as a Writer in Health and Social Care Settings
by Wendy French
This information sheet was co-commissioned by NAWE (National Association of Writers in Education) and Lapidus in 2010 to provide nuts and bolts information and advice on how to enter the hugely rewarding field of writing in health and social care. Topics covered include training, accreditation, how to get experience, getting work and setting up your own project.
About the author
Wendy French is a poet and editor. She works extensively to promote writing in healthcare, educational and community settings and is a former chair of the writing for health and wellbeing organization Lapidus. Her latest collection, surely you know this, was published by tall lighthouse in 2009. Wendy’s other collections include two chapbooks published by tall lighthouse and her first collection, Splintering the Dark, from Rockingham press. She has co-edited three books of poetry written by young people in hospital. All published by Rockingham.
About NAWE and Lapidus
NAWE's mission is to further the knowledge, understanding and enjoyment of Creative Writing and to support good practice in its teaching and learning at all levels. As a professional membership organization, NAWE aims to assist contemporary writers of all genres both in developing their own practice and sharing their art, craft and imagination with new writers of all ages and backgrounds in a wide range of educational and community settings. The Writer’s Compass is responsible for all NAWE’s professional development services, including its programme of seminars and events, its annual retreat and year-round professional development planning and coaching services, the majority of which are also open to non-members, together with all the information and advice services for writers generally formerly provided by literaturetraining. www.nawe.co.uk
Lapidus is the UK organization for writing and reading for health and wellbeing with regional groups in England, Ireland, Scotland and Wales. Its members are engaged in developing and supporting the wider arts and health movement. They include writers, poets, medical and healthcare professionals, therapists, complementary practitioners, artists, those involved in social care and education, and others with an interest, for professional or personal reasons, in the benefits of creative writing and reading for health and well-being. Lapidus practitioners support a diverse range of communities, individuals and groups. They work in health and social care environments and in the community to support people with disabilities, chronic illness, terminal illness, mental health problems and their carers, as well as refugees, offenders and others facing social disadvantages and challenges to their health and wellbeing. Lapidus is a valuable resource for anyone wanting to work in this area and offers CPD (continuing professional development) events, as well as a practice-led online journal, website resources and the opportunity to network with others. www.lapidus.org.uk.
Do I need any particular personal qualities to be able to work well in health and social care?
As with any area of work that involves working with people (whether adults or children), you must first and foremost like people. This may sound trite but it is essential because you may find yourself working with clients who have had quite a raw deal in life through illness or family problems. Damaged people (particularly children) can try to damage others but if you have a genuinely high regard for fellow beings, these negative feelings can be turned round once the client believes s/he is respected. You may be working with people whose raw emotions surface through this work. Sympathy and empathy are essential, even if you encounter unfamiliar situations.
It is helpful to have a patient, gentle style of working as a group session may develop in ways that you were not expecting owing to physical and emotional issues. You also need to be flexible in your approach. You may suddenly find yourself in a situation you hadn’t planned for – believe me, this can happen – so, while you should be well prepared for every session, it’s useful to have other ideas you can turn to.
A responsible practitioner will always debrief afterwards, either with another person or him/herself, and ask the question, ‘What could I or should I have done differently to have improved that session?’ Sometimes the answer is ‘Nothing. I handled it to the best of my ability.’, but the question should always be asked. Lapidus strongly advises regular supervision for practitioners, and the 'Core Competencies' document cited above states that it is a responsibility of host organizations to provide suitable supervision for the writer and ready access to the organization’s link staff member. It is important for practitioners to know when it is appropriate to refer a participant to someone else in an organization.
Do I need to have any kind of counselling or therapy qualification?
It depends what you mean by ‘need’. Some organizations will require a facilitator to have undertaken some kind of counselling or therapeutic training, others may not. Whether or not it is actually required, it is important to have undergone some form of training, even at an elementary level. 'Core Competencies' states that the writer in healthcare should have 'completed an approved counselling or therapy course and has understanding of psychological dynamics, appropriate boundaries and the necessity of supervision'. Such training helps to provide insight into yourself and is a guide to understanding others. It can also help you when you are working with powerful material (the material clients will bring to a session). This can be disturbing for the facilitator as well as for the rest of the group and counselling or therapeutic training can help in managing such situations. An accredited introductory course in counselling skills is a good place to start. These are offered by colleges and other providers around the country.
Lapidus (Writing for Health and Wellbeing) www.lapidus.org.uk
BACP (British Association for Counselling & Psychotherapy) www.bacp.co.uk
COSCA (Counselling and Psychotherapy in Scotland) www.cosca.org.uk
Do I need to be a published / produced writer?
Not necessarily but you do need to prove (to yourself and others) that you take writing seriously and understand the pitfalls and hard graft that it takes to produce a good piece of writing. And, published or not, you need to be writing regularly and reading widely both contemporary and past writers in the genres of your choice. Some places may ask for a published writer if the work is funded through a national scheme which operates eligibility criteria.
Can writers in all genres work in health and social care?
Quite simply, yes. The more genres clients have access to, the better. Different modes of writing excite different people and we need advocates for all areas of written and oral communication, short stories, plays, radio plays, poetry, novels, journal writing, films etc.
What kind of health and social care settings can I work in as a writer?
As a freelance facilitator of creative writing with appropriate skills and experience, you are potentially eligible to work in any health or social care setting such as hospitals, health centres, hospices, mental health services, prisons, as well as with community groups with specific needs, schools and libraries etc. However, you should be aware of the differences between these settings and even within them. Working with people suffering from dysphasia (language loss through a stroke or brain injury), for example, will require a very different approach from working with the visually impaired. You may find that you feel more of an affinity with one group than another. Work with whom you feel comfortable.
Before you approach an organization or answer an advertisement, you must decide what area interests you and why. You will need to research: the emotional and physical needs of the group, including any disabilities work that may or may not have been done previously the expectations of the host organization.
Can I undertake any training?
Yes, a number of training opportunities exist, ranging from day-long workshops to short courses and degree programmes including those run by
Metanoia Institute, London; Falmouth University; Newcastle Centre for the Literary Arts; Orchard Foundation; Ty Newydd Writers Centre Wales; London Metropolitan University
See www.lapidus.org.uk Courses page
and Writers Compass (NAWE bulletin) http://www.nawe.co.uk/the-writers-compass/events.html
Is there any form of accreditation for writers working in health and social care?
The US-based National Federation for Biblio/Poetry Therapy www.NFBPT.com offers certified courses for those wishing to become an applied poetry facilitator or therapist. (Several Lapidus members have undertaken these courses – if you email Lapidus email@example.com, they will be able to direct you to them.) It works closely with The National Association of Poetry Therapy www.poetrytherapy.org, a world-wide community of poets, writers, journal-keepers, health care professionals and educators who recognize the healing power of language. The term ‘poetry therapy’ encompasses all kinds of writing as well as bibliotherapy (the interactive use of literature) and journal therapy (the use of life-based reflective writing). There is no formal system of accreditation in the UK. Lapidus members and board have closely considered potential accreditation pathways but took the decision in 2011 that developments in this area needed to wait until funding was available to support the work necessary; its Professional Membership category was discontinued and all members join as Individual or Organizational members. Lapidus does however offer CPD (continuing professional development) events, issuing certificates for attendance at relevant conferences and training days.
How can I get experience?
This can be difficult. If you’re working in isolation, it is hard to gain experience from actual ‘hands-on’ work. The best way to gain experience and, therefore, feel more confident about delivering a good and stimulating package, is through either having a mentor or shadowing a fellow writer. Experience comes from the actual doing and delivering and every session will add to the store of wisdom and knowledge on which you can build your own work. If you shadow an experienced practitioner (and join in practically as long as this is agreed in advance), this will give you the most valuable experience possible. As well as learning from a mentor about management issues and confidentiality, an advantage of working alongside an experienced facilitator is being able to develop and deliver certain themes. Few formal mentoring or shadowing schemes exist. Lapidus is, however, currently developing a peer mentoring scheme for its members, where individuals opt to join an online list of writers and practitioners. The proposed scheme will enable Lapidus members with similar areas of interest to partner up and, within an arrangement they define at the outset, share ideas, writing, practice tips, experience, and give each other constructive feedback. Many Lapidus members also organise their own informal mentoring arrangements either by joining their regional Lapidus group, where there is the opportunity to meet people working in a wide range of health and social care settings, or by contacting someone through SKILLSEARCH, an online directory of Lapidus members who practise in the field of writing and reading for health and wellbeing. NAWE members can make similar use of the Professional Directory which NAWE operates – this is searchable by area of interest and region. Some organizations like the Scottish Book Trust and Literature Wales also maintain publicly accessible online directories of writers who are available to work in a wide range of settings which you can use to identify experienced writers in your area. It is also worth contacting your regional literature and arts in health organizations (see Appendix A for listing) to see if they are operating any writing in healthcare projects that offer shadowing opportunities (or might be persuaded to do so). Even if they aren’t, they may be able to direct you to writers working in the area you are interested in.
How can I get work?
Once you’ve got some experience, and gathered some references and testimonials, you’re ready to start getting some work. There are various ways that you can do this but, in general, you have to keep your eyes and ears open: quite a lot of work in this field is self-generated so don’t be afraid to be proactive. Look out for advertised opportunities. Good sources of national information on opportunities include: ArtsJobs – free e-mailing list operated by Arts Council England Subscribe online at www.artscouncil.org.uk/pressnews/mailinglists.php
Opportunities.CreativeScotland.Com – details of jobs, professional development opportunities and activities in Scotland and beyond. http://opportunities.creativescotland.com/
Voluntary Arts Network – information about arts jobs across the UK and Republic of Ireland http://www.voluntaryarts.org/
The Writer’s Compass (NAWE) – weekly jobs and opportunities e-bulletin. Subscribe online at www.nawe.co.uk
Register your details on online directories Online membership directories operated by organizations such as Lapidus (SKILLSEARCH) and NAWE (Professional Directory) provide prospective employers with an easy and trusted means of engaging suitably skilled and experienced writers. Similar databases are maintained by Literature Wales (Writers of Wales database / Writers on Tour scheme) and the Scottish Book Trust (Live Literature funding). Contact regional writing or arts in health programmes Another approach is to contact organizations in your region that run writing or arts in health programmes and see if you can apply to become part of their team of writers or even to be the first writer on their team. I did this successfully with a local branch of Age Concern. (See Appendix A for listing.) Set up your own projects Rather than wait for that elusive advertised opportunity, you can get something going yourself. For ideas and inspiration, visit the Projects Around the UK section of the Lapidus website. The Lapidus Journal http://lapidusjournal.org/ also regularly features articles about the setting up and running of projects.
How do I go about setting up my own writing in health projects?
Firstly you need to decide which areas of health or social care you are most interested in. Read around these areas (there is a list of useful books, magazines and websites at the end of this information sheet) and then decide what type of writing sessions you would like to facilitate e.g. a writing group for people in recovery, a poetry group in a hospice, groups for people with specific needs, identity or location. Once you are clear about this, the next step is to approach organizations in the setting where you would like to work – it’s best to start with those in your region initially and move on later to national organizations. You will need to put together a brief proposal outlining what you want to do, why you want to do it and your credentials for doing so, your evidence that it’s needed / a good idea, the planned outcomes, the benefits to the participants / staff, what it will cost etc. For advice from an experienced fundraiser, see the briefing Planning a project and funding it which is available to download free from The Writer’s Compass Resources section of the NAWE site. Very few places will have a reserve fund for this kind of activity so unless you are prepared to do the work on a voluntary basis (and while this may be something you are prepared to do when you are starting out in return for feedback and hopefully some glowing references!, it is not something we would recommend in the long-term), the question of how it is to be funded and who is to raise the funds will be key. There are some charitable foundations linked with hospitals but usually a new project will either be the result of a larger agency's involvement or require an initial feasibility study or pilot project. A pilot series of sessions on a voluntary basis will enable you and the host organization to orientate yourselves and evaluate the viability of the work. You may then be able to convince them or other funders of the value of continuing. Your proposal is likely to be greeted much more enthusiastically if you’ve already done some research and identified a number of possible sources of funding. As it can be difficult to get funding as an individual, it will probably be a case of the organization applying for funding on your behalf with you doing most of the work on preparing the application. You may find that they have other funding applications on the go and your project can fit in with some of this work. You could also think about joining up with other writers interested in this field and applying as a group.
Here are some possible sources of funding: Arts Council England – individuals can apply to the Grants for the Arts Scheme for grants of between £1,000 and £30,000. Comprehensive guidance is available at http://www.artscouncil.org.uk/funding/grants-arts/
Awards for All – a Lottery grants scheme funding small, local community-based projects in the UK http://www.awardsforall.org.uk/
Big Lottery Fund – awards lottery money to community groups and projects that improve health, education and the environment www.biglotteryfund.org.uk
Charitable trusts and foundations – there are thousands of grant-making trusts in the UK. To identify relevant ones, you can use directories like The Directory of Grant-making Trusts or A Guide to the Major Trusts (there should copies in your local reference library) or websites like Funding Central http://www.fundingcentral.org.uk.
Local authorities – you may be able to access Community Arts grants Local businesses with a corporate responsibility budget may be able to offer a grant – The Guide to UK Company Giving is a useful source of information. It’s also worth making contact with your local Chamber of Commerce. This early part of the work is time consuming but is stimulating and if you are serious about your work, it is worth pursuing all possible leads.
Are there recommended rates for pay and for travel and subsistence costs?
Rates of pay vary from one organization to another but in 2011, £200–250 per day (£100–125 per half day) is standard. You may be able to claim for travel: this depends on the organization and your contract. I know of very few organizations that provide a subsistence allowance.
Will I need a criminal record check?
Yes, writers undertaking work in healthcare are required to have a criminal record check or ‘Disclosure’. There are two types of check – standard and enhanced – and you will generally find that you need to have an Enhanced Disclosure. In this work, as in educational settings, we are often working with vulnerable people. It is in place to protect you as well as the clients you will be working with. The host organization may make a specific Disclosure Application to the Criminal Records Bureau (CRB) on your behalf at the time or may ask you to present your existing Disclosure. You are not allowed to apply for one yourself as an individual or if you are self-employed but if you join NAWE as a Professional member, they can make the application on your behalf. As registered body, they are also fully up-to-date with any Government policy changes in this area. The Directgov website http://www.direct.gov.uk/en/Employment/Startinganewjob/DG_195809 has a section on making criminal record checks or you can ring the CRB helpline 0870 9090811.
Do I need any kind of insurance?
Some kind of insurance cover is increasingly becoming a professional necessity for writers whose work brings them into contact with members of the public. The two types of insurance that are most relevant to writers working in healthcare settings are public liability and professional indemnity. Public liability: This protects you against claims for accidental bodily injury or damage to property. If you are, for example, working in a hospice, facilitating a writing for wellbeing workshop, and one of the participants is injured, or there is damage to property, you could be held legally responsible and have to meet the costs of any claims. Some of the healthcare settings in which you work may have blanket insurance cover, others may ask for proof that you have your own insurance before you can start work with them. In response to this situation, NAWE now offers free public liability insurance cover to its professional members who work as writers in public or educational settings. Professional indemnity: This protects you against claims for professional negligence resulting directly from services or advice you have provided. It’s a type of insurance which is mandatory for professions such as solicitors and accountants and those working in areas such as consultancy, advertising and PR often take it out as well. If you find yourself working as a writer within a clinical or therapeutic environment, ensure that you discuss insurance requirements with your supervisor or employer. He or she will advise whether professional indemnity is required, and whether you need to take this out personally. As this is a specialist area of insurance, it’s also worth seeking professional advice from a suitably experienced insurance broker as to whether or not you need it. You can search for brokers on the websites of the Association of British Insurers http://www.abi.org.uk/, British Insurance Brokers’ Association www.biba.org.uk or the Institute of Insurance Brokers http://www.iib-uk.com/.
You may also come across something called professional liability insurance. This is where the two types of cover have been packaged together and can often be found from insurance brokers that offer specialist cover for those working in the fields of therapy, psychology, counselling, coaching etc. These include: Holistic Insurance Services www.holisticinsurance.co.uk, Howden Professionals www.howdenpro.com, Towergate Professional Risks and Westminster Indemnity http://www.westminster-indemnity.co.uk/.
There is a very comprehensive and readable guide to the different types of insurance available in the Finance and Grants section of the Business Link website www.businesslink.gov.uk
Should I get a contract?
It is advisable to have a contract so that the following can be considered: the expectations of both the host organization and the writing facilitator whether there will be a volunteer from the organization to support the sessions confidentiality and reporting back timings (both of length of sessions and the length of the project in total) supervision (if any), record-keeping and feedback facilities: particularly the accommodation and arrangements for provision of any equipment that may be required and, of course, your fee (possibly including an allowance for preparation) and expenses. A clear understanding of the above requirements can iron out potential difficulties and give the project a high chance of succeeding.
Are there any useful books or magazines I could read?
There are many useful and well written books on the subject of working in health and social care settings. The ones I would recommend are written by practising facilitators as well as by academics who give an added perspective on the work: Creative Writing in Health and Social Care, Fiona Sampson (ed), Jessica Kingsley Publishers (2004); Prompted to Write, Zeeba Ansari and Victoria Field (eds), fal (2007); The Healing Word: A practical guide to poetry and personal development activities, Fiona Sampson, The Poetry Society (1999); The Self on the Page: Theory and Practice of Writing in Personal Development , Celia Hunt and Fiona Sampson (eds), Jessica Kingsley Publishers (1998); Writing Routes: A Resource Handbook of Therapeutic Writing, Gillie Bolton, Victoria Field and Kate Thompson (eds), Jessica Kingsley Publishers (2011) ; Writing Your Self: Transforming personal material, John Killick and Myra Schneider, Continuum Press (2010); Writing Well: Creative Writing and Mental Health, Deborah Philips, Liz Linington and Debra Penman (eds), Jessica Kingsley Publishers (1999); Writing Works: A Resource Handbook for Therapeutic Writing Workshops and Activities, Gillie Bolton, Victoria Field and Kate Thompson (eds), Jessica Kingsley Publishers (2006); Write Yourself: Creative Writing and Personal Development, Gillie Bolton, Jessica Kingsley Publishers (2011). Two more general books that give an overview to working with the arts in healthcare are: The Arts in Medical Education, a practical guide, Elaine Powley and Roger Higson, Radcliffe Press (2005) (Although this book has been written for medical students, it has some wonderful ideas and argues strongly for an arts-based medical undergraduate course. It is an enlightening read. ) Helping to Heal: The arts in health care, Peter Senior and Jonathan Croall, Calouste Gulbenkian Foundation (1993). There are many others. Lapidus members can access an extensive bibliography in the Members pages of the website. There are also books written for work in different educational settings that contain ideas that can be adapted to healthcare work. Always be on the look-out for something new and different. On the magazine front, Lapidus publishes an online journal for members three times a year featuring a wide range of articles on writing in health and social care. NAWE’s magazine Writing in Education frequently includes articles on the subject – an article search facility enables easy searching of back issues. And the bi-monthly digital magazine mailout.co covers a broad range of participatory arts including arts and health. Good luck with it all. © Wendy French November 2011
National organizations and websites
BACP (British Association for Counselling & Psychotherapy) www.bacp.co.uk
COSCA (Counselling and Psychotherapy in Scotland) www.cosca.org.uk
Culture and Wellbeing http://www.cultureandwellbeing.org.uk/ A national resource for creativity and health. Extensive directory of over 700 organizations and individuals using culture to improve health.
Healthy, Social, Creative http://www.healthysocialcreative.org.uk/ Information for health professionals working with people with long-term conditions.
Lapidus http://www.lapidus.org.uk/ The UK organization for writing and reading for health and wellbeing
NAWE (National Association of Writers in Education) http://www.nawe.co.uk/ The one organization supporting the development of creative writing of all genres and in all educational and community settings throughout the UK
mailout.co http://mailout.co/ The home of information, sharing and networking for participatory arts in the UK
The Poetry Society: Poetry in Healthcare archives http://www.poetrysociety.org.uk/content/archives/healthcare
Shape arts http://www.shapearts.org.uk/ Disability-led arts organization working to improve access to culture for disabled people.
Survivors Poetry www.survivorspoetry.com Promotes poetry by survivors of mental health
Voluntary Arts Network http://www.voluntaryarts.org/ Promotes participation in the arts and crafts across the UK and Republic of Ireland
The Wellcome Trust http://www.wellcome.ac.uk/ Works to improve human and animal health through public engagement, education and research.
Willis Newson http://www.willisnewson.co.uk/ Specialist arts in health consultancy Regional writing and arts in health organizations
England East Air Arts (arts program for Derby Hospitals NHS Foundation Trust) http://airarts.net/
Creative Arts East www.creativeartseast.co.uk
Suffolk Artlink http://www.suffolkartlink.org.uk/
Writers Centre Norwich http://www.writerscentrenorwich.org.uk/
North East Centre for Medical Humanities (based at Durham University) http://www.dur.ac.uk/cmh/
New Writing North http://www.newwritingnorth.com/
North West North West Arts and Health Network http://www.artsforhealth.org/network/
Arts for Health http://www.artsforhealth.org/
Manchester Literature Festival http://www.manchesterliteraturefestival.co.uk/
Writing East Midlands http://www.writingeastmidlands.co.uk/
West Midlands South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Arts for Health "Visit the South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Arts for Health website (opens in a new window)" t "_blank" http://www.southstaffshealthcare.nhs.uk/services/arts-for-health/
Writing West Midlands http://www.writingwestmidlands.org/
London CoolTan Arts (promotes the power of creativity to enhance mental wellbeing) http://www.cooltanarts.org.uk/
Creative Health Lab (offers creative writing on referral) http://www.creativehealthlab.com/
London Arts and Health Forum www.lahf.org.uk
Spread the Word (writer development) http://www.spreadtheword.org.uk/
South East Arts in Healthcare "Visit the Arts in Healthcare website (opens in a new window)" t "_blank" http://www.esht.nhs.uk/art
Healing Arts (Isle of Wight NHS Primary Care Trust) Contact Guy Eades, Director firstname.lastname@example.org
New Writing South EMAIL email@example.com
West Sussex Arts and Health Network Contact Anna Barzotti firstname.lastname@example.org
South West Arts and Health South-West www.artsandhealthsouthwest.org.uk
Arts for Health Cornwall and Isles of Scilly http://www.artsforhealthcornwall.org.uk/
Cyprus Well (writer and reader development) http://www.cypruswell.com/
Dorset Writing for Wellbeing Network Contact Sue Ashby email@example.com
The Writing Edge (writing for wellbeing) http://www.thewritingedge.com/
Yorkshire Artlink (Hull and the Humber) www.artlink.net.uk HYPERLINK "http://artlinkcentral.org/" Artlink (West Yorkshire) HYPERLINK "http://www.artlinkwestyorks.org/" http://www.artlinkwestyorks.org/
Northern Ireland Arts Care http://www.artscare.co.uk/
Community Arts Forum www.caf.ie
LitNetNI (literature development organization supporting writers and literature professionals) http://www.litnetni.com/
Prison Arts Foundation www.prisonartsfoundation.com
Scotland Artlink (Central) http://artlinkcentral.org/
Artlink (Edinburgh) http://www.artlinkedinburgh.co.uk/
Scottish Book Trust http://www.scottishbooktrust.com
Stories for Health http://www.storiesforhealth.org/
Wales Literature Wales www.literaturewales.org
Ty Newydd (the National Writers' Centre for Wales) http://www.tynewydd.org/english/home.html
A NAWE / Lapidus co-commission