Attitudinal barriers impacting adults with severe to profound multiple disabilities accessing creative arts therapy services: a critical interpretive synthesis using the International Classification of Functioning.

Miss Victoria Churchill1, Dr Grace Thompson1

1The University Of Melbourne, Melbourne, Australia

This research uniquely examines the presence and effect of ICF Environmental Factors on adults with severe to profound multiple disabilities as described in creative arts therapies literature.  It makes important contributions to knowledge by identifying substantial ‘Attitudinal Barriers‘ impacting service users, providers, and provision of services, that transcend the therapeutic setting in ways suggestive of wider systemic issues.

A critical interpretive synthesis of literature was conducted (Dixon-Woods et al., 2006; McFerran et al., 2017), with research questions focused on the identification of ICF Environmental Factors and their influence in creative arts therapies group work with adults with severe to profound multiple disabilities.  Nine sources were selected from a comprehensive search using systematic review processes and citation pearl growing.  Data was extracted and thematically analysed (Braun & Clarke, 2006), using the ICF Environmental Factors as a critical lens.

Key findings identify considerable ‘Attitudinal Barriers’ regarding the perception of adults with severe to profound multiple disabilities and their involvement in creative arts therapies.  These barriers arose from both therapists and support staff.  Provision of therapy and other services were also negatively impacted by ‘Services, Systems, and Policies’.

This research is significant in its identification of ‘Attitudinal Barriers’ within creative arts therapies that are reflective of wider systemic issues.  These issues, including the dehumanisation and violation of rights of adults with severe to profound multiple disabilities, show an urgent need for change in how we collectively view and collaboratively offer services to these people.   It is anticipated this research will fuel such discourse.


Victoria is a PhD Researcher at The University of Melbourne Creative Arts and Music Therapy Research Unit, and has over ten years experience as a Support Worker and Registered Music Therapist. She is particularly passionate about working with adults with complex and multiple disability of a severe to profound level.

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