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Sat, 08/10/2024 - 00:40
Edited Text
Care in the Creative
Community
A Resource Guide for Arts Engagement in
the Treatment of Individuals Experiencing
First Episode Psychosis
Presented by Marissa Georgiou, MA in Counseling- Art Therapy
Candidate Pennsylvania Western University
Purpose Statement
Limited research has been conducted on the intersection of First
Episode Psychosis (FEP) care, Recovery-Oriented Cognitive
Therapy (CT-R), Art Therapy, and Community Arts spaces.
Existing evidence indicates that both creative arts therapies and
community engagement may alleviate symptoms of psychosis.
This research provides a resource guide for safe, purposeful, and
effective integration of community arts interventions with FEP
care in the CT-R treatment model.
Justification
First Episode Psychosis is a critical juncture for patients and
families. Prolonged untreated psychosis leads to greater burdens
on families and heightened risks for negative outcomes such as
substance abuse and homelessness. Early intervention significantly
improves outcomes. Engaging patients in community arts
activities fosters acceptance and supports treatment progress,
especially for those responsive to the arts. Art therapy
interventions are also shown to enhance self-expression and wellbeing. Further research is essential to optimize the effectiveness of
art therapy in this population.
Terms
Art Therapy
Mania
Art Therapy Interventions
Museum-based Art Therapy
Community Arts Spaces
Negative Symptoms of Psychosis
Coordinated Specialty Care (CSC)
Positive Symptoms of Psychosis
Delusions
Psychosis
First Episode Psychosis
Recovery-Oriented Cognitive
Therapy (CT-R)
Hallucinations
Tardive Dyskinesia
Literature Review: Recovery- Oriented Cognitive Therapy (CT-R)
●
Cognitive Behavioral Therapies (CBT) are effective for diverse mental health
conditions, with offshoots like Dialectical Behavioral Therapy (DBT) and
Cognitive Behavioral Therapy for Psychosis (CBTp) tailored to specific
treatment populations.
●
Recovery-Oriented Cognitive Therapy (CT-R) is a strengths-based approach
derived from CBTp, focusing on empowering individuals with serious mental
health conditions to lead meaningful lives.
●
Throughout the CT-R program, goals may evolve, and clinicians continue to
work with participants to develop aspirations and pursue growth in their
lives and relationships.
Literature Review: Recovery- Oriented Cognitive Therapy (CT-R)
●
In CT-R, treatment planning involves four stages centered around activating "the
adaptive mode," where individuals engage with positive thoughts, feelings, and actions
unique to their interests.
●
The first stage involves identifying activities that access the adaptive mode and
engaging in them with patients.
●
The second stage focuses on helping participants develop goals and aspirations,
tapping into underlying meanings to foster feelings of hope and purpose.
●
In the third stage, clinicians support individuals in actualizing the meaning behind their
aspirations, enabling meaningful progress toward life goals.
●
The fourth stage involves strengthening individuals' resilience to maintain the
connection with the adaptive mode amid challenges and setbacks.
Literature Review: First Episode Psychosis (FEP)
●
First Episode Psychosis (FEP) marks the initial onset of symptoms consistent with
psychosis, which can vary widely and indicate serious mental or physical health
conditions.
●
Psychosis involves a loss of contact with reality through changes in perception and
thought, presenting with symptoms like delusions, hallucinations, and disorganized
behavior.
●
Diagnostic categories for Psychotic Disorders include Schizophrenia, Schizophreniform
Disorder, Schizoaffective Disorder, and others.
●
Early warning signs of psychosis, often missed or misunderstood, may include social
withdrawal, reduced performance, suspiciousness, and unusual thoughts or
perceptions.
●
Early Intervention for FEP aims to help individuals understand their condition,
strengthen coping skills, and engage with support structures to mitigate distress and
promote recovery.
Literature Review: First Episode Psychosis (FEP) Treatment
●
Outcomes are significantly influenced by timely treatment.
●
Specialized programs and theoretical care models have emerged to meet the needs of individuals
experiencing FEP.
●
Coordinated care settings centralize psychosis treatment, offering support for emotional, psychosocial, case management, and medical needs.
●
Psychiatrists monitor symptoms and prescribe medication, therapists aid in understanding mental
health conditions and developing coping skills, while case managers navigate medical and social
service systems.
●
Best practices for FEP care involve team-based treatment settings with youth-oriented approaches
and dedicated key workers for each patient.
●
Family engagement is integral to FEP recovery, given the often unavoidable connection with family
members during the onset and aftermath of psychosis.
●
Psychoeducation helps patients and families understand psychosis symptoms and presentations,
facilitating better support and reducing stigma.
Literature Review: Art Therapy for FEP
●
First Episode Psychosis (FEP) patients face challenges in expressing their thoughts and
feelings, which Art Therapy addresses by providing a non-verbal outlet for expression.
●
Art Therapy has been used in the treatment of serious mental illnesses, with research
focusing largely on chronically ill patients.
●
The largest study on Art Therapy in psychosis care, the MATISSE study, found
controversial results, with critiques of its methodology.
●
Early intervention with Art Therapy in FEP care is an emerging area of research, with
qualitative studies indicating its meaningful impact on both patients and practitioners.
●
Grounded theory studies suggest that Art Therapy in early psychosis treatment
enhances expression and communication, fosters connection, and reduces negative
symptoms, warranting further investigation.
Literature Review: Community Arts spaces in Art Therapy Practice
●
Community-based arts organizations enrich communities through education,
exhibitions, and public events, offering free admission compared to museums.
●
Engagement with community arts can reduce negative symptoms of psychosis,
with art therapy interventions in these settings yielding positive outcomes.
●
Participatory arts interventions in community settings enhance agency, skill
development, and socialization, benefiting groups such as people living with
dementia and psychosis.
●
Research across various countries demonstrates significant mental health
benefits from interdisciplinary treatment involving art therapists and community
arts organizations.
Resource Guide
Resource Guide
● Offers an introduction to the treatment space, with sections
relating to First Episode Psychosis, Recovery-Oriented Cognitive
Therapy, and art therapy practices based in community arts spaces.
● Outlines a Five Phase program for implementing community arts
therapy interventions in FEP care
● Provides a case study with examples of how each phase was
enacted at an outpatient FEP care site in a major metropolitan city
Phase I: Research Gathering
● Learning about participants- What are their interests? What
creative interventions would be the most beneficial for them? Are
common themes emerging, common interests among participants?
● Learning about local arts resources- What cultural institutions exist
in your area? Do they offer educational programs? Gather
information and contacts for individuals at these sites.
Phase II: Outreach
● Outreach to participants
○
Encourage engagement in programming through direct communication by phone,
in person, and through intra-office announcements and flyers
● Outreach to local Arts Resources
○
Identify yourself and the agency you represent
○
Justify your desired collaboration- Why does this intervention make sense at this
time, with these individuals and this arts organization?
○
Display an openness to answering questions about psychosis and mental
healthcare. Psychosis can be poorly understood and stigmatized. Help
community partners understand what your participants are experiencing and how
community arts engagement can help them.
Phase III: Intervention Planning
● Where are you going?
● What are you doing there?
● How will people be getting to and from the event?
Phase IV: Implementation
● Getting there
● Learning, exploring, creating
● Processing the experience
Phase V: Review and Future Planning
● How did it go?
● How can we make it even better?
● Closing the loop with community partners
● Expressing gratitude
Case Study: The Program in Action
Phase I: Research Gathering
●
In the research phase, we gathered information from staff, participants, and
the wider community
●
Narrative artmaking was identified as a major interest among participants
●
Themes identified for the group: storytelling, character creation, and
connecting with like-minded individuals
●
Research on local arts organizations prioritized venues accessible within a
half-hour by walking, car, or public transportation
Phase II- Outreach
●
Identified participants interested in narrative artmaking and connected with
them on-site and through communication channels.
●
Scheduled a meeting for an art therapy group focusing on narrative
artmaking.
●
Sent announcements to interested participants and displayed posters in the
office to reach others.
●
Reached out to arts organizations within a half-hour travel radius via phone
and email, incorporating elements of Identification, Justification, and
Psychoeducation.
Phase III: Intervention Planning
●
Group facilitators identified potential interventions that could connect group
participants with established community relationships
●
Discussed a community arts space with participants to identify areas of interest
●
Coordinated dates for the intervention and made plans for travel into the community
●
Planned event structure, including travel time, art viewing, and a sharing conversation
●
Shared information about the event with all staff and program participants to promote
engagement
Phase IV: Implementation
●
Gathered participants at the office to ensure safe travel arrangements
●
Provided a brief description of the event plan before heading into the community
●
Received an introduction from creative community partners about available resources
and the day's activity
●
Program staff facilitated the therapy group, ensuring participants' safety and emotional
processing
●
Facilitated a group conversation to practice social skills and explore the intervention
further
●
Encouraged participants to develop their own creative aspirations during the event
Phase V: Review and Future Planning
●
Checked in with community partners to express gratitude and appreciation for their
support and hospitality.
●
Offered space for feedback and answered questions regarding group facilitation and
psychosis care to foster further relationship development.
●
Engaged with program participants post-event to gather feedback on their
experiences.
●
Solicited input on what aspects were effective and what could be improved.
●
Utilized participant feedback to shape future community arts interventions.
●
Participants reported improved mood, reduced psychosis symptoms, and increased
feelings of future-oriented thinking regarding creative goals and aspirations.
Limitations
●
Limited research on Art Therapy within the CT-R treatment model and the intersection of FEP
with Museum-Based Art Therapy interventions underscores the need for additional research
to establish ethical treatment guidelines.
●
Research focused solely on individuals experiencing FEP in a major metropolitan area,
potentially limiting generalizability to smaller cities or towns with less access to the arts,
where alternative approaches may be necessary.
●
Programs were conducted in person, but remote options for care could expand opportunities
for community arts collaborations.
●
This research was developed in an Outpatient FEP program serving a diverse population aged
15-30, but approaches for individuals younger or older should be explored.
●
Time-limited research lacked follow-up study, leaving long-term effects of interventions
unknown
Areas for Further Research
●
Further study is recommended to better understand efficacy and long-term impacts of
community arts intervention in FEP care.
●
Additional guidelines are necessary for future studies to ensure standardization and
repeatability for reliable findings. A standardized program could establish connections
between interventions and outcomes.
●
Remote arts interventions may broaden collaboration opportunities, especially for
practitioners in smaller cities.
●
Success of art therapy interventions in serious mental illnesses suggests applicability to
conditions beyond FEP.
●
Model could be adapted for younger or older participants, with adjustments in
intervention frequency potentially yielding different outcomes.
Final Thoughts
●
First Episode Psychosis care is crucial for individuals and families, as untreated psychosis can disrupt
various aspects of life and lead to poor outcomes such as homelessness and addiction.
●
Recovery Oriented Cognitive Therapy focuses on activating the adaptive mode in patients, which can
be achieved through engagement with participant interests like art.
●
Art therapies have been shown to increase engagement and communication while reducing distress
from psychosis symptoms.
●
Community-based art therapy in the CT-R framework builds positive relationships between
individuals and their communities.
●
Limited research exists on this treatment niche, yet it holds potential for powerful intervention.
●
This resource guide offers recommendations for implementing community arts interventions as part
of CT-R treatment for FEP, providing a five-phase plan for collaboration with community arts partners.
Questions?
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Attard, A., & Larkin, M. (2016). Art therapy for people with psychosis: a narrative review of the literature. The lancet. Psychiatry, 3(11), 1067–1078. https://doi.org/10.1016/S2215-0366(16)30146-8
Ayano, G., Tesfaw, G., & Shumet, S. (2019). The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis. BMC psychiatry, 19(1), 370. https://doi.org/10.1186/s12888-019-2361-7
Bazooband, A., Courtney-Pratt, H., Tierney, L., & Doherty, K. (2023). Engaging in Participatory Community-Based Arts: Perspectives of People Living with Dementia. Health & Social Care in the Community , 2023 .
Beck, A. T., Grant, P., Inverso, E., Brinen, A. P., & Perivoliotis, D. (2020). Recovery-oriented cognitive therapy for serious mental health conditions . Guilford Publications.
Conrad, D., & Sinner, A. (Eds.). (2015). Creating together: Participatory, community-based, and collaborative arts practices and scholarship across Canada . Wilfrid Laurier Univ. Press.
Crawford, M. J., Killaspy, H., Kalaitzaki, E., Barrett, B., Byford, S., Patterson, S., Soteriou, T., O'Neill, F. A., Clayton, K., Maratos, A., Barnes, T. R., Osborn, D., Johnson, T., King, M., Tyrer, P., & Waller, D. (2010). The MATISSE study: a randomised trial of group art
therapy for people with schizophrenia. BMC psychiatry, 10, 65. https://doi.org/10.1186/1471-244X-10-65
Feldman, J., Best, M., Beck, A. T., Inverso, E., & Grant, P. (2019). What is Recovery-Oriented Cognitive Therapy (CT-R)?. https://doi.org/10.1016/j.aip.2013.05.011
Hamil, S. (2016). The art museum as a therapeutic space (Doctoral dissertation, Lesley University).
Hanevik, H., Hestad, K. A., Lien, L., Teglbjaerg, H. S., & Danbolt, L. J. (2013). Expressive art therapy for psychosis: A multiple case study. The Arts in Psychotherapy, 40(3), 312–321.
Hartman, A. (2021). Exploring museum-based art therapy: a summary of existing programs. In Museum-based art therapy (pp. 16-41). Routledge.
Holttum, S., & Huet, V. (2014). The MATISSE Trial–A Critique: Does Art Therapy Really Have Nothing to Offer People With a Diagnosis of Schizophrenia? SAGE Open, 4(2). https://doi.org/10.1177/2158244014532930
Irwin, L., Rhodes, P., & Boydell, K. (2022). Evaluation of a gallery-based Arts Engagement program for depression. Australian Psychologist , 57 (3), 186-196.
Jabar, L. S. A., Sørensen, H. J., Nordentoft, M., Hjorthøj, C., & Albert, N. (2021). Associations between duration of untreated psychosis and domains of positive and negative symptoms persist after 10 years of follow-up: a secondary analysis from the OPUS trial.
Schizophrenia Research, 228, 575-580.
Kane, J. M., Schooler, N. R., Marcy, P., Correll, C. U., Brunette, M. F., Mueser, K. T., Rosenheck, R. A., Addington, J., Estroff, S. E., Robinson, J., Penn, D. L., & Robinson, D. G. (2015). The RAISE early treatment program for first-episode psychosis: background,
rationale, and study design. The Journal of clinical psychiatry, 76(3), 240–246.
King, J. L. (2015). Art Therapy: A Brain‐based Profession. The Wiley handbook of art therapy, 77-89.
Lynch, S., Holttum, S., & Huet, V. (2019). The experience of art therapy for individuals following a first diagnosis of a psychotic disorder: A grounded theory study. International Journal of Art Therapy, 24(1), 1-11.
Malchiodi, C. A. (2003). Handbook of Art Therapy. The Guilford Press. https://psycnet.apa.org/record/2003-02672-002
Marshall, M., Lewis, S., Lockwood, A., Drake, R., Jones, P., & Croudace, T. (2005). Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Archives of general psychiatry, 62(9), 975–983.
https://doi.org/10.1001/archpsyc.62.9.975
May, R. (2004). Making sense of psychotic experience and working toward recovery. In J. F. Gleeson, & P. D. McGorry, Psychological Interventions in Early Psychosis : A Treatment Handbook (p 245-258). John Wiley & Sons. https://www.aledu.com/wp-content/uploads/2014/05/GleesonMcGorry-eds-Psychological-Interv entions-in-Early-Psychosis.pdf
Menezes, N. M., Arenovich, T., & Zipursky, R. B. (2006). A systematic review of longitudinal outcome studies of first-episode psychosis. Psychological medicine , 36 (10), 1349-1362.
Montag, C., Haase, L., Seidel, D., Bayerl, M., Gallinat, J., Herrmann, U., & Dannecker, K. (2014). A pilot RCT of psychodynamic group art therapy for patients in acute psychotic episodes: feasibility, impact on symptoms and mentalising capacity. PloS one , 9
(11), e112348. https://doi.org/10.1371/journal.pone.0112348
Narita, Z., Koyanagi, A., Oh, H., & DeVylder, J. (2022). Association between incarceration and psychotic experiences in a general population sample. Schizophrenia Research, 243, 112-117.
Nilsen, L., Frich, J. C., Friis, S., & Røssberg, J. I. (2014). Patients' and family members' experiences of a psychoeducational family intervention after a first episode psychosis: a qualitative study. Issues in mental health nursing, 35(1), 58–68.
https://doi.org/10.3109/01612840.2013.837992
Pate, M., Rastogi, M., & Daiello, V. (2022). Community-based art therapy and community arts. In Foundations of Art Therapy (pp. 493-541). Academic Press.
Peters, L. A. (2022). How do community-based arts activities enable the identity change recovery process from serious mental illness: A protocol for a realist review. N/A .
Reed, S. I. (2008). First‐episode psychosis: A literature review. International journal of mental health nursing , 17 (2), 85-91.
Rubin, J. A. (2011). The art of art therapy: What every art therapist needs to know. Routledge.
Simon, G. E., Coleman, K. J., Yarborough, B. J. H., Operskalski, B., Stewart, C., Hunkeler, E. M., Lynch, F., Carrell, D., & Beck, A. (2017). First Presentation With Psychotic Symptoms in a Population-Based Sample. Psychiatric services (Washington, D.C.), 68(5),
456–461. https://doi.org/10.1176/appi.ps.201600257
Spencer, E., Birchwood, M., & McGovern, D. (2001). Management of first-episode psychosis. Advances in Psychiatric Treatment , 7 (2), 133-140.
Watson, E., Coles, A., & Jury, H. (2021). ‘A space that worked for them’: museum-based art psychotherapy, power dynamics, social inclusion and autonomy. International Journal of Art Therapy , 26 (4), 137-146.
Community
A Resource Guide for Arts Engagement in
the Treatment of Individuals Experiencing
First Episode Psychosis
Presented by Marissa Georgiou, MA in Counseling- Art Therapy
Candidate Pennsylvania Western University
Purpose Statement
Limited research has been conducted on the intersection of First
Episode Psychosis (FEP) care, Recovery-Oriented Cognitive
Therapy (CT-R), Art Therapy, and Community Arts spaces.
Existing evidence indicates that both creative arts therapies and
community engagement may alleviate symptoms of psychosis.
This research provides a resource guide for safe, purposeful, and
effective integration of community arts interventions with FEP
care in the CT-R treatment model.
Justification
First Episode Psychosis is a critical juncture for patients and
families. Prolonged untreated psychosis leads to greater burdens
on families and heightened risks for negative outcomes such as
substance abuse and homelessness. Early intervention significantly
improves outcomes. Engaging patients in community arts
activities fosters acceptance and supports treatment progress,
especially for those responsive to the arts. Art therapy
interventions are also shown to enhance self-expression and wellbeing. Further research is essential to optimize the effectiveness of
art therapy in this population.
Terms
Art Therapy
Mania
Art Therapy Interventions
Museum-based Art Therapy
Community Arts Spaces
Negative Symptoms of Psychosis
Coordinated Specialty Care (CSC)
Positive Symptoms of Psychosis
Delusions
Psychosis
First Episode Psychosis
Recovery-Oriented Cognitive
Therapy (CT-R)
Hallucinations
Tardive Dyskinesia
Literature Review: Recovery- Oriented Cognitive Therapy (CT-R)
●
Cognitive Behavioral Therapies (CBT) are effective for diverse mental health
conditions, with offshoots like Dialectical Behavioral Therapy (DBT) and
Cognitive Behavioral Therapy for Psychosis (CBTp) tailored to specific
treatment populations.
●
Recovery-Oriented Cognitive Therapy (CT-R) is a strengths-based approach
derived from CBTp, focusing on empowering individuals with serious mental
health conditions to lead meaningful lives.
●
Throughout the CT-R program, goals may evolve, and clinicians continue to
work with participants to develop aspirations and pursue growth in their
lives and relationships.
Literature Review: Recovery- Oriented Cognitive Therapy (CT-R)
●
In CT-R, treatment planning involves four stages centered around activating "the
adaptive mode," where individuals engage with positive thoughts, feelings, and actions
unique to their interests.
●
The first stage involves identifying activities that access the adaptive mode and
engaging in them with patients.
●
The second stage focuses on helping participants develop goals and aspirations,
tapping into underlying meanings to foster feelings of hope and purpose.
●
In the third stage, clinicians support individuals in actualizing the meaning behind their
aspirations, enabling meaningful progress toward life goals.
●
The fourth stage involves strengthening individuals' resilience to maintain the
connection with the adaptive mode amid challenges and setbacks.
Literature Review: First Episode Psychosis (FEP)
●
First Episode Psychosis (FEP) marks the initial onset of symptoms consistent with
psychosis, which can vary widely and indicate serious mental or physical health
conditions.
●
Psychosis involves a loss of contact with reality through changes in perception and
thought, presenting with symptoms like delusions, hallucinations, and disorganized
behavior.
●
Diagnostic categories for Psychotic Disorders include Schizophrenia, Schizophreniform
Disorder, Schizoaffective Disorder, and others.
●
Early warning signs of psychosis, often missed or misunderstood, may include social
withdrawal, reduced performance, suspiciousness, and unusual thoughts or
perceptions.
●
Early Intervention for FEP aims to help individuals understand their condition,
strengthen coping skills, and engage with support structures to mitigate distress and
promote recovery.
Literature Review: First Episode Psychosis (FEP) Treatment
●
Outcomes are significantly influenced by timely treatment.
●
Specialized programs and theoretical care models have emerged to meet the needs of individuals
experiencing FEP.
●
Coordinated care settings centralize psychosis treatment, offering support for emotional, psychosocial, case management, and medical needs.
●
Psychiatrists monitor symptoms and prescribe medication, therapists aid in understanding mental
health conditions and developing coping skills, while case managers navigate medical and social
service systems.
●
Best practices for FEP care involve team-based treatment settings with youth-oriented approaches
and dedicated key workers for each patient.
●
Family engagement is integral to FEP recovery, given the often unavoidable connection with family
members during the onset and aftermath of psychosis.
●
Psychoeducation helps patients and families understand psychosis symptoms and presentations,
facilitating better support and reducing stigma.
Literature Review: Art Therapy for FEP
●
First Episode Psychosis (FEP) patients face challenges in expressing their thoughts and
feelings, which Art Therapy addresses by providing a non-verbal outlet for expression.
●
Art Therapy has been used in the treatment of serious mental illnesses, with research
focusing largely on chronically ill patients.
●
The largest study on Art Therapy in psychosis care, the MATISSE study, found
controversial results, with critiques of its methodology.
●
Early intervention with Art Therapy in FEP care is an emerging area of research, with
qualitative studies indicating its meaningful impact on both patients and practitioners.
●
Grounded theory studies suggest that Art Therapy in early psychosis treatment
enhances expression and communication, fosters connection, and reduces negative
symptoms, warranting further investigation.
Literature Review: Community Arts spaces in Art Therapy Practice
●
Community-based arts organizations enrich communities through education,
exhibitions, and public events, offering free admission compared to museums.
●
Engagement with community arts can reduce negative symptoms of psychosis,
with art therapy interventions in these settings yielding positive outcomes.
●
Participatory arts interventions in community settings enhance agency, skill
development, and socialization, benefiting groups such as people living with
dementia and psychosis.
●
Research across various countries demonstrates significant mental health
benefits from interdisciplinary treatment involving art therapists and community
arts organizations.
Resource Guide
Resource Guide
● Offers an introduction to the treatment space, with sections
relating to First Episode Psychosis, Recovery-Oriented Cognitive
Therapy, and art therapy practices based in community arts spaces.
● Outlines a Five Phase program for implementing community arts
therapy interventions in FEP care
● Provides a case study with examples of how each phase was
enacted at an outpatient FEP care site in a major metropolitan city
Phase I: Research Gathering
● Learning about participants- What are their interests? What
creative interventions would be the most beneficial for them? Are
common themes emerging, common interests among participants?
● Learning about local arts resources- What cultural institutions exist
in your area? Do they offer educational programs? Gather
information and contacts for individuals at these sites.
Phase II: Outreach
● Outreach to participants
○
Encourage engagement in programming through direct communication by phone,
in person, and through intra-office announcements and flyers
● Outreach to local Arts Resources
○
Identify yourself and the agency you represent
○
Justify your desired collaboration- Why does this intervention make sense at this
time, with these individuals and this arts organization?
○
Display an openness to answering questions about psychosis and mental
healthcare. Psychosis can be poorly understood and stigmatized. Help
community partners understand what your participants are experiencing and how
community arts engagement can help them.
Phase III: Intervention Planning
● Where are you going?
● What are you doing there?
● How will people be getting to and from the event?
Phase IV: Implementation
● Getting there
● Learning, exploring, creating
● Processing the experience
Phase V: Review and Future Planning
● How did it go?
● How can we make it even better?
● Closing the loop with community partners
● Expressing gratitude
Case Study: The Program in Action
Phase I: Research Gathering
●
In the research phase, we gathered information from staff, participants, and
the wider community
●
Narrative artmaking was identified as a major interest among participants
●
Themes identified for the group: storytelling, character creation, and
connecting with like-minded individuals
●
Research on local arts organizations prioritized venues accessible within a
half-hour by walking, car, or public transportation
Phase II- Outreach
●
Identified participants interested in narrative artmaking and connected with
them on-site and through communication channels.
●
Scheduled a meeting for an art therapy group focusing on narrative
artmaking.
●
Sent announcements to interested participants and displayed posters in the
office to reach others.
●
Reached out to arts organizations within a half-hour travel radius via phone
and email, incorporating elements of Identification, Justification, and
Psychoeducation.
Phase III: Intervention Planning
●
Group facilitators identified potential interventions that could connect group
participants with established community relationships
●
Discussed a community arts space with participants to identify areas of interest
●
Coordinated dates for the intervention and made plans for travel into the community
●
Planned event structure, including travel time, art viewing, and a sharing conversation
●
Shared information about the event with all staff and program participants to promote
engagement
Phase IV: Implementation
●
Gathered participants at the office to ensure safe travel arrangements
●
Provided a brief description of the event plan before heading into the community
●
Received an introduction from creative community partners about available resources
and the day's activity
●
Program staff facilitated the therapy group, ensuring participants' safety and emotional
processing
●
Facilitated a group conversation to practice social skills and explore the intervention
further
●
Encouraged participants to develop their own creative aspirations during the event
Phase V: Review and Future Planning
●
Checked in with community partners to express gratitude and appreciation for their
support and hospitality.
●
Offered space for feedback and answered questions regarding group facilitation and
psychosis care to foster further relationship development.
●
Engaged with program participants post-event to gather feedback on their
experiences.
●
Solicited input on what aspects were effective and what could be improved.
●
Utilized participant feedback to shape future community arts interventions.
●
Participants reported improved mood, reduced psychosis symptoms, and increased
feelings of future-oriented thinking regarding creative goals and aspirations.
Limitations
●
Limited research on Art Therapy within the CT-R treatment model and the intersection of FEP
with Museum-Based Art Therapy interventions underscores the need for additional research
to establish ethical treatment guidelines.
●
Research focused solely on individuals experiencing FEP in a major metropolitan area,
potentially limiting generalizability to smaller cities or towns with less access to the arts,
where alternative approaches may be necessary.
●
Programs were conducted in person, but remote options for care could expand opportunities
for community arts collaborations.
●
This research was developed in an Outpatient FEP program serving a diverse population aged
15-30, but approaches for individuals younger or older should be explored.
●
Time-limited research lacked follow-up study, leaving long-term effects of interventions
unknown
Areas for Further Research
●
Further study is recommended to better understand efficacy and long-term impacts of
community arts intervention in FEP care.
●
Additional guidelines are necessary for future studies to ensure standardization and
repeatability for reliable findings. A standardized program could establish connections
between interventions and outcomes.
●
Remote arts interventions may broaden collaboration opportunities, especially for
practitioners in smaller cities.
●
Success of art therapy interventions in serious mental illnesses suggests applicability to
conditions beyond FEP.
●
Model could be adapted for younger or older participants, with adjustments in
intervention frequency potentially yielding different outcomes.
Final Thoughts
●
First Episode Psychosis care is crucial for individuals and families, as untreated psychosis can disrupt
various aspects of life and lead to poor outcomes such as homelessness and addiction.
●
Recovery Oriented Cognitive Therapy focuses on activating the adaptive mode in patients, which can
be achieved through engagement with participant interests like art.
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Art therapies have been shown to increase engagement and communication while reducing distress
from psychosis symptoms.
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Community-based art therapy in the CT-R framework builds positive relationships between
individuals and their communities.
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Limited research exists on this treatment niche, yet it holds potential for powerful intervention.
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This resource guide offers recommendations for implementing community arts interventions as part
of CT-R treatment for FEP, providing a five-phase plan for collaboration with community arts partners.
Questions?
References
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