Art at the Start
: A mixed methods study of early art therapy intervention for attachments and wellbeing

  • Victoria Gray Armstrong

Student thesis: Doctoral ThesisDoctor of Philosophy


This thesis brings together the profession of art therapy with a psychology research framework, using mixed methods to look at the efficacy of art based interventions for supporting early attachment relationships and to explore the experiences of participants. The project was embedded within an arts centre and worked across a range of participatory and therapeutic approaches. At the core of the project was a service delivering dyadic art therapy groups for vulnerable infant and caregiver dyads. The outcomes of these groups have been explored statistically, using standardised outcome measures compared against a control sample, and an observational tool, as well as qualitatively through the thematic analysis of interviews. All these measures give robust results that show clear improvement to the caregivers’ wellbeing, to their perception of their relationship with their infant, and to the babies’ experiences of interaction with their caregiver. We were able to point towards potential mechanisms for change within the intervention by exploring how parents experienced the groups and looking at this in relation to the observed changes we saw in their behaviour. For example, caregivers were noticing more about their infant’s behaviour and picking up their communications and this was also evidenced in the increased responsiveness seen in our observation measure. We were also able to explore the benefits of art making beyond the therapeutic space, through the provision of art materials and guides to use in the home. Qualitative analysis of interviews similarly saw improvements to caregivers reported wellbeing and a reported increase in the quality of their interactions with their infant, such as engaging more within the play. Overall, this thesis provides a strong evidence base for the use of arts within support for early relationships.
Date of Award2023
Original languageEnglish
SponsorsWellcome Trust, Royal Society of Edinburgh & Institute for Social Sciences Research (ISSR)
SupervisorJosephine Ross (Supervisor), Emese Nagy (Supervisor) & Sarah Derrick (Supervisor)


  • Art Therapy
  • Attachment
  • Infant Mental Health
  • Perinatal Mental Health
  • Parent-Infant Relationship
  • Art
  • Observation
  • Wellbeing

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