Explainer – Mixed methods research and creative arts therapies

Caryn Griffin

Underpinning any research endeavour is a question. Questions can arrive in all different ways – spontaneously, through the answering of a different question, or through an intrinsic desire to understand what is not yet known. Once a gnawing question arises, researchers must consider how it can best be explored or answered. The tools that help to get us there are our research methods – which can broadly be classified as  qualitative (including though not limited to arts-based forms of inquiry, investigation into lived experience, open-ended questions, interviews and focus groups) or quantitative (think numerical forms of data – including psychometric assessment tools, scales and closed question surveys that can be statistically analysed to offer pre- and post- comparisons).

Creative arts therapists have historically been more comfortable with qualitative approaches (Kapitan, 2018), and this mode of inquiry has been essential for our field to generate knowledge, include diverse perspectives and open up further avenues for inquiry. While quantitative methods are certainly gaining traction within the field, this approach has been criticised due to the reduction of human experience to a box ticking exercise on a survey (Gilroy, 2006). For many, this does not align with the values and person-centred nature of our profession, despite being favoured by dominant healthcare paradigms that govern clinical settings where many creative arts therapists practice (Liamputtong et al., 2017). Fortunately, our options as researchers are not limited to one or the other. Rather, we can mix methods, much like how a practitioner may be informed by many different theories, frameworks, and arts-based processes in practice. When considered this way, utilising ‘mixed methods’ in our research endeavours certainly aligns well with the diverse and multi-modal approaches currently being explored in creative arts therapy practice.

What are mixed methods?

A mixed methods approach allows for a combination of qualitative and quantitative data collection and analysis to be used simultaneously to better understand a research question from multiple standpoints (Creswell & Clark, 2017). This provides flexibility to the researcher while also offering depth and understanding to the issue at hand. The underpinning philosophy behind mixed methods research is pragmatism, which seeks the most practical way to problem-solve a question (Newby, 2014). If that is through both qualitative and quantitative means, then so be it! This has many potential benefits for creative arts therapy researchers because it complements investigations of effectiveness with understandings of lived experience. Essentially, it is both “explanatory and exploratory” in its intentions (Kapitan, 2018, p.102) – meaning that it offers an explanation (quantitative) to the research question, while also allowing a deeper exploration (qualitative) of the issue, which often generates additional insights and knowledge.

What mixed methods can achieve – an example from a study

Using mixed methods in research can allow a deeper understanding of an issue by painting a bigger picture using multiple perspectives. For example, on the Mixed Method Explore page you will find a study by Watt et al. (2021) who set out to understand the benefits of group art therapy for psychiatric outpatients. The quantitative component allowed for pre- and post- comparisons of behavioural changes, therapeutic alliance and flow states to better understand whether art therapy had demonstrated any recordable changes to wellbeing. This was performed using closed questions on a survey that could be directly measured and calculated for answers. Meanwhile the qualitative component allowed for the participants’ voices to emerge through open-ended questions (i.e. what was important to you?) to better understand their overall experience of art therapy. While the initial research question of whether art therapy was ‘beneficial’ could be answered using recordable measures of well-being (quantitative), the qualitative questions allowed for the emergence of client voices to describe what well-being meant to them and how art therapy facilitated this. Often, qualitative questions also throw up surprising answers that may never had been considered by the researcher in the first place, which contributes to a wonderful sense of prioritising the voice of the participant – which is also central to therapeutic practice.

In addition to offering a richer understanding to the research question, the use of mixed methods in this study allowed for triangulation of results – where both the qualitative and quantitative evidence worked together to verify, reinforce or contrast each other (Mason, 2006). This can offer further legitimacy to the findings, while creating interesting and dynamic discussions and avenues to move forward. Clearly, the use of mixed methods in this example enhanced the way the research question was understood, and we can see why Kapitan (2018) suggested that mixed methods can “present the best of both worlds” (p.103).

How can I use mixed methods in my own research?

Utilising mixed methods requires knowledge about both qualitative and quantitative tools, and if you are unsure about one or the other, it is best to start small and remember that these don’t need to be treated equally in a study (Newby, 2014). Rather, the study can have a predominant mode of inquiry (i.e. qualitative) that is complemented by a smaller component, such as a quantitative survey. Just as in practice, research does not need to be a solo expedition, and connecting and collaborating with colleagues or running ideas by trusted minds can certainly support the building of resources and knowledge into the use of this approach.

A good starting point is to read through the papers and additional resources on the Mixed Method Explore page to get a sense of how other creative arts therapists have tackled mixed methods. Assessing your own research against a quality appraisal checklist is also a fantastic way to identify any areas for concern in the study design. The Mixed Methods Appraisal Tool (Hong et al., 2018) is excellent and freely available.

Summary

The use of a mixed methods approach is a growing area of interest in creative arts therapies research as it offers a powerful way to harness multiple perspectives to shed light on a topic. Researchers should not be daunted by the idea of incorporating mixed methods within their own investigation, as it offers an enriching experience to understanding an issue. Immersing yourself in mixed methods papers to learn how others have approached the task, and asking advice from a trusted friend or colleague who has knowledge in this approach will build confidence. Finally, go back to your research question and consider the best way to answer it – perhaps a multi-modal approach is just what you’ve been looking for.