Journal articles on the topic 'Child psychotherapy Study and teaching (Internship)'

OBJECTIVE To describe the fifth-year medical students' self-evaluation based on the reflexive discourse of the Activities Diaries (portfolio) from the Pediatric Internship I and Child Care Rotations. METHODS Cross sectional, qualitative and descriptive study using the collective subject discourse of the diaries used during the internship of the Medical School, in Catanduva, São Paulo, from January to November, 2011. The registered students' testimonials in the portfolio sections called self-assessment and students' impression were assessed according to their central ideas (discipline organization, breastfeeding outpatient clinic, number of admissions in the pediatric hospital ward and satisfaction with the Child Health training ), related to the teaching of Pediatrics and Child Care. The portfolios with incomplete registers were excluded. RESULTS The testimonials of 47 interns (75% of the students) were analyzed, and 21.3% of them expressed satisfaction with the discipline organization and 27.7% praised the inclusion of the breastfeeding outpatient clinics in the course. For 25.5% of the academics, the number of admissions in the pediatric wards was insufficient for an ideal learning; however, 70.2% were satisfied with the Child Health training. CONCLUSIONS This critical analysis allowed a summary of the reflections, suggestions and critics registered by the interns and can be used as a tool for improvement of the professional cycle.

Abstract This study aims to describe the learning, media, and curriculum of the SMK Negeri 3 Banjarmasin Accounting expertise program, describe the debriefing provided by the school before the Accounting expertise program students carry out the internship and describe the experience gained by the accounting expertise program at the SMK Negeri 3 Banjarmasin accounting program from the implementation of the internship in the relevant agencies. The research method used is a qualitative research method with data collection techniques through interviews, observations, and document studies. Sources of data obtained from interviews with informants are productive accounting teachers, deputy head of the public relations department, deputy head of the curriculum, administrative staff, and students of accounting expertise program at SMK Negeri 3 Banjarmasin. Data was also obtained from the document study results. The results showed that the Banjarmasin SMKN 3 in teaching and learning activities developed a KTSP-based curriculum, as well as carrying out industrial work activities for three months while students were in the third and fourth semester, and using online learning media to support learning while students were in the business world of industry. As for debriefing by the school when the child will carry out an apprenticeship given by productive teachers, counseling guidance. the head of the expertise program, the deputy head of the school, to the head of the school regarding student matters and readiness regarding the implementation of the internship. Industrial work practices provide special experience and illustrations for students related to business and the industrial world.

This study presents the findings of a qualitative investigation about four elementary preservice teachers’ experiences learning to teach social studies in the No Child Left Behind era. The participants’ internship took place in an elementary school which devoted the majority of the day to literacy and mathematics instruction. Because previous interns in the school had limited or no opportunity to teach social studies, the four participants were required to complete an Interdisciplinary Teaching Assignment to ensure that they were able to teach and reflect upon teaching social studies at least one time during the semester. Findings indicated the interns found the experience meaningful and rewarding because of their students’ enthusiasm toward the content and instructional approaches. After meeting the requirements of the assignment, the participants found ways to borrow time from the hours dedicated to literacy and mathematics instruction in order to address social studies topics and themes. The paper concludes with a discussion of teacher educators’ roles in preserving social studies education in American

The efficiency of the education systems fundamentally depends on the quality of teaching and learning in classrooms, workshops, laboratories, and other educational spaces. Perfect teachers, well-designed courses, and proper facilities, provision of necessary resources are required for an excellent education, but not enough. This study aims to evaluate child development associate degree program students in their learning during their summer internships the scope of Raelin’s Work-Based Learning Model. The individual level of this model takes place two types of learning (theory and practice) and four types of individual learning (conceptualization, experimentation, experience, and reflection) that arise from a matrix of two forms of knowledge (explicit and implicit). This research was designed as a case study, one of the qualitative research methods. Depending on the tradition of qualitative research, observation, semi-structured interview, and document review strategies were used to increase the reliability of this study. In the analysis of the qualitative data, the descriptive analysis technique was used to define and interpret the data in line with the predetermined themes. The findings obtained in this study revealed that although the students made various observations and practices during their internships, it has been identified that these studies did not include the learning types in the context of the model.

This study identified patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder within publicly funded mental health services and compared patterns for therapists delivering usual care to those trained in AIM HI (“An Individualized Mental Health Intervention for ASD”). Data were drawn from a randomized community effectiveness trial and included a subsample of 159 therapists (86% female) providing outpatient or school-based psychotherapy. Therapist strategies were measured via observational coding of psychotherapy session recordings. Exploratory factor analysis used to examine patterns of strategy delivery showed that among therapists in the usual care condition, strategies loaded onto the single factor, General Strategies, whereas for therapists in the AIM HI training condition, strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies. Among usual care therapists, General Strategies were associated with an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were associated with reductions in child behavior problems over 18 months. Results support the effectiveness of training therapists in evidence-based interventions to increase the specificity of strategies delivered to children with autism spectrum disorder served in publicly funded mental health settings. Findings also support the use of active teaching strategies in reducing challenging behaviors. Lay abstract This study was conducted to identify patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder receiving publicly funded mental health services and compare strategy use for therapists delivering usual care to those trained to deliver AIM HI (“An Individualized Mental Health Intervention for ASD”), an intervention designed to reduce challenging behaviors in children with autism spectrum disorder. For therapists trained in AIM HI, intervention strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies, while strategies used by usual care therapists grouped onto a broader single factor, General Strategies. Among usual care therapists, General Strategies were related to an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were related with reductions in child behavior problems over 18 months. Findings support the use of active teaching strategies in reducing challenging behaviors in children with autism spectrum disorder and provide support for the effectiveness of training therapists in evidence-based interventions to promote the delivery of targeted, specific intervention strategies to children with autism spectrum disorder in mental health services.

Objective. To analyze the application of case based learning (CBL) teaching method combined with situational simulation teaching in clinical teaching of anesthesiology and its influence on improving theoretical knowledge and clinical practice ability of anesthesiology medical students. Methods. 42 anesthesiology medical students who came to our hospital for internship from March 2019 to March 2020 were selected as the research objects, and were randomly divided into the study group and the reference group, with 21 students in each group. The CBL teaching method combined with situational simulation teaching was adopted for the study group, while the traditional teaching mode was adopted for the reference group. After the teaching, both groups of students were assessed in theory and skill operation, and the scores were compared. Results. There was no significant difference in gender ratio, average age, only-child or not, home address and aspiration to choose this major between the two groups (P>0.05). After training, the scores of theory test and skill operation in both groups were significantly higher than those before training (P<0.001), and the scores in the study group were significantly higher than those in the reference group (P<0.001). The scores of fill-in-the-blankquestions, noun explanations and essay questions of the study group were significantly higher than those of the reference group (P<0.001). The study group was better than the reference group in deepening learning and memory,improving autonomous learning ability, stimulating learning interest, and cultivating clinical thinking (P<0.05). The scores of professional practical ability, professionalattitude,management ability, interpersonal communication ability, professional development ability, and critical thinkingability in the study group were significantly higher than those in the reference group (P<0.05). After training, the humanistic care abilityscores of both groups were significantly higher than those before training (P<0.001), and the score in the study group was significantly higher than that in the reference group (P<0.001).The total recognition of the study group was significantly higher than that of the reference group (P<0.05). Conclusion. CBL teaching method combined with situational simulation teaching can significantly improve students’ mastery of theoretical knowledge and practical operation of clinical anesthesiology, and stimulate their humanistic care consciousness, which can lay the foundation for cultivating professional talents of anesthesiology in our hospital.

Higher specialist training in psychiatry requires the development of a broad range of knowledge and skills in a short space of time. However, a brief national survey of programme directors confirms reports from peers that structured, targeted teaching tends not to continue beyond completion of College Membership examinations. Exceptions to this rule are child and adolescent psychiatry and to a lesser extent psychotherapy, which reflects requirements laid out in the Higher Specialist Training Handbook (Royal College of Psychiatrists, 1998). Specialist registrars must therefore, using limited study time and funding, attempt to acquire knowledge from local and national courses. These, however, are usually aimed at more generic groups: for example, all health service specialist registrars or at consultants for fulfilment of continuing professional development.

This article focuses on analog and digital game play and the challenges it poses to future teachers in an educational context. For that, a review of the literature on the subject was made, addressing the theories of Piaget and Vygotsky. We refer to the game as a pedagogical resource, its relation to the teaching-learning process, and its role in stimulating the multiple intelligences referenced by the psychologist Howard Gardner. Structurally framed by this theoretical framework, we developed this study in an integrated internship context in a classroom of the First Cycle of Basic Education, with 20 children ages 9 and 10. In order to carry out this research, we developed teaching-learning experiences that allowed us to answer the following question: How do the different game supports (analog/digital) motivate children to the teaching-learning process? In order to answer this question, we have outlined the following objectives: i) to understand if the type of support in which children play influences learning; ii) develop activities in contexts, using games (analog and digital); (iii) understand, to what extent, playing games encourages the development of multiple skills. The study is part of a descriptive, interpretive, and reflexive process, framed in a qualitative approach. For data collection, we used participant observation, observation log grids, field notes, photographic records, and interviews with the children. After analyzing the data, these tend to reveal, among other aspects, a remarkable improvement in motivation of children, perceiving that the game is an excellent teaching/learning strategy that allows the development of social and communication skills of children, predisposing the child for learning. As far as the type of game support is concerned, we found that although digital is more appealing to children born in the Digital Age, we verified that both the game in analog and digital support, when properly integrated into the educational action, are also promoters of meaningful and lasting learning.

An Individualized Mental Health Intervention for ASD (AIM HI) was developed in collaboration with community stakeholders for delivery in mental health services in response to therapist- and caregiver-identified need to improve services for children with autism spectrum disorder (ASD). Primary findings from a cluster randomized Hybrid Type 1 effectiveness-implementation trial conducted in publicly funded mental health programs demonstrated the effectiveness of AIM HI therapist training on child and caregiver outcomes. This study examined therapist outcomes and therapist experience as a moderator of training effects. Mental health programs were randomized to immediate AIM HI training or usual care. Therapists and child/caregiver clients were recruited from participating programs. Therapists in the AIM HI training condition received consultation for 6 months while delivering AIM HI. Differences between training conditions were examined using multilevel modeling. Therapists receiving AIM HI training were observed to use more extensive active teaching strategies with caregivers, engagement strategies with children, strategies promoting continuity of care, and had more structured sessions with more extensively pursued skill building. Therapist licensure moderated some training outcomes. The current study provides support for evidence-based practice implementation in usual care mental health services. Lay abstract Publicly funded mental health services play an important role in caring for school-age children with autism spectrum disorder (ASD); however, therapists report a lack of specialized ASD training, which families identity as a barrier in obtaining mental health services for their children. An Individualized Mental Health Intervention for ASD (AIM HI) was developed in collaboration with community stakeholders to respond to identified needs of children and community therapists. The current study examined the effects of therapist training in AIM HI on the changes in therapist practice, including therapists’ use of evidence-based intervention strategies in session. Data were collected from a study conducted in community outpatient and school based mental health programs randomly assigned to receive AIM HI therapist training or observation of routine care. Therapist and child clients were enrolled from participating programs. Therapists in AIM HI training received training and consultation for 6 months while delivering the AIM HI intervention to a participating client; therapists in usual care delivered routine care. Both groups of therapists video recorded psychotherapy sessions which were scored by trained raters. Differences between training groups were examined using multilevel modeling. Therapists trained in AIM HI were observed to use more extensive active teaching strategies with caregivers, engagement strategies with children, strategies promoting continuity of care, and had more structured sessions with more effective pursuit of caregiver and children skill teaching. Therapist licensure moderated some training outcomes.

AimsThe field of psychiatry in Morocco has grown significantly since the 1970s, from less than 10 psychiatrists to the current number of around 400. The increased number of practising psychiatrists has enabled the expansion of local residency training programmes, which has been set up since 1974 to cater for the population needs of more than 36 million population of Morocco. This study is aimed to describe the current medical educational approach of the Moroccan postgraduate psychiatry training programme.MethodsThis descriptive medical educational study was based on official training documents and interviews with local faculty members involved in the training.ResultsThe entry requirement of the four-year Moroccan postgraduate psychiatry residency programme includes the completion of 1 year of foundation training and passing the entrance examination consisting of psychiatric semiology and pharmacology. The postgraduate residency programme is run by the local universities in collaboration with the Ministry of Health and accredited by the Moroccan government. Trainees have the option of taking up a voluntary or contractual position with the government or University Hospitals. All trainees will go through 34 months of general adult outpatient and inpatient, while liaison psychiatry training starts from the second year until the end of the training. On top of the core rotation, a trainee can opt for two months in old age and neuropsychiatry postings. Child and adolescent rotation is currently not available. Addiction psychiatry training is optional and can be done through a university diploma. The 4th year is a 12-month elective posting in any discipline that is relevant to psychiatry, which can be done either locally or abroad. Teaching methodologies involve lectures, seminars, ward rounds, case conferences, journal clubs, and skill training workshops. Formative assessments included case-based discussions and mini-clinical evaluation exercise. There are multiple high stakes summative assessments at year 1, year 2, year 3, and year 4. The summative assessment strategies includes modified essay question, clinical short case and long case. Viva voce is used to assess competency in research. Different mandatory skill competencies include electroconvulsive therapy, psychotherapy, and research.ConclusionThe advancement of local postgraduate psychiatry residency training in Morocco has improved the access of local trainees to quality training. Similar to other developing countries, Morocco requires more psychiatrists to improve the psychiatrists to population ratio so that the mental service can become more accessible to the local population.

Resumo: Na presente pesquisa realizamos uma abordagem de como as atividades lúdicas são essenciais na Educação Infantil e de como os seus feitos ocasionam o desenvolvimento de habilidades nas crianças, além do incentivo ao crescimento e aperfeiçoamento das práticas pedagógicas. No artigo em questão como objetivo geral analisamos as contribuições de atividades lúdicas na Educação Infantil, evidenciamos a importância de desenvolver essas práticas ainda quando crianças e apresentamos a docentes, futuros docentes e a comunidade em geral que as brincadeiras promovem a formação de um cidadão participativo, reflexivo e crítico. Como aporte teórico mencionamos os estudos desenvolvidos por Almeida (1995); Luckesi (2000) e Vygotsky (1984) dentre outros contribuintes. Contamos com uma pesquisa de metodologia, em termos de estudo e análises, de natureza qualitativa. Em relação ao objetivo do estudo é de origem exploratória e procedimentos técnicos de pesquisa bibliográfica. O interesse pela presente temática em abordagem surge através das disciplinas de estágio vivenciados de forma prática na Educação Infantil. A Educação Infantil pautada em um ensino lúdico evidencia que a aprendizagem se torna algo prazeroso e mais efetivo para as crianças. A alegria envolvida, a energia faz com que se tenha uma maior dedicação para realizar essas ações que vão além do pedagógico. O lúdico não pode ser tido como um passatempo, essa concepção precisa ser desconstruída e ser entendida que é uma experiência voltada para algum conhecimento e que está sendo trabalhado além do pensamento individual, o coletivo. O brincar, o lúdico não é desenvolvido sem nenhuma perspectiva, ao contrário, vários valores são abordados e colocados em prática para que a criança internaliza e leve esses valores para além da sala de aula.Palavras-Chave: Educação Infantil. Lúdico. Práticas pedagógicas. Abstract:In the present research we carried out an approach of how playful activities are essential in Early Childhood Education and how their achievements lead to the development of skills in children, in addition to encouraging the growth and improvement of pedagogical practices. In the article in question, as a general objective, we analyze the contributions of playful activities in Early Childhood Education, we highlight the importance of developing these practices even when children and we present to teachers, future teachers and the community in general that games promote the formation of a participatory citizen, reflective and critical. As a theoretical contribution, we mention the studies developed by Almeida (1995); Luckesi (2000) and Vygotsky (1984) among other contributors. We have a methodology research, in terms of study and analysis, of a qualitative nature. In relation to the objective of the study is of exploratory origin and technical procedures of bibliographic research. The interest in the present theme in approach arises through the internship disciplines experienced in a practical way in Early Childhood Education. Early childhood education based on playful teaching shows that learning becomes something pleasurable and more effective for children. The joy involved, the energy makes one have a greater dedication to carry out these actions that go beyond the pedagogical. The ludic cannot be seen as a hobby, this conception needs to be deconstructed and understood that it is an experience focused on some knowledge and that is being worked on beyond individual, collective thinking. Playing, the ludic is not developed without any perspective, on the contrary, several values are addressed and put into practice so that the child internalizes and takes these values beyond the classroom.Keywords: Early Childhood Education. Ludic. Pedagogical practices.

Context: The shortage of child and adolescent psychiatrists in France affects access to early interventions and mental health services and impacts therapeutic practices and prescribing trends. This study aimed to describe factors associated with choosing child and adolescent psychiatry (CAP) as a career specialty and with assessing the level of attractiveness of this discipline and its predictors.Methods: We generated a self-report questionnaire using a modified two-step Delphi approach. The survey was conducted from January 13 to February 16, 2020, and targeted French child and adolescent psychiatrists or psychiatrists, mainly working with children and/or adolescents. We used a logistic regression model to assess the factors associated with the perception of CAP as attractive. A thematic qualitative analysis of the free comments section of the questionnaire was performed.Results: Of 863 doctors contacted by email, the response rate was 77.4% (668 respondents). Two-thirds of respondents were female and had an official specialization in CAP. One-third were aged between 31 and 40 years. The main reasons for choosing to specialize in CAP were interest in working with children (64.2%), interest in psychotherapy (52.8%), and influence of an internship in CAP during medical studies (46.0%), although only one-third of respondents actually did an internship. Over half of respondents (57.3%) identified personal factors as implicated in their choice of CAP, mainly personal psychotherapy (22.2%) and personal trauma (14.4%). Although only 58.4% of respondents perceived CAP as attractive, 97.8% had no regret about their choice, and 83.5% would make the same career choice today. A positive perception by respondents' surroundings for choosing CAP at the time of the choice was associated with a perception of CAP as currently attractive by respondents (odds ratio: 1.82; 95% confidence interval: 1.27–2.60; p = 0.001).Conclusion: CAP is in crisis and faces many challenges in France, with an urgent need to redress its demographics. Many child and adolescent psychiatrists do not regret their choice and would choose the same specialty today. To increase its attractiveness, better visibility during medical school, enhanced academic recognition, and increased remuneration seem promising.

After World War II in the Netherlands, outpatient mental health care for children expanded greatly. The number of Child Guidance Clinics grew, and university child-psychiatric clinics and Youth Psychiatric Services were newly established. The leading diagnostic and treatment ideology was mainly Freudian and focused on psychotherapy. During the 1960s the Child Guidance Clinics were outstripped by the more innovative university clinics that introduced new kinds of treatment, such as play- and group-therapy. This ended the hegemony of psychiatrists, as child psychologists and psychiatric social workers replaced them as therapists. At the same time, psychologists of the two denominational university Paedological Institutes took the lead in the scientific study of children’s more serious psychopathology and the development of play-therapy and remedial teaching methods.

Women by virtue of their being are confronted with many challenges. This is particularly the case in South Africa where gender-based violence, women abuse and femicide are pervasive. This study sought to highlight the contribution of academic libraries in South Africa to SDG 5 on gender equality through Community Engagement (CE) initiatives. The study followed a multi-methods qualitative approach and online interviews with 20 heads of public university libraries, and focus group discussions with 33 Librarians in eight focus groups were its data collection methods. Findings showed that academic libraries in the country contribute to SDG 5 through visits and donations to safe houses and prisons, Take a Girl Child to Work initiative, providing internship opportunities to females, collection and donation of sanitary towels in schools, and panel discussions, visits and displays that tackle women’s issues. These results affirm the contribution of academic libraries to the SDGs through CE. CE can be adopted in academic libraries to provide direct contribution to the SDGs that are not always associated with their traditional teaching, learning and research support role.

The article examines a serious problem with the implementation of the "comprehensive three-child policy" in China, the lack of personnel in educational institutions starting from the first stages of child development. The training of preschool teachers, teachers, lecturers and heads of educational institutions is of great importance to fill the gap in the lack of personnel. The study selected a local undergraduate college in China and Malaysia for comparison. The used methods of content analysis and comparison made it possible to carry out an in-depth analysis of the goals of education, the structure, nature and content of the curriculum, the number of courses of two selective colleges, thus obtaining a general situation for building a system of education on the main existing problems of these two colleges. As Malaysia and China are Asian countries, there are similarities and differences in the curricula of their education majors, especially in the number of courses. It was determined that when drawing up a training program, it is necessary to find out the basics and principles of the training program. The curriculum must meet the requirements of national educational laws and regulations regarding basic knowledge and the quality of student talents in preschool education and take into account the characteristics of the educational facilities. At the same time, it must be formulated based on comprehensive consideration of the diverse needs of subject matter experts, early childhood educators, teacher education managers, early childhood education students (including graduates), planning experts, and other personnel. Learning objectives should meet the talent requirements determined by the subject of study and level of training, and the level of training of preschool teachers and undergraduate students should be higher than that of junior students. In addition to the training of staff teachers, it is also necessary to develop the potential management talents of preschool educational institutions. It is proposed to integrate practice into other educational courses, mandatory internship and various forms of practice in course implementation. Teaching methods should be optimized according to the needs of students, and a certain amount of time for independent study should be provided to develop their ability to study independently.

Resumo: O artigo relata resultados de uma pesquisa que teve como objetivo compreender os sentidos e contribuições da formação inicial em Pedagogia para o processo de iniciação à docência no contexto da creche. O referencial teórico contempla questões ligadas à formação docente e aos desafios da prática pedagógica nos anos iniciais da carreira. Como eixo metodológico, utilizamos a pesquisa qualitativa de caráter descritivo-analítico sendo que levantou-se a tendência investigativa sobre a docência na Educação Infantil junto ao Banco de Teses e Dissertações da CAPES e nos GT´s 07 e 08 da ANPED, bem como recorremos a dados de entrevistas semiestruturadas com quatro professoras iniciantes que atuam no município de Naviraí/MS. Os resultados do trabalho de campo identificaram os seguintes elementos: a) a pesquisa sobre professores iniciantes na Educação Infantil ainda é pouco explorada nos estudos brasileiros; b) a relação entre teoria e prática foi apontada pelas entrevistadas como sendo o principal desafio nas primeiras vivências no espaço escolar; c) o estágio e o sentido da experiência prática com a docência foram apontados como elementos que contribuem para o início da carreira e; d) a necessidade da formação inicial de professores incorporar, no processo formativo, momentos de reflexão tendo a inserção na escola como objeto de aprendizagem para os futuros docentes. Palavras-Chave: Formação docente. Professoras iniciantes. Educação Infantil. TEACHER TRAINING AND EARLY CAREER IN EARLY CHILDHOOD EDUCATION Abstract: This paper is an account of the results from a study whose purpose was to understand the meanings and contributions of the basic training in Pedagogy for the process of transition to start teaching in the context of a daycare center. The theoretical framework includes issues associated with teacher education and the challenges of the pedagogical practice in the early years of their career. As methodological approach, we have utilized qualitative research of descriptive/analytical nature in which the investigative trend was surveyed in the search for teaching in Child Education in the Database of Theses and Dissertations of CAPES and in the Work Groups 07 and 08 of ANPED, and we turned to data form semi-structured interviews with four beginning teachers who serve in city of Naviraí/MS. The results of the fieldwork identified the following elements: a) the research on beginning teachers in Child Education remains unexplored in the Brazilian studies; b) the relationship between theory and practice was pointed by the interviewees as the major challenge in the first experiences in the school ambience; c) internship and the meaning of the practical experience with teaching were indicated as elements that contribute in the beginning of the career; and d) the need for basic training of teacher to include, along the formative process, moments of reflection having the entry in a school as the object of learning for future teachers. Keywords: Teacher education. Beginning female teachers. Child education.

The National Cultural Policy Discussion Paper—drafted to assist the Australian Government in developing the first national Cultural Policy since Creative Nation nearly two decades ago—envisages a future in which arts, cultural and creative activities directly support the development of an inclusive, innovative and productive Australia. "The policy," it says, "will be based on an understanding that a creative nation produces a more inclusive society and a more expressive and confident citizenry by encouraging our ability to express, describe and share our diverse experiences—with each other and with the world" (Australian Government 3). Even a cursory reading of this Discussion Paper makes it clear that the question of impact—in aesthetic, cultural and economic terms—is central to the Government's agenda in developing a new Cultural Policy. Hand-in-hand with the notion of impact comes the process of measurement of progress. The Discussion Paper notes that progress "must be measurable, and the Government will invest in ways to assess the impact that the National Cultural Policy has on society and the economy" (11). If progress must be measurable, this raises questions about what arts, cultural and creative workers do, whether it is worth it, and whether they could be doing it better. In effect, the Discussion Paper pushes artsworkers ever closer to a climate in which they have to be skilled not just at making work, but at making the impact of this work clear to stakeholders. The Government in its plans for Australia's cultural future, is clearly most supportive of artsworkers who can do this, and the scholars, educators and employers who can best train the artsworkers of the future to do this. Teaching Artsworkers to Measure the Impact of Their Work: The Challenges How do we train artsworkers to assess, measure and articulate the impact of what they do? How do we prepare them to be ready to work in a climate that will—as the National Cultural Policy Discussion Paper makes clear—emphasise measuring impact, communicating impact, and communicating impact across aesthetic, cultural and economic categories? As educators delivering training in this area, the Discussion Paper has made this already compelling question even more pressing as we work to develop the career-ready graduates the Government seeks. Our program, the Master of Creative Industries (Creative Production & Arts Management) offered in the Creative Industries Faculty at Queensland University of Technology in Brisbane, Australia, is, like most programs in arts and cultural management in the US, UK, Europe and Australia, offering a three-Semester postgraduate program that allows students to develop the career-ready skills required to work as managers of arts, cultural or creative organisations. That we need to train our graduates to work not just as producers of plays, paintings or recordings, but as entrepreneurial arts advocates who can measure and articulate the value of their programs to others, is not news (Hadley "Creating" 647-48; cf. Brkic; Ebewo and Sirayi; Beckerman; Sikes). Our program—which offers training in arts policy, management, marketing and budgeting followed by training in entrepreneurship and a practical project—is already structured around this necessity. The question of how to teach students this diverse skill set is, however, still a subject of debate; and the question of how to teach students to measure the impact of this work is even more difficult. There is, of course, a body of literature on the impact of arts, cultural and creative activities, value and evaluation that has been developed over the past decade, particularly through landmark reports like Matarasso's Use or Ornament? The Social Impact of Participation in the Arts (1997) and the RAND Corporation's Gifts of the Muse: Reframing the Debate about the Benefits of the Arts (2004). There are also emergent studies in an Australian context: Madden's "Cautionary Note" on using economic impact studies in the arts (2001); case studies on arts and wellbeing by consultancy firm Effective Change (2003); case studies by DCITA (2003); the Asia Pacific Journal of Arts and Cultural Management (2009) issue on "value"; and Australia Council publications on arts, culture and economy. As Richards has explained, "evaluation is basically a straightforward concept. E-value-ation = a process of enquiry that allows a judgment of amount, value or worth to be made" (99). What makes arts evaluation difficult is not the concept, but the measurement of intangible values—aesthetic quality, expression, engagement or experience. In the literature, discussion has been plagued by debate about what is measured, what method is used, and whether subjective values can in fact be measured. Commentators note that in current practice, questions of value are still deferred because they are too difficult to measure (Bilton and Leary 52), discussed only in terms of economic measures such as market share or satisfaction which are statistically quantifiable (Belfiore and Bennett "Rethinking" 137), or done through un-rigorous surveys that draw only ambiguous, subjective, or selective responses (Merli 110). According to Belfiore and Bennett, Public debate about the value of the arts thus comes to be dominated by what might best be termed the cult of the measurable; and, of course, it is those disciplines primarily concerned with measurement, namely, economics and statistics, which are looked upon to find the evidence that will finally prove why the arts are so important to individuals and societies. A corollary of this is that the humanities are of little use in this investigation. ("Rethinking" 137) Accordingly, Ragsdale states, Arts organizations [still] need to find a way to assess their progress in …making great art that matters to people—as evidenced, perhaps, by increased enthusiasm, frequency of attendance, the capacity and desire to talk or write about one's experience, or in some other way respond to the experience, the curiosity to learn about the art form and the ideas encountered, the depth of emotional response, the quality of the social connections made, and the expansion of one's aesthetics over time. Commentators are still looking for a balanced approach (cf. Geursen and Rentschler; Falk and Dierkling), which evaluates aesthetic practices, business practices, audience response, and results for all parties, in tandem. An approach which evaluates intrinsic impacts, instrumental impacts, and the way each enables the other, in tandem—with an emphasis not on the numbers but on whether we are getting better at what we are doing. And, of course, allows evaluators of arts, cultural and creative activities to use creative arts methods—sketches, stories, bodily movements and relationships and so forth—to provide data to inform the assessment, so they can draw not just on statistical research methods but on arts, culture and humanities research methods. Teaching Artsworkers to Measure the Impact of Their Work: Our Approach As a result of this contested terrain, our method for training artsworkers to measure the impact of their programs has emerged not just from these debates—which tend to conclude by declaring the needs for better methods without providing them—but from a research-teaching nexus in which our own trial-and-error work as consultants to arts, cultural and educational organisations looking to measure the impact of or improve their programs has taught us what is effective. Each of us has worked as managers of professional associations such as Drama Australia and Australasian Association for Theatre, Drama and Performance Studies (ADSA), members of boards or committees for arts organisations such as Youth Arts Queensland and Young People and the Arts Australia (YPAA), as well as consultants to major cultural organisations like the Queensland Performing Arts Centre and the Brisbane Festival. The methods for measuring impact we have developed via this work are based not just on surveys and statistics, but on our own practice as scholars and producers of culture—and are therefore based in arts, culture and humanities approaches. As scholars, we investigate the way marginalised groups tell stories—particularly groups marked by age, gender, race or ability, using community, contemporary and public space performance practices (cf. Hadley, "Bree"; Gattenhof). What we have learned by bringing this sort of scholarly analysis into dialogue with a more systematised approach to articulating impact to government, stakeholders and sponsors is that there is no one-size-fits-all approach. What is needed, instead, is a toolkit, which incorporates central principles and stages, together with qualitative, quantitative and performative tools to track aesthetics, accessibility, inclusivity, capacity-building, creativity etc., as appropriate on a case-by-case basis. Whatever the approach, it is critical that the data track the relationship between the experience the artists, audience or stakeholders anticipated the activity should have, the aspects of the activity that enabled that experience to emerge (or not), and the effect of that (or not) for the arts organisation, their artists, their partners, or their audiences. The combination of methods needs to be selected in consultation with the arts organisation, and the negotiations typically need to include detailed discussion of what should be evaluated (aesthetics, access, inclusivity, or capacity), when it should be evaluated (before, during or after), and how the results should be communicated (including the difference between evaluation for reporting purposes and evaluation for program improvement purposes, and the difference between evaluation and related processes like reflection, documentary-making, or market research). Translating what we have learned through our cultural research and consultancy into a study package for students relies on an understanding of what they want from their study. This, typically, is practical career-ready skills. Students want to produce their own arts, or produce other people's arts, and most have not imagined themselves participating in meta-level processes in which they argue the value of arts, cultural and creative activities (Hadley, "Creating" 652). Accordingly, most have not thought of themselves as researchers, using cultural research methods to create reports that inform how the Australian government values, supports, and services the arts. The first step in teaching students to operate effectively as evaluators of arts, cultural and creative activities is, then, to re-orient their expectations to include this in their understanding of what artsworkers do, what skills artsworkers need, and where they deploy these skills. Simply handing over our own methods, as "the" methods, would not enable graduates to work effectively in a climate were one size will not fit all, and methods for evaluating impact need to be negotiated again for each new context. 1. Understanding the Need for Evaluation: Cause and Effect The first step in encouraging students to become effective evaluators is asking them to map their sector, the major stakeholders, the agendas, alignments and misalignments in what the various players are trying to achieve, and the programs, projects and products through which the players are trying to achieve it. This starting point is drawn from Program Theory—which, as Joon-Yee Kwok argues in her evaluation of the SPARK National Mentoring Program for Young and Emerging Artists (2010) is useful in evaluating cultural activities. The Program Theory approach starts with a flow chart that represents relationships between activities in a program, allowing evaluators to unpack some of the assumptions the program's producers have about what activities have what sort of effect, then test whether they are in fact having that sort of effect (cf. Hall and Hall). It could, for example, start with a flow chart representing the relationship between a community arts policy, a community arts organisation, a community-devised show it is producing, and a blog it has created because it assumes it will allow the public to become more interested in the show the participants are creating, to unpack the assumptions about the sort of effect this is supposed to have, and test whether this is in fact having this sort of effect. Masterclasses, conversations and debate with peers and industry professionals about the agendas, activities and assumptions underpinning programs in their sector allows students to look for elements that may be critical in their programs' ability to achieve (or not) an anticipated impact. In effect to start asking about, "the way things are done now, […] what things are done well, and […] what could be done better" (Australian Government 12).2. Understanding the Nature of Evaluation: PurposeOnce students have been alerted to the need to look for cause-effect assumptions that can determine whether or not their program, project or product is effective, they are asked to consider what data they should be developing about this, why, and for whom. Are they evaluating a program to account to government, stakeholders and sponsors for the money they have spent? To improve the way it works? To use that information to develop innovative new programs in future? In other words, who is the audience? Being aware of the many possible purposes and audiences for evaluation information can allow students to be clear not just about what needs to be evaluated, but the nature of the evaluation they will do—a largely statistical report, versus a narrative summary of experiences, emotions and effects—which may differ depending on the audience.3. Making Decisions about What to Evaluate: Priorities When setting out to measure the impact of arts, cultural or creative activities, many people try to measure everything, measure for the purposes of reporting, improvement and development using the same methods, or gather a range of different sorts of data in the hope that something in it will answer questions about whether an activity is having the anticipated effect, and, if so, how. We ask students to be more selective, making strategic decisions about which anticipated effects of a program, project or product need to be evaluated, whether the evaluation is for reporting, improvement or innovation purposes, and what information stakeholders most require. In addition to the concept of collecting data about critical points where programs succeed or fail in achieving a desired effect, and different approaches for reporting, improvement or development, we ask students to think about the different categories of effect that may be more or less interesting to different stakeholders. This is not an exhaustive list, or a list of things every evaluation should measure. It is a tool to demonstrate to would-be evaluators points of focus that could be developed, depending on the stakeholders' priorities, the purpose of the evaluation, and the critical points at which desired effects need to occur to ensure success. Without such framing, evaluators are likely to end up with unusable data, which become a difficulty to deal with rather than a benefit for the artsworkers, arts organisations or stakeholders. 4. Methods for Evaluation: Process To be effective, methods for collecting data about how arts, cultural or creative activities have (or fail to have) anticipated impact need to include conventional survey, interview and focus group style tools, and creative or performative tools such as discussion, documentation or observation. We encourage students to use creative practice to draw out people's experience of arts events—for example, observation, documentation still images, video or audio documentation, or facilitated development of sketches, stories or scenes about an experience, can be used to register and record people's feelings. These sorts of methods can capture what Mihaly Csikszentmihalyi calls "flow" of experience (cf. Belfiore and Bennett, "Determinants" 232)—for example, photos of a festival space at hourly intervals or the colours a child uses to convey memory of a performance can capture to flow of movement, engagement, and experience for spectators more clearly than statistics. These, together with conventional surveys or interviews that comment on the feelings expressed, allow for a combination of quantitative, qualitative and performative data to demonstrate impact. The approach becomes arts- and humanities- based, using arts methods to encourage people to talk, write or otherwise respond to their experience in terms of emotion, connection, community, or expansion of aesthetics. The evaluator still needs to draw out the meaning of the responses through content, text or discourse analysis, and teaching students how to do a content analysis of quantitative, qualitative and performative data is critical at this stage. When teaching students how to evaluate their data, our method encourages students not just to focus on the experience, or the effect of the experience, but the relationship between the two—the things that act as "enablers" "determinants" (White and Hede; Belfiore and Bennett, "Determinants" passim) of effect. This approach allows the evaluator to use a combination of conventional and creative methods to describe not just what effect an activity had, but, more critically, what enabled it to have that effect, providing a firmer platform for discussing the impact, and how it could be replicated, developed or deepened next time, than a list of effects and numbers of people who felt those effects alone. 5. Communicating Results: Politics Often arts, cultural or creative organisations can be concerned about the image of their work an evaluation will create. The final step in our approach is to alert students to the professional, political and ethical implications of evaluation. Students learn to share their knowledge with organisations, encouraging them to see the value of reporting both correct and incorrect assumptions about the impact of their activities, as part of a continuous improvement process. Then we assist them in drawing the results of this sort of cultural research into planning, development and training documents which may assist the organisation in improving in the future. In effect, it is about encouraging organisations to take the Australian government at its word when, in the National Cultural Policy Discussion Paper, it says it that measuring impact is about measuring progress—what we do well, what we could do better, and how, not just success statistics about who is most successful—as it is this that will ultimately be most useful in creating an inclusive, innovative, productive Australia. Teaching Artsworkers to Measure the Impact of Their Work: The Impact of Our Approach What, then, is the impact of our training on graduates' ability to measure the impact of work? Have we made measurable progress in our efforts to teach artsworkers to assess and articulate the impact of their work? The MCI (CP&AM) has been offered for three years. Our approach is still emergent and experimental. We have, though, identified a number of impacts of our work. First, our students are less fearful of becoming involved in measuring the value or impact of arts, cultural and creative programs. This is evidenced by the number who chooses to do some sort of evaluation for their Major Project, a 15,000 word individual project or internship which concludes their degree. Of the 50 or so students who have reached the Major Project in three years—35 completed and 15 in planning for 2012—about a third have incorporated evaluation into their Major Project. This includes evaluation of sector, business or producing models (5), youth arts and youth arts mentorship programs (4), audience development programs (2), touring programs (4), and even other arts management training programs (1). Indeed, after internships in programming or producing roles, this work—aligned with the Government's interest in improving training of young artists, touring, audience development, and economic development—has become a most popular Major Project option. This has enabled students to work with a range of arts, cultural and creative organisations, share their training—their methods, their understanding of what their methods can measure, when, and how—with Industry. Second, this Industry-engaged training has helped graduates in securing employment. This is evidenced by the fact that graduates have gone on to be employed with organisations they have interned with as part of their Major Project, or other organisations, including some of Brisbane's biggest cultural organisations—local and state government departments, Queensland Performing Arts Centre, Brisbane Festival, Metro Arts, Backbone Youth Arts, and Youth Arts Queensland, amongst others. Thirdly, graduates' contribution to local organisations and industry has increased the profile of a relatively new program. This is evidenced by the fact that it enrols 40 to 50 new students a year across Graduate Certificate / MCI (CP&AM) programs, typically two thirds domestic students and one third international students from Canada, Germany, France, Denmark, Norway and, of course, China. Indeed, some students are now disseminating this work globally, undertaking their Major Project as an internship or industry project with an organisation overseas. In effect, our training's impact emerges not just from our research, or our training, but from the fact that our graduates disseminate our approach to a range of arts, cultural and creative organisations in a practical way. We have, as a result, expanded the audience for this approach, and the number of people and contexts via which it is being adapted and made useful. Whilst few of students come into our program with a desire to do this sort of work, or even a working knowledge of the policy that informs it, on completion many consider it a viable part of their practice and career pathway. When they realise what they can achieve, and what it can mean to the organisations they work with, they do incorporate research, research consultant and government roles as part of their career portfolio, and thus make a contribution to the strong cultural sector the Government envisages in the National Cultural Policy Discussion Paper. Our work as scholars, practitioners and educators has thus enabled us to take a long-term, processual and grassroots approach to reshaping agendas for approaches to this form of cultural research, as our practices are adopted and adapted by students and industry stakeholders. Given the challenges commentators have identified in creating and disseminating effective evaluation methods in arts over the past decade, this, for us—though by no means work that is complete—does count as measurable progress. References Beckerman, Gary. "Adventuring Arts Entrepreneurship Curricula in Higher Education: An Examination of Present Efforts, Obstacles, and Best pPractices." The Journal of Arts Management, Law, and Society 37.2 (2007): 87-112. Belfiore, Eleaonora, and Oliver Bennett. "Determinants of Impact: Towards a Better Understanding of Encounters with the Arts." Cultural Trends 16.3 (2007): 225-75. ———. "Rethinking the Social Impacts of the Arts." International Journal of Cultural Policy 13.2 (2007): 135-51. Bilton, Chris, and Ruth Leary. "What Can Managers Do for Creativity? Brokering Creativity in the Creative Industries." International Journal of Cultural Policy 8.1 (2002): 49-64. Brkic, Aleksandar. "Teaching Arts Management: Where Did We Lose the Core Ideas?" Journal of Arts Management, Law and Society 38.4 (2009): 270-80. Czikszentmihalyi, Mihaly. "A Systems Perspective on Creativity." Creative Management. Ed. Jane Henry. Sage: London, 2001. 11-26. Australian Government. "National Cultural Policy Discussion Paper." Department of Prime Minster and Cabinet – Office for the Arts 2011. 1 Oct. 2011 ‹http://culture.arts.gov.au/discussion-paper›. Ebewo, Patrick, and Mzo Sirayi. "The Concept of Arts/Cultural Management: A Critical Reflection." Journal of Arts Management, Law and Society 38.4 (2009): 281-95. Effective Change and VicHealth. Creative Connections: Promoting Mental Health and Wellbeing through Community Arts Participation 2003. 1 Oct. 2011 ‹http://www.vichealth.vic.gov.au/en/Publications/Social-connection/Creative-Connections.aspx›. Effective Change. Evaluating Community Arts and Community Well Being 2003. 1 Oct. 2011 ‹http://www.arts.vic.gov.au/Research_and_Resources/Resources/Evaluating_Community_Arts_and_Wellbeing›. Falk, John H., and Lynn. D Dierking. "Re-Envisioning Success in the Cultural Sector." Cultural Trends 17.4 (2008): 233-46. Gattenhof, Sandra. "Sandra Gattenhof." QUT ePrints Article Repository. Queensland University of Technology, 2011. 1 Oct. 2011 ‹http://eprints.qut.edu.au/view/person/Gattenhof,_Sandra.html›. Geursen, Gus and Ruth Rentschler. "Unravelling Cultural Value." The Journal of Arts Management, Law and Society 33.3 (2003): 196-210. Hall, Irene and David Hall. Evaluation and Social Research: Introducing Small Scale Practice. London: Palgrave McMillan, 2004. Hadley, Bree. "Bree Hadley." QUT ePrints Article Repository. Queensland University of Technology, 2011. 1 Oct. 2011 ‹http://eprints.qut.edu.au/view/person/Hadley,_Bree.html›. ———. "Creating Successful Cultural Brokers: The Pros and Cons of a Community of Practice Approach in Arts Management Education." Asia Pacific Journal of Arts and Cultural Management 8.1 (2011): 645-59. Kwok, Joon. When Sparks Fly: Developing Formal Mentoring Programs for the Career Development of Young and Emerging Artists. Masters Thesis. Brisbane: Queensland University of Technology, 2010. Madden, Christopher. "Using 'Economic' Impact Studies in Arts and Cultural Advocacy: A Cautionary Note." Media International Australia, Incorporating Culture & Policy 98 (2001): 161-78. Matarasso, Francis. Use or Ornament? The Social Impact of Participation in the Arts. Bournes Greens, Stroud: Comedia, 1997. McCarthy, Kevin. F., Elizabeth H. Ondaatje, Laura Zakaras, and Arthur Brooks. Gifts of the Muse: Reframing the Debate about the Benefits of the Arts. Santa Monica: RAND Corporation, 2004. Merli, Paola. "Evaluating the Social Impact of Participation in Arts Activities." International Journal of Cultural Policy 8.1 (2002): 107-18. Muir, Jan. The Regional Impact of Cultural Programs: Some Case Study Findings. Communications Research Unit - DCITA, 2003. Ragsdale, Diana. "Keynote - Surviving the Culture Change." Australia Council Arts Marketing Summit. Australia Council for the Arts: 2008. Richards, Alison. "Evaluation Approaches." Creative Collaboration: Artists and Communities. Melbourne: Victorian College of the Arts, University of Melbourne, 2006. Sikes, Michael. "Higher Education Training in Arts Administration: A Millennial and Metaphoric Reappraisal. Journal of Arts Management, Law and Society 30.2 (2000): 91-101.White, Tabitha, and Anne-Marie Hede. "Using Narrative Inquiry to Explore the Impact of Art on Individuals." Journal of Arts Management, Law, and Society 38.1 (2008): 19-35.

IntroductionThis article addresses the experience of designing and conducting life-writing workshops for a group of clients with severe mental illness; the aim of this pilot study was to begin to determine whether such writing about the self can aid in individual ‘recovery’, as that term is understood by contemporary health professionals. A considerable amount has been written about the potential of creative writing in mental health therapy; the authors of this article provide a brief summary of that literature, then of the concept of ‘recovery’ in a psychology and arts therapy context. There follows a first-hand account by one of the authors of being an arts therapy workshop facilitator in the role of a creative practitioner. This occurred in consultation with, and monitored by, experienced mental health professionals. Life-Writing as ‘Therapeutic’ Life-story or life-writing can be understood in this context as involving more than disclosure or oral expression of a subject’s ‘story’ as in psycho-therapy – life-story is understood as a written, structured narrative. In 2001, Wright and Chung published a review of the literature in which they claimed that writing therapy had been “restimulated by the development of narrative approaches” (278). Pennebaker argues that “catharsis or the venting of emotions” without “cognitive processing” has little therapeutic value and people need to “build a coherent narrative that explains some past experience” in order to benefit from writing” (Pennebaker, Telling Stories 10–11). It is claimed in the Clinical Psychology Review that life-writing has the therapeutic benefits of, for example, “striking physical health and behaviour change” (Esterling et al. 84). The reasons are still unclear, but it is possible that the cognitive and linguistic processing of problematic life-events through narrative writing may help the subject assimilate such problems (Alschuler 113–17). As Pennebaker and Seagal argue in the Journal of Clinical Psychology, the life-writing processallows one to organise and remember events in a coherent fashion while integrating thoughts and feelings ... This gives individuals a sense of predictability and control over their lives. Once an experience has structure and meaning, it would follow that the emotional effects of that experience are more manageable. (1243)It would seem reasonable to suggest that life-writing which constructs a positive recovery narrative can have a positive therapeutic effect, providing a sense of agency, connectedness and creativity, in a similar, integrating manner. Humans typically see their lives as stories. Paul Eakin stresses the link between narrative and identity in both this internal life-story and in outwardly constructed autobiography:narrative is not merely a literary form but a mode of phenomenological and cognitive self-experience, while self – the self of autobiographical discourse - does not necessarily precede its constitution in narrative. (Making Selves 100)So both a self-in-time and a socially viable identity may depend on such narrative. The term ‘dysnarrativia’ has been coined to describe the documented inability to construct self-narrative by those suffering amnesia, autism, severe child abuse or brain damage. The lack of ability to achieve narrative construction seems to be correlated with identity disorders (Eakin, Fictions in Autobiography 124). (For an overview of the current literature on creative and life-writing as therapy see Murphy & Neilsen). What is of particular relevance to university creative writing practitioners/teachers is that there is evidence, for example from Harvard psychiatrist Judith Herman and creative writing academic Vicki Linder, that life-narratives are more therapeutically effective if guided to be written according to fundamental ‘effective writing’ aesthetic conventions – such as having a regard to coherent structure in the narrative, the avoidance of cliché, practising the ‘demonstrate don’t state’ dictum, and writing in one’s own voice, for example. Defining ‘Recovery’There remains debate as to the meaning of recovery in the context of mental health service delivery, but there is agreement that recovery entails significantly more than symptom remission or functional improvement (Liberman & Kopelowicz). In a National Consensus Statement, the Substance Abuse and Mental Health Services Administration (SAMHSA) unit of the US Department of Health and Human Services in 2005 described recovery (in general terms) as being achieved by the enabling of a person with a mental illness to live meaningfully in a chosen community, while also attempting to realize individual potential. ‘Recovery’ as a central concept behind rehabilitation can be understood both as objective recovery – that is, in terms of noting a reduction in objective indicators of illness and disability (such as rates of hospital usage or unemployment) and a greater degree of social functioning – and also as subjective recovery. Subjective recovery can be ascertained by listening closely to what clients themselves have said about their own experiences. It has been pointed out (King, Lloyd & Meehan 2) that there is not always a correspondence between objective indicators of recovery and the subjective, lived experience of recovery. The experience of mental illness is not just one of symptoms and disability but equally importantly one of major challenge to sense of self. Equally, recovery from mental illness is experienced not just in terms of symptoms and disability but also as a recovery of sense of self … Recovery of sense of self and recovery with respect to symptoms and disability may not correspond. (King, Lloyd & Meehan; see also Davidson & Strauss)Symptoms of disability can persist, but a person can have a much stronger sense of self or empowerment – that is still recovery. Illness dislocates the sense of self as part of a community and of a self with skills and abilities. Restoring this sense of empowerment is an aim of arts therapy. To put it another way, recovery is a complex process by which a client with a mental illness develops a sense of identity and agency as a citizen, as distinct from identification with illness and disability and passivity as a ‘patient’. The creative arts have gone well beyond being seen as a diversion for the mentally ill. In a comprehensive UK study of creative arts projects for clients with mental illness, Helen Spandler et al. discovered strong evidence that participation in creative activity promoted a sense of purpose and meaning, and assisted in “rediscovering or rebuilding an identity within and beyond that of someone with mental health difficulties” (795). Recovery is aided by people being motivated to achieve self-confidence through mastery and competence; by learning and achieving goals. Clearly this is where arts therapy could be expected or hoped to be effective. The aim of the pilot study was not to measure ‘creativity’, but whether involvement in what is commonly understood as a creative process (life-writing) can have flow-on benefits in terms of the illness of the workshop participant. The psychologists involved, though more familiar with visual arts therapy (reasonably well-established in Australia – in 2006, the ANZAT began publishing the Australian and New Zealand Journal of Art Therapy), thought creative writing could also be valuable. Preparation for and Delivery of the Workshops I was acutely aware that I had no formal training in delivering a program to clients with mental health illness. I was counselled during several meetings with experienced psychologists and a social worker that the participants in the three workshops over two weeks would largely be people who had degrees of difficulty in living independently, and could well have perceptual problems, could misjudge signals from outside and inside the group, and be on medication that could affect their degree of engagement. Some clients could have impaired concentration and cognition, and a deficit in volition. Participants needed to be free to leave and rejoin the workshops during the afternoon sessions. Attendance might well fall as the workshops progressed. Full ethical clearance was attained though the University of Queensland medical faculty (after detailed description of the content and conduct of the proposed workshops) and consent forms prepared for participants. My original workshop ‘kit’ to be distributed to participants underwent some significant changes as I was counselled and prepared for the workshops. The major adjustment to my usual choice of material and approach was made in view of the advice that recounting traumatic events can have a negative effect on some patients – at least in the short term. For the sake of both the individuals and the group as a whole this was to be avoided. I changed my initial emphasis on encouraging participants to recount their traumatic experiences in a cathartic way (as suggested by the narrative psychology literature), to encouraging them to recount positive narratives from their lives – narratives of ‘recovery’ – as I explain in more detail below. I was also counselled that clients with mental health problems might dwell on retelling their story – their case history – rather than reflecting upon it or using their creative and imaginative ability to shape a life-story that was not a catalogue of their medical history. Some participants did demonstrate a desire to retell their medical history or narrative – including a recurring theme of the difficulty in gaining continuity with one trusted medical professional. I gently guided these participants back to fashioning a different and more creative narrative, with elements of scene creation, description and so on, by my first listening intently to and acknowledging their medical narrative for a few minutes and then suggesting we try to move beyond that. This simple strategy was largely successful; several participants commented explicitly that they were tired of having to retell their medical history to each new health professional they encountered in the hospital system, for example. My principal uncertainty was whether I should conduct the workshops at the same level of complexity that I had in the past with groups of university students or community groups. While in both of those cohorts there will often be some participants with mental health issues, for the most part this possibility does not affect the level or kind of content of material discussed in workshops. However, within this pilot group all had been diagnosed with moderate to severe mental illness, mostly schizophrenia, but also bipolar disorder and acute depression and anxiety disorders. The fact that my credentials were only as a published writer and teacher of creative writing, not as a health professional, was also a strong concern to me. But the clients readily accepted me as someone who knew the difficulty of writing well and getting published. I stressed to them that my primary aim was to teach effective creative writing as an end in itself. That it might be beneficial in health terms was secondary. It was a health professional who introduced me and briefly outlined the research aims of the workshop – including some attempt to measure qualitatively any possible benefits. It was my impression that the participants did not have a diminished sense of my usefulness because I was not a health professional. Their focus was on having the opportunity to practice creative writing and/or participate in a creative group activity. As mentioned above, I had prepared a workshop ‘kit’ for the participants of 15 pages. It contained the usual guidelines for effective writing – extracts from professional writers’ published work (including an extract from my own published work – a matter of equity, since they were allowing me to read their work), and a number of writing exercises (using description, concrete and abstract words, narrative point of view, writing in scenes, show don’t tell). The kit contained extracts from memoirs by Hugh Lunn and Bill Bryson, as well as a descriptive passage from Charles Dickens. An extract from Inga Clendinnen’s 2006 account in Agamemnon’s Kiss: selected essays of her positive interaction with fellow cancer patients (a narrative with the underlying theme of recovery) was also valuable for the participants. I stressed to the group that this material was very similar to that used with beginning writers among university students. I described the importance of life-writing as follows: Life-writing is simply telling a story from your life and perhaps musing or commenting on it at the same time. When you write a short account of something chosen from your life, you are making a pattern, using your memory, using your powers of description – you are being creative. You are being a story-teller. And story-telling is one very important thing that makes us humans different from all other animals – and it is a way in which we find a lot of meaning in our lives.My central advice in the kit was: “Just try to be as honest as you can – and to remember as well as you can … being honest and direct is both the best and the easiest way to write memoir”. The only major difference between my approach with these clients and that with a university class was in the selection of possible topics offered. In keeping with the advice of the psychologists who were experts in the theory of ‘recovery’, the topics were predominantly positive, though one or two topics gave the opportunity to recount and/or explore a negative experience if the participant wanted to do so: A time when I was able to help another personA time when I realised what really mattered in lifeA time when I overcame a major difficultyA time when I felt part of a group or teamA time when I knew what I wanted to do with my lifeA time when someone recognised a talent or quality of mineA time I did something that I was proud of A time when I learned something important to meA memorable time when I lived in a certain house or suburbA story that begins: “Looking back, I now understand that …”The group expressed satisfaction with these topics, though they had the usual writing students’ difficulty in choosing the one that best suited them. In the first two workshops we worked our way through the kit; in the third workshop, two weeks later, each participant read their own work to the group and received feedback from their peers and me. The feedback was encouraged to be positive and constructive, and the group spontaneously adopted a positive reinforcement approach, applauding each piece of writing. Workshop DynamicsThe venue for the workshops was a suburban house in the Logan area of Brisbane used as a drop-in centre for those with mental illness, and the majority of the participants would be familiar with it. It had a large, breezy deck on which a round-table configuration of seating was arranged. This veranda-type setting was sheltered enough to enable all to be heard easily and formal enough to emphasise a learning event was taking place; but it was also open enough to encourage a relaxed atmosphere. The week before the first workshop I visited the house to have lunch with a number of the participants. This gave me a sense of some of the participants’ personalities and degree of engagement, the way they related to each other, and in turn enabled them to begin to have some familiarity with me and ask questions. As a novice at working with this kind of client, I found this experience extremely valuable, especially as it suggested that a relatively high degree of communication and cognition would be possible, and it reduced the anxiety I had about pitching the workshops at an appropriate level. In the course of the first workshop, the most initially sceptical workshop participant ended up being the most engaged contributor. A highly intelligent woman, she felt it would be too upsetting to write about negative events, but ultimately wrote a very effective piece about the empowerment she gained from caring for a stray cat and locating the owner. Her narrative also expressed her realisation that the pet was partly a replacement for spending time with her son, who lived interstate. Another strong participant previously had written a book-length narrative of her years of misdiagnoses and trauma in the hospital system before coming under the care of her present health professionals. The participant who had the least literacy skills was accepted by the group as an equal and after a while contributed enthusiastically. Though he refused to sign the consent form at the outset, he asked to do so at the close of the first afternoon. The workshop was comprised of clients from two health provider organisations; at first the two groups tended to speak with those they already knew (as in any such situation in the broader community), but by the third workshop a sense of larger group identity was being manifested in their comments, as they spoke of what ‘the group’ would like in the future – such as their work being published in some form. It was clear that, as in a university setting, part of the beneficial effect of the workshops came from group and face to face interaction. It would be more difficult to have this dimension of benefit achieved via a web-based version of the workshops, though a chat room scenario would presumably go some way towards establishing a group feeling. Web-based delivery would certainly suit participants who lacked mobility or who lived in the regions. Clearly the Internet is a vital social networking tool, and an Internet-based version of the workshops could well be attempted in the future. My own previous experience of community digital storytelling workshops (Neilsen, Digital Storytelling as Life-writing) suggests that a high degree of technical proficiency can not be expected across such a cohort; but with adequate technical support, a program (the usual short, self-written script, recorded voice-over and still images scanned from the participants’ photo albums, etc) could make digital storytelling a further dimension of therapeutic life-writing for clients with mental illness. One of the most useful teaching techniques in a class room setting is the judicious use of humour – to create a sense of sharing a perspective, and simply to make material more entertaining. I tested the waters at the outset by referring to the mental health worker sitting in the background, and declaring (with some comic exaggeration) my concern that if I didn’t run the workshop well he would report adversely on me. There was general laughter and this expression of my vulnerability seemed to defuse anxiety on the part of some participants. As the workshop progressed I found I could use both humorous extracts of life-writing and ad hoc comic comments (never at the expense of a participant) as freely as in a university class. Participants made some droll comments in the overall context of encouraging one another in their contributions, both oral and written. Only one participant exhibited some temporary distress during one of the workshops. I was allowing another participant the freedom to digress from the main topic and the participant beside me displayed agitation and sharply demanded we get back to the point. I apologised and acknowledged I had not stayed as focused as I should and returned to the topic. I suspect I had a fortunate first experience of such arts therapy workshops – and that this was largely due to the voluntary nature of the study and that most of the participants brought a prior positive experience of the workshop scenario, and prior interest in creative writing, to the workshops. Outcomes A significantly positive outcome was that only one of the nine participants missed a session (through ill-health) and none left during workshops. The workshops tended to proceed longer than the three hours allotted on each occasion. Post-workshop interviews were conducted by a psychologist with the participants. Detailed data is not available yet – but there was a clear indication by almost all participants that they felt the workshops were beneficial and that they would like to participate in further workshops. All but one agreed to have their life-writing included in a newsletter produced by one of the sponsors of the workshops. The positive reception of the workshops by the participants has encouraged planning to be undertaken for a wide-ranging longitudinal study by means of a significant number of workshops in both life-writing and visual arts in more than one city, conducted by a team of health professionals and creative practitioners – this time with sophisticated measurement instruments to gauge the effectiveness of art therapy in aiding ‘recovery’. Small as the workshop group was, the pilot study seems to validate previous research in the UK and US as we have summarised above. The indications are that significant elements of recovery (in particular, feelings of enhanced agency and creativity), can be achieved by life-writing workshops that are guided by creative practitioners; and that it is the process of narrative construction within life-writing that engages with or enhances a sense of self and identity. NoteWe are indebted, in making the summary of the concept of ‘recovery’ in health science terms, to work in progress by the following research team: Robert King, Tom O'Brien and Claire Edwards (School of Medicine, University of Queensland), Margot Schofield and Patricia Fenner (School of Public Health, Latrobe University). We are also grateful for the generous assistance of both this group and Seiji Humphries from the Richmond Queensland Fellowship, in providing preparation for the workshops. ReferencesAlschuler, Mari. “Lifestories – Biography and Autobiography as Healing Tools for Adults with Mental Illness.” Journal of Poetry Therapy 11.2 (1997): 113–17.Davidson, Larry and John Strauss. “Sense of Self in Recovery from Severe Mental Illness.” British Journal of Medical Psychology 65 (1992): 31–45.Eakin, Paul. Fictions in Autobiography: Studies of the Art of Self-Invention. Princeton: Princeton UP, 1985.———. How Our Lives Become Stories: Making Selves. 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