Dance Movement Psychotherapy for the Wellbeing of Children on the Autism Spectrum and their Caregivers: A Mixed-Methods Study

Student thesis: Doctoral Thesis

Abstract

Children with Autism spectrum disorder (ASD) and their caregivers can find sustaining their wellbeing to be highly demanding. Dance Movement Psychotherapy (DMP), with a holistic and non-verbal character, may present as a relevant intervention option for this group of children and their caregivers. This doctoral research study aimed to explore the contributions of DMP towards the wellbeing of children with ASD and their caregivers. The study was conducted in two phases using a mixed-methods approach. Phase I involved a systematic review of the available literature to identify, evaluate, and synthesise the outcomes of DMP towards the wellbeing of children with ASD. The findings of the review identified the potential of DMP to promote the wellbeing of children with ASD and highlighted the lack of evidence for its effectiveness and clarity on the therapeutic process. Phase I also involved the development of two DMP intervention protocols for children and caregivers based on the key findings of the systematic review along with theoretical foundations and clinical experiences of the therapist, supervisor and researcher. These protocols were piloted in Phase II of the study which investigated the effects of DMP on the emotional and social wellbeing of children with ASD and their caregivers using a randomised and controlled crossover convergent mixed-methods design. Fidelity assessments were also conducted that showed 75% and above adherence to each criterion, good agreement among the three raters (researcher, therapist and an external expert) and reflected that the protocols were implemented across groups consistently. Twenty-six children with ASD and thirty-seven caregivers participated in the study. Quantitative data were collected before and after DMP while the qualitative and arts-based data were collected during the intervention using a battery of methods. Social Communication Questionnaire (SCQ) and Strengths and Difficulties Questionnaire (SDQ) for children with ASD have shown statistical and clinical significant improvements in the wellbeing measures irrespective of their mode of communication. The qualitative strand for children described multi-layered and complex processes. Three main themes with 18 sub-themes were identified through the thematic analysis of qualitative data including a) individual transformation process; b) group transformation process; c) overall process and outcomes of DMP. A dance piece was created through the artistic inquiry process that identified six key moments of change during DMP sessions with children. Similarly, for caregivers both outcome measures used i.e. Parenting Stress Index-Short Form (PSI-SF) and Adult Wellbeing Scale (AWS) indicated clinically significant improvement after DMP and a statistically significant impact on post-intervention scores for AWS but not for PSI-SF. In addition, a significant association was found between pre-intervention scores, number of sessions attended with the post-intervention scores of both AWS and PSI-SF. Their engagement in the therapeutic intervention was significantly related to the post-intervention measures. The qualitative findings from caregivers involved six main themes and twenty sub-themes which revealed that participants experienced some helpful and unhelpful factors such as (beholding within and around; reflecting and reinforcing strengths; exchanging views; looking back and carrying forward; core benefits; challenges to engage in DMP) that influenced the process and outcomes of DMP. Four key moments of change were noticed through the artistic inquiry process which were woven into a dance piece. Due to many dropouts from the intervention groups of caregivers, a bidirectional association between wellbeing of children and caregivers was not explored through statistical analysis. Instead, two exploratory case vignettes were presented which highlighted the potential bidirectional influence of experiences of wellbeing. The limitations and appropriateness of the research methods implemented in this study for their use in a large RCT are discussed. Overall, the findings highlight the value of DMP for improving the lives of young vulnerable groups and their caregivers.

Date of Award14 Dec 2020
Original languageEnglish
Awarding Institution
  • Edge Hill University
SupervisorVicky Karkou (Director of Studies), JOANNE GREIG (Supervisor) & STERGIOS MAKRIS (Supervisor)

Keywords

  • Autism Spectrum Disorder
  • Dance Movement Psychotherapy
  • Pilot intervention study
  • Crossover design
  • Mixed-methods
  • Caregivers
  • Wellbeing

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