A review of doctoral research in art therapy across Europe: a project of European Federation of Art Therapy’s (EFAT’s) Research Committee to create a European database for doctoral theses
Avgustina Stanoeva 1Mimmu Rankanen 2
1 kbo-Isar-Amper-Klinikum Region München, Haar bei München, Germany
2 Department of Art, Design and Drama, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
Abstract
Background: The Research Committee (RC) of the European Federation of Art Therapy (EFAT) aims to promote high quality art therapy research with ethical values in Europe. To contribute to the goal a working group was established under the RC to collect information about the state of doctoral research in the field of art therapy across Europe. This paper is based on the work of RC and its PhD working group.
Objective: This review paper aims to gather knowledge of the variety and trends in doctoral art therapy research that has been conducted in Europe until 2022. The goal is to present an overview of the current situation and fill in the gaps in existing knowledge as well as create a vision of the continuing developments in the field of doctoral research in art therapy in Europe.
Methods: The data was collected by sending an official call for information about completed doctoral theses to all EFAT members. The data was identified and collected over a two-year period and then subsequently analyzed. The evaluation included titles from 1972 to 2022 which were compiled in textual, tabular, or graphical form.
Results: In sum, we found 185 PhD dissertations from nineteen European countries. The largest number of studies were from Germany and the United Kingdom (UK). Based on the analysis of the titles, 31% of the PhDs were related to art therapy in a hospital. It follows the category educational with 24%, as well as therapeutic and preventive with 19%. Of the studies, 72 (39%) had an abstract in English and based on the analysis of abstracts, the majority of the studies were using qualitative research methods.
Discussion: Many of the abstracts or titles of doctoral studies did not clearly state their study design, target group or research methods. Furthermore, only 39% of the dissertations had an abstract available online and in English. That is why we are unable to present a representative or exhaustive view on implemented doctoral research in the field of art therapy across Europe. Since art therapy is an interdisciplinary approach that integrates art with human interaction, no single research approach can catch all the crucial aspects of the art therapeutic process and its effects. Thus, it is important to have a rich range of different research approaches. Nonetheless, with regard to the quantitative evidence-base we need for promoting inclusion of art therapy on national health-care guidelines in different European countries, we note an encouraging trend: the increase in use of more quantitative methods in art therapy research.
Introduction
Officially registered in 2018, the European Federation of Art Therapy (EFAT) has the aim to unite art therapists and professional art therapy associations in Europe. One of the important aims of EFAT is to actively promote further development of professional practice, training, and research, and to contribute to the recognition of the profession. As a part of EFAT the Research Committee (RC) aims to contribute strategically and substantially to the evidence base for art therapy in order to promote the recognition of the profession in all European countries. The Research Committee supports the development of high-quality art therapy research with ethical values by developing a supportive and inspiring research culture fostered by international collaborations. One of the first projects that EFAT’s RC initiated was the PhD overview. It started by collecting information about the state of research in the field of art therapy across Europe in order to assess the current situation. With this exposure we would like to promote transparency and sharing of information by art therapy researchers. Additionally, we are hoping to motivate art therapy professionals starting their own research projects.
Why is doctoral research in the field of art therapy important?
The relevance of science and scientific methods in the field of art therapy was a controversial and intensively discussed topic in the past [1]. Nowadays, it is understood that more empirical research is needed in the field of art therapy for the recognition of the profession. Development of doctoral studies and PhD research is necessary for the survival of art therapy and education of future researchers. It enables the free, creative, critical, and systematic exploration of advanced philosophical, theoretical and practical issues of art therapy [2]. The research in art therapy can inform about key questions regarding the needs of clients and practitioners in the different countries, establish more connections between practitioners and researchers, and respond to current challenges (for example the corona crisis). In addition, the research helps inform about the areas of development of art therapy across Europe (clinical, educational, etc.). Furthermore, it reports different methods and provides tools for the development of an effective professional identity and evidence-based research [3]. In many European countries, there are strict conditions for professional recognition in health care, such as top-down policy demands for research evidence [4]. Following the different terminology and the importance of recognition of art therapy as a profession, we need clear definitions in research of what art therapy is; how it works; what kind of specific methods it uses and what kind of specific change factors it includes.
Why is a review needed?
It is challenging to find information of what kind of PhD’s are conducted in art therapy across Europe, since often the research is unpublished, written in multiple different languages and conducted in numerous different Universities and Faculties. The research is also often conducted under the faculties of other disciplines than art therapy, especially if there does not exist a department of art therapy at the university in question. Doctoral programs in art therapy represent a diversity of institutions in terms of their missions, curricula, pedagogy, and research profile. This diversity is both an important advantage and a challenge for assessing the current and future state of doctoral education [2].
A review of PhD studies in the field of art therapy across Europe focuses on this gap in the previous knowledge and presents an overview of the current research situation on an academic level. However, the situation is not complete and homogeneous. Still, the overview can be useful in filling the gaps and developing a review of the continuing developments in the field, learning more from each other as professional art therapy researchers. That is why we started with an overview of the dissertations across Europe. This project continued to a PhD review, which has the aim to systemize and analyze the collected data.
Challenges
The project PhD overview started in 2019 by collecting information about the state of research in the field of art therapy across Europe with the purpose to find out the current research state based on the doctoral dissertations. Firstly, we created a PhD working group and defined clear goals. In online meetings we specified the further steps periodically. For the purpose of the project, an official call for support has been sent to all EFAT members because a greater part of the PhDs could not be found in a digital format on the internet. The only existing database of doctoral theses we found was EThOS The Electronic Theses Online System provided by the British Library that we used for finding the PhD studies related to art therapy in the UK. To find information from other European countries, we had to rely on the information we received from EFAT members. Depending on the response rate, we were able to collect 185 PhD studies in the field of art therapy from nineteen countries across Europe. Data was subsequently analyzed and annually updated over a two-year period.
In summary, we can describe the challenges as follows: A large part of the PhDs had no title or abstract in English and we needed help from EFAT members to translate the titles of the studies. All titles in the source language were translated into English. For this reason, the current analysis assesses primarily PhD studies which had an abstract in English and were available online. Additionally, many of the abstracts did not clearly state their title, study design, target group or research methods which made the analysis difficult. EFAT owes its existence to the cultural diversity in Europe, but since we do not have a common language, it also creates a challenge and makes it crucial to write at least the titles and abstracts in English to make the conducted research more accessible. In addition, it was a challenge that the tradition and form of PhD studies differs in different countries. In many countries the dissertations are monographs, but in some countries, such as in the Netherlands and Sweden, it is typical to do article dissertations, which means that one study can include multiple different part studies that pose challenges for categorization under a single category of study type and methodology.
Objective
As a systematic literature review [5] this study has the objective to describe known knowledge in the field of doctoral studies of art therapy in the European landscape and to provide an overview of the current research state based on the dissertations. It aims to give an overview of quantitative, qualitative, art-based, and mixed method studies completed at the level of doctoral studies.
Methods
In order to compile the current state of research in the field of art therapy across Europe, the EFAT’s Research Committee collected PhD titles from nineteen European countries in a PhD overview. For the purpose of the project, an official call for support was sent to all EFAT members from 35 European countries. The data was identified and collected over a two-year period then subsequently analyzed and annually updated. The evaluation included titles from 1972 to 2022 which were compiled in textual, tabular, or graphical form.
The PhDs’ analysis based only on the titles makes a distinction between different research areas organized in eight categories: a) art-based, b) theoretical, c) educational, d) hospital, e) therapeutic and preventive, f) institutions for people with special needs, g) others, as well as h) unclear. For this objective the categories are described in detail below in the text.
In the literature, the term ‘art-based research' is mostly used in case that art making has been used as a tool for data collecting and data analysis, as well as in the presentation of findings [6], [7], [8]. In the context of art therapy, art-based research has been formulated as a creation of knowledge using artistic means within a research perspective [3], [9]. The current study defines the category art-based research (a) as research that includes artistic positions of the art therapists in the context of their art therapeutic work. Theoretical research (b) includes studies posing questions associated with theoretical concepts and positions. The category educational (c) consists of studies which investigate research questions in conjunction with schools, universities, or other educational institutions. Target groups could be pupils, students, teachers, or art therapists. Doctoral research, which was implemented in different hospitals inclusive psychiatry with inpatients, outpatients, and/or in partial hospitalization setting addressing diagnoses to the ICD-10 or DSM-V classifications was categorized as a hospital (d). The category named therapeutic and preventive (e) includes projects that took place outside the constraints of a clinic or hospital, have a distinct structure, specific space, and therapeutic goals have been stated. It also includes art therapy projects, which were provided as a prevention. Further, there is the category of institutions for people with special needs (f) that focuses on the research and application of art therapy in institutions for people with different disabilities. The area others (g) includes dissertations which investigate art therapy in prisons, management, further training programs (different to art therapy) or in an unspecified context. Finally, there is an area unclear (h) for PhDs, which based only on the title, are not clearly defined about the research subject or sector of investigation. Excluded from this review were dissertations in the fields of music-, drama- and dance movement therapy because the aim of the project was to study the European research landscape of art therapy with focus on visual arts.
PhDs with an abstract in English were organized separately in a tabular form in alphabetical order by author with information about name, year of publication, country, research design, target group, sample size, aims, and keywords.
In the analysis, we differentiated between qualitative, quantitative and mixed methods research design. In the research methods, we could distinguish between qualitative, quantitative, art-based, qualitative & quantitative, or mixed methods. Qualitative research was split into phenomenological, grounded theory, ethnographical, historical, narrative, action research, case studies and field research [3]. Quantitative research was distinguished in experimental, quasi-experimental, and non-experimental (descriptive or correlational) categories [3].
Results
The PhD overview consists of 185 PhD studies in the field of art therapy from nineteen countries across Europe (Table 1 [Tab. 1]): Bulgaria (5), Czech Republic (2), Denmark (2), Finland (2), France (3), Germany (47), Greece (5), Hungary (1), Iceland (1), Ireland (2), Lithuania (3), Netherlands (4), Poland (1), Russia (22), Slovakia (8), Slovenia (2), Spain (28), Sweden (4), United Kingdom (43). All titles in the source language were translated into English. Seventy-two of the collected 185 PhDs (39%) provided an abstract in English.
Table 1: 185 PhD studies in the field of AT from nineteen countries across Europe were organized tabularly.
Forty-seven dissertations in art therapy (25%) originate from Germany. However, only ten of them provided an abstract in English. The United Kingdom (UK) follows with forty-three dissertations (23%), Spain with twenty-eight (15%), as well as Russia with twenty-two (12%). More than half of the studies in Germany (25) were conducted in a hospital setting. From the UK, the largest category of the studies (15) are from the therapeutic and preventive research area, but many studies are also from hospital context (12). In Spain the major category (6) is studies from a hospital setting. Most of the PhD studies in Russia (16) were conducted in an educational context and with children (13).
Based only on the dissertation titles, the 185 studies were divided in eight categories: art-based, theoretical, educational, hospital, therapeutic and preventive, special needs, others, as well as unclear (Figure 1 [Fig. 1]). The largest section (31%) is the sector with dissertations which were implemented in a hospital setting. It follows the category educational with 24%, as well as therapeutic and preventive with 19%. The same categorization was done separately for the 72 PhDs that had English abstracts available online, and it is uniform with the first analysis - the biggest part with 39% is hospital setting (Figure 2 [Fig. 2]).
Figure 1: 185 PhDs were divided in eight categories: art-based, theoretical, educational, hospital, therapeutic and preventive, special needs, others, as well as unclear. 
Figure 2: 72 PhD studies with an abstract were divided in the same categories.
PhD studies with an abstract in English were organized separately in a tabular form in alphabetical order by author with information about name, year of publication, country, research design, target group, sample size, aims, and keywords (Attachment 1 [Att. 1]).
Depending on the research methods and on the research subject, different study designs can be identified. For the purpose of clarity, quantitative research was distinguished in experimental, quasi-experimental, and non-experimental (descriptive or correlational) categories [3]. Qualitative research was split into phenomenological, grounded theory, ethnographical, historical, narrative, action research, case studies and field research [3].
The further analysis of the abstracts focused on the type of the research design (Figure 3 [Fig. 3]) which shows that 65% of the PhDs with an abstract have a qualitative research design. The mixed-methods-design, as well as quantitative research design follow with 21% and 10%, respectively. Art-based studies are still only a minor approach in the doctoral dissertations.
Figure 3: 72 PhD studies with an abstract: comparison based on the type of the research design.
Discussion
Categorizing the studies based only on the title and/or abstract of the doctoral research is a challenge and limits the trustworthiness of our analysis. As described above, many titles and/or abstracts of the collected PhD studies did not clearly state the research details like aims, study design, target group, research methods or outcomes. Furthermore, we would like to draw attention to the importance of translating the titles and abstracts in English in the European art therapy studies and publishing these online. We are still missing a large part of the information, because we did the analysis based on 39% of the PhD studies, which provided an abstract in English. That is why we are not able to state that we currently have a representative and exhaustive view on implemented research in the field of art therapy across Europe. However, we can see many general trends related to PhD studies in Europe.
Our findings show, that in majority of the countries, there has been conducted only 1–5 PhD studies and only in four countries there is larger number of doctoral research related to art therapy. This is a challenge, since many art therapists need to do their doctoral studies under other disciplines, and it can be difficult to find other art therapy researchers to collaborate with and to further develop the research field and methods. Also, it does not enable the research skills and knowledge to accumulate enough to create ground for building education on art therapy discipline and doctoral research in the national universities. This is an important reason why collaboration on art therapy research and doctoral studies across European countries and different Universities is necessary. It also highlights the importance of European wide organizations such as EFAT in supporting the individual art therapy researchers.
Qualitative methods are the dominant approach to research in art therapy PhD studies. However, we can note an encouraging trend – the implementation of more quantitative and mixed-methods in art therapy research. As already illustrated in graph 3 researchers increasingly choose research design with mixed methods in their projects (21%). Art-based approach is instead still very rare. Certainly, the part of the projects with quantitative research design is also quite small (10%) compared to the other research types. But this knowledge of underrepresented research approaches could inspire research beginners planning new studies to be creative and to implement new designs using various research methods.
Currently, we can notice that more empirical research is needed in the field of art therapy for the recognition, and for the development of the profession. We also need more accessible information from PhD researchers about the study designs, approach, measuring instruments, target groups, results, effects, and tools of analysis of their research. In general, we need more transparency and better accessibility to the conducted doctoral research in art therapy. Scholars should pay more attention to the growing importance of transparent and comprehensive descriptions reporting individual approaches, methods, and outcomes in the abstracts.
Additionally, we would like to underline the great importance of translating the research studies and abstracts into English for the availability as well as the professional recognition. Already in the ‘90s Gantt [1] recognized the need to rethink the content of graduate programs and to integrate both humanistic and scientific approaches in order to spark more research in art therapy. She also addressed the multilevelness in art for the development of measuring instruments [1]. It is becoming more apparent today how significant knowledge of research methodology and statistics are in education and academic work.
Finally, we would like to underline the important role of the universities in this task by including and discussing different research methods in art therapy bachelor’s and master’s training programs.
Limitations
It was not possible to carry out the research in the existing databases except in EThOS, because most PhD studies were unpublished and were not listed in any databases. That was why we needed to use EFAT members as our source, since they represent art therapy in 35 European countries. We used snowball sampling and asked the EFAT members to contact specialist societies in the respective countries in order to find as many PhD dissertations as possible that had been conducted in their country. We are aware that there might be bias in our review related to possible limitations in finding all conducted PhD studies related to art therapy in Europe. However, our study is important and worth pursuing because there does not yet exist a database and we have now managed to gather a large amount of PhD studies that have been conducted in Europe so far and created a novel EFAT database of art therapy dissertations.
Conclusions and future work
Without being able to read the unpublished full texts, it is challenging to draw very detailed conclusions of the conducted PhD studies in Europe. However, we can get an overview of the more general trends related to the research methods and subjects of the study. Also, we get a picture of the spreading of doctoral research across different countries in Europe. With the PhD review we would like to motivate beginners to do their own research projects in art therapy and to be creative in designing their studies and clear in their concepts. In order to develop high quality research in art therapy we should also be aware of the role of ethics and protection of human rights in research.
This investigation needs periodical reviews when more data is collected. In the future, the analysis could also be more concretely specified according to the diagnosis of the target group, and also differentiated between children and adults.
Notes
Competing interests
The authors declare that they have no competing interests.
References
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[6] Greenwood J. Arts-Based Research: Weaving Magic and Meaning. International Journal of Education & the Arts. 2012;13(1):2-20.
[7] Greenwood J. Arts-Based Research: Oxford Research Encyclopedia of Education. New York, NY: Oxford University Press; 2019. DOI: 10.1093/acrefore/9780190264093.013.29
[8] Leavy P. Research Design: Quantitative, Qualitative, Mixed Methods, Arts-Based, and Community-Based Participatory Research Approaches. New York, NY: The Guilford Press; 2017.
[9] Sullivan G. Art practice as research: Inquiry in the visual arts. 2. Ed. Los Angeles, CA: Sage; 2010.
Attachments
| Attachment 1 | PhD review table (Attachment1_jat000040.pdf, application/pdf, 889.56 KBytes) |
