Arts therapies transforming young lives
Pathfield School has become the first school to engage Chroma to provide the full range of arts therapies to its pupils. NR Times learns more
In a pioneering project, a special school in North Devon has adopted all three disciplines of arts therapy - art, drama and music - to support its pupils’ social and emotional wellbeing far beyond what is traditional in an academic environment.
Pathfield School has partnered with Chroma, the UK’s leading provider of arts therapies, to build upon its long-established music therapy provision within the school by commissioning Chroma’s full arts therapies team.
The new Arts Therapies Service - one of the only such initiatives of its kind integrated in a single school in the UK - consists of an in-house team of Chroma arts therapists—including a neurologic music therapist, art therapist and drama therapist.
Each therapist has a different role, but overall the team help children and young people to express and explore a wide range of emotions, thoughts, relationships and experiences for which it is difficult, or not possible, to communicate in words.
This year, over 400 therapy sessions have been delivered to 28 children by the Chroma team, with plans firmly in place to extend the arts therapy provision into the 2021/22 academic year and beyond.
While most arts therapies sessions are currently delivered in an individual therapy context, the Chroma team, working with the school, are looking to develop more group work in the future to support pupils with peer interactions, build confidence and further develop their communication skills.
Pathfield recently expanded to include the Pathways Discovery Centre - a new centre created to meet the specific needs of children with more complex social, emotional and mental health barriers to education.
Much of the art therapy work is based at the centre, though this provision can also be accessed by pupils on the main site. Pupils who engage in these sessions tend to be more cognitively aware and able to work through this means.
The new service also sees the introduction of neurologic music therapy techniques for those pupils receiving music therapy with a brain injury or neurological condition, to help them regain or attain functional skills that will help them overcome significant challenges and barriers to learning.
Using standardised specialist assessments, Chroma arts therapists assess, monitor and evaluate children’s functioning in different domains as well as progress and outcomes.
This sees the therapists working closely with parents, carers and class teaching teams to identify aims for the work and support the child in achieving positive outcomes.
Arts therapists form an integral part of the multidisciplinary team (MDT) in order to help the children to achieve their goals. This requires close liaison with other professionals - educational and clinical psychologists, social workers, physiotherapists, occupational therapists, and speech and language therapists.
Drawing on other professionals’ expertise in specific areas is an important part of the work and the work by Chroma therapists further enhances the input provided by the other members of the MDT.
Together, in partnership with parents, carers and teachers, and the pupils themselves, the Chroma team are focused on contributing to the Education and Health Care Plan (EHCP) to help them achieve meaningful personal goals.
THE POWER OF THE ARTS
Through the use of arts therapy in a school setting, children are given the opportunity to express themselves in different ways to what is traditionally offered.
By being given the space and freedom to manage feelings in new ways, their ability to manage such powerful emotions is increased.
And while the impact of an arts therapy intervention can be significant through the offering of one discipline, the availability of three - music, drama and art - is where Pathfield School is leading the way in its support of pupils by engaging methods which lie outside of the core curriculum.
“It’s very rare to have all three arts therapies in a school, but it’s very effective to have multiple therapists working together in the same team, triaging referrals, aligning assessment practices and recording outcomes as a team” says Lucy Collings Pettit, specialist neurologic music therapist at Chroma and senior arts therapist for the Arts Therapies Service at Pathfield.
“Arts therapies provide a safe, confidential space in which art, drama and music can be the bridge to relate to the young person and enable them to access means of expression without the need for words. This can be particularly important for those children with communication difficulties or who struggle to articulate their feelings.
“Through establishing and building trust, we can work towards outcomes for that child. That may take a long time or it may be a shorter process, it is very much about the child.”
“It’s important to provide a consistent space each week in doing that,” says Emily Tudge, specialist art therapist with Chroma.
“Using arts therapy is quite a different approach, as often schools will be working towards set goals in terms of academic progress, but with arts there is a much more open space for feelings and emotions.
“Outcomes are very important in the longer-term, but in each session, it’s about meeting the child where they’re at emotionally that day.”
Amy Gunther, a drama therapist at Chroma, says: “It’s important we take into account what comes from teacher or parents and any ideas they have, but that we work with the children so they know that this is their session.
“Building that rapport and trusting relationship so this is a safe space for them is so important, so a child comes along and understands how different this is from a lesson. We want this to be valuable time for them.
“Therapy wouldn’t be successful without meaningful goals, but the priority is saying to the child ‘This is a space for you’ and for them to articulate themselves however they want to do that.”
“Arts therapies allows a child to bring their agenda. If there is a high level of stress on children and families, we can’t underestimate the impact of that, and indeed we have seen the impact of children not being given the safe space to deal with this,” says Lucy.
“Maybe they don’t have the safe space to be open at home, so these sessions in school are a very valuable opportunity for them.”
A HEADTEACHER’S STORY - STUART ALLMAN, PATHFIELD SCHOOL
“We have had music therapy here for quite a long time, we have been supported by Lucy for a number of years, and more recently we have added art and drama to that too. We wanted to try something different to see what more support we could offer.
“I don’t think there are many, if any, other schools, at least in this part of the country, who have such a wide therapy offering.
“Through having the range of therapies, one of the advantages is that the therapists can meet the social and emotional needs of different pupils, from those with more profound difficulties through to those with challenging behaviour and severe learning disabilities, there is a whole range of needs we are now able to meet in new ways.
“By having a therapy team here, if a child is in crisis - perhaps they have had a bereavement - then they can immediately do something about it. In the past, it would have been reactionary and we would have to find a support service to come in, but now we have that in place, we can be much more flexible in response to situations and our young people’s needs.
“One of the things that comes up from families is how important this additional support is, as a school it is outside our normal core offer but we were aware we weren’t experts in therapy but realised how much our children could benefit from it. It works very well alongside our education and health plans, and parents and pupils themselves appreciate the work that is going into it.
“While music therapy is very familiar, art and drama doesn’t feel like an add-on, it has become an accepted part of what we do, the pupils haven’t seen it as anything different and it’s just part of what they do at school. It’s something they look forward to.
“Already, we’re seeing a lot of surprises along the way. We know our pupils really well but there are lots of reactions coming out that we maybe hadn’t expected, often some talents come out too. There is some great engagement with the sessions.
“While music is very established, it is early days for art and drama, but so far it has been great. We’ve had a lot going on over the past 18 months and being able to offer these additional therapies, even continuing the support through remote sessions during lockdown, has been really great.
“The use of Zoom and Teams is something we maybe wouldn’t have thought would work for these kinds of sessions, but it has shown to be really valuable. We have one individual who is selective mute but they have been able to converse virtually through art, which I’m not sure would have happened if not for lockdown.
“Lucy works with one girl with quite profound learning difficulties but she would still engage over the computer - we are so impressed with how well our young people are engaging.
“Art and drama therapy were beyond our scope, but by working with Chroma we have one port of call for the whole service. They provide that and oversee it for us, and as a school it has massively increased our therapeutic offer.
“There is now one portal and one way of working across all of our arts therapies. It is managed the same way with referrals, they are managed centrally then triaged to look at the best fit for that young person. The thinking processes are a lot more joined up this way.
“We’re certainly looking to build on the work we’ve done so far - it has been really well-received and we are definitely hoping to grow the provision.”
DRAMATHERAPY
Through the use of movement, character and expression, drama can help children express and manage their emotions and feelings.
By engaging in role-play, voice work and storytelling, young people are supported to better understand problems and to find ways of dealing with that.
Amy Gunther is a Chroma therapist who specialises in drama work. While a more recent introduction into Pathfield’s offering, children have embraced the variety of opportunities drama offers to manage personal and social issues - while having lots of fun at the same time.
“There are various ways of working in dramatherapy - we want to externalise what is happening and can use imagination to create a story to understand things differently.
“Often, that can involve using our bodies and movement. We can do role play to create characters and stories. Sometimes children can feel overwhelmed, so we might start with some art work where we could create a character. We can create their personality, who they are, where they live, and create some role play and dialogue around that. By developing this into a character, it can help create some distance from their feelings.
“If we find they cannot connect with their feelings, perhaps they are depressed and this manifests more in the body than in the head, then we could look at some exercises. When we feel anxious, we can feel that in our body, so moving that body part can be really regulating. If someone feels very flat, then big movements can help open up that feeling - or if it’s overwhelming, we can look at how we can shrink it.
“It can be a very playful approach - rather than talking about feelings we would play with Play Doh and create objects. This is a space for the children, and we want them to feel safe in expressing themselves however they wish.”
ART
The messy environment created in art therapy sessions at Pathfield are often a metaphor for what is happening inside a child’s mind.
“Mess making can be thought of as a physical version of emotional and psychological mess,” says Emily Tudge, art therapist at Chroma.
“We allow the child to have the space to make this mess but together, in a safe and contained way, and together we can clean it up. At the beginning of an intervention, it may feel very chaotic but through the process, mess-making can become a safe and contained expression of emotion. Using art in this way can support the child to self-regulate as well as internalising the experience that was mess, both physical and emotional, can be managed.
“Art therapy is very much a space to externalise a lot of challenging feelings. We make use of sensory engagement, using tactile materials, and the product at the end can be really valuable for the child to reflect on. This can allow the child to think about the difficult feelings they felt whilst making the imagery, whilst being separate to them. Children might want to dispose of it, or keep it stored confidentially as something really precious.
“There can also be the visual representation of their feelings through the materials we use. We could work with clay, for example, which is soft and malleable when it’s wet but looks and feels so different the following week when it is dry and brittle and can easily break. It opens up the topic of thinking about change and disappointment.
“We can address very challenging emotions in a way which is really engaging, making use of sensory materials and supporting each child to express themselves. We can use art to show that internalising feelings sometimes can get difficult, but there are ways to manage it which are also fun and that they enjoy.”
MUSIC
Music therapy is the most well-established of the arts therapies at Pathfield and has successfully engaged students with a wide range of needs.
Many pupils have found comfort in being able to express themselves through writing songs and lyrics, whilst others find a release in more improvised forms of music making - but each way of working is equally valuable and the impact of music therapy is found in what works for each individual child, says Lucy Collings Pettit.
“There are a number of different approaches we take, depending on a child’s needs. As a form of psychological therapy, music can be the primary means of communication for some pupils, those who are unable to communicate verbally or may have difficulty articulating thoughts or feelings. We work with many children for whom difficult feelings manifest in their behaviour, most often displayed through aggression towards themselves or others, or presenting as withdrawn,” says Lucy.
“A child’s musical expressions can sometimes be quite chaotic but music therapy is a co-active process with both the therapist and the child actively involved - the therapist can help a child to express themselves and their different emotions, and can provide emotional containment for the child in the joint music-making process.
“Words can also play an important part in the therapy - for those pupils who are able to verbalise, song writing can be such a release. They start to share some of their inner world through song writing processes and really relate to the lyrics, and it can be a positive way for children to start making sense of their emotions or experiences.”
While sometimes the consideration of lyrics can help bring great comfort, equally it may be that the musical creations and expressions are instead ‘in the moment’, says Lucy.
“Sometimes the music may be captured in a more concrete form, such as recorded to create a CD or written on paper, but also it can be lost, audibly in the air, a musical expression that just relates to that time. It can be a powerful tool in exploring different expressions and emotions,” she says.
“We have children who are dealing with feelings of grief, some pupils are children that are in care and have experienced a lot of changes in their primary care giver - they may wish to express and explore their experiences and ways of relating through music and we give them a safe space to do that.”
Lucy, a specialist Neurological Music Therapist, also has the skillset to support children with brain injuries and neurological conditions at Pathfield, equally to great effect.
“Some pupils have more profound difficulties, with their injuries or conditions significantly impacting their functional skills, and we employ a very different approach using specific techniques. We can work with a speech and language therapist or a physiotherapist to create something very planned with specified goals so we can help achieve positive functional outcomes,” she says.
“We work on, for example, using rhythm to enable a child to increase their range of motion or their walking speed. This can help a child gain motor function and the techniques employed benefit a pupil’s speech and language, and cognitive skills. NMT is a very different part of our work, but one which can achieve hugely successful outcomes for a child.”
Case Study: Emma
Emma, a 16 year old pupil at Pathfield School, benefitted from weekly individual music therapy input that provided her with valuable opportunities to express and explore difficult emotions through a positive means. Emma had experienced traumatic events in her early childhood, and was experiencing feelings of abandonment following the sudden exit of a parent from her life.
At the point of referral, Emma was struggling to cope with difficult feelings and this was regularly manifesting in aggressive, destructive and self-harming behaviours; she was also presenting with very low self-esteem, experiencing depressive symptoms, and she would often become very withdrawn. Emma’s emotional difficulties were impacting significantly on family and peer relationships, and on her ability to engage with learning at school.
Following an assessment, Emma received weekly individual music therapy sessions at school; she developed a trusting relationship with the therapist and, within the safety of this relationship, she was able to use a combination of music-making processes and words to express, explore and process her emotions and experiences that she had previously not been able to articulate and which had been resulting in maladaptive behaviours.
During her sessions, Emma brought the agenda; the sessions were child-led and she was able to bring material that was relevant to her at that moment in the week. At times, this involved improvised play with the therapist on a range of instruments, including percussion, guitars and a piano; at other times, she chose to engage with songwriting and she was supported by the therapist in creating a song that expressed her emotions and reflected something of her inner world.
Emma has consented to the sharing of the opening two verses of her song, for the purposes of illustrating this clinical work
The therapeutic songwriting process took place over a number of sessions, with key themes emerging through verbal reflection following improvised instrumental play with the therapist. Songwriting within the safety of a confidential music therapy context allowed Emma to express and explore difficult and confusing emotions through a positive and containing means, with the musical form of the song itself providing her more chaotic thoughts with a valuable structure and allowing them to feel more manageable.
Emma had found it difficult to talk about her emotions and experiences, often struggling to articulate these, but she found that having consistent opportunities to express herself creatively within a confidential space to be a safe and non-threatening way of working. She sometimes found it useful to revisit lyrics that she had written, jointly reflecting with the therapist on the lyrical content, helping her to make more sense of her feelings and gaining insight into her emotional responses.
Initially, Emma shared that she would not sing in front of anyone, attributing this to comments previously made about her singing, stating that she was “bruised of singing”, and she described the act of singing as “scary”. Remarkably, towards the end of her therapy, Emma began to use her own singing voice, an indication of her trust and feelings of safety in the therapy context. She was able to gain a sense of ownership over her song in the process, with her now singing the lyrics that she created.
By the end of her music therapy journey, Emma reported that the severity of her depressive symptoms had reduced, she was better managing difficult emotions, showing a reduction in incidences of self-harming behaviour, talking more openly with trusted members of school staff, better engaging with her learning, and maintaining relationships with peers and family members more effectively.
