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Pilot Project 2018

Degrees of Engagement

Purpose of the Model

This model was developed while working in an acute inpatient setting in order to capture patient engagement over the course of an admission. This approach helps demonstrate and capture the different ways in which individuals access the therapy space within a session, and across time.


How it Works

The diagram illustrates six-degrees of client engagement;

  • (1) Watching from afar 

  • (2) Watching at table

  • (3) Verbal engagement at table

  • (4) Verbal engagement sat at table

  • (5) Art making (no verbal engagement)

  • (6) Art making with verbal engagement

The code used identifies the highest degree of engagement from a participant during a session, and does not necessarily reflect a participants’ general engagement throughout.

Recording Data

All data are captured in digital table format that allows readers to view by session and by client, identifying;

  • degree of engagement (by colour and number)

  • duration of engagement with group (in minutes from 5 to 80, in increments of 5)

  • at which point in time engagement took place (beginning, middle, end, discontinuous, or full session)

For example  2B10  would indicate that a client engaged in watching at the table for approximately 10 minutes at the beginning of the session, whereas  5D50  would indicate a client engaged in discontinuous art-making over approximately 50 minutes

This approach to capturing engagement, along side the artwork created within sessions, allows us to see how clients use the group across time. The following example shows a client's progress over seven weeks*, from arrival at Crisis House to leaving for new accommodation;

  •  6D70  - used clay work to self soothe while chatting with other group members (2 other clients present)

  •  6D50  - used collage and mixed media to create powerful image, vocal throughout (4 other clients present)

  •  6D55  - continued with last week's image, reworking with paint until destroyed, appeared frustrated (5 other clients present)

  •  2B5  - approached table at beginning of session, did not verbally acknowledge group, declined to join group (3 other clients present)

  •  3B5  - addressed group verbally at beginning of session, declined to join group, "I'll come next week" (3 other clients present)

  •  6E65  - discussed difficulties faced, created large painting, provided verbal support to a new group member (3 other group members)

  •  6D75  - spoke positively about support provided by service staff, created image to hang on wall of his new accommodation (4 other group members present)

We can see how this detailed measure of engagement captures the client's journey across time, and can provide much needed context for both staff and clients during review sessions

*this is a hypothetical client that is representative of the type of journey seen within the service

If you would like to more information on using the model, or to request permission to see the DoE data from the pilot project please contact me directly

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