Creative activities as intervention in mental health. Exploring the concept and the occupational value of creative activities as intervention

Abstract: This thesis focuses on describing the concept of creative activities as intervention (CaI) and the occupational values experienced in doing CaI. Creative activities are frequently used as interventions in occupational therapy and are associated with subjective health and wellbeing. There is a lack of clarity in the definitions of the concept and there is no research presented regarding the experiences of occupational value (OV) when doing CaI.The aim of the thesis was thus to describe the concept of CaI as defined in occupational therapy literature and explore how and to what extent people with mental illness experiences OV in doing CaI in a mental health context.Two studies are included in the thesis. Study I is a concept analysis (including a systematic review) of CaI using 15 selected scientific publications. The results were validated by using a questionnaire sent to a reference panel of occupational therapists. Study II has an explanatory sequential mixed-methods design. Data were obtained by the OVal-9 questionnaire at two measure points from 33 participants with severe mental illness, who were participating in interventions using creative activities. Eight of the participants participated in additional qualitative semi-structured interviews. Non-parametric statistical methods and manifest content analysis were used for the data analyses.In Study I, five attributes describing CaI were identified: 1) Often consisting of elements of art and craft using mind and body, 2) Being experienced as meaningful, 3) Creating creative processes, 4) Developing skills, enhancing occupational performance and managing everyday life, and 5) Being easy to modify individually or in groups with different approaches. Three cases were generated from the five attributes to illustrate the integrity of the analysis. The attributes and the cases were recognized and found relevant for research and practice by the reference panel. In Study II, a high degree of experienced occupational value was indicated, both at measure point 1 (M1) and measure point 2 (M2) in the process of doing CaI. The experiences reported were associated with all three dimensions of occupational value. No statistically significant difference in perceived occupational value was detected after the process of doing CaI except for one item: “I feel happiness and/or pleasure.This thesis contributes to the knowledge base in terms of the description of the attributes of CaI and ability of CaI to facilitate a high level of experienced occupational value. The results are discussed and reasoning on how this specific intervention benefits to mental health recovery. This knowledge provides research and practice with a shared language and may develop and facilitate the use of CaI in supporting rehabilitation processes in mental health care.