May 15, 2014
This article will be featured in the Spring 2014 issue of CIIS Today.
Contra Costa Health Services (CCHS) is a public safety net: a behemoth public organization whose facilities support more than 640,000 visits annually for medical and behavioral health services—the largest department of Contra Costa County government and one of its largest employers.
A “safety net” hospital or health system maintains an open door, offering patients access to services regardless of their ability to pay, insurance status, or health condition.
By legal mandate or adopted mission, it is committed to providing a substantial level of care to the most vulnerable populations, including low-income, uninsured, and Medicaid-dependent.
As the literature says, “CCHS seeks to reduce health disparities by addressing issues of diversity, and linguistic and cultural competence and encouraging creative, ethical and tenacious leadership to implement effective health policies and programs.”
One such tenacious leader is Dr. Alan Siegel, a family physician based at the West County Health Center in San Pablo. Siegel, a musician, is a passionate believer in the healing potential of the arts.
Siegel, who is also the director of Nor Cal Arts & Health Alliance, has been chairing the development of the county’s Art of Health and Healing (AHH) initiative to ensure that patients, their families, staff, and community have the opportunity to reap the benefits offered by the use of arts practices in health care.
THE HEALING ARTS IN COMMUNITY
Feeling that medicine had become too sterile, Siegel sought ways to reincorporate spirituality and add arts into healing—to use the full spectrum of therapeutic tools available for clinicians to treat, engage with, and heal patients.
Conferences, consultations, and field research led him to expressive arts, and in fall 2012, to Shoshana Simons, Expressive Arts Therapy Program (EXA) Department Chair at CIIS. Siegel wanted to collaborate on a strategy for providing expressive arts therapy services throughout the county.
Simons saw the partnership between CIIS and the AHH program at CCHS as “a unique opportunity to align our human, material, and creative resources in service of the needs of both communities.”
Siegel agreed with Simons, saying “building our partnership between a school and a public institution and being able to provide something that works for both groups is exciting.”
In a collaboration between the Contra Costa Regional Medical Center (CCRMC), a 164-bed facility in Martinez, and EXA, a paid practicum and graduate internship was created. Faculty member Phil Weglarz, a hospital-based expressive arts therapist and supervisor, was instrumental in implementing the partnership.
“I find that writing poetry invites people to talk about their feelings in a safe way, a way to share their inner, often hidden feelings,” she says. “Writing poetry assists the client in externalizing their feelings, to write them down and get them out of the body. Using the Expressive Arts is a doorway, a way to invite the deeper self into the conversation.”
BY THE BEDSIDE AND BEYOND
2013 welcomed the first cohort of interns: EXA graduates Ruth Davis-Fyer, Krishna Munoz Harrison, and Saskia Pouw. They work at patients’ bedsides on medical units, provide groups and milieu therapy in inpatient psychiatry and the psychiatric emergency room, and facilitate expressive arts in outpatient medical groups. Some of the modalities they’re using are music and singing, writing and poetry, visual arts, and guided imagery.
“They are gaining paid hours toward licensure as Marriage and Family Therapists and REAT’s while serving the needs of patients and staff who are living and working in richly diverse, economically impoverished and under-resourced communities in Contra Costa County,” says Simons.
Early in 2014, the team expanded to include EXA graduates Jen Alt, Adrian Scharfetter, and practicum student Lori Tuttle. Additionally, EXA alums Suraya Keating and Patricia Rojas-Zambrano were hired as part-time supervisors.
“Whether it be the charge nurse in intensive care, labor and delivery staff, resident preceptors, or upper administration, they all see the added value of expressive arts in the healing process,” says Rojas-Zambrano, “next, we’re focusing on staff—caring for the caregivers.”
Tuttle particularly loves working with pregnant women, new mothers who are having difficultly bonding with their babies, and mothers in recovery, “I find that writing poetry invites people to talk about their feelings in a safe way, a way to share their inner, often hidden feelings,” she says. “Writing poetry assists the client in externalizing their feelings, to write them down and get them out of the body. Using the Expressive Arts is a doorway, a way to invite the deeper self into the conversation.”
EXPANDING EXA'S REACH
The AHH partnership fosters opportunities for cross-fertilization with other allopathic and artistic healers. The team has created and participated in several community rituals and unit-wide celebrations for patients, family, and staff, including art receptions, the annual Healthcare Workers as Creators multiarts festival. There’s also a booth at the CCRMC Tuesday Farmers Market, where the public can engage in individual and communal expressive arts processes.
Additionally, the program provides staff in-services and education about the potential of expressive arts therapy.
“In the future,” says Simons, “we hope to create an Arts in Healthcare Certificate Program that will train interested healthcare workers in how to implement arts-based activities with patients while also being trained in systemwide arts-based action inquiry as a means of sustaining the health and well-being of the community as a whole.”
Siegel believes that now is a great time for growth. “Moving forward, I would like to expand our work to have more effect on the masses,” he says. “This is a very large county health system. I want to expand our EXA work, and conduct research at our site. I want to extend our reach—to offer Expressive Arts certificates to staff. The interest is huge.”
“In a large system like CCH,” adds Siegel, “there is so much need and so much opportunity. If we had 100 interns, we could keep all of them busy.”
Top Photo, L-R: Patricia Rojas-Zombrano, Ruth Davis Fyer, Jen Alt, Karen Lloyd, Adrian Scharfetter