This study aimed to provide and evaluate an art-based intervention for a specific population of youth benefitting from an after-school program in rural Quebec. A descriptive qualitative design was used, and data consisted of group discussions, observational data, and individual semi-structured interviews with the students. These were analyzed using both inductive thematic analysis and content analysis. The primary themes that emerged from this work included general appreciation and acceptability of the intervention, students’ attitudes towards the activities, and feelings associated to art-making.
General appreciation and acceptability of the intervention
Students’ general enjoyment of the intervention indicated that, for the most part, they liked the activities and themes included in the project. These positive feelings towards the intervention lend support to the use of art-based interventions with youth (Kim et al., 2022; Boaz & Bat-Or, 2022; Malboeuf-Hurtubise et al., 2021) as an acceptable means for intervention. However, it should be noted that some students showed occasional reluctance to participate in the intervention. This may be attributable to academic pressures or feared judgment from peers, which we discuss further below.
Based on results from this study, students reported being positively impacted by the art-based workshops. Namely, students expressed self-discovery and feeling more comfortable and confident around their peers and the program staff. These findings are consistent with that of previous work amongst youth in low income areas, which showed that an expressive art-based intervention improved participants’ confidence (Forrest-Bank et al., 2016). However, it should be noted that some indicated, on the contrary, that they disliked the activities. In digging further, many of those who expressed their dislike for the intervention gave various feedback. This feedback included students stating that they experienced positive emotions during art-making, but later mentioning that the intervention had no impact on their emotional well-being. Other students mentioned that they would like to participate in the study again, despite not enjoying the intervention. Varying mechanisms could be at play to explain this somewhat contradictory feedback. Perhaps students lacked introspection, as previous research shows that metacognition to deeply reflect on one’s own thoughts and feelings is still in development in early adolescence (Mertens et al., 2022). It is also possible that students may have simply experienced short term benefits from the intervention, rather than long term impacts they could reflect on during the interviews which took place after the intervention ended.
Another plausible explanation pertains to the difficulty associated with completing certain activities, such as creative writing and dancing. It is possible that these activities were least preferred by students because they were too challenging. However, it should be noted that some students later expressed desire to participate in them again because they were proud of overcoming personal limits.
This explanation is corroborated by existing research by Léger-Goodes et al. (under review) on the use of an art-based intervention with elementary school students. Within this work, it was found that although students felt challenged by a dance activity, they felt proud of themselves for overcoming their feelings of embarrassment (Léger-Goodes et al., under review). It is also possible that mental health-related stigma prevented students from sharing that the intervention helped (and hence potentially admitting needing help). Indeed, the research process may have been too threatening for students as we regularly spoke of emotions and mental health. Previous research supports how some youth can be particularly reluctant to discuss sensitive topics such as mental health in interview settings (Wasserman et al., 2018). Indeed, interview questions were phrased in a direct manner, so those surrounding students’ mental health may have been too confronting and thus impacted students’ responses. For example, students were asked “if you think back to before we started the art activities and now, what differences do you see in how you feel and the emotions you experience?” However, these are only tentative explanations, given it was difficult to discern why students provided this feedback as they were particularly reluctant to expand on the responses given during the individual interviews. Nonetheless, this reluctance also points to a difficulty for students to be vulnerable and share how they feel.
Although differing feedback prevents us from drawing concrete conclusions about the benefits of our intervention for this population, our overall observations indicated a positive effect. Specifically, when considering the socio-economic context of our participants and the adversity that many of them faced in their daily lives, many students took a liking to our research team and many positive interactions occurred between the research team and participants, suggesting that high quality relationships were developed throughout the course of the research. Previous work regarding school-based mentorship programs imply the wide range of effects quality mentorship has on youth (Bayer et al., 2015; Chan et al., 2013; Deutsch et al., 2013; Dutton et al., 2023). Indeed, youth mentorship programs resulting in sustained quality relationships are associated with improved mentee outcomes, such as academic outcomes (Bayer et a., 2015), connectedness resulting in increased prosocial behaviour (Deutsch et al., 2013), and improved relationship quality with parents and teachers (Chan et al., 2013). It is our understanding that similar mechanisms were at play in this project.
A core component of successful mentorship relationships and qualitative research overall is establishing trust (Pryce, 2012; Pitts & Miller-Day, 2007). As such, it is possible that this bond may have strengthened the perceived effects the intervention had on students’ well-being. Indeed, research examining the research-participant relationships indicated that a strong partnership between researcher and participant can positively impact research outcomes (Rongits, 2022), especially when conducting community-based participatory research (Holden et al., 2014). Notably, positive mentorship developed in the present intervention in just seven weeks, with student interactions of one hour per week. By contrast, existing research such as that of Kuperminc et al. (2020), which found that group mentorship improved high school students’ school support, school belonging, prosociality, and peer relationships, was conducted over a full academic year. Findings from the present work suggest that mentorships can develop and have a positive impact on youth in just a short period of time. A strong therapeutic alliance may have been particularly important for the participants based on the numerous challenges they faced on a daily basis. Despite the therapeutic alliance being set, it may not have been strong enough for students to talk at length on an individual basis. Although having access to youth-appropriate mental health services such as art-based interventions was deemed beneficial by the students, simply being present and attentive of children who lack role models, face isolation and stigma has also had a positive impact on vulnerable youth (Kuperminc et al., 2020).
Furthermore, art-based interventions could also play an active role in facilitating quality mentorship relationships, as they allow for youth to make sense of their thoughts and feelings (Cecil, 2019). Comprehension of their emotions would allow them to share their feelings, which is particularly important in establishing a quality mentorship. Indeed, greater mentee openness has been correlated with higher mentor relationship quality across nine youth programs in New Zealand (Dutton et al., 2023). When considering the context of the participants in the present work and the bonds that were created, it appears likely that the support and mentorship from our research had a positive influence on students.
Students’ perceived impact of the intervention
Several students exhibited positive changes in their mental health, overall life, and skillset. Of those who elaborated on the specific changes experienced, becoming more confident, comfortable, calm, and happy were mentioned most frequently. These findings mirror results of previous art-based work amongst youth (Collins et al., 2023; Versitano et al., 2023), although the interventions used in these studies lasted for an hour; much longer than the twenty-five minute sessions implemented in this project. For example, Collins et al. (2023) conducted weekly art therapy sessions for twelve weeks amongst youth in a secure care facility. Participating youth experienced enhanced hope and resilience by 29% and 16% respectively, and it was found that the intervention improved youths’ goals, levels of self-determination, and future orientations (Collins et al., 2023). Furthermore, Versitano et al.’s (2023) work, which assessed the effectiveness of an art-based intervention and other group therapies amongst adolescents in inpatient mental health care, was conducted over a four month period. Those in the art-based intervention group reported that their sessions were both enjoyable and helpful, and it was found that the use of creative elements promoted consistent group engagement (Versitano et al., 2023).
In addition to referencing feeling more confident, comfortable, happy, and calm, experiencing self-discovery was discussed by participants who enjoyed the intervention simply due to liking art-making. These positive perceived impacts of the intervention indicate that the intervention was relevant to the context and needs of our participants, which was a core component of our community-based approach. Previous work suggests that art-based interventions can be conducive to self-discovery in youth (Huang et al., 2021). Specifically, adolescents who took part in two hour group art sessions for a period of eight weeks expressed starting to get to know themselves better, becoming able to explore their inner selves while noticing their emotions, developing a more positive self-concept, and having a clearer vision of their goals (Huang et al., 2021). Self-discovery and increased confidence may be particularly important for this population in helping them develop a clear and optimistic vision of the future.
Students’ attitudes towards activities
Students’ favourite and least favourite activities to take part in were often attributed to the medium of the art activity, rather than its theme. However, upon observation of the students, it was often difficult to determine whether students’ perceptions of the activities was attributable to either theme or medium. For example, the writing activity was based around relationships, and students were asked to write a letter about a loved one. Many of the students stated that the task was challenging because they felt their writing skills were poor, or because they thought the task was too personal. In this case, we cannot be sure if this activity was many students’ least favourite because of the medium or the theme. However, this activity may have been inappropriate for the students because of both reasons. Overall, both medium and theme may be important for engagement. Including a variety of art mediums is important so that students can feel challenged by the activity and remain engaged throughout the intervention. In accordance with a community-based approach, using themes and mediums that are relevant to the participants’ lives is important (Hanania, 2018).
Moreover, when asked about activities that appeared to be particularly challenging, such as the dance activity on coping, students’ enjoyment varied. Many participants enjoyed the activity, while others felt quite embarrassed or were entirely unwilling to participate. In terms of the importance of providing challenging interventions, the dance activity may have been too challenging for some students. Within this activity, students were asked to think of a time where they coped with something challenging, represent overcoming the challenge through three movements, and then share those movements with a partner. As these students experienced emotional and behavioural challenges, and were thus prone to high emotional reactivity and negative affect, it is likely that students exhibited emotional avoidance (Kennedy & Ehrenreich-May, 2017). Indeed, enduring high, seemingly uncontrollable negative emotion often leads to ineffective attempts at emotional regulation that provide a short-term solution to coping, but ultimately result in long-term maintenance or exacerbation of negative symptoms (Kennedy & Ehrenreich-May, 2017). Thus, it is possible that if students were asked about more positive emotions or experiences, they would have been more willing to participate. If students were granted more time to become comfortable with movement or were educated on how it has been used for emotional expression and coping with trauma, and hence felt more connected to movement, they may have been more willing to participate. Indeed, an eight month dance intervention amongst adolescent girls found that dance in a non-judgmental environment resulted in participants feeling empowered, and gave rise to emotional expression, self acceptance, and trust in oneself (Duberg et al., 2016). Considering these findings, participation may have been better if students felt more comfortable and accepted by one another. Indeed, results tend to indicate that students were more willing to participate and enjoyed the activities where they were not asked to do anything they perceived as too personal or embarrassing. For example, students were open to discussing certain colours and images they chose in a drawing, but were reluctant to share the letter they wrote.
Students’ perceptions of created art
Student creativity was promoted as they were allowed autonomy and choice within creation. However, a couple of students illustrated alarming images at various points of the intervention (e.g., school shooting illustration). These comments suggest that these students face considerable emotional disturbances. Indeed, at-risk youth who experience emotional and behavioural challenges have a history of problems in the school and community (Cox et al., 2022). Existing research maintains that risk is further compounded by living in a rural area as they are affected by factors such as poverty, stigma of seeking services, and lack of availability to services, all of which can contribute to mental health concerns (Heflinger & Hoffmann, 2009) and influence further behavioural and emotional difficulties (Cox et al., 2022).
In terms of how students felt about the work they created, many felt most proud about the activities where they were able to include their favourite things, activities, or places. In other words, the students enjoyed creating the things they liked. There was a lack of enjoyment, however, when students engaged in more challenging activities. Yet, they described feeling less shy, more comfortable, and proud of themselves for taking part in the more difficult activities. By contrast, one participant, who did not feel particularly proud of any piece they made, described feeling most proud of the person they were, rather than the art they created. Although this feedback suggests the student did not value creating art, it demonstrates how lessons behind certain activities were beneficial to them. Specifically, the student referenced feeling proud of the lessons they learned in the activity (or activities) that involved memories - which would be the dance and meditation. The themes behind these activities were coping and optimism, respectively, and the students feedback suggested that they were able to apply these themes to their life experiences.
Other students felt particularly proud about the art that they felt was more aesthetically pleasing. Attributing pride about one’s creations to perceived artistic skill goes against a fundamental component of art-based methods: the importance of focusing on our subjective experiences in the creative process, rather than the finished piece of art (Fraser, 2008; Lyshak-Stelzer et al., 2007; Moon, 1999). Although criticizing one’s art goes against the aim of art-based interventions, it demonstrates the extent to which students focus on performance. The emphasis on performance was mirrored by other students, one of whom mentioned that they would not want to continue doing art at school because they were being graded on the finished product. As such, future work should aim to help children detach from performance. A solution for doing so is engaging in philosophical discussions about art and beauty. For example, discussing questions such as “what makes art beautiful? Can art be perceived differently by different people? How so? Does art need to be beautiful to be considered art?” could mitigate the focus on performance.
Feelings associated to art-making
Art-making elicited positive feelings for students during and after weekly sessions. The emotions of happiness and peacefulness that were discussed by students echo results from previous art-based work amongst inpatient care patients, where it was found that art-making had a calming effect (Noble & Hackett, 2023). In terms of the negative feedback, students who felt bored during art-making and expanded on their reasoning attributed their feelings to having done similar art mediums previously and feeling as though the aim of the activities were redundant. As mentioned, when asked about what they thought the purpose of the intervention was, one of these students stated that every activity aimed to calm the students down, so they grew bored and eventually stopped paying attention during sessions. Although the aim of the study was presented at the beginning of the intervention, and almost every weekly theme was presented to the students prior to the activity, it appears as though reminding students every week about the purpose of the intervention to avoid wrongly assuming the aim may have positively influenced art-making. Specifically, students who understood the weekly theme, the overall purpose of the study, and found both of these useful to them, may have put in greater effort and been more enthusiastic to participate. However, further research regarding how participants’ perception of an intervention impacts their effort and engagement in a given project is needed.
Similarly, participants’ engagement in the activities appeared to have an impact on the emotions they felt about art-making. Specifically, the more engaged students were, the more positively they felt about art-making. This finding aligns with previous work on client engagement and therapeutic outcomes. For example, through their review of 97 studies, Holdsworth et al. (2014) aimed to determine how client engagement with psychotherapeutic interventions had been defined and assessed, the client and therapist characteristics associated with positive engagement, and the treatment factors involved. Although understanding and assessment of client engagement varied across the reviewed works, it was found that clients’ capacity to address their problems was positively associated with engagement (Holdsworth et al., 2014). Indeed, as it appeared that participants lacked the willingness or ability to self-reflect and address their emotions, capacity to introspect may explain poor engagement in the present intervention.
Students who were particularly unengaged during the activities were also hesitant to share their work during the weekly discussion. Considering that students who attend this after-school program come from unstable homes and face a variety of challenges, it is likely that those who were hesitant to share lacked confidence; an important aspect of self-esteem, which can be inhibited by low socioeconomic status (Yuan et al., 2022), family functioning, and parenting (Shaheen et al., 2023). Indeed, family functioning has been shown to have an indirect effect on adolescents’ behaviour problems via self-esteem (Shaheen et al., 2023). To encourage participation during the weekly discussion periods, members of the research team in charge of leading the activities would share their own creation with the group. By contrast, those who felt positively during art-making were much more likely to share their art during discussion periods. This suggests that, within the context of group art-based interventions, comfort level and enjoyment of art influence feelings associated with art-making. Indeed, research amongst 5th graders regarding openness to creativity, which is implied through enjoyment of the arts, supports this notion (Theurer et al., 2021). Furthermore, participants’ age appeared to have impacted art-making as the French 5th grade students appeared to be more open to creativity during art sessions than French 6th grade students. Specifically, as youth approach adolescence they become increasingly aware of what their peers think of them (Irani et al., 2024). This increased sensitivity can act as motivation for youth to maintain positive relationships by acting in accordance with group norms and expectations (Irani et al., 2024). Thus, older students may have been less willing to participate in art-making because they feared being judged by their peers.
At various points of the intervention, students ignored the weekly theme and instructions provided, neglecting to give their full effort into the activity. Students may have approached art-making in this manner because they felt that the activities were not catered to their needs or what they felt was important. Indeed, the intervention may have met the needs of some students, but not all. The intervention was co-created alongside the program coordinators, in that they elaborated on the unique lives and perceived needs of the students. Despite this, neglecting student voices in the creation of the intervention appears to have impacted participation. Regardless of the increase in youth-led movements, which demonstrate their capacity for orchestrating change, existing community-based research does not typically consider youth as full community partners (Bettencourt, 2018; Merves et al., 2015). Youth are typically excluded from the research process because our prevailing views, policies, and practices regarding youth are deficit-focused (Teixeira et al., 2021). A barrier to youth participation in research is adultism, which is “a lack of pro-child social norms that includes negative attitudes about youth, laws that delegitimize youth, and youth internalizing these negative beliefs” (Teixeira et al., 2021, p. 143). Indeed, what is considered healthy youth development has been defined by adult “experts” rather than by, or in collaboration with, youth themselves (Langhout & Thomas, 2010; Teixeira et al., 2021). Adultism can be combatted by identifying youth in research in a manner that gives them agency and respects their ability to contribute (Teixeira et al., 2021), rather than limiting them to their age or lack of experience (Bettencourt, 2018). Existing youth community-based participatory research which provides youth with a leading role in the research process has found that partnering with youth can enhance the success and sustainability of adolescent health interventions (Merves et al., 2015).
Challenges impacting art-making
As mentioned, the primary factors which impeded art-making included lack of time and poor student behaviour. Indeed, in this study, time was a major constraint. As the weeks went on, observational data showed that some students would rush through activities because they feared they would lack sufficient time to complete their creation. This led them to put lesser effort into the activities. Additionally, these students would typically begin their homework after the artistic activities and some felt particularly anxious about having enough time to complete their homework. Indeed, anxiety surrounding students’ homework appears to have negatively impacted participation in the intervention. Noteworthy, this did not necessarily translate into them disliking the intervention. Considering that those who attend this after-school program are those who face the most difficulty, be it in their family lives and/or academically, it was interesting to see that many students wanted to hurry through the activities so that they could do homework; an activity in which most young students dislike and avoid. Although this could be interpreted as rushing through the art activities, we argue that this behaviour was in fact rushing to homework. The reason for this stance being that students are guaranteed help with their homework at this after-school program, and they may not receive the same support at home. Another possible explanation is that students may have wanted to complete their homework so that they no longer had to stress about doing it. Holland et al. (2021), who investigated the non-academic impact of homework for youth in grades 3–6, found that increasing academic demands is correlated with various challenges for youth, such as worsened well-being, sleep, emotional health, and parent/child relationships. Although art-based interventions with youth have often been administered in academic settings (e.g., Forrest-Bank et al., 2016; Sutherland et al., 2010; Malboeuf-Hurtubise et al., 2021), perhaps a different setting where students are removed from academic pressures would improve student engagement.
By contrast to those who rushed, students who took their time and enjoyed the workshops felt as though they did not have enough time to complete each session. Our research team often had to hurry through describing each activity and its theme so that students could have enough time for art-making. However, this cohort of students were further impeded by those who did not wish to take part in the activity, or who chose to rush through it, as they were particularly disruptive during sessions. Overall, approximately ten minutes of every twenty-five minute session was dedicated towards settling the group down so that we could conduct the activity. Generally, art-based interventions with youth are no shorter than forty-five minutes (e.g., Kim et al., 2022; Boaz & Bat-Or, 2022; Malboeuf-Hurtubise et al., 2021), further solidifying the challenge posed by limited time in this project. Nonetheless, the majority of participants, even with limited weekly time devoted to artistic creation, reported a positive impact on their well-being and mental health.
Student behaviour was arguably the most challenging aspect of this project, namely with regards to hyperactivity and impulsivity. Considering the context of our population, it is very possible that some had psychological disorders or were malnourished, although we did not compile this data in the current study. Indeed, students were provided with a healthy snack upon arrival to the after-school program to aid in mitigating potential malnourishment. Moreover, it is important to emphasize that these sessions took place directly after a full day of school, where students had been required to give their complete attention for hours on end. Naturally, it can be challenging to gain the attention of a large group of students, but this task can be exacerbated when they have just spent a full day at school.
Furthermore, some students expressed having difficulty determining what to create because they either lacked inspiration or felt embarrassed about participating in the activity. We attribute lacking inspiration partially to time restraints, as students were not given much time to consider what they wanted to create. However, embarrassment about art-making can likely be explained by the group dynamic between the students. Specifically, students tended to make fun of one another and joke around, making those who took the intervention seriously uncomfortable to describe their art with full transparency. This idea was supported through feedback received in individual interviews, where many students were much more vulnerable than they were with the group. Indeed, childhood bullying and victimization have negative implications on the mental health and well-being of youth (Hong et al., 2018). Research has also shown that programs should aim to both reduce bullying and improve connectedness to one’s school, as focusing on only risk or protective factors of youth well-being - and not both - may be ineffective (Dow-Fleisner et al., 2023). Moreover, Yan et al. (2019), who conducted art therapy with children in rural China, found that art therapy effectively reduced childrens’ vulnerability to bullying. Indeed, art-based interventions have been found to increase empathy and emotional awareness in middle and high school students (Morizio et al., 2021). As such, future art-based interventions should aim to create a positive, supportive environment amongst students by including themes such as mutual respect, anti-bullying, and empathy.
Future directions
Considering the feedback students provided and the challenges that emerged during this work, future research should further investigate the importance of the therapeutic alliance in youth community- and art-based participatory research, particularly how the age of the facilitator can enhance rapport. Moreover, future works should aim to investigate the effectiveness of varying artistic mediums versus varying the theme of the creation, as our participants’ perceptions of the activities were typically determined by the activity’s medium, rather than theme. Interestingly, many students’ least favourite activity was also the one they were most proud of. Further research is needed to understand how art-based interventions, although sometimes unenjoyable, can have positive implications through pushing personal limits. Despite the time constraints we faced, future art-based research amongst youth populations should aim to ensure students’ understanding of the activities and allow for suitable time, at least forty-five minutes, for art-making. Future interventions should also address both risk and protective factors of youth well-being, as previous research demonstrates that the atmosphere during art-making can have an impact on the intervention outcomes.