In the wake of the Matisse RCT: What about art therapy and psychosis?

Abstract

The Matisse RCT carried out by Crawford and colleagues in 2012 suggested that for many people with a diagnosis of schizophrenia, art therapy as conducted in that trial may have no benefit. This article aims to contribute to identifying what might be learnt from Matisse, help art therapists defend their work and, where appropriate, help people retain access to it. Mental health work is still strongly influenced by the difficult history of schizophrenia. Aspects of Matisse and what it managed to test are questioned. The article argues that the British Medical Journal editorial review of the trial, though generally well considered, is mistaken to consider that Matisse tested art therapy as currently practised in the UK. It is important to design future research trials that test art therapy approaches specifically adapted for use with people who experience psychosis. Ideas about recovery (which are in the social psychiatry lineage of art therapy), and the growing strength of service user movements worldwide, indicate that there are ways forward for work and research in this area. Art therapy is not a stand-alone approach for people with these diagnoses, but it can contribute to combinations of treatments and there is still some evidence that it can aid service engagement and counter negative symptoms.