In 2015 the Alchemy Project delivered a pioneering ‘treatment’ for mental illness. It was modelled on contemporary dance training and was a different way of engaging with people and supporting their recovery. It was based on the work of Dance United and its proven, award-winning methodology. The premise was ambitious: that in just four weeks, participants would go from a place of no experience to a high-end artistic professional dance performance. There was daily practice working towards the performance in front of an audience of a 20-minute choreographed piece, ‘El Camino’ (‘The Way’ in Spanish). The mission was for dance to be a catalyst for radical change, helping to realise the potential of individuals. The teaching methodology is all about engaging and inspiring people struggling in their lives and it is innovative, holistic, and focuses on wellbeing rather than deficits.
There’s an idea that this kind of intervention is taking away from the traditional medical model. As doctors and psychiatrists, that is what we’re used to; we work in clinics, see patients, diagnose illnesses, and prescribe and treat with medication. Yes, there is psychotherapy, but treatment is predominantly about medication. But you can bring the arts into health, and it shouldn’t just be an add-on. It can be an integral part of what we do, and I absolutely believe that we should be prescribing projects like this.
In a way, the project was about moving away from diagnoses. No patient in the project was labelled, no one knew each other’s diagnosis or background, and in fact, I didn’t know the patients in the project. For me, as a doctor, it was incredible to be in a space where patients were just people and, more than that, they were dancers.
What were the challenges?
When we started in 2013 there hadn’t been a contemporary dance intervention in the NHS service before, this was totally new territory. We were asking that people were referred intensively, on a full time basis, for four weeks. As you can imagine it was a very different way of working, not only for clients but also for the service. While developing the pilot, ‘Seabreeze’, so many questions arose: would clients turn up? Would they be able to engage intensively? Would they cope with an intervention like this? Would it be too stressful to perform on stage? Would it be possible to recruit young adults? Would they stay for the duration of the project?
What problems did it address?
Three key problems were identified, that conventional treatments were having a limited impact on.
- Patients felt isolated and they struggled with interpersonal relationships.
- Patients struggled with their body awareness and physical fitness, and this has a negative impact on overall levels of confidence.
- Patients found it hard to get up in the morning, and maintain energy and optimism, and often over-focused on their condition.
From our experience, we knew that dance could have a big impact on these issues. Building evidence for this was crucial, and so we started to develop a theory of change right from the beginning.
During the project, participants were learning what it means to be in physical contact with people. When you have a mental illness, life can be very isolating. This is particularly so for people with psychosis, who may be hearing voices, be very confused, and paranoid about the world around them. It was a massive step for the young people to take. They were finding out what it means to be on a stage, in front of other people and in front of an audience.
What were the results?
Sixteen individuals were recruited and completed the pilot, and we started to find answers to our questions.
They were able to engage and work intensively. They turned up every day and committed to it. They particularly flourished being called a ‘dancer’ and working together as a dance company, towards a shared goal. We saw clinically significant results in their wellbeing.
After the pilot we knew we needed to test the project further. The Alchemy Project has proved that it can be repeated, and last year there were two further interventions. We have been testing the impact of the methodology and building the evidence base, so we can support offering similar interventions in the future.
Participant’s wellbeing improved undoubtedly, but we also have the numbers to back it up. The Warwick-Edinburgh scale is used to measure mental health. As context, interventions in the NHS settings were seeing +1.2 points improvements. The pilot study saw an increase of 6.7 points, so very significant numbers, and in the Alchemy Project it was up 7.9 points.
We also looked at other measures – resilience, ability to trust others, concentration and focus. For me, the project is amazing because it taps into and improves all of these skills. It isn’t just about a four week project, and then ‘brilliant you’ve improved, and now we’re going to leave you’. The project had another arm which continued, and the participants went on to attend a dance college, they continued to meet each week, and did another performance.
What does this mean more broadly for arts and health?
We’ve built the evidence base. The big questions now are how do we do future projects and how do we break that commissioning barrier? But we hope the Alchemy Project doesn’t stop here.
Featured image credit: Reproduced and used by permission from Dance United. Copyright © 2015 Dance United.