As part of Creativity & Wellbeing Week 2020: Positive Futures (18-24 May) the BSG Creative Ageing SIG are posting some reflections on the role of the arts during Covid-19.

Our first blog comes from Vicky Guise (Arts Therapies Representative) – Vicky is a Music Therapist, but provides reflections from a range of perspectives.

Background

Within the UK, Arts Therapies is an umbrella term often used to encompass Music, Art, Dance and Drama Therapies. An Arts Therapist is trained to Masters level within their own therapeutic speciality and is considered a health care professional who is required to register with the Health and Care Professions Council (HCPC).

Arts Therapies & Covid-19

The Coronavirus outbreak has placed us all, including therapists, in the midst of unchartered territories. Arts Therapists support some of the most vulnerable and potentially isolated groups in society, including older people living in the community, in care homes and in hospitals. Due to the outbreak and lock down measures currently in place throughout the UK, the work of Arts Therapists in particular has changed dramatically. In general, face-to-face work has been paused and the impact of quarantine, isolation, trauma and grief has become key areas for therapists to consider when working with older adults.

As a Music Therapist, it has been inspiring to see and be a part of the Arts Therapies community as they work together to adapt and develop new, creative ways to maintain the therapeutic connection with older clients during this difficult time. This blog aims to provide a small insight into some of this work following discussions with therapists from all artistic disciplines. 

Much of the work of Arts Therapists, including that with older adults, has moved to online or telephone formats. The Arts Therapies have had to modify how they deliver services, as well as consider  how this change in format may impact  the client experience.

Music Therapy

Within Music Therapy, training in online working has been provided by organisations including Chiltern Music Therapy and North London Music Therapy, where various potential methods of continuing to connect therapeutically using these remote methods could be explored and discussed. This has helped therapists to develop their skills and increase confidence, while creatively adapting their sessions in order to maintain connections with clients. One such example is the project Together in Sound (Anglia Ruskin University, 2020). Developed as a collaboration between the Saffron Hall Trust and the Cambridge Institute for Music Therapy Research at Anglia Ruskin University, the project brings music therapy to those living with dementia and their carer. Following the groups move to online sessions, Claire Molineux, the session leader, stated that 

“It was incredibly heart-warming and encouraging to witness our Together in Sound participants access the online music therapy sessions. At these difficult and uncertain times, it feels imperative to try and find a way to enable connection, provide stimulation and a sense of community”. 

“It was very moving to observe participants recognise, engage with each other, and respond to the various musical interactions we offered via their screens. This continuation of the bonds they have made with each other in the music therapy sessions is vital in the face of the increased isolation that COVID-19 has brought.” (Anglia Ruskin University, 2020). 

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Another project that has adapted to remote methods of working is the Silver Singers, run by Chiltern Music Therapy. This therapeutic choir for older adults includes a number of members who are isolated alone and with no access to online resources. The therapist has described how she has been in contact with these members to provide song sessions by phone, which has ensured that we are staying connected and in touch and making sure that [the choir members] are not forgotten during this time. It also has provided a space to talk and voice what they are going through

In some cases, particularly in care homes, it has proven difficult if not impossible to move to remote service delivery. The decision to postpone therapies may be made when having a therapist appear virtually (rather than in person) may be more disorientating than beneficial. This is particularly relevant for those individuals living with later stage dementia. In these cases, a number of Art and Drama Therapists have described how they have sent resources to care homes and have educated care staff on how to engage with clients in therapeutic activity, with support provided by telephone when necessary.

Drama & Art Therapy

Roundabout Drama Therapy, based in Surrey, have described how they have continued to maintain a connection with their clients based in care homes using these approaches. They have initially been “sending out weekly letters and postcards” with the aim of sending out a package to each client containing items and pictures that we know will have meaning for them and or might interest them” in time.

One group of Arts Therapists whose work has particularly changed are those employed by  the NHS. Many Therapists have been redeployed to offer support to different professionals or departments during the outbreak, where their therapeutic and creative skills have been able to offer support at particularly challenging times. For example, Louise Combes described online (@Louisecombes) how Drama Therapists re-deployed to ICU’s within NHS settings were creating memory boxes for families of patients who had unfortunately passed away from Coronavirus, including older adults. These are based on 4Louis boxes (4louis, 2020) which are created for families that experience a miscarriage or still birth, and include objects to support families in reminiscence and discussions of their lost family member. Boxes made to remember those lost to COVID-19 include a letter from the staff member who cared for the patient. At a time where visiting is restricted, this can provide a huge comfort to families who have lost loved ones.

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Other Arts Therapists of all specialities are adapting and continuing to work in some capacity within their usual bases in NHS hospitals, particularly in wards for older adults. A number of therapists have highlighted how the necessary use of Personal Protective Equipment (PPE) has changed the development of a therapeutic connection. One therapist described how this has led to them halting one-to-one therapy sessions on the ward, as it was felt that the use of PPE was negatively impacting the development of the therapeutic relationship vital to the process of therapy. A number of patients, particularly those living with dementia, have appeared to have found the changed appearance of staff in PPE distressing . These potential impacts and responses to the use of protective equipment is an area that has been particularly highlighted to be important to the continuation of individual work in this setting. 

Each of these projects and individual examples serve to highlight the creativity and resourcefulness that Arts Therapists have utilised to adapt and develop new ways of supporting older adults during the pandemic. Although this may lead to a discussion around whether all of these interventions could be described as ‘Arts Therapy’ in its traditional sense, I believe that in this moment we, as therapists, need to be working alongside our clients to provide the best support possible as we navigate through this time together. By still ‘being with’ and, in the words of Donald Winnicott (1973), providing a ‘good enough’ therapeutic experience, we are ensuring that our older adult clients feel heard, understood, and most importantly, connected.

Thank you to Vicky for sharing these insights from Arts Therapies in the UK. Find out more from the various associations here:

British Association of Art Therapists (BAAT)

British Association of Dramatherapists

British Association for Music Therapy

Association for Dance Movement Psychotherapy UK (ADMP UK)


References

4Louis (2020) 4Louis – Supporting families through miscarriage, still birth and loss. Available at https://4louis.co.uk/memory-boxes

Anglia Ruskin University (2020) Couples with dementia are still Together in Sound.  Available at https://aru.ac.uk/news/couples-with-dementia-are-still-together-in-sound

Winnicott, D (1973), ‘The Child, The Family and the Outside World’, London: Penguin. 


Thanks to our Blog Editor Kate for editing this blog.

Stay safe, well & creative – Emily BSG Creative Ageing SIG Founder & Chair

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THIS VIBRANT COMMUNITY OF INTEREST IS CROSS-DISCIPLINARY, INTERNATIONAL, AND GROWING IN STATURE, AS A RAPIDLY EVOLVING EVIDENCE-BASE DEMONSTRATES THE POTENTIAL FOR CREATIVITY TO CONTRIBUTE WIDELY WITHIN THE LIVES OF INDIVIDUALS AND COMMUNITIES.

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