Using the Creative Arts in Therapy and Healthcare

A Practical Introduction

Bernie Warren

• Publisher: Routledge
• Year: 2008
• eBook ISBN: 9781134139262
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Using the Creative Arts in Therapy and Healthcare provides a practical introduction to the uses of arts and other creative processes to promote health and encourage healing.

This latest edition includes newly edited chapters from the original and second edition covering the therapeutic use of dance, drama, folklore and ritual, story telling and the visual arts. Information on guidelines, preparations and practical hints for leaders and facilitators has also been updated. New chapters provide an international perspective in the field of the arts and healthcare, and show how the artist can alleviate distress for patients through art, music and drama.

Illustrated throughout with ideas and examples of how the arts can be used in a range of healthcare settings, this book will be essential reading for creative arts therapists and healthcare professionals throughout the world.

Chapter 1
Looking backwards, looking forwards

A preface and introduction to using the creative arts in therapy and healthcare

Bernie Warren

What follows is a personal retrospective in which I briefly look back at the first two editions of this book, try to place them in context and introduce the changes in this new edition.

The more the world changes

This book was first conceived over 25 years ago. In 1982 when I was first approached by Tim Hardwick to write this book the world was a very different place. The United Nations International Year of the Disabled Person had just finished. I had just completed my work with the LUDUS Dance-in-Education company’s Special School Project ‘Learning Through Dance’ and had recently moved to Canada to begin what has turned out to be my career as an academic.

So much has happened since then. There have been incredible discoveries in technology and medicine that have positively affected people’s lives. At the same time, the events of 11 September 2001 and its aftermath have changed the world immeasurably. Moreover, if all leading experts are to be believed we seem to be facing potential ecological disasters of incomprehensible proportions.

Yet while the world may have become a scarier place, the arts not only continue to exist but also, with the advent of new technologies and media, continue to evolve. Throughout all the many changes to the world and our place within it, the arts in all their forms (visual, performing, electronic, written, mixed media) remain expressions of personal vision and belief, ways of conveying emotion and thought.

Expanding human horizons

The focus of the first editions

When this book was first considered, it was against a backdrop where, for the first time, persons with a disability were seen as human beings who should be empowered, enabled and encouraged to express themselves creatively. The subtitle for the original book, ‘The Power of the Arts Experience to Expand Human Horizons’, in part reflected this.

The goal of the first edition was to provide a practical introduction to the use of the arts not as therapy or treatment but rather as a way of expressing each individual’s humanity. Most particularly it was focused on working with persons with a disability to help them find a creative voice and to use it to express themselves. In 1984 I wrote the following:

We have created the concept that artistic creation is the responsibility of a few gifted individuals. In so doing, we have denied the majority of individuals within our urban and technologically advanced society their birthrights: that, as a human being, everyone has the right to make his or her own ‘unique creative thumbprint’¹ – one that no one else could make. We all have a need to make this ‘mark’, not because we necessarily wish to be the reminders to a future generation of a long-lost culture but because each creative mark reaffirms the self. It says ‘I am here’, ‘I have something to express.’

(p. 4)

In the 1993 edition I elaborated on this point:

In using the creative arts in health care, rehabilitation and special education settings, and seeing the resulting growth in self-image, self-esteem and healthy social interactions, society as a whole is being handed a mirror concerning what is possible for all its members if only they are given the opportunity…. Slowly people are becoming aware of their creative potential, their need to make their mark. As a result more and more individuals, who because of birth, crisis or accident had previously been denied their rights as ‘full members’ of their society, are finally gaining access to the arts. The results, in some cases, are quite staggering. Individuals, previously seen as useless, incapacitated or catatonic, have begun to speak, move more freely and in some cases, over a time, take a full and active part in society.

(p. 4)

In 1983 when I began writing the first edition, there was no internet. When I was writing the revised edition, the world wide web was only just beginning. Now in 2007, it is possible for anyone to place their personal blogs, videos and music on the web enabling them to share their thoughts and creativity instantly with anyone who wishes to hear. Some may still question the ‘quality’ of these transmissions. Nevertheless the ability to make this mark certainly provides the opportunity for individuals to reaffirm themselves.

‘You say potato, I say …’

A few words about ‘arts for health’ and ‘arts therapy’

From the beginning I actively fought against using the word ‘therapy’ in the title of the book—a battle which I lost. In 1993 I put my disagreement with the notion of the arts being used as therapy with persons with a disability into the Introduction:

As the workplace has become increasingly dehumanising and sterile (with fewer and fewer outlets for creative expression) it is not surprising that the arts have come to be seen as therapy. However, Therapy (which implies a prescribed course of treatment with predetermined expected results for a specific diagnosed condition) and the Art(s) (which at least in part suggests an exploration, one that usually finds the notion of predetermined expectation anathema) are strange bedfellows. Art is not a medicine that must be taken three times a day after meals. However, it can feed the soul, motivate an individual to want to recover and, in certain circumstances, cause physiological changes in the body.

(pp. 3–4)

These comments did not endear me to some arts therapists. However, it must be noted that I have always believed in the therapeutic power of the arts. What I took and continue to take issue with was the practice of calling any artistic experience or exploration therapy simply because the participants had disabilities. I did try to clarify this point by penning a working definition of ‘creative therapy’:

the use of the arts … and other creative processes to promote health and encourage healing. Implied in this working definition is the use of artistic and creative activities to help individuals accommodate to a specific disability; or recover from a specific medical or surgical procedure; or simply improve the quality of an individual’s life.

(p. 8)

However, in the revised edition I did also observe that there had been more opportunities for people to participate in arts activities, not because they necessarily wanted to be a professional dancer, painter or singer but because participating in the process made them feel good about themselves:

More and more people are becoming aware that being involved in the process of artistic creation is every bit as important as and in many cases more important than the end product…. The recent move towards ‘Arts for Health’ (which suggests the benefits of participation in creative activity) as distinct from arts therapy (which implies the treatment of a condition that produces ‘ill-health’) is a healthy and honest extension of these developments.

(p. xi)

Since the publication of the original book there have been huge developments in the fields of arts therapy and arts for health.² Over the past 25 years there has been a rise in the use of the arts therapies in healthcare and with it a concomitance to professionalism and organizations to promote it.³ Parallel to this there has been an upsurge in the role of the arts and artists in healthcare settings and organizations dedicated to their work.⁴

While some jurisdictions have clearly articulated their different scopes of practice (most notably in the UK),⁵ professional organizations representing these distant ‘cousins’ often still eye each other warily. Nevertheless, many professional artists and arts therapists not only work amicably shoulder to shoulder in the same healthcare structure, but are also members of organizations representing both approaches to the work.

Putting the arts into professionals’ practice

In 1984, I was hoping that the book would encourage professionals to incorporate arts activities into their practice. It was designed as a practical introduction to be accessible not just to trained artists and arts therapists but also for occupational therapists, nurses, psychologists, social workers and others working with persons with a disability or individuals who were in some way disadvantaged. Over the years I know that some professional arts therapists took issue with this. In part the problem can be attributed to the book’s title which still contained the word ‘therapy’. However, I wholeheartedly agree with their argument that therapists need to be trained in therapeutic procedures and should not be in the hands of untrained ‘amateurs’. It should nevertheless be noted that the book’s intended readership were already trained professionals. Nevertheless, in 1993 I did try to address what I felt were the therapists’ concerns:

It is important to realize that this book does not provide a panacea for all problems, nor will it make the reader an instant creative specialist. However, it will give an insight into some of the techniques, originating in the creative arts, that have proved beneficial in health care, rehabilitation and special education settings in aiding individuals to gain better understanding and control of their bodies and emotions. One outcome of this is that they are better able to explore their own ‘unique creative thumbprints’ within the fabric of their daily lives.

(p. xii)

However, it is important to remember that the arts do not stand in isolation and are most definitely not in themselves a cure for all ills. Nevertheless, in each individual’s act of creation, the arts engage the emotions and free the spirit. This can encourage individuals to do something because they want to and not just because someone else decides it is good for them. The arts can motivate in a way possibly no other force can. It is only through making a mark that no one else could make, that we express the individual spark of our own humanity.

(p. 4)

Changes to the second edition

While the world has changed markedly in the last 25 years, much of the material contained in the original and second editions remains relatively timeless. Included in this volume are edited chapters from the original and second editions of the book. Some such as Cheryl Neill’s chapter on storytelling (Chapter 9), my own on drama (Chapter 8), and Wende Welch’s chapter on masks and puppets in ensemble performance (Chapter 10) have only had superficial editing. The chapter on dance (Chapter 6) once again has been updated and revised.

Sadly, Yon’s sudden and unexpected death in July 2002 not only robbed the world of one of the most dynamic, innovative and interdisciplinary teachers of the arts, but also meant that he could not revise his own chapter on music (Chapter 7). I have tried my best to be true to the essence of my late friend’s work while streamlining his chapter.

Roberta Nadeau’s chapter on visual art (Chapter 5) has also been streamlined a little,⁶ while Rob Watling’s chapter on the significance of folklore and other traditional material has been added to and brought up to date by Veronica James to include reference to rituals within modern society (Chapter 4).

New chapters in the third edition

The chapters in the third section provide stories with an international perspective in the field of arts in healthcare that focus not so much on activities (the focus of the original book[s]) but rather on the area of developing programs in hospital and other healthcare settings.

Judy Rollins’ ‘Arts for children in hospitals: Helping to put the “art” back in medicine’, and Susan Pointe’s and Shirley Serviss’ ‘Friends’ art in healthcare program at the University of Alberta Hospital: Fostering a healing environment’ look at the ways in which artists can alleviate distress for patients in the hospital, regardless of their age.

My piece on ‘Healing laughter: The role and benefits of clown-doctors working in hospitals and healthcare’ takes a look at Fools for Health’s clown-doctor and familial clown programs and suggests ways that readers may develop similar programs even if they do not live in a large urban centre.

These themes are picked up in Magdalena Shamberger’s ‘Songlines: Developing innovativ...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• List of illustrations
• Notes on contributors
• Acknowledgements
• 1 Looking backwards, looking forwards: A preface and introduction to using the creative arts in therapy and healthcare
• 2 Guidelines, preparations and practical hints: A brief checklist for workshop leaders
• 3 Don’t forget to breathe and smile: Breathing exercises as warm-ups for art activities in healthcare settings
• 4 Folklore and ritual as a basis for creative therapy
• 5 Using the visual arts to expand personal creativity
• 6 Dance: Developing self-image and self-expression through movement
• 7 Expanding human potential through music
• 8 Drama: Using the imagination as a stepping stone for personal growth
• 9 Storymaking and storytelling: Weaving the fabric that creates our lives
• 10 Creating community: Ensemble performance using masks, puppets and theatre
• 11 Arts for children in hospitals: Helping to put the ‘art’ back in medicine
• 12 Friends’ arts in Healthcare Programs at the University of Alberta Hospital: Fostering a healing environment
• 13 Healing laughter: The role and benefits of clown-doctors working in hospitals and healthcare
• 14 Songlines: Developing innovative arts programmes for use with children who are visually impaired or brain injured
• 15 LaughterBoss: Introducing a new position in aged care
• Appendix: Resources