Accreditation in the field of literary arts in health and social care
by Dominic McLoughlin Sessional Lecturer in Counselling at Birkbeck, University of London FCE, and for the MA in Creative Writing for Personal Development at CCE, University of Sussex. 2004
This contribution to the debate on accreditation was originally sought from the Writing for Personal Development special interest group within Lapidus. This group was formed to cater for those in the membership who have an interest in the field of writing for personal development as participants rather than as practitioners, i.e. people who don’t necessarily want to run workshops for other people. Although I was one of the founder members of the group I have not consulted formally with members of the special interest group so in no way can I speak on their behalf. I do have personal experience of using writing as a way of recovering from depression, but my contribution here is mostly an exercise in imaginative thinking. I have asked myself what might the key issues be around accreditation from the ‘user’ or client perspective?
This presentation is also an attempt to draw on my own experience of working with clients in hospice and mental health settings as a workshop leader, and as someone presently involved in delivering training in the field. I look briefly at the following questions: What is the activity that is being accredited? Who is being accredited? What are the competencies that need to be measured?
When defining the activity of using the literary arts in health care it is useful to acknowledge the tension between writing as therapy and a more artistic approach. However perhaps it is ultimately more productive to side step the art versus therapy debate and to concentrate on another paradigm: that of learning. On this model using literature in health and social care is seen an educational activity. The aims and outcomes for the activity are around learning new skills and understanding new concepts. The activity does not aim to produce works of art, and it is not therapy, although hopefully it will be therapeutic. How might it be so?
This approach assumes that the literary arts can be therapeutic in the way that any educational or leisure activity might be. Additionally the literary arts are seen to present a distinctive opportunity for students in the way they value the implicit. By definition, literary works can’t be reduced to what they are ‘about’. Readers are led to attend to the form and the content of the work, and to come to know the poem or the novel in a way that is not purely intellectual, but which involves a full engagement of our thoughts and feelings. Philip Davis says more on this theme in his chapter ‘The Place of the Implicit in Literary Discovery’ (2003). One consequence of this way of approaching literature is that students are not expected to have to produce an original artistic or intellectual response to the literature they read. Students’ originality is rather “not so much to do with thinking something new, but thinking something which is new to them, as individuals” (2003: 150). If the place of the implicit can be preserved, uses of literature in health care – creative writing, reading, storytelling – all offer a distinctive way of engaging with the world. This creates a space for us to change our perceptions and gain a new way of seeing things as individuals, even when we are in ill health (when the conditions for such a change can be especially valuable).
Within Lapidus practitioners can come from a range of backgrounds and this is one of the strengths of the organisation. Lapidus does not categorise members according to their professional role, but according to their interest in and commitment to a particular approach to the literary arts and personal development. Writing in health care attracts writers for whom the literary arts has been helpful in terms of their own personal development or at a time of recovery, and those who appreciate that as a facilitator, students (or clients) in healthcare are creative, enjoyable and rewarding to work with.
Writing in health care also attracts health care workers and professionals who want to offer a service to their clients but who know that a talking cure may not be right for some people for some of the time, or for some people at any time. It also attracts health professionals who see that the literary arts have a normalising function in a health care setting. That is, engagement with the literary arts can breakdown barriers between individuals coming from hugely different backgrounds and with different health problems to contend with, by emphasising the human concerns we have in common.
The sorts of competencies I would expect in a writing facilitator in a health care setting would be counselling skills, literary skills and knowledge, and an understanding the theoretical concepts in the emerging field of the literary arts in health care.
In the first category of counselling skills the facilitator should have the sorts of skills and attitudes taught on a course at certificate level. This would include for example an ability to be clear about the aims of the work with a client, a commitment to working within limits of one’s training, and to work according to appropriate ethics and boundaries. There is also a degree of self-awareness required of a practitioner. It is imperative that the client shouldn’t be made worse, which can happen if they are by made to feel the impact of concerns that belong more properly to the practitioner themselves.
In terms of literary knowledge the practitioner should be able to draw on their own skills and interests as a writer and reader. Their level of knowledge in this area and the level of their ability to communicate it to others will determine how effectively they can use literature as a resource for therapeutic learning. I wouldn’t expect the facilitator to have to be a published writer, although a track record of working with literature in some capacity should be evident.
In terms of understanding of theoretical concepts in the emerging field of the literary arts in health care I would expect the facilitator to have developed rationale – on the basis of sound theoretical knowledge – as to how and why writing can be used as a therapeutic tool. The focus here could be on a study of how literature works to help us process thoughts and feelings. As a user I would not necessarily want to know about the facilitator’s rationale, but I would want there to be one, and for it to be manifest in the way the workshop was run.
I think people using writing in health care settings want to feel they are being led into an enjoyable, creative activity, which is safe and yet which could be challenging too if they wanted it to be. A form of accreditation for practitioners would help all concerned to know that the rationale for the activity had been thought through with care, and that the skills for facilitating it had been fully acquired, before the practitioner has begun to work with vulnerable clients.
Davis, P (2003) ‘The Place of the Implicit in Literary Discovery:
Creating New Courses’ in Teaching Literature: A Companion eds. Agathocleous & Dean, London: Palgrave