Section A reviews whether arts-based activities for people with a dementia (PWD) have significant cognitive, social, and psychological benefits for this population. There is a variety of theoretical perspectives on dementia that encompass the biological, psychological, and social effects of the disease on the wellbeing of PWD. Visual arts may be an appropriate way of addressing some of the challenges that PWD face by providing a means of ameliorating some of their cognitive, social, and psychological difficulties. Literature from the field of arts-based activities with PWD suggests that there is no apparent theoretical conceptualisation in the area, as most studies have attempted to evaluate various art programmes with no clear rationale for expected findings; rather, they have taken a more exploratory stance. However, they indicate that arts-based activities can have social and psychological benefits by increasing confidence, enthusiasm, enjoyment, social contact, mood, quality of life, and ratings of depression. The review concludes with a rationale for why it is important to expand the current evidence base on arts-based activities for PWD. Section B: Dementia refers to a variety of diseases that are characterised by cognitive difficulties and an overall decline in daily living skills. Arts and health interventions may be particularly valuable ways of improving the lives of PWD and their family carers. This exploratory study involved six people with mild to moderate dementia and six family carers attending an arts-based intervention at a major London art gallery for three sessions over three weeks, in which they engaged in art-viewing and art-making. Using audio recordings to record PWDs’ responses, rather than standardised measures, which are often problematic with this population, the study sought to explore possible changes in cognition of PWD during the intervention, namely episodic memory and verbal fluency. Using a mixed methods design, data were collected at five points and analysed using content and thematic analyses. The findings suggested that episodic memory and verbal fluency appeared to improve during the art gallery-based intervention. This was substantiated by family carers who also reported that PWD showed increased mood, confidence and social interaction, and that they valued the shared experience and learning opportunity. Whether these changes can be attributed to the intervention is a matter for further research beyond this exploratory study. Future research is proposed to further understand the implications of these preliminary findings. Section C presents a critical appraisal of the research. Research skills that have been learned and developed over the course of the process are discussed, such as increased awareness of the benefits of working within a wider research community. There is consideration of the need to communicate clearly and sensitively with other professionals from differing backgrounds and organisations, as well as the importance of building on a coherent evidence base when designing a research project. Better organisation relating to recruitment and investigation into recording during the art-viewing sessions at the gallery are identified as aspects that would be done differently, as well as consideration of using a case study approach. Clinical consequences of the research are discussed, such as utilising a community psychology approach and involving art and creativity in therapeutic sessions. Finally, further research in the area is considered, such as by expanding the study and using robust neuropsychological measures to detect cognitive change.

Section A explores the role of creative arts therapies (CATs) in assisting recovery from severe mental illness (SMI). It examines the congruence of CATs with recovery models, and critically reviews evidence for the effectiveness of art and drama therapy with adults with mental health problems. It then examines one form of CAT which combines art and drama therapy – therapeutic puppetry. Underlying theoretical models and the existing evidence base with adults with SMI are outlined and critiqued. The review concludes with a summary of proposed arguments and research recommendations. Section B reports on a pilot investigation of group therapeutic puppetry with people with SMI. Background: Therapeutic puppetry is the use of puppets to aid emotional healing. There is no published research investigating the effectiveness of therapeutic puppetry with people with SMI. Aims: A pilot investigation of group therapeutic puppetry with people with SMI tested the hypotheses that this intervention results in improvements in mental wellbeing, self-esteem, and body connection. It also investigated mechanisms of change, and service user acceptability and experience. Method: This mixed methodology study utilised five single AB design case studies with time series data analysed using simulation modelling analysis. Qualitative data was collected via participant observation and participant interviews and analysed using thematic analysis. Results: Three participants experienced statistically and clinically significant changes in either positive or negative directions during the intervention, with all participants describing therapeutic puppetry as powerful and beneficial. Conclusions: Therapeutic puppetry is a potentially powerful medium which could be utilised by various mental health professionals. Service users find therapeutic puppetry acceptable and beneficial despite it being an occasionally difficult and intense experience. Section C is a critical appraisal of the conducted research, examining lessons learnt, identified training needs, changes to clinical practice and future research directions.

Section A consists of a review of the literature relating the therapeutic use of creative writing. It highlights gaps in the literature and suggesting potential avenues of further research. Section B presents the findings of a phenomenological study which aimed to explore the experience and significance of creative writing at times of personal difficulty through the analysis of written accounts. Method. Twenty one people who had personal experience of creative writing in the context of difficult life experiences submitted written accounts. These were analysed using Interpretative Phenomenological Analysis (IPA) (Smith, Larkin & Flowers, 2009). Results. Four main themes were identified: 1) Struggle with a difficult experience, 2) Turning to creative writing, 3) Dealing with it ‘as a matter of words’ and 4) Rejoining the world. A conceptual model illustrating how these master themes are related is presented. Conclusion. Creative writing was deemed to have played an important and meaningful role in helping participants to integrate and move beyond difficult life experiences. Limitations and clinical implications of the study are discussed and suggestions are made for future research. Section C involves a critical appraisal of the study presented in Section B. Reflections on the process of the study, as well as further implications and clinical applications are discussed.

There is limited research concerning the sharing of writing associated with times of personal difficulty. This study aimed to explore the experience and significance of this process with a focus on the interpersonal factors involved and how the potential benefits could be conceptualised. Eight participants were recruited through purposive sampling and interviewed regarding their experiences. Interpretative Phenomenological Analysis was used to analyse the transcripts. Four superordinate themes of ‘Putting the self into the world’; ‘Taking ownership of the process’; ‘Making connections with others’; and ‘Moving beyond surviving to thriving’ were interpreted from the data. Interpersonal factors were of great significance and were discussed in connection with a range of theorists including those from fields of psychoanalysis, phenomenology and humanism. The overall findings were conceptualised through identified links with Ryff’s (1989) multidimensional model of well-being. The findings suggest that the sharing of creative writing associated with times of personal difficulty may be a valuable activity in promoting well-being in both clinical and non-clinical populations. It may be particularly helpful for people who have experienced, or are at risk of social isolation given the experiences that first led the participants to creative writing, and the centrality of ‘connection within others’ within their accounts.

There is increasing interest in the personal benefits of writing poetry and a growing field of practical application within healthcare. However, there is little direct research and a need for practice-based theoretical integration to improve understanding of the specific changes, creative processes and challenges involved. This study investigates the way that writing poetry can affect self-experience. It also contributes to the development of combined modes of creative and critical inquiry. A first-person account of the experiential and creative outcomes of writing poetry over an extended period is presented. The results of this are subjected to reflexive analysis and a critical theoretical explication. Four factors relating self-experience to the experience of writing poetry are identified: a failure of conscious intention; an inhibiting objectification of experience; an implicit assumption of a separate self, and a changed experience of self that felt more embodied and fluid. These findings are the basis of a theoretical examination that utilizes the work of Ignacio Matte Blanco and Michael Polanyi, in conjunction with insights derived from contemporary psychoanalysis, embodied cognition, neuroscience and attention training. An original theoretical integration is developed. It is proposed that poetry has a characteristic bi-logical form that condenses and integrates difference and identity in a simultaneous and concentrated manner. The process of composition requires a reciprocal interplay of conscious and unconscious processes, which can be enhanced by an increase in embodied awareness, a decrease in the exercise of deliberate volition, and the facilitative use of images. This involves a flexible oscillation of awareness that, modulated by the breadth of attention and the degree of identification or separation from experience, directly alters the boundaries and quality of self-experience. This framework avoids the limitations of reductive or eliminative views of the self and allows for the creative operation of what is dubbed the 'nondual imagination'.

The performer's conceptualisation and perception of herself is projected through the acoustic voice and impacts upon vocal delivery in rehearsal and performance. However, in the context of performer voice training in Western theatre practice the performer's sense of self, or identity, is seldom the focus of development. Vocal development is inherently a transformational process that requires the performer to expand beyond what has become habitual selfexpression. Since vocal expression is embedded in identity, an attempt to change the voice necessitates a deeper understanding, questioning, and challenging of the performer's established sense of self. In this dissertation I posit that acoustic vocal development can be successfully achieved through an embodied and imaginative approach that investigates the performer's metaphorical voice through learning opportunities provided by a process that integrates the practices of Voice Movement Therapy (VMT) and maskwork. This dissertation presents art-based autoethnographic research into the potential value of such an integrated approach to performer vocal development. The VMT maskwork approach is fundamentally an embodied and envoiced process that provides a vastly different and heightened experience of the bodymind and invites the performer to play in the liminal realm of active imagination, which is triggered by the mask-image. The dissertation investigates the vocal development benefits of using self-made masks as a psychophysical training tool to expand the performer's understanding and experience of the bodymind. The area of archetypes and subpersonalities has been identified as a primary intersection between the two modalities and three ways of working are proposed, either taking impulses from the image (mask-image and/or imagination), the body and its movement, or the voice. These three ways of working trigger the bodymind into a process of active imagination that evokes a creative and integrated mask-voice-body exploration of archetypes and/or subpersonalities. The process gives permission to, and provides a safe container for, the amplified expression of the extremes of self and voice. This dissertation offers a tri-phase VMT maskwork process structure, and highlights key steps for the VMT practitioner-led facilitation of such a process. It positions the mask as a useful transitional object which encourages reengagement with imagination, body, voice and emotion, and thus encourages an on-going and multi-layered reflection and investigation of self and voice is possible. The research showed that the integrated approach of VMT maskwork resulted in vocal expansion in all 10 of the VMT 10 vocal components; pitch, pitch fluctuation, loudness, glottal engagement, free air, disruption, violin, register, timbre and articulation. Apart from acoustic vocal expansion, the approach fostered expansion in the performer's metaphorical voice and resulted in improved grounding and confidence in performance. These conclusions support the research statement that VMT maskwork may be a valuable approach to vocal development in the context of theatre performer voice training. As researcher practitioner I hold that the embodied learning process of VMT maskwork exposes the performer to a vastly different experience of self, which fosters a process of self-reflexivity leading to personal meaning making, self-knowledge, the challenging of vocal habits, and ultimately, vocal transformation. / Dissertation (MA)--University of Pretoria, 2016. / Drama / MA / Unrestricted

An emerging body of evidence indicates that museum object handling sessions offer short term benefits to people in health care settings. The aim of this study was to further understanding of the psychological and social aspects of a museum object handling group held in an older adult mental health setting. Older adults (N = 42) from a psychiatric inpatient ward with a diagnosis of depression or anxiety took part in one or more of a series of nine museum object handling group sessions. Audio recordings of the sessions were subjected to a thematic analysis. Five main themes were identified: “responding to object focused questions”, “learning about objects and from each other”, “enjoyment, enrichment through touch and privilege”, “memories, personal associations and identity” and “imagination and storytelling”. The first four themes were congruent with existing literature associated with positive wellbeing and engagement outcomes. Imagination and storytelling was a new finding in the group context. This study offers preliminary support for museum object handling group sessions as an intervention in this healthcare setting. There may be potential to develop the therapeutic aspects of the sessions. Further research is recommended and areas for enquiry discussed.

The purpose of this study was to see how meaningful and practically challenging a combined and structured arts therapy approach can be for an island-style counselling scenario. The overarching rationale with this particular arts therapy approach was to enable the client to gain self-insight by means of constructing a holistic view of present concerns and aspirations by capturing them in personal, functional and professional-looking artefacts conveying relevant self-messages. The client self-generated the content of each exercise, according to a manual and strategic interventions, and was guided by the counsellor in the user-friendly application of the arts. Apart from the unique combination of arts therapies in this study, another factor that may contribute to counselling practice is the attempt to make use of video as a non-threatening integrating medium. Throughout the process, the client made rehearsed video appearances to consolidate personal gains. At the end of the counselling process, the respondent enjoyed an “objective” screening of the process and he left with the personal constructs, a video tape and a CD-Rom application of the recorded process. The literature study reveals the numerous techniques, exercises and most common combinations spread across the domain of the 26 expressive modalities that were scrutinised to gain insight into this vast field. The empirical process revealed that it is possible to utilise the arts therapy approach meaningfully to enable a client to build a “visual narrative”. To optmise the potential this approach holds, the environment facilitating the process needs to be adequately equipped and the counsellor needs to be skilled in the application of particular electronic media or, alternatively, a group of experts need to co-operate. / Dissertation (MEd (Learning Support, Guidance and Counselling))--University of Pretoria, 2005. / Educational Psychology / unrestricted

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2008. / ENGLISH ABSTRACT: The focus of this study is a reflection by an educational psychologist of a five year old girl and her use of art media during her therapy sessions. The rational behind art therapy is that underlying feelings and problems are brought to the surface through the interaction with art media and art production (Oster & Crone, 2004). This enables the client to perceive the problem visually and learn how to process it. Educational psychologists are not necessarily trained to do art therapy. However the use of creative media can form part of their practice. A principle of art therapy – to create a safe environment for the person to work uninterrupted, was used in this study. A qualitative ex post facto study was used to complete this research. This entails a study of an occurrence (a child‟s use of art media in therapy) after it has been observed by the researcher. The aim of this research was to study, by means of a case study, a five year old girl‟s interaction with art media such as paint, clay and felt-tip pens throughout her therapy process. The amount of time spent with media, techniques and colours used, symbols made, as well as verbal and non-verbal behavior was observed. The participant‟s therapy sessions and informal interviews with her mother were recorded on video. The videotapes were studied and field notes of these, together with personal records and the artistic products that resulted from her sessions were used for data-collection. In addition and to enrich the study the possible meaning of the symbols depicted were also discussed. Inductive data-analyses (bottom to top) were used to process the data. The researcher‟s perspective during the study was of a reflective practitioner. The description of the participant‟s interaction with art media showed that she became more involved with it as time passed. There were noticeable changes in her use of colour, techniques and media. A positive change in her verbal and nonverbal behaviour was observed towards the end of her therapy-process.

As rodas de artesanato são uma modalidade de atendimento psicológico baseada nos grupos vivenciais de orientação junguiana. Os aviamentos e outros materiais úteis para a prática artesanal são compreendidos como recursos expressivos, maleáveis e convidativos à imersão num clima psicológico de relaxamento, ludicidade, acolhimento, apaziguamento e partilha, propício à imaginação e transformação criativa. A interação das participantes com os recursos expressivos, com o grupo, com o contexto institucional e com sua realidade de vida mais ampla é compreendida como simbólica, comunicando algo sobre o self grupal. O estabelecimento de um enquadre terapêutico vivencial prioriza mais a convivência do grupo com os símbolos expressos, do que a interpretação verbal e a racionalização. Deste modo, as queixas, experiências, conflitos ou fantasias devem sobrepairar ao centro da roda, sendo respeitosa e democraticamente autenticadas como reais e relevantes. Nesta pesquisa, as rodas de artesanato foram formadas por mulheres que acompanhavam crianças e jovens com deficiências físicas em atividades numa escola de educação especial, inserida num centro de reabilitação física. Devido às especifidades do contexto, suas rotinas implicavam em aguardar o período de aulas no pátio, muitas vezes ociosas ou envoltas em conflitos interpessoais. Além disso, devido às limitações no desenvolvimento neuropsicomotor dos filhos, à sobrecarga de tarefas e ao excesso de recomendações terapêuticas e pedagógicas, muitas viviam a inflação da identificação do ego com a persona em sua faceta de cuidadora. As rodas de artesanato foram propostas a fim de ampliar o enfoque terapêutico interdisciplinar ainda influenciado pela perspectiva médico-científica, revelando-se uma proposta maleável e sensível à identificação das necessidades da população atendida e aberta para a constelação de símbolos naturalmente indicativos de caminhos terapêuticos. Entre março de 2009 e março de 2010, foram realizados encontros semanais de uma hora e meia de duração, sendo o conteúdo transcrito para posterior confecção de narrativas. A discussão dos resultados visou à interlocução com a comunidade científica entremeando autores junguianos e estudos publicados em áreas afins como historiografia, ciências sociais, metodologia da pesquisa qualitativa participante e práticas em reabilitação. Os processos vivenciados nas rodas de artesanto indicaram que o respeito às preferências, escolhas, modos e tempos de agir, incentivam a busca por maior autonomia e a integração de potencialidades e habilidades negligenciadas, processos tão preconizados na prática clínica junguiana como no âmbito da reabilitação física / Arts and crafts activities may be used as a modality of psychological treatment based on Jungian-oriented experiential groups. Ornaments and other materials used in arts and crafts are understood as malleable and inviting expression resources for ones immersion in a psychological environment of relaxation, playfulness, acceptance, peacefulness and sharing, which is extremely valid for imagination and creative transformation purposes. Participants interaction with the expression resources, with the group, the institutional context and with their own reality, from a broader perspective, is understood as a symbol which provides indications on the group self. The establishment of an experiential therapeutic setting is more focused on the groups experience with the expressed symbols than on verbal interpretation and rationalization. The arts and crafts activities, developed in groups of people organized in a circle, will be hence permeated by each individuals complaints, experiences, conflicts or fantasies, which shall be respectfully and democratically authenticated as real and significant. In this study, these arts and crafts circles were comprised of women who accompany physically disabled children and teenagers during their activities at a special education school located in a physical rehabilitation center. Given the specificities inherent to the context, their routines implied waiting for the youngsters during class time, which was often spent either idly or amidst interpersonal conflicts. In addition, because of the limitations to their childrens neurological and psychomotor development, the overwhelming number of tasks and excessive therapeutic and pedagogical recommendations, many of these women experienced the inflation of the ego identification with the persona, as a caregiver. The arts and crafts circles were suggested in order to broaden the interdisciplinary therapeutic focus, still influenced by the medical-scientific perspective, and actually proved to be a flexible proposal which is open to the identification of the needs of the treated individuals and to the wide array of symbols that naturally indicate therapeutic pathways. Weekly sessions were held during one hour and a half from March 2009 to March 2010; the content thereof was transcribed for the further preparation of narratives. The discussion of the results was aimed at providing for the interlocution with the scientific community, using Jungian authors and studies published in correlated fields of knowledge such as historiography, social sciences, participant, qualitative result methodology and rehabilitation practices. The processes experiences in arts and crafts circles revealed that the respectful treatment given to preferences, choices, methods and time of action encourage the pursuit for greater autonomy and integration of potentialities and neglected skills, processes largely implemented both in Jungian clinical praxis and in physical rehabilitation