participant as patient. Writing therapy may come to be viewed as just another variant of psycho-therapy. Or worse still, one more institutional demand.Secondly, an approach to literature which sees its primary function as a means of reaching feelings,treats literature as though it is neutral; a knowable and transparent tool. This approach fails to ad-dress the complex relationship between reader and text and is unable to provide participants withthe space to develop the necessary skills to question and deconstruct texts: to question the implicitvalues encoded in every text, including their own narratives.Thirdly, an approach which focuses on a text’s ability to suggest solutions or ways of dealing withproblems runs the risk of using literature to merely teach certain values. And not create the spacefor the patient/client to explore and choose their own values.Fourthly, an approach which uses literature to offer psychotherapeutic interpretations may, if toorigidly applied, pre-form the desired response regardless of need. If psychotherapists are encour-aged not to interpret excessively or wildly the same needs to be said for a therapist using litera-ture. It can be disturbing and anxiety-provoking to patients to have their needs and feelings brought to their attention before they are ready. A focus on a psychological reading of the text andthe feeling responses of the participants runs the risk of blocking the reﬂective space available toparticipants and limiting discussion to the psychological paradigm.This appropriation and psychologising of art is, therefore, to be strongly resisted. The moment artis institutionalised and administered from a health-care perspective it will lose its ‘otherness’ andpotency to effect change.
Artists working within health-care settings often employ models from outside the health-careparadigm. They do this for many reasons. Many perceive a need to remain ‘from the outside’ if they are to offer those in a therapeutic community a cultural experience. And to de-medicalise thespace in which they ﬁnd themselves, must work against the dominant health-care paradigm whichviews people as patients. Their choice of model will depend on many factors; the needs of thecommunity, their own particular skills, the length of the residency and the particular constraintspresent within the community. Models may also emphasise different priorities and be inﬂuenced by a variety of theories including; communication, literary, feminist, oral history, community art,and cultural development.
So how does this work out in practice?
The following account is based on my experiences as Writer-in-Residence at the Psychiatry Unit,Prince Henry Hospital. This residency was funded by the Writer-in-Community Program/ Litera-ture Board of the Australia Council and it was during this time I faced many of the issues I haveoutlined. My residency, although supported by various senior medical staff, was seen by the hospi-tal administration as belonging to the ‘too difﬁcult basket’. They were wary of my coming in as awriter and keen to make sure I did not conduct what could be construed as therapy. On the otherhand, as time went by and they saw that what I was doing was therapeutic they were thrilled tohave me there. And when my contract expiry date loomed were more than happy for it to be ex-tended, but only if the Literature Board of the Australia Council was willing to continue to providefunding.The model I chose to work with was a ‘participatory model’. This meant that patients would not beregarded as patients attending a writing group but rather, as participants engaged in writing andreading groups that would, as far as possible, be directed by their needs. This decision took intoaccount the shortness of my residency and the necessity to work slowly and gently against themany resistances to my working as a writer in a psychiatric setting.It was important to provide participants with access to an activity that was not therapy-based andthat would allow them to ﬁnd their own voice. I also believed there should be a strong culturalcomponent to the residency and set up a library of contemporary Australian literature in my ofﬁce.