Psychosocial Creative Programme

The Harley Street Clinic
Credit artist, Merlin Evans

The Psychosocial team of the paediatric ward at Harley Street Clinic has been working on a number of creative projects in 2016. These projects highlighted the importance of working collaboratively with the members of multidisciplinary (MDT) team to enhance the quality of care for our young patients and their families. These projects were part of the ongoing psychosocial programme aiming at addressing physical, psychological and educational needs of our patients.

The aims of the programme are:

This programme was delivered by the paediatric psychosocial team of Harley Street Clinic, a private hospital. 

-        Addressing the quality of MDT care through creative interventions

-        Organising a series of creative projects which would involve commissioned artists-in-residence and hospital staff to address psychological, physical, educational, emotional needs of our long-term and short-term young patients and their families

-        Establishing a platform for enhancing collaborations within the multi-disciplinary team (dietitian, pharmacist, psychotherapists, infection control managers, play specialists, music and art therapists, psychologists, nurses etc.)  

Description of the art activities (some practice examples):

  1. In project “Feelings” the team collaborated with a Charity “Magic Lantern” (interactive learning about arts). This project was focused on emotional literacy – how we recognise feelings and deal with them. Children sometimes struggle to identify and express feelings, so emotional learning is one of the key factors in helping children to understand better not only themselves but also people and the world around them. It is a life-long skill which assists in building confidence, communicating effectively and becoming better learners. For instance, in a medical setting children as well as parents can be stressed and it becomes important to address effective coping strategies to reduce anxiety and make them feel more connected with a medical team.    We organised interactive sessions over four weeks which incorporated art presentations (showing images from renowned London museums and galleries) and art making with a focus on coping strategies. Each week we debated a different theme: “Happy-Sad”, “Angry-Calm”, “Scared-Safe”, “Embarrassed-Proud”. Children and families actively discussed ideas and engaged creatively in art making. As part of this the Music therapist led a creative process of making music CDs by patients – on the themes which were resonant with their emotional experiences. We received very positive feedback such as “I enjoyed it, it was entertaining and I got involved” (Patient, 14 year old), “It was encouraging and amazing to see the effect of paintings on my child” (parent); “the highlight for me was to express and talk about different feelings” (Parent). Interactive discussions and art making sessions facilitated the process of exploring motives which were prevalent in the group – for example, bonding between parents and children and how bonding could be disrupted in hospital environment. 
  2. The “Infographics” we tested innovative ways of visually presenting ideas about health education and how various concepts such as ‘Infection control’ can be communicated to our patients in more accessible and comprehensive way. In the last decade it has become clear that text is no longer doing the job – and the way we consume and process information now is increasingly based on visual format. Visual representation of ideas is now gaining more importance as a tool for building team cohesion, enhancing engagement and triggering innovation. Information with visual impact increases the chance of a message not only being seen, but also remembered.   This project had two strands: working with staff and working with patients. The team of paediatric ward focused on a subject of infection control and the work was led by infection control manager, whereas patients were invited to think about the factors which help them in a hospital setting. In a series of creative workshops facilitated by artist-in- residence and art psychotherapist the members of the team, including nurses, dieticians, pharmacists, cleaners, physiotherapists, play specialists  and psychotherapists, were invited to think about recurring challenges in their daily work in relation to infection control and new ways of addressing them. Participants enthusiastically created artistic versions of their ideas which later were incorporated in a series of striking visual posters completed by the artist. In our workshops with young patients we encouraged them to reflect upon factors which help them in the hospital environment. The process was engaging and amplified aspects which are essential for the quality of care. Children drew amazing pictures of a ‘dream hospital’ where patients might enjoy having a water fountain in the garden and toys in operational theatre. However children also commented in their art works on the very real experiences they had during their admissions such as smiling nurses, kind touch of a doctor, space to be with a family, tasty food, playing and making art and music.   All these aspects can make one’s own experience of a hospital less anxiety-provoking and more bearable. The project illustrated innovative ways of interpreting health education data in the engaging format.
  3. The 'Nature to Nurture' project focused on another aspect of MDT care – pharmacological interventions. An artist-in- residence co-facilitated this project with the hospital team for three weeks, including pharmacist, complimentary therapist, art psychotherapist.  Within the framework of this project we organised a series of creative workshops for young long-term spinal and oncology patients and their families. We focused on medicinal properties of plants (such as Catharanthus roseus which is used for making chemotherapy drugs) and printmaking techniques, which enabled every patient to create a little book of prints with useful annotations. Workshops also helped with multisensory integration for some of our patients (bringing together smell, touch, sight, hearing and taste) – it is an essential element of child's development. The strength of this project was in collaborative work making pharmacology a subject patients can relate to and understand better. We received positive feedback from our patients regarding its educational and creative impact: "this event was really fun, and helpful, it taught us how plants can be used to treat people”'. 
  4. The Song Writing project focuses on allowing patients an alternative outlet of feelings and emotions through creative musical experiences and production of a cd with songs. Patients worked on lyrics and songs with the music therapist in sessions, the songs offer a platform for expressing feelings and experiences during their stay in hospital. Using technology patients are able to create a chosen style of music and record their lyrics with the music therapist. The collection of songs and music are put together onto a cd for each patient involved. 

All projects illustrate how creative interventions can enhance multidisciplinary care and support for the patients and their families.

Details of the project participants

Participants of the projects were mainly children and their families undergoing treatment at the hospital, as well as members of multidisciplinary team. The patients were aged between 4 and 16, and undergoing treatment for oncology, cardiac or spinal diagnoses. The majority of the patients were from overseas (non-English speakers) and from diverse cultural backgrounds.

Project management

All the projects were run by the members of psychosocial team with supervision from clinical psychologist. There were no costs to participants. We collaborated with two Charities which supported our projects: ‘Chance for Life’ and ‘Magic Lantern’. For every project we gained participant consent and asked them to fill the evaluation form. Project outlines were approved by the manager of the paediatric services.

Evaluation methods and findings

Methodology

-        Assess the psychosocial impact of creative interventions as an integral part of MDT care   

-        Focus was on utilising art therapies to support communication and expression

-        Feedback was gathered from the participants and their families, members of MDT team about their perception of the activities and use of services

-        Reflective interviews with the artists and charities who co-facilitated workshops with the team members

-        Projects outlined the objectives, expected outcomes and resources as well as risk assessments and ethical concerns which needs to be addressed, and the plans were thoroughly discussed within the team as well as with the supporting charities

Findings

The evaluation of the programme confirms the idea that integrated care contributes towards the quality of hospital experience for our patients. Feedback received from patients and team members supports the methodology used to address the existing challenges of integrated care.  The programme also provided evidence for a responsive approach to patients’ needs.  As well as highlighting the benefit of collaborative between the hospital and external organisations.  All patients were able to complete their projects.

Projects helped with:

For patients:

-        To create  a platform for helping to educate and socialise children having long-term treatment

-        To help with developing life skills, social skills, communication, team-working

-        To enable peer-learning

-        To keep inclusive culture of the activities

-        To enable the children to feel empowered and exercise their control within a hospital environment

For the hospital staff:

-        To widen the spectrum of supportive and innovative services for the families

-        To help long-term patients to settle in the clinical environment and cope with a long-term treatment

-        To optimise hospital environment for the patients

-        To create new connections within MDT team

Supported using public funding by the Arts Council England