This thesis explores the experience of a dance movement therapy group as part of a post graduate diploma course in higher education. The prime focus is the students' perspective of the group training as preparation for their subsequent role as dance movement therapists in practice. The research follows a group of seven students through a two year dance movement therapy group experience using an action research methodology in a collaborative mode. Through a series of systematic, planned, in-depth, semi-structured interviews, it uses the students' own account of the experience and correlates this with their practice as trainees. The third and final year fieldwork explores, from the students' perceptions, the way such an experience is integrated into eventual practice. The thesis is grounded in a literature review drawn from the psychotherapy, counselling and arts therapies fields. An international survey of training organisations for the arts and psycho therapies provides significance of the group experience in the training of arts therapists. The major conclusion is that although group experience in dance movement therapy is crucial for the training of dance movement therapists it requires extremely sensitive handling to cope with the feelings of loss, anger, grief and struggles with models of practice. There are, in addition, many difficulties experienced in learning to be a group as well as an individual within the group. The issue of authority in particular, which is central to any course in higher education, has to be carefully worked through for these students. The thesis concludes with recommendations for curriculum development in the post graduate training of dance movement therapists and allied professions.

This thesis explores the change that occurs through the experience of Applied Theatre and participatory drama with specific participant groups: adults with learning disabilities, and those recovering from mental illness. Termed 'transformation' through an anthropological perspective of theatre and subsequent links with ritual theory, the thesis asks how and why this change (and the potential for it) can be identified through the fictive situation offered by participation in drama or theatre. This analysis occurs through the application of a particular theory: Turner's liminality (1969). Turner's (1969) theory of ritual, following Van Gennep (1977) is applied to discussion of practical field work with seven different groups to unravel the relationships between individual and group, the pretence and the real, and the self within the pretence and the real. Methodological and ethical issues arising from this are discussed. Turner's theory of the 'liminal zone': the space 'in between' one state in ritual and the next, is applied to the space of the 'theatre event' in both making (the process) and performing (the product) drama and theatre. Turner's 'communitas' is outlined as a description of the human group connection that occurs during this making and performing. The conceptual relationship between the social form of reality and the aesthetic form of pretence is discussed with reference to the work of Schechner (1988). The potential of a different objective self is of particular relevance for these participant groups because the fiction challenges the social categorisation of these groups imposed by contemporary British society. One outcome of the research is the recognition of this correlation between the fiction and reality. The participants recognise their ability as objective selves (within the pretence) and this contributes to a changed perception of their subjective selves (beyond the pretence). This is affirmed by the witnessing of the changes effected by the pretence and underlines the importance of the group within the theatre event. This transformation is outlined as a reflexive cycle, drawing on research in Health and Social Care, and in disability politics, in situating the participants as active contributors to the research practice.

Background There is growing interest in the idea that arts and singing have effects on health, wellbeing and quality of life in older individuals. This study assesses the effectiveness and transferability to Italy of an English model of health promotion which promotes wellbeing and quality of life in older people through participation in singing groups (Silver Song Clubs). The model developed in the South East of England has proved to be successful. A recently completed randomized controlled trial (Coulton, et al. in press) demonstrated a significant improvement in mental health with a reduction in measured anxiety and depression for older people living independently. The current study adopted the same measures. Method A mixed method approach was adopted with research divided into two parts; Part A was focused on exploring the status of older people living in Rome, their interest in music and singing today and in the past and in taking part in a singing experience. It also explored how local politicians and social workers see the status of older people. Part B was focused on setting up and evaluating singing groups and gathering information from participants on their experiences of singing. The primary outcome measure was an Italian version of the York SF-12 which provides scores for physical and mental wellbeing. The Italian version of the EQ-5D-3L questionnaire was also employed. Results Results from Part A revealed a highly fragmented Italian family, with widespread poverty and social isolation and a need for emotional support and leisure activities among older people. In Part B, three singing groups were established in different areas of Rome with weekly sessions over a period of three months. Participants completed the standardized measures of health and wellbeing at baseline (n=62), after the singing experience (n=45) and three months later (n=41). After the singing experience, older people showed a statistically significant decrease in their levels of anxiety and depression, but this was not maintained over the three month follow up period. However, a significant improvement was found from baseline to follow up in reported performance of „usual activities‟. Conclusions Silver Song Clubs provide a health promotion model which was successfully transferred from England to the different cultural setting of Italy. Singing can be widely used because it is grounded in a fundamental human ability to engage with music. The present study had a number of limitations, primarily a lack of a control group and small sample size. However it provides a good foundation for the development of further research on singing and the wellbeing of older people in Italy.

Research on art therapy and psychosis has typically focused on individuals who have experienced psychotic symptoms for many years. This study used a grounded theory methodology to explore how service users experience art therapy following their first diagnosis of a psychotic disorder, and the possible mechanisms through which art therapy might be helpful for such individuals. Eight participants were interviewed, with two participants being interviewed twice. A preliminary theory was created and seven categories were constructed from the data, namely unpressured atmosphere, pleasure and engagement in art-making, expression and communication, connecting with others, changing emotional experience and experience of self, supporting recovery and continuation of art, and barriers. Participants reported that through the atmosphere of art therapy, art-making, and communication, they were able to build relationships, connect with others, experience a sense of commonality, absorption, sense of freedom and discover alternative perspectives and different understandings. Whilst this study suffered from some limitations, the results build on the current research base by suggesting possible processes and mechanisms through which art therapy is helpful, and focusing on a previously under-represented population. The findings are considered alongside existing research and theoretical perspectives. Clinical implications and recommendations for future research are also highlighted.

Dementia is a progressive disease characterised by a widespread impairment of mental functioning including cognitive skills. Research has suggested that arts and health interventions can have positive effects in terms of physical and mental health in people with a dementia. The current study evaluated the impact of two, eight week, art-gallery based interventions, including art-viewing and art-making, for 13 people with dementia and their carers. Audio recordings of these sessions were transcribed and analysed using content analysis. The study sought to identify the impact of the intervention on cognition, in particular, on verbal fluency and memory. The findings suggested that on the whole, the intervention promoted increases in verbal fluency and in memory stimulation, which is consistent with previous research. Despite the methodological limitations inherent in this pilot study, the findings provide rationale for further controlled research and implications for clinical practice in encouraging clinicians to seek out links with community art gallery resources in order to facilitate the development of further interventions of this kind.

Dementia refers to a variety of diseases that are characterised by cognitive difficulties and an overall decline in daily living skills. Psychologically-informed arts and health interventions may be particularly valuable ways of improving the lives of people with a dementia and their carers. This study investigated arts-based interventions at two, London and Nottingham, art galleries where 12 people with mild to moderate dementia and their 12 carers were engaged in art-viewing and art-making. Post-intervention interviews with participants (n=12) and facilitators (n = 4), field notes and extensive written communication between the facilitators and research team was analysed using a grounded theory approach to establish how the intervention affected those involved. Three categories, a valued place, intellectual stimulation and social interaction, combined to create positive emotional and relational effects for both those with dementia and carers. In addition, there was evidence of a changed perception of dementia by facilitators. The resulting theory has potential implications for the use of arts within health and social care by applied psychologists, health, social care and museum professionals, as well as community services.

Dominant narratives about psychosis portray individuals as lonely, dangerous and unable to contribute to society. Such views may be incorporated into an individual’s personal story and are associated with negative outcomes for personal and clinical recovery. Art-making is associated with personal meaning-making and alternative forms of expression. It is therefore considered potentially relevant to narrative modification. Adult service-users with psychosis participated in a gallery-based art-making intervention. At interview, participants used their self-created images to help tell their story. Literary, experience-centred and culturally-oriented lenses were used to analyse narratives. Turning-points as modifiers of stigmatised dominant narratives were explored, as was how the intervention supported recovery. Art-making was associated with achievement, challenge and satisfaction. Story-telling using visual and verbal means opened up stories and alternative perspectives for participants. Recovery-principles including hope and aspiration were supported, identified through goals and recognition of achievement. Sharing experiences with others with similar experiences was viewed as impacting positively on mental-health. The intervention represented effective partnership working between NHS services and a gallery in overcoming barriers to accessing the arts, for people with psychosis. Achievements in art-making and narrating experience using visual and verbal means offered alternatives to personally limiting and illness-dominated narratives.

This project builds on the existing evidence that suggests that art-based interventions can be beneficial for the wellbeing of people with dementia and their carers, and explores whether such interventions can be delivered via a touchscreen tablet device using an application that allows them to view art images. Twelve pairs of volunteers with dementia and their informal carers were recruited through Alzheimer’s Society Dementia Cafés. A quasi-experimental mixed-methods within-subjects study evaluated the impact of art-viewing on wellbeing using visual analogue scales as well as exploring the experiences of participants qualitatively with thematic analysis. Quantitative results showed a significant effect for change in composite wellbeing from viewing session one to session five. Wellbeing subdomain scores showed an impact on wellbeing which tended to increase with the number of sessions. Qualitative findings were reported in relation to shifts in cognition, changes in behaviour, mood and relationships between people with dementia and their carers. These changes tended to be viewed as positive by interviewees. The results suggest that touchscreen based art interventions have the potential to provide an activity people with dementia can engage in with their carers which can benefit their wellbeing. A larger-scale controlled study would help to further determine whether wider dementia care practice implications can be drawn for clinical psychologists and other healthcare providers.

Previous research has shown that people with dementia and carers derive wellbeing-related benefits from group art-viewing, and that facilitated museum object handling is effective in increasing subjective wellbeing for people with a range of health conditions. The present study aimed to compare the impact of these activities on subjective wellbeing of people with dementia and carers. A quasi-experimental crossover design was used. People with early to middle stage dementia and their respective carers (N = 66) attended a museum session in small groups where they participated in three activities: museum object handling, a refreshment break and art-viewing. Visual analogue scales were used to rate subjective wellbeing pre and post object-handling and art-viewing. Mixed-design ANOVAs indicated wellbeing significantly increased for people with dementia and carers during the museum session irrespective of the order in which they participated in object-handling and art-viewing. Analysis of pre and post-condition scores across pooled orders indicated wellbeing significantly increased from object-handling and art-viewing for carers; wellbeing for people with dementia significantly increased from object-handling; the increase from art-viewing was not statistically significant. A refreshment break did not produce significant change in wellbeing for either group. An end-of-intervention questionnaire indicated that experiences of the session were positive. Limitations and directions for future research were discussed. Results provided a rationale for partnership working between museums and healthcare professionals.

This study aimed to explore children’s experiences of art therapy in order to create a theory of change processes within school-based art therapy. A total of 14 children were interviewed at two different schools, along with their parents, teachers, and art therapists. All children had received art therapy within the last 12 months. Semi-structured individual interviews were undertaken with 40 participants. Children completed a craft activity within their interview as a visual expression of their therapy experience. Interview data was analysed using grounded theory methodology. The results generated three theoretical models. The first model highlighted the systemic nature of the art therapy as well as describing it as mysterious. Model 2 described the processes within art therapy, focusing on the individualised child-centred nature of the intervention. Art doing was considered central to the children’s expressions and developing understandings. Model 3 described the trajectory of change for the children. The study recommends that psychologists consider art therapy for children who are struggling to verbalise their difficulties; that clinicians focus on therapeutic experiences being fun and enjoyable for the child, as well as embedded within the child’s system; and lastly that clear target problems are identified at the start of therapy.