Clinical Meeting: Evaluate, value and validate

It seems that many art therapists view the idea of “evidence based practice” and “research” with a degree of suspicion. After all, we chose to go into a field which deals with notions such as creativity, play and self-expression; many of us work with concepts which are difficult to measure, such as transference and counter-transference. Furthermore, the process of healing in art therapy seems so individual, so unique to each client or to each group, that surely reducing it to statistics or generalisations takes away the essence of the work we do in the consulting room. Or does it?

These concerns and questions came to the fore during the art-making part of this month’s clinical meeting, when we were asked to think about “research”. The presentation, given by Gary Nash (co-founder and co-clinical director of the London Art Therapy Centre) and James West (coordinator of the BAAT Private Practice and the Addictions Special Interest Groups) considered these questions, as well as the possibilities and opportunities offered by research in a private practice setting.

The presentation started off by outlining the purpose of research in the profession: apart from being an evaluative process which we are required to engage in as a state-registered profession, we can only remain relevant and reflexive if we to continue to ask ourselves – how and why we do what we do? What have we learned from it? As art therapists, we regularly engage in an ongoing process of reflection and evaluation by keeping process notes, attending clinical supervision and CPD events. As Joy Schaverien points out in her chapter The Retrospective Review of Pictures, we should regularly evaluate our practice, reflect on the therapeutic process and validate the experience by “checking in” with our clients through conversations, reviews of the artwork and by encouraging them to make choices about the duration, focus and efficacy of their own therapy.

While this form of evaluation is an important part of the work, it is also crucial to think beyond the consulting room (or art therapy studio) and consider the opportunities private practice can offer to the growing body of knowledge and evidence in art therapy research. Looking at the writing of Gilroy & Lee in Research in the Creative Therapies, Gary and James considered the epistemology – or “ways of knowing” – emerging from art therapy practice and the most appropriate research method for our profession. This led to a discussion about the recent use of quantitative research methods in art therapy – most famously (as with the Matisse study) randomised control trials – which are most commonly used in pharmaceutical research. Are these the most suitable ways to gather knowledge about the way art therapy works? Outlining several different research methods, such as phenomenological studies, historical research and evaluation research, alongside techniques used in visual anthropology and art-based research, James and Gary made it clear that there is a myriad of ways to develop knowledge and understanding in our field.

Many art therapists in private practice enjoy having relative freedom from the centralised bureaucracy of the NHS and the lack of pressure to partake in research. Yet, it seems we are in a unique position to contribute to research opportunities. Free from the “top down” pressures of large organisations, from the expectations to fit into specific outcomes or to provide justification for the profession’s inclusion in an increasingly stretched public sector, we can conduct research in a “bottom up” way. We can ensure that our research paradigm does not conflict with the very thing we are trying to study; we can consider the role of the artwork and whether this can be used in studies. Additionally, the relationships we establish with our clients in private practice – and the level of choice and autonomy they have over their therapy – offers opportunities for collaborative research, either by writing with clients about the therapeutic process or by inviting them to be an active part of research through feedback and interviews. Ultimately, in order to find out how to be better at what we do we need to learn more about the experience of the client, what he or she found most useful and why it was helpful to them.