A Novel Landscape for Understanding Physical and Mental Health: Body Mapping Research with Youth Experiencing Psychosis

Authors

  • Katherine M. Boydell Black Dog Institute, University of New South Wales
  • Jeffrey Ball Community Adolescent Outreach Service, Canterbury Hospital
  • Jackie Curtis The Bondi Centre
  • Adèle de Jager Black Dog Institute
  • Megan Kalucy The Bondi Centre
  • Julia Lappin School of Psychiatry, University of New South Wales
  • Simon Rosenbaum School of Psychiatry, University of New South Wales
  • Anna Tewson Black Dog Institute
  • Priya Vaughan Research School of Humanities & the Arts Australian National University
  • Philip B. Ward School of Psychiatry, University of New South Wales
  • Andrew Watkins The Bondi Centre, Southeastern Sydney Local Health District

DOI:

https://doi.org/10.18432/ari29337

Keywords:

arts-based research, qualitative research, body mapping, early psychosis, physical health

Abstract

Estimates indicate the lifespan of individuals with psychotic illness is reduced by approximately 15-20 years. Consequently there is a need to address the physical health of those who live with a mental illness, like psychosis. The Bondi Centre provides an integrated model of care to young people with a first episode of psychosis. The Keeping the Body In Mind program focuses on prevention and early intervention of physical health issues and is offered alongside treatment for mental health and social issues as part of routine care. We used body mapping, an arts-based research method, to explore the complexity of this physical health intervention. Our aim was to develop an in-depth understanding of experiences of young clients of the early intervention centre, with a particular focus on the embodied relationship between physical and mental health. Six young people engaged in creating life-sized body maps depicting their experience of the physical intervention program over four 3-hour sessions, followed by an in-depth interview. Analysis of our body maps drew on thematic analysis and narrative inquiry. The narrative trope was one of recovery, highlighting the importance of the link between body and mind, individual and community, and the balance between light and darkness. There was an emphasis on developing feelings of connectedness (to self and others), hope and optimism for the future, a sense of having an identity, and a sense of meaning and empowerment. Recovery was conceptualised as an ongoing process rather than an end product or fixed state. Involvement in the body mapping process was consistently identified as therapeutic, offering an opportunity for reflection on the journey to recovery with a focus on past, present and imagined storylines of the future. 

Author Biographies

Katherine M. Boydell, Black Dog Institute, University of New South Wales

Katherine M. Boydell is Professor of Mental Health at the Black Dog Institute, University of New South Wales. She is a qualitative methodologist working in the child and youth mental health field. Her research program focuses on advancing the science of knowledge translation using innovative arts-based strategies. 

Jeffrey Ball, Community Adolescent Outreach Service, Canterbury Hospital

Jeffrey Ball is Consultant Child & Adolescent Psychiatrist, Community Adolescent Outreach Service, Sydney Local Health District. He is Conjoint Lecturer, School of Psychiatry, University of New South Wales and Clinical Researcher at the Black Dog Institute with a background in qualitative mental health research.

Jackie Curtis, The Bondi Centre

Jackie Curtis is a Psychiatrist at the Bondi Clinic. Her clinical research focuses on cardiovascular morbidity in youth with first episode psychosis, including prevention and intervention of obesity and weight gain.

Adèle de Jager, Black Dog Institute

Adele de Jager is a Clinical Psychologist and Research Officer whose main interests focus on qualitative inquiry in the mental health field.

Megan Kalucy, The Bondi Centre

Megan Kalucy is a psychiatrist with expertise in working with young people experiencing their first episode of psychosis and in sleep disorders in the context of mental illness. She is also an experienced textile craftsperson with a strong interest in the benefits to health and wellbeing from engaging in artistic practices.

Julia Lappin, School of Psychiatry, University of New South Wales

Julia Lappin is a Consultant Psychiatrist at the Bondi Junction Early Psychosis Program, South Eastern Sydney Local Health District, and a Senior Lecturer at University of New South Wales in the School of Psychiatry. Her research interests include improving outcomes in severe mental illness.

Simon Rosenbaum, School of Psychiatry, University of New South Wales

Simon Rosenbaum is a Senior Research Fellow in the School of Psychiatry, University of New South Wales, Sydney and the Black Dog Institute. Simon is an exercise physiologist with expertise in the design, delivery and evaluation of physical activity programs for people living with mental illness.

Anna Tewson, Black Dog Institute

Anna Tewson studied creative writing in her Bachelor of Arts degree, before moving into a research assistant position at the Black Dog Institute utilising arts-based research techniques to explore mental health. Anna recently completed a course in narrative therapy, and is now completing her Master of Social Work.

Priya Vaughan, Research School of Humanities & the Arts Australian National University

Priya Vaughan is a research assistant at Black Dog Institute collaborating with Katherine Boydell and her team to undertake arts-based research in the mental health space. She is currently completing her PhD in social anthropology at ANU.

Philip B. Ward, School of Psychiatry, University of New South Wales

Philip Ward is a clinical neuroscientist who has developed a translational research and evaluation program focussed on improving physical and mental health outcomes in people with mental illness. He has overseen the development and implementation framework for the Keeping the Body in Mind Program at the Bondi Centre.

Andrew Watkins, The Bondi Centre, Southeastern Sydney Local Health District

Andrew Watkins is the co-developer and lead of Keeping the Body in Mind (KBIM) across South Eastern Sydney Local Health District (SESLHD). He has a longstanding interest in the physical health of people with severe mental illness.

References

Alvarez-Jimenez, M., Gonzalez-Blanch, C., Crespo-Facorro, B., Hetrick, S., Rodríguez-Sánchez, J. M., Pérez-Iglesias, R., & Vázquez-Barquero J. L. (2008). Antipsychotic-induced weight gain in chronic and first-episode psychotic disorders: a systematic critical reappraisal. CNS Drugs, 22(7), 547-562.

Barry, C., Britten, N., Barber, N., Bradley, C., & Stevensen, F. (1999). Using reflexivity to optimize teamwork in qualitative research. Qualitative Health Research, 9(1), 26-44.

Bellack, A., & Drapalski, A. (2012). Issues and developments on the consumer recovery construct. World Psychiatry, 11(3), 156-60.

Berger, P. L. & Luckmann, T. (1966). The social construction of reality: A treatise in the sociology of knowledge. Garden City, NY: Anchor Books.

Boydell, K. M. (2011). Making sense of collective events: The co-creation of a research-based dance. Forum Qualitative Sozialforchung/Forum: Qualitative Social Research, 12(1), Art. 5. Retrieved from: http://nbn-resolving.de/urn:nbn:de:0114-fqs110155

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.

Brett-MacLean, P. (2009). Body mapping: Embodying the self living with HIV/AIDS. Canadian Medical Association Journal, 180(7), 740-741. Retrieved from: http://www.cmaj.ca/content/180/7/740.full.pdf+html

Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health and Illness, 4(2), 167-182.

Chenhall, R., Davison, B., Fitz, J., Pearse, T. & Senior, K. (2013). Engaging youth in sexual health research: Refining a “youth friendly” method in the Northern Territory, Australia. Visual Anthropology Review, 29(2), 123-132.

Creswell, J. (2003). Research design: Qualitative, quantitative and mixed methods approaches (2nd ed.). Thousand Oaks, CA: Sage Publications Inc.

Curtis, J., Watkins, A., Rosenbaum, S., Teasdale, S., Kalucy, M., Samaras, K., & Ward, P. (2016). Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic-induced weight gain in first-episode psychosis. Early Intervention in Psychiatry, 10(3), 267-276. doi: 10.1111/eip.12230

Curtis, J., Newall, H. D. & Samaras, K. (2012). The heart of the matter: cardiometabolic care in youth with psychosis. Early Intervention in Psychiatry, 6(3), 347-53.

Davy, C., Magalhaes, L., Mandich, A. & Galheigo, S. M. (2014). Aspects of the resilience and settlement of refugee youth: a narrative study using body maps. Cadernos de Terapia Ocupacional (UFSCar) 22(2), 231-241.

Deegan, P. E. (1993). Recovering our sense of value after being labeled mentally ill. Journal of Psychosocial Nursing, 31(4), 7-11.

De Hert, M., Correll, C., Bobes, J., Cetkovich-Bakmas, M., Cohen, D., Asai, I., . . . Leucht, S. (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry, 10(2), 52-77.

de Jager, A., Rhodes, P., Beavan, V., Holmes, D., McCabe, K., Thomas, N., . . . Hayward, M. (2016). Investigating the lived experience of recovery in people who hear voices. Qualitative Health Research, 26(10), 1409-1423.

de Jager, A., Tewson, A., Ludlow, B. & Boydell, K. M. (2016). Embodied ways of storying the self: A systematic review of body mapping. Forum Qualitative Sozialforchung/Forum: Qualitative Social Research, 17(2), Retrieved from http://www.qualitative-research.net/index.php/fqs/article/view/2526

Eakin, J. & Mykhalovkiy, E. (2003). Reframing the evaluation of qualitative health research: Reflections on a review of appraisal guidelines in the health sciences. Journal of Evaluation in Clinical Practice, 9(2), 187-194.

Fisher, P. & Lees, J. (2015). Narrative approaches in mental health: Preserving the emancipatory tradition. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 20(6), 1-17. Retrieved from http://eprints.whiterose.ac.uk/88910/3/Health24July%5B1%5D.pdf

Frank, A. (1995). The wounded storyteller. Chicago, IL: University of Chicago Press.

Gastaldo, D., Maglhães, L., Carrasco, C. & Davy, C. (2012). Body-Map storytelling as research: Methodological considerations for telling the stories of undocumented workers through body mapping. Retrieved from: http://www.migrationhealth.ca/undocumented-workers-ontario/body-mapping.

Guillemin, M. & Gillam, L. (2004). Ethics, reflexivity, and “ethically important moments” in research. Qualitative Inquiry,10(2), 261-280.

Hjorthøj, C., Stürup, A. E., McGrath, J. J., & Nordentoft, M. (2017). Years of potential life lost and life expectancy in schizophrenia: A systematic review and meta-analysis. The Lancet Psychiatry, 4(4), 295-301. doi: 10.1016/S2215-0366(17)30078-0

Le Boutillier, C., Leamy, M., Bird, V. J., Davidson, L., Williams, J. & Slade, M. (2011). What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidelines. Psychiatric Services, 62(12), 1470-1476. doi: 10.1176/appi.ps.001312011.

Lincoln, Y. & Guba, E. G. (1985). Naturalistic inquiry. Thousand Oaks, CA: Sage Publications Inc.

Lloyd, C., Wong, S.R., & Petchkovsky, L. (2007). Art and recovery in mental health: A qualitative investigation. British Journal of Occupational Therapy, 70(5), 207-214.

Mental Health “Recovery” Study Working Group. (2009). Mental health “recovery”: Users and refusers. Toronto, ON: Wellesley Institute. Retrieved from: http://www.wellesleyinstitute.com/wp-content/uploads/2011/11/Mental_Health-_Recovery.pdf

Mitchell, A. J., Hardy, S., & Shiers, D. (2017). Parity of esteem: Addressing the inequalities between mental and physical healthcare. British Journal of Psychiatric Advances, 23(3), 196-205.

Morgan, V. A., Waterreus, A., Jablensky, A., Mackinnon, A., McGrath, J. J., Carr, V., . . . Saw, S. (2012) People living with psychotic illness in 2010: The second Australian national survey of psychosis. Australian and New Zealand Journal of Psychiatry, 46(8), 735-752. doi: 10.1177/0004867412449877

Orchard, T. (2017). Remembering the body: Ethical issues in body mapping research. Cham, CH: Springer, Springer Briefs in Anthropology.

Plummer, K. (2000). Documents of a life: An invitation to a critical humanism (2nd ed.). London, UK: Sage.

Pope, C., Ziebland, S., & Mays, N. (2000). Analyzing qualitative data. The British Medical Journal, 320(7227), 114-116.

Riessman, C. K. (2005). Narrative analysis. In N. Kelly, C. Horrocks, K. Milnes, B. Roberts & D. Robinson (Eds.), Narrative, memory & everyday life (pp. 1-7). Huddersfield, UK: University of Huddersfield.

Rhodes, P. & de Jager, A. (2014). Narrative studies of recovery: A critical resource for clinicians. Clinical Psychologist, 18(3), 99-107.

Shiers, D. & Curtis, J. (2014). Cardiometabolic health in young people with psychosis. The Lancet Psychiatry, 1(7), 492-494.

Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., . . . Whitely, R. (2014). Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems. World Psychiatry, 13(1), 12-20.

Solomon, J. (2002). “Living with X”: A body mapping journey in time of HIV and AIDS. Facilitator’s Guide. Retrieved from: http://www.comminit.com/healthafrica/content/living-x-body-mapping-journey-time-hiv-and-aids-facilitator%E2%80%99s-guide

Teasdale, S., Harris, S., Rosenbaum, S., Watkins, A., Samaras, K., Curtis, J. & Ward, P. B. (2015). Individual dietetic consultations in first episode psychosis: a novel intervention to reduce cardiometabolic risk. Community Mental Health Journal, 51(2), 211-214. doi: 10.1007/s10597-014-9787-7

Vancampfort, D., Stubbs, B., Ward, P. B., Teasdale, S. & Rosenbaum, S. (2015a). Why moving more should be promoted for severe mental illness. The Lancet Psychiatry, 2(4), 295.

Vancampfort, D., Stubbs, B., Ward, P. B., Teasdale, S. & Rosenbaum, S. (2015b). Integrating physical activity as medicine in the care of people with severe mental illness. Australian & New Zealand Journal of Psychiatry, 49(8),681-682.

Van Lith, T. (2015). Art making as a mental health recovery tool for change and coping. Art Therapy, 32(1), 5-12. doi: 10.1080/07421656.2015.992826

Cover image by John Rae, No limit, 76 X 56 cm acrylic and collage

Downloads

Published

2018-09-15

How to Cite

Boydell, K. M., Ball, J., Curtis, J., de Jager, A., Kalucy, M., Lappin, J., … Watkins, A. (2018). A Novel Landscape for Understanding Physical and Mental Health: Body Mapping Research with Youth Experiencing Psychosis. Art/Research/International:/A/Transdisciplinary/Journal, 3(2), 236–261. https://doi.org/10.18432/ari29337

Issue

Vol. 3 No. 2 (2018): Art/Research International: A Transdisciplinary Journal

Section

Art/Research In Action

License

Copyright (c) 2018 Art/Research International: A Transdisciplinary Journal

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Authors who publish with Art/Research International agree to the following terms:

a. Authors retain copyright and grant the journal right of first publication and the right to sublicense the Contribution, in the form in which it is published by the journal, to others under the terms and conditions of the of the Creative Commons Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) that allows others to download the work and share the work with others with an acknowledgement of the work's authorship and initial publication in this journal, but they cannot change the work in any way or use any part of the work commercially.

b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive public distribution and display of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

d. Authors wishing to include items (such as images or other media, or any creative works of others whether previously published or not) must contact the original copyright holder to obtain explicit permission to publish these items in Art/Research International. Writing permission should include: the title(s) of any copyrighted work, original place of publication if applicable, and an acknowledgement of having read Art/Research International's copyright notice. Authors are responsible for obtaining this permission and keeping it in their own records for later verification.