Evaluation of Artworks Royal Aberdeen Children’s Hospital 2006 – 2009 June 2009 Delday and Douglas, rgu insert Insert rach rgu art logo logo

Areas for development
Scheduling and allowing for the unforeseen

The staff representative thought that there was a need to manage/coordinate the artist’s schedule more effectively and thereby allowing plenty of time for the installation stage – practical considerations (materials arriving etc) and for the artist being experimental and thereby accepting that some design ideas might fail or need to be modified.

The rush to complete was, in part, the artist’s and staff representative’s decision. The coordinator explained that she would have been very happy to re-schedule work and did not set a deadline of 28^th March 2009 for the RACH Event day. She had made an allowance of 3 months for slippage (originally the deadline was December 2008) and, in normal circumstances, 3 months would be sufficient. However, in this case, there were other factors impacting on the rush at the end. Firstly, the artist acknowledged that she was stretching herself and the budget to the maximum and it became one of the most ambitious projects she had undertaken. Secondly, the artist had been off ill for 2 months (autumn 2008). Additionally, the refurbishment work by the Estates Department was not completed on time and this should have been done before installation.³⁰
A part-time coordinator

Due to the slippage in a number of the projects in the programme the coordinator could not allocate as much time to the Rosehill project at the installation stage as otherwise might have been possible and this was further complicated by the coordinator also being absent from work (February-March 2009). It was significant (and acknowledged by the coordinator) that the Sub Art Group were invaluable in being able to step in at this time and assist the artist to ensure the project was completed on time. This is testimony to an excellent working relationship between the Art Group and the coordinator and seems key to the successful delivery in the programme.

It is significant that the artist (and the artist in Case study 3) both commented on the fact of the coordinator being part-time (2.5) days was not ideal. Both thought that in a programme of this scale either one full-time or two part-time people would have been better.
Building on the work undertaken

Many of the staff voiced a desire to continue the installation (the imagery continuing and reorganisation of the space) into their own rooms where they hold consultations. There was also interest in whether an artist could (further) research specific toys for different age groups.

Given the clear therapeutic benefits of the workshops this could be an important area for development. Future workshops would not necessarily feed into the permanent installation (though it could draw from an aspect of the work) rather it would be the value of participating in creative activity. Workshops that produce a tangible end product were appreciated by staff because the children gained confidence and self-esteem through making ‘almost anything’. For example, making T-shirts was enjoyed particularly by boys, and they had something they had made to take home. Other children enjoyed the exploratory creative process and discussions with the artist, where great attention to detail and being able to make choices were important qualities.
Developing feedback loops - learning

The RACH Event (28^th March 2009) was hosted by the Art Group with help from other clinical staff. This was important in terms of giving participants (particularly the external youth groups) the chance to see the finished work and give a sense of completion of the project. However, it was also, in part, the coordinator creating a feedback loop by asking two (of the three) groups to take part in the event by making presentations, and helping to document the work.³¹ This gave the young people a unique chance to reflect on the process and communicate their experience on a public platform.

The idea to creating feedback loops at different stages of the process could be developed further - particularly given that learning is an important quality embedded in the emergent model (e.g. 2b Re-defining the brief).
Questions for the wider sector
What does creative consultation mean?

A key question underpinning the RACH approach is in what ways does the artist frame participation and how can their creative processes be adapted (or not) to the different stakeholder groupings and situation? The corollary to this is to what degree can this be known at the outset and should this be made explicit at the beginning?

In this case study we see workshops as a series of activities building on one another.³² Some people were confused by this – how did this link to the final artwork, what was their input? (in 2a and 2b). Though it did become clearer further into the process and with explanation from the artist. For other participants dipping into one bit of the process (one workshop) was enjoyable and fun, and it didn’t matter that it was part of a larger process. Given the breadth of consultancy the artist’s strategy seemed appropriate.
Future development could look at different kinds of workshops and artistic processes. Precisely how workshops or engagement through creative activities are conducted, and what the specific processes and benefits from the interaction might be, are not understood in detail. It is noteworthy that two artists in two case studies (5.2 and 5.3) mentioned that, in their experience, a) this was the most thorough consultation undertaken and b) they had been asked to make their processes transparent and this is not usual. This kind of information on creative process and impact would be useful to commissioners of public art in hospitals.
Case study 2(b) Lowit Unit
5.2.10 Staff support and involvement
At the outset (i.e. the funding stage) the coordinator approached the art therapist with the proposal for an art project and draft brief for comment. He was nominated by the Unit as their representative for the project and attended the interview for the artist (along with the staff representative for Rosehill House). He expressed a little concern over the language the artist had used in the presentation and hinted at the possibility of a project happening outside, but it was felt and agreed that the artist was a suitable candidate for the project.³³

The staff representative offered staff and children’s thoughts which he had gathered.³⁴ Hopes were for ‘lots of visual and tactile stimulation, use of natural materials, work that ‘looks bright and welcoming’, ‘children's thoughts and ideas are taken into account and valued’. Specific ideas were offered and included: ‘totem pole, painting, computer art, football, TV programmes, sculptures, tactile pictures, surprises, treasure hunt.’ Perceived challenges were that some children would be unable or refuse to join in as a group.

Visit to Lowit Unit, February 2008 (Studio 77, coordinator and evaluator)

The staff representative gave a tour of the Unit followed by a question answer session where Studio 77 learnt a great deal about the service, in particular the role of art therapy with emphasis on the complexities of the children attending the unit. Approximately 14 children attend the unit with at least one staff member working individually with each child. He stressed that the children found people from outside, or strangers coming into the unit, difficult to cope with. It had been decided (previously by the staff representative and coordinator) that it was not appropriate for Studio 77 to work in the Unit.³⁵

5.2.11 The artist’s process and responses (staff and artist)
The artist conducted 4 workshops engaging with children and staff. For the first visit the artist was accompanied by the coordinator and met staff and talked about the project. The coordinator felt it was a very good meeting with every member of staff present (taking place after the children had left). The staff were very enthusiastic because the project would mean the children’s ideas and views were ‘respected and taken on board’. The majority of time was spent with staff explaining some of the difficulties the children experience (and giving some examples) and the artist showing them some of her work, including work generated at Rosehill House.³⁶
The staff felt it important that as a first stage the children should get to know the artist and for her to get to know them and this happened at the next visit before any art activities started.³⁷ Because of the emphasis on the difficulties the children experienced and that they found strangers difficult to deal with at first, the coordinator decided to step back and to not be present during the artist’s workshops fearing that this would be detrimental to the project.^{38 39} The artist would keep her fully updated on progress.
It was decided by staff that the workshops would take place in the afternoons, as the children attended school in the mornings and this was a time when everyone was together (all the children and all the staff).⁴⁰ In the afternoons the children were involved in ‘therapeutic group work’ (e.g. learning socialisation skills, building self-esteem). The artist worked with a group of 8-10 children with each child assisted by a member of staff. The Head of Department saw their role as ‘to manage the group and the artist’s to manage the project’. Often children would have to leave and come back for various reasons such as assessments or appointments with various therapists (e.g. language), and if a child was having difficulty with coping they were taken out of the room by a member of staff and given ‘time out’ of the group. The staff representative decided to not take part in the artist sessions, nor to observe. Instead he met the artist after the workshop finished to discuss what had happened (one-to-one).
The staff (i.e. 4 staff nurses, 1 play staff) all found the artist pleasant and thought that she tried really hard to engage with the children. The artist had to adapt her process because staff explained that it would not be a good idea to ask the children about how they felt (i.e. about the space in the Lowit) as this could be too emotionally upsetting. Instead of making words on feelings the artist engaged them in finding objects, selecting colours and taking photos. As anticipated by staff, on occasion a problem arose with children unable to understand what was being asked of them or becoming confused with the task.⁴¹
The most enjoyable session for the children was making T-shirts, although all the staff felt the making part was a bit rushed at the end because the majority of time was spent with the artist talking and explaining the activity. They felt that the children could not cope with long explanations very well and so they got restless. One of the nurses explained that it was quite difficult for them to explain to the children why the artist was asking them to do a specific activity in terms of it being relevant to the final work i.e. ‘doing up’ the Lowit in some way. The nurses themselves were having difficulty in understanding this and found supporting the children in the workshops very hard work. For example, when the artist asked the group which areas and things they would like to see changed, some children didn’t understand, others took it literally and got quite excited, while others did not want anything changed. The nurses were very eager to get the children involved in the project and tried their best.
Some of the visual material on the walls and ceilings were used as part of the therapeutic work and the artist tried to make helpful suggestions such as, to how to organise the material better or, perhaps not to have everything on display all of the time and, to everyone, e.g. having the ‘ladders of success’ like a blind that could be rolled up (hidden) and at other times on display thereby giving the child choice. The artist found the nurses helpful.
The Art Group met with the two staff representatives (from both sites) and Head of Unit to discuss progress and later the Chair of the Art Group met with the Head of Unit to discuss if they really wanted to continue with the project because the artist was having difficulty understanding which areas/spaces they wanted to change. They did want to continue, and another workshop was planned with the aim of having staff consultation and deciding exactly where the work might be situated. The anticipated consultations did not go according to plan (with staff being unavailable).⁴² The artist did however consult (one-to-one) with 3-4 staff, asking them what they might like to see changed in the unit and tried to understand which areas they wanted addressed.
The artist had assumed that staff did want to change their space and commented (to the evaluator) that it was one of the most cluttered spaces she had ever encountered. In her view the area that had been suggested, the entrance, was the area with the ‘least emotional attachment’ (and one of the few areas not covered in material). She thought that, to do the project justice, and to really work closely and productively with the staff and children a much longer time was necessary (1-2 years of workshops and developing ideas together).
Because there was little consensus on the area to be addressed coupled with a perceived reluctance to change the space in a meaningful way (as far as the artist could understand), the chair of the Art Group took the decision to withdraw the project (June 2008) and to re-direct the budget to the other site in the project (Rosehill House). At this time the coordinator was on holiday. She understood it was something of a risk to do this as progress reports were coming mainly from one person (the artist). However she felt it was a risk worth taking because time was passing and there was still no clear direction as to how the work would develop and theArt Group was accountable to the funders of the programme.
After the project was withdrawn the evaluator interviewed staff (4 nurses, play staff, the staff representative, Head of Unit as well as 2 members of the Sub Art Group (i.e. those most directly involved in the project management) and the coordinator.
5.2.12 Responses and learning from the experience.
Listening

The coordinator learned that she must learn to ‘really listen’ to staff at the very early stages. At the outset she believed that the staff genuinely wanted the kind of project that was on offer, but later understood that it was not what they wanted. Although people might say that they want to embark on a project brief, be involved in the commissioning of the artist etc, it might be necessary to probe much more deeply to see if this is a reality and that they understand what the project brief might involve. She also learned that she should definitely not take a step back from being physically present in a department throughout the artist’s consultancy stage.⁴³ She considered whether she should have shadowed the artist at the sessions (in addition to introducing the artist and discussing the project with staff), but concluded there was a limit as to how much time she could spend on one project given the pressures on her time.⁴⁴

Communication

The same process was used in this project as for the other projects in the programme, in terms of the Art Group initiating the project with staff and inviting them to become fully involved (e.g. draft brief, interview panel). The coordinator had assumed communication would be very much a two-way process with senior staff responsible for the project, however this did not seem to be the case at the beginning of the project, nor as the project unfolded.⁴⁵ The coordinator had also learned not to rely on staff representatives in any given project to be responsible for communicating details of a project to their line managers.⁴⁶

Accepting the risks involved in this approach

The Chair of the Art Group had learned to accept that not all projects will succeed and that this was not necessarily a failure on their part, but part of the riskwith this kind of approach. She completely trusted the coordinator’s professionalism and regretted that herself or others in the Art Group had not actually gone into the Lowit Unit themselves to support and she hoped that the coordinator felt supported by them.⁴⁷ She felt that the same process had been used here as in other projects and stressed that, in no way, had the project been forced upon them, nor had they at any point explained that the project or the artist, wasn’t suitable for them.

Ambition of the brief - two sites in the project

Everyone acknowledged that the project was ambitious from the beginning. It needed an artist that could work with children with complex needs and there were two sites. One of the Art Group had reservations from the outset about there being two locations, both with distinctly different characters. In purely practical terms this would make it complex with two sets of staff and two separate sets of planning and discussions. The brief had stipulated that possibly a partnership or collaboration between two artists might be appropriate for the commission, but this had not been possible. It was quite a tall order for one artist.⁴⁸

Not making assumptions about anything

One member of the Art Group thought that it was a difficult line to tread in terms of the RACH approach - to ask staff what they want to do with an art project. You do not want to give too much information ‘and seem like you’re talking down to people’. Yet when something does not go according to plan, it is then that you wish there had been more dialogue at the outset. However this is at the risk of seeming insulting or patronising to fellow professionals.

She thought on reflection that they had made too many assumptions; the assumption that they were dealing with professional people who were looking after the project and helping to set it up, but in fact may not have had the understanding to do it properly; the assumption that when talking about an art project people understand what you mean by project and terms such as ‘artwork for an environment’; the assumption that people know what an ‘art workshop’ is; the assumption of the role of the art therapist in the mix of people and their part in delivering the project (i.e. a role that is very different to professional artists); the assumption that the art in the unit is different to art in a general sense.
More planning

She did not think that it was appropriate at all for an artist to be working with such a large group (8 -10) of children with such complex needs.⁴⁹ She thought that there should have much more planning months in advance as to how the workshops would be organised (where, how many, number of children, age groups, outcomes, how to disseminate information to staff).

In retrospect all the members of the Art Group regretted not accompanying the artist and being more physically present, observing and assisting in the Unit whilst the artist was on-site.
Two distinct roles

The staff representative decided not to take part in the artist’s session because he did not want his role as art therapist confused with the role of being an artist (by the children).⁵⁰ He enjoyed talking with the artist after the workshops and thought a few of the ideas she came up with might be good (e.g. the roller blind idea for ‘ladders of success’), but stressed these would have to be tried out to see if they worked. He thought it was very challenging to have two sites in the project and his preference from the very beginning seemed to be creating an artwork outside (e.g. totem pole, sculpture).⁵¹

Understanding the brief

The Head of Unit was not familiar with the brief and clearly seemed to want a different kind of project where the artist worked with the children and their work was celebrated and displayed in the Unit. She felt that planning at the beginning of the project should have been more thorough and that the artist was in fact proposing an interior designer solution, which they did not particularly want. She also found the artist’s exploratory creative process confusing and thought that this should have been made clear at the outset.

Practical advice from the nurses

The nurses offered clear and useful advice on the kind of art project they thought would be good for the children.⁵²

Firstly, before any activities started, plenty of time would be needed: for the children to get to know the artist and vice versa; to observe and learn about how the staff support the children; to see how they work as a group and how the Unit operates; to really understand the therapeutic work and the reasons for it.
Secondly, the children needed a very clear and simple step by step process with a beginning, a middle and an end so that they could understand what they were trying to achieve and how they would do that. Vagueness was not good, nor abstract ideas. It would be better to keep instructions brief and to have more activities than talking (attention spans could be short and too long explanations liable to confuse them). Basically they required a very simple process which would produce a tangible result quite quickly. They also thought that a decision by adults regarding in which area the art project might take place should be made at the beginning and that, if they knew exactly what the artist intended to do, then it would be easier for them to keep the children ‘on task’.⁵³
Finally, the project should be based on the levels and difficulties of the children.
Timescale too short

The artist explained that she only had a short time with people in the Lowit Unit (1.5 hours per week as opposed 1-2 whole days in Rosehill for each block) and clearly this affected the project. Because this was one of the most visually cluttered areas she had ever encountered, she thought that to do justice to the project – i.e. to work with staff and children to visually create ‘order, containment with display solutions and pleasing storage and a fresh identity for the space’ – a project of this scale would take 1-2 years of workshops and working collaboratively.⁵⁴ To do anything less would be ‘a token gesture’.⁵⁵

5.2.13 Summary of Findings

Areas for development
Scope of the brief and its interpretation

It was acknowledged by everyone that having two sites in this project and only one artist would be very challenging. The brief asked for the artist not only to work with two sets of children and two sets of staff, but in two environments within the same department that operate very differently. The brief asked for ‘artistic solutions that would work on both sites and join the sites visually’.⁵⁶ It was clear in the brief that the Rosehill environment was in need of improvement (i.e. the corridors, the planned refurbishment), but that is was not stipulated in the brief for the Lowit Unit per se. However, it became clear from the ‘hopes and challenges at the outset’ by the Art Group members that a) there were hopes for changing the environment in the Lowit Unit (e.g. a dark, windowless and very cluttered space) and b) there were slightly different emphasis in the interpretations of the brief from individual members of the group. One interpretation was a focus on the environment where the project might ‘in some small way’ help bring them together (visually) and with the Lowit operating very independently from the rest of the service, the project might (in a modest way) help ‘open the door to art’, and bring the Lowit more within the rest of the whole mental health unit. Another interpretation was seeing the children’s workshops as being ‘a positive creative experience’ where the outcome might feed into, or help inform the installation at Rosehill.⁵⁷

The artist clearly wanted to do the best she could and actually change the interior spaces and make a better working environment in collaboration with the staff. The nurses wanted to have much simpler (clearer) artist workshops with the children’s work celebrated. The senior staff did not want the space changed (or only minimally).
More planning

The fact that the Lowit was perceived as ‘closed’ i.e. a distinct history and culture quite independent from the rest of the hospital, suggested that more planning would be required in the future and was noted by everyone after the event.⁵⁸ Also noted was the need for a more proscribed process (where, who, how many children, when etc) as opposed to the more interpretative approach with the artist working with the staff (supported by the coordinator) to develop the open-ended ideas in the brief.

Revisiting the brief after the artist is appointed

Communication (by senior staff, within and outwith the department) and assumptions (by the Art Group) were problems in this project and it became clear that the staff were unfamiliar with the brief and did not actually want this type of ‘interior design’ project, but something different. That the project was also for and by them was either not understood, or not actually wanted.⁵⁹

It might be necessary to revisit a brief with staff after the appointment of artist to review it. This would also ensure a level of dialogue with the senior members of staff in terms of their understanding and interpretation of the brief and what they might wish to do. In this way a common understanding of what is desirable and, importantly, possible, could be achieved and project aims might be considerably delimited.
The need for closure – an exit strategy/process

Some of the nurses explained that they were very surprised when the project was stopped and didn’t really understand why.⁶⁰ As a result there was no feeling of there being an ending for the children and this was (in their view) a missed opportunity which could have been ‘worked on, talked through and a plan made’ (i.e. therapeutic development).

Future work should include developing an exit strategy should a project not progress to completion. This might include a group meeting bringing all the stakeholders together so that all the individuals involved (the Art Group, artist, staff) do not feel as though they have failed and learning occurs.