An Evaluation ReportAda Hui & Dr Theodore Stickley

Making art available to all

3

Making Art Available to AllAn Evaluation Report

Ada Hui & Dr Theodore Stickley

4

Acknowledgements/Foreword

Our foremost acknowledgement is to John Whyman for capturing the innovative idea of Guidelines to Art, without which many people would not have had the confidence to paint. John Hope-Hawkins developed this idea further and has helped to promote the use of guidelines nationally through his role as Chairman for the Society for All Artists. A special thank you goes to all those involved in making this evaluation report possible; the people who are actively involved in watercolour painting through using the guidelines templates, the staff and volunteers nationwide, and in particular to all the people we have met through journeying this report; Linda Molineaux and Chris Allen at Beaumond House, Newark; Carol Scott at Gifts Hospice, Grantham and Valerie Greenhill at Nottinghamshire Hospice, to name but a few.

Dr Theodore Stickley Associate Professor Faculty of Medicine & Health Sciences University of Nottingham

“Art washes away from the soul the dust of everyday life…” (Pablo Picasso, 1881-1973)

“Art is unquestionably one of the purest and highest elements in human happiness. It trains the mind through the eye, and the eye through the mind. As the sun colours flowers, so does art colour life.” (John Lubbock, 1834-1913)

“The secret of life is in art.” (Oscar Wilde, 1854-1900)

John Whyman

5

Contents

Acknowledgements/Foreword 4

Introduction 6

Context 6

Guidelines to Art: Making Art Available to All 6

Background 7

Aims & Objectives 8

Research Methodology 9

Analysis of Data 9

Findings 10

About the Organisations 10

We can all become artists 10

Personal Benefits 11

Possession, Ownership & Identity 12

Sense of Achievement; Confidence, Self-worth & Self-esteem 13

Focus on Ability rather than Disability 14

Group Identity & Relationships 16

Engagement & Socialisation 16

Involvement & Contributions 16

Potential Challenges 17

Future Potential 18

Guidelines to Art: A Transformational Concept 19

Importance of Art 20

Ideas for the Future & Potential Users 21

Discussion 22

Conclusion 23

References 24

Appendices 1 26

Appendices 2 27

Appendices 3 28

Comments 29

Comments 30

6

Introduction

Context

This report represents the evaluation carried out on behalf of The Society for All Artists by researchers from the Faculty of Medicine and Health Sciences at the University of Nottingham. The researchers were invited to work alongside the organisation, staff and ‘budding artists’ using the Guidelines to Art templates developed by John Whyman. Research was conducted across four different sites within Nottinghamshire, including a NHS hospital as well as independent charitable hospices. Research data was also gathered from other locations throughout the United Kingdom. Observations, reflections and interviews were methods used to gather data. The evaluation and subsequent report sets out to capture the innovative work Guidelines to Art has to offer to people, within hospitals, hospices as well as for people in their own homes.

Guidelines to Art: Making Art Available to All

The idea of using Guidelines to Art was initially developed by John Whyman, a retired school teacher, around eighteen years ago. After his retirement, John began volunteering at local hospices, close to his hometown of Rochdale. It was during this time that he realised many people could either not draw or lacked the confidence in doing so. This is when he began to use hand cut stencils from odd bits of card and cornflakes packets, allowing these to be used as a basis for drawing and subsequently applying water colour.

Through his ideas, time, commitment and genuine passion for his work, John was nominated for an award with the Society for All Artists, with the motto “to inform, encourage and inspire”. John’s personal motto in creating the guidelines was in “making art available for all”. In July 2007, John was awarded a bursary

of £500 through this organisation for art materials. The Society for All Artists later worked in collaboration with John in continuing to develop his ideas further, designing two different art kits. One full kit consists of five stencils, instructions and enough materials for six people to paint sixty pictures, plus a back-up kit of five more stencils and extra consumables such as paint and paper. The second kit is a ‘one-to-one’ kit with enough materials for two people to paint twelve pictures, specifically designed to be taken by a visitor to a person’s bed space or home.

So far, the Society for All Artists has supplied and distributed these kits to over three hundred BUPA care homes, and workshops are continuing to be run with activity organisers around England, Scotland and Wales demonstrating their use. Hospices and independent care homes have also been approached, and whilst people have generally begun by feeling nervous and anxious with starting something new, feelings have usually altered by the end of the session, with positive feedback being given at the end of each workshop.

John himself continues to deliver water colouring sessions within the Rochdale area, along with his wife and assistants. The Society for All Artists continues to promote the use of Guidelines to Art through encouraging members of their organisation to use the art kits within their local areas. The Society for All Artists also plan to further showcase the use of guidelines through various workshops and road shows around the country within the near future.

7

Background

“Music, poetry, dance, drama and the visual arts have always been important to our mental and physical wellbeing... collective participation and engagement in the arts is a fundamental element of any civilised society...” (Alan Johnson, Secretary of State for Health, 16th September 2008)

Art has been around for millennia, yet within healthcare it is something that has largely been ignored or its significance dismissed until relatively recently, (Camic, 2008). Despite mounting evidence regarding the benefits of art since the 1990’s, particularly within the United States of America and the United Kingdom, (Arts Council England, 2004; Staricoff, 2004), the very first formal government document supporting the use of arts within healthcare, Report on the Review of Arts and Health Working Group, was not published until 2007.

The key findings from this report were that:

Arts and health are, and should be firmly recognised as being, integral to health, healthcare provision and healthcare environments, including supporting staff

Arts and health initiatives are delivering real and measurable benefits across a wide range of priority areas for health, and can enable the Department and NHS to contribute to key wider Government initiatives

There is a wealth of good practice and a substantial evidence base

The Department of Health has an important leadership role to play in creating an environment in which arts and health can prosper by promoting, developing and supporting arts and health

The Department should make a clear statement on the value of arts and health, build partnerships and publish a Prospectus for arts in health in collaboration with other key contributors (Department of Health, 2007)

Indeed the Arts Council for England has previously produced numerous publications documenting the benefits of art and health and continues to do so, (Arts Council England, 2004; 2005; Staricoff, 2004). One of the key suggestions made within some of these research papers has been that the term ‘art’ itself is a generally broad concept encompassing many different areas, including; visual arts, music, dance, theatre, singing, performance, literature, creative writing and culture, (Arts Council England, 2004; 2005; Staricoff, 2004). The second issue recognised by the Arts Council England is that the term ‘health’ also holds different connotations and meanings within different disciplines or ideologies, (Arts Council England, 2004; 2005).

Health can extend to broader social, economic and environmental determinants, relating to physical, mental and social well-being, (Lupton 1995; Putland, 2008). These embody all psychological, behavioural, cultural and spiritual aspects of health, (Baum 2002; Keleher et al., 2007; Putland, 2008). The importance of this being that the overarching term ‘art’ delivers health benefits in different ways for different people, extending above and beyond simply the ‘absence of illness’.

For the purpose of this report, the term ‘art’ will hereon refer to the physical and visual art of drawing, painting and producing art as a product to be looked upon and appreciated, unless otherwise stated. Efforts have been made by the researchers to include background literature that has roots grounded within the visual arts arena in supporting and governing this report. This however, has largely only been made possible where arts literature has specifically stated which forms of art they are specifically referring to and so some of the literature included may still refer to art as a general principle.

8

Evidence has demonstrated that art has health, (Staricoff et al., 2001; Staricoff, 2004; social, (Arts Council England, 2005; McQueen-Thompson & Zigauras, 2002; Thiele & Marsden, 2003) and community benefits, (Arts Council England, 2005; Kagan et al., 2005; Putland, 2007 & 2008). Furthermore, art is a form of expression, personal to the individual and their experiences, (Gadamar, 1977; Heidegger, 2001; Merlau Ponty, 1964a; 1964b; 1964c; 1998). Art holds the ability to tell a story, can be interpreted in different ways depending on feelings, thoughts and perception, (Maclagan, 2001), thereby being multifaceted and multidimensional, (Stafford, 1998).

Through art, it has been argued that an educational process ensues, (Billey & Galvin, 2007; Gallagher, 2007). Art is a powerful tool through which to illustrate thoughts, feelings and emotions, (Arts Council England, 2004), and provides an alternative medium of communication to that of the conventional linear narrative, (Maclagan, 2001). This provides deeper insight and creates a greater magnitude of possibilities for both the artist and the observer, (Darbyshire, 1999; Leight, 2002; Wikström, 2000), in turn promoting a holistic, collaborative and person-centred approach to healthcare which has the capacity to enhance awareness and increase understanding of individual experiences, (Gallagher, 2007).

Anyone, regardless of age, training, qualifications and physical or intellectual abilities has the potential to participate in art, whether within formal or informal settings, (Wali, Severson & Longoni, 2002); amongst public, private or voluntary sectors, (Arts Council England, 2004; Kaye & Blee, 1997). Art can thus help to promote social inclusion and reduce isolation; providing a means to build social networks, trust and community engagement, (Arts Council for Health, 2004; Berkman & Kawachi, 2000; Department for Culture, Media & Sport, 1999; Wilkinson & Marmot, 2003). These all hold potential in contributing towards greater levels of confidence and self-esteem, a sense of control and self-determination, (Health Development Agency, 2000; Jermyn, 2001, Staricoff, 2004; VicHealth, 2003; Williams, 1995).

Art enables people to feel empowered both at a social as well as individual level, (Lawthom, Sixsmith & Kagan, 2007; Secker et al., 2007). Indeed Biley & Galvin (2007), go as far as to state that art holds the potential ability to “rehumanise the world of health and social care and its underpinning sciences”, (page 800). This may hold a role in transforming the documentation of human experiences, (Maclagan, 2001), in turn, creating stimulation and motivation for health and development, (Runco, 1996; Sternberg, 2006).

Aims & Objectives

The aims and objectives of this evaluation are as follows:

To evaluate the impacts and effectiveness of Guidelines to Art;

To gain an insight into people’s experiences of using Guidelines to Art through visiting four different sites within Nottinghamshire, including NHS hospitals as well as independent charitable hospices and to gain feedback from artists, art facilitators and managers within the United Kingdom;

To explore both the potential benefits and challenges of using Guidelines to Art within different settings and amongst different care groups;

To explore the relationships between art and health based upon existing research;

To consider art as a tool for engagement;

To identify recommendations for the future

9

Research Methodology

The evaluation of Guidelines to Art was conducted using a multi-method qualitative approach including participant observation, informal interviews and conversations with artists, arts facilitators and managers. This triangulation of data gathering was felt most suitable due to the nature of the activity, and the varying physical and cognitive abilities of the client groups.

As part of the participant observation one researcher attended four different venues within Nottinghamshire, including a NHS hospital and independently run charitable hospices. During that time the researcher carried out observations while participating in the activity. This approach afforded the opportunity to chat with the participant artists in a relaxed and informal manner as they carried on with their drawing and watercolour painting. Although the emphasis was on a casual engagement with individuals and the activity, prior to the participant observation a thematic framework had been devised, which directed observation and conversation with the artists to pre-assigned indicators of wellbeing. These included aspects such as engagement in the activity, thoughts and feelings regarding use of the Guidelines to Art as well as the artists perceived benefits of art, (see appendix 1).

Interviews were conducted with participating staff; namely arts facilitators; including volunteers, who may or may not have had professional training in activity co-ordination, as well as service managers. Again, an interview schedule had been devised prior to the interview, covering thematic areas central to the research topic, (see appendix 2). Due to the restricted time and resources available to attend all the sessions countrywide, the research design included data from diary notes of sessions. Those staff members participating along with their client group were asked

to fill in a pro forma sheet indicating their own observations of the sessions along with any other relevant feedback. The diary sheets also asked for observations on particular members of the group, whose behaviour or participation was recognised as extraordinary to that individual, (see appendix 3). It was felt that such an approach would yield a more accurate representation of the group process and of individuals within it; as the workers, through prior involvement, have greater insight to the clients.

Analysis of Data

The observational and interview data were analysed with a view to identifying and exploring the personal and social benefits of using the Guidelines to Art. In order to document what is an internalised state felt by the individual, the research will present the external behaviours, actions and speech-acts of participants as proxy indicators of wellbeing. In addition, without inflating claims for wider outcomes, evidence which demonstrates the social benefit of engagement with the project will also be highlighted. This second aspect of the analysis brings to light the instrumental qualities of art participation and is revealed in evidence of the groups’ actual and aspirational engagement with other organisations in the community.

By approaching the data analysis in this way, the report moves out from the individual to the group and onto opportunities for involvement with the community. And that wellbeing, a property of individuals, can be mediated by people’s contact with the group and community.

A caveat must be mentioned. This evaluation, due to the limitations of time, cannot fully explore the long-term implications of people’s involvement with the Guidelines to Art. However, what the evaluation attempts to do is phenomenologically capture the impact upon individual wellbeing, as a result of taking part in the activity. The research attempts to describe both at the individual level and at group level, the immediate and potential contribution of participating in visual arts in people’s lives.

10

Findings

About the Organisations

Four localities were visited by the researchers within Nottinghamshire:

Daybrook Ward, City Hospital Nottingham; Nottinghamshire Hospice; Beaumond House Hospice in Newark; Gifts Hospice in Grantham

Feedback was also gathered from other sites around the country including; Dr Kershaw’s Hospice, Oldham; The Stroke Association, Ashton-Under-Lyne; Springhill Hospice, Rochdale and Birch Hill Hospital, Rochdale as well as numerous other locations within Essex, Lancashire and Devon.

These venues each have a role in caring for adults or older people, or a combination of both care groups; either with physical or mental health problems. Many of the people with physical health problems were deemed to be ‘living with a life-debilitating illness’ or being ‘terminally ill’ and often being in receipt of end of life, palliative care. The nature of people’s mental health problems encompassed both functional as well as organic mental health needs. Needles to say, due to the nature of health and illness, combinations of both physical and mental health problems often presented collectively.

We can all become artists

Many positive images of the Guidelines to Art were elicited from all those involved within the evaluation project. A large extent of these were surrounding the simplicity of the templates as well as the element of surprise at individual capabilities of art alongside people’s artistic achievements through using the Guidelines to Art.

“The beauty of it is the simplicity and the design of the template… the simplicity of it says it doesn’t and shouldn’t work… but it does!” (Clinical Service Manager, Nottingham)

“An excellent idea! Fantastic for our residents with Dementia…” (Activity Organiser, Peterborough)

“Everyone’s [paintings] look very different, when you line them up, they look like separate pictures which is great, all the end details are different...” (Arts Facilitator/Volunteer, Newark)

“Something that’s so simple translates into the delight of the patients who attend… it’s absolutely wonderful!” (Clinical Service Manager, Nottingham)

“[The Guidelines to Art] are very easy to work with, they give people confidence, because a lot of people think that they can’t draw or paint and I think they’re very pleasantly surprised when they see that they can, they can all achieve something...” (Arts Facilitator/Volunteer, Newark)

“[People who attend the hospice] don’t always have the energy capacity; something like art doesn’t demand a lot of energy, in terms of physical energy; not physical but certainly the mental capacity... With this template they’re halfway there I think!” (Clinical Service Manager, Nottingham)

www.saa.co.uk © Teaching Art 2008

You will need

Paints (only add a drop of colour to your palette)guide 32

Painted by Stacey CoughlinInstructions for Guide 32 ref:ST032I

To Start

Light Blue

Let it all dry.

Light Brown

Tip: to get a dry well pointed brush, dip it into the water then gently dab the side on some tissue.

Grey

Yellow

Tip: for a pale wash just add more water.

YellowYellow Grey

Yellow Grey

Let it all dry.

YellowGrey

Light Blue Grey

GreyLight Brown Grey

Grey

11

“[The Guidelines to Art are] structured in a way that was quite simplistic and easy to handle particularly for people with limited movement...” (Nurse Manager, Grantham)

“Everyone managed quite independently, didn’t need a lot of help...” (Nurse Manager, Grantham)

“The concept is so simple, people are quite confident at doing it... It’s stirred up creativity amongst people... It gives people the confidence to try it...” (Nurse Manager, Grantham)

“I think what people think is that you’ve got to be able to draw to be able to paint, and the fact is that the Guidelines are good because it’s so simplistic; it just gives people that outline to build up. People say that I can’t draw so I can’t paint, when actually they can. I think people worry about spatial awareness, but actually the Guidelines gives you perspective on the sheet...” (Nurse Manager, Grantham)

“I’ve done water colouring myself on my own and without the templates its quite hard; you’ve got drawing skills to bring into it and you’ve also got to make decisions about the colours and the mixes and it presupposes a big background in painting to be able to paint at that level. But this, because there are very clear instructions about what colours to use, how to mix them and which part of your picture to do first and to let it dry and move onto another area it is very very good , it supports the teacher or facilitator in knowing what to do...” (Arts Facilitator/Volunteer, Newark)

“You wouldn’t necessarily need a background in painting because the CD that comes with it explains all these techniques quite well...” (Arts Facilitator/Volunteer, Newark)

“A total novice can pick it up and do it...” (Nurse Manager, Grantham)

“All of them I’m sure find it really helps them to achieve what they want to get out of the picture which is basically to copy the one they are given and the template gives them the confidence to place things on the paper, but you still have to join up the lines, so you still have that individuality in your drawing coming through to some extent, but particularly when you start and you think you can’t do it, the templates gives people an enormous amount of confidence.... I think the templates act as the key to what you achieve... it’s a prop isn’t it? (laughs)...” (Arts Facilitator/Volunteer, Newark)

Personal Benefits

Through participant observation and informal conversations with artists, it became apparent that many people using the Guidelines to Art experienced a sense of relaxation as they were drawing and painting. Many stated that they found the process “very enjoyable” and that they “liked it” or “liked it very much”, however, individuals sometimes appeared to find it difficult to describe or quantify in words the reasons why. Quotes from participants included;

12

“I am an artist and I didn’t know it…”

“Really interesting, I have learnt a lot”

“Feel absolutely amazing and I’m incessantly excited to spread the word…”

“Absolutely brilliant…”

“Exciting, fun, great, can’t wait to show as an activity…”

“A thoroughly enlightening experience can’t wait to get started…”

“Really good, relaxing and therapeutic…”

“So easy to try, it’s excellent!”

From participant observations, researchers noted on one particular visit, the following:

“One female who appeared to be suffering from severe depression, affecting her ability to concentrate and required much support throughout the session; however, whilst concentrating on the task of painting, smiles were evident and she was able to make jokes with others during some parts of the session...”

“Individuals on their second session using the Guidelines to Art appeared much more confident and self-assured than previously and took much pride in their work...”

“Members of the group, despite the onset of Alzheimer’s Disease, were able to remember much from the previous session and were able to work much more independently with few prompts and positive feedback regarding their work...”

“Individual skills appeared to have improved from previously, with new skills acquired, adapted and assimilated into their paintings this week...”

“Individuals answered that they would very much like to become part of a regular group involved in art and would very much like to have the opportunity to paint again...”

“Several members of the groups asked when the arts facilitator might be able to visit again and commented that they would very much like to continue to be involved in the arts whether this be on the ward or at home...”

Arts facilitators, volunteers and managers have also noticed multiple benefits to using art and particularly the Guidelines to Art; including aspects of self confidence, achievement, identity and self-worth related to perceived ability rather than disability or illness, changes in mood and possession or ownership of one’s individuality, skill and talent. These have been grouped under the headings of: ‘possession, ownership and identity’; ‘sense of achievement; confidence, self-worth and self esteem’; and ‘focus in ability rather than disability’; presented as follows:

Possession, Ownership & Identity

“They’ve created something of their own so they can take possession of their skills that they’ve learnt, they take possession of their end product, it’s their picture, it’s something they’ve done for themselves and I think that’s important for a lot of people...” (Arts Facilitator/Volunteer, Newark)

13

“It’s been a very big success story on many levels... I think there are many benefits to art; you can discover creativity you never realised you had... A lot of positivity, it can totally change someone’s mood...” (Nurse Manager, Grantham)

“Painting has encouraged patients to rekindle an interest in the world about them and for some, given a new skill; for others a chance to rediscover a talent…” (Day Hospice Sister)

“Everyone is seen as individuals, we’ve all got something to contribute and the point is art is very personal, so what you produce is unique, it’s your interpretation of what you decide you want it to be, and that’s where identity comes in... You put your own mark on it...” (Nurse Manager, Grantham)

“Creative things, I think are what people need, when they perhaps feel that the end of their life is approaching when they think they are no longer able to do these things, particularly if they’ve not done these things before, it shows them another side to life going on really for them...” (Arts Facilitator/Volunteer, Newark)

“It’s amazing, I think, looking at the templates how different each one of them are; they all have a little bit of themselves in the painting, they all express themselves in a different way...” (Clinical Service Manager, Nottingham)

“To see a smile and a blossom on someone’s face from doing art; it gives something to someone that they own, that they have done...” (Clinical Service Manager, Nottingham)

Sense of Achievement; Confidence, Self-worth & Self-esteem

“The templates encourage people to do their own picture and gives them the confidence of doing their own picture and then that confidence can be developed to work without the template, to begin to add things in or perhaps draw things in eventually, at the moment people seem to feel limited perhaps by putting the lines where they’re supposed to but maybe with experience they would dare to go beyond that and draw something a bit more freehand if they wanted to...” (Arts Facilitator/Volunteer, Newark)

“They [the Guidelines to Art] reinforce self-worth.” (Clinical Service Manager, Nottingham)

“They have always thoroughly enjoyed the sessions and have produced some fabulous work, of which they are very proud…” (Day Hospice Sister)

“It’s fun as well as creative; if you get the balance right it is very enjoyable...” (Nurse Manager, Grantham)

“From the very negative, well I tried something but it never worked... it gives the person the challenge to just give it a go... to become involved...” (Clinical Service Manager, Nottingham)

14

“The sense of achievement in being able to produce and take home a lovely painting within a two hour period has given a lot of people a huge boost to their self esteem and confidence…” (Communication Support Co-ordinator)

“The greatest benefit is that it says to someone you can do something and do something and complete it; because of the nature of their illness it’s not always possible to complete something, whereas with this, they can...” (Clinical Service Manager, Nottingham)

“Stimulates their mind; rather than just sitting and doing nothing, it stimulates the brain and it’s healthy...” (Clinical Service Manager, Nottingham)

“The fact that they created something that was so tangible at the end of it that was really presentable was really nice...” (Nurse Manager, Grantham)

“Plus, I think, the relaxation qualities and the creativity tends to be relaxing and I think they actually surprised themselves, everybody says I can’t paint, I can’t paint when actually they can... They took them home and got them framed!” (Nurse Manager, Grantham)

“People now have the confidence to carry on trying more things at home…” (Communication Support Co-ordinator)

“A few people are particularly interested in painting anyway, so it’s quite nice because the guidelines allow them to reinstate that...” (Nurse Manager, Grantham)

“[The Guidelines to Art are] Very good, really enjoyed it... People get lost in it and the time goes so quickly...” (Nurse Manager, Grantham)

Focus on Ability rather than Disability

“People are finding that there is something that they can do after losing some ability in other activities due to their illness; they’ve lost everything, they’ve lost part of themselves, so they can find or rekindle a new skill; finding new opportunities...” (Clinical Service Manager, Nottingham)

“I am not just the illness, I am someone who can contribute; being able to take the finished article home, it’s an achievement; we all flourish on praise...” (Clinical Service Manager, Nottingham)

“It’s been very productive, very much so and it’s handmade which is another nice thing...The focus is not all about illness, you’re not talking about what’s wrong with you or what’s gone wrong in life, it’s an uplifting factor mentally...” (Nurse Manager, Grantham)

“I do think creativity creates confidence and with confidence comes choice; you make choices if you feel confident...” (Nurse Manager, Grantham)

15

“Identity is important because when you become ill it is one thing you lose sight of, you stop becoming a person, you become a patient and its actually grabbing some of that power back, it’s saying I might have an illness, I am still a person, I have got capabilities...” (Nurse Manager, Grantham)

“We lose sight of the bigger picture; people tend to be defined by illness... [with the Guidelines to Art] It’s about seeing the person first and the illness second...” (Nurse Manager, Grantham)

“It’s great for concentration; especially for people with Parkinson’s who have problems with concentration and focus... the sessions go really quick... people get totally engrossed in it...” (Nurse Manager, Grantham)

Not only do the artists appear to gain much from the experiences from using the Guidelines to Art, moreover, the arts facilitators and other staff members also report perceived benefits for themselves in being involved in the process:

“It’s been an enormously positive experience for me, I love coming, and when I’m away I always think it’s my day at the day centre today and I’m not there, and I miss them you know, people become friends and I feel its opened up avenues for me, like this, which I really love doing and would like to do more of... before I went on this course to learn how to do it, I wouldn’t have thought of it myself, so its strengthened my experience somewhat...” (Arts Facilitator/Volunteer, Newark)

“We have volunteers who do it too [use the Guidelines to Art], so it’s not just the clients, it’s everybody, it helps everyone relax...” (Nurse Manager, Grantham)

“One of the men today gave one of the volunteers his finished picture which she very gracefully accepted and she will remember him through his picture, its lovely...” (Arts Facilitator/Volunteer, Newark)

“The people here give what they can, the patients give us a lot, I feel very humble about that sometimes, that they can still give and they have a lot to give, they perhaps don’t appreciate that sometimes...” (Arts Facilitator/Volunteer, Newark)

“You can give so much by doing a small service to people but you also get a lot out of it because you realise people are enjoying themselves, they’re enjoying the experience...” (Arts Facilitator/Volunteer, Newark)

“You’re giving them something that they wouldn’t otherwise get...” (Arts Facilitator/Volunteer, Newark)

Social Benefits

The social benefits of using the Guidelines to Art have included the instrumental aspects observed and elicited through the collection of data. These have encompassed characteristics such as engagement, forming a group identity, socialisation rather than isolation and developing relationships with others. There also appears to be a sense of importance amongst people to feel that they have contributed towards something, in being able to share their thoughts and ideas with others.

16

Group Identity & Relationships

“It challenges the group to want to explore something new; to experience something new and to be encouraged by the person who is overseeing the group...” (Nurse Manager, Grantham)

“It reinforces and forms a bond between the group...” (Nurse Manager, Grantham)

“People lose confidence when they’re not in contact with many people, they lose the confidence in making decisions and actually relating to people, they lose the art of conversation... [The Guidelines to Art] make a good talking point...” (Clinical Service Manager, Nottingham)

“Carers were really surprised, particularly people who had never painted before...” (Clinical Service Manager, Nottingham)

Engagement & Socialisation

“Some people have lost the art of socialisation and been reluctant to come, however, people come out of their shell because they’re engaging and they start to realise there are people like themselves, so they become less self-pitiful; they start to see their life in a different way...” (Nurse Manager, Grantham)

“People were very involved and it makes the morning seem very short, they’re always amazed when its lunchtime. It takes about at least an hour to paint a picture, or like this morning, about an hour and a half...” (Arts Facilitator/Volunteer, Newark)

“Brings people together and gives people something to talk about...” (Clinical Service Manager, Nottingham)

“There is a buzz around the table... It gives a healthy competitive edge... Socialisation and contact with other people...” (Nurse Manager, Grantham)

“Some mornings people will just sit in here and chat, and that’s all that happens. There are other activities but sitting chatting, sometimes the talk turns to your illnesses or things that don’t really cheer you up, we try to keep the tone light-hearted but the painting takes people out of that...” (Arts Facilitator/Volunteer, Newark)

“I think especially in the home, it’s important to because of the isolation, it’s very important to fill that time, fill that void...” (Clinical Service Manager, Nottingham)

Involvement & Contributions

“As a group it’s a very powerful means, everyone has their own contribution, people feel valued...” (Clinical Service Manager, Nottingham)

17

“[the Guidelines to Art] method of watercolour painting has given many people their first introduction to art of any form…” (Communication Support Co-ordinator)

“They take away an object they’ve made and they can take it home and show other people and share it with other people and can talk about it, talk about their experiences...” (Arts Facilitator/Volunteer, Newark)

“There are pictures in Inverness & Lincolnshire taken away by people’s families...” (Arts Facilitator/Volunteer, Newark)

“[the Guidelines to Art] have brought tears of joy to our relatives’ eyes, which is not a common sight…” (Unit Manager)

“The paintings have made lovely keepsakes for families after their loved ones have died…” (Day Hospice Sister)

“I think they’re quite keen to put together several pictures that they’ve created here and display them to other people, just to share them...” (Arts Facilitator/Volunteer, Newark)

“I have seen many pieces of work proudly displayed in people’s homes for all to see…” (Communication Support Co-ordinator)

Potential Challenges

During visits to the different sites within Nottinghamshire, individual artists had spoken of their fondness of painting and having found new interest and enjoyment in an activity they had previously done little or none of. Despite this however, on returning to certain venues, individuals had stated that they had not had opportunity to paint in the interim. This was, most significantly, due to a “lack of opportunity” rather than a lack of want or ability to paint. Other potential challenges cited by those interviewed as well as through feedback have included;

“There aren’t enough hands for the amount of people that want to do it... It depends on the level of care needed as to how many facilitators are required...” (Clinical Service Manager, Nottingham)

“As a charity unfortunately its quite expensive, but I think the benefits outweigh the money, and I think once you’ve got it, you only have to recoup on the things you use and it is accessible to all the groups...” (Nurse Manager, Grantham)

“I do see the limitations of that in that the number of templates we have will eventually become exhausted, everybody will have done one of those pictures, and of course it runs through a fair amount of paper. It’s not an endless amount of water colour paper and it isn’t particularly cheap to renew but it’s so worthwhile... The paints won’t want renewing very often but the paper will...” (Arts Facilitator/Volunteer, Newark)

“I think the session has to be very flexible and you need to be aware of peoples differing needs... Particularly for the very disabled people who find it really hard if they’ve got shaky hands for instance that can be quite a problem, or if they can’t reach the table properly or whatever, and I think the facilitator needs to be aware of that and help them when the going gets tough, like

18

making very thin lines on the picture and I think some of the people, some of the patients, might find it hard to accept help in those respects and the facilitator needs to be sensitive to this...” (Arts Facilitator/Volunteer, Newark)

Future Potential

Whilst some observations and feedback suggested that people may have been tentative at using the Guidelines to Art initially, largely due to people’s anxieties surrounding trying something new, these people’s opinions would be transformed by the end of the session. As one the researchers noted in their observations;

“Some people were enthusiastic whilst others appeared much more anxious and reluctant regarding their abilities. At the start of the session the participants required much reassurance in feeling comfortable with what they were doing... One of the ladies was particularly nervous regarding her ability to paint since she has glaucoma, however, with support and reassurance and encouragement from the group, she was able to complete the process and produce a fantastic work of art which she, herself seemed surprised with...” (Observations from 6th February 2009)

John Whyman himself has also noted similar experiences of this initial reluctance followed by an ‘element of surprise’ throughout his use of Guidelines to Art, one of which most notably was a narrative account:

A Care Home Visit.

“One morning in March, we (five of us) were making a return visit to Lakeside Nursing Home, Littleborough. We had, last November, completed a six-week session there, and this was our return visit to ensure that the art idea didn’t die.

Blythe, the Matron (or is it Manager?) greeted Margaret, my wife, and I with a hug and asked how many tables we required. I prefer working on a one-to-one basis, so five residents were given the privilege of painting – we finished up with seven, of course!

I started painting with Evelyn who had the use of both hands, was not in a wheel-chair, and whose vision was good – but she stated firmly that I mustn’t ask her to draw anything – “I just can’t draw”. “Oh no, you don’t have to draw”, I assured her – “but do you think you could put a dot here?” said I, producing the template. “Oh I think I can manage that”, replied Evelyn, and so we proceeded – joining dots together. I don’t think she realised that she was drawing a picture.

Suddenly, Blythe appeared with a lady on her arm and introduced me to Maggie who had a very cautious look in her eyes – she sat down and looked completely detached from her surroundings. I showed Maggie the picture we had just drawn – ‘Hollingworth Lake’. Maggie said “I have painted before” – but I wasn’t convinced for she sat rigidly and did not seem to be in the real world. I asked Evelyn if she’d mind if I helped Maggie draw the picture.

Maggie achieved the template (never speaking a word). I placed my drawing before her and she quietly copied it and from then on she followed all that I was doing, very slowly but carefully. Cobalt for the lake, and I just left her with the colour, the water and the picture to copy. “Just the lake Maggie” and with a blank look she quietly applied herself.

The picture completed and in a mount, Maggie said not a word but gazed intently at her picture. “Perhaps you could sign your name Maggie?”

19

I suggested. She inscribed her full name, plus the day and date, and then stood up remaining perfectly still. I asked her if she would like to sit somewhere quietly – she didn’t reply but I asked one of the staff and Maggie picked up her picture and went.

Blythe, the manager, commented on what Maggie had achieved – I said how surprised I was and Blythe replied, “Not as surprised as I was!”

Some day the value of watercolour painting as a magic key to reaching people such as Maggie will be recognised...” (John Whyman, 30th March 2009)

All of the people interviewed and providing feedback on the use of the Guidelines to Art gave very positive images of the potential for continuing the use of the templates and developing the idea further. For the vast majority of places, the Guidelines to Art provided the only painting group for individuals involved in the service. There was the suggestion that alongside the individual benefits of being involved in art, art may be used to develop community engagement. People acknowledged the benefits of using Guidelines to Art as a tool for inspiring individuals to paint, recognised the potential importance of arts and health and gave ideas of other venues or care groups in which the Guidelines to Art might be used.

Guidelines to Art: A Transformational Concept

“I’m really pleased to have been given the chance to be involved in this, I really think the person who developed it and who started it up has done a really good job and I’d love to see it continue and be developed, I think other places wherever the need might be, I think a lot of the scheme...” (Arts Facilitator/Volunteer, Newark)

“The templates attract different people than other forms of art...” (Clinical Service Manager, Nottingham)

“I like the idea that everybody should be able to produce something, I like the philosophy of it, and it’s very important that people are given the opportunity...” (Nurse Manager, Grantham)

“Anybody can use them, right across the board age wise, right across the board ability wise...” (Nurse Manager, Grantham)

“Art has no gender; it is socially accepted for both males and females to do art...” (Clinical Service Manager, Nottingham)

“[The Guidelines to Art] attract everyone as long as they are able to hold a pencil or a brush... They will all give it a go...” (Arts Facilitator/Volunteer, Newark)

“This is the only art group at the hospice; there is a craft group but this is the only group that does painting...” (Arts Facilitator/Volunteer, Newark)

“It would be interesting to see how things develop... people would know where to place things which is the art of drawing and perspective which is very difficult to learn...” (Arts Facilitator/Volunteer, Newark)

20

“I only have my experience here; I haven’t done this work anywhere else before...” (Arts Facilitator/Volunteer, Newark)

“I haven’t come across it before, other than in this context, I feel maybe that it is undervalued...” (Arts Facilitator/Volunteer, Newark)

“Everywhere we take them they work!” (John Hope-Hawkins, Chairman, Society for All Artists)

“The Guidelines have a part to play in teaching people principles of watercolour painting in a way that is achievable ... it is not painting by numbers, it is creating a person’s own picture; a personal achievement...” (John Hope-Hawkins, Chairman, Society for All Artists)

“I would certainly recommend it; I’m very impressed with it!” (Nurse Manager, Grantham)

Importance of Art

“It’s of immense value; I would envisage that I would like to see it being part of the patient’s activity on a weekly basis… I would be saddened having seen the delight of the patients who use it to lose it, so I would envisage that it would be continued to be used here at the hospice...” (Clinical Service Manager, Nottingham)

“There is capacity for 25 patients a day; around 29 come for the painting!” (Clinical Service Manager, Nottingham)

“Staff members come in and take a great interest in it and give lots of praise, and they’re quite surprised at what people achieve and they’re quite keen on the project continuing...” (Arts Facilitator/Volunteer, Newark)

“I think the advantages and what people get out of it far outweigh any of the disadvantages...” (Arts Facilitator/Volunteer, Newark)

“There are lots of things that people can enjoy, even if they’re very ill or their days are numbered, I think they can still enjoy art and music and these things perhaps need developing so that they can go in different directions...” (Arts Facilitator/Volunteer, Newark)

“I do feel there is a great benefit in music and also making music that we don’t explore and probably the same is true of art...” (Arts Facilitator/Volunteer, Newark)

“There are 50-60 new members joining the Society for All Artists per day; demonstrating people’s ambition to paint...” (John Hope-Hawkins, Chairman, Society for All Artists)

“Art I’m sure has enormous therapeutic value, not just painting but whether you’re doing craft or painting or writing poetry, or poetry reading or talking out loud or performing or music and…I think they all are a vital part of our make-up… I hope that this recession that we’re getting into now will get people to stop worrying so much about their money and start achieving something with their lives...” (John Hope-Hawkins, Chairman, Society for All Artists)

21

“I think Art and health are vital, I think that was proved a long time ago...” (John Hope-Hawkins, Chairman, Society for All Artists)

“[The Guidelines to Art] demonstrates the benefits of doing something creative, with other people, it’s tactile...” (John Hope-Hawkins, Chairman, Society for All Artists)

Ideas for the Future & Potential Users

“There’s now an emphasis on working with people holistically, this gives people an opportunity to put their money where their mouth is...” (Nurse Manager, Grantham)

“[The Guidelines to Art] could be made into a sponsored event; sponsored painting for everyone to have a go, to display them in the lounge and to raise funds for the hospice...” (Nurse Manager, Grantham)

“I think what could be useful is if people could be encouraged to use it at home, if it could be cheaper, you wouldn’t necessarily have to buy the whole thing for one single person, but potentially a mini pack, that might be something that would be worth pursuing... A mini pack with all the basic essentials, maybe a clipboard to help keep the paper in place to help with agility...” (Nurse Manager, Grantham)

“I think even in hospitals, it is something that people could do in bed, to help overcome boredom...” (Nurse Manager, Grantham)

“Carers themselves, it would be quite relaxing for them, to de-stress in an environment that is non-threatening and for carers to develop new skills...” (Nurse Manager, Grantham)

“Carers; because carers are so important in terms of finding something that’s just for themselves...” (Clinical Service Manager, Nottingham)

“People with learning disabilities; rehabilitation...” (Clinical Service Manager, Nottingham)

“I think it’s endless, I think where there are people be it health or social I think it can be used...” (Clinical Service Manager, Nottingham)

“I think it would work ideally in an adolescent unit; such as an oncology unit...” (Clinical Service Manager, Nottingham)

“Friends or neighbours... The older age group...” (Nurse Manager, Grantham)

“[The Guidelines to Art] could be taken to care homes, hospitals, hospices, day centres, people’s homes, WI, painting on wheels; one to one... it works with all age groups...” (John Hope-Hawkins, Chairman, Society for All Artists)

22

“I would think that it would particularly benefit maybe mentally handicapped people who perhaps don’t have an opportunity to try art or know that you can do it if you want to... Children as a starting point to help develop imagination...” (Arts Facilitator/Volunteer, Newark)

“Our vision is to develop a series of guidelines: currently we have Guidelines to Art: Watercolour; we would also like to see oils, acrylics, pastels, landscapes, flower...” (John Hope-Hawkins, Chairman, Society for All Artists)

Discussion

The findings of this evaluation will add to the scope of evidence available in support of the benefits for arts and health. In doing so, the findings from this report will be discussed in light of pre-existing evidence and knowledge relating to the role of arts for health.

The findings from this research have been overwhelmingly positive regarding the use of the Guidelines to Art as well as the benefits of art for individuals. The interviews with arts facilitators, volunteers and other staff members gave particularly moving and often poignant insights into the impacts and effects of art not only for the individuals

involved but also for workers and carers as well; especially when discussing art as showcasing a memory of a loved one.

Staff members, in particular, highlighted the importance of art and particularly the use of Guidelines to Art as holding a ‘dual role’. This was in the sense that art impacts upon all of those involved; not only having benefits for the artist but also for the facilitator in feeling they have contributed towards somebody else’s achievement, development of confidence and self-worth.

All those involved in using Guidelines to Art commented on the simplicity and accessibility of the templates, without feeling the need to have had any prior training or experience beforehand. Indeed, many people commented that the accompanying DVD with the arts kits was enough to provide a sound knowledge base of how to implement the Guidelines to Art.

Many personal benefits were noticed both by the artists as well as staff members. Although individual artists found it difficult to explain in words why or how they felt they had benefitted from being involved in art, all of the individuals spoken with acknowledged that they had; whether these were in terms of elements of relaxation, achievement or just simply passing the time. Indeed staff members and carers were noted often to be surprised at individual achievements. Arts facilitators, volunteers and managers also noticed that individuals became more confident, created a new identity for themselves that did not involve ‘illness’ and appeared to have a renewed or increased sense of self-worth and esteem through a new challenge and interest. These health benefits resulting from art have all been previously recognised with arts and health literature, (Arts Council England, 2004; 2005; Baum, 2002; Department of Health, 2007; Keleher et al., 2007; Putland, 2008; Staricoff, 2004)

Arts facilitators, volunteers and managers often commented upon art as providing a focal point, aiding the development of new relationships through providing people with a topic to talk about. Observations also supported this in finding that art brought people together who might not otherwise have engaged either in an activity or necessarily with one another. Professor John Zeisel, President and co-founder of the Hearthstone Alzheimer’s Family Foundation and Hearthstone Alzheimer Care Ltd, stated that, “there needed to be a greater emphasis on activities to stimulate engagement and improve language skills, such as day trips to the seaside, painting and community activities,” (The Times, 4th June 2009)

When in a group, people were noticed to be particularly supportive of one another and people’s moods were noticed to be improved. A ‘community spirit’ was also identified through people wanting to showcase their

23

work, develop and open the opportunity of using the Guidelines to Art for others, as well as wanting to give something back to providers, whether this be hospices, carers or staff members. Again, the notion of community engagement has been well documented as an outcome for art, (Arts Council England, 2004; 2005; Berkman & Kawachi, 2000; Department for Culture, Media & Sport, 1999; Kagan et al., 2004; 2005; Putland, 2007; 2008; Wilkinson & Marmot, 2003).

Most importantly, art, and painting in particular, is something that people wanted to be involved in and engage with, both as individuals and as part of a group. Previous findings have suggested that “people with a limiting longstanding illness were less likely to attend both performing and non-performing arts or culture” and “were also less likely to participate in sociable or physically demanding activities”, (Arts Council England, 2005; page 101). This however, was certainly not the case amongst the hospices visited or where feedback was gained. The opposite of these findings would appear to be a more accurate representation amongst the locations on which this report is based.

Conclusion

The Guidelines to Art have offered a new method of providing art to individuals within care homes, hospices, hospitals and within people’s own homes. Much positivity has been gained through art by all those involved; including, artists, arts facilitators, volunteers, carers and other staff members. This has been in terms of self-confidence, esteem, self-worth alongside engagement and socialisation with others. The use of the Guidelines to Art have also offered people the opportunity to view themselves beyond their illness; affording people a new identity based upon capability rather than disability.

Individuals involved in this project have suggested many other venues in which the Guidelines to Art might be used. These have included a wide range of diverse possibilities, including suggestions for carers, children, older people, people with learning disabilities, friends and neighbours. However, as told by some;

“Art has no gender; it is socially accepted for both males and females to do art...” (Clinical Service Manager, Nottingham)

“Anybody can use them, right across the board age wise, right across the board ability wise...” (Nurse Manager, Grantham)

“I think it’s endless, I think where there are people, it can be used...” (Clinical Service Manager, Nottingham)

Art therefore holds no bounds. Currently, the benefits of art are being seen within cardiovascular and intensive care units, medical procedures, pain management and surgery, (Staricoff, 2004). What is also emerging are the benefits of art in addressing ‘neighbourhood renewal’ amongst communities, including health, reduction of crime, improving employment and education, (Arts Council England, 2005; DCMS, 1999). Perhaps the Guidelines to Art might also be developed and utilised within these areas and amongst these groups of individuals, in recognising both art and watercolour as “a magic key to reaching people”, (John Whyman, 30th March 2009).

24

References

Arts Council England (2004) The Impact of the Arts: Some Research Evidence, Arts Council England, London

Arts Council England (2005) Your Health & the Arts: A study of the association between arts engagement and health, Arts Council England, London

Baum, F. (2002) The New Public Health, Oxford University Press, Melbourne

Berkman, L.F. & Kawachi, I. [Eds.] (2000) Social Epidemiology, Oxford University Press, New York

Biley, F.C. & Galvin, K.T. (2007) Lifeworld, the arts and mental health nursing, Journal of Psychiatric & Mental Health Nursing, 14, 800-807

Camic, P.M. (2008) Playing in the Mud: Health Psychology, the Arts and Creative Approaches to Health Care, Journal of Health Psychology, 13 (2) 287-298

Darbyshire, P. (1999) Nursing, Art & Science: Revisiting the two cultures, International Journal of Nursing Practice, 5, 123-131

Department for Culture, Media & Sport (1999) Arts and Sport: Policy Action Team 10, A Report to the Social Exclusion Unit, Department for Culture, Media & Sport, London

Department of Health (2007) Report of the Review of Arts and Health Working Group, Department of Health, London

Gadamar, H.G. (1977) Philosophical Hermeneutics, University of California Press, California

Gallagher, A. (2007) The role of the arts in mental health nursing: Emperor’s new suit or magic pill? Journal of Psychiatric & Mental Health Nursing, 14, 424-429

Health Development Agency (2000) Arts for Health: A review of good practice in community-based arts projects and initiatives which impact on health and well-being, Health Development Agency, London

Heidegger, M. (2001) The Origin of the work of art from poetry, language and thought, Harper Collins, New York

Jermyn, H. (2001) The arts and social exclusion: A review prepared for the Arts Council England, Arts Council England, London

Johnson, A. (16th September 2008) Speech given at: Arts & Healthcare Event, “Open to All”: Mental Health, Social Inclusion and Museums & Galleries, The Wallace Collection, London

Kagan, C., Sixsmith, J., Siddiquee, A., Bol, S. & Lawthom, R. (2005) Community psychology meets participatory arts, Research Institute for Social Change, Manchester

Kaye, C. & Blee, T. [Eds.] (1997) The Arts in Healthcare: A palette of possibilities, Jessica Kingsley, London

Keleher, H., Murphy, B. & MacDougall, C. (2007) Approaching Health Promotion, in: Keleher, H., Murphy, B. & MacDougall, C. [Eds.] Understanding Health Promotion, Oxford University Press, Melbourne (pages 1-13)

Lawthom, R., Sixsmith, J. & Kagan, C. (2007) Interrogating Power: The case of arts and mental health in community Projects, Journal of Community & Applied Social Psychology, 17 268-279

Leight, S. (2002) Starry Night: Using story to inform aesthetic knowing in women’s health nursing, Journal of Advanced Nursing, 37, 108-114

Lupton, D (1995) The Imperative of Health, SAGE, London

Maclagan, D. (2001) Psychological Aesthetics: Painting, feeling and making sense, Jessica Kinsley, London

McQueen-Thompson, D. & Zigauras, C. (2002) Promoting mental health and well-being through community and cultural development: A review of literature focusing on community arts practice, The Globalism Institute, Melbourne

Merlau Ponty, M. (1964a) Cezanne’s Doubt, in: Dreyfus, H. & Dreyfus, P. [trans.] Sense and non-sense, Northwestern University Press, Evanston (pages 1-193)

Merlau Ponty, M. (1964b) Indirect language and the voices of silence, in: McCleary, R. [trans.] Signs, Northwestern University Press, Evanston (pages 39-83)

Merlau Ponty, M. (1964c) Eye and Mind [L’Oeil et I’espirit] in: Kearney, R. & Rasmussen, D. [Eds.] Continental Aesthetics Romanticism to Postmodernism, Blackwell, Oxford (pages 288-306)

Merlau Ponty, M. (1998) Phenomology of Perception, Routledge, London

Putland, C. (2007) Art and community-based health promotion: Lessons from the field, in: Keleher, H., Murphy, B & MacDougall, C. [Eds.] Understanding Health Promotion, Oxford University Press, Melbourne (pages 299-312)

25

Putland, C. (2008) Lost in Translation: The question of evidence linking community=based arts and health promotion, Journal of Health Psychology, 13 (2) 265-276

Runco, M.A.[Ed.] (1996) The creativity research handbook: Volume 1, Hampton Press, New Jersey

Secker, J., Spandler, H., Hacking, S., Kent, L. & Shenton, J. (2007), Empowerment and arts participation for people with mental health needs, Journal of Public Health, 6 (4) 14-23

Stafford, E. (1998) CCD: Why do we do it? Artwork Magazine, 39, 16-20

Staricoff, R.L. (2004) Arts in Health: A Review of the Medical Literature, Arts Council England, London

Staricoff, R.L., Duncan, J., Wright, M., Loppert, S. & Scott, J. (2001) A study of the effects of visual and performing arts in healthcare, Hospital Development, 32, 25-28.

Sternberg, R.J. (2006) Creating a Vision of Creativity: The first 25 years, Psychology of Aesthetics, Creativity and the Arts, 1, 2-12

Thiele, M. & Marsden, S., (2003) Engaging in Art: The Artful Dodger’s Studio, Jesuit Social Services, Richmond

VicHealth (2003) Creative Connections: Promoting mental health and well-being through community arts participation, Victorian Health Promotion Foundation, Victoria

Wali, A., Severson, R. & Longoni, M. (2002) Informal Arts: Finding cohesion, capacity and other cultural benefits in unexpected places, Centre for Arts Policy, Chicago

Wikström, B. (2000) Nursing education in the art gallery, Journal of Nursing Scholarship, 32, 197-199

Williams, D. (2005) Creating Social Capital: A study of the long-term benefits from community based arts funding, Community Arts Network South Australia, Adelaide

Wilkinson, R. & Marmot, M. (2003) Social determinants of health: The Solid Facts, World Health Organisation, Geneva

26

Appendices 1

Guidelines to Art

Participant Observation Framework with Artists/Participants

How are you finding the Guidelines to Art?

Do you like doing arts/crafts?

What other things do you do?

How do you feel when you are involved in art and doing painting? (e.g. happy, sad, bored, relaxed etc.)

Have you been sharing your ideas with the group? (explore feelings about this)

What do you get out of art & painting? (e.g. friendship, socialisation, something to do, new skills, learning something new)

Observation Themes

Choice Happiness

Confidence Group involvement

Emotions Stimulation

27

Appendices 2

Guidelines to Art Project Interview Schedule

John Hope-Hawkins:

Background to SAA & how the guidelines project came about.

Where are the templates currently being used?

Where do you see the templates being used in the future?

How do you think Art benefits individuals?

What are your visions for the future with regards to Art & health?

Activities Co-ordinators/Arts Facilitators/Managers:

What were your initial thoughts about the templates?

How do you envisage them being used within your workplace?

Potential benefits and challenges for the care group you work with?

Where else do you think the templates might be used?

What are your personal experiences of using Arts within health services?

What do you think are the benefits of Art?

28

Appendices 3

Guidelines to Art Assessment - Making a positive contribution. Please add your thoughts, in the hope of increasing the benefits of ‘Guidelines to Art’.

Thank you.

Date Venue Leader

Staff contact name Telephone

How many people took part? Female Male

Score: 1 = negative 5 = positive Score Comments

Were they worried or unsure about achieving success beforehand?

How easy did they find it to paint the picture?

Did they find it easy to concentrate?

Did they find it tiring?

Were they happy during the lesson?

Were they happy after the lesson?

Did the session improve their self esteem?

Have you noticed any positive changes in their behaviour or attitude since the session?

Has it had a beneficial effect on their well-being?

How many want to take part again?

How often would you like to have a painting session? Daily / Weekly / Monthly

Do you have a member of staff or volunteers who could run the painting sessions after receiving guidance?

Please add any other comments or observations you would like to make overleaf. This is in the strictest confidence to assess the benefits gained from ‘Guidelines to Art’ and only for internal use.

Please return to:

John Hope-Hawkins FRSA, SAA, PO Box 50, Newark, Notts. NG23 5GY

Direct: 01949 845230 Switch: 01949 844050 Fax: 01949 844051

john@saa.co.uk www.saa.co.uk

The SAA exists to inform, encourage and inspire all who want to paint, whatever their ability.

29

Comments

30

Comments

The Society for All Artists,PO Box 50, Newark, Notts. NG23 5GYTel: 01949 844050www.saa.co.uk

Dr Theodore Stickley,Associate Professor

Faculty of Medicine & Health Sciences University of Nottingham