The Alchemy Project is taking on an intensive way of using dance to benefit young adults using Early Intervention in Psychosis services through the South London and Maudsley NHS Foundation Trust (SLaM).
It’s estimated that mental illness affects 1 in 4 people in England(1) while psychosis in young adults is on the rise. As Dr Matthew Taylor, one of our clinical collaborators and a leading psychiatrist in the field, points out: “The rates of psychosis in South London are very high, the highest in Europe.”
“The Early Intervention in Psychosis service is a new approach to helping people with psychosis that has really taken off in the last ten years – teams specialise in dealing with people in their first episode of illness, helping them to get better, get back to their lives and stay well,” adds Dr Taylor.
The methodology underpinning The Alchemy Project is a way of working that is radically different from, yet complements, conventional clinical treatments. Our work in psychosis began with a pilot project that was successfully trialled in 2013 and resulted in ‘clinically significant’ improvements in mental and emotional wellbeing. Since then The Alchemy Project has led the use of dance in further supporting frontline clinical provision, helping young adults with their recovery.
We use a distinctive methodology that’s modelled on professional contemporary dance training and performance. Those who are referred to one of our projects work full-time over an intensive four-week period concluding with a performance in a professional theatre. Dance facilitates huge shifts in the way they meet new people, build new relationships, find motivation and go on to experience a real sense of achievement in accomplishing something new and of high quality. The project becomes a springboard for people to think more positively about what they can do in their lives and this is critical to supporting their recovery.
A distinctive feature of The Alchemy Project has been the collaboration from the very beginning between the dance team and leading clinicians, Dr Taylor and Dr Lauren Gavaghan. Taking in the contributions made by a wide range of healthcare professionals across the service this has been very much a joint venture with everyone playing a crucial role.
Before our pilot, contemporary dance had never been used before in a front-line mental health service within SLaM. Dr Taylor was instrumental in enabling the pilot project to take place in 2013, fully aware that this would be a radical thing to do in a mental health service within the NHS. From our many years of experience working with people in challenging circumstances the dance team knew that dance could have a real impact on people and could spark positive benefits in service users such as improving their communication skills, resilience, concentration, focus and trust in others.
For Dr Taylor and the Early Intervention team, this was uncharted territory; it was dance, full-time and ended with a performance in front of an audience. Indeed, the methodology was a challenge for all the healthcare professionals but they quickly saw the exciting potential for engaging clients in a new way that could help to improve their clients’ physical fitness, body awareness and interpersonal relationships, as well as their ability to work with others and function successfully in a team.
The project was also a profound challenge to healthcare professionals (at all levels) when it came to their perception of dance. At the outset, the very notion of dance was seen as daunting but over the course of the work our healthcare partners witnessed – and discovered for themselves – just what can be made possible through dance. I believe we turned sceptics into strong advocates and champions of the work. A key to this shift was experiential learning, getting healthcare professionals to step out of their comfort zones and into a dance studio. We wanted them to focus on the body instead of the mind, to connect with others and to truly experience the dance methodology first hand.
Of course, just as dance was an unknown quantity for this frontline service, working in a mental health context was equally alien territory for the dance artists. We discovered that working with people with mental health conditions was very different from what we had imagined. We confronted a number of unknowns: how would people who have mental health conditions present in the dance studio each day during the project? Would working intensively be overwhelming? Would people struggle to turn up each day and commit to the project? What would be the effects of their medication? Would it be too stressful to perform at the end of the project in front of an audience? Despite initial questions (and doubts) we knew that we, and other artists like us, had applied the dance methodology successfully in a wide range of other contexts. And it proved to be the case in this setting, too.
How have we adapted the methodology? Well, we don’t focus on mental health conditions, labels or people’s ‘deficits’. Rather, we work with them as dancers and enable them to become a dance company working towards a performance. We focus on the individual in the here and now. Dance is all about being present and being in the moment.
As Dr Gavaghan explains: “These dancers, when they walk in the room, are no longer patients; they are no longer people with an illness but they are dancers in a dance company.
“I think there is incredible impact just from that, so people can be pushed to their full potential. Rather than concentrate on deficit and illness, The Alchemy Project focuses on what people can do and can achieve.”
We drive towards high artistic standards when we’re in the studio. We have high expectations of what can be achieved. Over time, we have found that groups (whatever the setting) will reach whatever standards are set, hence the reason for setting the bar high. The group will always come with you and there is satisfaction in their knowing they have been pushed to achieve at an unexpected level. So often, the people we work with are made to believe they can’t achieve amazing things. As Jacqui Dyer, a mental health campaigner and councillor, puts it: “What’s actually core to supporting people is building trusting relationships and that’s what’s possible through dance, because there’s no emphasis on who you are in terms of your diagnosis; the emphasis is on expanding your world by learning something new, something that you never thought you could do before.”
Dance creates a social and physical connection between individuals and helps to counteract the feelings of isolation and fragmentation characteristic of people with serious mental health problems. We work together as an integrated team of dance and support staff to create a welcoming, supportive and safe space for participants. We engage the group in trust-building and team-building exercises and share healthy breakfasts and lunches. At every stage the aim is to develop a strong sense of community as a dance company.
During the course of the four-week project, participants learn how to dance, rehearse and perform an original dance work to an invited audience in a professional theatre setting. Perhaps contrary to some of our expectations the groups we’ve worked with have been particularly creative, playful and fun to be with.
Touch, connecting with and trusting other people is key, as Dr Gavaghan explains: “As psychiatrists we don’t tend to pay much attention to this idea of touch, but I think in dance, touch is an absolutely integral part of the practice and in the studio we touch each other very naturally, very often. I think it’s this sense of closeness between human beings or being in a group which actually is incredibly valuable in terms of reducing the sense of isolation and aloneness that often comes with mental illness.”
The performance challenges perceptions and stigma and shows what can be achieved through dance. At the end of the four weeks participants confidently stand on stage as dancers and perform together as a dance company. They are seen and witnessed (by healthcare professionals, families and friends) in a new light – they are capable, confident, expressive and dynamic.
One of our participants commented that the process had been a powerful shift for him: “Dancing feels amazing. It’s nothing like I’ve really experienced before, it’s very liberating both in terms of mind and body and you’re just there, very much present in the space when you’re dancing.”
“For me, my head’s always full of rubbish, full of things going round and round and round and I never really get a break from it but when you’re dancing you’re just there in the space and that’s a very special feeling”.
Dr Gavaghan is now convinced that the physical activity of dancing addresses symptoms of mental illness and the effects of medication, which can include apathy, lethargy and a lack of motivation. She has written a blog about her experience:
www.rcpsych.ac.uk/discoverpsychiatry/blogzone/thealchemyproject.aspx
Since the pilot, The Alchemy Project has carried out further dance-led programmes specifically as part of an action research project to further test the impact of the methodology. This will build evidence to support the long-term use of dance within the Early Intervention in Psychosis service and to assist insecuring future commissioning decisions.
The research(2) so far has shown that dance acts as a powerful catalyst in the recovery of service users’ mental health. It also shows that our dance methodology can positively affect clients’ mental health and wellbeing, enabling and facilitating recovery.
Info
info@thealchemyproject.co.uk
twitter.com/ThAlchemyPrjct
The Alchemy Project is an enterprise established by Cultural Utilities and Enterprises (CUE) in association with Dance United Yorkshire (DUY) and made possible with funding from Guy’s & St Thomas’ Charity, Maudsley Charity and Arts Council England, with the support of South London and Maudsley NHS Foundation Trust Early Intervention in Psychosis Services, SLaM and SLaM Arts Strategy. With thanks also to Andrew Coggins, Ellen Steinmuller and Gwen Van Spijk.
References
1. Statistic from Rethink Mental Illness
2. Independent evaluation led by Optimity Matrix.