A controlled evaluation of an “arts in health” program designed to enhance psychosocial health in Mater Young Adults Health Centre patients

This is a two arm controlled evaluation in which patients of the Mater Young Adults Health Centre (YAHC) aged 18 to 25 years will be offered their choice of three arts based group interventions designed to enhance their psychosocial well-being and engagement with health services: art therapy group; vocal group; and make-your-own-podcast group. Participants who are placed in an arts group immediately will continue to receive treatment-as-usual at the Mater YAHC (condition TAU+ARTS). Their data will be compared with participants who are receiving treatment as usual only during the six weeks period (condition TAU). a) Art Therapy group Educators: Kate Palmer and an intern psychologist or art therapist Kate Palmer, Social Worker (7 years) and Art Therapist (1 year) is well qualified and experienced to be the lead educator of this group. Kate will be joined by a provisionally registered clinical psychology postgraduate student, or postgraduate art therapy student, as part of their supervised practice program (under the supervision of Kate and Dr Genevieve Dingle). These students will have already completed several courses in mental health and therapy and have completed about 100 hours of client contact so they are well prepared to work as co-facilitators of this group. They will comply with the requirements for students on placement at the Mater in terms of confidentiality agreements, vaccinations, and workplace orientations. Content: The six session art therapy program involves a range of art activities including fluid painting, bridge drawing, and mask making. There is growing demand for Art Therapy within the Mater YAHC, and both groups have yet to be empirically evaluated. The art therapy component runs for approximately two hours each session, and encourages group members to explore sense of self, self-identity, independence and life goals through art. There is evidence to support art therapy decreasing social isolation in young people with medical conditions and creating an opportunity to meet others with similar experiences and learn from such experiences and works (Bitonte & Santa, 2014; Rubin, 2005). Positive group experiences are also related to a successful transition to adulthood from adolescence more generally (Riley, 2001). For young people with complex experiences like medical illness, art therapy is a powerful tool for emotional expression, processing and supports social, cognitive and physical development (Kline, 2016). Mallay (2002) and Kline (2016) propose that art therapy is ideal for working with young people when sensory, cognitive or physical capabilities are impaired as it does not rely on verbal output in the way that other psychotherapies do. In this field, it is common for the young person to have either one or more of the following impairments: speech, language, cognitive, physical, social and psychological. Art Therapy also supports physical and fine motor rehabilitation (Kline, 2016). b) Vocal Group Educators: Malcolm Hume (Brisbane State High School teacher and choral director) and Kate Palmer. Malcolm has degrees in both music and education, and he directs Bella Voce, the premier senior vocal ensemble at Brisbane State High School. He is familiar with musical repertoire and techniques suitable for working with young people. He will be joined in the group face-to-face sessions by Kate Palmer, in order to have a clinician on hand if the need arises. This six session program will be offered in both face-to-face or virtual modes so that young people who are able to attend the choir in person may do so, while young people who experience barriers in terms of their immunity level or location may attend online. After each session, Malcolm will post song conducting instructions online and the participants will record themselves singing and send their recording to Malcolm to merge into a soundtrack which all participants can hear. In this way we expect that group benefits will be experienced by all participants even if they are participating virtually. Content: There is both quantitative and qualitative evidence to support the use of group singing interventions to increase emotion regulation, mental health, and wellbeing (Dingle, Brander, Ballantyne & Baker, 2013; Dingle, Williams, Jetten, Welch, 2017). When participants sing together they have an important role in creating the choral sound, and there is no reference being made to their psychological health status. It has been found that engagement in such choir groups increases social connection, social functioning, employment capacity, self-perception, emotion regulation and positive emotions (Dingle et al, 2013; 2017). Despite young adults with health problems reporting similar concerns around social functioning (Zebrack, 2011) the use of group choir singing has not yet been evaluated in a young adult health context. c) Make Your Own Podcast group Educators: 2 MentalMusic team members and Kate Palmer and/or Alan Heady (Mater YAHC Health Psychologist) www.MentalMusic.org is a group of Brisbane young people who make podcasts about mental health and social issues that affect young people (Hinchcliffe, 2017). They will be responsible for providing education in the sessions, while a clinician (Kate and/or Alan) will also be present at all sessions. The role of the educators from MentalMusic is focused on skills instruction – this is in keeping with the arts programs being more like ‘courses’ than ‘therapy’ groups per se. The groups will be kept small in number (ie., 4-6 participants, with 2 MentalMusic educators and at least 1 clinical facilitator) so participant behaviour, emotions and interpersonal dynamics are expected to be readily managed. It should be noted that the MentalMusic educators will not be responsible for managing mental health issues (or health issues) experienced by participants during the podcast making program – instead the Mater clinical facilitator/s who will be present in all of the sessions will take on that role. These staff members are experienced group facilitators and able to manage any group dynamics or other issues arising, and for debriefing with the educators after each group session. Content: In the current project, we expect that participants will select topics related to their medical experiences and associated social and developmental issues. The topics and preparation for interviews will be conducted in the group sessions, and the educators will assist participants to select topics, and also the participants will conduct their interviews with each other (ie. other participants in the podcast making group) for the purpose of skills building during the program. This means that the topics, interview questions, and editing of recorded material for the podcasts can be carefully monitored by the project team. The MentalMusic.org members will show small groups of MYAHCB participants how to conduct research on the topic, microphone and interviewing technique, how to set up and conduct interviews, and how to edit the podcasts and make them available online. All three programs will be offered in groups, face-to-face at the Dome, on level 4 of the Mater Salmon Building. The vocal group will also be offered in virtual format for participants who are unable to attend sessions face to face. Typically the programs will be delivered over six weeks, 90 minutes per session; however, there may be some groups conducted in intensive mode (i.e. 3 x 3 hour sessions over three weeks). Participants will be allowed to enrol in more than one arts based program however only their first program will be evaluated at pre-and post-program; subsequent programs will be evaluated at post-program only.