Perceived effects of art therapy in the treatment of personality disorders, cluster B/C: A qualitative study

•We constructed a theoretical model of perceived effects of AT by patients with PD.•Interviews with patients were analysed according to Grounded Theory Approach.•Patients with PD experienced improved sensory perception, more personal integration, emotion regulation, insight and behaviour change.•The added value of AT came forward as a direct way to access emotions and to more constructive emotion regulation. Art therapy (AT) is frequently used in the treatment of patients diagnosed with cluster B/C personality disorders, but there is little evidence for its efficacy. This study aimed to provide insight into the perceived effects of AT. We interviewed 29 adult patients in individual and focus-group in-depth interviews, including a ‘negative case’, starting with a topic list coming from the literature study. Data were gathered and analysed using the Grounded Theory Approach in order to generate concepts and interrelated categories. The constructed theoretical model of effects of AT consisted of five core categories: improved sensory perception; personal integration; improved emotion/impulse regulation; behaviour change; and insight/comprehension. Compared to verbal therapy (VT), patients experienced AT as an experiential therapeutic entry with a complementary quality next to VT and a more direct way to access emotions, which they attributed to the appeal of art materials and art making to bodily sensations and emotional responses. AT was found to fit well the core problems of patients with personality disorders, to offer a specific pathway to more emotional awareness and constructive emotion regulation. The perceived effects give input for further development and research and the development of an assessment tool to examine the efficacy of AT and within clinical practice.