USING THE CREATIVE ARTS IN THERAPY AND HEALTHCARE: A PRACTICAL INTRODUCTION

This book was first published in 1984 as ‘Using the Creative Arts in Therapy: The Power of the Arts Experience to Expand Human Horizons’, with a second edition in 1994 differently subtitled, ‘A Practical Introduction’, and now in a revised and expanded edition, with ‘and healthcare’ added to the title. Warren says he “actively fought against using the word ‘therapy’,” because “it implies a prescribed course of treatment with predetermined expected results for a specific diagnosed condition”, whereas the arts find “the notion of predetermined expectation anathema”. There are paradoxes and debates here.

This edition’s range is wide, and the lucidly well-written contributions contextualise different practices, offering much to the ‘practicality’ of the title. Warren’s own guidelines for workshop leaders are full of robust common sense, and many contributors follow suit. Chapters on visual arts, music, dance/movement, drama, story making, arts and clowns in hospitals, and working with disabled children all provide good introductions to their fields, many backed up with useable tips for developing these modes. Most are excellent, a few are less so. For instance “Only providing large pieces of paper”, to “end timidity” can be as intimidating as liberating.

The breadth delivers a good state of the art report for the participatory and community arts in healthcare. While the role of arts in creating healing environments gets some coverage in one chapter, the medical humanities and the arts therapies, which are key areas of arts and health practice, are not represented at all (with the exception of one collaboration), making the book’s contents less broad than its title. The majority of the practice and practicalities are group-work based. It would have been useful to have the complexities of this properly addressed.

The implications of working with the distress and loss inherent in healthcare are also neglected. Is it safe for the practitioner to work with a dying child (as instanced), without informed psychologically and emotionally intelligent preparation, support and supervision? Maybe they were provided, but it is vitally important that this aspect of the work is explicit. Similarly, is it safe for the participants for the practitioner to “encourage honest expression... even if a person has ugly, angry feelings?” As this contributor later notes, we don’t know whether “cruelties have occurred that are too inhuman to deal with in creative arts sessions”. Especially when working within mental health, asking participants to, for instance, make vivid recreations of the house they grew up in, can very easily evoke trauma, whether or not that was the intention. Recently an unprepared artist triggered an uncontained traumatic reaction, resulting in serious harm and a large out-of-court settlement.

Offering the arts in a healthcare context implies a claim to offer a beneficial healthcare outcome, as many of the contributors do. Why else would the healthcare organisations fund them? This makes the introduction’s claim of a sort of ‘purity’ for arts practice as distinct from therapeutic practice difficult to sustain. Contributors (wrongly) claim that arts therapists “interpret and prescribe specific expressive activities”, and that they are “formally integrated into a diagnostic and treatment model”. Yet Warren’s own chapter on drama claims there is a benefit in “learning to act acceptably”, and that one game is useful “as a diagnostic tool”. You can’t get much more normative, or medicalised, than that! The British Association of Art Therapists’ ‘Statement on Diagnosis’, by contrast, simply states that “Art Therapists do not diagnose… and there is no literature or research to support this.” This updated edition is to be welcomed as useful addition to the literature. Readers could, however, be misled by what it leaves it out, as much as enlightened by what it puts in.