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Background: North Carolina has a growing refugee population from Burma, with an estimated 400 Burmese families living in Orange County alone. For refugee youth, coping with past hardship, immigration, and acculturation often leads to excessive stress and increased risk of mental health disorders. The Art Therapy Institute (ATI) implements an innovative, school-based art therapy program for refugee youth from Burma in Chapel Hill-Carrboro City Schools. This program, known as the Burma Art Therapy Project (BATP), uses art therapy to facilitate self-expression and alleviate mental health symptoms through non-verbal communication methods. During the 2013-2014 academic year, a team of students from the UNC Gillings School of Global Public Health worked with ATI to evaluate BATP and increase organizational capacity through the creation of a user guide, submission of a grant proposal, and subsequent dissemination of evaluation results. Through this work, the Capstone team aimed to fill gaps in the literature regarding art therapy, to improve ATI's capacity to attract funding, and to ensure sustainability of the BATP program. Methods: To scale-up the evaluation, we modified and added to the data collection protocol created by the previous Capstone team. We created an evaluation user guide and data management system and trained clinicians on data collection protocols. BATP clients were assessed at baseline and follow up after four months of art therapy sessions to measure impact of art therapy on mental health indicators. During the evaluation, assessments were collected, entered into the data management system, and analyzed. Findings were used to show impact and need and incorporated into a grant proposal, evaluation report, and presentation of findings. We wrote a manuscript to share lessons learned from the evaluation with broader academic community. Results: The evaluation demonstrated that refugee clients needed access to mental health services. ATI clients experienced many traumatic events in Burma, and had higher symptoms of anxiety and depression as compared to age-matched US populations. Following 12-16 weeks of art therapy, ATI client showed significant decreases in symptoms of anxiety. Throughout the evaluation process, we noticed that the assessments were not fully capturing the strengths and difficulties of ATI clients. These findings resulted in a manuscript that we intend to submit to the Journal of Health Promotion Practice. In addition, the grant proposal strengthened ATI's business model and created relationships with funders. Discussion: The results from the outcome evaluation are the first step toward building ATI's evidence base for the effectiveness of BATP and art therapy. The five deliverables produced each contribute uniquely to the sustainability of BATP and ATI. The user guide and data management system improved ATI's capacity to conduct program evaluation in years to come. The evaluation report documented need among ATI clients, and the grant proposal contributed to the financial sustainability of BATP. Lastly, the presentation of findings and manuscript contribute to the art therapy field as a whole by demonstrating the effectiveness of this therapy for refugee populations. In the future, we recommend that ATI utilize a mixed methods approach to fully capture the benefits of art therapy and further build evidence for the positive impacts of BATP. |
