Published:
December 2020

Issue:
Vol.15, No.1

Word count:
4500

About the author

  • PhD, MAT, MA(AppAnthCommtyYthWk), Dip(Psych), Dip(AppPsych), Dip(Drama), AThR

    Emma is an art therapist, predominantly working in the areas of neurodiversity, complex support, and mental health. She currently facilitates individual and group art therapy with children and young people impacted by trauma. Emma has also spent a considerable

    amount of time facilitating community arts projects with marginalised groups in the UK, Mexico and Australia. Her research interests lie in art as a tool for expression and connection; and as a nuanced research method. She hopes to continue researching how art-making supports people’s well-being in both the long and the short terms. She utilises democratic,

    person-centred frames in both practice and research to increase equity, agency and

    belonging. Emma is a keen photographer and sculptor who has exhibited work in the

    UK, Mexico and Australia.

This work is published in JoCAT and is licensed under a CC BY-NC-ND-4.0 license.

Facilitating art groups: How art therapy and community arts paradigms can intersect to support connection with marginalised groups

Emma Gentle

Abstract 

Art therapists and community arts workers often find themselves facilitating art groups with people who are marginalised. Conversely, guides on facilitation techniques are limited, and usually fall under art therapy or group work. Drawing from a PhD thesis that explores art-making in a regional studio in Australia, this paper aims to bring these and other elements of facilitation together. The qualitative study utilised a single case-study design with participatory action research methodologies. The research included ten central and eight third-party participants. Data collection methods included: three Talk Aloud (T/A) sessions, nine observations, eight third-party interviews, and twelve images. NVivo software with thematic coding tools was central to analysis. The research found that art-making groups form a plethora of connections, influenced by facilitation techniques that incorporate both art therapy and community arts paradigms. A facilitation model that emphasises connection during group art-making sessions was built from the findings. 

Keywords

Art-making, community arts, facilitation, marginalisation, relationship, community.

Introduction

Connection is essential for well-being in most populations; however, it has particular significance for people who experience difficulties with their mental health and/or structural, and consequently social, marginalisation (Gentle & O’Brien, 2020). A lack of relationships and support is one of the main psychosocial risk factors to well-being for marginalised people, as social networks are often disproportionately restricted (Gentle & O’Brien, 2020). Research has demonstrated how group art-making has the capacity to address some of the associated loneliness, disconnection and mental health difficulties marginalised people face (Abbotts & Spence, 2013; Waller, 2012). 

Customary art therapy paradigms use the process of art-making to express the self by visually revealing inner worlds and, also, as a response to environmental influences (Rubin, 2008). Equally, Kramer and Gerity (2000) described how ‘art as therapy’ resolves the perpetual conflict between the individual’s instinctual impulses and expectations of society. By imbedding the voices of marginalised populations in their publicly displayed art, community arts can similarly connect individual empowerment with social activism (Gentle, 2018; Thompson, 2019). Thus, community art exhibitions have the power to augment equitable societal principles and functioning (Frostig, 2011). The juncture of arts activism through community arts practice and exploration of self through art therapy is creating its own discipline (Frostig, 2011; Kaplan, 2007; Thompson, 2019). It could be said that art therapy provides specific tools for self-exploration relative to one’s environment, whilst community arts can anchor the self within that environment. 

The complexity of the boundless interwoven connection in art-making is explicated by Dewey (1934), whose ‘reflex arc’ theory describes a dynamic, reflexive, circular connection formed between the art-maker and the art object, rather than art-making being a one-directional process (Davies, 1999; Dewey, 1896). Similarly, research by Massola (2016) with Gija people in the Warmun Art Centre illuminated the deep connection local artists had to their art. She describes the relationship between Gija artists and their artworks as profoundly immersed in belonging, as the art processes encompassed being, land and community (Massola, 2016). This concept of deep connection describes art-making processes regardless of the art-making frame. 

Furthermore, the embodied artwork tells a story (Kasat, 2013; Rappaport, 1995). This is of central importance in community arts paradigms, as stories tell us who we have been and what we can be (Rappaport, 1995). Kasat (2013) reveals that although community arts are often considered from the perspective of their social and cultural importance, the actual making of the art is in, and of itself, significant. The artwork can provide a safe place to release inner stories that are difficult to verbally communicate (Schaverien, 1992). Visual stories can also reduce stigma in marginalised populations who exhibit their art, by eliciting emotional connection from the viewers, and, in turn, the artists themselves (Gentle et al. 2020). In addition, the processes involved in showing artworks that express an embodied or externalised story hold comparable value within art therapy and community arts paradigms. 

Group art-making and facilitation 

McNeilly (2006) shows that over-direction of an art therapy group often interferes with the formation of relationship between the participants, the facilitator and the artworks. Thus, limiting art direction allows for a deeper freedom of expression, in which the rules of art-making can be disregarded in favour of unfettered expression (Linnell, 2010; Rhodes, 2008). Linnell (2010) explicates the way bearing witness to people’s worlds during an art therapy session, thus sharing their experience, communicates a client’s expertise in their own lives. Therefore, this method empowers the art-maker. McNeilly (2006) uses a psychoanalytic approach to facilitation; nonetheless, his understanding of the dynamics of group art-making can be employed within a person-centred humanistic model. For example, utilising the humanistic ‘here and now’ and ‘positive regard’ concepts (Crago & Gardener, 2012; Rogers, 1961), while using less directive facilitation, can be a valuable tool for bearing witness. Therefore, these methods can effortlessly transfer to art-making studios to inspire a therapeutic facilitation frame. The anodyne environment that humanistic art therapists provide can also be offered by arts workers facilitating community arts groups. 

Grassroots movements often inspire community arts projects, making them fundamentally empowering (Kenny et al., 2015). Freire (1970) and Shakespeare (2006) advocate instilling democratic process when working with oppressed populations because it affords agency, and thereby can challenge oppressive structures. However, Rooke (2013) highlights that agency must be practised and supported for authentic empowerment, and for real change to occur. Therefore, offering opportunity for people to engage with democratic process could contest oppressive systems at both an individual and community level (Rooke, 2013). A democratic frame becomes vital when working with groups whose voices are rarely heard (Gentle, 2018). This experiential involvement allows people to practise making decisions and engage in processes that directly affect them. 

Bucciarelli (2016) emphasises that the discipline of art therapy is based on the understanding that art-making is therapeutic; and furthermore, that utilising a transdisciplinary approach can increase its effectiveness. Hence, this research project was designed with a transdisciplinary frame that incorporated both art therapy and community arts approaches (Gentle, 2018). The study explored art-making with neurodiverse populations, who experience marginalisation through socially constructed barriers, in regional Australia. Accordingly, a democratic, person-centred facilitation technique was utilised to increase participation, as advocated by Rooke (2013). 

Method

This study gained ethics approval from the Human Research Ethics Committee at The University of Sydney and was conducted in full accordance with the World Medical Association Declaration of Helsinki (2001). The methods of the original study can be found in Gentle (2018). 

As this research was set in an authentic art group context, the data collection was focused on participants’ subjective experience. It utilised key aspects of participatory action research (PAR), a democratic methodology that maximises participant engagement at all stages of the research. PAR influenced the reflexive design of the research cycle of this project, and was especially pertinent to the analysis of data. PAR ensured the research process was relevant to participants, and also democratic. The research procedures were developed through the collaborative, planning, action and reflection cycles embedded in PAR processes (Kemmis, McTaggart, & Nixon 2014). It was reflective in both methodology and practice, and thus aligned with art therapy approaches. The therapeutic factors of the data collection process included: the group’s communication of information; advancing socialising techniques; emulating one another’s behaviours; utilising interpersonal learning; and forming group cohesiveness (Yalom & Leszcz, 2005). 

Recruitment 

Enquiries were made at the three local disability services that provided art-making groups on the Mid-North Coast of Australia, and two agreed to advertising the research information-sharing session. The people who had shown interest were each given the easy-read participant information sheet (PIS), and an easy-read consent form to take home: each participant signed their own consent form with support from their families, or advocates.

Table 1. Data collection timeline (Gentle, 2018). 

Participants  

Ten people consented to the study. Each of these central participants regularly attended local art studios in the area. Half the group had worked together before. They all shared an experience of social exclusion and lack of agency, as described in the Cultural Model of Disability that emphasises individual identity, societal norms and historical context (Devlieger, 2005). One participant attended the research project only ten percent of the time, and another participant attended only 33 percent of the time. The latter’s data were incorporated in the study. 

Each of the eight consistent participants also chose a third party familiar with their arts practice to be interviewed by the researcher. They chose either family members or arts workers, who for the purpose of this study were termed ‘arts advocates’. 

Design  

A single case-study design was implemented to explore the nuances (Baxter & Jack, 2008) of a series of art workshops. The study aimed to avoid historically entrenched inequities by utilising a participatory action research (PAR) approach to data collection that recognised neurodivergent people as the experts (O’Brien et al., 2014). Accordingly, the participants contributed to the design of the art workshops by incorporating their ideas through the planning, action and reflection cycles of PAR. At the start of each session the researcher discussed with the participants the data from the previous session. This member-checking process ensured authentic participation and accuracy (Radermacher, 2006). 

Table 1 shows how the iterative three phases (P1, P2, P3) of art workshops were core to data collection, with the observations and interviews verifying the data. There were three art workshop sessions of four hours in each phase. The timeline is shown below in Table 1 along with the data collection techniques. 

In the first phase, the participants had stated they wanted to be famous artists, or enjoyed showing their work. Consequently, an exhibition in a local gallery was organised, becoming the fourth, unplanned phase (P4). This provided an appropriate conclusion to the PAR project, as it had been directed by participants. Other participant-led changes through PAR methodology included the focus groups transforming to think aloud (Eccles & Arsal, 2017) groups, and using the beach as another art-making space that encouraged creativity with natural materials. This allowed the researcher to ask participants about their art processes in a novel setting, and provided a means for participants to interact with their community outside the studio. 

The first three phases employed group think aloud (T/A) sessions, observations, art-making, photographs and interviews. Table 1 shows the method timeline with the P4 exhibition, which allowed for further photographs and short interviews to occur outside the workshops.

The research frame  

The art groups were not intended to be therapy. However, therapeutic factors were considered in its design, as facilitation could make the therapeutic aspects particularly potent if handled using art therapy paradigms. The author was both art workshop facilitator and researcher. This provided the research with a unique and authentic perspective within the naturalistic research environment (Bronfenbrenner, 1979). By employing humanistic ‘here and now’ practices (Crago & Gardener, 2012), with ‘positive regard’ techniques (Rogers, 1975), the facilitation remained focused on the group and each individual. The facilitation adopted relational modelling by providing the opportunity to show and discuss each artwork during the sessions. This process builds connection with others in the group, as the artworks express something of the participant (Malchiodi, 2012; Skaife, 2001). By incorporating democratic processes throughout the times of decision making, all voices were heard and considered (Jeffers & Moriarty, 2017; Smith, 2001). 

Providing an art workshop that has democratic process, person-centredness and PAR cyclical reflective processes could sit within both art therapy and community arts practice. The therapeutic aspect stretches across both realms. This research highlights the potential for both social activism and internal reflective practices to support development of an inner world. 

Data collection procedures  

The data were collected directly from three sources: the participants; the observations of the researcher/facilitator; and interviews with the art advocates. The concept of the PAR research, and the way a focus group functions had been explained to the participants at the start of the research. However, during the first focus group, the questions were met with silence. The PAR frame encouraged feedback from participants during the reflection phase. Thus, when the researcher enquired, each had said they would prefer to be making art, with quiet conversation rather than a group discussion. Therefore, this was put into action. As the group created art, the researcher utilised the original focus-group questions to conduct group and individual conversations. The focus groups were converted into a T/A method, in which the researcher asks the participants to describe their thoughts throughout the research. This is often used during problem-solving or language enquiries, where linear and prescribed methodologies would be less likely to capture the complexity of a person’s viewpoints (Koro-Ljungberg et al., 2013). T/A allowed for nuanced data collection throughout each phase of the study. 

The observations were transcribed from the video-recorded session and the researcher’s daily reflections immediately after each session. The third-party, 45-minute interviews were voice recorded and transcribed immediately afterwards. Photographs of the workshops visually illuminated the triangulated data. The data were coded and then themed to correspond to the research questions. 

Data analysis   

The analysis utilised a constructivist grounded theory that demanded the author use both deep reflective processes and subjective pragmatism (Charmaz, 2011, 2017). The transcripts from each method were uploaded to the NVivo thematic analysis program, then coded to help identify themes. Thus, the data were mined for repeated codes whilst also responding to the research questions. 

The participants’ responses were verified by the observations of the researcher, then consolidated with the third-party interviews; the three sources led to triangulation of the data. This ensured that the majority of codes and all themes could only be realised if they had been found in each source. Using multiple methods and sources was core to the study, leading to triangulation of sources and methods in the analysis.  

Findings and discussion   

The findings are organised into three main categories: 1. Connection to Self; 2. Connection to Others; and 3. Connection to Community. The codes and themes that built each are described and discussed in relation to the facilitation technique, and relevant theoretical standpoints. The relationships that developed through art-making are further elucidated in Gentle (2018); and Gentle and O’Brien (2020).  

1. Connection to Self    

The findings are organised into three main categories: 1. Connection to Self; 2. Connection to Others; and 3. Connection to Community. The codes and themes that built each are described and discussed in relation to the facilitation technique, and relevant theoretical standpoints. The relationships that developed through art-making are further elucidated in Gentle (2018); and Gentle and O’Brien (2020). 

Self-esteem 

Agency was found in every stage of the art group. The participants chose: to attend the group; their materials and techniques; and whether they would show or discuss their work. The PAR process encouraged agency, and mirrored the democratic, person-centred frame as participants led the group’s direction as time progressed. Agency was also seen when they decided that they would make art outside using natural materials, and that they would exhibit their works in a culminating exhibition. Positive Feelings were coded when the groups showed they were enjoying themselves through banter, jokes, smiles and laughs, and occurred throughout each phase. Identity as Artist was found as they more confidently showed and discussed their art, materials, techniques and hopes to exhibit. Identity as Artist was closely connected to Positive Feelings and Agency. All wove together to form the core theme of Self-esteem. 

Focus 

The theme of Focus was created with Concentration and Tiredness. This occurred at each session when the participants were fully immersed in their art-making and, conversely, when they showed fatigue at the end of the day. They displayed a deep connection to their artwork through their concentration and this is what appeared to be at the heart of the Zen-like, quiet stillness of the space. Conversely, after focusing intently on their art, by the afternoon participants would display obvious signs of tiredness; some talked of the effort that art-making requires. 

Expression 

Expression was coded with Communication and Self-expression. The participants created imagery that communicated something of themselves and then often showed and/or described it to the group. They displayed confidence and autonomy in the way they utilised art techniques and materials without inhibition. The subsequent discussions were a useful way for participants to get to know each other and learn about each other’s different perspectives.  

Figure 1. Focusing on the artwork (Photographer: Gentle, 2018). 

Figure 2. This is Me, an expression of Self (Photographer: Gentle, 2018). 

Facilitating Connection to Self 

The group were encouraged to make a myriad of choices throughout the process and were given options if this felt overwhelming. This semi-direction encouraged communication by providing themes of ‘all about me’ and ‘who/what is important to me’. The group were always given the option to ignore the loose themes; instead, they could choose to create according to their whims on the day. The facilitator encouraged each person in the group to talk about their process whilst they made art, then again when they had finished. They were asked how it felt to make art, why they chose certain techniques and materials, and how they felt about the completed work. The rest of the group were also encouraged to communicate about each of the artworks. Figure 1 shows the connection between a participant and their artwork. Figure 2 (overleaf) shows an expression of self by a different artist. 

The research utilised a bearing-witness approach as described by Linnell (2010). This was achieved with the utilisation of a person-centred frame that ensured focus was given to each individual’s art process. Reflection practices of art-making process, and the created object, enabled integration between internal and external processes, conflicts and problem solving (Parr, 2006). In this way, making art was a window to the self, where the unconscious was expressed through creativity, with meaning becoming apparent through the image (Gilroy, 2007; Schaverien, 1992; Skaife, 2008). Reflective processes enhanced the understanding of self by understanding the embodiment of self within the artwork, as was seen when participants identified themselves within their artworks. This embodiment has the power to align the art-maker’s internal differences with their diverse societies (Havsteen-Franklin, 2008). The embodied artwork gave license to fully express the inner self (Hall, 2013). It was this connection that created the Zen-like atmosphere that was both peaceful and productive at the same time. Connecting to Self conjured the reflex arc of Dewey (1934) through the circular connection of the artwork and the artist. This process is embedded in art therapy, and can be utilised in both art as therapy and community arts groups. 

Connecting to Self is empowering, as it helps develop the self-esteem, agency and autonomy that are often remiss in the lives of marginalised people. Art groups can be facilitated to specifically increase this inner connection by providing deep, in-the-moment presence, choice and creative freedom. 

2. Connection to Others   

The core theme of social was coded when the participants Built Relationships within the art-making space, and when they created an artwork for someone, or discussed Gifting the artwork. The codes were built from data from each of the three sources. 

Building relationships 

Social connection occurred in each session when participants talked, showed and described their artworks to each other (Gentle & O’Brien, 2020). This connection reached beyond the studio when participants made plans to see each other in a different venue or talked about a social occasion they had attended, or would attend. Their individual creative processes were sometimes influenced by each other’s styles, themes or materials and techniques. The participants collaborated on a couple of pieces, and when they were working autonomously, discussed each other’s work. 

Gifting 

Participants spoke of gifting their artworks to family and friends for birthdays or other special occasions. They displayed enthusiasm and pride in their art-making and when their art was exhibited. Though most expressed that they wanted to sell their artwork at local auctions or exhibitions, they wanted to gift them if they did not sell. 

Figure 3. Connecting to others through collaboration on a collage (Photographer: Gentle, 2018).

Figure 4. Making art amongst the local community (Photographer: Gentle, 2018). 

Facilitating connection to others 

The facilitator encouraged the group to try new things. They were asked if they would like to work together, but were not advised on one way of working over another. The facilitator did not detract from their interactions but rather, through the person-centred approach, was aware of what was going on by using the technique of ‘holding the space’ (Crago & Gardener, 2012). The facilitator was then able to encourage or support social interactions, depending on each person’s reactions to others and, indeed, to the facilitation (Gentle & O’Brien, 2020). The group’s development was supported by the facilitator remaining present and focused on the group, and quietly observing the dynamics. Figure 3 shows collaborative art-making. 

The importance of social and cultural aspects of art-making cannot be overlooked. Both physical and mental health are adversely impacted by isolation and lack of social relationships (Cohen, 2004; Valtorta et al., 2016). Thus, the relationships the participants developed were protective factors (Steptoe et al., 2015), and strengthened through their participation (Gordon-Nesbitt & Howarth, 2020; Scott, 2000). What is more, they connected (Swan, 2013; White, 2006). The art group offered the richness of symbolic communication (Peloquin, 1996; Waller, 2012), and enhanced relationships by providing non-verbal interaction. A sense of belonging was seen in their easy interactions and art processes (Gentle & O’Brien, 2020; Hall, 2010; McDonald & Mason, 2015). 

3. Connection to community   

This connection occurred outside the studio when the participants created or showed their art to people who may not have been familiar with their art practice (Gentle & O’Brien, 2020). It was coded from the data from each of the three sources. 

Making art outside 

In the second phase, the group asked to make art outside on the beach. Their request showed autonomy, agency, ownership, creativity and other attributes that most artists would generally take for granted but have greater significance with people who are structurally marginalised. Whilst making art outside, passers-by asked what the group were doing, and each was able to show and/or describe their artworks to them. Figure 4 shows how they incorporated natural objects in a natural setting
using a variety of styles that the public could access. These interactions increased their identity as artists, pride and self-esteem and thus traversed the themes of connection. 

Exhibition 

The PAR design had meant that the participants’ ideas of both making art outside on the beach in the community, and exhibiting their work, could be fulfilled. The exhibition data incorporated the three main themes of Connection to Self, Connection to Others and Connection to Community, and thus was a fitting culmination of the project. The participants invited their families, friends and the general public to an opening event that was advertised locally, increasing their visibility to their communities as artists. They exhibited and sold their work to the local community. The exhibition is shown in Figure 5. 

Figure 5. The culminating exhibition (Gentle, 2018). 

Facilitating connection to community 

The participants’ artist identity had been a major part of the strengthened Connection to Self. In addition, the exhibition provided a space to engage socially with each other and the wider community. Hall (2010) demonstrates how gifting completed artworks increases social connection, and thus can attach the artist to their wider community. This was richly demonstrated at the culminating exhibition. This community participation can build the resilience that greatly supports individuals and their communities (Gordon-Nesbitt & Howarth, 2020). Thus, the art studio in this research was full of the interactions that support well-being and are particularly pertinent when working with marginalised groups (Gentle, 2018; Gentle & O’Brien, 2020). 

In Table 2 the findings have been organised into stages that helped develop the facilitation model that is seen in Figure 7 (overleaf). The model was created to support facilitation that aims to increase connection within, and beyond, the art studio.

Table 2. The themes of the research findings associated with stages (Gentle, 2018). 

Figure 7. A six-stage art-making model that emphasises the formation of connections (Gentle, 2018). 

Facilitating connection to community 

The participants’ artist identity had been a major part of the strengthened Connection to Self. In addition, the exhibition provided a space to engage socially with each other and the wider community. Hall (2010) demonstrates how gifting completed artworks increases social connection, and thus can attach the artist to their wider community. This was richly demonstrated at the culminating exhibition. This community participation can build the resilience that greatly supports individuals and their communities (Gordon-Nesbitt & Howarth, 2020). Thus, the art studio in this research was full of the interactions that support well-being and are particularly pertinent when working with marginalised groups (Gentle, 2018; Gentle & O’Brien, 2020). 

In Table 2 the findings have been organised into stages that helped develop the facilitation model that is seen in Figure 7 (overleaf). The model was created to support facilitation that aims to increase connection within, and beyond, the art studio.

The Six-stage Model   

Figure 7 illustrates the six-stage art-making model that was created from Table 2. The model is described in more depth in Gentle (2018). 

The six-stage art-making model was developed through the PhD research and first appeared in Gentle (2018). As seen in Figure 7, Stage 1, Setting Up, relationship to Self begins by making choices through person-centred group-holding and ‘walking with’ techniques as described by Crago & Gardener (2012), and Rogers (1975). Remaining in the ‘here and now’ helps the facilitator also ensure person-centredness and a democratic frame that enables the whole group to make decisions together rather than be led by the facilitator. 

In Stage 2, Art-making, self-expression is encouraged by using a semi-direction or non-direction (Linnell, 2010; Rhodes, 2008). This helps participants communicate part of themselves with each other through their art and/or discussion (Kasat, 2013; Rappaport, 1995; Schaverien, 1992), and utilise their agency throughout (Rooke, 2013). Identity as an artist develops when choices are made about art materials and techniques (Gentle, 2018). 

The classic art therapy technique of Showing and Discussing the work with others, using reflective practice, leads to Enrichment in the art-making space, as seen in Stage 4. The enrichment increases through both focus and flow. This gives the group a stability, in which the artists feel a strong sense of belonging. 

Enrichment eventually leads to Stage 5, Taking the Lead of the group. In this stage, their agency means they can make larger decisions on the development of the group. 

In Stage 6, the group Transitions to outside the safety of the art group and into the community. Here they are able to show their artistry and, thus, parts of themselves.

These stages are not always linear, rather they can intertwine, overlap and coexist (Gentle, 2018). Further work on verifying the model with other marginalised populations would be beneficial in developing this facilitation model and learning more about its innate dynamism. 

The study has limitations. Neurodivergent people are all different, therefore the small numbers cannot purport to represent all neurodivergent people who access art studios and live regionally. Nor can it claim that the amalgamation of techniques would ever be able to be replicated. However, though the model has not been verified it was tested at the ANZACATA Symposium (2019) with 20 participants and was shown to certainly have potential. 

The six-stage model   

Providing an art workshop that has democratic practices, person-centredness and cyclical reflective processes can sit within both art therapy and community arts practice. The therapeutic aspect stretches across both realms. By amalgamating community arts and art therapy facilitation frames, the art-making group included the social activism that upholds the rights of marginalised groups (Kenny et al., 2015; Thompson, 2019), whilst providing the autonomous agency and belonging that is too often absent from marginalised people’s lives (Gentle, 2018). This can lead to strengthening connection to Self, with Others and to the wider Community (Gentle, 2018). This deep relationship resembles timeless concepts of art-making seen with the Gija people at the Warmun Art Centre in the East Kimberley region of Australia (Massola, 2016). Such profound connections contribute to well-being for people who could be considered art therapy outsiders: that is, people who may find the concepts of art therapy incongruent to their idea of art or, possibly, confusing. 

The empowerment of the participants within this art-making group was enhanced by utilising a facilitation frame that encouraged participants to tell their stories through images, with or without accompanying discussion (Kasat, 2013; Rappaport, 1995; Schaverien, 1992). This empowerment was enhanced by an exhibition that invited the wider community to bear witness to their stories (Linnell, 2010), which is beneficial to stigma reduction (Gentle et al., 2020). 

This research has shown how art processes can both empower the individual and influence societal constructions through the integration of art therapy and community arts facilitation techniques. The six-stage model was produced from a PAR project that amalgamated art therapy and community art frames without detracting from either (Gentle, 2018). The model has the potential to provide a frame for supporting the art group participant to interact with themselves through their art, with the people within the group, and in art-making spaces and galleries external to the group (Gentle & O’Brien, 2020). The integrated art-making frames fortified both the individual and the group, hence were therapeutic without being ‘therapy’. The integrated art-making structures may sit more comfortably with people who experience marginalisation in their day-to-day lives. 

Acknowledgements

Thank you to Emeritus Professer Patricia O’Brien, Professer Colin Rhodes and Emeritus Professer Trevor Parmenter for their support and substantial guidance throughout the study.

References

Abbotts, J., & Spence, W. (2013). Art and wellbeing in a deprived Scottish community. Journal of Public Mental Health, 12(2), 58–69. https://doi:10.1108/JPMH-12-2012-0022 

Baxter, P., & Jack, S. (2008). Qualitative case study methodology: Study design and implementation for novice researchers. Qualitative Report, 13(4), 544–559. 

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press. 

Bucciarelli, A. (2016). Art therapy: A transdisciplinary approach. Art Therapy, 33(3), 151–155. https://doi:10.1080/07421656.2016.1199246 

Charmaz, K. (2011). Grounded theory methods in social justice research. In N. K. Denzin & Y. S. Lincoln (Eds.), The SAGE handbook of qualitative research (pp.359–380). SAGE. 

Charmaz, K. (2017). The power of constructivist grounded theory for critical inquiry. Qualitative Inquiry, 23(1), 34–45. https://doi:10.1177/1077800416657105 

Cohen, S. (2004). Social relationships and health. The American Psychologist, 59(8), 676–684. https://doi:10.1037/0003-066X.59.8.676 

Crago, H., & Gardener, P. (2012). A safe place for change. Interactive Publications. 

Davies, C.A. (1999). Reflexive ethnography: A guide to researching selves and others. Routledge. 

Devlieger, P.J. (2005). Generating a cultural model of disability. Paper presented at the 19th Congress of the European Federation of Associations of Teachers of the Deaf (FEAPDA). 

Dewey, J. (1896). The reflex arc concept in psychology. Psychological Review, 3(4), 357–370. https://doi:10.1037/h0070405 

Dewey, J. (1934). Art as experience. Minton, Balch & Co. 

Eccles, D.W., & Arsal, G. (2017). The think aloud method: What is it and how do I use it? Qualitative Research in Sport, Exercise and Health, 9(4), 514–531. https://doi:10.1080/2159676X.2017.1331501 

Freire, P. (1970). Pedagogy of the oppressed (30th ed.). Bloomsbury Publishing.

Frostig, K. (2011). Arts activism: Praxis in social justice, critical discourse, and radical modes of engagement. Art Therapy, 28(2), 50–56. https://doi:10.1080/07421656.2011.578028 

Gentle, E. (2018). Autonomous expression and creative connection: An exploration of art-making with neurodivergent people in regional Australia. (PhD thesis). Northern Clinical School, University of Sydney, Australia. http://hdl.handle.net/2123/20416 

Gentle, E., Linsley, P., & Hurley, J. (2020). “Their story is a hard road to hoe”: How art-making tackles stigma and builds well-being in young people living regionally. Journal of Public Mental Health, 1, 109–118. 

Gentle, E., & O’Brien, P. (2020). Forming relationships through group art-making: An exploration with neurodivergent people living in regional Australia. Health Promotion Journal of Australia. https://doi:10.1002/hpja.431 

Gilroy, A. (2007). The use of art work in art psychotherapy with people who are prone to psychotic states. A clinical practice guideline. International Journal of Art Therapy, 12(1), 49–50. https://doi:10.1080/00207540701272490 

Gordon-Nesbitt, R., & Howarth, A. (2020). The arts and the social determinants of health: Findings from an inquiry conducted by the United Kingdom All-Party Parliamentary Group on Arts, Health and Wellbeing. Arts & Health, 12(1), 1–22. https://doi:10.1080/17533015.2019.1567563 

Hall, E. (2010). Spaces of social inclusion and belonging for people with intellectual disabilities. Journal of Intellectual Disability Research, 54, 48–57. https://doi:10.1111/j.1365-2788.2009.01237.x 

Hall, E. (2013). Making and gifting belonging: Creative arts and people with learning disabilities. Environment and Planning A, 45(2), 244–262. https://doi:10.1068/a44629 

Havsteen-Franklin, D. (2008). The composite image: An exploration of the concept of the ‘embodied image’ in art psychotherapy. International Journal of Art Therapy, 13(2), 53–64. https://doi:10.1080/17454830802503438 

Jeffers, A., & Moriarty, G. (2017). Culture, democracy and the right to make art: The British community arts movement. Bloomsbury Methuen Drama. 

Kaplan, F. (2007). Art therapy and social action. Jessica Kingsley. 

Kasat, P. (2013). Community arts and cultural development: A powerful tool for social transformation. (Masters thesis). Murdoch University, Perth, Australia. 

Kemmis, S., & McTaggart, R. (2014). Communicative action and the public pphere. In S. Kemmis, R. McTaggart & R. Nixon (Eds.), The action research planner: doing critical participatory action research (3rd ed., pp.559–604). SAGE. https://doi.org/10.1007/978-981-4560-67-2 

Kenny, S., Taylor, M., Onyx, J., & Mayo, M. (2015). Challenging the third sector: Global prospects for active citizenship. Policy Press. 

Koro-Ljungberg, M., Douglas, E.P., Therriault, D., Malcolm, Z., & McNeill, N. (2013). Reconceptualizing and decentering think-aloud methodology in qualitative research. Qualitative Research, 13(6), 735–753. https://doi:10.1177/1468794112455040 

Kramer, E., & Gerity, L.A. (2000). Art as therapy: Collected papers. Jessica Kingsley. 

Linnell, S. (2010). Art psychotherapy and narrative therapy: An account of practitioner research. Bentham Science Publishers. 

Malchiodi, C.A. (2012). Psychoanalytic, analytic and object relations approaches. In C.A. Malchiodo (Ed.), Handbook of art therapy (2nd ed., pp.57–74). The Guilford Press. 

Massola, C.A. (2016). Living the heritage, not curating the past: A study of lirrgarn, agency and art in the Warmun Community. (PhD thesis). Australian National University, Canberra, Australia. 

McDonald, J., & Mason, R. (2015). Creative communities: Regional inclusion and the arts. Intellect. 

McNeilly, G. (2006). Group analytic art therapy. Jessica Kingsley. 

O’Brien, P., McConkey, R., & García-Iriarte, E. (2014). Co‐researching with people who have intellectual disabilities: Insights from a national survey. Journal of Applied Research in Intellectual Disabilities, 27(1), 65–75. https://doi:10.1111/jar.12074 

Parr, H. (2006). Mental health, the arts and belonging. Transactions of the Institute of British Geographers, 31, 150–161. 

Peloquin, S.M. (1996). Art: An occupation with promise for developing empathy. American Journal of Occupational Therapy, 50(8), 655–661. 

Radermacher, H.L. (2006). Participatory action research with people with disabilities: Exploring experiences of participation. (Doctoral thesis). Victoria University, Melbourne, Australia. http://vuir.vu.edu.au/id/eprint/484 

Rappaport, J. (1995). Empowerment meets narrative: Listening to stories and creating settings. American Journal of Community Psychology, 23(5), 795–807. https://doi:10.1007/BF02506992 

Rhodes, C. (2008). An other academy: Creative workshops for artists with intellectual disabilities. The International Journal of the Arts in Society, 3(1), 129–134. 

Rogers, C. (1961). On becoming a person: A therapist’s view of psychotherapy. Constable. 

Rogers, C. (1975). Empathic: An unappreciated way of being. The Counseling Psychologist, 5(2), 2–10.
https://doi:10.1177/001100007500500202 

Rooke, A. (2013). Contradiction, collaboration and criticality: Researching empowerment and citizenship in community-based arts. In M. Mayo, Z. Mendiwelso-Bendek, C. Packham, & C. Palgrave (Eds.), Community research for community development (pp.150–169). Palgrave Macmillan. 

Rubin, J.A. (2008). Art therapy has many faces. Expressive Media. 

Schaverien, J. (1992). The revealing image: Analytical art psychotherapy in theory and practice. Tavistock/Routledge. 

Scott, P.A. (2000). The relationship between the arts and medicine. Medical Humanities, 26(1), 3–8. https://doi:10.1136/mh.26.1.3 

Shakespeare, T. (2006). Disability rights and wrongs. Routledge. 

Skaife, S. (2001). Making visible: Art therapy and intersubjectivity. Inscape, 6(2), 40–50. https://doi:10.1080/17454830108414030 

Skaife, S. (2008). Offshore: A deconstruction of David Maclaglan’s and David Mann’s ‘Inscape’ papers. International Journal of Art Therapy, 13(2), 44–52. https://doi:10.1080/17454830802489133 

Smith, M.K. (2001). “Community.” In Encyclopedia of Informal Education. http://infed.org/mobi/community/ 

Steptoe, A., Deaton, A., & Stone, A.A. (2015). Subjective wellbeing, health, and ageing. The Lancet, 385(9968), 640–648. https://doi:10.1016/SO140-6736(13)61489-0 

Swan, P. (2013). Promoting social inclusion through community arts. Mental Health and Social Inclusion, 17(1), 19–26. https://doi:10.1108/20428301311305278 

Thompson, A. (2019). Community art installation as an approach to art therapy: A community engagement. (Masters thesis). Lesley University, Cambridge, Massachusetts. https://digitalcommons.lesley.edu/expressive_theses/220/

Valtorta, N.K., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: Systematic review and meta-analysis of longitudinal observational studies. Heart. https://doi:10.1136/heartjnl-2015-308790 

Waller, D. (2012). Group art therapy: An interactive approach. In C.A. Malchiodi (Ed.), Handbook of art therapy (pp.353–367). The Guilford Press.

White, M. (2006). Establishing common ground in community-based arts in health. Journal of the Royal Society for the Promotion of Health, 126(3), 128–133. 

World Health Organization. (2001). World Medical Association Declaration of Helsinki. https://www.who.int/bulletin/archives/79(4)373.pdf

Yalom, I.D., & Leszcz, M. (2005). Theory and practice of group psychotherapy. Basic Books.