Accreditation: Celia Hunt

Accreditation to work with the Literary Arts in Developmental and Therapeutic Contexts

by Celia Hunt, Reader in Continuing Education and Convener of the MA in Creative Writing and Personal Development, Centre for Continuing Education, University of Sussex 2004 

Amongst my hopes for Lapidus when it was first established in 1996 were that it would be able to organise training for people wishing to work with the literary arts as a developmental and therapeutic tool, and also to facilitate accreditation for such people. Training has been the easier of these to achieve, and it has been exciting to see the development in recent years of short training courses and the peer-learning programme organised by Anne Caldwell and others. The Postgraduate Diploma (now MA) in Creative Writing and Personal Development at the University of Sussex which I set up with Fiona Sampson in 1996 was also partly a desire to provide such training, and in the last two years the expansion of the programme into a two-year part-time MA has enabled us to include specific professional development options for people wishing to work with the literary arts in therapeutic contexts.

Accreditation has been longer in coming. Several times during my terms of office as Chair I suggested that Lapidus might consider introducing a professional level of membership, in addition to ordinary membership. I envisaged that, whilst Lapidus would be primarily a broad-based membership organisation providing for many different kinds of interest in the literary arts and personal development, it might also have a ‘professional wing’, as it were, which could act as an accrediting body. It was only at the Lapidus Conference in 2003 that accreditation was seriously discussed, in particular at the meeting of the Special Interests Group on Education. There was general agreement at that meeting that some form of accreditation was desirable, but there was insufficient knowledge amongst the group members of the various models of accreditation and what might be most appropriate for Lapidus members. At the final plenary of the conference the group suggested that Lapidus carry out a small research project to explore the possibilities and to make some recommendations on the basis of which we might then proceed to formulate our approach. Unfortunately there wasn’t sufficient money available in the budget to undertake such research, but the SIG Education continued to discuss the matter through email and focused on it again at the conference in Shropshire this year. This paper is in part a summary of some of the issues that have arisen in discussion, together with some thoughts of my own. I hope that it will be seen as part of the larger discussion that Lapidus is now having.

Who or what is being accredited?

There are, in my view, two areas of accreditation to consider: Accreditation for writers wishing to work with the literary arts in developmental and therapeutic contexts; and Accreditation for courses that fulfil, in part or in full, the training needs of those under (a).

I should say at the outset that I am not so concerned in this discussion with the issue of a ‘writing therapy’, which seems to loom large in some people’s fears about accreditation. For me, a writing therapist is someone who has undergone a therapeutic training of some kind and who uses the literary arts with clients as the main therapeutic intervention or one intervention amongst others. Personally I am not in favour of people calling themselves ‘writing therapists’ if they haven’t undergone a formal therapeutic training. I am not against the development of a writing therapy, but believe that it is important to distinguish between ‘writing therapists’ and what we might call ‘literary arts practitioners’ when thinking about issues of accreditation, and it is the latter with whom I am primarily concerned here.

This group consists of both established writers as well as those who are in the process of developing their writing but may not yet be published. They may or may not have counselling or therapeutic qualifications, but even if they do, they are unlikely to think of themselves primarily as therapists. They work or wish to work freelance with groups and individuals in the community, using the literary arts as a developmental and therapeutic tool. Within this group it is those who are not yet published or not fully established as writers and who wish to work in health and social care settings, who are most in need of accreditation, so that they can more easily obtain paid work. Established writers, by virtue of their publishing profile, have a greater likelihood of being chosen for arts-funded residencies, although acquiring formal accreditation might enhance their chances of being selected to work in health and social care settings. Writers who aspire to teach creative writing in further or higher education already have access to recognised forms of training and accreditation, in the form of teaching certificates and the like, although again formal accreditation would add another dimension to the work they are able to do.

There is no doubt that there is a pressing need for some kind of accreditation for these people. Enquirers to the MA often ask me whether the qualification they will get as a result of completing the programme will qualify them to work in health and social care. At the moment what I say in response is that the MA is an academic rather than a professional qualification, i.e. that it is not accredited by any professional body outside of the university. Therefore technically it does not qualify people to be ‘literary arts practitioners’; indeed that there is no such formal qualification at present. However, as the MA is the only postgraduate programme in Britain that includes an element of professional training for this kind of work, it is likely to stand people in good stead in obtaining work in the field. Obviously it would be advantageous both to us as a provider of education and training, and to people wishing to work in the field, if the MA were formally accredited by Lapidus as a professional training for work of this kind. By accrediting programmes such as this, and other such courses and programmes that already exist or are likely to be established in the future, Lapidus would be able to ensure that the training available to literary arts practitioners is thorough and appropriate.

Who will be doing the accreditation?

There are, as I see it, two main models of accreditation that might be useful to Lapidus as a starting point for thinking about a model of its own. The first is a vertical or top-down approach, i.e. Lapidus or a grouping within Lapidus acting as an accrediting body; the second is a horizontal approach, i.e. Lapidus as an umbrella for a peer accreditation network.

A vertical or top-down approach might involve a ‘professional wing’ within the Lapidus membership acting as an accrediting body, devising a code of practice, and identifying appropriate kinds and amounts of training and experience needed to work as a ‘literary arts facilitator’. People wishing to obtain such accreditation would be expected to provide evidence to an accrediting committee that they fulfil these basic requirements, such evidence including, for example, references from employers to indicate good practice. The accrediting committee of existing professional members would evaluate this evidence and decide whether or not the applicant should be added to the register. This is a model adopted by many professional bodies. Whilst the National Association of Writers in Education doesn’t require specific training for inclusion on its register of writers available to work in education and is certainly not an accrediting body of the above kind, it does expect people on its register to have had a certain amount of experience of working in schools and to be able to provide good references from employers as evidence.

An example of a horizontal approach to accreditation is the peer network model of the kind that operates in the therapeutic field, the Independent Practitioners Network (www.ipnet.org.uk). According to its website this is ‘an alternative structure for validating and monitoring therapists, counsellors, facilitators, and others in the field. It was founded in November 1994. Its central concept is that membership is by peer group: the members of each peer group (of at least five practitioners) stand by each others’ work, and also by the work of at least two other member groups to which they are linked. In this way a web of self and mutual responsibility is woven, where loss of confidence in an individual or group will mean that links are withdrawn and their membership will lapse’. ‘Standing by’ involves responsibility for each other’s process of self-monitoring, helping in the resolution of any problems arising between practitioners and clients, and offering support and challenge as appropriate. The network has no permanent centre, but individual members take on specific roles for short periods of time. There is a code of practice, to which member groups have to agree, and individual members are expected to attend at least one of the three national gatherings each year. Members are normally fully trained as therapists, counsellors, etc. before they join a group.

Either of these two approaches could provide a basis on which to develop a workable model for accreditation under the auspices of Lapidus. The latter or some variant of it might be particularly suitable for literary arts practitioners, particularly as Lapidus already has a network of local groups, and might assuage fears of a potentially heavy-handed top-down approach, but of the two models it would certainly be the more difficult to operate and might not be sufficiently rigorous to fulfil the purposes of accreditation.

What is the purpose of the accreditation?

Accreditation for literary arts practitioners would serve several different purposes. First, there is a huge growth in this area of work. Recent applicants to the MA, for example, are using or want to use the literary arts with a very wide range of groups and individuals including children, young people, older people, asylum seekers, HIV sufferers, women going through the menopause, women who have lost babies, people in the business world, people with mental health problems or learning disabilities, people with borderline personality disorders, people who have suffered strokes or spinal injury, people in prisons. Some of these applicants are already health or social care professionals and don’t need separate accreditation, although they are seeking additional training. Many of them, though, are not in any profession or are looking to change their profession, in order to find a more meaningful way of making their living. Working with the literary arts as a developmental and therapeutic tool in some area of the community appeals because it not only has the potential for enhancing their own creativity, but it is a creative and potentially fulfilling way of working with others.

Some of those who have completed the MA tell me that finding paid work in the community has proved to be quite difficult because employers, both in the public and private sector, are wary. One factor in this is that, as there is no formally recognised profession of ‘literary arts practitioner’, employers are not yet sufficiently aware of what such a person does. Another factor is that people who work in areas such as the Health Service are normally expected to have undergone certain kinds of training, to obtain certain kinds of qualifications and to have a certain amount of experience. Employers are unlikely to take people on to work with vulnerable patients or clients if they are not fully convinced that these people know what they are doing. They want evidence and credentials. Accreditation would facilitate this.

Second, accreditation would provide a means of regulating practice – at least to some degree – so that vulnerable people can be protected. Facilitating therapeutic writing is not easy; it’s not something we automatically know how to do, unless we have training and experience in healthcare or pastoral work. Personally, it’s taken me years to work out what it is I’m doing in an educational setting and how best to do it, and I would certainly have benefited from a training course when I started out, or from the existence of a peer network. One of the students of the Postgraduate Diploma in Creative Writing and Personal Development, Ceri Davies, undertook a piece of research as part of her studies, which compared the attitudes of visiting writers working with clients in a healthcare context with those of occupational therapists doing the same thing. Her findings showed that, perhaps not surprisingly, there was much less awareness of ethical issues and boundaries amongst the writers than amongst the professionals.

We clearly need to be more aware of these kinds of issues when we use the literary arts as a developmental or therapeutic tool. We are not therapists and yet the work we do has a strong therapeutic dimension. How do we handle people in our groups when their writing puts them in touch with painful or frightening material? How do we make sure that we don’t plunge them into emotional crisis? What sort of relationship do we need to have with care staff in a health or social care context? An agreed code of practice and some firm expectations as to what kind and amount of training is necessary to carry out this work safely and effectively would guide our own practice and protect those we work with. These requirements would also go some way to reassuring potential employers.

Thirdly, there is the question of support and supervision for writers who work in this field. As important as the effects on the people we work with are the effects on us as practitioners. How do we deal, for example, with the serious illness or death of people we encounter when we work in a hospital or a hospice? One of the first residencies I set up when I was Literature Officer at South East Arts was at the Princess Alice Hospice in Esher, Surrey, in 1992, and I remember vividly the writer-in-residence, Colin Archer, telling me how difficult it was to cope with the deaths of the people he was working with. On average, he said, he only had about ten days with any one patient before their demise. Some writers in these circumstances find their own means of support and fortunately many residencies these days do have inbuilt provision for supervision and support. But this is not always the case and, whilst a hospice is perhaps an extreme example, the emotional strains of working with the literary arts as a therapeutic tool can be significant in any setting, even in an educational context. A professional peer network of the kind discussed above could help to provide supervision and support for all of us working in the field.

Accreditation – a dirty word?

I know that some Lapidus members don’t like the idea of accreditation. Prior to the one-day conference on this topic some emails were circulated to those attending from people who couldn’t be present but who wished to contribute to the discussion nevertheless. Those emails argued passionately that introducing any form of accreditation would necessarily impair or undermine the subtle and creative process involved in working with the literary arts in health and social care settings. I read these emails in full and I have to say I’m not persuaded that this is the case, although I am aware how carefully we need to think about the kind of accreditation that would work best for our members and for the kind of work we are doing. Perhaps it is the word ‘accreditation’ itself that is the problem, with all the red tape and formality it implies. Interestingly the Independent Practitioners Network is currently discussing whether to replace this term with ‘evaluation’ or ‘accountability’.

Whatever we call it, we need something of this nature. The society we live in requires it and with good reason, and one way or another it is going to happen. As I have been saying over many years, if Lapidus doesn’t provide a framework for it, someone else will, and that will be a great pity, because it will then be out of our hands, and we might find it extremely difficult to have an influence over what is instituted. I worry about the possibility that the Health Service might introduce its own requirements before we have had time to think things through for ourselves. I worry too about adopting the model of the National Association of Poetry Therapists in the US, which would effectively formalise therapeutic writing into a ‘writing therapy’. As I have said above, I don’t think this is the right model for those people who are first and foremost writers but who wish to work with the literary arts as a therapeutic tool in health and social care. That is not to say that there isn’t a place for poetry therapists, or that Lapidus could not provide a place for poetry therapy under its ‘broad church’ umbrella. A professional category of membership could cover different kinds of practitioners, as NAPT’s indeed does, but without necessarily using their terminology.

Thinking about how we might bring a more formal structure to what we are doing when we use the literary arts therapeutically is important and urgent. It will benefit us as practitioners and those people with whom we work. We have a great deal of experience to draw on from amongst the Lapidus membership. The challenge is, as Emma Metcalfe said at the SIG Education discussions in April this year, to find a way of balancing creativity with society’s requirements. I do hope Lapidus can take the lead on this, and soon.

Celia Hunt, 2004

This paper is based on my talk to the Lapidus Accreditation Day on 15th May 2004.  This term was used at the Accreditation Day and I have adopted it here.   Where training is concerned, it would be advantageous for all creative writing teachers to have some training in the therapeutic dimensions of teaching, especially where people are using an autobiographical approach. The professional development courses of the MA in Creative Writing and Personal Development are as useful for working in education as in health and social care.   This is apparently being reconsidered, as standing by two other groups has been found to be too onerous.  We are currently receiving some forty applications per annum for the part-time MA; a full-time programme will be available in addition from October 2005.  C. Davies (1997) ‘Occupational Therapy and the Visiting Writer: A Comparative Study of Attitudes to Facilitating Creative Writing Groups in Mental Health Settings’, unpublished dissertation for the Postgraduate Diploma in Writing and Personal Development, University of Sussex.