Towards an Empirically Informed Theory of Action of the Art-based Mental Health Rehabilitation Program All on Stage
Main Article Content
Abstract
Despite increasing evidence supporting the efficacy of art-based programs for mental health rehabilitation, the active ingredients and therapeutic processes of these interventions are still poorly understood. In the present study, our objective was to empirically derive the theory of action of the program All on Stage, an innovative art-based rehabilitation program for youths with stabilized mental disorders. We conducted individual and group semi-structured interviews with twenty-four participants at post-program and three-month follow up. At post-program, we similarly interviewed the artists and psychoeducator who facilitated the program and the clinicians who referred participants to it. We also collected field observations throughout the program using a participatory approach. We performed qualitative thematic analyses on all relevant material. Analyses revealed four mechanisms that seem to be at work in the program: 1) social experience and gratification, 2) desensitization by gradual exposure, 3) success and valorization, and 4) normalization. The emergence or impact of these mechanisms appeared to be favored by various program characteristics, including the non-clinical setting and facilitation of the program, the heterogeneous composition of the groups, the use of performing arts, and the pursuit of a collectively achieved artistic product and its sharing with an external public. Our study offers a rare example of inductive theory building in the context of a real-world program evaluation. Study conclusions can guide the planning and delivery of future initiatives in the fields of youth mental health and arts in health.
Keywords:
Youth, mental health rehabilitation, art-based interventions, theory of action, process evaluation
Article Details
How to Cite
ARCHAMBAULT, Kim et al.
Towards an Empirically Informed Theory of Action of the Art-based Mental Health Rehabilitation Program All on Stage.
Medical Research Archives, [S.l.], v. 13, n. 7, aug. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6702>. Date accessed: 05 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i7.6702.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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26. Stickley T, Hui A. Social prescribing through arts on prescription in a UK city: Participants’ perspectives (Part 1). Public Health. 2012;126(7):574-579. doi:10.1016/j.puhe.2012.04.002
27. Fenner P, Ryan B, Latai L, Percival S. Art making and the promotion of wellbeing in Samoa: Participants’ lived experience of a recovery-oriented intervention. Arts Health. 2018;10(2):124-137. doi:10.1080/17533015.2017.1334677
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29. Thomas Y, Gray M, McGinty S, Ebringer S. Homeless adults engagement in art: First steps towards identity, recovery and social inclusion. Aust Occup Ther J. 2011;58(6):429-436. doi:10.1111/j.1440-1630.2011.00977.x
30. Van Lith T, Fenner P, Schofield MJ. The lived experience of art making as a companion to the mental health recovery process. Disabil Rehabil. 2011;33(8):652-660. doi:10.3109/09638288.2010.505998
31. Wimpenny K, Savin-Baden M. Using theatre and performance for promoting health and wellbeing amongst the 50+ community: An arts-informed evaluation. Int J Soc Polit Community Agendas Arts. 2014;8(1):47-64.
32. Argyle E, Bolton G. Art in the community for potentially vulnerable mental health groups. Health Educ. 2005;105(5):340-354. doi:10.1108/09654280510617178
33. Goodman-Casanova JM, Guzman-Parra J, Mayoral-Cleries F, Cuesta-Lozano D. Community-based art groups in mental health recovery: A systematic review and narrative synthesis. J Psychiatr Ment Health Nurs. 2023;31(2):158-173. doi:10.1111/jpm.12970
34. Nitzan A, Orkibi H. The contribution of integrated arts-based groups to people with mental health conditions and community members: Processes and outcomes. Psychol Aesthet Creat Arts. Published online 2022. doi:10.1037/aca0000501
35. Coholic D, Schinke R, Oghene O, Dano K. Arts-based interventions for youth with mental health challenges. J Soc Work. 2020a;20(3):269-286. doi:10.1177/1468017319828864
36. Coholic D, Schwabe N, Lander K. A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth. Child Adolesc Soc Work J. 2020b;37(5):511-526. doi:10.1007/s10560-020-00657-5
37. Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. Br J Psychiatry. 2011;199(6):445-452. doi:10.1192/bjp.bp.110.083733
38. Sweeney S. Art therapy: Promoting wellbeing in rural and remote communities. Australas Psychiatry. 2009;17 Suppl 1:S151-S154. doi:10.1080/10398560902948498
39. Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry. 2010;10:113. doi:10.1186/1471-244X-10-113
40. Lamb J. Creating change: Using the arts to help stop the stigma of mental illness and foster social integration. J Holist Nurs. 2009;27(1):57-65. doi:10.1177/0898010108323011
41. Salaheddin K, Mason B. Identifying barriers to mental health help-seeking among young adults in the UK: A cross-sectional survey. Br J Gen Pract. 2016;66(651):e686-e692. doi:10.3399/bjgp16X687313
42. Whittemore R, Chase SK, Mandle CL. Validity in qualitative research. Qual Health Res. 2001;11(4):522-537. doi:10.1177/104973201129119299
43. Bowling A, Ebrahim S. Handbook of Health Research Methods: Investigation, Measurement and Analysis. Open University Press; 2005.
44. Khoury E. Narrative matters: Mental health recovery – considerations when working with youth. Child Adolesc Ment Health. 2020;25(4):273-276. doi:10.1111/camh.12419
2. Gordon-Nesbitt R. Creative Health: The Arts for Health and Wellbeing. All-Party Parliamentary Group on Arts, Health and Wellbeing; 2017. http://www.artshealthandwellbeing.org.uk/appg-inquiry/Publications/Creative_Health_Inquiry_Report_2017_-_Second_Edition.pdf
3. Fancourt D, Aughterson H, Finn S, Walker E, Steptoe A. How leisure activities affect health: A narrative review and multi-level theoretical framework of mechanisms of action. Lancet Psychiatry. 2021;8(4):329–339. doi:10.1016/S2215-0366(20)30384-9
4. Kelly S, Davies L, Harrop D, McClimens A, Peplow D, Pollard N. Reviewing art therapy research: A constructive critique; 2015.
5. Patton MQ. Qualitative Research & Evaluation Methods. 4th ed. Thousand Oaks, CA: Sage Publications; 2014.
6. Rogers P, Petrosino A, Huebner TA, Hacsi TA. Program theory evaluation: Practice, promise, and problems. New Dir Eval. 2000;87:5-14. doi:10.1002/ev.1177
7. Rossi PH, Lipsey MW, Freeman HE. Evaluation: A Systematic Approach. 7th ed. Thousand Oaks, CA: Sage Publications; 2003.
8. Warran K, Burton A, Fancourt D. What are the active ingredients of 'arts in health' activities? Development of the INgredients iN ArTs in hEalth (INNATE) framework. Wellcome Open Res. 2022;7:10. doi:10.12688/wellcomeopenres.17414.2
9. Van Lith T, Schofield MJ, Fenner P. Identifying the evidence-base for art-based practices and their potential benefit for health recovery: A critical review. Disabil Rehabil. 2013;33(16):1309-1323. doi:10.3109/09638288.2012.732188
10. Archambault K. Évaluation d’un programme novateur de réadaptation par les arts de la scène pour les jeunes présentant un trouble psychiatrique stabilisé : le programme Espace de Transition. [Doctoral dissertation, Université de Montréal]; 2014.
11. Archambault K, Archambault I, Dufour S, Brière FN†, Garel P. A mixed methods evaluation of the effects of an innovative art-based rehabilitation program for youths with stabilized psychiatric disorders. Ado Psych. 2015;5(3): 212-224. doi:0.2174/221067660503151204113049
12. Lipsey MW, Cordray DS. Evaluation methods for social intervention. Annu Rev Psychol. 2000;51:345-375. doi:10.1146/annurev.psych.51.1.345
13. Denzin NK, Lincoln YS. Handbook of Qualitative Research. 5th ed. Sage Publications; 2017.
14. Miles MB, Huberman M, Saldaña J. Qualitative Data Analysis: A Methods Sourcebook. 4th ed. Thousand Oaks, CA: Sage Publications; 2020.
15. Provalis Research. QDA Miner, Version 3.2 [computer program]. Montréal (QC): Provalis Research; 2009.
16. Macpherson H, Hart A, Heaver B. Building resilience through group visual arts activities: Findings from a scoping study with young people who experience mental health complexities and/or learning difficulties. J Soc Work. 2016;16(5):541-560. doi:10.1177/1468017315581772
17. Perez RM, Archambault K, Dupéré V. Déploiement et contribution des relations sociales au sein d’un programme parascolaire artistique conçu pour des jeunes vivant avec des difficultés socio-émotionnelles. Rev Psychoéduc. 2023;52(2):519-549. doi:10.7202/1107456ar
18. Zarobe L, Bungay H. The role of arts activities in developing resilience and mental wellbeing in children and young people: A rapid review of the literature. Perspect Public Health. 2017;137(6):337-347. doi:10.1177/1757913917712283
19. Logan ML. 'There was something magical about this group': Building cohesion in a psychiatric hospital [master’s thesis]. Cambridge, MA: Lesley University; 2019.
20. Torrissen W, Stickley T. Participatory theatre and mental health recovery: A narrative inquiry. Perspect Public Health. 2018;138(1):47-54. doi:10.1177/1757913917723944
21. Otto MW, Safren SA, Hearon BA. Mechanisms of action in the treatment of social anxiety disorder. In: Hofmann SG, DiBartolo PM, eds. Social Anxiety: Clinical, Developmental, and Social Perspectives. 3rd ed. Elsevier Academic Press; 2014:777-800. doi:10.1016/B978-0-12-394427-6.00027-3
22. Stickley T, Wright N, Slade M. The art of recovery: Outcomes from participatory arts activities for people using mental health services. J Ment Health. 2018;27(4):367-373. doi:10.1080/09638237.2018.1437609
23. Harter S. The Construction of the Self: Developmental and Sociocultural Foundations. 2nd ed. Guilford Press; 2012.
24. Heenan D. Art as therapy: An effective way of promoting positive mental health? Disabil Soc. 2006;21(2):179-191. doi:10.1080/09687590500498143
25. Lawson J, Reynolds F, Bryant W, Wilson L. 'It’s like having a day of freedom, a day off from being ill': Exploring the experiences of people living with mental health problems who attend a community-based arts project, using interpretative phenomenological analysis. J Health Psychol. 2014;19(6):765-777. doi:10.1177/1359105313479627
26. Stickley T, Hui A. Social prescribing through arts on prescription in a UK city: Participants’ perspectives (Part 1). Public Health. 2012;126(7):574-579. doi:10.1016/j.puhe.2012.04.002
27. Fenner P, Ryan B, Latai L, Percival S. Art making and the promotion of wellbeing in Samoa: Participants’ lived experience of a recovery-oriented intervention. Arts Health. 2018;10(2):124-137. doi:10.1080/17533015.2017.1334677
28. Gallant K, Hamilton-Hinch B, White C, Litwiller F, Lauckner H. “Removing the thorns”: The role of the arts in recovery for people with mental health challenges. Arts Health. 2019;11(1):1-14. doi:10.1080/17533015.2017.1413397
29. Thomas Y, Gray M, McGinty S, Ebringer S. Homeless adults engagement in art: First steps towards identity, recovery and social inclusion. Aust Occup Ther J. 2011;58(6):429-436. doi:10.1111/j.1440-1630.2011.00977.x
30. Van Lith T, Fenner P, Schofield MJ. The lived experience of art making as a companion to the mental health recovery process. Disabil Rehabil. 2011;33(8):652-660. doi:10.3109/09638288.2010.505998
31. Wimpenny K, Savin-Baden M. Using theatre and performance for promoting health and wellbeing amongst the 50+ community: An arts-informed evaluation. Int J Soc Polit Community Agendas Arts. 2014;8(1):47-64.
32. Argyle E, Bolton G. Art in the community for potentially vulnerable mental health groups. Health Educ. 2005;105(5):340-354. doi:10.1108/09654280510617178
33. Goodman-Casanova JM, Guzman-Parra J, Mayoral-Cleries F, Cuesta-Lozano D. Community-based art groups in mental health recovery: A systematic review and narrative synthesis. J Psychiatr Ment Health Nurs. 2023;31(2):158-173. doi:10.1111/jpm.12970
34. Nitzan A, Orkibi H. The contribution of integrated arts-based groups to people with mental health conditions and community members: Processes and outcomes. Psychol Aesthet Creat Arts. Published online 2022. doi:10.1037/aca0000501
35. Coholic D, Schinke R, Oghene O, Dano K. Arts-based interventions for youth with mental health challenges. J Soc Work. 2020a;20(3):269-286. doi:10.1177/1468017319828864
36. Coholic D, Schwabe N, Lander K. A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth. Child Adolesc Soc Work J. 2020b;37(5):511-526. doi:10.1007/s10560-020-00657-5
37. Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. Br J Psychiatry. 2011;199(6):445-452. doi:10.1192/bjp.bp.110.083733
38. Sweeney S. Art therapy: Promoting wellbeing in rural and remote communities. Australas Psychiatry. 2009;17 Suppl 1:S151-S154. doi:10.1080/10398560902948498
39. Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry. 2010;10:113. doi:10.1186/1471-244X-10-113
40. Lamb J. Creating change: Using the arts to help stop the stigma of mental illness and foster social integration. J Holist Nurs. 2009;27(1):57-65. doi:10.1177/0898010108323011
41. Salaheddin K, Mason B. Identifying barriers to mental health help-seeking among young adults in the UK: A cross-sectional survey. Br J Gen Pract. 2016;66(651):e686-e692. doi:10.3399/bjgp16X687313
42. Whittemore R, Chase SK, Mandle CL. Validity in qualitative research. Qual Health Res. 2001;11(4):522-537. doi:10.1177/104973201129119299
43. Bowling A, Ebrahim S. Handbook of Health Research Methods: Investigation, Measurement and Analysis. Open University Press; 2005.
44. Khoury E. Narrative matters: Mental health recovery – considerations when working with youth. Child Adolesc Ment Health. 2020;25(4):273-276. doi:10.1111/camh.12419