How can I support participants who experience difficult emotions?

As you will be dealing with potentially sensitive issues, it is possible that some participants may get upset or emotional during or after the workshop.
For this reason, it is helpful for there to be at least two people running the workshop, so that someone can be watching out for and dealing with any such responses. Ideally, at least one of the facilitators should have some training and/or experience of supporting individuals or groups with their mental health.
At the start of the workshop, make sure you take time to discuss and agree as a group on some ‘ground rules’. These might include an agreement to listen and respect each other, and not to force anyone to share their drawings if they do not wish to. It might be a good idea to have a box on each table into which people can place any drawings they do not want anyone to see.
Ask participants to decide what they would like to happen if any of them gets upset or emotional. One option might be to agree that in this situation the affected individual(s) will leave the room and take e.g. 5 minutes of ‘time out’, after which one of the facilitators will come and offer their support.
Please ensure that no participant leaves the workshop upset and that they all receive adequate contact information in case they are worried about their physical or mental health (e.g., General Practitioner, NHS, charities).

What are the theoretical ideas underlying DrawingOut?

DrawingOut is based on the following theoretical principles/assumptions:

  1. Disease and health experiences are shaped by social, cultural, economic, political and environmental factors. These factors can only be fully understood by adopting an approach that aims to capture how individuals within a particular context make sense of their experiences.
  2. The use of any art form at any point in the research process can contribute positively to the creation and dissemination of knowledge. In particular, it tends to be used to increase the representation of groups that are marginalized in mainstream science (such as ethnic and religious minorities) and to make findings/outputs available to the participants, the wider public and/or relevant stakeholders (e.g., health professionals, public bodies). In general, it allows for greater engagement with the research process and its outputs than more traditional methods.
  3. Drawings are an important way of overcoming linguistic barriers in communication. They make it easier to for vulnerable groups with lower levels of language proficiency to participate. They may also facilitate the communication of topics or experiences that cannot easily be expressed verbally, or that are sensitive or taboo and therefore hard to talk about. Drawing is an accessible art form because drawing materials are cheap and easily available, and most people have had at least some experience of drawing.
  4. People naturally use metaphors to convey their health and disease (or other) experiences. For example, they can talk about feeling depressed as ‘being down’ or ‘being in a dark place’, or about cancer as taking them on ‘a journey’. Inviting people to draw visual metaphors (pictures of concrete, visible things that express something invisible, like a though or a feeling) may help them avoid conventionalised verbal metaphors that can be simplistic and harmful (e.g., talk of ‘battling’ a disease may increase patients’ sense of guilt and failure). The visual metaphors people create also tend to represent their own cultural backgrounds and social contexts, as well as their own unique values and experiences, more accurately.
  5. DrawingOut is a form of participatory research. By involving people in research and focusing on obtaining ‘knowledge for action’, rather than just ‘knowledge for understanding’, one can better ensure that the interests and needs of participants are at the centre of the research process. . This is reinforced by the co-production of the outputs for dissemination.

Suggested reading:

Bleakley A (2017). Thinking with Metaphors in Medicine: The State of the Art. London and New York: Routledge.

Cornwall, A., & Jewkes, R. (1995). What is participatory research? Social Sciences & Medicine, 41(12), 1667-1676.

El Refaie, E., Payson, A., Bliesemann, B. G., & Gameiro, S. (2018). Pictorial and spatial metaphors in the drawings of a culturally diverse group of women with fertility problems. Visual Communication (Online first).

Gameiro, S., Bliesemann de Guevara, B., El Refaie, E., & Payson, A. (2018). DrawingOut – An innovative drawing workshop method to support the generation and dissemination of research findings. Plos One, 13(9), e0203197.

Guillemin, M. (2004). Understanding illness: Using drawings as a research method. Qualitative Health Research, 14(2).

Houts PS et al. (2006). The role of pictures in improving health communication: A review of research on attention, comprehension, recall and adherence. Patient Education and Counseling 61(2):173-90.

Knowles, G., & Cole, A. (2008). Handbook of the Arts in Social Science Research: Methods, issues and perspectives. Thousand Oaks, CA: Sage.

Can DrawingOut be used to run group drawing workshops about other topics?

On this website, DrawingOut is used specifically to enable people affected by socially invisible diseases (such as infertility, endometriosis, ME, cystic fibrosis, or diabetes) to share their experiences of living with their condition, so all the examples given here are about such diseases. However, DrawingOut can be adapted easily to other contexts and topics.
The only changes you may need to make relate to the following exercises:

  • Full-body self-portrait : instruct your participants to ‘ Draw yourself in a pose that best represents how you feel about [topic of the workshop]’
  • Using words: instruct your participants to ‘Add a speech or thought balloon to your self-portrait to express who you feel about [topic of the workshop]’
  • What if…: Here you will have to consider which word combinations to include in the table that best reflect the topic of your workshop (under the ‘if your’ column) and which visible things may be more useful for participants to express themselves (under the ‘was/were’ column).
  • Create a final piece: Instruct your participants to ‘Do a final drawing to express whatever you like about [topic of the workshop]’ and adapt the additional explanations an suggestions to be consistent with the new instruction.

DrawingOut is suitable for use with young people and adults, including individuals from a minority ethnic background or who do not speak fluent English.

Is the DrawingOut tool copyright protected?

The DrawingOut individual drawing exercises and group workshop tool are licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).

This means that the materials can be copied and redistributed in any medium or format, as long as they are not used for commercial purposes. Reasonable changes and adaptations are permitted, but you must indicate if changes were made.

If you distribute your adapted version, this must be done under the same license as the original.

If you use the Drawing Out materials as presented or with reasonable changes or adaptations beyond the confines of this website, please cite the DrawingOut website and Gameiro, S., Bliesemann de Guevara, B., El Refaie, E., & Payson, A. (2018). DrawingOut – An innovative drawing workshop method to support the generation and dissemination of research findings. Plos One 13(9), e0203197.

We would also be very grateful for your feedback, so that we can continue to develop the resource. Please complete our feedback forms.

How can I get feedback from the participants?

If you want to get feedback from your participants, you can, if you wish, use/adapt either of these two templates:
The basic feedback form has questions about participants’ experience during and after the workshop.
The emoticon feedback form uses emoticons to assess participants’ experience before, during and after the workshop.

Alternatively, at the end of the workshop you can invite oral feedback from participants (either individually or in small groups), or ask them to write their comments on post-it notes (e.g. green: positive; red: suggestions for improvement) and stick them on posters with one question at the top.

What copyright issues need to be considered?

If you want to use the drawings and reported experiences for educational or awareness-raising materials you should also make sure participants are aware that they will retain the copyright (intellectual property) for the drawings, and ask them if they will grant you a free-of-charge, non-exclusive, non-transferable and non-commercial license to use the drawings and commentaries for your specific purposes. It is also important that you inform participants they can withdraw their consent at any time and that you explain the mechanism to do so (e.g., by emailing you).

What ethical aspects need to be considered?

It is important to provide participants with as much information as possible about the aims and content of the workshop in advance, so that they can make an informed decision about whether to sign up or not. It is always worth stressing that no previous drawing experience or training is required, and that the emphasis will be on enjoyment and self-expression, rather than the creation of ‘good’ artwork.

As this is a group workshop, it is important to establish basic rules of conduct during the workshop. These are brief instructions to ensure that participants respect each other and their views, and that participants can choose not to share their drawings or views at any time without needing to justify their decision. It is also important to ask all participants not to discuss the comments of other participants after they have left the workshop and to respect the right of each participant to remain anonymous.

If you want to use some of the drawings and reported experiences for educational or awareness-raising materials, please make sure the participants give their informed consent. It must be clear that it is entirely up to individuals whether they wish to give consent or not, and that they can withdraw their consent at any time. Here is an example of an illustrated informed consent form that you can adapt for your own purposes.

Another aspect to consider is ensuring the anonymity of participants (unless they are happy to be named). At the minimum, this implies that the artwork cannot be signed, but it is also important to examine the drawings to ensure that there are no identifying elements that can be linked back to individual participants.


How can the artwork created in the workshop be used for education and awareness-raising?

The workshop participants’ drawings and verbal commentary can be used in different ways to support the educational and awareness-raising work of individuals and organisations. For example, they can form the basis of information booklets (see examples on the website), or to illustrate posters, websites, or blogs. All the drawings by one person could be presented together, or else the work by several people may be grouped under common themes. The drawings can be allowed to speak for themselves, or they can be linked to the verbal commentary that was collected during the workshop (or afterwards).

It is important that all participants whose work is used in any of these ways give their informed consent in advance (see ethics and copyright sections below). You may wish to invite the workshop participants to co-produce the materials with you. In any case, it is a good idea to show drafts of the materials to the participants before dissemination in order to avoid misrepresentations.

What drawing materials are needed to run a workshop?

You will need to provide plenty of white (A4 and/or A3) paper, as well as some basic drawing tools, such as (coloured) pencils and pens. Since the aim is to encourage participants to rediscover the joy of drawing that they will have experienced as young children, crayons and thick felt-tip pens may help them to loosen up and be less worried about how accomplished their drawings are.

For some of the tasks you will need to print at least one worksheet per participant (CircleSheet.pdf, available on the website). If you decide to not to use the DrawingOut PowerPoint (DrawingOut PowerPoint.ppt, available on the website), you may also need to print off some of the slides to illustrate the various drawing tasks.

For the final task of the workshop, you may also want to provide larger sheets of (A3) paper, as well as coloured (tissue) paper with different textures or patterns, newspapers, scissors and glue, in case people want to experiment with collage.

Make sure you have enough of everything so that you can split them across the different group tables.

What facilities are needed to run a workshop?

You will need a room where you can sit your participants in groups of between 3 and 6 people. Each group should be seated at a different table with enough space for each individual participant.

You will need to check if you need to make arrangements to cater for disabilities or other special requirements. It is possible to run the workshop without any IT equipment. However, if you decide to use the DrawingOut PowerPoint (DrawingOut PowerPoint.ppt, available on the website), you will need a computer, a projector, and a screen or white wall to project the presentation. If you want to record participants’ conversations about their artwork you will need audio recorders (ideally one per group, placed at the centre of each table). Make sure in advance that they are all functioning properly and that their batteries are fully charged.

How long does it take to prepare the workshop?

All the steps are described in detail and the materials are available from the “DrawingOut Invisible Diseases” website. So, the main preparation involved will be of a practical nature (inviting participants, finding a venue, organising refreshments, etc.). Facilitators may also wish to go through the drawing exercises themselves before the event, as this will give them a better idea of the potential challenges, as well as helping to plan the day with respect to timings.

How long does the workshop take?

The workshop is designed to take a full day, so e.g. from 9.30 to 17:00, but with a 1-hour lunch break and plenty of shorter breaks in-between. This will give participants enough time to get to know each other and enjoy the various activities, without feeling rushed. However, depending on the size of the group, the nature of the topic of the workshop, and the extent of participants’ previous drawing experience, it may make sense to either run the workshop over two or more days, or to spend less time on some of the warming-up exercises.

What skills do the facilitators need to have?

The workshop is designed to be delivered by anyone, and it does not require any particular training, experience, or even talent in drawing. However, some previous experience of running training workshops or group events would be an advantage. Workshop facilitators should try to be engaging, impartial, non-judgmental, and sensitive to the social and cultural needs of their group. It is also helpful to try not to influence participants’ responses by asking leading questions or giving more attention to some topics or individuals than others. Some participants will always be more willing to share their experiences than others; try to find ways of enabling everyone to contribute, but without forcing anyone to reveal more than they wish to. There are many useful websites that provide free information and advice about running workshops.

How many facilitators are needed to run a workshop?

For smaller groups, it is possible to run a DrawingOut workshop with only one facilitator, who will introduce the different drawing exercises and moderate the discussions. However, with larger groups and/or if you want to keep a record of participants’ views and make sure you remember which drawings they were talking about, it is useful to have at least one other facilitator present to take notes.

How many participants should there be per workshop?

This will depend partly on what you would like to achieve. Even two or three participants are likely to benefit from the opportunity to share their experiences, but if you work for a support organisation and wish to use the workshop to find out about how best to assist your members, you may want to have more participants. Having more than 12 participants per workshop may make it difficult to create a safe, mutually supportive atmosphere and ensure that everyone has the opportunity to share their experiences.

Why use DrawingOut?

DrawingOut workshops are designed specifically for use by support organisations, charities and educational institutions, for the purpose of support, research and advocacy. The advantages of this method are:

  1. The clearly structured drawing exercises create a relaxed and supportive atmosphere where people feel at ease and willing to share their experiences and views with each other, even if some of these may be painful or taboo.
  2. People who may lack verbal fluency, or whose first language is not English, are also able to participate in the workshop.
  3. The workshops are often able to reveal hidden aspects of people’s views and experiences, which in turn may help organisations develop new strategies and policies to better support their members.
  4. The artwork and reported experiences created during the workshops can be used to develop colourful and engaging educational materials or public awareness campaigns.