Where the art is

From mobile theatres to song, dance and multi-sensory experience
– Carol Lewis reports on the growing role of the arts and related
therapy in social care.

There have always been a few clowns in health and social
services, but today there are also purveyors of every type of
artistic skill – painting, sculpture, music, dance, drama, film,
radio and video.

The use of arts in health and social care is burgeoning. So much
so, that since its launch six months ago the National Network for
Arts in Health (NNAH) has signed up 350 members ranging from
government departments to local councils, from NHS consultants to
local artists.

Xanthe Phillips, information officer at the NNAH says: “It is
not just about arts in a healthcare setting, it is about writing,
theatre, sculpture, painting…it is about every different type of
art form being used with every different sector of the
community.”

One of the first to sign up for NNAH membership was the Isle of
Wight’s Healing Arts project. Artistic director Guy Eades enthuses:
“The use of art in healthcare settings and with healthcare users is
more popular than ever before. A wider cross-section of people
understand that art has a role to play in health and
well-being.”

Under the project, local artists bring art, music and literature
to in-patients, out-patients and community health users. Their work
often bridges health and social services. For instance, one new
scheme offers music sessions for young mothers from pregnancy to
the child’s first birthday.

Other initiatives include employing a musician to play together
with, and for, NHS staff and patients in hospitals and day centres,
sign language theatres for deaf people, poetry posters on wards and
creative writing workshops for those with mental health problems in
the community.

The NHS has used performance artists for several years, but this
has evolved rapidly in the past few years with groups such as Oily
Cart offering touring one-to-one theatres for children with
profound and multiple learning difficulties. Oily Cart is one of 24
organisations offering arts-based services to or by disabled people
as part of the Learning Disability Arts Network for London.
Waving, which is its current show, uses music, light,
aromatherapy and massage to stimulate the children in and around a
hydrotherapy pool.

Another of the network’s star projects is south London’s
Entelechy Arts which works with older people, people with learning
difficulties, and people in institutions.

Director of Entelechy David Slater says: “Arts projects enable
people who have been excluded and marginalised for most of their
lives to become recognised, respected and valued members of their
communities.

“It is about helping people to make choices and explore new
possibilities, using a person-centred approach. The work is about
membership, and inclusion, recognition, respect and equality.”

Entelechy schemes include “ambient jam sessions” where people
with complex disabilities, musicians, dancers, visual artists,
residential support staff, physiotherapists, and arts students
spend time together.

Slater explains: “It is a multi-sensory experience: the smell of
fresh mint, projections of light, the improvised music of old fire
alarms (apparently often mistaken for Tibetan bells) fragments of
song, improvised dance, video clips, walls covered in fresh thyme.
People moving, singing, listening, improvising with movement and
dance.”

Julia Honess, Entelechy’s older people programme co-ordinator,
helps run an event called Beyond the Tea Dance, in which older
people from different communities, and those with learning
difficulties, take part in a weekly programme of arts activities
and large-scale multi-media theatre events.

Honess says: “The work gives a context and a starting point for
people from similar generations who have had very different
journeys and life stories to have the opportunity to share their
experiences and recognise the experiences of others, bringing
together the stories and experiences of people whose paths may not
normally cross. The work provides new opportunities for older
people to explore totally new territories and experiences.”

She cites the examples of two 84-year-olds visiting a recording
studio to record their stories to be used as part of a performance
and another older woman working with a computer artist to produce a
CD-Rom of her story.

Entelechy also runs annual training programmes for artists,
social workers and health workers. The Between Two Worlds programme
aims to show 20 professionals each year how different techniques
and skills can be used and the local possibilities and
opportunities available.

Coventry is one social services department that is well aware of
the opportunities and possibilities for the use of arts in social
care. It is one of the few social services departments in the
country to employ a full-time art therapist. She is Camilla Hall,
and she offers a city-wide service for adults with mental
health-related problems. She runs group sessions for self-harmers,
women with eating disorders and men with relationship problems. She
also takes individual referrals from social and health workers.

Hall describes her work as “psychotherapy with the capacity to
make images”. She uses paint, sculpture and collage techniques to
help clients “say things that they cannot put into words”. The aim
is not to produce high art but to use the materials at hand to
express yourself.

Coventry social services have developed a highly specific
operational policy which lists those who can benefit from referral
to the art therapist and those who cannot. Those who can include
people who have communication problems, who are unable to come to
terms with a particular life event, and, naturally, those who have
a willingness to use art materials.

Hall says that employment of art therapists by social services
is a “growing area,” although the majority of the UK’s 800 or so
art therapists are employed by the NHS or work on a freelance basis
in the charity, community, education, or health care settings.

Hall recently led a series of eight two-hour weekly evening
workshops for social services staff partly as a team-building
exercise and partly as a way of showing them the opportunities. It
was, however, one of her best sessions. Although she gained few new
referrals, the social workers found they really valued the
opportunity to unwind and discuss how clients made them feel by
using art.

Across the UK, art therapists are using traditional art, drama,
dance and music to help a broad range of people. Caryl Sibbett, an
art therapist in Northern Ireland, has just started a new session
for children who have suffered trauma and bereavement as a
consequence of the conflict there.

In short, art therapy can benefit everyone and anyone. As
Sibbett says: “Those who want to maintain or restore well-being,
not just those with a problem as such.”

The problem for all these projects, from the hospital ward mural
to curvaceous sculptures of a teenage bulimic, is not, as you might
expect, funding. Funding is currently flowing from a very diverse
range of sources: the NHS, social services, borough councils,
charities, businesses, the arts councils, regional arts boards, to
name just a few.

No, the problem is to keep it flowing. The projects will need to
justify the cash. In a system where schemes must increasingly show
measurable benefits, anecdotal evidence is not going to suffice.
Someone somewhere is going to want some figures. And although there
has been some research to date, there is not a substantial body of
evidence.

For art therapists, a profession registered with the Council for
Professions Supplementary to Medicine, this is inevitable. Hall
says she sees evidence-based art therapy as a “priority” and she is
already using “core evaluation systems, to measure both qualitively
and quantitively, indicators such as social functioning, depression
ratings and self expression to demonstrate the importance of art
therapy.”

For arts projects in health and social care a new research body
has been established especially to answer these questions: the
University of Durham’s Centre for the Arts and Humanities in Health
and Medicine.

According to Chris Smith, secretary of state for culture, media
and sport, who spoke at a recent conference on art in healthcare in
Strasbourg, France: “[the centre] has engaged on a programme of
research that will help to underpin the case for the arts in
health”.

He continued: “Many remain to be convinced, and will continue to
deploy misguided arguments about there being a stark choice between
funding arts projects and providing say, coronary and cancer care.
We must make a clear argument based on good research in order to
convince them.”

For more information contact NNAH. Tel: 020 7247 6015; e-mail:
info@nnah.org.uk; web: www.nnah.org.uk

Fred’s story

Fred had lived in Darenth Park Hospital in Kent for 60 years
before he was moved back to Southwark in south London when the
hospital closed in the mid-1980s.

Entelechy supported Fred and two other former residents to make
a radio play with a group of older people and children from the
neighbourhood where he used to live as a boy. The project was
designed to enable older people [those with disabilities who had
been sent to the institution and those without who had remained in
the community] to share experiences of childhood with a group of
young people from a local music project.

In the beginning Fred and his friends were very uncertain about
being with new company. They were quite old and rather frail. The
other older people were a little awkward and uncertain about how to
make connections socially with the men who had very different
stories and experiences.

As the group started meeting for coffee every week the group’s
imaginations moved through streets that have now been bulldozed.
Remembered names, objects, occupations and everyday tasks unlocked
individual memories and experiences.

Fred almost became the boy he once was, remembering the errands
he used to run for the blacksmith. He became a respected and valued
member of the group. His speech was difficult to understand but
among his childhood peers the briefest utterance, prompted by his
part of the collective memory, was fully understood.