What art therapy can offer in the NHS and CAMHS

Can you tell us about your role and the trust you work for?

I’m the Trust Lead for Psychological Therapies in Oxleas NHS Foundation Trust, which offers a wide range of NHS healthcare services to people living in South- East London, and to people in prison across the South of England.

I’m also the Head of Psychological Therapies for Oxleas’ Children and Young People’s Services, which includes CAMHS and specialist children’s community health services.

Why did you choose to include art therapy as part of the services you offer?

I was pleased to discover that art therapy was already well-established across Oxleas when I came into my role, with art therapists working with both children and adults across the Trust. Over the last five years, we’ve been able to invest further, and have extended our art therapy provision across a range of community, inpatient and secure settings.

We’ve chosen to grow our art therapy offer in recognition of its relevance and  positive outcomes for service users presenting a wide range of difficulties. We also recognise the need to offer a choice of therapeutic modalities to meet the individual needs of our service users – as one size doesn’t fit all in terms of accessibility, engagement and what is most likely to help and support that person.

What are the benefits of including art therapists in your staff team?

Our art therapists make an important contribution to their teams and predominantly work in multidisciplinary service settings.

Alongside their training and professional development in delivering art therapy interventions, our art therapists have often developed specialist clinical expertise in areas such as mentalisation-based therapy, systemic practice and compassion-focused therapy.

Likewise, as well as undertaking clinical casework, art therapists also make a valued contribution to the wider work of their teams, via multidisciplinary and multi-agency liaison, consultation, joint working, supervision and training.

Do you measure the impact of the art therapy services you provide?

The impact of art therapy interventions across Oxleas is measured in various ways, including via service evaluations and audits. For example, we are currently evaluating the impact of a recently established perinatal art psychotherapy offer, with promising early findings.

We also use routine outcome measures (ROMs) across Oxleas’ services, to measure change over time in our service users’ clinical symptoms, quality of life and day-to-day functioning. The measures we use vary, depending on the client group and service area.  Our art therapists also use ROMs to measure the impact of their individual and group work.

What challenges do you face in including art therapy into your services, and how do you overcome them?

As a relatively small professional group in a large NHS Trust, it’s important we ensure that our art therapists have visibility, and that they feel a sense of professional belonging. Having a strong professional governance structure, with leadership from a consultant art therapist, and showcasing art therapy practice through CPD events, can help to address these issues.

There is also the perennial issue, not unique to art therapy, of finding sufficient funding to embed specialist therapeutic roles in NHS services. This means that some areas are better resourced than others when it comes to art therapy provision.

Finally, on occasion, we’ve needed to overcome some practical challenges in making sure that our clinical rooms are suitable for art therapy sessions.

What would you say to someone considering including art therapy within their service offer?

Art therapists have an important part to play in delivering accessible and effective therapeutic support within NHS services. Our service users come to us with increasingly complex individual and systemic difficulties, and we have a growing awareness of the need to address barriers to accessing mental health support. In this context, art therapy offers a modality that is well suited to engaging with and addressing a wide range of mental health needs.

To successfully embed art therapy roles, it’s important to make sure that there is a suitable professional governance and CPD structure in place, ideally relating jointly to Psychological Professions and Allied Health Professions leadership within the organisation. We are fortunate to have a joint over-arching Therapies Directorate in Oxleas, which provides a home to art therapy that allows for support from both professional groups.

What about art therapy in CAHMS?

We’ve found that art therapy is a suitable treatment for many of the mental health presentations commonly seen in CAMHS. Children and young people who may benefit from art therapy include those who are integrating stressful life experiences, such as trauma or bereavement; those experiencing difficulties with emotional regulation; young people with symptoms of psychosis; and those who would struggle more generally to access talking therapies.

Our CAMHS art therapy offer includes individual art therapy, as well as dyadic (parent–child) art therapy – with the latter focused on working with families where there has been attachment disruption, complex trauma and related parent-child relationship difficulties. Within this approach, working directly with the relationship, using art materials, offers a live opportunity in the room to facilitate attunement, connection and relational goals.

Is there evidence for providing art therapy in CAMHS?

While the evidence base for art therapy in CAMHS is still growing, there is an emerging evidence base that supports its deployment as part of a wider multidisciplinary CAMHS approach.

For instance, a recent systematic review found evidence for the effectiveness of art therapy for children and young people who have experienced trauma – who tend to be over-represented in CAMHS (Braito et al., 2022). Likewise, there is now good evidence that art therapy is an effective intervention for anxiety in children and young people (Zhang et al., 2024).

We have also been guided by the recent recommendation by NICE, that art therapy should be made available as part of the children and young people’s treatment for psychosis and schizophrenia (NICE CG155, updated 2016). Alongside this, our significant practice-based learning speaks to the clinical utility of art therapy within CAMHS.

References

• Braito, I. et al. (2022). ‘Review: systematic review of effectiveness of art psychotherapy in children with mental health disorders’, Irish Journal of Medical Science, 191, pp. 1369–1383.
• NICE CG155 (2013, updated 2016). Psychosis and schizophrenia in children and young people: recognition and management.
• Zhang, B. et al. (2024). ‘The effects of art therapy interventions on anxiety in children and adolescents: A meta-analysis’, Clinics, 79