Art therapy for people diagnosed with schizophrenia: therapists' views about what changes, how and for whom

National guidance recommends that clinicians consider the offer of arts therapies including art therapy to people diagnosed with schizophrenia. However, because schizophrenia is a heterogeneous condition and this recommendation is based on population-level evidence, it may be difficult to meaninfully apply locally. Whilst art therapy is inexticably linked with 'psychosis' and received clinical support, those charged with implementing guidance, developing and delivering services need to know more about art therapy, specifically what changes, how and for whom. We used grounded theory methods to address these questions from the perspective of art therapists. The data demonstrates richness and diversity in practice and therapists' abiding belief in its inherent value; art therapy is 'good' for those who engage. We present therapists' understandings of schizophrenia, conceptualise therapy as occurring in the complex interaction of use of art materials, space, therapist and participant and propose mechanisms of action, understood as both unique and universal and potential 'outcomes'. Whilst therapists' dedication to their practice is apparent and the potential benefits of its non-medical system status cannot be ignored it seems that integration of art therapy within the specturm of care necessary to effectively support people diagnosed with schizophrenia will require clear articulation of theory and practice.