Reflecting on the RCOT x NCCH webinar
On October 31st, the Royal College of Occupational Therapists (RCOT) co-hosted an interactive webinar in collaboration with the National Centre for Creative Health (NCCH) and UCL’s MASc in Creative Health, with a focus on Creative Health within occupational therapy practice. The webinar aimed to reposition occupational therapy narratives and stakeholders within the rapidly evolving Creative Health field. Delegates convened to discuss current creative initiatives to consider the barriers and benefits to practising creatively, both within and beyond statutory services to improve future collaboration.
A Shared History
Creative Health can be defined as creating the conditions for creativity to be embedded into public health and wellbeing. Occupational therapists have been actively engaged in creative health service provision since its inception. Occupational therapy has been paving the way, placing value on how meaningful activities shape healthy lives. The aftermath of World War One for example, impacted the health of the public drastically stretching the health service which resulted in the consideration of new creative ways to address health and wellbeing. Similarly, the Creative Health movement has seen it’s advancement during an arduous economic climate after over a decade of austerity. Creative health stakeholders advocate the impact access to nature, culture and the arts have on individuals and communities, particularly in redressing social determinants of health. The 2017 All-Party Parliamentary Group on Arts, Health and Wellbeing report “Creative Health: The Arts for Health and Wellbeing” provides a comprehensive overview of the field, documenting over 1000 studies of the arts supporting health and wellbeing. Despite sharing many of the same values and paths to inception, there has been relatively limited conversations between occupational therapists and creative health stakeholders thus far. Considering the current climate, collaboration to redress the wider determinants of health and support statutory health services is needed now more than ever.
Interactive whiteboards were used throughout the webinar to allow collaboration, co-production and sharing between all parties. Attendees included occupational therapists working within statutory services, charities, independent practice, higher education and a variety of professionals within arts and health. Many shared motivations for attending as increasing collaboration between professionals, to gain peer support and inspiration, and to celebrate current creative practices in occupational therapists.
Current Creative Initiatives in Occupational Therapy
The webinar began by showcasing examples of occupational therapists engaging in creative practice. Becca Fortescue from Breathe Arts Health Research presented on Breathe Magic, a programme for young people with hemiplegia where engagement in magic results in clinically significant improvements for bi-manual function and enhanced self-esteem. We heard from Marcus Janusz and Eleri Watson who developed a programme integrating arts and culture into a hospital setting in collaboration with museums as part of their role-emerging placement. Odeth Richardson, Chair of RCOT, highlighted creative outputs from an exchange museum research project exploring shared South Asian, African and Caribbean Identities and Histories in Britain. The project prompted co-produced creative endeavours including music theatre productions, slam poetry, film making and temporary exhibitions. Helen Mason of Powderham Castle contributed a thought provoking presentation of her experience in creative occupational therapy roles, discussing her collaborative work with creative therapies and artists.
Barriers to Creative Practice
A Q&A and panel followed, with panellists and attendees being asked to consider the barriers that prevent occupational therapy research being used in creative health. The consensus was that occupational therapists need to advocate more deliberately to highlight the creative work we are and have been doing for decades. Karin Orman, RCOT, reflected that occupational therapists are often “fantastic at leading from behind… less confident at standing up and leading from the front”. Lack of confidence in communicating our theoretical underpinnings and evidence base within the current healthcare system was thought to influence reduced advocacy. Some reflected that occupational therapy training does not place enough emphasis on how to disseminate our unique occupational focus to healthcare stakeholders. Additionally, chronic understaffing and high pressure in statutory services meant occupational therapists often do not have the time to present case studies or advocate innovative practice. These challenges result in reduced knowledge sharing across disciplines and ultimately occupational therapy not being acknowledged in the creative health sphere.
Working within “traditional” healthcare structures was consistently reported as a barrier to engaging in creative practice. Many occupational therapists felt the value of creative pursuits were not acknowledged or understood by the biomedical model of health. Some occupational therapists asked whether we have rejected our creative roots in favour of the biomedical model in order to gain greater endorsement within the current health paradigm. Occupational therapists acknowledged feeling obliged to conform to the biomedical model in order to secure increased funding and staffing within statutory services. Attendees were encouraged to consider how we can move within these structures whilst staying true to our occupational science roots.
Moving Forward
With the recent Covid-19 pandemic and enforced social isolation, many have rediscovered the power of creative pursuits in maintaining and improving our health and wellbeing. Whilst the biomedical model has not historically recognised the value of the arts in healthcare provision, it appears a paradigm shift is beginning to evolve and society is considering the benefits of health creation. It is essential that occupational therapy and creative health capitalise on this shift in order to improve structures, policy and service provision for the most vulnerable in our society. Breakout rooms allowed participants to consider practical solutions to moving creative occupational therapy forward in the current climate.
Although occupational therapy is often required to move within the current biomedical paradigm, this does not mean we need to dilute our unique skills in order to conform to other clinical professional’s priorities. The fundamental ingredient to successful occupational therapy practice is remaining occupation-focused, and occupational therapists should consider “if it is not occupation-focused, you must ask yourself, why are you doing it?” Allowing space for occupational therapists to reflect on their occupation-focused practice, providing opportunities for peer support and sharing new, innovative practices were identified by panellists as potential solutions in remaining true to our grounding in occupational science.
Increasing confidence in advocating the value of occupational therapy within creative health is vital. Supporting occupational therapy students must be a key focus to ensure the future promotion of the breadth of the occupational therapy role. Participants called for an increased focus on creative practice in university curriculums to equip students with a firm foundation of knowledge in the evidence base. Creative-based placements were also identified as opportunities for occupational therapy students to enhance their confidence in providing creative interventions. For practising occupational therapists, we discussed the value of peer-led forums and networking opportunities to empower professionals in flexing their creative wings.
Connecting, collaborating and creating was a shared priority for all in moving forward. Odeth Richardson beautifully described occupational therapists as “boundary spanners”, and the role we must play in knowledge sharing and promoting interdisciplinarity. Our role as occupational therapists is primarily to facilitate engagement, and it is vital that we break down the hierarchy of “professional” versus artists in order to improve access to creative occupations for all. Co-producing research and intervention with artists and service users may redress the power imbalance of the healthcare professional being the expert, and allow marginalised voices to be heard.
