(1) Men's Crisis House

Pilot Project 2018

Phase 1 - Men's Crisis House Group

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Location: St Mungo's, Men's Crisis House

Duration: 80 minutes (60 minutes art-making, 20 minutes reflective time)

Group Size: Maximum 10 men

Frequency: Weekly, Wednesday afternoon

Pilot: Nov 2017 - Dec 2018

Aims

To provide a weekly art therapy group in an open area within the Crisis House that anyone staying there could access at whatever level they feel able to. To work closely with the staff team in supporting individuals make sense of their experiences while at the Crisis House through non-verbal art-making and reflective discussion. Sessions take place at a large table in an open communal space within the building, all materials are provided.

Description of visit

Handover from Crisis House team / set up room (60 minutes)
Art therapy session / clearing up room (90 minutes)
Handover to Crisis House evening staff (30 minutes)
Additional 1-to-1 post-session support may be offered to individuals when required (approx. 30 minutes)
1-to-1 review sessions may be offered to individuals prior to their leaving the Crisis House (approx. 30 minutes)

Engagement

We have developed a bespoke method of capturing client engagement within the Crisis House that allows us to track an individual's progress over time - view the Crisis House engagement data here

Staff feedback

At the beginning of June 2018 I invited staff at the Crisis House to complete a short questionnaire as an opportunity to share their experiences of having an art therapist within their project. Seven staff have given consent for their answers to be used anonymously. Here are the main findings;

Expressing Emotion Through Art-Making

Staff noted art-making as a way of expressing powerful emotions;

"Sessions provide a safe space for clients to explore and express emotions via an external medium. It can allow clients somewhere safe to hold their issues and to feel positive about how these issues have been explored"

"I have seen one client very powerfully express his emotions in a very raw way with a painting which demonstrated the dark place he was in... the a few weeks later express immense positivity in an equally powerful way."

"One client who found it very difficult to discuss his emotional distress put his palm in some paint and slammed it down on a piece of paper. It may have been an act of frustration but it seemed to open up dialogue."

A Non-Directive, Non-Verbal Space to Make Sense Together

Staff noted non-verbal expression as a way of articulating and communicating thoughts and feelings together;

"It offers clients a space where they can express themselves creatively, sometimes where they had found this difficult to do verbally."

"Art therapy encourages clients to connect with their own feelings / experiences as well as each other. It allows clients who struggle to articulate their feelings and experiences to communicate them."

"One client used the sessions to express feelings about his housing circumstances that had been difficult to verbally articulate."

Engagement in a Open Communal Space

Staff noted the communal setting allowed clients to engage in the group at their own pace;

"The session is a good opportunity for clients to engage with the service and each other in a comfortable and supportive setting."

"I found it great that those engaging with art therapy found it a non-pressurised group. There were also those who might have been floating around the communal area were sessions took place who would quite often eventually find themselves drawn to the table. For many of our clients even the act of sitting at a table with a group of strangers was a big step forward."

* for information on how we capture engagement at the Crisis House please see Degrees of Engagement

Aiding the Team's Understanding of Clients

Staff noted insights gained through art therapy have supported their client work;

"From a staff perspective art therapy is useful in that it can shed light on where a client is psychologically, if they are unable / unwilling to express verbally or behaviourally."

"In my opinion all clients that have attended an art therapy session have benefitted in one way or another, perhaps sometimes this has been as simple as that it has served as a distraction from difficult feelings that they were struggling to verbalise. This has been helpful for staff to gain insight into where a client 'is at'"

"Art therapy often helps clients to open up or look at issues in a different way and this can feed into key-working."

Using Art-Making Beyond the Art Therapy Group

Staff have seen clients utilising art-making as a useful method of expression and relaxation after attending art therapy group;

"A client who at times struggled to articulate their feelings has started drawing pictures as a way of describing them."

"One client in particular had not done any art activities for years - participating in art therapy helped him start painting again, giving him a much needed relaxation / mindfulness / distraction technique, as well as a way to express his emotions."

"One client used the technique of drawing their emotions later that day when they became overwhelmed and were unable to articulate."

Artwork as a Record of a Client's Progress

Staff noted that clients are able to look back at their artwork as a record of their stay at the Crisis House;

"One client came to our service experiencing suicidal ideation and engaged with the sessions to express how he was feeling. He reported finding the sessions helpful to process this and explained to staff that he saw a difference in the theme of his work over the course of his stay, and wanted to take his work home with him to remind him of his progress"

Post-Crisis House Engagement in Art Therapy (at St Mungo's Recovery College)

Staff noted the importance of links with the Recovery College art therapy service in supporting engagement and recovery;

"I have seen many clients on a journey with their art. These journeys vary in magnitude. For one client in particular who came to the Crisis House in emotional despair I would say that in this case art therapy with Ben Gage was the 'gateway' to his recovery. The client in question has continued with art therapy beyond the Crisis House and engaged with other groups as a result. He maintains strong in his recovery 6 months on."

"A service user engaged well with the art therapy sessions, and this formed part of a link in with the Recovery College on a regular basis. He now goes to the Recovery College on a regular basis and credits art therapy as a strong part of his recovery journey."

"If clients have enjoyed or benefitted from the session it is a good signposting opportunity for the group at the Recovery College"

Suggested Improvements

Staff suggested additional sessions, greater resources, and additional skills training could improve the service;

"As it is it is an excellent service, in an ideal world a designated space with more equipment and more sessions would be brilliant."

"I cannot think of any way to improve sessions - they're great!"

"I healthier budget."

"Maybe some simple activities that staff can use with groups of clients between sessions - for distraction / relaxation purposes."

Training & Knowledge

Of the seven staff who replied to the questionnaire, two had attended the 'Introduction to Art Psychotherapy' training session, and both stated that they felt they now had a good understanding of art therapy and would recommend the training to others, with one staff member adding;

"Ben's 'Introduction to Art Psychotherapy' was a very informative training session which powerfully explained and demonstrated how art therapy can work and explored some of the issues involved such as people's history with groups or art having an impact positive or negative to their interaction, as well as how to create positive closure and ownership of work."

All five remaining staff expressed interest in attending the training in the future, with one person adding;

"I feel I have a basic understanding, but would like to build on this."

Ben's Approach

Staff highlighted Ben's professionalism and communication skills, as well as the value of thorough handovers;

"Ben is always professional, attends handover before the session so he is aware of issues within the house and with individual clients. He always gives a thorough handover after the session so issues can be followed up with clients."

"5-star. Always has handover and debrief. A consummate professional, and often early."

"Ben is extremely reliable and professional. He communicates with staff thoroughly during handovers and takes the time to answer our questions when discussing a client's art piece."

"Excellent."

"Ben is a fully qualified art therapist which shows in his passion and commitment to his work. He is always on time, and communicates very well both what has happened in groups as well as what art therapy is about. He has also developed excellent systems for demonstrating clients' levels of engagement."

"In my experience Ben has been very reliable and his handover to the team showed him to bean insightful and professional therapist."

"Ben is also very likeable and has received positive feedback from clients."

Advocacy

All staff that completed the questionnaire stated that they would recommend an-in house service to other St Mungo's projects.

Summary of Findings

Art therapy offers a unique and important service at the Crisis House, creating a safe, non-pressured space for clients to express and process difficult emotions in a group context; it also provides staff with insight into the experiences clients thereby aiding their work. Attending art therapy has allowed clients to discover the benefits of art-making outside of the group as a mode of expression and relaxation, and many clients have gone on to engage in groups at the Recovery College as a result of their attending the Crisis House group.

The Crisis House team is very satisfied by the current service, suggesting that additional art therapy sessions, a healthier budget, and additional skills training for staff by Ben would be desirable. Those who had attended the 'Introduction to Art Psychotherapy' training felt they had a good understanding of art therapy and would recommend it to others, while those who had not attended the training all expressed interest in attending in future. Ben's approach has been praised by staff who have highlighted his professionalism and communication skills, and approach to handovers to and from the team. Staff at the Crisis House would recommend art therapy to other St Mungo's projects.