Six older adults lined up excitedly for their last session in a new program called GATE-ways to Recovery at St. Barnabas. They were eager to continue where they'd left off a few days earlier, creating art and telling their stories through their creations.
"Each session offered a chance to reminisce, make decisions, create artwork and socialize," said St. Barnabas Quality of Life Director Carrie Ezell. "The program is also designed to decrease anxiety and depression, while increasing skills and cognition."
Founded in Australia by Margaret Muir, B.Sc., GATE-ways (Gestalt Art Therapy Experiences) has spread throughout Australia and become popular in Europe as caregivers and families see the benefits. The pilot program at St. Barnabas represents the first time GATE-ways has been implemented in the U.S.
"The program focuses on the positive," says Megan McDill, GATE-ways certified practitioner and Ms. Muir's only official contact in the U.S. and Canada. "Participants develop a sense of safety and trust, their mastery and skills increase, self-worth increases, and socialization increases."
Ms. Muir created GATE-ways after many years of observation and practice in her work with older adults afflicted with dementia and Alzheimer’s. GATE-ways, a psychotherapeutic intervention, is based on the person-centered approach and includes a series of 10 art therapy sessions with specific goals, therapy interventions and art creation which culminate in a book gifted to the resident at the end of the program.
"Central to the program is the belief in the importance of personhood, the sense of self and self-worth, and the recognition that personhood can be eroded by the behavior, attitudes and actions of others," said Ms. Muir. She believes basic human desires for comfort, attachment, inclusion, occupation and identity are imperative to meeting the psychological needs of the person.
Since inception, Ms. Muir says the program has been demonstrated and evaluated rigorously. Her formal study was conducted and evaluated with what she describes as the some of the most marginalized people in developed societies: women with dementia in residential care. Ms. Muir collected data using the mini mental, dementia care mapping, anxiety scales and depression scales as well as tracking behavioral changes for the duration of the study. Statistical and empirical data indicated that through GATE-ways participants experienced reduced anxiety, lowered levels of depression, improvement in memory, improved physical ability, enhanced sense of self as a valued human being, increased well-being and social interaction skills.
During the five-week program at St. Barnabas, data was also collected for ongoing research, which showed an increase in participant engagement, physical abilities, social interaction, and well-being. At the end of the series, St. Barnabas hosted a celebration at which residents received a book of all the artwork they had produced at each of the 10 sessions, along with their accompanying stories.
"This group was worth getting up for," said participant Stephanie Dillard. "I feel like now I'm calm."
Research increasingly demonstrates that occupation is key to maintaining physical and mental health and well-being. Because cognitive impairment affects the ability to engage in activity, it often results in omission from treatment programs as it is assumed the individual will show no clinical improvement. According to Ms. Muir's research, however, it is possible to see improvement in cognition and function when an individual's cognitive abilities as well as limitations are identified and when the demands of an activity are understood.
"I am thrilled that GATE-ways to Recovery has made it to America!" said Ms. Muir. "GATE-ways provides a wonderful opportunity for improvement in self-awareness, self-esteem, memories, hopes, imagination, delight in life and more. My hope is that many more residents in aged care facilities in America will be able to benefit from it."
St. Barnabas provides skilled rehabilitation and long-term care.