Art groups support health and well-being
through social identity gain

By Elyse Williams and Genevieve Dingle

The ‘arts in health’ is a nascent field of research and practice in which participants engage in creative arts (such as singing, instrumental music, artwork, creative writing, and drama) in order to enhance their health and wellbeing. In Australia, the National Arts and Health Framework acknowledges the role of arts practice in the prevention and treatment of chronic health conditions. However little is known about how participation in arts groups may influence wellbeing and for whom this approach is most effective. To explore this, SIGN members Dr Genevieve Dingle and Elyse Williams have developed research partnerships with the School of Hard Knocks and Aveo Retirement Village.

The School of Hard Knocks is a charitable organisation that offers a range of arts based programs for Australians with chronic mental health conditions. In a one-year prospective study, the experiences of 59 members of the Queensland branch (34 choir members and 25 creative writing group members) were explored.  Among the sample, 44% were diagnosed with a mood disorder, 41% were diagnosed with an anxiety disorder, 25% with a substance use disorder and 20% with schizophrenia. Across the year, participants’ measures of mental health, emotion regulation[1], and wellbeing improved, and this effect was found to the extent that participants formed a group identity with their choir or creative writing group. Participants reported that they felt accepted and supported when they attended the groups. Exploring their creative ability provided participants with a sense of esteem, agency, and enjoyment. Moreover, having a place they could regularly attend and engage in a meaningful activity provided them with a sense of purpose in life[2].

A second example of an arts group is Live Wires – a music program designed to enhance social connections and cognitive health in older Australians in a retirement village context. In a trial this year, 50 residents (81% female; average age = 81 years) were randomly assigned to either the 8 session Live Wires program or to a wait list control condition. Measures of cognitive and social functioning, mental and physical health, were collected in individual sessions before and after the 8 weeks and again at 8 weeks follow up. This design allowed for a test of the social identity model of identity change[3], with three pathways: a) a direct relationship between multiple group memberships before the transition into the retirement village and current wellbeing; b) an indirect identity continuity pathway (those who continued their social identities with former groups were expected to show better wellbeing); and c) an indirect identity gain pathway (those who joined and identified with the new Live Wires group were expected to show better wellbeing than the control participants who did not gain a new identity). Results of model testing showed the direct multiple group membership pathway was supported, as well as the identity gain pathway, while the identity continuity pathway was not supported[4].

 

Taken together, these findings help to explain how arts groups enhance health and wellbeing of participants – it is by the gain of a valued social identity as a member of the arts group, in addition to multiple group memberships before a transition that predicts later wellbeing. The minority of participants who did not form a strong group identity (or who dropped out of their arts group) did not show improvements in their wellbeing at the subsequent assessment. These findings are echoed in the 2017 UK All Party Parliamentary Report ‘Creative Health: The Arts for Health and Wellbeing’ that summarised a large body of evidence attesting to the diverse benefits of arts within health settings, and the cost effectiveness of such arts programs in terms of participant outcomes[5]

The School of Hard Knocks research was supported by a grant from the Wesley Medical Research Institute and the Live Wires project was supported by a UQ School of Psychology seeding grant.

[1] Dingle, G. A., Williams, E., Jetten, J., & Welch, J. (2017). Choir singing and creative writing enhance emotion regulation in adults with chronic mental health conditions. British Journal of Clinical Psychology, in press. DOI:10.1111/bjc.12149

[2] Dingle, G., Williams, E., Sharman, L., & Jetten, J. (2016). School of Hard Knocks QLD Final Evaluation Report. School of Psychology, University of QLD.

[3] Haslam, C., Holme, A., Haslam, S.A., Iyer, A., Jetten, J., & Williams, W.H. (2008). Maintaining group membership: Identity continuity and well-being after stroke. Neuropsychological Rehabilitation, 18, 671-691.

[4] Ellem, R., Dingle, G., Haslam, C., Williams, E., Clift, S., Davidson, R, & Humby, M. (in preparation). Connecting Live Wires: A social identity approach explains how a music group enhances wellbeing in older adults.

[5] APPGAHW (2017) Creative health: the arts for health and wellbeing. Inquiry Report. London: All-Party Parliamentary Group on Arts, Health and Wellbeing.