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Matisse Interactive group art therapy for people with schizophrenia: The Matisse study. www.awp.nhs.uk enabling and empowering people to reach their potential and live fulfilling lives Background Emerging evidence base (Crawford & Patterson, 2007)

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matisse

Matisse

Interactive group art therapy for people with schizophrenia:

The Matisse study.

www.awp.nhs.uk

enabling and empowering people to reach their potential and live fulfilling lives

background
Background

Emerging evidence base(Crawford & Patterson, 2007)

Negative symptoms and social functioning respond less well to medication

NICE guidelines find evidence that arts therapies are effective in reducing negative symptoms (2009)

However;

-Concerns about methodological quality of trials to date (Ruddy R & Milnes D, 2005)

-No evidence on outcomes such as social functioning, quality of life, or cost effectiveness.

background3
Background
  • Interactive group art therapy
    • Psychotherapeutic approach that synthesises concepts from art and group therapies.
    • Aims to encourage open communication, self-expression and interaction through the use of art materials and the group context.
    • The combination of image making and reflection can enable a person to work through difficult feelings.
    • A safe and consistent environment.
    • A non directive therapeutic stance.
    • Dame D. Waller (1996; 2000)
a randomised controlled trial
A Randomised Controlled Trial
    • Multicentre Art-Therapy in Schizophrenia Systematic Evaluation (MATISSE)
  • Single blind Randomised Controlled Trial (RCT)
    • group art therapy plus standard care
    • activity group plus standard care, and
    • standard care alone.
study history
Study History

Funding

£960K

Study duration

3yr originally, extended 9 months

Study centres

2 London, AWP and Belfast

Sample size 419

study aims
Study Aims

Hypotheses:

Among people with schizophrenia, interactive group art therapy is associated with improved:

  • global functioning and 2. cost effectiveness

compared to attention control treatment or standard care alone.

Inclusion Criteria:

Schizophrenia (working diagnosis + Opcrit)

study design
Study Design

Outcome measures include:

  • Global Assessment of Functioning (GAF) scale.
    • Positive and Negative Symptom Scale (PANSS);
    • Quality of Life questionnaire;
    • Social Functioning questionnaire;
    • the General Wellbeing Scale;
    • Adult Service Use Schedule;
    • Morisky Scale and a satisfaction with care questionnaire.
  • Outcomes assessed at: Baseline, 12 months and 24 months after randomisation.
study design10
Study Design
  • Art therapy
    • Weekly groups (median 12 months)
    • Facilitator and co-facilitator
    • Max 8 per group
  • Activity Groups
    • Provide participants with an opportunity to meet socially with peers and undertake a range of activities in a relatively informal, yet structured environment
    • Participation in social and recreational activities with the support of ‘group leaders’
success matisse participants
Success – Matisse Participants
  • Success dependent upon Matisse participants
    • Agree for notes to be screened
    • Provide Informed Consent
      • Discussing complex research issues
      • Agreeing to randomisation process
      • Completing baseline assessment
    • Attend groups
    • To meet with the researcher for FU assessments at 12 and 24 months
success awp clinical teams
Success – AWP clinical teams
  • Success dependent upon AWP clinical teams
    • Engage with and adopt Matisse study
      • Successful adoption of Matisse trial across Trust
    • Identify participants and make first contact
      • Confidentiality and consent
    • Help clarify the Working Diagnosis
      • Study eligibility defined on a case by case basis supported by staff
    • Rate studyoutcomes
      • Primary outcome measure (GAF)
      • Staff questionnaire
    • Support follow up with researcher at 12 and 24 months after randomisation
      • Provide up to date contact information
      • Arrange appointments where contact difficult
      • Assess lone working risk, even attend assessments
success mhrn
Success – MHRN
  • Success dependent upon R&D hosted Mental Health Research Network (MHRN)
    • Clinical Studies Officer time to support recruitment of study participants.
    • Conducting FU assessments where researcher has been fully unblinded.
benefits
Benefits
  • Opportunity for AWP service users to be offered an intervention that they may not have been offered outside of the study.
  • Provide an opportunity for participants to contribute to the evidence base by taking part in research.
  • Providing additional contact time for the service user with the Trust at baseline, 12 and 24 months via the researcher.
  • Provides the Trust with an opportunity to assess the effectiveness of an intervention within a gold standard model.
  • Provision of financial remuneration in the form of service support costs for staff involvement.
  • Provide an opportunity for Trust staff to get involved with the design and conduct of a national research project.