Moments of disappointment in art therapy: patients’ perspectives

Background: Recent psychotherapy studies have examined patients’ perspectives on disappointment during treatment to better understand the reasons for rupture and drop-out. However, these topics have received less attention in art therapy. Aims: The study aimed to identify the factors contributing to disappointment in art therapy and how patients cope with this feeling. Method: Fifty-two adult patients participated in a qualitative study using semi-structured interviews with six open-ended questions. The participants were asked to reflect on instances when they were disappointed during treatment and describe how they navigated these experiences. Thematic analysis was employed to analyse the data. Results: The analysis revealed three themes related to disappointment and one to patients’ coping. The first theme addressed therapist passivity or overactivity and showed how patients’ perceptions of therapists’ excessive indifference, shallowness, or controlling behaviours hindered exploration. The second theme focused on relational ruptures and pointed to the adverse effects of interruptions in the therapist-patient dynamic. The third theme covered constraints in the creative setting, confusion related to the perceived curtailment of creative processes, and the tension between artistic and verbal expressions. The fourth theme reflected how these patients navigated disappointment by ending therapy, seeking meaning in an unsatisfactory relationship, or avoiding conflict. Conclusion: The findings highlight the potential risks inherent to unsatisfactory therapeutic relationships and how the poorly adjusted use of art can lead to early drop-out. Implications for practice: The findings underscore the need for greater attention to the complex triangular relationship between the patient, the therapist, and the creative process. Plain-language summary: Recent research has explored how patients feel about disappointment in therapy, but this topic hasn’t been as thoroughly examined in art therapy. This study aimed to discover what causes disappointment in art therapy and how patients cope with those feelings. Fifty-two adults participated in interviews where they shared their experiences of disappointment during their therapy sessions and how they handled those moments. The researchers analysed their responses for common themes. They identified three main themes related to disappointment and one that relates to coping. First, they found that a therapist’s apparent lack of engagement or excessive control could make it harder for patients to explore their feelings. Second, disruptions in the therapist-patient relationship could negatively impact the therapy experience. Third, patients felt confused by limitations in the creative process and experienced tension between expressing themselves through art and words. As to the issue of coping, some patients chose to end therapy, try to find meaning in unsatisfying relationships, or avoid conflict. Overall, the findings highlight the risks associated with unsatisfactory therapeutic relationships and demonstrate how inappropriate use of art in therapy can contribute to patient drop-out. The study suggests that paying more attention to the complex relationships between patients, therapists, and the creative process is important.