This study examines patients' pictorial representations of their chronic pain, alongside their accounts of those images, in order to help our understanding of their lived experience of the condition. The sample comprises 7 women in middle adulthood from southern England. They began by drawing what their pain felt like and were then interviewed about their portrayals. The interviews were analyzed with interpretative phenomenological analysis. The participants produce strong, vivid, abstract pictures. In many of the pictures, the pain is objectified as punitive and sinister. This is enhanced through the use of stark colors of red and black. Paintings also often have a temporal element, showing either the movement from self before pain to self since the pain had started, or pointing to aspirations for the possible relief of pain in the future. The analysis of the images is grounded in the participants' accounts of them. The images and accounts provide a powerful insight into the internal world of the pain sufferer and the subjective experience of chronic pain. We link this work to other attempts to represent patients' pain and point to the particular contribution our work makes. We make some suggestions for subsequent research following on from what is presented here and we also argue that the methodology outlined in the article offers considerable potential for research on other health conditions.

Responsive art making, using arts media to respond to the affect within the therapeutic context, is emerging as an important method in the clinical repertoire of art therapists working within health care settings in the UK. This article develops a rationale for the importance of responsive art making as an interactive mentalizing process that establishes relational change through the interactive art-making process. A clinical vignette helps to illustrate how the art response as a method of communication can be used when words have been unavailable, particularly in conditions of high affect arousal and avoidant attachment patterns. The article concludes that methods of responsive art making require further research and examination with a mental health population.

This article sets out to describe provisional guidelines for the art therapist using an in-session art response. Art therapists are known to use art materials to respond to patients as part of their clinical work in health care settings. Using several survey and knowledge acquisition techniques, the author elucidates what techniques are being used and then establishes a first set of guidelines for art therapists working within Central and North West London NHS Foundation Trust (CNWL). The guidelines are not prescriptive, but offer a range of methods based on current practice. The guidelines pull together different ideas and methods and seek clinical consensus on the validity and reliability of each statement based on clinician and service user opinions. The resulting guidelines are in keeping with the ethos of NHS clinical governance to demonstrate clearly what interventions are being applied and to what effect. These guidelines are intended as a first set of principles to support innovation in clinical practice through recognition of standards to be developed.

Crisis events, such as the COVID-19 pandemic, can have a devastating effect on communities and the care professionals within them. Over recent years, arts-based interventions have helped in a wide range of crisis situations, being recommended to support the workforce during and after complex crisis but there has been no systematic review of the role of arts-based crisis interventions and whether there are cogent themes regarding practice elements and outcomes. We, therefore, conducted a systematic review to (i) define the arts-based change process used during and after crisis events, and (ii) explore the perceptions of intermediate and long-term mental health benefits of arts-based interventions for professionals in caring roles. Our search yielded six studies (all qualitative). All data were thematically aggregated and meta-synthesized, revealing seven practice elements (a safe place, focusing on strengths and protective factors, developing psychosocial competencies to support peers, emotional expression and processing, identifying and naming the impact of the crisis, using an integrative creative approach, and cultural and organizational sensitivity) applied across all six studies, as well as a range of intermediate and long-term benefits shared common features (adapting, growing, and recovering; using the community as a healing resource; reducing or preventing symptoms of stress or trauma reactions, psychophysiological homeostasis). The ways in which these studies were designed independently from one another and yet used the same practice elements in their crisis interventions indicates that there is comparability about how and why the arts-based practice elements are being used and to what effect. Our findings provide a sound basis and meaningful parameters for future research incorporating quantitative and qualitative approaches to firmly establish the effectiveness of art-based interventions, and how arts can support cultural sensitivity, acceptability and indicated outcomes, particularly those relating to stress and trauma during or following a crisis.