I welcome the representatives of the education special interest group of the Irish Association of Creative Art Therapists to discuss creative art therapy in education. They are Pauline Sweeney, drama therapist, Fran Burns, dance movement therapist, Deirdre Horan, music therapist, and Bríd Shanahan, art therapist. I draw attention to the fact that members of the committee have absolute privilege but this privilege does not apply to witnesses appearing before the committee. Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against persons outside the House or an official by name or in such a way as to make him or her identifiable.
Art Therapy in Education: Presentation.
Ms Pauline Sweeney
Thank you for this opportunity to make a presentation on behalf of the Irish Association of Creative Art Therapists. We are members of the education special interest group. I am a drama therapist and have been working in primary education for the past eight years.
This presentation is a summary of the document which we have sent to members of the committee. We will be using some images from our work. Owing to the confidential nature of this work, we request that photographic or technological copies should not be made of the images shown.
Bríd Shanahan is an art therapist who works with adolescents. Deirdre Horan is a music therapist who works in primary education with children in socially disadvantaged areas. Fran Burns is a dance movement therapist who works with children in schools in Donegal. Unfortunately one of our members, Siobhán O'Donnell, an art therapist who contributed a great deal in compiling this document and presentation, is unable to be with us today.
The purpose of this presentation is to inform the committee of the ongoing work of creative art therapists in primary and secondary schools in socially disadvantaged areas; to draw attention to the fact that creative art therapies require secure funding from the Department of Education and Science to maximise the effectiveness of the work and maintain it in the long term. Creative art therapies are divided into four disciplines — drama, art, music, and dance movement therapy. These therapies provide an alternative means of communication through highly accessible creative media. The process offers a symbolic language through which children and young people can express and work through the concerns which have brought them to therapy. By this we mean that through the various art forms the child or young person can communicate his or her difficulties in a creative way. Often the verbal means of communication on which we as adults depend to express ourselves is very difficult for young people, particularly those who are at risk.
Creative art therapies can be used to treat a range of emotional and behavioural disturbances in children and adolescents. Presenting issues may include the following: non-conforming behaviour, self-harm, loss or bereavement, parental alcohol or drug addiction, emotional and physical abuse, and neglect. Many of the children with whom we work miss a great deal of school due to truancy. Others have suffered major bereavement or loss. Many are neglected and come from homes where alcohol and drug addiction are prevalent. Others are exposed to violence, emotional and physical abuse, which has a detrimental impact on emotional and social development. This can lead to aggression, self-harming, and withdrawal.
Creative arts therapies in education have the potential to provide a service that reaches the most marginalised families in disadvantaged communities. Children's ability effectively to access education can be seriously impacted by emotional difficulties which are not addressed. If education is to be truly child-centred, the emotional needs of children and young people cannot be neglected. Creative expression is a powerful, non-threatening therapeutic means of engaging children and young people in personal work. It can open up feelings and issues in ways which words alone cannot. Children can relive events and experiences in order to make sense of them and, if necessary, explore alternative ways of dealing with them. Creative arts therapy intervention presents children or young people with an opportunity to resolve difficulties that may affect their future development. The child or young person develops an increased ability to express anger appropriately and is consequently less a danger to self or others.
The broad goals of therapeutic intervention with children are as follows: to encourage expression of emotions; to develop social skills; to build self-concept and self-esteem; to improve communication skills; to develop insight; to develop problem solving and decision-making skills. In order to provide this therapeutic service in schools, we need a commitment to long-term funding. The primary sources of funding for creative arts therapies in disadvantaged schools have been area partnerships and school completion programmes. The fact that the school completion programmes are funded by the Department of Education and Science indicates an awareness of the need for alternative approaches to tackle disadvantage. Unfortunately, owing to the way it is structured, such funding tends to be short-term in nature. The lack of adequate funding has an impact on the consistency and effectiveness of the service that can be provided.
The child or young person with whom we deal quite often comes from a very fractured family background and has not experienced a great deal of reliability or consistency. To build a relationship of trust with a vulnerable child or adolescent and to have it taken away may arguably do more harm than good. Long-term funding is necessary to plan and implement an effective therapeutic service within our schools to link with teaching staff so that the effectiveness of the service is maximised; to foster relationships with services in the local area; and, most importantly, to retain experienced professionals in the field.
We have cited in our submission a number of responses from teachers, children and young people and parents. This was part of an evaluation following one of our programmes. One teacher says:
All children have developed in self-confidence and appear more at ease with themselves. Self-expression has improved. The children have become good friends and have a support system in that interaction.
A child says:
I learnt that life is not always bad. I loved coming to the group. It gave me the inspiration to be more good in school.
A parent says:
Perhaps if we stop and realise that our children's mental health cannot be quantified in monetary terms we may be half way to helping them. What price can be put on a child's emotional well being?
That letter from a parent is in the appendix, which I recommend to members. Group work in the creative arts therapies is particularly effective in helping children and young people to develop social skills, cultivate peer relationships, build self-confidence, deal with bullying — be it as victim or aggressor — and work on relationship issues.
We will now focus on the work of one art therapist, Bríd Shanahan, with an adolescent boy during a very difficult time in his life. We will show images and a vignette to illustrate this. This boy was aged 16 and we will call him Alan for the purpose of this presentation. Alan's parents are separated. His mother suffers from manic depression and frequently has to be hospitalised. He has two siblings, an older sister aged 18 years and a younger sister aged seven years. Alan presented as aggressive and disruptive in school and his attendance was poor. During his first session with Bríd, rather than verbalise his feelings he was able to move towards working with image and depicted his older sister and her friend. It is obviously easier at this stage for him to speak about his sister rather than himself. He describes his sister as "going daft on drugs". He depicts her with a black heart and her friend with a red, good heart. In this image Alan appears to mirror his own story with drugs. At this stage Alan is beginning to develop a level of trust and feels safe enough to tell his own story.
During Alan's first session with Bríd he showed her his hands, which had been burned by cigarettes by friends who tried to get from him money that he owed them for drugs. He created a second image as a result of being able to speak about that incident. The second image connects with the cigarette burning incident. Alan describes how he grabbed a knife from one of his attackers and stuck it in his leg and ran. He tried to depict how he felt and said his friends had a gun to his head and a knife in his back. Alan was then able to reveal what life is like for him. This is his reality. Young people like Alan present at school as disruptive and out of control. Many drop out of school and, eventually, out of society. Early intervention is essential if we are to prevent this downward, destructive spiral.
Alan's third image is more hopeful. In it he depicts his fear of falling from the sky into the sea or a dangerous Spike Island, as he called it. As he was drawing, he said: "I'm falling, I'm falling". He added a parachute and oxygen mask, which are symbolic of his cry for help. This was his way of depicting his reaching out for help.
Alan's fourth image illustrates a turning point in his therapy session with Bríd. On this occasion, he was angry with his parents and said the image was of the film "The Matrix". He then pulled up his sleeves and showed where he had cut his arms after a row with his parents. He asked the art therapist to speak to his doctor saying, "No one believes me that I'm feeling so desperate". The art therapist referred to the contract she had made with him that should he or anyone else be at risk she would have his permission to speak to his guidance counsellor at school. After initial hesitation, Alan gave permission for this action. The school authorities, following consultation with Alan and his dad, let him know he was being taken seriously. As a result, there was a major shift in his behaviour and his discipline improved in the school environment. Alan was beginning to externalise his problems and became less of a danger to himself and to others.
The purpose of this submission is to show the value of the creative arts therapies for children or young people in disadvantaged school circumstances and the necessity for secure, long-term funding to provide this essential service. It is our hope that the creative arts therapies will become a more intrinsic part of the education system. We would welcome an opportunity to contribute to the Department of Education and Science's action plan on disadvantage.
I thank the committee members for their attention. The presentation will end with a number of images that represent various sessions, including drama therapy, art therapy, music therapy and dance movement therapy, following which my colleagues and I will be happy to answer questions. I ask members to bear in mind that we are speaking of some of the most vulnerable children in our education system and in society.
I thank the delegation for its submission.
I welcome the delegation and thank it for the presentation, which was self-explanatory. I have two practical questions for the delegation.
Does the Irish Association of Creative Arts Therapists have links with the National Education and Welfare Board and if so, does the board refer students to IACAT? Ms Sweeney mentioned at the end of her contribution that the association would like an opportunity to contribute to the Department of Education and Science's action plan on disadvantage. The Minister for Education and Science stated at the teachers'conference approximately three weeks ago that the plan would be published within a month. I assume the association has not yet had an opportunity to contribute to the plan. Has it been contacted about making a contribution, given that the plan is fairly well advanced?
How often does a therapist meet the person referred to him or her? While I am aware of the association's aims, what are its aims in terms of ending a person's therapy? If a therapist is working with a 17 year old within the school system, does therapy end when he or she leaves school? If such a person is not within the school system, does therapy end when he or she becomes an adult? Many children referred to therapists with whom they build up relationships are often worse off when that therapy is cancelled as a result of a lack of funding and so on. Perhaps the delegation would comment on that point.
We will take a number of questions together.
I, too, welcome the delegation and presentation, which brought home to us exactly what art therapies are about. The individual case mentioned was interesting.
The association requested this meeting to help us to understand its work and to see what progress can be made in terms of obtaining secure funding. I will focus on the issue of funding. It was mentioned that the area partnerships and the school completion programme funded the association. Has it had dialogue with the Department of Education and Science in terms of persuading it to provide the association with secure funding for its work? The committee would be interested in furthering such dialogue.
Who refers the children to therapists? Are the therapy sessions individual or group based? I presume drama therapy takes place within a group. I am familiar with a group in Limerick called The Blue Box Creative Learning Centre, which I believe is affiliated with IACAT. That group is doing excellent work with a number of schools in the Limerick area. I presume developing the service is very much dependent on funding. Are there people who could benefit from therapy who currently are not benefitting because of a lack of resources? Are schools referring clients to the association but it is not available to take them on because of a lack of resources?
I welcome the Irish Association of Creative Art Therapists and thank it for its impressive presentation. The committee has been enlightened on an issue with which I was not familiar until now.
How many therapists are there in Ireland and how are they divided up in terms of art, drama and music therapists and so on? Where do people wishing to pursue this career get training? How is IACAT funded? While I understand the association is seeking additional funding, perhaps it will tell the committee how it is currently funded. I get the impression the association is city-based rather than located outside Dublin, though I may be wrong on that point. Are people living outside large urban areas fortunate enough to be able to access these services? As everyone is aware, the issue of dysfunctional families is not strictly confined to the urban setting.
I would be interested to know a little more about dance movement therapy and music therapy. While the art therapy was well represented, I ask the association to elaborate on how these other therapies are effective in schools.
I welcome the delegation. The association concluded it would welcome an opportunity to contribute to the Department of Education and Science's action plan on disadvantage. In what way does the association wish to contribute, by way of submission or by becoming part of the action plan group looking at this area?
The association stated that its main problem, due to lack of funding, seems to be one of maintaining services. How is the association funded at present? Does it receive an annual grant? Will the representatives expand on what they mean by long-term funding?
Special needs assistance is another area with which the association is concerned. How many special needs assistants have training in creative art therapy? Can the association make a direct impact on pupils by taking up a special needs assistance role? The association emphasised the value of the therapy in schools and the positive effect it would have on students. Are there studies to support this assertion?
Whereas I welcome the work concerned, my difficulty on funding is that it is a different approach. I presume the reluctance in providing funding arises from the fact that the association is coming at this matter from a different angle or from outside the box.
My experience is of the role of the arts in dealing with addiction. Having spoken to adults involved, it has been positive for many people with a heroin addiction. They felt it helped them develop as individuals. I am also aware that where children have been in abusive situations, the role of art has helped in drawing out their emotional difficulties, etc. If it works in those areas, it would seem to make sense that it should work in the particular areas of disadvantage to which our guests referred, where children have emotional problems. It is a different way of operating. While cynics might say that this is a waste of time and money — surely there must be better ways to spend money, considering the shortage of teachers in schools, etc. — it comes down to the matter of research. Unless volumes of confirming research are available, it will not be taken seriously.
Is this international best practice? Which other countries would use this type of arts therapy and how successful is it abroad? Is this therapy used in the mainstream abroad?
I also welcome the association. Most of my questions have been asked by Deputies Hoctor and Crowe but I am struck by a couple of matters. Our guests seemed to distinguish between the contribution of creative arts therapists in mainstream and special education and the fact that they work on a freelance basis. Would they elaborate on that? Are their services provided outside school hours? If so, do they seek recognition in their own right or in terms of the overall programme of creative arts therapy in education?
The association also mentioned the contribution it makes to the school completion programme, by which it is part funded. I wish to hear a little more about that because I happen to be fairly familiar with the school completion programme in my area and the good results arising from it.
Ms Fran Burns
I will attempt to answer several questions together. There was a question on the length of therapy and how it ends. In ideal circumstances, the therapy depends on the needs of the child. For some children, that will be short term. It may be merely that their grandmother or somebody very close to them has died and they need to deal with that. With another child, there may be issues of abuse or long-term issues that are more difficult. For other children, it may be that they have poor impulse control and that may need to be dealt with over a shorter period.
At the outset, the therapist will usually decide on the goals of the therapy. In that, she — we are mostly women but there are some men — will have a sense of the duration of the therapy. The therapist also sets up a contract with the child, in terms of what will happen in therapy, which includes a sense of the ending. During the therapy, the therapist has a sense of how it is proceeding and of whether she is reaching the goals. There is always an awareness of the ending and how to deal with that in the context of the child's issues, so that they are not left unaddressed. The time to which we refer in that regard is when the therapy is cut short, where it is not within the therapeutic frame. That refers to the length of therapy and how it ends.
Ms Sweeney
One of the members referred to someone aged 17 in, perhaps, their final year of school. We are also in a position to make referrals. We link with other agencies and that is part of our work. Due to the nature of the funding and the way we are not sure whether it will be available in September, I would try, if possible, to make referrals to other agencies. These would be agencies of which clients or their families would be unaware or perhaps unable to reach. One would usually try to follow up or make some link with another agency so that the child or young person would not be left in limbo.
Ms Bríd Shanahan
A member asked where one could undertake the training involved. I qualified following a two-year full-time postgraduate course in Edinburgh, Scotland. All of the courses are postgraduate. Some have been recognised as masters degrees. There is not much difference in the training. Whereas some colleges recognise it as a masters degree, in other cases it is recognised as postgraduate study. At this stage, most of them are masters degrees.
There are a number of such colleges in Britain but Crawford College in Cork now has a three-year part-time postgraduate course in art therapy. Limerick University offers a masters degree in music therapy. Drama therapy may be studied at the National University of Ireland, Maynooth. That course, which has a two-year cycle, began two years ago. One group has finished and another has already started. Ms Burns will tell the committee about training in dance movement.
Ms Burns
There is no dance movement training programme in Ireland at present. However, there are more dance movement therapists than there were until recently. There are approximately four or five in Ireland but a couple of years ago there were only two. Training is available in England and some people have availed of this. I trained in America. We hope to put our own training programme in place but we have not got that far yet. We still need to build resources for that. People must go elsewhere to train at present.
Ms Shanahan
In recent years people have become very aware that these therapies are extremely powerful and effective if given a chance. I note that many members have also become aware of this. As a result, people who are not qualified are including these therapies as part of the way they work. If such people are psychotherapists already or hold such qualifications, often one can say it is safe. The danger is that it may not be safe if used by somebody who does not have a proper qualification or who has just done a short counselling course. Training is focussed on the psychodynamic and psychotherapeutic approaches. One would deal much more with the unconscious through these therapies than would be the case with verbal therapy.
Many can hop on the bandwagon but it must be remembered people's lives, whether they are children or adults, are precious. There are many risks and care must be given in terms of how we carry out these therapies. Art in itself is therapeutic. It can be used in a therapeutic way without it being a therapy. It is a different matter if an individual attempts to be a therapist when he or she is not qualified. We have to be aware of these problems.
There are quite a number of therapists throughout the country. I do not have the exact numbers to hand. However, the numbers involved are increasing annually.
Ms Deirdre Horan
There are 45 music therapists in Ireland, North and South, some 35 of whom are working in the Republic. I do not have the exact figures for the four disciplines.
Ms Burns
The therapists to whom Ms Horan refers are trained and serviced. Other people may call themselves SAP therapists but only five are properly trained.
Ms Sweeney
There are approximately 35 drama therapists.
Ms Shanahan
Art therapists comprise the largest number, approximately several hundred. I also work on addiction with adults. I was recently able to refer an individual from a rural community to an art therapist in his locality. It was vital that I could do this because after an individual has been on a short residential programme of six weeks, he or she could be on a high through the work but is then landed back in the community.
There is a problem with securing funding to ensure the continuity of therapy. On occasion, when continuity cannot be achieved, it is soul destroying. An individual could be in the middle of a powerful piece of work, doing very well, at a school or centre but cannot continue with it. In the case of a child with whom I was dealing at Easter, I refused to take him on unless I was guaranteed that I would be able to work with him over the summer. That child was sleeping on the streets. Another child in the same centre was self-harming. In June, we have to give other children a chance and take them on a holiday. Who is most in need? One of those children ended up being taken into care. This is the reality of our work. Those who work in this area are enthusiastic about what they do. We are not working for money because there is none in it.
Ms Sweeney
I want to earn a living as a drama therapist. I am self-employed and have worked on a freelance basis for the past eight years. In the first six years, the Finglas-Cabra partnership funded me. Each June, I was told it could not guarantee funding for the following September. I would be contacted at the end of July to be informed of the outcome. A big issue is whether I can inform the child that I will return in September.
Regarding the school completion programme, I work during school hours and find this the most effective way of making contact with the children because they are within the school system. I ran some sessions with a group of adolescents after school hours. However, it did not work as well in the late evenings as they have other priorities. It is during school hours much of the work and education happens.
The support from principals and teachers we have all received within the schools has been fantastic because there is a real recognition of the need to have us in schools. Considering the amount of pressure and stress under which teachers operate daily, it is important for them to know someone is meeting the emotional and social needs into which they might not be able to tap within a large class system.
Ms Burns
How the work is decided for individuals or groups depends on the needs of particular children. For some children, they will need individual work. For others, groups are essential. Such groups are small and are vital for those children who have difficulties getting on with their peers and in cases where there is aggression and bullying. These issues can be addressed when they emerge within a small group. This is where the creative arts therapies, particularly drama and dance movement therapy, are important because group interaction arises. In most cases, a child is seen by a counsellor on his or her own and sometimes the issue may not be identified. They may do fine in a one-to-one with an adult. However, it is when they are with their peers that difficulties arise. This is one of the values of dance movement therapies. It is a way of helping children, particularly those of a younger age, to control their impulses because they find their internal locus of control and begin to use their bodies in different ways. By controlling their impulses, they are less of a danger to themselves and other people.
This is one effect of dance therapy in schools. However, not much work has been done on it in Ireland. I have done some work in County Sligo on a school completion programme. Special programmes have been established in the US in this field, particularly in the area of bullying in schools, which have been effective.
As to how creative arts therapy can work with special needs assistants, I have been working with children with physical, sensory and mild learning disabilities. The approach in creative arts therapy is different to that taken by special needs assistants. It is important to have a good dialogue with the assistant but the difference lies in training. The creative arts therapist will see a child usually once a week. In that session, there is a hope that the child is learning about himself or herself so that his or her behaviour and being in the world is different over time. With a special needs assistant, this will happen but be more around the child's physical needs and how he or she manages. Creative arts therapy is very much about the child's psychological needs. The training for creative arts therapists is quite extensive. There is also quite an amount of research, again from the United States, in terms of pre-teen children and teenagers who are getting into trouble and having difficulty. It has been found that the creative arts have been hugely valuable in bringing down the level of difficulty they are experiencing and improving their performance at school. They have done much better in school because they have been involved in the creative arts programme.
A creative arts programme is a little different from creative arts therapy, but the therapy can address those who sometimes are not able to use the creative arts programme. A child who is desperate and out of themselves may feel threatened by a drama or dance therapy group. We do not always call it dance therapy. If I am working with teenage boys, I do not mention dance therapy. The basic objective is to get through to the child in a language they can understand and help them to be themselves and take control for themselves.
In terms of our ability to be of assistance, have you put in a submission to the Department?
Ms Sweeney
This is our first formal submission. Our association would have made contact with the Department but this is our first formal face to face meeting. Today is really about presenting the case so that the committee can bring it further.
The Minister set up a committee before Christmas to report back in the summer on student behaviour and to make positive proposals. There was a golden opportunity for this organisation to make an input. Did you make any approach to have an input to that committee? I am not sure who was appointed to head the committee. It may have been Dr. Mairéad Walshe. This group would appear to have a very considerable contribution to make to the final outcome to that committee.
Are the arts therapists always geared towards people who have emotional difficulties or have you ever provided a summer school for children to be expressive through the arts who may not necessarily have emotional difficulties? We have heard a lot about educational disadvantage from the current Minister for Education and Science and her predecessor. This committee must bring this presentation to the Department. Their input has been largely hidden, although very effective. It is central to the area of disadvantage in schools and communities.
The presentation has certainly enlightened us as to the value of deciphering a message which may not always be verbal. We all have a difficulty with language. We do not have to be a Michelangelo to express ourselves visually. That message has come across clearly and we as a committee have a duty to bring this to the Minister and the Department to advance it further and consider the request for funding.
Ms Shanahan
On Deputy Hoctor's question as to whether this relates only to the emotionally deprived, any of us can benefit from becoming a bit more alive and expressing ourselves in alternative ways. When teaching I often found myself spontaneously doing art therapy, without realising it. I would never have dreamt of engaging in therapy without a qualification, but I found myself wanting the children to take up a piece of clay and to mould it, close their eyes, and let whatever came to them emerge. It was astounding. I would not always call it therapy because there are a lot of boundaries around therapy and one would not engage in therapy with people you know, for example. People can benefit without even necessarily having to share. That is the beauty of the therapies. One can actually do profound work without naming it or knowing how to name it. Much of the symbolism that emerges is so astounding that you ask where it comes from. The person is much more of a mystery than we realise and is touched by means which are not merely verbal.
Ms Sweeney
Deputy Crowe referred to our request for long-term funding. Funding is on an annual basis and this does not work. We end in June and this is a difficulty for the children and young people with whom we are working. We are seeking commitment to a five-year plan or something of that nature so that we can carry out research, evaluate and prove that this work is valuable and effective. We want our work to be mainstreamed, but we would welcome a commitment to funding for, say, ten years. I have been working for eight years in disadvantaged schools in Finglas. Security is essential for me as a professional and for the young people with whom we are working.
Is it a pilot scheme?
Ms Sweeney
It started out as a pilot scheme and I then insisted that we should call it a programme because it could hardly be a pilot scheme three years down the line.
A huge number of pilot schemes within the system have been going on for years. Eight years is not unusual.
Ms Sweeney
In terms of therapies, it is not good enough.
Do you have any input to that committee on student behaviour to address the problems in schools? The ongoing problem is acknowledged by everyone, both inside and outside the profession.
It presents you with an opportunity.
Ms Sweeney
Thank you for that.
Thank you for an excellent presentation and giving us the background to the work you are doing. All of us as public representatives have contact through our clinics with the problem of behavioural difficulties. We are glad to be informed of the input you are making. We as a committee will do everything we can to ensure that you receive funding from the Department.
The joint committee adjourned at 12.30 p.m. until 11.30 a.m. on Thursday, 5 May 2005.