Towards an Empirically Informed Theory of Action of the Art-based Mental Health Rehabilitation Program All on Stage

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.