Training creative arts therapy and professional artists for a career in healthcare

The use of the arts in healthcare is expanding throughout the world. In the United States over 20,000 music, drama, dance, poetry, art and expressive art therapists work in psychiatric hospitals, rehabilitative facilities, medical hospitals, outpatient clinics, day care treatment centers, agencies serving developmentally disabled persons, mental health centers, drug and alcohol programs, senior centers, nursing homes, hospice programs, correctional facilities, halfway houses, schools, and private practice.

That number, impressive though it is, represents at most only about half of the artists working in healthcare. An equal number, if not more, professional artists and arts administrators also work in healthcare. They work in hospitals, hospice, mental health centers and all the other places as do creative arts therapists. The best programs hire about an equal number of both.

You may ask, what is the difference between a creative arts therapist and a professional artists working in healthcare? An arts, dance, music, drama, poetry or expressive arts therapy person is an artist who has been trained how to use their artistic talent to achieve a measurable therapeutic outcome. A professional artist uses the arts to entertain a patient, provide them a distraction from pain, an opportunity to use their own artistic abilities to express their emotions or create a more welcoming environment. There may be a therapeutic benefit, but that is not their intention.

Let me give you an example of each. Last spring in the United States, a deranged man shot Congresswoman Gabrielle Giffords in the head while she was standing in a parking lot visiting with voters. The bullet went through the left side of her brain causing terrible destruction. She nearly died. Fortunately she was quickly rushed to a hospital where doctors saved her life, and later she was transferred to a trauma clinic in Houston. Among other problems she lost her ability to speak as this function is based in the left side of our brains. However, our ability to sing is based in the right side of our brains.

A music therapist was brought in who had been trained on how to work with people who have sustained traumatic injuries. She started singing songs to the Congresswoman, songs that the music therapist learned were her favorites from her husband and family. Soon she had the Congresswoman nodding along with the music. It wasn’t too long after that the music therapist encouraged her to sing along. Initially it was very difficult, but they slowly made progress. Once she got good at singing songs, they started changing the words of song first in fun and then into the words she wanted to tell people. She learned that she could sing what she wanted to say, even though she could not speak those same words as you would in a normal manner. Eventually the music therapist got Congresswoman Giffords to slow down the singing until she was able to talk again – she used music to help rewire the Congresswoman’s brain.

Putting words and sentences to music was fun, and because it was fun the Congresswoman would practice it again and again until she got the knack. As any of you who have ever created something know, when you get engaged in making a drawing or trying to write a song time can slip away. So too time slipped away for the Congresswoman and, as a consequence, it seemed to her as if it was in no time at all, that she was able to experience the progress her efforts were making.

Now let me give you an example of a professional artist, in this case a dancer, who used his skills to support the healing of others.

Back in 1986, when I was the director of arts and productions at the Cathedral Church of St. John the Divine in New York City, a dancer, who was living with AIDS, and who participated in a musical review that we had organized to raise money to support other people who were HIV positive, noticed that we had many children in our homeless shelter. He had never thought that homeless people might have children and expressed his surprise to me. I said, yes, people who are homeless have children too. The parents are very depressed. They have no home, no job and these children to feed. Some of the parents have problems with drugs and alcohol. So the children are bored.

This dancer did not set out to provide therapeutic experience, but his ability as a dance instructor and choreographer changed these peoples lives, and the experience also changed his own because he started taking better care of himself as well. One difference is that the music therapist knew how to measure the results of her efforts and, because she also understood how the brain works, could figure out a way to use music to activate a different part of the brain and, in a step by step process, teach one part of the brain to take over for another part. The dancer on the other hand had all the gifts of a professional choreographer and teacher, he could take a group of children, teach them how to dance and create a performance. He taught them all that they could be very creative, and he inspired their parents. Both the music therapist and the professional dancer used their skills to help other people heal, but they used a different approach and drew upon different skills.

The first question though is what does a person need to learn to become a creative arts therapist or a professional artists working in healthcare.

At Lesley University in Cambridge. MA, where I work, a degree in dance therapy is a 60-hour course that trains students in the psychotherapeutic use of dance and movement, which breaks down into 36 hours of dance/movement therapy coursework, 12 hours of psycology courses, and 12 hours of field experience. Students learn to integrate the emotional, cognitive, physical, and spiritual health of the individual. Dance/movement is the primary medium used for observation, assessment, research, therapeutic interaction, and intervention. In addition, the students are required to have 1,100 hours of direct supervised contact with clients drawn from a range of ages and health problems, activities that can take place in hospitals, mental health centers, geriatric centers, schools, and clinics.

An alternate approach for getting a dance therapy degree requires 24 credits of dance/movement therapy coursework, 18 hours of psychology, group process and research and methodology coursework, 200 hours of fieldwork supervised by a licensed mental health professional, 700 hours of internship supervised by a board certified dance therapist and five years of concentrated study in dance such as modern, ballet, jazz, tap, ethnic or folk.

In general, the other creative arts therapies require a similar approach, a mix of courses in creative arts therapies balanced with courses psycology and followed by at least 1,000 hours of supervised interaction with patients. Within these courses of study, students can often chose to focus on specific populations, such as working with children, older adults, people living with certain disabilities. Generally people wishing to enter these disciplines need to display a certain mastery of a particular art form as a prerequisite to taking on a course in a creative arts therapy.

At this time there are no similar graduate courses of study for a professional artist working in healthcare, though a number of certificate courses are being established. The best known and oldest is a two-week summer intensive offered by the Center for Arts in Healthcare Research and Education at Shands, the University of Florida Hospital at Gainseville, FL.

Participants in the Shands program may choose the arts clinical practice or arts administration track. Both tracks include workshops in the history, philosophy and physiology of art and healing, experiential workshops in the visual arts, music, dance, theatre and writing, workshops in compassion fatigue and self-care, facilitating the arts at the bedside, arts in healthcare program implementation, administration, and grant writing, research, and practical bedside arts experience with the Shands Arts in Medicine program. The intensive now includes new online modules, including Patient Safety, Understanding the Experience of Illness, Healthcare Culture, and Healthcare Communication.

The benefits of offering a certificate program, as they do at the University of Florida, is that it creates a course of study that is relatively short in nature that can be offered not only to Academy students, but to professional artists, arts administrators and others who may wish to learn how to develop arts in health programs. A key component would be establishing relationships with hospitals, elder care facilities and other organizations to provide the participants experiential learning activities in a health care setting. Ulan Ude is blessed with a variety of institutions that can offer the participants the choice of working in a children’s hospital, a hospital for adults, orphanages, after school programs for youth at risk and centers for the elderly amongst others.

Another growing opportunity is the use of the arts to help veteran soldiers recover from the emotional and physical trauma resulting from their military service. Participating in arts activities can provide soldiers with opportunities for individual and collective self-expression. The reality is that not everyone is comfortable talking about their feelings, but many find it easier to make a drawing of or write a poem about their experience and then talk about the drawing or poem. A skilled director or choreographer can turn veterans’ experiences into a play or a dance, and then engage the audience in a post performance discussion about what they saw or experienced.

No matter which direction the Academy decides to take it will be important to teach the students the basics of arts administration and how to work in a healthcare setting. Hospitals are very challenging places to work for an artists as they have to work around the schedules of the doctors, nurses and various treatments. They also have to learn the rules of a hospital, such as the importance of washing hands, protecting the privacy of the patients, and understanding that not all music or artistic images are appropriate. They also have to use art materials that are safe for the patients.

Artists can make hospital spaces more attractive and relaxing, they can use music and singing to reduce tension and uplift people spirits, dance to make rehabilitation exercises more fun, and poetry and drama to help people express their emotions. They also have to learn how to measure the effectiveness of what they do and record words of support to use to gain the financial support of hospital administrators. Developing programs for the hospital staff is just as important as developing programs for the patients as the staff, especially the nurses, have very difficult jobs.

Moving forward one of the key challenges for the Academy will be getting members of its own faculty trained as dance, music and arts therapists so that they in turn can train future students in the creative arts therapies and provided the students supervision when they practice in healthcare institutions. Launching this new academic program will not be easy, but the potential rewards and career opportunities will be great. It is a journey well worth undertaking.