Learning Disability Group Art Therapy: Looking and Asking

Study Overview
=================
Brief Summary
-----------------
A qualitative study of group art therapy in England for adults with a learning disability accessing community services. Different stakeholder views and experiences will be gathered using ethnographically-informed group observation, semi-structured individual interviews and a focus group. People with a learning disability will support the data analysis and dissemination of findings in accessible means.

Official Title
-----------------
Group Art Therapy Practice for People With a Learning Disability (GATher-LD): A Qualitative Study

Conditions
-----------------
Learning Disability, Adult, Mental Health

Intervention / Treatment
-----------------
* Other: Ethnographically-informed group observation
* Other: Semi-structured Interviews
* Other: Focus Group


Participation Criteria
=================
Eligibility Criteria
-----------------
INCLUSION CRITERIA: Participants who are art therapists must: Be a HCPC registered arts therapist practicing in the UK Have experience of delivering group arts therapy in a community setting to this population Be able to give informed consent and communicate in English Participants who are adults with a learning disability must: Be 18 years old or over Have a diagnosed learning disability or be accessing an NHS specialist learning disability service or using their personal budget to access a third sector art therapy group for this population Have experienced mental distress, have a diagnosed mental health condition or be accessing support for their mental health Be currently accessing group arts therapy Be able to give informed consent with adapted communication aids and approaches to meet their communication preferences Have a level of verbal ability to ensure they can communicate their views and meaningfully engage in the study Participants who are paid support staff or family carers must: Be 18 years old or over Be identified by the person with a learning disability as someone who knows them well and could represent the carer perspective in this study Be able to give informed consent Have adequate command of the English to be able to meaningfully engage in the study Participants will be excluded if they: Are unable to engage in the informed consent process; this is likely to exclude people who have a more severe form of learning disability Delivering the arts therapy group on an inpatient or acute ward Trainee arts therapists, or those who have yet to complete registration with the HCPC

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Art Therapist<br>Professionally qualified and HCPC registered Arts Therapists delivering group arts therapy in the community settings in the UK | Other: Ethnographically-informed group observation<br>* The chief investigator will visit each art therapy group 3-6 times; there will be up to 5 groups recruited. They will record observational data and insights; making use of visual reflective journaling where appropriate. These will later be written up as full field notes.<br>Other: Semi-structured Interviews<br>* Individual interviews will take place with all three key stakeholders in group art therapy at different stages of the study. Each interview will have a topic guide to structure the discussion and will combine arts-based methods with conversation to maximise accessibility. Interview location, timing and format (online or in-person) are flexible, and the chief investigator will adapt to the needs of the participants.<br>Other: Focus Group<br>* After data collection and initial analysis (likely 3-5 months after final observation and/or interview) a focus group will be held with the art therapist participants. This session will use arts-based engagement to support member checking of the initial results and triangulation of the findings, which is likely to include potential active ingredients in group art therapy and principles of practice with this client group.<br>|
| People with a Learning Disability<br>Adults (18 years+) currently attending an art therapy group who have a learning disability and can consent and communicate in a way that supports meaningful engagement in the study. | Other: Ethnographically-informed group observation<br>* The chief investigator will visit each art therapy group 3-6 times; there will be up to 5 groups recruited. They will record observational data and insights; making use of visual reflective journaling where appropriate. These will later be written up as full field notes.<br>Other: Semi-structured Interviews<br>* Individual interviews will take place with all three key stakeholders in group art therapy at different stages of the study. Each interview will have a topic guide to structure the discussion and will combine arts-based methods with conversation to maximise accessibility. Interview location, timing and format (online or in-person) are flexible, and the chief investigator will adapt to the needs of the participants.<br>|
| Identified Support Person<br>Person who is well-known to the person with a learning disability (e.g. NHS staff, paid support staff or family members who are carers) who provides practical and/or emotional support to the person with a learning disability attending the art therapy group | Other: Semi-structured Interviews<br>* Individual interviews will take place with all three key stakeholders in group art therapy at different stages of the study. Each interview will have a topic guide to structure the discussion and will combine arts-based methods with conversation to maximise accessibility. Interview location, timing and format (online or in-person) are flexible, and the chief investigator will adapt to the needs of the participants.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To understand the features of current group art therapy practice for people with a learning disability | Through using ethnographically informed observation of art therapy groups, arts-based semi-structured interviews and focus group to gather key stakeholder perspectives from service users, carers, and art therapists | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Identify the potential active ingredients of art therapy with this client group through describing the procedures used by art therapists |  | 12 months | 
| Understand how people with a learning disability experience art therapy to identify helpful therapist behaviours and highlight possible future domains of outcome measurement |  | 12 months | 
| Identify the components of the intervention, which includes dynamic administration and how best to include the person's network |  | 12 months |