Democratising the discourse: co-production in art therapy practice, research and publication

Abstract

By definition co-production actively invites diversity and participation, but some contexts lend themselves more easily to this approach than others. If art therapy is placed within the broader mental health treatment field, it must engage with a difficult history of power abuse, stigma and exclusion. We present an argument here that these issues at once make co-production methodology more challenging and more needed. However, in acknowledgement that power and exclusion have themselves so often been transacted through language and labels, we wish to clarify the terms we apply to the roles individuals may take in the co-production before proceeding to that argument. We broadly define co-production as people who use and provide art therapy services working together to develop theory in such a way that values both the consensus and differences between each perspective. We use the term service user to describe an individual’s action of seeking help from an art therapist or professional but without implying any lasting personal characteristic of that individual. Service user is currently one accepted term used in the UK, but it is not without limitations, particular in potentially implying a transactional or passive stance which is not intended by our use of it. We refer to lived experience researcher or lived experience practitioner to denote the role of a non-professional involved in co-production, and explicitly differentiate that capacity from the term service user. Other authors in this special issue have chosen their own terms as they saw fit. Co-production can be applied to both practice and research. In all cases, the methodology requires flexibility to ensure those contributing lived experience will share control and influence with professionals. To our reading, the matter of how lived experience is given form to be communicated amongst co-producers is a primary consideration in that flexibility. For example, approaches which assume all partners can use words to describe experience immediately disadvantages those whose verbal communication is challenged by developmental, cognitive or traumatic factors. Conversely, strategies which draw on a range of communication forms increase inclusion and thereby the potential effectiveness of projects. We suggest it is to this, arguably under-studied, area of co-production methodology that this special issue may make a particularly valuable contribution. We hope the examples presented will be of interest both within, and beyond art therapy in demonstrating how art can mediate co-production where people cannot find the words to otherwise be involved. We are grateful to be offered space in this editorial to explore co-production in greater depth. Our aim in doing so is pragmatic: to draw on both literature and our project experience to elucidate practice points for those considering co-production approaches. One feature of practice we share with other authors published here, was that our initial collaboration was therapeutic, where Springham (NS) was Xenophontes’ (IX) art therapist in a National Health Service (NHS) setting. At the close of that therapy we moved from those roles to act as colleagues within the same organisation. We discuss the learning involved in that transition below. Our co-production experience then took various forms within and outside of art therapy, both together and in separate projects. Although this experience was varied, it shared a common feature in that no project we encountered ever simply progressed from plan to action to outcome. All involved negotiation, revision and effortful perseverance to succeed. By contrast, most published projects we read gave the impression that a linear process was the norm. For this reason, we wish to emphasise that we have chosen to focus our discussion on co-productivity principles, rather than procedures. This is because, in a practice reality where it is important to respond coherently to continuously changing circumstances, we found principles were the better guide. Moreover, clarity about those principles also offers a framework for us to discuss the wider potential impact co-production methodology may invite for BAAT and art therapy if the practice continues to grow.