‘ I never get this space anywhere else’ – the development of Outside, Alongside – an NHS art therapy group outdoors

Abstract

Background There is a developing body of research concerning the benefits of outdoor art therapy, but little published concerning its use with adults with severe mental illness (SMI). This paper, co-authored by a group participant, describes the development of an outdoor art therapy group for adults in an NHS mental health setting.Context Three cohorts of participants (19 people) took part in a 12-week outdoor art therapy group in an NHS Trust in the Midlands, UK.Approach The group was facilitated by two trained art psychotherapists using a semi-structured, coproduced format which evolved through the development of the group. Natural materials were used to create images and objects and to facilitate group reflection and discussion. Principles of eco-therapy and outdoor art therapy were drawn upon. The group runs in all seasons, rather than just in Spring and Summer.Outcomes Positive outcomes were reported in outcome measures and through service user feedback forms, poetry and verbal feedback. The following themes were identified: adapting and resilience, increasing accessibility, re-connecting with play, levelling out, connecting with others and self through nature.Conclusions Outdoor art therapy appears to offer multiple benefits to participants and opportunities to expand the range of psychological therapies on offer in a way which is more accessible to those who find indoor spaces difficult, who may find groups difficult and who may benefit from working creatively outdoors.Implications for research Further research is required, particularly on the benefits of outdoor group art therapy for adults with SMI.Plain-language summary This paper describes a new art therapy group which took place outside in an adult NHS mental health setting in the Midlands, UK. Three groups of people, 19 in total, took part in a 12-week outdoor group which was facilitated by two qualified art psychotherapists. The group was held in the grounds of a Victorian building owned by the Trust with established woodland and trees for the group to work in. The group aimed to appeal to people who find traditional clinical spaces difficult to be in, who might find being in groups difficult but who feel lonely and who might benefit from being creative and being outside. There is more and more research available which shows the benefits of being outside and being creative for improving mental ill health, but limited research which explores the benefits of being creative outdoors.The paper has been written by a service user participant and the two art psychotherapists who facilitated the group.The paper describes the theory which supported the development of the group and the way in which the group was designed and developed by the art psychotherapists and the participants over the three cohorts. It shows the range of positive feedback from participants and highlights where more research is needed to develop the evidence base further.We also discuss how this group aimed to address unequal access to traditional art therapy held indoors and other verbal-focused psychological interventions.The paper includes images which show some of the artwork made by participants.

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