The MATISSE Trial–A Critique

U.K. national guidelines for the treatment of schizophreniarecommend art therapy among other approaches. However, a recent major trial calledMATISSE (Multicenter evaluation of Art Therapy in Schizophrenia: Systematic Evaluation)suggests that art therapy may not be helpful. The purpose of the present study was toexplore reasons for the MATISSE trial findings. A critical review of the MATISSE trialdrawing on six papers reporting on the trial and its processes was performed. TheMATISSE trial appeared to have weak conceptualization of the mechanisms for change, lackof piloting, incomplete process and subgroup analyses, and inappropriate assumptionsabout the generalizability of findings. The MATISSE trial’s conclusion that art therapyis of no value to people with a diagnosis of schizophrenia is unwarranted. More accountshould be taken of extant quality guidelines for complex interventions, includingproposed change mechanisms, piloting, process analyses, variations in practice andcontexts, and the effect of randomization on generalizability