Primary school mentalisation-based art therapy (Primary-smART): A person-based approach optimisation study

Background
The children’s mental health crisis in the UK continues to worsen and more and more schools are employing art therapists (ATs) to provide services for children experiencing social, emotional, and mental health (SEMH) difficulties. Although some studies have found indications of positive SEMH outcomes following art therapy, the evidence-base is still emerging. The initial development of a formalised art therapy intervention called Primary-smART included children, teachers, parents/carers, and art therapists. Indications from exploratory research showed this intervention could be helpful for children experiencing SEMH difficulties.

Aims
This study aimed to optimise a Primary-smART toolkit to ensure it is acceptable, engaging and persuasive for ATs in preparation for a future evaluation study in primary schools with children.

Methods
The Person-Based Approach (PBA) to intervention development was used to develop Primary-smART. In this study, feedback gained through online interviews with ATs was used to refine and optimise the toolkit.

Results
The 18 ATs who participated in this study perceived Primary-smART as acceptable overall. However, ATs during Rounds 1, 2, and 3 had important concerns which may have resulted in barriers to using Primary-smART. Seven out of eight main sections were modified and no new significant barriers were fed back by Round 4.

Conclusions
This study was successful in refining and optimising the Primary-smART toolkit. Results show that PBA methods enabled the research team to meet the study's aims.

Implications for practice/policy/future research
Future evaluation studies are now needed to test the clinical, carbon and cost effectiveness of Primary-smART.