Student Self-Care and Mental Health Well-Being through Creative Art and Art Journaling: Facilitating Self-Care Opportunities through Creative Art for Students in the Helping Professions ()
1. Introduction
Post-secondary education can be an exciting and overwhelming adventure for students, which can also lead to feelings of stress and anxiety (Moghimi et al., 2023) . Students often face separation from their families for the first time, new and challenging social networks, academic pressures, financial strain, and relationship angst. Post-secondary students have been identified as struggling with their mental health and well-being, especially in the early years of their education journey (Moghimi et al., 2023, Lee & Jang, 2015) . Understanding that the main goal of post-secondary institutions is to facilitate education and intellectual functioning, academic achievements can be enhanced by supporting the whole student, including their health and well-being. The Canadian Association of College and University Student Services (CACUSS) suggests that when students are healthy, they can concentrate on their studies and reach their potential (American College Health Association, 2013) . However, with limited funding and resources available to enhance student success, post-secondary institutions are looking for other innovative ways to mitigate student stress and mental health concerns and increase overall well-being (Glauser, 2017) . Knowing that students are experiencing stress, we wanted to look at creative ways to help alleviate some of the stress and enhance learning for students in their practicum experience in their second year of human service programs. This paper explores an innovative approach to assisting students in managing their mental wellness and coping skills while enhancing their learning by encouraging creative thinking through art journaling.
2. Supporting Literature
The transition from high school to post-secondary can leave students vulnerable to mental health stressor such as loneliness, changes in social activities, new scholastic expectations, conflicts with roommates, making new friends, romantic relationship issues, changes in sleep habits, financial difficulties, new responsibilities, change in use of drugs or alcohol, computer problems, increased class load, low class grades, searching for careers, car troubles, and messy living conditions (Lee & Jang, 2015; Barankevich & Loeback, 2022) . Post-secondary education can create an environment of competitiveness and stress, resulting in the potential for compromised well-being, burnout, psychological and emotional distress, increased likelihood of depression, anxiety, and stress disorders (Kiltz et al., 2019) .
We know that once students begin their studies within the helping professions, they encounter increased challenges. Further impacting their stress is the pressure from new experiences in field study practicum placements alongside some degree of regular coursework. Students are often overwhelmed by information and experiences in their practicum that can impact their ability to process information (Kostouros, 2017) .
Studies show that stress increases cortisol, which creates exhaustion, causing impairments related to executive function, attention, and memory (Jonsdottir et al., 2017) . Further, “from an education perspective, increased stress can have a negative impact on student’s academic success” (Lisnyj et al., 2023: p. 852) . Frazier et al. (2019) found that students with the highest stress levels had lower GPAs, coping self-efficacy, resilience, and social support. It is reported that short exposure to creative and expressive art sessions significantly reduced anxiety in students, thus improving their overall academic performance (Sandmire et al., 2012) .
Arts-based methods of inquiry support creative arts practices by inquiring into the multi-sensoriality of lived experiences, reflections and memories of time, space, self, and other as integrated with theory and research (Barone & Eisner, 2012) . Resilience goes hand in hand with well-being and a student’s ability to cope and learn in the face of challenges or adversity (Kiltz et al., 2019) . Therefore, building personal resources to aid in the ability to bounce back is important to maintaining well-being in the helping professions.
We found that several human service-based practice professions use creative arts as therapeutic tools in practice with clients. Kendell (2011) explains that the arts have been incorporated as adjunctive techniques in individual, family, group, and community practice for years. Any creative arts modalities (art, drama, music, photography) may be used as a primary form of therapy or an adjunct to other modalities to improve individuals’ physical, cognitive, and psychosocial well-being Kendell (2011) . A study by Leitch (2006) showed that creative modalities can facilitate, promote and support well-being and self-care. Leitch (2006) showed that “through the creation of images about self, new meanings, previously unaware, unvoiced, unexpressed, half-understood came to be significant and capable of being incorporated into the participants’ social and/or emotional understanding of themselves, to the point that new actions or directions could be taken in their lives” (Leitch, 2006: p. 566) . As researchers with an interest in expressive and creative arts for the purpose of well-being, we wanted to see if expressive and creative art would provide a positive impact on student well-being and learning outcomes.
3. Pilot Study
To determine what impact expressive and creative arts might have on student well-being and learning, we offered an eight-week facilitated program (one 2-hour session per week) of creative art journaling in both Winter and Spring terms to students studying in second-year professional human service programs who were also doing a community practicum. Having two terms would allow building group cohesion and tend/attend to the evolving creative process (Levine, 2003) as a process of breaking down barriers and “healing through creative action” (Levine, 1992: p. 25) of individual group members and the group as a whole. We were interested in discovering what happens when post-secondary students in human services are invited to engage in art journaling and creative arts practices. What do art journaling and creative arts methods reveal about post-secondary students’ self-care practices and well-being in human service professional programs?
The Creative arts activities included variations of exercises using paint, mixed media and drawing with colour, based on learning plans and resources/tools in art journaling and creative arts. Each week, we proposed a new creative exercise connected to a theme and included a prompt to get participants started. Themes included essentials of stress management challenges of self-care, identity as student learners, practicum experience, time, relations with other students, family, friends and instructors, etc. (Malchiodi, 2007; McNiff, 2011) . Exploring themes through creative methods allowed participants to connect to the topic in a different way, promoting reflexivity and attention to the aesthetics of life (Leavy, 2019) .
The students who participated in the study were from the disciplines of child studies, education, and social work at a small undergraduate university. We were scheduled to meet with the student participants weekly for eight weeks. However, in week three, we were interrupted by the onset of Covid-19 and could not continue to meet in person. At the student’s request, we approached the university ethics board and submitted a revision to our study to continue meeting virtually in a Google Meets space, which we were granted. The remaining five weeks were spent meeting weekly for an hour in a Google Meet virtual space. All of the students but one remained in the study as participants.
The creative group process helped ignite our collective imaginings and helped us see we are not alone when grappling with difficult situations, decision-making, learning, and other relational aspects of human services and professional work (Moon, 2010) . The methodology we engaged in is arts-based narrative inquiry, which, when effective, is useful for participants to engage more thoughtfully (Barone & Eisner, 2012) . Using the arts as a primary mode of inquiry means the students engaged in art journaling, creating a piece of art, then responding to their creation by journaling about their art and the experience of creating and learning. McNiff (2003) suggests that through art, we let go of negative attitudes and the need for control, enhancing interactions with others, opening our minds to more original ways of looking at problems and how to solve them. Within a group setting, this can lead to adapting to a more supportive environment, allowing new insights to form.
Collage, for example, when used as an exploratory form of inquiry, adds images and words to evoke new learning potentials and scaffold the creative process of reflective writing (Butler-Kisber & Poldma, 2010) . The idea behind the tasks is to engage in one’s creative process as one is called to do while in the presence of others who hold that sacred space (safe and supportive peer atmosphere) conducive to risk-taking and self-exploration through creativity (Murrant et al., 2000) . Also, reflective journaling was incorporated into the art journal kept by the participants to track their processes and work between sessions as a means of “examining assumptions and constructs’’ in order to raise critical consciousness and self-awareness, leading to increased problem-solving ability (Kress et al., 2008) .
We aimed to grow and nurture supportive learning environments for students of professional programs through creative endeavors to influence positive well-being and grow personal strategies for self-care maintenance throughout their professional lives (Kagan et al., 2014) . Narrative inquiry was used to analyze and represent the data and the images evoked by metaphor to convey the expression of art-making (Prendergast, 2009) . As Clandinin and Connelly (2000) describe, narrative inquiry is a collaboration between researcher and participants over time, in a place or series of places, and social interaction with milieus.
Barone and Eisner (2012) write that the audience vicariously enters the virtual world by re-experiencing these mental images. Written reflective and visual representations were used as both a method of engaging participants and as a layering of found excerpts that emerge from the data. The phrases, images and language/words create a visual depiction that we sort through to find our path (Prendergast, 2009) .
4. Method
Information about the pilot study was shared with child studies, social work, education, and nursing program students. Approximately 20 people initially expressed interest, but in the end, 12 participants attended the facilitated workshop sessions. Participants attended the workshop sessions and were given an art journal and art supplies as theirs to keep. This art kit became their travel art kit and was intended to be used between facilitated sessions. The workshops were held in an art room where additional materials were supplied for use during the weeks we met in person. Participants were also entered into a draw at the end of the study for one of two $50.00 gift cards to a local art store. The ethics review board at our institution approved the study. Before starting the facilitated workshops, the participants completed a pre-questionnaire self-care inventory (National Alliance on Mental Illness, 2020) . Participants engaged in creating their art and writing the complementary narrative in their journals during the facilitated sessions. The researchers engaged in the art alongside the participants and took field notes based on their observations. Additionally, the participants allowed photographs of their art to be taken and narrative journal entries as data. The sessions were followed up by a post-questionnaire self-care inventory (National Alliance on Mental Illness, 2020) and a post-study semi-structured interview. As our study was interrupted by the onset of COVID-19, we could not complete it as planned. As such, we are reflecting on the outcome of what we were able to complete under rapidly changing circumstances.
Our strategy for analyzing the data collected was to use thematic analysis. The interviews were transcribed, and both researchers analyzed the data separately, identifying themes and then reviewing commonalities. The exact process was repeated with the observation notes collected during the facilitated workshop sessions. Finally, we compared the pre- and post-self-care inventory surveys (National Alliance on Mental Illness, 2020) for differences.
5. Results
The themes that stood out from the interview data as important to the participants include reflection on self-practice, application of creative arts-based practice, relaxation and stress reduction, self-care, the importance of having time and dedicated space to practice art-based self-care, and increased confidence, which is supported by Malchiodi (2005) stating that “the experience of doing, making, and creating can actually energize individuals, redirect attention and focus, and alleviate emotional stress, allowing clients to fully concentrate on issues, goals, and behaviors” (p. 10). Participants reported that engaging in art-based activities and journaling helped them to reflect on their practice and the experiences they had in their practicum practice placement, helping them to relate more personally to clients they were working with in their placements and organize learning priorities, prioritize what they wanted for themselves instead of someone else’s expectations. One participant said, “I did not know how much I needed this”. Participants mentioned the benefit that art had on them and how they think it will greatly benefit their clients as well, they described the activities as helping them to relax and de-stress (especially during the initial lockdown and stress of the unknown of Covid-19), and that art journaling helped contribute to their self-care. Specific comments from participants include, “The activities helped me in practicum, especially the inner critic [activity], it helped me to change my thinking about myself”; “I had to show up, no matter how late I was, because I loved it so much”; and “as a 40-year-old, starting a new career that I did not think I was smart enough to do, the activities helped me to move away from that thinking”.
6. Limitations
The main limitation affecting this study was the onset of COVID-19. The initial study intended to work with various types of art media in a community practice environment on campus in an art studio. We had hoped to see a community of practice evolve from the time participants spent together working on inspiring and creative art journal projects, journaling together, and sharing. Unfortunately, three weeks into the study, we were met with COVID-19 lockdown mandates that suddenly removed us from campus. Students had their journals and mini travel art kits that held a few items, and that was it. Our initial response was to delay the project by a couple of weeks while we waited out COVID-19, but we soon realized that would not be the case. We allowed the participants to abandon the project for the semester and start again when we could come back to campus. However, the participants wanted to continue to meet virtually. It soon became apparent that the participants needed time together during the unknown period of the onset of COVID-19. Students said, “I did not expect how much I would benefit from it,” “It was the highlight of my week,” and “The past four weeks during self-isolation helped me to de-stress.”
7. Discussion
Although we did not have the study we had initially planned, we established enough information to determine that there appeared to be a benefit to using art journaling as a form of self-care and stress reduction for students in the helping professions doing practice placements. However, due to the COVID-19 interruption, we cannot say if the study results would have looked different had we not been forced into lockdown and isolation. However, we can say that it appeared that the unintended result of using art journaling as a form of self-care helped students during the unknown period of isolation. A virtual community of practice was available twice weekly for four weeks; it was well attended and reported as helpful to their well-being, decreasing their stress and allowing them to attend to their learning. It would be beneficial to try this again post-COVID to see the results after running an entire eight-week facilitated program.
8. Conclusion
A pilot study examining the use of creative art journaling through an arts-based method of inquiry and thematic analysis of data was initiated and interrupted by COVID-19. However, despite the interruption, enough data was collected to recommend the potential for a positive impact on the well-being of students who engage in creative arts-based journaling practice. Students in the helping professions who are often exposed to the pain of others need a place to put the pain they are carrying. Art journaling is an easy and effective way of working through life stressors and emotions that come from working in the helping professions and would benefit from being explored further. The data collected in this study suggests further possibilities for studying the effectiveness of using art journaling as a self-care practice technique alongside practice placements.