Sanatorium art therapy

Domain VIII · Creative & expressive arts therapies · Adrian Hill · 1938 · Midhurst, Sussex, England

What it is

This is a historical practice, not a current manualised therapy. Adrian Hill (1895–1977) was a painter and a former war artist, not a clinician. He was being treated for tuberculosis at the King Edward VII Sanatorium in Midhurst, Sussex, in 1938. While there he drew objects within reach of his bed…

Format

• No phases, session counts or progression criteria were found in any source opened. The book's chapters "The Personal Approach" and "The Psychological Problem" are named in the 1946 review, but their content is not drawn on. What follows is (A) the historical course reconstructed from the sources…
• A. Historical course at Midhurst (reconstructed)

Who practises it, and how they are trained or regulated

• Professional frame: No regulated profession of "sanatorium art therapy" exists. In the UK, "art therapist" and "art psychotherapist" are protected titles. They require an HCPC-approved master's degree (two years full-time or three years part-time) and HCPC registration, and using the title without registration is a criminal offence under the Health Professions Order 2001. A psychotherapist who is not HCPC-registered…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• agitation in delirium or dementia; it is working if the patient anticipates and chooses the changes.
• pressure to perform; exposure of personal content. It is working if the patient feels pride without anxiety.
• confusing an arts-in-health activity with therapy. It is working when the environment changes and patients use it.
• imposing your own taste; images becoming triggers. It is working when the patient comments on the picture or asks for a change.
• lessons turning into performance or judgement; the patient deferring to you for every mark. It is working when the patient sets their own next step.

Problems the guide addresses

• Lethargy, apathy and declining (stuck or non-adherent clients)
• "I can't draw" and fear of judgement (resistance)
• Fatigue, breathlessness and physical limits (overwhelm, physical)
• Infection control and the medical setting
• Emotional overwhelm and distressing content
• Reading too much into the art
• Patients producing what you seem to want (pseudo-compliance)
• Ruptures and dependence
• Loss of creative drive on recovery
• Deaths and deterioration on the ward

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.