GAIN group art psychotherapy for children: a service evaluation and acceptability study

Background Children and young people with long-term physical health conditions (LTPHCs), such as Juvenile Idiopathic Arthritis (JIA), are at increased risk of mental health difficulties, including anxiety and depression. Despite this, access to psychological support in paediatric healthcare settings remains limited. Group Art Psychotherapy Intervention for communicating the Needs of children with long-term health conditions (GAIN) was developed as an online, manualised group intervention to support the psychological well-being of children with LTPHCs and their families.Aims This service evaluation aimed to assess the acceptability of the GAIN intervention as an online, home-based treatment, explore the suitability of standardised outcome measures, and develop a logic model to inform future implementation.Methods Twelve young people with JIA participated in two age-stratified, six-session online art psychotherapy groups, facilitated by an HCPC-registered art psychotherapist. Data were collected via focus groups with therapists, patient and parent questionnaires (PedsQL, RCADS, SDQ), therapist session notes, and supervision reflections.Results The intervention was well-received, with participants reporting increased social connectedness, emotional expression, and empowerment. Four themes were identified from the thematic analysis: Peer support and discussion, Youth centred empowerment, Barriers and revisions, Age group differences. A logic model for the GAIN intervention is presented, and the acceptability of the questionnaires is reported.Conclusions The GAIN intervention demonstrated strong acceptability and potential benefits for children with LTPHCs, particularly in promoting peer support and emotional expression.Implications for practice/policy/future research The evaluation informs future adaptations and the development of the evidence base for art psychotherapy in paediatric healthcare settings.Plain-language summary Children and young people with long-term physical health conditions, like Juvenile Idiopathic Arthritis (JIA), can sometimes feel worried, sad, or lonely. Getting mental health support is not always easy. The GAIN programme (Group Art Psychotherapy Intervention for communicating the Needs of children with long-term health conditions) is an online group art therapy designed to help children and their families. In this study, twelve young people with JIA joined online art therapy sessions led by a trained art therapist. They made art, talked, and shared their experiences. Feedback came from children, parents, therapists, and group discussions. The results showed that most children enjoyed the sessions and found them helpful. They felt less alone, more confident, and better able to express their feelings. The sessions also helped them connect with others going through similar challenges. Overall, GAIN seems to be a helpful and supportive programme for children with long-term conditions. The feedback will be used to make the programme even better and to guide future research on art therapy in children’s healthcare.