered with a service user in the role of ‘Peer Arts Worker’; it aims to develop artistic confidence and identity; and the group offers an opportunity to gain social confidence and a sense of inclusion.

The group is held at Phoenix Brighton, an arts organisation in the city centre. Art exhibitions and workshops are regularly run in the onsite gallery and the building houses over 100 artists’ studios. ATIC uses an art studio within the building. The choice of venue is designed to help participants develop an identity away from mental health settings and build their confidence accessing community based resources. One participant described the group as “A place where I feel great walking in and out of. I don’t look or feel like a mental health patient. I feel like an artist.” This change and growth in identity has been shared by many of the group’s participants and has had a positive impact on their mental health and wellbeing.  The group contributed art works to a permanent exhibition at Mill View Hospital, Hove, in 2014.

Sessions are run weekly by two art therapists. The group format includes time for check-in, art making and discussion of images. The therapists engage with service users throughout the session, offering both emotional and practical support. Art therapists maintain regular contact with service users’ care teams between sessions, informing them of any clinical concerns.

Details of the project participants

The art therapists who run ATIC are also part of the acute hospital staff team and are responsible for identifying potential group members who they believe would benefit from ATIC. This also provides a continuity of care as members work with the same art therapists both in a hospital and a community setting.  Referrals are also taken from the hospital and community service.

Project management

The project is coordinated by art therapists working within Sussex Partnership and reports to the local management team. The group is free to attend.

Evaluation methods and findings

An evaluation of ATIC was published in The International Journal of Art Therapy in 2014. ‘ATIC: Developing a recovery-based art therapy practice’ by Joanna Stevens, Julie Allan, Heather Barford, Florence Horwood and Gerard Tanti) used a pre-post mixed methods approach: quantitative data were collected from each participant at the beginning and end of their participation at ATIC via standardised outcome measures, and qualitative data were gathered via interviews at the end point of participation.

The evaluation collected and analysed data from the CORE Outcome Measures (Clinical Outcomes in Routine Evaluation) and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). Out of the 13 participants who took part, 9 people showed reliable change on either CORE or Warwick-Edinburgh.

The thematic analysis identified five overarching themes; experiences of being in a group, experiences of creating art, improvements in wellbeing, factors that make the group successful and plans after ATIC.

  • Experiences of being in a group

With one isolated exception, these were overwhelmingly positive and focused around receiving support from others ‘in the same boat.’

  • Experiences of creating art
    In total, eight individuals mentioned having learnt a new skill or having enjoyed experimenting with art, with three people in particular focusing on their newly discovered (or re-discovered) artistic identity. Participants identified that art provided a meaningful activity, a distraction and a chance to ‘focus on something other than negative thoughts.’ The art-making process was described by seven individuals as a chance for self-expression.
  • Improvements in wellbeing
    Many service users mentioned ways in which their wellbeing had improved. The three most frequently mentioned changes were increased confidence or motivation, improvements in self-care, and improved relationships within and outside ATIC.
  • Factors that make ATIC successful
    The most frequently mentioned factors related to the other people in ATIC, specifically, the non-judgemental behaviour of others and the way this created a friendly and supportive atmosphere. Four members discussed the benefits of having a safe space in which to express themselves, and the weekly structure of the group was also helpful as it gave members a regular commitment. The final factor was the importance of ATIC being held in an artistic building rather than a clinical one.
  • Plans after ATIC
    The majority of group members had made future plans to continue with art, attend further groups, or both. Some of these were directly related to art, such as becoming a Peer Arts Worker, signing up for a foundation art course, undertaking evening courses, or setting up an arts group. Other members have gone on to help other service users in voluntary roles.  Although it cannot be concluded that ATIC was the cause of these positive changes, feedback suggests that the group helped to build social confidence which may have provided a gateway into the more socially inclusive avenues members pursued upon leaving.

The qualitative data gathered from this project identifies a strong link between recognised recovery outcomes and what ATIC members are describing.

Supported using public funding by the Arts Council England