Following recent high court judgements (regarding a case JB) concerning a client cared for by local authority wanting to use a sex worker, the call for a closer look at consent and capacity was highlighted.
Consent is giving permission to do something and in these cases, can refer to an agreement between participants to engage in sexual activity. Capacity is the ability to understand information and make decisions about your life.
Chroma believes creative arts therapies (CATs) offer a viable method to help case managers determine if their clients have the capacity for consent and could help care staff have conversations about the impact of these judgements.
In cases such as these, CATs are prepared for the high level of emotional need from the client and those who support them. When clients are found to not have capacity and are prevented from starting a relationship or using a sex worker – it is impactful, not only for the client, but for the family, carers and case managers, whose role it is to enable the person to live with the best quality of life. Arts therapists are equipped to help the client, and their network, through the psychological impact.
All modalities (Art Therapists, Dramatherapists, Music Therapists and Neurologic Music Therapists) are capable of finding out and demonstrating the ability to make decision and choice, to work with cognitive ability e.g. holding information in mind, looking at issues around memory, organisational/problem solving skills, and sense of self.
Above all else, creative arts therapies offer a supportive therapeutic space for addressing psychological issues.
Creative arts therapies serve as a holistic means of support that can enable clients to develop the skills they need to be able to show ‘capacity’. Arts therapists can support clients in having conversations with people around them about their needs and wants, as well as being able to work with the client and their network – offering emotional support regarding what they are expressing.
For example, a dramatherapist may use role-play to embody what it may feel like to start a relationship with someone. Role-play is commonly implemented in cases where clients require help to understand the emotional effect they have upon others regarding their inappropriate touching and behaviour – to great success.
An art therapist may use creating art as a means to help a client understand how they are presenting themselves to the world and how they see themselves. This process helps clients to understand personal safety and their vulnerabilities.
Music therapy, particularly neurologic music therapy, can focus on the cognitive abilities necessary for someone to understand what consent and capacity entails. NMT implements techniques that help boost someone’s ability to hold information in mind.
The issue of ‘ongoing consent’ means clients who cognitively struggle to hold information in mind (such as brain injury survivors) and who are unable to hold somebody else in mind, may be considered incapable of starting a relationship or seeking out a sex worker.
Creative arts therapists can implement techniques in sessions, such as song writing, to determine if a client is capable of demonstrating ongoing consent.
If the client can create a song, is able to plan and explain to the therapist the structure of the lyrics and music – creating the song to the clients satisfaction, and then, the following week, was able to recreate that process, it demonstrates the clients’ ability to hold information in mind.
Although this may not change the capacity assessment, it does help the multidisciplinary team and the clinician performing the capacity assessment as it allows them to see what the clients’ capabilities are. It also allows CATs to present information on behalf of the client.
Arts therapies have an innate ability to highlight everyday abilities through a creative medium. Asking a client to use art materials in a sequence to produce an object shows there is capacity to learn, and through this, demonstrates the possibility that they can learn the first step in, for example, dating – making conversation with someone. Dramatherapists also use role-play dating to help clients learn the sequence.
In essence, there is an interaction between a person’s mental capability and cognitive ability, so what creative arts therapists can do physically in sessions may contribute to how it is learnt.
Creative arts therapists, while they do specialise in one, generally bring elements of the other modalities into sessions when warranted. Creativity means adapting to each client’s needs at that time and by adapting, arts therapists help clients develop brain function whilst performing an activity.
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