International Art Therapy Practice / Research Inaugural Conference Report - Day One: 11th July 2019
21 January 2020
The inaugural International Art Therapy Practice / Research Conference report on the conference’s Keynote sessions and Round Table discussions: Conference Day One - Thursday 11th July 2019
The inaugural International Art Therapy Practice / Research Conference was organised by BAAT in partnership with AATA (the American Art Therapy Association). It was attended by more than 700 delegates from over 35 countries around the world. Each day of the conference began with delegates coming together for a keynote session. Thereafter people could choose from a diverse programme of research and practice paper presentations, round table discussions, masterclasses, and workshops. The conference included a small exhibition of facsimiles of works from the Adamson Collection. The International Art Therapy Practice / Research Conference (IATPRC) is now set to become a biannual event. Report on the conference’s Keynote sessions and Round Table discussions by Simon Richardson with photos by Samantha Jayne Fawcett and Lex Bágust.
Conference Day One - Thursday 11 July
Welcome / Morning Keynote Session
Val Huet (CEO of BAAT) opened the session by inviting Professor Diane Waller OBE, Honorary BAAT President, and Christianne Strang PhD, President of AATA, to give the conference welcome to delegates.
Diane Waller began by talking about how east London (where Queen Mary University of London is situated) has changed over the past 25 years. Lots of creative industries had moved into or set up in the area - the 2012 Olympics were held in nearby Stratford - but this rapid pace of transformation has come at a cost to the local population. Established communities have been uprooted and there was still much social and economic inequality. Mental health services in the area, particularly for children, were few and far between; and these are the kind of services in which art therapists are often employed. Waller then looked at how art therapists ability to work together has helped to build the profession.
BAAT and AATA have been developing contacts over many years. ECArTE (European Consortium for Arts Therapies Education) has contributed to the exchange of ideas and experience between European arts therapists. This raised the question of how UK art therapists can support colleagues in other countries. Waller shared her experience of developing art therapy training, including in Bulgaria in the 1980s, and since then in several other Eastern and Western European countries. This has been a “massive learning experience”. She hoped the conference would help delegates forge links and gain a greater understanding of the realities practitioners face in different parts of the world.
Christianne Strang welcomed international delegates to the conference. She thanked BAAT for collaborating with AATA in organising and creating the conference, and echoed Diane Waller’s view that art therapists’ ability to work together has been a vital part of building the profession. The IATPRC offered the chance to learn from the research and experience of colleagues from around the world. AATA’s 50th anniversary on 26 June 2019 marked not only a time for the association to reaffirm its aims and objectives for art therapists in the USA, it also provided an opportunity to think about how AATA could work with and support art therapists around the world.
Tim Wright, Chair of BAAT, thanked Diane Waller and Christianne Strang and added BAAT’s welcome to delegates. Val Huet then briefly outlined the impetus behind the IATPRC, in particular the value of there not being a gap between practice and research. Research should challenge practitioners and take them to new places. She also talked about her pride at being part of the international art therapy community and commented on the commitment and compassion that was apparent in all the papers submitted to the IATPRC. With the welcomes concluded, the conference proceedings then opened.
Professor Lynn Kapitan
The Social Imperative in Art Therapy Research: Claiming Spaces, Transforming Narratives.
Dr. Lynn Kapitan introduced her talk on how art therapists can achieve their research obligations as relevant in addressing urgent social imperatives. This is made more challenging because we live in a polarised world full of inequality and oppression. While it can be tempting to sink into despair, Kapitan suggested art therapists should move towards supporting resilience and making art therapy more socially engaged. Her aim was for research to be grounded in social justice. This meant working with the awareness that our research, methods, and the knowledge we produce can potentially be oppressive as well as liberating. Research often takes us to the borders of experience and knowledge but, Kapitan suggested, this is as it should be. Research needs to be located in the ‘borderlands’ for it to develop and grow.
Knowledge, Kapitan continued, should be seen as a dynamic, ever-changing landscape of which we are a part. We can gain insight from the overlaps between what we currently know, what we are able to know, and what we need to know. She cited, as an example, the narrative that used to exist about autism based on assumptions that we no longer recognize as valid today. The treatments provided have improved and become less oppressive as the experiences of people on the autistic spectrum themselves have been heard and acknowledged. Research needs to hold in mind two types of interaction in the borderlands: (i) border crossing, which involves interconnections and hybridity, and (ii) border maintenance, which makes visible the value of difference. Both aspects are important and require working with the discomfort of difference. Each is influenced by the roles and power relations art therapists take on in different situations.
Kapitan then turned to the work of Cantera in Nicaragua to illustrate these ideas. Her involvement with this non-governmental organization began as an invited co-researcher with their community projects. Cantera’s aim is to empower people who attend their trainings to change socio-political conditions they identify in their local communities. Kapitan outlined how Cantera’s participatory approach works in practice, particularly the support it offers people in putting their research knowledge into collective action. Exposure to Cantera’s work has had a huge impact on the way Kapitan works too. Initially it led her to question her identity as an art therapist; subsequently it has transformed her entire approach to practice.
Nicaragua recently has been experiencing political violence arising out of protests about an erosion of the people's democratic rights. Kapitan described a brutal crackdown by government forces that has left many protesters left dead, imprisoned, or exiled. The socially-involved art therapy research she had been doing for many years suddenly looked quite different in light of the harsh reality of this political situation. It highlighted the always risky difficulty of undertaking socially engaged research with people one feels morally obligated to assist. It laid bare Kapitan's unconscious belief in the ever-forward move towards a more egalitarian society. She came to see that, particularly (though not solely) in a communitarian culture, art therapists must understand how they are part of a situation and not see themselves as outside of it. Cantera’s response to the crisis was to draw from their research knowledge and organize an art-based community intervention to support people affected and traumatised by these events. Kapitan showed images from a retreat held in December 2018 where art making helped people come together in community and begin to process how they were coping with and gaining strength in the face of fear and despair.
Kapitan raised the question of how organizations create sustainable social action through research, and noted that Cantera was effective in terms of building community resilience and well-being by working across boundaries of difference, mobilising participatory action, and contributing to the community's social learning. Kapitan then asked conference delegates to consider how using this model of socially-engaged practice might influence their experience of the IATPRC over its three days. She suggested it would offer a chance to hear each others' stories and, in so doing, to inhabit the borderlands between us where growing and learning take place. This would help in the process of art therapists opening up their knowledge bases and building their capacity to create research that informs and transforms their practice and the profession itself.
Find out more about the work of Cantera Nicaragua here
Professor Ephrat Huss
The Missing Social Theory: Towards an Embodied, Socially-Embedded, Aesthetic in Art Therapy Research and Practice.
began by suggesting there is a lack of art theory in art therapy. The universalist theories of art used by art therapists propose how artworks come into being but at the cost of decontextualising the art in art therapy. When art is socially contextualised it can be seen to have many roles; and including these in art therapy is a way to bring social theories be brought into art therapy? Huss felt it should mean not only thinking about art therapy as being about subjective experience, but also being concerned with how people function within the social settings and systems and types of marginalization in which they live and which often are the source of their personal pain. She wanted to think about a theory of art in art therapy that saw it as more than a way of contacting unconscious or even phenomenological processes.
The the theory of embodied socially embedded aesthetics enables a broader social theory of arts that contains the cultural, autobiographical, sensory perceptual experiences of an aesthetic experience: This takes the art beyond fine art and beyond the art therapy room, into different embodied aesthetic experieces that are contextualized in different ways in different cultures. This calls to broaden art therapy’S definition of “ what is art” and “ what is therapy”
For example, Trauma. t can equally be understood as the breaking of safe spaces in the social world as being an individual experience of inner distress or “ illness”. What kinds of art might then be included in working with trauma? She felt that crafts and ‘low’ arts - things which were not historically valued in modernist art theory - can mean that art therapy takes place in a range of social contexts. Art therapists need to stop and see how people use art in their daily life, such as crafts, personal decoration, didactic art, creative place making, and others: A key aspect is that these art forms have a significance for the people who use them, where the art processes conventionally used in art therapy may not. She emphasised the value of art therapists working with their clients’ understanding and use of art. This means thinking about what can be art in art therapy and, in the process, redefining art therapists roles and spaces so as to integrate with community practitioners and artists, become an advocate for clients’ social needs, find ways to evaluate the impact of social arts projects, and learn from the client about their art practices and how they help them.
Art can be seen to function as a didactic tool, a way to transform how people think, although this idea tends to be avoided in art therapy. Huss cited the use of visual imagery in advertising or journalism, where it is used in effect to transform peoples’ thinking. Expressing individual feelings through art - central to the psychologically-informed art therapy practice that has developed in the UK and USA - cannot be universally applied as a theory of art and its use in other cultures, and may be unhelpful or even counter-productive for some clients. Huss showed some drawings done by girls from a culture where they would be married as teenagers. The drawings enabled them to talk about the kind of husband they want to marry but also led into a conversation about how they felt about being in this situation. Using arts in a shared-reality group like this, she felt, provides a methodology to transform both the self and society. Art becomes a way to excavate stories when they would otherwise remain hidden or unheard; art making can then be seen to be an interactive process that enables people to be heard and to change their social world
Huss’s second point was to outline a set of mechanisms of art that can be used to analyse art through social theories; She suggested the arts can be a way of excavating ‘silenced knowledge’; Art making, Huss suggested, gives expression to someone whose views and experience may otherwise be marginalised or go unheard. When that person makes a piece of art they are given some kind of voice for their experiences. The interaction between the form and content and how this is worked out can help that person communicate about themselves in the social context in which they live.
Another aesthetic mechanism inherent to art is the inherent aesthetic tension between figure ( individual)and background( social context) that is central to art forms This enables a social analytical understanding adds to what might otherwise have been a clinical, decontextualised view. A personal statement can then be seen in the context of its social placement. Similarly, focusing on background as a space that has different, types of recourses, and lack of recourses for the figure, helps to make marginalization manifest rather than hidden under abstract professional language.
Find articles and papers by Ephrat Huss on social theories in art therapy research to view and download here
Afternoon keynote session
Lord Howarth of Newport
Arts in Health and Arts Therapies as Fundamental to Health Strategy
Lord Howarth began by saying that arts therapists have been the torch bearers for the arts in health in its broadest sense. In particular they have insisted on high professional standards and training to ensure that practice is safe and expert. Over the years - as Minister for the Arts from 1998 to 2001 and as a member of the House of Lords from 2005 - he had supported the efforts of various organisations working to convince those in government and the medical professions of the benefits of the arts in health in wellbeing. Lord Howarth described some of these initiatives, such as the Arts Council’s 2007 report on the arts in health, and how the response from mainstream health care providers had tended to be to sideline or rebuff them. From 2010, in any case, the medical profession and policy makers were largely preoccupied with mitigating the effects of the Coalition government’s austerity policies as well as the Lansley health reforms in the Health and Social Care Act 2012.
In 2014 Lord Howarth founded the All Party Parliamentary Group on Arts, Health and Wellbeing and was joined by forty other colleagues. The group held an inquiry into the state of the arts in health in England and was partnered by the National Alliance for Arts, Health and Wellbeing, the Royal Society for Public Health, King’s College London, and the Guy’s and St Thomas’ Charity. The project was funded by Wellcome and Paul Hamlyn. An advisory panel was also set up which included BAAT among its members. A series of round table events was organised to bring together people from a range of professions, service users and other stakeholders. Howarth talked about a number of arts in health services that the All Party Parliamentary Group looked at, including the charity Artlift. In a three year study it had been found that interventions by the Artlift Arts-on-Prescription scheme, supporting people in their recovery, had led to 37% less demand for GP appointments and 27% fewer referrals to hospital for people using their services.
In 2017 the All Party Parliamentary Group published ‘Creative Health: the Arts for Health and Wellbeing’ with the aim of bringing about a change of culture on the part of policy makers to recognise the benefits of the arts in health. The report had a warm response both in the UK and internationally, with the Arts Council of England being very positive in its response to it. Since then the Culture, Health and Wellbeing Alliance has gained a lot of support and membership. However, the medical establishment has been slow to change its position. Initially, some GPs were aggressively dismissive of ‘Creative Health’ and NHS England was largely impenetrable The All Party Parliamentary Group has since worked on different strategies to achieve the aims of the report, including holding conferences throughout the UK and events in parliament.
Lord Howarth affirmed that attitudes towards the arts in health are now changing,. Matt Hancock, Secretary of State for Health and Social Care, had made an important speech about social prescribing in November 2018, stating that the arts in health should be central to this approach. Cost pressures have put the current model of the NHS under strain and shown that there needs to be more of a focus on wellness rather than illness. Lord Howarth felt there needed to be a culture change so that people take responsibility not only for their own health but that of their local communities and wider society. What is being done for the arts and culture, he argued, has to be part of a much wider social policy that sees a move towards mutuality and communal support.
to view or download the ‘Creative Health: the Arts for Health and Wellbeing’ report.
Donna Betts, PhD
Unifying and Promoting the Arts for Health and Wellbeing
opened her talk by emphasizing the importance of building relationships, with the IATPRC as an outcome of the fruitful connection between the American Art Therapy Association (AATA) and the BAAT. Betts then reviewed how, through meaningful experiences of art making, art therapists can provide a healing process that enables clients to work through issues in their lives. One problem, however, is that there are not enough art therapy services to meet the growing need, meaning access to art therapy is limited. In the USA policy makers have recognised that one way to overcome this is to have a more integrated approach to the provision of services. Yet, while practitioners know the arts and arts therapies are well suited to this, further research and advocacy is needed to convince commissioners of the contribution these interventions can make. The body of evidence available to support such advocacy is growing, with training and standards of practice a crucial part of achieving this.
Betts then explained why unification and collaboration by arts in health bodies is necessary to improve access to and provision of services. She cited the work done by the National Organization for Arts in Health (NOAH) which has made significant progress in bringing together commissioners and policy makers to find a way forward. The NOAH document ‘Addressing the Future of Arts in Health in America’ identifies the creative arts therapies, expressive arts therapies, and arts in health as three key areas which make up a continuum of care. Networking and relationship building over many years has been crucial to reaching this stage.
Betts highlighted the work of the US National Endowment for the Arts' ‘Creative Forces Military Healing Arts Network’. Creative Forces provides creative arts therapies services to military patients and veterans as well as their families and caregivers. It also contributes to civilian health care and is leading the effort to promote community arts initiatives in the US. Developing an evidence base has been vital to support its campaigns to encourage commissioners and policy makers to include arts in health in service provision. Creative Forces shows how integrating the arts in health into medical services helps to improve the overall effectiveness of healthcare settings and enhance health care environments. Collaborative research projects like ‘Sound Health’, a partnership between the National Institutes of Health and the John F. Kennedy Center for the Performing Arts, have contributed to this evidence base. The co-ordinated effort to develop such programmes has helped with making the case that many more people should have access to arts in health programmes like these.
In closing, Betts outlined the next steps for NOAH. They include the formation of a national coalition to collaborate on new research and advocate on arts in health interventions, and the creation of a research database to help make the evidence more accessible. She added that many of the people involved in this work come with experience of creating public communities and building partnerships. Their knowledge of how to use current best practice and research to promote collaboration between different groups is proving invaluable in making the case for more arts in health services.
for a write-up of Betts' keynote lecture, and here
to find out more about the work of the National Endowment for the Arts Military Healing Arts Network.
Professor Susan Hogan
What Can Arts Therapies Contribute to Public Health?
began by stating she is both an art therapist and a member of the Royal Society for Public Health, Arts Health & Wellbeing group. This is important because the arts are now being used in medical training; for example, students are making art and using it to help them think about ethical questions. The arts on prescription has a long history and examples of art being "prescribed as medicine" were given dating to 1847; the National Association for the Prevention of Tuberculosis (NAPT) and British Red Cross were important in promoting it in 1940s and 50s and someone involved in this was pioneer art therapist Adrian Hill. He was a patient in a tuberculosis sanatorium himself and then started offering other patients the chance to make art. Hill is attributed with coining the term 'art therapy' in 1942. He did a lot of things present day art therapists do - and some things they have largely stopped doing. He provided art making facilities and he listened to people when they talked about their work in a therapeutic way. He also brought in artists to talk about art and to create debates, he ran competitions, and he held exhibitions of patients’ work. Hogan felt that art therapists ought to reclaim these wider arts in health activities which art therapists used to do, as they offer a useful range of ways of engaging and working with clients.
To show one way of putting this into practice Hogan presented some of the research from the Birth Project, which uses the arts to explore the impact of birth. She talked about how it gives new mothers the chance to explore their experiences of giving birth and how they were treated. It is both therapeutic and educational and aims to enable participants to develop and maintain their own art practice. Women shared their experiences of giving birth and there was also the opportunity for professionals to talk about working in obstetrics. The project was able to explore what role the arts and humanities might have in ante-natal and post-natal care, while researchers also heard about some of the iatrogenic effects arising from the care women received. Art groups proved to be a valuable resource for mothers to make sense of their experiences in giving birth and the support they received.
Hogan then discussed what art can offer to research projects like this. It can capture inchoate emotions in a away that language-based research may not do. Participants had found sharing their experiences in a supportive group beneficial and this resulted in more of these groups being provided for patients. Some people found using art materials helped them communicate their experiences more easily; and the art making also helped people feel more a part of the research process. The Birth Project showed it is the quality of care and the relationship with the healthcare provider that is most important for birthing mothers. Poor institutional practices did have negative iatrogenic effects, often leaving women feeling disempowered and angry; for example, medical interventions often interfered in bonding between mother and baby. The medical professionals were able to reflect on institutional care and how it can affect mothers. They saw how it can often override what women expect, leaving some in shock.
An important aspect of the Birth Project has been in developing resources that can be used in training midwives and other medical professionals. Medical students interviewed agreed that the films they saw with mothers’ reactions to how they were treated had changed the way they would work with people in future. Similarly, participants in the ‘Mothers Make Art’ sessions had found them beneficial not just because it helped them to understand their experiences better but because it had also taught them about making art. At the close, Hogan pointed conference delegates who wanted to know more about the Birth Project to its website, which includes a series of the films made of people talking about their experiences.
See more about the Birth Project here
Round Table Discussion
Arts Therapies and Arts in Health: Identity, Partnerships and Growth
The members of the Round Table panel:
Tammy Sheila, Art Therapy Manager, Cleveland Clinic Arts and Medicine Institute, USA
Ben Pearce, Director, Paintings in Hospitals, UK
Jenny Regan, CEO, London Arts in Health Forum, UK
Dr David O’Flynn, Chair, Adamson Collection Trust, UK
Victoria Hume, Director, Culture Health and Wellbeing Alliance, UK
Val Huet, CEO, British Association of Art Therapists
Chair of the discussion:
Donna Betts, Clinical Research Advisor, Creative Forces, USA
The round table discussion began with each of the panel members outlining the work done by their organisation and then offering a ‘provocation’ to the others. A core issue that emerged from these introductions was how the organisations negotiate the relationship between the arts, art in health, and the health and social care sector. Several expressed concerns that social prescribing was often perceived by government or commissioners as a way of moving spending on vulnerable or ‘at risk’ groups out of already stretched health and social care budgets. There was also the potential for artists or arts in health workers being asked to run sessions with clients with severe and enduring mental health issues that they did not have the skills or training to work with safely. Questions of risk, risk assessment, supervision, and the potential for practitioners to add to (rather than alleviate) trauma often seemed to be absent when services were being considered or set up.
The discussion began with Professor Susan Hogan asking for the panel’s thoughts on social prescribing and how much understanding arts in health organisations have on tendering to run services. Victoria Hume commented that a number of handbooks and guidance are being produced at present. However, there remains a sense that things are happening quite fast, hence the risk issues panel members had raised. Val Huet agreed that there was no consideration being given to risk assessment or suitable premises to run services in.
The panel were then asked: as social prescribing is a new domain, where does the knowledge come from? The questioner felt social prescribing has been authorised and mandated but no resources have been put into it. There was a sense of it being a way of denying care to those most in need and shipping resources out of the health and social care sector. Jenny Regan suggested that in fact social prescribing has been happening for years. A questioner felt there can be an oversimplification: if you feel sad go to a gallery, look at art, and you will feel better. The problem then is that all art-based interventions are seen simply as panaceas.
Another questioner suggested it would be useful to think about a taxonomy of what it is that the arts in health or arts therapies do. This would have to be backed by evidence otherwise funding or commissioning bids would founder. Donna Betts commented that the National Organisation for the Arts in Health in the USA is consulting with creative arts therapists and arts in health workers on what it is they do with service users. Victoria Hume agreed that the idea of a taxonomy was valid: it could make things clearer for social prescribers so that people are not sent to the wrong kind of service. Tammy Sheila echoed this point. She had found that colleagues in other professions often do not know about art and need some way to understand the continuum from art to art in health to art therapy.
A contributor from the floor talked about the problem of prescribing someone to an art class but then the person running that class not having the skills to deal with what might come out in a picture. They felt it was really about socially prescribing a technique: either using art as a teaching method or using it as a way of therapeutically helping someone to understand their situation. Jenny Regan added it is important for the arts in health and the arts therapies to work together. This is possible and it can be very helpful for service users. Val Huet felt it is a very strong outcome when someone goes from service user to artist, taking on a very positive identity.
Victoria Hume suggested that when social prescribing is done well, it is about GP practices thinking about how they work effectively in their local communities. People are treated holistically so they can take more control of their own health. David O’Flynn cited personal budgets as another method of facilitating this. Richard Whitaker responded that this kind of funding can often end up as a postcode lottery, with stakeholders fighting over the money. Social prescribing needs collaboration otherwise it becomes a competition between different professions or special interest groups. Val Huet echoed the concerns that a divide and rule approach to funding could develop, especially if a no-deal Brexit were to happen.
Ben Pearce talked about the work of Painting in Hospitals. For over sixty years it had been bringing art into hospitals and other caring environments and has managed to mitigate the issue of risk. Despite some of the concerns raised in the discussion, he felt it was important to emphasise that social prescribing is about recognising that a medicine-focused approach to health care is not the totality of what patients should be offered. Donna Betts brought the discussion to a close by citing one of the programmes ‘Creative Forces’ offers. When veterans leave care they often have a need for continuing engagement in the arts. Not necessarily in art therapy but they want to be involved in creativity or participate in arts in health. This is a model that other service providers are feeling they could learn from for use with client groups other than veterans. That felt like a very positive step forward in health care provision.
You can find the Conference Report from Day Two on 12th July 2020 here
The International Art Therapy Practice/Research Conference was held on 11-13 July 2019 at Queen Mary University of London, Mile End Road, London.
You can see highlights from the conference on Twitter using #ArtTherapyIntConf
Find out about The 10th Attachment & the Arts Conference: The Relational Human Body
on 10th July 2020
at Mary Ward House Conference Centre, London here
You can see highlights from the Attachment & the Arts conference 2018 on Twitter using #AttachmentArts