Imagining Futures: Evaluation of a blended programme of dialectical behaviour therapy and the creative arts for young women with a history of self-harm.

Objectives: To evaluate an arts-enhanced dialectical behavioural therapy skills group for managing emotions and self-harm, implemented via an innovative public sector/third sector partnership to increase access to care.

Design: This is a pilot mixed-methods study.

Methods: To assess participant experience in the 'Imagining Futures' programme, we examined self-report questionnaires and qualitative focus group interviews using framework analysis. We collected recruitment, session attendance and programme completion rates. To explore impact, we also report on quantitative psychological outcome measures, including self-harm frequency and overall well-being.

Results: We recruited 45 young women (mean age: 15.9, s.d. = 1.24, range 13.9-18.0 years) with a history of emotional dysregulation, self-harm and other contextual risks who were not receiving support from statutory child and adolescent mental health services in the United Kingdom. Participants were 22% not in education, employment or training and 77% were from United Kingdom racially minoritized backgrounds. The overall completion rate was 62% (n = 28/45). Qualitative data analysed from respondents (n = 25/28 young people and n = 12 parents) suggested high levels of satisfaction with the project. Thirteen themes were identified which described service elements perceived to support engagement and observed impact. There was an important role for relationships and the creative components. Quantitative clinical data indicated reductions in the frequency of self-harming, significant reductions in the perceived impact of difficulties and increased perceived social support.

Conclusions: This novel delivery of a DBT skills group, incorporating blended psychology arts activities, has the potential to support engagement with psychological supports that improve mental well-being.