Report to the Neighborhood Mini-Grant Program

from The Circle of Friends for Mental Health

Evaluation Project “We Have Questions”.

Introduction

by John Dame

First of all, we would like to thank you for this opportunity; I know it has been one of the most enlightening experiences of my life.

Carolyn came to me and said that she wanted me to help with writing a grant proposal. We worked on the grant a number of times that month, and submitted it when we felt it had been completed to our satisfaction. Carolyn suggested that we contact Jim Fickens from Clean Start, a clubhouse operated by CPC (Community Psychiatric Clinic) and to enlist his support for helping to create the surveys. Jim said that it was of critical importance to be able to gather measurable information and to relate it to progressive recovery, and that the aim of the study should be to measure a participant’s satisfaction, self-expression, self-confidence, communication skills, and interpersonal relationship building skills in regard to their participation in various art and music groups. These were skills that we were interested in because it shows progressive recovery when clients start

to work at a higher level of functioning by working with others to build community.

As this report unfolds, we shall present a history of Circle of Friends for Mental Health, the survey data ( listed under percentages of respondents answers), and an analysis of that data, and finally an evaluation of how we believe our organization effects and supports the Mental Health community. We will use data from other organizations and testimonials to support our findings, and give you a comprehensive history of Clubhouses (appendix I).

As we started to gather information, the clients functioning level became an issue, as many of them have had some difficulty in filling out the survey and required some extra assistance. Some of the answers they gave are interesting to say the least, but also analyzing and assessing their answers has taken more time than we were hoping to spend.

The information we have collected shows that clients not only enjoy doing the art, but also benefit greatly from the reduction of stress and anxiety, and build communication skills. But the biggest issue we have faced is building trust. So, building trust through building community is one of our main goals that are going to allow Circle of Friends to expand its role in the Mental Health Community.

Different methods of collecting the information;

Creating the survey questionnaires was a bit difficult and it took several attempts to get it right. One of the problems we faced at the beginning was the reluctance of the clients to participate in the survey. Again, this is a trust issue and in many cases we are just

beginning to earn their trust. We thought that most of the clients would be able to fill out the surveys on their own, which is the case, but many of them required additional help when filling them out. At Clean Start I only had to help two clients fill out the survey, but at Summit Inn the clients needed more direction and to have the questions explained to them. When giving the survey at Wallingford House two of the clients there also required a bit more help, and the clients at Emerald House were mixed in their ability to fill out the surveys.

Please note: There is a variable here in that clubhouses and congregate living facilities have different classes, different teachers, different mediums, and so there is a difference in the quality of instruction. The surveys were designed to fit specific classes, and different questions appeared on the survey for that particular class.

Table of contents

Page 2-3 Introduction by John Dame

Page 3 Different Methods for Collecting the Information

Page 4 Table of Contents

Page 5 Circle of Friends Program Details

Page 6 Circle of Friends Participants

Appendix I Comprehensive list of survey questions and answers

Appendix II History of the Clubhouse

Appendix III Brief Description of Instructors

Appendix IV Drumming Project at Clean Start

Appendix V Map of Sites

CIRCLE OF FRIENDS Program Details.

“When Art enters us, it performs its healing magic, like a massage for the soul.”

- Jan Phillips

CIRCLE OF FRIENDS sponsors classes for groups of 10-20 mentally ill adults, some of whom are unable to live independently. The classes last an hour and take place at locations overseen by two Seattle-based community mental health agencies, Community Psychiatric Clinic and by Seattle Mental Health. The classes allow for a wide latitude of activities and goals. This year we have had 1500-2000 individual contact hours.

Inventory and Map. See Appendix V..

Circle of Friends Classes

Most CIRCLE OF CARE classes are held at clubhouses and living facilities for adults with chronic mental illness. Some are convened in public places like the Seattle Center. The first classes were held in the spring of 2003 at three Seattle clubhouse facilities for adults with mental illness. The three facilities included Wallingford House, Emerald House, and Keystone. Five instructors led a series of seven weekly arts and crafts classes at Emerald House. Three artists led classes at Wallingford House, and a weekly creative writing group was convened at Keystone. Very popular “laughter” sessions were held in which participants were encouraged to share their humor and laugh with each other.

In 2004 a second weekly arts and crafts classes was added at Emerald House; Wallingford House continued its arts and crafts class and added a knitting class; and the writing class continued at Keystone.

The arts and crafts and writing classes were continued in 2005. In addition Emerald House started a weekly drumming group, and Rainbow Creek in Bellevue initiated an arts and crafts group.

The program expanded during the 2006-2007 school year to include new art classes at Summit Inn-Community House, Clean Start, Seattle Center House, and Noel House. Wallingford House and Emerald House continued weekly afternoon arts and crafts classes. Keystone continued its writing group. Clean Start offered both an art class, followed by music sessions on Friday afternoon. A photography class that used donated film and cameras was held on Wednesday afternoons at Seattle Center House. The Summit Inn Art class met on Wednesday afternoons. An art group was convened on Wednesday afternoons at Noel House.

The schedule for fall 2007 includes afternoon classes at all seven facilities. The only shift in focus is from writing to a physical activity at Keystone. Painting, music, creative writing, drumming, and crafts will continuing on a weekly basis.

Photography classes and drumming circles are in the upcoming program plan Art contributions have been varied. Interns and volunteers come to us through the
”list serve” kept by the Universities and organizations and by requirements of the schools for community work. When we find someone with a skill they will share, we try to find the correct place and connection. The artists from the Kirkland Art Center, have stepped up when we were in need of substitutes, or leaders to tackle a first event like the “Art in the Park.” Potters who have skills, printmakers, watercolorists, readers, quilters, all have shared their skills and good will with us.

Circle of Friends Participants

Participants in the CIRCLE OF FRIENDS program are adults ages 18 and older who have serious mental illnesses and are living in King County. Some are living in congregate care facilities, some are homeless, and some live in Section 8 apartments.

They are members of clubhouses or residents at facilities where the classes are held. Their abilities vary considerably, and the groups take on different identities depending upon both the level of functioning and the personalities of the members. In 2004-5 an estimated 420 adults with mental illness participated in the COF program for a total of 1,500 contact hours.

Circle of Friends Instructors

Circle of Friends classes are led by volunteer instructors and often are also supported by presence of counseling staff from the clubhouses where they are convene.  Volunteers from the community and interns from various University and Community Colleges lead and support the classes.  In the spring of 2004 the University of Washington recognized the Circle of Friends as a program in which interns could receive credit for participation.  Over the years the Circle of Friends has enjoyed commitment of over 28 talented volunteer instructors.  They have come from art departments at our local universities, from the community of professional artists and as professionals interested in supporting persons with mental illness.  Interns attend non-profit board and committee meetings and participate in fundraising activities.  Successful instructors reflect a blend of artistic talent, energy and commitment, and sensitivity to and empathy with the challenges of mental illness.  The evaluation report summarizes the following information about the 30 instructors:  where they came from, what their artistic skill is, and how long they have worked with the program.

Where did COF Instructors come from?  Eleven instructors were art students from UW, and 2 were studying at SCC.  Seven instructors have been professional artists; three have been art teachers, one a social worker, and one a nurse.

What were their artistic skills?  Thirteen of the 30 instructors could be considered “generalists” across a range of artistic areas. The remaining 17 could be considered specialists in a broad range of artistic areas including drama (4), drumming (3), music (1), drawing (1), pottery (1), graphics (1), painting (1), writing (1), quilting (1), and photography (1).

How long have instructors worked with the program?  Five of the COF instructors have volunteered for 2 years or longer, five have given 1-2 years.  Six have taught one or two whole classes (equivalent to one academic quarter); nine have volunteered briefly, and three volunteer from time to time.

In Appendix II is a brief description of the contributions from these 30 instructors.

Special Events and Products Shared with the Community

Besides convening regularly scheduled classes, Circle of Friends sponsors other arts related events in the community.

Holiday Gift-Making. At holiday time Circle of Friends goes to many more facilities to hold gift-making events. Many community members step up to help when we make

holiday gifts. In addition musical groups accompany us to perform at the various sites. In 2004 we held special holiday events at three clubhouses and residential facilities. In 2005 we expanded this program to 6 locations and by 2006 to 13 locations.

Other events occur when the opportunities present themselves.

Drumming. A drum circle has a powerful, spontaneous improvisational flow of changing rhythms that creates a space of unity, creativity, and empowered self-expression. Volunteers procure materials, lead clients in making their own drums, and then all drum together. COF has held a number of drumming events described below.

Drumming at Emerald House. A volunteer who had worked with homeless people before and knew the population led drumming. He had many kinds of drums and a history of different countries and their instruments. Everyone learned about drums, music and history and had a great time playing the variety of things he brought.

Drumming at Clean Start, workshop for Social Workers led by an African drummer who volunteers with Circle of Friends and leads “Oceanmi,” a professional music group. The production was excellent and was written up in the Clean Start newsletter by Jim Fickens, the Clean Start Director. (Appendix IV )

Drumming in the Park by our African drumming volunteer. The leader always wears his African clothes when he comes to lead. He is fun, refreshing and engaging both personality wise and as a skilled historian and musician.

Publishing writing. The creative writing groups have produced and sold books of their stories and poems, with proceeds going back to the clients.

Attending local theater. The drama group attended three theater productions at Public Theater as part of their drama experience.

Visiting art museum. The group from Emerald House visited the Frye Museum when “mentally ill” artist was featured.

Displaying art in public. Circle of Friends has been invited to give two art shows. The first was at Form/Space Atelier Gallery in Seattle where Emerald House students

showed their art. The gallery had a wonderful opening with music, food and crowd. Several members attended. Two pieces were sold. The Espresso Splendido showed

Wallingford House art last year during December. All 29 pieces were sold. Everyone was thrilled! The owner told us he would find us more places to show. The Emerald House group created a seven ft tall bamboo sculpture of Pegasus. They are currently seeking a place for display.

Producing plays. A friend of Circle of Friends has written a play for the organization that is comprised of six powerful vignettes about the meaning of art and creativity in the lives of persons with mental illness. Two of the play vignettes have been shown on Seattle TV.

Publicizing Circle of Friends. Members of the Circle of Friends board and participants have taken advantage of several opportunities to publicize the organization’s activities. Carolyn Hale was featured as “change agent” in an article in Real Change, the local weekly newspaper distributed by members of the homeless community. Carolyn was also interviewed on Seattle TV in the show where two of the play vignettes were broadcast. A client at Emerald House spoke about Circle of Friends at the King County Council meeting. He was asked by Acorn, a non-profit organization from the Asian community to speak in support of the county funding the “1/10-cent for mental health.” He spoke wonderfully and most in attendance were not aware he has a mental illness and is deaf.

Volunteers sponsored an “Ashiana Dinner and Education Night”, our first event to spread the word about our work and raise some funds for basic supplies. Three East Indian couples lead in with a dinner, with East Indian Theme and the friends painting hands with henna, East Indian ford prepared by Tandoori Fire Restaurant and board members sitting at each table telling our goal and program ideas. Usha Jose continued to work with us a bit as a teacher and as an IT person. She is working on a Master’s degree at The UW and informs me that she will have some time this year for us to do some IT and wants to continue our connection.

CIRCLE OF FRIENDS Evaluation Methods:

The CIRCLE OF FRIENDS evaluation, entitled: “We Have Questions: Evaluation of Circle of Friends for Mental Health Art Therapy Project,” was funded through a grant from the Washington State Consumer and Family Evaluation Minigrant Program. The evaluation was carried out by an instructor who served as the project director and the president of the board of directors, who served as the evaluation project co-director. The evaluation team received technical assistance from a program evaluation expert at the University of Washington. The evaluation had two goals. One was to systematically document the activities of the program to date. The methods for carrying out this part of the evaluation was to review historical materials including class schedules, board meeting minutes, instructor rosters, published articles, and testimonials. These materials were organized into a descriptive report. The second was to systematically gather information from program participants, instructors, and counselors to understand program benefits and shortcomings. The method for carrying out this part of the evaluation was to design and administer consumer satisfaction questionnaires. The project director conducted this

part of the evaluation. Questionnaires were administered to clients at six sites, including Emerald House, Clean Start, Keystone, Wallingford House, Summit, and the

photography class. Responses from participants were tallied separately for each site. Responses for instructors were combined across sites, as were responses from counselors. Comments that were written on consumer satisfaction questionnaires were transcribed into the report.

Different questionnaires were designed for different types of classes (art, music, photography, writing). In general, however, the questionnaires ask about such topics as the value of the class, which aspects of class participants like the most, whether participation helped to accomplish other goals, what skills were learned, whether the class was fun, and what could be done to improve the classes. Questionnaires asked gender and age of participants, but were otherwise anonymous. The evaluation project director administered them before or after group sessions. Participation in the evaluation was voluntary. Those who participated received a small incentive (cookie and can of pop).

The Clubhouses Clean Start (CPC); Clean Start is a part of Community Psychiatric Clinic, and has been in service since 1987. Inspired by the Fountain House format, it started out as a place where recovering addicts could go and take a shower, get a fresh change of clothes, and do their laundry, hence the name Clean Start. Clean Start has served many downtown clients over the years, with a variety of services such as mental health education classes, community resource referrals, team building groups, meals, counseling, clothing, as well

as art and music groups. Clean Start encourages its members to actively engage in recovery by taking steps toward rebuilding self-confidence, productivity, and independent community living. In general the clients who attend Clean Start seem to be at a higher level of functioning because of the life skills that they exhibit.

Emerald House (SMH); Emerald House is a clubhouse operated by Sound Mental Health and serves a substantial amount of clients. The services range from counseling to protective payees, to medication dispensing, meals, and housing, and entertainment such as field trips to the Arboretum, art classes, and movies. The clients at Emerald House

function at different levels, but seem to be at a lower functioning level than the ones at Clean Start.

Summit Inn (CH); Summit Inn is a resident housing unit operated by Community House. The clients at Summit are at a level of functioning that need a lot of supervision and it requires them to live at this facility so that they can be provided with care constantly. One of the biggest issues at Summit has been earning the client’s trust. Since I have been working there, the clients are slowly, but surely joining in on the art classes, even though many of them have been on-lookers foe several months before they felt comfortable

enough to join in. Services at summit are comprehensive due to the amount of care needed by the clients.

Keystone (CPC); Keystone is a congregate living facility for thirty-five clients. The people who live there are generally in need of medical supervision, but are better able to take care of themselves than many others that we work with. The Creative Writing class there has been running for around three years and is led by a nurse. Two books have been written called “The Keystone Chronicles”, where the clients submitted the stories and poems. The group has also decorated baskets. Unfortunately, the teacher is leaving and the group is in need of a new instructor.

Wallingford House (CPC); Wallingford House is another clubhouse operated by the Community Psychiatric Clinic. Initially started as a clubhouse, it has gone through many changes in recent times, and is in the process of rebuilding itself. Wallingford House offers a number of services including meals, art classes, counseling and worker retraining. The clients at Wallingford House function at different levels, some higher than others.

Noel House (Catholic Charities) Noel House is a 20 homeless shelter for women and a few beds for transient women in the downtown Seattle. Between eight and ten people come.. Our wonderful artist teacher has been welcomed and tells poignant stories that come forth during the classes.

Photography Class (COF); Circle of Friends operates their new photography class from Century Square in Westlake Plaza. This class is open to clients from any mental health facility. Since its inception at Seattle Center, the class has doubled in size and is expected

to keep growing, which has presented us with the challenge of keeping up with the demand for cameras, film, and developing. This is just a photography class and offers no support services other than the camaraderie of working together in groups. The clients that participate in the photography class seem to be at a higher level of functioning as they must be able to get to the class by themselves, and operating a camera takes a bit of skill.

Percentages of respondents answers;

Clients: 52 respondents total;

How long have you attended this class? 27 respondents; 15 % first time, 4 % 1 month, 15 % 3 months or more, 20 % 6 months or more, 36 % 1 year or more, 8 % 2 years or more, 12 % 3 to 5 years.

How valuable is this class to you? 36 respondents; 6 % not valuable, 12 % average, 27 % fairly valuable, 66% very valuable.

How do you feel when you are in class? 36 respondents; 3 % not good, 27 % average, 36 % fairly good, 45 % very good.

How do you feel after class? 35 respondents; 3 % not good, 12 % average, 27 % fairly good, 48 % very good.

Do you think about the work you did in class at other times during the week? 39 respondents; 78 % said yes, while 22 % said no.

How has the class affected your self-confidence? not improved, improved a little, greatly improved. 3 % not improved, 45 % improved a little, 54 % greatly improved.

Do you feel that you have been successful in this class? 35 respondents; 90 % said yes, while 10 % said no.

What skills have you learned in this class? 10 respondents; 100% said positive things such as conservation, patience, technique, social and people skills, sobriety, relieves the pain, gratitude for movement.

Has this class helped your: job skills, communication skills, self-confidence? 33 respondents; 18 % said job skills, 30 % said communication skills, 51 % said self-confidence.

Have you made new friends through class? 27 respondents; 78 % said yes, while 22 % said no.

Is this class fun? 24 respondents; 90 % said yes, 10 % or less said no.

Does the group laugh and express humor? 36 respondents; 90 % said yes, while 10 % or less said no.

How do the teachers make you feel? 31 respondents; 45 % said fairly good, while 55 % said very good.

When we teach this class again, will you come back to do it again? 7 respondents; 86 % said yes, while 14 % said no.

Instructors; ; 8 total, 5 female, 3 male, ages 20-73.

How often do the clients show up to do the classes?

12 % uncertain- 12 % said every other week- 75 % said on a regular basis.

Have you noticed any changes in the participants who attend the art therapy groups? Work better together, less angry or emotional, happier, more focused, other? 100 % said happier- 37 % said all apply.

Do participants talk about their art during the week or at other times that you know of? 36 % said don’t know- 36 % said yes- 12 % said I hear they do from the counselors.

Are they happy to have their art displayed, or when they do music therapy, to be listened to? 12 % uncertain-82 % said yes.

What kinds of activities do they enjoy the most? Drawing, painting, masks, collages, clay, charcoal, murals, apron painting, signs, other?

Please note that instructors are teaching different classes so this set of answers is negligible. Too many variables, so I’ll list a few responses.

Most said drawing, painting, and collages, for the art classes. One instructor said variety is a plus; they seem to enjoy them all. Creative writing class instructor listed poems, short stories, Haiku’s, and about their week and current events. One instructor said photography and music. The clients want to do tye-dye t-shirts. We made a bamboo sculpture of a flying horse that stood seven feet tall, it was great fun.

Do you have any suggestions that you think could improve the groups?

Again responses.

Have more supervisors to encourage clients to participate in the classes.

Meet more often. Longer class time, increase to 3 ½ to 4 hours (for clay). Better materials (voiced by many instructors). Have all of the new instructors meet with the board of COF and work up new strategies for motivating clients and increase instructors abilities to apply art techniques. We have plenty of professionals already, we just need to get together and bump heads. The music teacher wrote: If more clients could show up on different days, then yes that would be effective.

What ways could we get the word out about our classes to more people?

100 % said flyers, posters, or colorful signs.

Have the instructors always been respectful to the staff and participants?

100 % said yes.

Is there something that we do that has caused a problem or been unconstructive?

72 % said no. 12 % said no, but I believe we can be more constructive. 12 % said wash the floors after art class, not before. No one said anything negative here.

Should we enlist a professional or knowledgeable trainer to teach the students/instructors how to work with the participants?

50 % said no (but they are artists)- 12 % said sure- 12 % said its up to us- 12 % said yes, but we already have professionals, we just need to get together and bump heads.

Should we offer art classes more than one time a week?

12 % said no, we offer 4 classes a week- 72 % said yes, most emphatically- 12 % said that it depends on the facility, some already do, and some could use more. The music teacher said; Yes, if we could get more clients to show up on different day, then it would be effective.

Counselors; 5 total, 3 male, 2 female, ages 31-55

How often do the clients show up to do the classes?

40 % said every once in a while, 60 % said on a regular basis.

Have you noticed any changes in the participants who attend the art therapy groups? Work better together, less angry or emotional, happier, more focused, other? 60 % said happier- 40 % said more focused- 1 also said it seems to give them better insight into mental illness.

Do participants talk about their art during the week or at other times that you know of? 100 % said yes. 1 said art is the frequent topic at the club.

Are they happy to have their art displayed, or when they do music therapy, to be listened to? 100 % said yes, 1 said they are very proud- 1 said the display of a client’s art seems to be a great boost to the clients’ lives and self-esteem- 1 said yes, very much so- 1 said yes, they like to put their art up on the walls- 1 just said yes.

What kinds of activities do they enjoy the most? Drawing, painting, masks, collages, clay, charcoal, murals, apron painting, signs, other?

1 said I don’t know, but its good to have a structured activity- 1 said I don’t know- the others said drawing, painting, collages, writing, and music.

Do you have any suggestions that you think could improve the groups?

Have more supervisors to encourage clients to participate in the classes.

Meet more often. Longer class time, increase to 3 ½ to 4 hours (for clay). Better materials (voiced by many instructors). Have all of the new instructors meet with the board of COF and work up new strategies for motivating clients and increase instructors abilities to apply art techniques. We have plenty of professionals already, we just need to get together and bump heads. The music teacher wrote; A monthly goal of a certain amount of songs that the clients should complete within that time frame.

What ways could we get the word out about our classes to more people?

100 % said flyers or posters, colorful signs, or brochures.

Have the instructors always been respectful to the staff and participants?

100 % said yes.

Is there something that we do that has caused a problem or been unconstructive?

100 % said no.

Should we enlist a professional or knowledgeable trainer to teach the students/instructors how to work with the participants?

60 % said no- 20 % said I always think training is worthwhile- 20 % said yes, professional instructors and teachers would be an excellent addition to our efforts.

Should we offer art classes more than one time a week?

40 % were unsure- 40 % said no, once was enough for their program- 20 % said yes.

Community impact has been growing. Our mailing to supporters brings the information about our program and the hopefulness that it spreads. The wonderful examples that come forward bring a clear picture of the small but continuing successes we have.

Family members from out of state have asked to meet us. I have one meeting scheduled for next month. The National Alliance for the Mentally Ill “Family to Family” students often maintains interest in the program. Many groups that are now asking us to help, asking for information and wanting to cooperate with us. Harborview Hospital’s Mental Health program asked us to lead art tables at their first “Art in the Park.” Very Special Arts of Washington asked to cooperate with us in finding artists for their gallery and has invited us to show photographs from our class in the gallery later, probably in January 2008.

Rainbow Creek, a clubhouse on the Eastside wants an art leader. It has been difficult to find students with a car or people who are willing to cross the bridge to the Eastside. They know our work and have recommended places for a new volunteer “reader.”

The Form/Space Atelier Galley and the Espresso Splendido have helped persons in the community by showing their artwork. People can begin to understand the abilities and the struggles of these participants. Peace in the Street Kids has asked us for an art teacher. They work with kids from ages 17-26 and recognize that art builds health.

Art vs. Art Therapy?

Testimonials from Surveys and Recollected Comments

Below are comments that were written by members of the Circle of Friends for Mental Health, participants, instructors, board members, and others and were collected over the years.

Holly Ann, intern, now graduated: “I had so much fun working with Circle of Friends. It has been one of my favorite moments so far in my college career. Thank you for giving me the opportunity.”

Margaret, creative writing instructor: “I had a really good class on Tuesday. We are getting somewhere with the writing and I seem to be getting more imaginative writings and answers. So I think we can find some very good short pieces for the website and I have a smaller group these days. In fact, some of what was written on Tuesday would be good to share with others. One member of the group is of Japanese descent (1^st generation), and his grandmother and mother are no longer alive. In his story about kite

flying, he wrote about his grandmother and mother sitting by the campfire making mushroom tea, while his father and he flew kites. I had asked them to imagine themselves on the beach flying a kite. But he is so clever. He wrote what was happening between his grandmother and mother, while he and his dad were in the background. It was poetry. You would have to have been there. It was just so touching.”

“One thing I do know is that maybe you don't realize how many people's lives you have touched by little "ripples" like circles. I have met a lot of people because of you, and you have had a big impact on my life. If it wasn't for your boldly suggesting that I do a writing group at Keystone, my life would not be so rich.”

Mac, consumer/artist: “The art you left on our walls is, by the way, very thrilling and several people were quite taken away exploring it.”

Terry Proctor, “Thanks for standing up so valiantly for this much maligned community. Peace.”

Sara, volunteer artist and COF board member: “It’s truly amazing how great the people at Wallingford House have been. Last week they made a goodbye card for us. And when I told them that I was going to continue volunteering they were all really happy to hear that. It’s also amazing how different the houses are but both have good atmospheres. I’ve grown to like the both for different reasons.”

Family member after Holiday event: “I was reminded of what courage, hope and faith mean as seen through the eyes of many residents who persevere despite incredible challenges.”

Liz, intern. “Thanks so much for all your care and dedication to this program, and for all of the support that is given us as interns. It has been really amazing and wonderful to be a part of the Circle of Friends. Thanks so much.”

Mindy Meyering “May God Bless you and everyone else who gives their time, talent, kindness and caring to help those who suffer from mental illness. Happy Holidays and all the best in 2007!”

Susan, COF volunteer: “You are a great organization with amazing ideas.”

Johenses, Harborview Medical Center CEO: “Art provides positive ways to express emotions, focus concentration, rebuild motor skills. It gave our patients a sense of pride. It gives immediate feedback. Art lets you see inside somebody. When people want to write they have things to tell us. Anything that makes a person more alive, makes the person more creative. Poems can be outrageous and fun or they can give a peaceful, elegant mood that seems to out of place today. This is a retreat that we need more than ever. Achievement motivation is like a muscle, the more you use it, the stronger it grows.

Inner self feeds the whole self.‘

Carolyn, President COF: “A large, shy, black friend, who has a beautiful voice, sings to me when we do art at one of the Centers. I’m trying to get him to sing at our holiday events. Artists in our group are now making décor and paintings to complement the writings, ‘Keystone Expressions’ that is now their second booklet.”

“Arts Create Health! Help us in a great cause! Art, music, writing, drama, for those with brain illness!”

From COF flyer: “Charles, a very soft spoken client hovers around to join our art group and gently takes a chair trying not to get in someone’s way. The student intern encourages him to sit and use the materials and learn skills using a variety of art forms: paint, charcoal and beads, Japanese inks, etc. Charles smiles and often sings with a low melodious voice ballads of the South in tones so smooth tones that one thinks one of the great black singers is with us. Sometimes the voice is full of fun and we join him …“I’ll get a line and you get a pole, honey,” I’ll get a line, you get a pole, Babe,…we’ll go down to the fishing hole”. The music lightens up the day as the group makes holiday gifts.

Courageous young persons like Charles receive $58.00 a month for all their needed supplies, for any movie, museum or activity they want for the month. Due to the seemingly relentless cuts to support the Mental Health System, the Circle of Friends are stepping up in the community creating opportunities for enrichment and friendship by bringing the arts, drama, music to persons like Charlie.

Your support will give us a big jump to reach the many young persons needing fulfillment and building health along the way. Help us as you can this holiday season.”

From article in REAL CHANGE: “Carolyn Hale (COF founder and president) believes in the healing power of art. That’s why she formed Circle of Friends, a small-scale project that joins people who are mentally ill and community volunteers to paint, write, and do other creative projects together. It is in part a response to cuts in services for the mentally ill, and also an effort to increase public understanding and compassion.

Volunteers share their art talents and develop new relationships in the process. For mentally ill participants, art projects help build confidence and can also be a valuable form of communication. Art is ‘an instant telling of something within yourself,’ Hale says. ‘If you don’t have words, it’s another way to express it.’

Ultimately, Hale takes pride in small acts of understanding and accomplishment – the satisfaction of selling a painting, or a ride offered to someone who hasn’t been in a car in months ‘’ that contribute to participants’ well-being. As one backer of Circle of Friends observed, ‘drugs help with symptoms, but art builds health.’” Rachel Rubinstein,January 17-23, 2007

Poetry from Circle of Friends participants

I gave my love an Easter Egg Brian Youngberg 3/2/07

I gave my love an Easter Egg

painted with a mommy bunny and her child.

My love turned away the mommie’s face,

and turned away the child.

Freud said there are no mistakes in life,

but my love mistakes her life as mis-happenstance,

and so was…and that was…and so-on…and so-on…

until it stopped with her.

The alarm clock I bought to wake her up to take the test

sits on the kitchen table

and ticks but doesn’t move.

Frozen in the moment,

jiggling to escape, unable to be free,

trying hard not to be defective,

but out of warranty.

The clock and bunnies sit face to face by a potato

sprouted horribly alive and green,

resting beside some pickled, Mediterranean, gourmet mushrooms

soaking in a fancy jar.

I remember a passage by Eli Weisel

my daughter recited when she won a scholarship contest

at the annual, parochial, all-city elocutionary fair.

Eli Weisel held a prisoner all night until he killed him

as an enemy of the new, Israeli state.

And in the morning, Weisel’s face reflected in the kitchen window

and faded in the dawn.

He lost sight of himself in the holy city of the holy land,

and he learned then that our enemy is in fact ourself,

because we are all one with one another…

(It is a beautiful passage, and you must read it.)

We can cry, as we fade away.

We can die, as Weisel showed, by the hand of others.

Or by our own hand.

Or we can die, because we were never born.

But we can’t hide from ourselves.

And we can’t hide from our mothers.

My love sleeps quietly with her dog and cat,

while I am up worrying about the world and why she doesn’t like me,

composing poetry, drinking coffee and fading in the black window…

…We can cry,

for we will all die,

but for this moment we are alive,

and we can love each other or hate ourselves.

We can hate each other, but if we do so…

we cannot love ourselves.

None of us are mistakes,

for even Hitler could have been guided to be a good boy.

Even your mother could have been guided to be a good mother.

I love you, even though you don’t like me.

And I will always love you, whether you like me or not.

You are as beautiful as the Easter Egg catching the rosy light of day.

You are as beautiful as the sprouted potato.

You are as beautiful as the pickled, Mediterranean mushrooms..

…as the african violets in the window sill--

reflected in blues and emeralds in the black window of the night

as the pink dawn rises

and my own pale image fades away.

Irises Mac Crary 2007

Contemplating Hiroshige's woodblock of irises

as the Chinatown cherry blossoms

begin blooming

I imagine the century of men before me

pleasantly inspired

for whom the blue tints of time

in Hiroshige's print

awoke the heart's hummingbird dance
for the laborious turning of the ground.

It is as if

by engraving them as painters

the human-ness of a flower

becomes real.

Through the woodblock

the little garden blossoms

become wise men.

Much as the Buddha
smiles

from a living lilac.

FUTURE PLANS

Carolyn Hale

Future Plans are to find a drama leader, get the production started and begin more active education of public with the dramas--the small vignettes presenting them to boards, church groups and public events. The dramas should help develop more supporters and guilds.

Our plan is to reach out to Seattle Art Council, the King County Arts Council, the Seattle Art Museum and Cornish and Pratt Art schools.

We expect to have more art shows at places showing our art and sell art on line on our web site.

The Circle of Friends hope to develop more pottery, maybe even find a site where we can continue using pottery wheels and more developed clay work. We will reach out to get supporters from the U. Washington Alumni, the RSVP, and the Seniors Mayor’s list of volunteers.

Our goal is to broaden our places adding 2 or 3 a year. It is hoped that we could have a second art events mid-year at all the homes we service with the holiday events.

It is hoped that we find places for the music groups to play. Perhaps even individuals that play guitars or pianos or single instruments. I have heard them playing in the parking lot at Wallingford House and at Victriola coffee shop.

A story collection may be started with all the expressions that have come forward.

Each home may find a person to help them starting with just supplying old magazine for people to read. Perhaps they can grow ideas that would build on the needs.

Card stock is being used to make cards that we can sell at the St. Marks Christmas sale. Perhaps the artist persons can join and help sell.

Our brochures are scheduled to be printed and will help us find new support and acceptance.

Funding ideas include finding some group or persons to lead “guilds-(circles) that will support us.

Plans for fund raising dinners by board members are in process and videos about Mental Health will be shown.

Plans to have some more wine tasting are in the offing-wine experts are available. Possible places are the Kirkland Art Center, Barbara Hurst has offer her home again and the Edmonds gallery where Judy Heim is involved.

We expect to seriously reach out to the King County Disability commission for funding next year. Barbara Hurst and Dan Moreland are on the committee and should help us. It may give us some on-going support.

Dan Schmidt is working on a grant for us. He feels it will be one that we can use the information for other grants when it is readied. Dan is a grant writer and worked for Very Special Arts of Washington.

Operation and Functioning of the Survey

By John Dame

Initially I thought that doing the survey would have been a lot easier. When conducting the surveys we met quite a bit of resistance (in general) from the clients. It took some coaxing to get them involved, and many of the questions we asked went unanswered, or the answers were illegible and or unintelligible. Some of the counselors also had trouble filling out the questionnaires as they had never participated in a survey before and felt like they couldn’t give us answers that supported us. I had to convince them that they were quite capable of doing it and to just be honest about the interactions they have seen. So it was very difficult to stay on our time line, and things got put off until they could be done more effectively. The second set of surveys didn’t get done, (it was hard enough to get the first ones), and we see now how things could have been done better. We have learned a great deal from this experience about how to conduct surveys with the mentally ill. It took a considerable amount of time, energy, coaxing, and bribing

(cookies and pop), to get the client’s interested in being involved in the project.

The instructors did a good job on the surveys for the most part, some were a bit rushed as they’re students in college and have intensely busy schedules. All in all, I feel good about the outcome and the results of our project, especially being that it was our first one. After meeting and talking with our technical coach from the state, I realize how much better things could have been, if only we had the support available from the beginning. I called early in the beginning to see if I could get some help, but I didn’t realize that I needed to try harder, I thought that they were just too busy to help us. After meeting with Ann, I see now that I just didn’t understand how your system works and that you really are that busy. The money coming late wasn’t really that much of an issue, although it may have helped get the surveys done earlier, and stay on top of the time line.

Future Plans

John Dame

I don’t know if you’re excited yet, but you should be! The amount of energy being created by a small, community activist operated nonprofit organization is considerable considering the circumstances. Carolyn Hale should be nominated for some kind of humanitarian award for the amount of time, energy, and money out-of-pocket that she has put into creating and operating this outstanding organization. When you consider all of the adversity she has faced and is still highly active in the mental health field, it is nothing less than amazing. Circle of Friends has operated almost entirely out-of-pocket with very little monetary support from the community, and used volunteers exclusively.

There are many projects already in the works to expand the operations of Circle of Friends for Mental Health. Our new drumming class is about to begin at two locations, Emerald House and Clean Start. This will be a class where clients build and learn to play their drums. The photography class is such a success that we have had to stop taking new students because there aren’t enough cameras. However, Steven (the instructor) and I are working to see if Nikon Cameras will sponsor the class by giving us one hundred digital cameras that the clients can keep after they complete an orientation with instruction, and the class.

Carolyn and I have been working hard to recreate our drama program. This class has been particularly difficult to facilitate due to lack of qualified instructors. I am currently working with faculty at Seattle Central Community College to secure a space with members of their drama department to supervise the operations of this class. I believe that once things are rolling, this will be a productive class.

I intend to spend a bit (most) of the money that I receive from the grant to buy supplies for getting the art that has been produced matted and framed and ready for

showing in galleries. There is a woman that came to our photography class that works with about twenty art galleries in downtown Seattle. She told us that she would help us get spaces for showings. There are other persons with connections to galleries that we are currently trying to enlist their help also. Much of this looks very promising, as when the art sells, it does so much for building the client’s self-esteem and confidence.

I wear a lot of tye-dye shirts when I teach classes, and many of my students are expressing the desire to do tye-dyes. I just need to come up with the money for the supplies. One of my friends does marbling with shirts and said that he would be thrilled to run a class. This is to be a series of upcoming classes.

Right now we are in the process of motivating some of the more talented students to make cards that they can sell at our Christmas events. They are currently making the cards and packaging them.

A Creative Writing Professor from Seattle Central has started teaching classes at Emerald House, and I am trying to enlist his services at Clean Start so they can run their own newsletter. He is also working with Steven to help with securing the deal with Nikon.

Carolyn has been very busy trying to drum up support from a long list of people from the Mayor’s office to a variety of organizations working in the Mental Health field. We hope some of that support is funding, but also we are canvassing for volunteers to teach classes. I have just contacted the Intern Coordinator at Antioch College that facilitates

placing students in service positions. These students are going for their degrees in art therapy and should be a major boost to the quality of services we offer.

There are a number of clubhouses that we used to be involved with, but due to turnover of staff, and other problems such as distance, we have had difficulties in placing

instructors at these facilities. We are currently in the process of opening these places back up and expanding the classes to cover more of a variety of mediums. I have just contacted

the person who oversees the operations of Community House and she seems interested in having art classes at more of their facilities.

Jim at Wallingford House wants me to put together a panel of higher functioning mentally ill persons to come in and talk to other clients who are lower functioning, to inspire and motivate them. I have already spoken with several persons and they seem excited to be involved with this and it looks very promising.

Carolyn mentioned that she wanted to put together a music/dance class that involved movement. I thought it would be just fantastic to create a class where clients could make a drum, play the drum, and dance to the music they played. Some of the clients could play, while others danced, and then they could switch places. We realize the effectiveness of art and movement together when combating depression and other disorders, and so these are some of the things we have in the works.

One of our future plans is to do the survey over again, but to do it with a control group, and to be more concise about collecting the data. We will have to create a new set of questionnaires that are considerably more comprehensive, and target a wider range of measurable information.

Conclusion

By John Dame

The one issue that stands out more than anything else that I have observed when working with the mentally ill is that it takes time to build trust. Without trust there is no interaction, no healing, and no community. In the nine short months that I have worked at this volunteer position, I have experienced some interesting changes in the clients’ behavior. They were slow to warm-up at first, but now that we have been working together doing art, they are genuinely happy to see me when I walk through the door of their clubhouse. We get along well and have a really good time doing art projects as a group or as individuals. 100 % of the counselors said that the clients were happy to have their art displayed. The clients are proud of their work and it seems to be a great boost to their self-esteem.

When I went to research statistics from other mental health organizations the typical statements seem to center around the common theme of “Well, there just hasn’t been any real scientific data collected on the benefits of using art therapy with the mentally ill”.

I read a number of case studies and testimonials from qualified Art Therapists and they all have a fair amount of success stories. If you haven’t got any facts either, I have one for you. Persons’ who are mentally ill love to do art! I know this because they keep coming back to do the art classes. 75 % of the instructors said that clients show up on a regular basis. Here’s another one, 100 % of the instructors said that clients were happier while doing art. When I tallied the responses from the counselors and instructors, most of them said that clients show up on a regular basis, are happier, and are more focused.

I was looking at an article published by the American Cancer Society, which backed up my theory on art therapy. The article states;

“Numerous case studies have reported that art therapy benefits patients with both emotional and physical illnesses. Case studies have involved many areas

including burn recovery in adolescents and young children, eating disorders,

emotional impairment in young children, reading performance, childhood grief, and sexual abuse in adolescents. Adult studies have included working with adults or families with bereavement, addiction, and bone marrow transplant, among others. Some of the potential uses of art therapy to be researched include reducing anxiety levels, improving recovery times, decreasing hospital stays, improving communication and social function, and pain control.”

One of the main things that I do with my students is to try and bring some normalancy to their lives by treating them just like an average person. By creating an environment where the clients feel safe to come out from behind their mask and interact with the community is of critical importance. That is when they start to feel good about themselves and the possibility that their lives may become a little more livable and productive. Building trust through building community!

Developing Strategies and Technique to motivate the clients.

The fact that I am a client, as well as an instructor and the director of the evaluation project, has helped me to earn the clients’ confidence. Many times the clients ask me about my disorders and we discuss the realities and problems of living with such disorders, and what we can do to overcome such adversities in our lives. Many times when clients come into the art room and I ask them if they would like to join in, they say “I’m not an artist, or “I don’t know how to do that”. I tell them that I’m not an artist either, but I like to draw, and I’m just having fun anyway. Sometimes it works and they

sit down and ‘play’ with us, and after a while several others will join in and we all start talking and joking and having fun. It’s really a great feeling watching them create a piece that their proud of. When we asked the counselors and instructors if the clients were

happy to have their art displayed, the comments were, “Yes, they’re very proud when we display their work and it seems to be a great boon to client’s lives and self-esteem”.

Now that I have earned their confidence they share things with me and I’ve started to ask them about how the art affects their lives. Many of them say that doing the art relieves their stress and anxiety levels or builds confidence in their abilities to do other things. Many others say that doing the art helps relieve the depression or helps with pain.

So at this point I am just learning how to do things to help increase the clients’ self-esteem, and confidence levels. I’m working with some of the lower functioning clients and it has been a bit trying at times, its slow going, but we’re making progress that you can see in their work and in their behaviors. I can tell when I’ve been working with a client that has said many times they can’t do something, and I laugh with them and show them that they have already done it. After a while they usually quit saying they can’t do it any more, and just do it.

Our music group is a big success story!

When our instructor took over the music class at Clean Start he told me that the group was at odds with each other. They weren’t working together very well because they weren’t communicating. The guitar players would turn their amps up to drown each other out and there was a bit of anger going on with them. The instructor got them to start communicating and working together, and now the group is playing songs and having a lot of fun. This has been working well for the last six months and now the group is performing at a local tavern where open microphone jams are held. The music teacher said: “ I volunteered at Clean Start for about five months, and by the time I was finished, I was completely astounded by the improvement of the music produced by these individuals as a team”. I too, have sat and listened to them on several occasions, and even though they are a bit loud for my taste, they are very happy to be playing music together. I’m fairly critical of musicians, but I have to admit that they sound pretty good. In fact they’re “rockin.” The music teacher writes: “Volunteering at CPC Clean Start was fun, at times challenging, but in the end rewarding. I believe that music therapy is a very effective way to get people involved in working together productively and boosting their confidence”. To me that’s progressive recovery, when the functioning and skill levels start to rise and the client becomes more capable of doing tasks and interacting with the clubhouse community without coaching. From what I have seen, it is this integration back into the community that is the basis for recovery, and the starting point for many of the clients back into society at large.

Appendix I Statistics from the Surveys

As we present this information we will give you a comprehensive breakdown of clients answers, and we will list some of reasons they gave.

Clean Start art class (CPC); 7 respondents, 3 male, 5 female, ages 24-54.

How long have you attended art class? 1- first time, 3- several months, 1- 1 year, 2- not legible.

How many times have you missed class in the last month? 1-not legible, 2-none, 1-2 times. 2-3 times. 1-5 times.

Reasons given; recovery classes, work, an appointment, gone.

How valuable is this class to you? 1-not legible, 2-fairly valuable, 4-very valuable.

How do you feel when you are in class? 1-not legible, 1-average, 1-fairly good, 4-very good.

How do you feel after class? 1-empty, 1-average, 2-fairly good, 3-very good.

Comments; happy, the staff here are always supportive and its empowering, I’ve accomplished something that is beneficial to my mental health.

Do you think about the work you did in class at other times during the week?

8-yes.

How has this class affected your self-confidence? 1-not legible, 1-don’t know, 2-improved a little, 3-greatly improved.

Do you feel that you have been successful in this class? 1-not legible, 6-yes.

Comments; getting a job with my Social Security, it gives me motivation to get things done, focus, I do my own art for my musical recordings.

What skills have you learned in this class? 1-not legible, 1-don’t know, 5-positive.

Comments; wonderful colors, conservation, patience, art, music, social skills, safety plans, sobriety, art skills and people skills.

Clean Start music group; 3 respondents, all male, ages 37-59.

What instrument(s) do you play? Drums/guitar, guitar, bass guitar.

How long have you played this instrument? 25+ years, 20+ years, 11 years.

If a professional teacher taught music classes, would you attend every class? I would attend most, no, yes.

If a monthly drum circle were provided, would you commit to attend every class? 3-yes.

What do you like best about playing together? Togetherness, being part of the group, commonality/relaxation, I can express myself.

How would you describe your feelings about the music group? I love it- very, very good- good.

How have things changed since Circle of Friends/Max took over? We now have a core group and the songs we play are getting tighter and everyone is getting better on their instruments. I wish we had a singer and better equipment-truly different/more comfortable-we play much better now and we all get along and have a lot of fun.

Emerald House (SMH); 13 respondents, 5 male, 8 female, ages 24-58.

How long have you attended art class? 1-first time, 1-1 month, 1-2 months, 1-3 months, 1-5 months, 1-6 months, 1-7 months, 1-1 year, 3-2 years, and 1-4 years.

How many times have you missed class in the last month, and what was the reason?

3-0 times, 4-once, 1-twice, 1-3 times, 2-5 times, 2-no response.

Reasons given; sick, had kitchen detail, anxious about class, other commitment.

How valuable is this class to you? Of the 13 respondents 3 said fairly valuable, while 10 said that the class was very valuable to them. There were no negative responses.

Comments; This is important because it helps with my self-expression.

How do you feel when you are in class? 4-said average, 4 said fairly good, 5 said very good.

How do you feel after class? 1 said average, 5 said fairly good, 7 said very good.

Do you think about the work you did in class at other times during the week?

11 said yes, 2 said no.

How has the class affected your self-confidence? 0 said not improved, 6 said improved a little, 7 said greatly improved.

Do you feel that you have been successful in this class? 12 said yes, 1 no response.

Do you feel that your success in this class has helped you accomplish other things outside of class? 10 said yes, 3 said no.

What skills have you learned in this class?

Responses; Patience, relieves the pain, gratitude for movement, mastery of technique, take my time and don’t worry.

Are you able to use the skills that you’ve learned in this class in other areas of your life? 7 said yes, 3 said no, 3 no response.

Comments; working with other people, to follow through on something.

Has this class helped improve your- job skills-communication skills- self-confidence? 3 said job skills, 5 said communication skills, 9 said self-confidence.

Have you made new friends through this class? 12 said yes, 1 no response.

Is this class fun? 11 said yes, 2 no response.

Does the group laugh and express humor? 10 said yes, 2 said no, 1 no response.

How do the teachers make you feel? 3 said fairly good, 9 said very good, 1 no response.

What could they do differently to improve the class?

Comments; have class on Wednesday also, better supplies, more technique.

Other comments; we need a lot more people to support us, more clay.

Summit Inn (Community House); 7 respondents, 2 male, 5 female, ages 30-55+.

How long have you attended this class? 3- 9 months, 1rst time, 3-3 months.

How valuable is this class to you? 2-not very valuable, 1-average, 3-fairly valuable, 1-very valuable.

How do you feel when you are in class? 1-not very good, 1-average, 3-fairly good, 2-very good.

Do you think about the work you did in class at other times during the week?

5-no, 2-yes.

How has the class affected your self-confidence? 1-no answer, 1-not improved, 2-improved a little, 3-greatly improved.

Do you feel that you have been successful in this class? 3-no, 4-yes.

Have you made new friends through this class? 2-no. 4 yes, 1-no answer.

Has this class helped improve your: job skills, communication skills, self-confidence? 2-no response, 1-job skills,3 -communication skills,4-self-confidence.

Is this class fun? 2-no response, 1-no, 4-yes.

Does the group laugh and express humor? 1-no response, 1-no, 5-yes.

How do the teachers make you feel? 1-no response, 1-fairly good, 5-very good.

Keystone House (CPC) Writing class; 5 respondents, gender and age unknown.

What kind of writing do you like the best? 3-journaling, 2-poetry.

Does the teacher give you good ideas about your project? 1-no, not much, 4-yes, a lot.

Do you feel that you are a better writer than before? 1-unsure,4-yes, much better.

What feelings do you have when you are working on your project? comfortable, pleasant, fun, physical, I like writing it makes me feel good, visions about nature.

How would you feel about seeing your work in print? OK, it seems a little too personal, I would really like it, yeah-the good stuff.

What feelings do you have after class? accomplishment, relaxation & quiet, refreshed, makes me feel good.

Do you write when you are not in class? 1-no response, 4-yes.

Do you remember what you have written in class and want to write some more? 1-no response, 4-yes.

What could we do to make this class better? keep it responsive and spontaneous, teacher is great, I’d like to finish my book in class, twice a week.

Wallingford House (CPC); 10 respondents, 7 male, 3 female, ages 35-55.

How long have you attended this class? 1-2 classes, 1-6months, 1-1year, 2-more than a year, 1-2 years, 1-4 years, 1-5 years, 3 no response.

How many times have you missed class in the last month? 3-none, 2-once, 2-twice, 1-3 times, 1-5 times, 1-no response.

Comments; taking a course at school, meds make me sick, not here, pneumonia, helping friends, (usually I don’t miss- I love art- its my favorite class and therapy).

How valuable is this class to you? 3-average, 1-fairly valuable, 6-very valuable.

Comments; I need the encouragement and focused time that I have during this group.

(I live for art-I get depressed if the clubhouse does not have it-I do not want to come to the clubhouse if there is no art class- the teacher is excellent.)

How do you feel when you are in class? 2-average, 4-fairly good, 4-very good.

Comments; happy, relaxed, creative, (when I draw, I have focus and more energy.)

How do you feel after class? 2-average, 2-fairly good, 6-very good.

Comments; fulfilled, happy, relaxed, rich.

Do you think about the work you did in class at other times during the week?

1-no, 1-no response, 8-yes.

How has the class affected your self-confidence? 5-improved a little, 5-greatly improved

Comments; I like myself the best when I think of myself as an artist, its my dream come true, I wasn’t sure that I could draw again.

Do you feel that you have been successful in this class? 1-no, 9-yes.

Do you feel that you success in this class has helped you accomplish other things outside of class? 3-no, 6-yes, 1-no response.

Has this class helped improve your: job skills, communication skills, self-confidence? 4-no response, 2-job skills, 2-communication skills, 4-self-confidence.

Have you made new friends through this class? 2-no, 8-yes.

Is this class fun? 2-no response, 8-yes.

Does the group laugh and express humor? 2-no response,8-yes.

Comments; we feel comfortable together, there is trust knowing we will do no harm, the teacher encourages humor, one of the other clients puts humor into his art, the teacher is funny and free spirited, and her tone sets the mood of the class.

Photography Class (Circle of Friends); 7 respondents, 3 female, 4 male, ages 31-57.

How many times did you attend the photography classes in the last month?

If you missed class, what was the reason? Sick, anxious, substance related other?

Missed two, didn’t know they were happening- anxious about class-3, other-only attended two classes so far-anxious about class-attended every time- 100 % attendance.

When you went to the Seattle Center to do the classes, did you enjoy getting out of your house to go there? Absolutely, thank you-yes-big time- This is a positive thing for me and it is comforting to meet new friends-By all means, they’re renovating my

Did you go out in a group, or do you like to work alone? 2Both-2 alone-3group.

If you worked with a group of people, did they laugh, and have fun? 6 yes, 1 no.

Would you recommend this class to other people like you? 6 yes, 1 no.

If you could go do this class somewhere else, where would you like to go? The Pike Place Market, the beach, the mountains, Greenlake, or another park, other?

All, the mall, the freeway-the mountains-All, North and South Dakota are really cool-All-Any of the above-Cityscapes, sailing vessels, islands in the sound, wildlife close ups-the mountains.

Does doing photography class help you with: self-confidence, communication skills, job skills, other? Not really helpful-Yes-creative ideas-All-Self confidence and communication skills, I am a nervous person and this helps me work through my anxiety.

When we teach this class again, will you come back to do it again? No-Yes, I must-Yes, I would love to- 4 x yes.

building-yes-yes, fun.

What kind(s) of subjects did you like to photograph the most? People, buildings, plants/trees, other? People, plants/trees, shadows- buildings-things-plants/trees, birds, all kinds of things-All-buildings, plants/trees-Art and other subjects, I want to do a portrait study of faces, especially pretty faces.

Instructors; 8 total, 5 female, 3 male, ages 20-73.

How often do the clients show up to do the classes? 1 uncertain- 1 every other week-6 on a regular basis.

Have you noticed any changes in the participants who attend the art therapy groups? Work better together, less angry or emotional, happier, more focused, other? 8 said happier- 3 said all apply.

Do participants talk about their art during the week or at other times that you know of? 3 said don’t know- 3 said yes- 1 said I hear they do from the counselors.

Are they happy to have their art displayed, or when they do music therapy, to be listened to? 1 uncertain-7 yes.

What kinds of activities do they enjoy the most? Drawing, painting, masks, collages, clay, charcoal, murals, apron painting, signs, writing, music, photography, other?

Please note that instructors are teaching different classes so this set of answers is negligible. Too many variables, so I’ll list a few responses.

Do you have any suggestions that you think could improve the groups?

Again responses.

Have more supervisors to encourage clients to participate in the classes.

Meet more often. Longer class time, increase to 3 ½ to 4 hours (for clay). Better materials (voiced by many instructors). Have all of the new instructors meet with the

board of COF and work up new strategies for motivating clients and increase instructors abilities to apply art techniques. We have plenty of professionals already, we just need to get together and bump heads.

What ways could we get the word out about our classes to more people?

Most instructors said make and post flyers or posters. One said create a web page. One said create brochures.

Have the students/instructors always been respectful to the staff and participants?

8 said yes, always. One said everyone has been wonderful above and beyond the call of duty. Everyone is genuinely enjoying themselves.

Is there something that we do that has caused a problem or been unconstructive?

6 said no. 1 said no, but I believe we can be more constructive. 1 said wash the floors after art class, not before. No one said anything negative here.

Should we enlist a professional or knowledgeable trainer to teach the students/instructors how to work with the participants? 4 said no (but they are artists)- 1 said sure- 1 said its up to us- 1 said yes, but we already have professionals, we just need to get together and bump heads.

Should we offer art classes more than one time a week? 1 said no, we offer 4 classes a week- 6 said yes, most emphatically- 1 said that it depends on the facility, some already do, and some could use more.

Counselors; 3 male, 2 female, ages 31- 55.

How often do the clients show up to do the classes? 2 said every once in a while, 3 said on a regular basis.

Have you noticed any changes in the participants who attend the art therapy groups? Work better together, less angry or emotional, happier, more focused,

other? Most said happier- 2 said more focused- 1 said seems to give them better insight into mental illness.

Do participants talk about their art during the week or at other times that you know of? 5 said yes. 1 said art is the frequent topic at the club.

Are they happy to have their art displayed, or when they do music therapy, to be listened to? 1 said yes, they are very proud- 1 said the display of a client’s art seems to be a great boost to the clients’ lives and self-esteem- 1 said yes, very much so- 1 said yes, they like to put their art up on the walls- 1 just said yes.

What kinds of activities do they enjoy the most? Drawing, painting, masks, collages, clay, charcoal, murals, apron painting, signs, other? 1 said I don’t know, but its good to have a structured activity- 1 said I don’t know- the others said drawing, painting, collages, writing, and music.

Do you have any suggestions that you think could improve the groups?

4 said no- 1 said develop strategies and techniques to motivate participation.

What ways could we get the word out about our classes to more people? All said flyers or posters, colorful signs.

Have the instructors always been respectful to the staff and participants? All responded yes. Is there something that we do that has caused a problem or been unconstructive? All responded no.

Should we enlist a professional or knowledgeable trainer to teach the

students/instructors how to work with the participants?

3 said no- 1 said I always think training is worthwhile- 1 said yes, professional instructors and teachers would be an excellent addition to our efforts.

Should we offer art classes more than one time a week?

2 were unsure- 2 said no, once was enough for their program- 1 said yes.

Appendix II

Clubhouses: Communities Creating Opportunities for People with Mental Illness

What is a Clubhouse?

A Clubhouse is first and foremost a community of people. Much more than simply a program, or a social service, a Clubhouse is most importantly a community of people who are working together toward a common goal. A Clubhouse is a community intentionally organized to support individuals living with the effects of mental illness. Through participation in a Clubhouse people are given the opportunities to rejoin the worlds of friendships, family, important work, employment, education, and to access the services and supports they may individually need. A Clubhouse is a restorative environment for people who have had their lives drastically disrupted, and need the support of others who believe that recovery from mental illness is possible for all.

“Clubhouse”

The descriptive name of “Clubhouse” was taken from the original language that was used to communicate the work and vision of the first Clubhouse, Fountain House in New York City, started in 1948. As the first community of its kind, Fountain House has served as the model for all subsequent Clubhouses that have developed around the world. Fountain House began when former patients of a New York psychiatric hospital began to meet together informally, as a kind of “club.” It was organized to be a support system for people living with mental illness, rather than as a service or a treatment program. Communities around the world that have modeled themselves after Fountain House have embraced the term “Clubhouse,” because it clearly communicates the message of membership and belonging. This message is at the very heart of the Clubhouse way of working.

Membership

A Clubhouse is a membership organization, and therefore the people who come and participate are its members. Membership in a Clubhouse is open to anyone who has a history of mental illness. This idea of membership is fundamental to the Clubhouse concept, as having membership in an organization means that an individual has both shared ownership and shared responsibility for the success of that organization. To have membership in an organization means to belong, to fit in somewhere, and to have a place where you are always welcome. For a person living with the effects of mental illness, these simple things cannot be taken for granted. In fact, the reality for most people with mental illness is that they have a constant sense of not fitting in, of isolation, and rejection. Mental illness has the devastating effect of separating people from others in society.

“Mental patient”, “client” “disabled”, “consumer,” “user” -- these are the terms with which people living with mental illness are accustomed to being defined. The rest of society, then,

segregates them according to these labels, and wholly defines them by these images. The person with mental illness, then, is seen as someone who needs something, who is primarily a burden that needs to be managed.

The Clubhouse turns this all around. Here, a person who has struggled with mental illness is seen first as a valued participant, a colleague, and someone who has something to contribute to the rest of the group. Each person is a critical part of a community engaged in important work. A Clubhouse is designed to be a place where a person with mental health problems is not a patient and is not defined by a disability label.

In a Clubhouse program each member is given the message that he or she is welcome, wanted, needed and expected each day. The message that each member’s involvement is an important contribution to the community is a message that is communicated throughout the Clubhouse day. Staff and other members greet each person at the door of the Clubhouse each morning, with a smile and words of welcome.

The daily work of the Clubhouse community, too, is organized and carried out in a way that repeatedly delivers this message. This is not difficult, because in fact the work of the Clubhouse does require the participation of the members. The design of a clubhouse engages members in every aspect of its operation, and there is always much more work than can be accomplished by the few employed staff. The skills, talents, and creative ideas and efforts of each member are needed and encouraged each day. Participation is voluntary but each member is always invited to participate in work which includes clerical duties, reception, food service, transportation management, outreach, maintenance, research, managing the employment and education programs, financial services, and much more. Membership in a Clubhouse community gives a person living with mental illness the opportunity to share in creating successes for the community. At the same time, he or she is getting the necessary help and support to achieve individual success and satisfaction.

Values

Clubhouse communities are built upon the belief that every member can sufficiently recover from the effects of mental illness to lead a personally satisfying life. Clubhouses are communities of people who are dedicated to one another’s success -- no matter how long it takes or how difficult it is. The Clubhouse concept is organized around a belief in the potential for productive contributions from everyone, even the member struggling with the most severe effects of mental illness. Clubhouse communities hold the conviction that work, and work-mediated relationships, are restorative and provide a firm foundation for growth and important individual achievement (Beard, Propst, Malamud, 1982). In the Clubhouse world it is also a strongly held belief that normalized social and recreational opportunities are an important part of a person’s path to recovery.

Meaningful Relationships (the core ingredient)

The Clubhouse environment and structures are developed in a way to ensure that there is ample opportunity for human interaction and that there is more than enough work to do.

Clubhouse staffing levels are purposefully kept low to create a perpetual circumstance where the staff will genuinely need the members in order to accomplish their jobs. Members also need the staff and other members in order to complete the work, but even more importantly, the relationships that evolve through this work together are the key ingredient in Clubhouse rehabilitation. (Vorspan, 1986). The Clubhouse members and staff as a community are charged with prioritizing, organizing and accomplishing the tasks that are important to make the Clubhouse a successful place for members to move forward in their lives.

Relationships between members and staff develop naturally as they work together side-by-side carrying out the daily duties of the Clubhouse. All of the staff have generalists roles in the Clubhouse and are involved in all of the Clubhouse activities including the daily work duties, the evening social and recreational programs, the employment programs, reach out, supported education and community support responsibilities. Members and staff share the responsibility for the successful operation of the Clubhouse. Working closely together each day members and staff learn of each other’s strengths, talents and abilities. They also develop real and lasting friendships. Because the design of a Clubhouse is much like a typical work or business environment, relationships develop in much the same way.

In a Clubhouse the staff role is not to educate or treat the members. The staff are there to engage with members as colleagues in important work and to be encouraging and engaging with people who might not yet believe in themselves. Clubhouse staff are charged with being colleagues, workers, talent scouts and cheerleaders.

The Basic Components of a Clubhouse

1. A Work Day

The daily activity of a Clubhouse is organized around a structured system known as the work-ordered day. The work-ordered day is an eight-hour period, typically Monday through Friday, which parallels the business hours of the working community where the Clubhouse is located. Members and staff work side by side, as colleagues, to carry the work that is important to their community. All of the work in the Clubhouse is for the Clubhouse and not for any outside agency or business. There are no clinical therapies or treatment-oriented programs in the Clubhouse. Members volunteer to participate as they feel ready and according to their individual interests.

2. The Employment Programs

As a right of membership Clubhouses provide members with opportunities to return to paid employment in integrated work settings through both Transitional Employment and Independent Employment programs. Transitional Employment is a highly structured

program for members returning to work in community-based business and industry. Transitional Employment placements are at the employer’s place of business, are part time (15-20 hours per week), and include a lot of on the job and off site support from Clubhouse staff and other members.

These placements generally last from six to nine months. Members then can try another placement or move on to independent employment. This program is specifically designed as a vocational rehabilitation program where a member can gain or re-gain the skills and confidence necessary to have a job while he or she is employed in a “real world” position. The only requirement from the member to participate in Transitional Employment is the expressed desire to work.

Independent employment is a program of the Clubhouse through which members, when ready, are given help from the Clubhouse to apply for and acquire a job of their own. The Clubhouse then provides on-going support and encouragement for the members as long as they remain employed and request assistance. There is no on-site support at the place of business for members in independent employment. All of the support is at the Clubhouse.

3. The Evening, Weekend and Holiday Programs

In addition to the work opportunities, Clubhouses provide evening, weekend, and holiday social and recreational programming. Members and staff together organize structured and non-structured social activities. These activities are always scheduled outside of the work-ordered day. Holidays are celebrated on the day on which they fall. Activities are scheduled at the Clubhouse and in the community.

4. Community Support

People living with mental illness often require a variety of social and medical services. Through the work day at the Clubhouse members are given help accessing the best quality services in their community. Help is given to members in acquiring and keeping affordable and dignified housing, good mental health and general medical services, government disability benefits and any other services they may need. Members and staff from the Clubhouse provide all of this support and assistance.

5. Reach-out

Part of the daily work of the Clubhouse involves keeping track of all of the active members. When a member does not attend the Clubhouse or is in the hospital a “reachout’ telephone call or visit is made to the absent member. Each member is reminded that he or she is missed, and welcome and needed at the Clubhouse. This process not only encourages members to participate but it is an early warning system for members who are experiencing difficulties and may need extra help.

6. Education

Many Clubhouse members have had their education plans interrupted by mental illness. Some have not finished secondary school and others had their university experience

disrupted. The Clubhouse offers educational opportunities for members to complete or start certificate and degree programs at academic institutions and adult education programs. The Clubhouse also utilizes the talents and skills of members and staff to provide educational opportunities in the Clubhouse.

7. Housing

Safe, decent dignified housing is a right of all members. The Clubhouse helps members to access quality housing. If there is none available for members the clubhouse seeks funding and creates its own housing program.

8. Decision-making and Governance

Decision-making and governance are an important part of the Clubhouse work. Members and staff meet in open forums to discuss policy issues and future planning for the Clubhouse.

Clubhouses also have an independent board of directors or advisory board that is charged with oversight management, fundraising, public relations and helping to develop employment opportunities for members.

Summary

Although Fountain House started more than fifty years ago and has been replicated more than four hundred times around the world, the clubhouse concept is still a radically different way of working in the field of community mental health. Most program models still focus on assessing a person’s level of disability and limiting the expectations based on that assessment. Most use teaching or treatment as the vehicle for providing rehabilitation. In a Clubhouse the expectations are high and mutual work, mutual relationships, and meaningful opportunities in the community are the vehicles of choice.

References:

Anderson, S. B. (1998). We Are Not Alone: Fountain House and the development of clubhouse culture. New York, New York, Fountain House

Beard J. H., Propst, R,& Malamud, T. (1982) The Fountain House model of psychiatric rehabilitation. Psychiatric Rehabilitation Journal, 5, 47-53. Boston, MA

ICCD, (2002) The International Standards for Clubhouse Programs . New York, New York

Vorspan, R., (1986), Attitudes and Structure in the Clubhouse Model, The Fountain House

APPENDIX III

Brief Description of Instructors for Circle of Friends

1.Tanli Wu: UW intern taught 2 years at two places. Took a job with the Asian Referral Center. Has said she would help with our education session for new students at the UW this fall.

2. Hsin Pin Lin: UW intern taught for 2 years at Emerald House. Made real connection with Mac. We sent to have lunch with her at Fred Hutch because Mac had a book about the politics of China that he wanted to give her. They had discussed politics about her homeland at Emerald House. He asked if we wanted to go to the ballgame with him. I couldn’t really find the time and it didn’t happen. However, he was so kind to give her the book. Worked on a file of ideas for us. Will help organize and lead the Holiday gift days this fall/winter.

3. Max Stiles: SCCC student- who wanted music and took his guitar and went to two spots. One at Clean Start and made real inroads teaching them to make music together and to be a group. He went to Sunrise Center in North Seattle two times and worked with instruments and the group of mentally ill disabled students. I think it was new to them and it was less “musical.”

Heidi Otterbein: UW graduate in religion, who is a drummer and helped us get started at Clean Start. She was there for 1-½ years and now stops in from time to time. We bought a drum set from Bellevue Drum School (got it quite cheaply) and she set it up. It was an instant hit. A man with an automatic wheel chair drove in, announced that in one month he could have his foot making the drum go. I looked down and he had an artificial limb. Whenever I’m there on Friday’s there is lots of drumming/guitar/singing going on. It’s really happening. The music group came to Wallingford House, the day that we made holiday gifts. They are now going to Open Mikes and playing. I’m looking for places for them to play. Continuing

5. Donna Schill, Ph.D in Art/Graphics, led arts using printmaking. She is an advisor. She designed the logo. We spoke of cleaning it up, but thought perhaps it looked more like us—learning the arts. Member of the Board of the Kirkland Arts Center.

Worked on the Art in the Park this year for Harborview. Had filled in many times and is a holiday helper/leader.

6. John Dame, our grant writer/artist group leader. A Social Psychology student at Seattle Central Community College. Has worked many days at two sites and helped with the evaluation project this summer. He has put in many hours and spoken to many people about our work.

7. Margaret Mulroney (Zucker), a volunteer creative writing teacher. Margaret is a retired nurse. She worked tirelessly for the group at Keystone Resource Center. Her health has been an issue and she has stopped this summer. The taught for us for three years. Two small books were printed with writings and poetry and some art décor to accompany it. She attended a number of board meetings and supports us with her good thoughts and outreach.

8. Helena Hillinga, a woman I met at the Kirkland Art Center in a painting group. She has taught art at Wallingford House for two and a half years, unfailingly. Her group has shown its work at Espresso Splendido and sold 29 paintings last December. Everyone was ecstatic! She has arranged for an art show at the University Unitarian Church, December or January, I believe. She tells people that the “Circle of Friends for Mental Health” is the most democratic thing she has seen since coming from Holland. She builds health and friendship and teaches art skills with her winning support of everyone!

9. Judy Heim, a board member now, but an artist and teacher who has worked with us from time to time, particularly in the summer when students were harder to find.

10. Joan McNabb, a teacher who came to us and supported the arts at Emerald House. Her work has made the timing for classes not work, but she still brings things by to use in art classes and still emails us about her ideas. She worked for about one and ½ years.

11. Gilda Kabbini, taught two months of ink drawing at Wallingford House. She also did the “art with “dough” that is on the web page. She is a “part-time cook” and is an artists. She gave us two of her professional prints for us to sell and raise funds. She offers to have dinners for us to raise funds.

12. Carla Peery, a teacher who gave her time doing quilting and fabric art at Wallingford House. She has offered to train persons to work with the groups if we find willing quilt workers.

13. Tod Wheeler, did craft one day at Emerald House. She said that she would recommend her draughts to teach Photography class. Alice Wheeler has said that she would in the future. Timing has not yet worked. Alice is a professional photographer.

14. Chris Balinski, a theater person led the drama group for a while. We all felt they were not able to put on the production at this time, so we stopped and did some more theater games and work with readings.

15. Quinn Elliott, Executive Director at Kirkland Art Center led three sessions of Theater Games at Keystone Resource Center. They were wonderful. Have not found anyone as able to lead since.

16. Kofi Anang led drumming classes at Clean Start. Two times at the site and once in the Park. We had hoped to bring people from all over the city to the Park. We were unable to use the Seattle Center. Not many found the park. He was a wonderful, talented man, a professional teacher/musician who works with schools around the country teaching drumming. He knows the history and is skilled. He then led a drumming day showing the ways to build health for the social workers at community Psychiatric Clinic.

17. Julia Hohlben, a student just headed for the UW this fall. Interested in recreation and planned to do art, physical work (yoga and Frisbee and walking) and music on three different days. She has been ill with a glandular problem and hopefully is beginning this week.

18. Clinnie Cannon, an artist, potter who lead crafts at Emerald House and then helped with a number of Christmas events. Has filled in during the summer. She has many ideas that she shares with us about projects.

19. Maria Fyles, art students at UW. Taught and worked with art group at Clean Start. One and 1/2 years. Mostly a supporter.

20. Elizabeth Nixon, a UW student worked in the summer of 2005 doing art at Emerald and Wallingford Houses. She took out outside to paint..

21. Veronika Orebinskaia, taught at Emerald House and Wallingford House in fall of 2004. Comment by Heather,--She did a great job!

22. Yun Chang, UW Intern – summer and fall 2004. Emerald House and Wallingford House. Still willing to help out when she can. Has full time job now. Heather marks Excellent!

23. Rebecca Ridenour, drama student taught the drama group winter spring at Univ. Congregational Church. She was warm, wonderful and a good leader and said she would lead the group this fall when she returned from Europe. She understood the people and had the skills to direct a play. Hope she can do it for us.

24. Phyllis Galbraith, a sister of one of the Council House members who was a retired social worker. She lived in Everett and took the bus to Rainbow Creek (Bellevue, SMH) to lead journaling and some writing and some art classes. She went for four months. She was a senior about 60 years in age.

25. Janat Richmond, A teacher and dramatist that I met through the League of Women Voters She led drama for 6 months at Emerald House. She attended a drama event in Alaska and fell, hurting herself badly, which ended her work with us. Janat also attended a meeting for us to see about getting a Seattle Parks Grant. An intelligent woman. She tried several ways to work with a Readers Theater, with new books, with drawing pictures that could be used to get people to come to the play.

26. Holly Lendosky, a wonderful student from the UW who led art at Keystone for about 6 months. She was most happy and gave us wonderful testimony about her work.

27. Erica Foss. Erica worked in tandem wit Tanli Wu leading groups every other week and acting as a supporter on the other weeks. The two worked at Wallingford House and Emeralds House for about 52 years. She made creative things like “Seattle Monopoly Boards” and when everyone made their own clay figurine to use on the board. Very clever artist and ideas. Two students working together is a good system.

28. David Chaus, drummer, from the Drumming Society brought wonderful variety of instruments that he owned himself from around the world. Drums from other countries, shakers, rattle, etc. He talked about their history; everyone got to play the beat. Three or four months he led the group.

29. Usha Jose, an Indian woman who taught some writing classes, with Margaret Zucker and helped organize the Ashiana dinner. Her husband has done some fund raising for us also.

30. Susan Earl, a former Social Service worker who had led music was helpful with the holiday events, but has moved out of state.

AppenA

Appendix IV

Drumming Project at Clean Start with CPC and Circle of Friends

Appendix V

Map of Sites