Judy Willcocks, Head of the Central Saint Martins Museum and Study Collection
This case study describes the contribution made by the Central Saint Martins Museum and Study Collection (UAL) to the Museums on Prescription research project, which explores the value and role of museums in ‘social prescribing’. A means of connecting patients with non-medical resources, socially prescribed activities are a low-cost alternative to medication or therapy, offering opportunities to take part in creative, physical or learning activities that improve physical or mental well-being. This article argues that the pedagogic approaches used in art and design, particularly when coupled with a museological approach to ‘object-based learning’ (Paris, 2002), present an ideal basis for social prescribing as the activities it involves challenge participants, encourage self-reflection and create opportunities for emotional engagement.
object-based learning; social prescribing; museology; well-being
Health and illness are significant themes that are rooted in society and influenced by the environment in which people live. Within this environment cultural encounters can bring ‘tangible health and well-being outcomes’ and, as argued by Chatterjee and Noble, cultural institutions such as museums, should be seen as assets for enhancing health and well-being ‐ with the potential to make a considerable contribution to public health (2016, p.2). Yet, as Silverman notes, key audiences within this context, ‘those with depression or coping with the onset of old age and related losses of function’ are seldom reached by museums (2002, p.69).
Museums on Prescription (MoP) is a three year research project (2014 ‐ 2017) exploring the value and role of museums and galleries in ‘social prescribing’ for older audiences. Social prescribing is ‘a mechanism for linking patients with non-medical sources of support within the community’ (CentreForum, 2014, p.6). The MoP project is led by Professor Helen Chatterjee (Principal Investigator), Professor Paul Camic (Co-Investigator) and Dr Linda Thomson (Senior Research Associate) and funded by the Arts and Humanities Research Council (AH/L012987/1). The research specialisms within this team encompass psychology, cultural value, health, well-being and museology.
A report compiled by the MoP team, Social Prescribing: A Review of Community Referral Schemes (Thomson, Camic and Chatterjee, 2015), details how social prescribing is on the rise as a result of the decentralisation of healthcare and a growing emphasis on prevention rather than cure. Successful schemes include Art, Books, Education and Exercise on Prescription, with referrals made by GPs, practice nurses and social workers. Social prescribing can be useful in its own right and is recommended in support of medical and psychological therapies. Evaluation of social prescribing schemes in the UK shows positive outcomes for participants including improved self-esteem, increased sociability, a sense of empowerment and improved psychological well-being. Socially prescribed activities can also reduce symptoms of anxiety and depression, contributing to a reduction in GP visits and healthcare referrals.
Importantly, the benefits of social prescribing ‘have been particularly pronounced for marginalised groups such as mental health service users and older adults at risk of social isolation’ (Thompson et al., 2015, p.5). Focussing on the latter group, the MoP programme aims to connect socially isolated, vulnerable and lonely older people to partner museums in London and Kent. The programme tests the extent to which creative engagement with museums and their collections can improve participants’ sense of well-being, by employing a combination of qualitative and quantitative methods from the social sciences, psychology and health sciences to assess the impact of the scheme on those who take part. As one of six museum partners involved with the MoP project, the Central Saint Martins Museum and Study Collection (M&SC) has delivered a series of ten weekly workshops to older people (11 participants, aged 65 to 94) from the London Boroughs of Camden and Islington.
It has been suggested that museums can provide a sense of community cohesion and connection to others as well as well as opportunities for self-reflection, relaxation and emotional engagement (Silverman, 2002). In addition to fostering these qualities, the M&SC has brought to the project its unique position as a museum situated within UAL, one of the largest and most comprehensive art and design institutions in the UK. This position has also generated a parallel research interest and opportunity to explore ‘object-based learning’ (Paris, 2002), the practice of facilitating learning through objects.
The particular contribution provided by the M&SC arises from the knowledge of the staff and their experiences delivering object-based learning workshops to a broad variety of audiences. Several members of the M&SC team have undertaken a Postgraduate Certificate in Academic Practice ‐ effectively a teacher training qualification for Higher Education. As a result, art and design pedagogy shapes the way collections engagements are framed, and has led staff to move away from a traditional museum model of the ‘expert curator’ to a model more focussed on co-creation and co-production with workshop participants.
As a project working with vulnerable adults, there have been a number of ethical issues to consider in running these workshops. These related to staff training as well as carefully managing the relationship with workshop participants. M&SC staff attended a training day with the MoP team and other museum professionals with experience of social prescribing to discuss potential problems and how to address them. Staff also undertook a course in safeguarding vulnerable adults run by the local Borough Council. Contact with the workshop participants was managed by our project partners, the research team at University College London (UCL) and a trained psychologist sat in on all sessions, with full ethics approval from the UCL Research Ethics Committee (REC ‐ Project ID: 4526/001).
Many of the therapies used to treat mental health are outcome focussed, seeking to construct or change ‘knowledge, attitudes, values, skills’ and other attributes. Silverman argues that for museums to fulfil their potential as ‘therapeutic tools’ they need to adopt a similar approach (2002, p.75). An emphasis on outcomes is also used within art and design pedagogy, where activities are aligned to contribute towards pre-defined learning outcomes and the acquisition of certain skills (Biggs and Tang, 2011).
In keeping with this outcome focussed methodology, the M&SC developed a series of ten workshops for the MoP programme. At the end of these workshops it was intended that participants should be able to: describe different art and design practices and their historical contexts; articulate emotional responses to objects; exhibit a broad spectrum of making skills; communicate a range of imaginative ideas to their peers. Shreeve, Waring and Drew list some of the skills encouraged by art and design teaching practice including adaptability, emotional intelligence, confidence, resourcefulness and team working (2009, p.355). In developing the workshops, it was recognised that all of these skills might prove useful to older people suffering from social isolation or mental health issues, and while it was not possible to fully develop all of them in a short series of sessions, it was hoped that participants’ confidence levels and team working skills would be improved. Each workshop was designed to start with a handling session based on objects held within the M&SC, before moving into a variety of activities including printmaking, collage, weaving, guided gallery tours, interactions with students and informal discussions.
The way the object handling element of each session was framed set the tone for the workshops. Art and design education involves not just cerebral activity but the emotions and senses (Shreeve, Sims and Trowler, 2010) and learning is seen as a partnership activity or exchange of ideas with students where outcomes are ambiguous and uncertain. Accordingly, the MoP sessions assumed that there was no expert in the room. Rather, museum objects were offered as a point of meaning-making and self-reflection, allowing participants the space to explore their own responses. Direct handing of the object was also encouraged.
Brookfield observes that, unless teaching practice is critically self-reflective, the classroom can ‘mirror the structures and inequalities of the wider society’ (1995, p.266). In order to prevent further entrenchment of the issues experienced by workshop participants (such as loneliness or social isolation) the initial MoP session was structured in a way that enabled facilitators to find out about the skills base and mental well-being of the group. Working in partnership with the psychologist from UCL who sat in on the workshops it was discovered that participants came from a broad social spectrum including long time carers, and older men and women from a diverse range of socio-economic and cultural backgrounds. The group also encompassed a number of disabilities including mobility issues, impaired motor skills and deafness.
Practices that aim to widen participation are particularly well embedded in art and design pedagogy. For the MoP workshops M&SC staff were able to draw on their experience of working with so-called ‘non-traditional’ groups in this context. Bhagat and O’Neill note the importance of not ‘othering’ or problematising those who sit outside the assumed norm (2011, p.22). The art and design pedagogic system is structured to be accessible to all and traverse normative assumptions, creating spaces where learners’ own ‘narratives or subjective experiences’ can be expressed and valued (Bhagat and O’Neill, 2011, p.140). Museum staff brought to MoP the confidence to deal with language barriers, disability, learning difference and issues of self-confidence.
Conversations with participants revealed that they had a much higher level of prior knowledge and understanding of art and design than had initially been anticipated, with many of them being makers themselves. Subsequent sessions were modified accordingly to reflect these levels of interest and experience. Participants were encouraged to bring in work of their own and many brought in drawings, photographs and even short films, which they shared with the group.
Shared experience and exchange of ideas quickly emerged as an important and valued part of the workshops. ‘Peer to peer’ learning is a central element in art and design pedagogy and the ‘crit’ or critique is a common way of managing group participation (Shreeve, Waring and Drew, 2009). A successful crit ‐ which may involve storytelling or personal narrative (Shreeve, Sims and Trowler, 2010) ‐ involves the creation of a supportive environment where participants feel heard and have the confidence to challenge the opinions of others. This requires an awareness of the power dynamics in the classroom and tutors are required to resist the temptation to lead the discussion.
MoP workshop sessions employed the techniques of a crit to draw participants into conversation with the wider group. Each session provided an opportunity for sharing personal experiences, discussing participants’ own creative practice or swapping tips about other places one might go for intellectual stimulation and social activity ‐ something that seemed to be lacking in many of the participants’ lives. It could be argued that this approach represents a benign version of the crit, which can be problematic as it can cause anxiety among students (Shreeve, Waring and Drew, 2009). However, given that this was an informal rather than a formal learning setting, working with potentially vulnerable participants, a more gentle adaptation of the crit format seemed to best serve the context.
Evaluation of the MoP programme is on-going and not due to be completed until 2017. However, preliminary assessment of feedback from participants and workshop facilitators indicates a number of positive outcomes from the M&SC programme of activities.
The mood, mental well-being and social inclusion of participants were evaluated qualitatively and quantitatively at the beginning, middle and end of the programme (in weeks 1, 5 and 10). The evaluation used several measures comprising: the ‘Positive Well-being Umbrella (Older Adult)’ from the UCL Museum Well-being Measures Toolkit, which measured psychological well-being (Thomson and Chatterjee, 2014, p.2015); the ‘Warwick-Edinburgh Mental Well-being Scale’ (WEMWBS) to gauge mental well-being (Tennant et al., 2007); and the ‘Revised UCLA Loneliness Scale’ (R-UCLA) to determine loneliness and social isolation (Russell, Peplau and Cutrona, 1980). Participants and facilitators were interviewed at programme-end and took part in follow-up interviews with the UCL psychologist at intervals of three and six months after the programme had ended. These interviews used shortened versions of the measures, comprising the ‘3-item Loneliness Scale’ (Hughes, Waite, Hawkley and Cacioppo, 2004) and the ‘Shortened WEMWBS’ (Stewart-Brown et al., 2009). Participants, carers, workshop facilitators and observers also kept weekly diaries recording their experiences of the workshops. These were shared with the UCL research team and formed part of the evaluative process .
The UCL Positive Well-being Umbrella is a custom-designed measure, specifically developed at UCL to assess the changes in psychological well-being derived from these museum sessions. The findings from the M&SC workshops evidenced a general improvement in mood and well-being across participants as the programme progressed. Loneliness and well-being ‐ as assessed by the WEMWBS and R-UCLA scales ‐ was less clear-cut, however, data is being recorded from over 100 participants across all the museum partners involved in the MoP project, which taken as a whole, may prove more revealing in the longer term.
Facilitator diaries noted how participants became increasingly connected with one another as the 10 week programme of M&SC workshop activities progressed. Participants became less self-contained and more engaged with making activities. Sessions that involved ‘privileged’ access to rare or precious museum objects were particularly successful, drawing more reluctant participants to connect with the wider group.
In general, participants responded positively to the way that sessions were structured and seemed keen to share their ideas, memories and experiences. They described sessions as ‘inspiring’, ‘invigorating’ and ‘stimulating’ and noted the importance of facilitators ‘listening to our ideas’. Participants felt it was important that they were intellectually challenged by the workshops and particularly welcomed opportunities to engage with students from Central Saint Martins who led creative activities and gave talks about their work. Almost all of the workshop participants reported how much they enjoyed meeting young people and hearing about their creative approaches.
Intelligence gathered at the three-month follow up event (attended by 7 of the 11 participants) was particularly useful in obtaining an overview of thoughts and feelings about the sessions. One participant reported that since taking part in the programme they felt ‘more positive about my life and health and more determined to keep up my practice of photography and painting’. Another reported visiting museums or galleries six times in the past three months, despite not being a frequent user before. A third had joined an art class and some of the participants had stayed in touch with one another after the programme ended.
The short series of MoP workshops staged by the M&SC represent a temporary intervention in the lives of a small number of people. Though claims beyond this small-scale intervention are difficult to surmise, the wider MoP project is building upon the success of this and previous social prescribing programmes to gather a body of evidence on how cultural engagement can improve mood, self-confidence and a sense of belonging. Social prescribing has already been shown to have positive outcomes for older people at risk of social exclusion, helping to counter the anxiety and depression that are precursors of dementia. Art and design teaching practice adds another dimension to socially prescribed activities, further benefiting participants through an emphasis on self-awareness, self-confidence and an exchange of ideas.
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Judy Willcocks is Head of the Central Saint Martins Museum and Study Collection (UAL) and an Associate of the Museums Association with twenty years’ experience of working in museums. She has a long-standing interest in developing the use of museum collections to support teaching and learning in higher education and teaches an archiving unit for Central Saint Martins’ MA in Culture, Criticism and Curation. Judy is also interested in developing relationships between universities and museums in the broader sense and is the co-founder for the Arts Council funded Share Academy project, exploring the possibilities of cross-sector partnerships.