The MATISSE Trial–A Critique

U.K. national guidelines for the treatment of schizophrenia recommend art therapy among other approaches. However, a recent major trial called MATISSE (Multicenter evaluation of Art Therapy in Schizophrenia: Systematic Evaluation) suggests that art therapy may not be helpful. The purpose of the present study was to explore reasons for the MATISSE trial findings. A critical review of the MATISSE trial drawing on six papers reporting on the trial and its processes was performed. The MATISSE trial appeared to have weak conceptualization of the mechanisms for change, lack of piloting, incomplete process and subgroup analyses, and inappropriate assumptions about the generalizability of findings. The MATISSE trial’s conclusion that art therapy is of no value to people with a diagnosis of schizophrenia is unwarranted. More account should be taken of extant quality guidelines for complex interventions, including proposed change mechanisms, piloting, process analyses, variations in practice and contexts, and the effect of randomization on generalizability.