Bob Allston

April, 2000 with February 2003 update





  1. The Shands Arts in Medicine (AIM) program has enjoyed a privileged position at the University of Florida Shands teaching and research hospital, Gainesville, Florida, over the past nine years, sheltered from its competing professions with essentially a monopoly to practice throughout most of the hospital. And from this sheltered position, it has attempted to launch its ideology of art healing to other hospitals and institutions around the world.

  2. When the arts are employed for healing, their effectiveness is measured in the same manner any other modality of healing is measured. (One of the most common forms of measurement being of course clinical trials.) However, Arts in Medicine has openly flouted the conventional academic, medical, and research norms and conventions that its competing professions (doing the same thing) adhere to as well as the norms and conventions that the founder's own respective professions of medicine and nursing adhere to.

  3. Thus such things as commercialism, unsubstantiated claims of effectiveness, pop culture and new age rhetoric, anti-science ideology, and supernatural leanings surface repeatedly in the program. These particular problems are explored in greater detail in a Web site I introduced in April, 1999, entitled Mainstreaming Arts in Medicine .

  4. If you take the link to the above site, you will notice that the first paragraph opens with the statement "Arts in Medicine (AIM) is a new movement that is gaining popularity around the world". However, unknown to me at the time, this just wasn't the case; nor is it the case at this writing. I think I just let myself be taken in by the program's self aggrandizing hype. For the fact is Arts in Medicine isn't gaining in popularity and indeed isn't going much anywhere.

  5. Therefore the purpose of this site is to remedy this omission by examining AIM's competitive market position within its family of related disciplines. Thus the former site concentrates on the problems within AIM at UF's Shands Hospital while this site concentrates on the difficulties AIM has had in exporting itself to other institutions, largely as a consequence of these problems.

  6. I have been a volunteer for over a year in the Shands Hospital Arts in Medicine program and over two years in the Recreation Therapy program practiced at the VA Hospital just cross the street (Archer Road) from Shands Hospital. In March, 2000, I received recognition from the VA for 750 hours of volunteer service at the VA Recreation Therapy Department. (It is a few minutes walk through a tunnel under Archer Road between the two hospitals).

  7. Arts in Medicine and Recreation Therapy are closely competing professions; and the case can be made that Recreation Therapy is the closest competing established profession to Arts in Medicine. Thus, because I have had experience with both disciplines, because Recreation Therapy is arguably Arts in Medicine's closest competitor, and because it is taught at UF through the Ph.D. level, this analysis focuses on the relative merits and market position of these two professions.

  8. In sum, this analysis finds that Arts in Medicine suffers from a host of crippling problems, making it far inferior to virtually all of its competing professions. And for this reason, it can claim at best less than one percent of the market, with the vast majority of the remaining market going to the therapy professions. For a quick overview of the problems before examining the details, consult the last section, Summary of AIM's Competitive Shortcomings.

  9. Furthermore, implicit in these findings, is the fact that the use of art in healing would have been far more advanced over the past nine years had the Shands program been operated under one of the related therapy professions. This is extremely unfortunate, for Shands is the State's foremost teaching hospital, presenting excellent opportunities to advance fundamental knowledge in the area.

  10. As a publicly supported institution, Shands of course has a very basic obligation to advance all areas of health care and deliver the best health care it can to its patients. The most likely reason for Shands' apparent indifference in this regard is that the Arts in Medicine program was set up and operated by a long established medical doctor at the hospital; whereas AIM's major competing professions are outsiders lacking such support and only one of them (Recreation Therapy) is even taught at UF.

  11. Indeed, when one realizes the many deficiencies in this program, one can't help but wonder how many other "off limits" pet programs at Shands are similarly taking up precious resources and displacing far better programs at the expense of taxpayers, patients, and progress in the health sciences.

  12. Although this study is intentionally limited to Web sources in order to provide equal, free, and no hassle sources for everyone; I think you will find them to be sufficiently complete and accurate to support the conclusions. However of course be warned that Web sources tend to change frequently without notice (although I have a dated file of them). But I'll try to keep up with any important source changes, especially if someone is kind enough to bring them to my attention.

  13. I love the concept of using the arts for healing and I think there is much to be explored and learned. It is my hope that this and my previous site will help put this modality of healing on track for reasonable claims of effectiveness, reasonable academic/research standards and honesty and credibility otherwise, whether practiced at Shands or elsewhere. This would in turn reduce its cult character (at Shands) thus making it attractive to a vastly wider spectrum of volunteers and staff than it now attracts capable of numerous and varied contributions.

  14. In keeping with my customary web site architecture, I have constructed this site in the straight forward style of a professional paper printable in black and white.

    Bob Allston,
    April, 2000


  15. If a term such as "Arts in Medicine" is found in the title of a Web page, there is of course a high probability that it is a principal subject of the page.

  16. Thus the relative popularity of a subject on the Web may be measured by the number of times it appears in title pages. And since the Web increasingly mirrors society in general, such an analysis might be expected to yield an approximation of the relative popularity of the subject in the general population as well.

  17. In seeking a search engine capable of returning such results, I have found that Altavista (among others) has the capacity to return only those Web pages that include the key search word or phrase in the title of the page and appears to be capable, for the most part, of limiting its returns to only one page for any given Web site; a process which would appear to give a more accurate picture. As well, AltaVista has a substantial data base. Thus I am choosing it for the survey.

  18. Of course there will be Web sites that AltaVista does not carry that other search engines do carry and vice versa. However, it is not necessary to know the actual total number of sites that have the particular subject of interest in them if only the relative number of sites for the different subjects of interest can be reasonably ascertained; probably a reasonable expectation. That is, even if Altavista doesn't pick up all the sites in a particular search, it will probably be missing roughly the same percentage of Web sites in each different search, thus making a comparison of the number of returns across all the different searches about the same as if Altavista did pick up all the Web sites.

  19. Since "Arts in Medicine" goes by other names such as "Arts in Healing" and "Arts in Healthcare", as well, I shall employ all of these names as key phrases for Arts and Medicine.

  20. The principal artists in the program are called "artists in residence". Arguably one might employ this phrase also but it appears unnecessary. For, an AltaVista search to locate all of the web sites with it in the title produced 106 sites. However, in reviewing the first 10 returns, none of them appeared to be about art in hospitals or related issues; for the phrase is commonly used to characterize artists at schools, summer camps, music and art schools, etc. In doing further more complicated searches on AltaVista and other search engines I only found a few sites that fit the criteria; so I think its safe to assume that whether or not the phrase is employed would not materially change the results in any event.

  21. Some related disciplines are the "therapy" professions such as Recreation Therapy as discussed above, Art Therapy, Music Therapy, and Dance Therapy. As a generalization, Recreation Therapy is broader in scope than Arts in Medicine and the other therapy professions, encompassing such things as games (both physical and mental) of many different kinds, exercising, and recreational outings, etc.; as well as the arts employed in Arts in Medicine and the other therapy professions. Of course, as a general rule, Recreation Therapy doesn't specialize to the degree the others do either; although its practitioners do so when they choose. Thus one may readily concentrate on arts of various kinds within the framework of Recreation Therapy.

  22. Outside of these professions, we have competing modalities of healing such as acupuncture, herbal medicine, meditation, yoga, etc.

  23. It is of course beyond the scope of this survey and my knowledge of these professions/modalities of healing to attempt to either name or characterize completely all of those that might be said to be in competition with Arts in Medicine. However to reasonably profile AIM's competitive position, it isn't necessary to analyze more than one of its closest competitors among the therapy professions, because AIM's competitive problems relative to all of them are in many ways similar. Thus I've chosen recreation therapy.


  24. The following is a listing of the number of AltaVista returns, starting with the smallest number, from a search on: title:"subject of interest". Thus for instance, the search for Arts in Medicine is: title:"arts in medicine". I am also employing only lower case letters in the searches, which appears to give the most complete returns. Thus, for instance, on a search for Arts in Medicine, the search is done on "arts in medicine".

  25. Of course, Web sites change as well as appear and disappear constantly, so the links below and the number of sites may be expected to change from the time this analysis is made on April 10, 2000.

  26. The total for "Arts in Medicine" is four pages. The first two are from the same Shands Hospital site Arts in Medicine: Information about AIM and, Arts in Medicine: Art in the Hospital . The third page is the Florida State University site, Arts in Medicine, Medical Music Therapy , and the fourth is my page, Arts in Medicine and the Web.

  27. Although there are two apparently redundant Shands sites with a page from each, good research methods suggest it would not be appropriate to remove the redundant site/page, unless one was going to try somehow to find all the redundant sites/pages and remove them for all of the searches undertaken; an all but impossible task.

  28. The total for "Arts in Healing" is two pages: MEDIA ALERT: "Mental Health Art Exhibition - Arts In Healing" and my page, Arts in Healing: Exploring our Niche. On examining the former page, it appears to refer only to a temporary art exhibit, not to any kind of permanent AIM program. The latter page is from my site returned above, although a different page.

  29. I also know of one Arts in Healing site that this search did not reveal that is Arts in Medicine co-founder, Mary Rockwood Lane's site (discussed below). Again, for the same reason it would be impossible to remove all of the redundant pages from the same site, it would be impossible to include all the sites that the search doesn't find. Thus this site is not included in the total.

  30. The total for "Arts in Healthcare" is three pages: Arts in health care: Healing Arbor. , 10020607.htm Arts in Healthcare , and a second copy of the latter site, 10020607.htm Arts in Healthcare . The first link is to a single page dealing with arts in healthcare out of a large site dealing with other matters. The second two links are to the same page describing a program on the Channel Islands (Europe) as an "Organisation to bring cultural entertainment to those in institutions of care."

    Most significantly, there is no reference in any of the Arts in Medicine, Arts in Healing or Arts in Healthcare programs to an artist in residence program, which of course is the highly touted core of the Shands Arts in Medicine program, although of course it is possible there is one.

    As well, there is no reference or link to founder Mary Lane's site with its high concentration of supernatural phenomenon; although of course I might have overlooked something.

  31. There are other differences as well. Thus it appears unlikely that any of the pages refer to programs that resemble the Shands Arts in Medicine program to any degree, although of course there are other arts programs of various kinds. (The FSU site has the same name as the Shands Arts in Medicine program and appears to be a substantial program but, as discussed below, it is very different in character.)

  32. Thus for comparative purposes for Arts in Medicine we have 4 pages, for Arts in Healing 2 pages, and for Arts in Healthcare 3 pages, for a total of 9 pages; although these links represent only 6 separate sites.

  33. Thus although it would appear that there are no actual programs that resemble the Shands Arts in Medicine program to any degree, if we are just counting program titles, the figure is 9. And since it isn't practical to attempt a similar analysis of all AIM's competing professions, the figure 9 will be employed for comparitive purposes.

  34. For the remaining analysis, there are too many sites to make it practical to include links to each site; so just the total number of sites will be given:

    1. The total for Arts in Medicine (including Arts in Healing and Arts in Healthcare) is 9 sites.

    2. The total for Dance Therapy is 39 sites.

    3. The total for Recreation Therapy is 40 sites, and the total for Therapeutic Recreation is 148 sites. These are two names for essentially the same discipline thus the two results may be added, making a total of 188 sites.

    4. The total for Art Therapy is 650 sites.

    5. The movie Patch Adams, about a doctor who clowns around to cheer up hospital patients relates to AIM; and the the total for Patch Adams is 807 sites.

    6. The total for Music Therapy is 1,039 sites.

    7. The total for acupuncture is 6,654 sites.

    8. The total for meditation is 16,166 sites.

    9. The total for medicine is 156,222 sites.

    10. The total for arts is 352,489 sites.

  35. Thus the search results continue to suggest that compared to all its related and competing disciplines, Arts in Medicine, as practiced at the University of Florida Shands Hospital (including Alachua General Hospital) appears to have grown little if any beyond Shands hospital, remaining almost entirely there.

  36. This result would also appear to be supported by Arts in Medicine founder Mary Lane's Web page, Art Programs in Hospitals . For it mentions only six hospital (I assume the Society for the Arts in Healthcare is not a hospital) sites where she claims Arts in Medicine is established. However, of those, she has links to only three; one of which is her own site about the University of Florida AIM program, another of which (Dartmouth College) is (at this writing) a bad link, and the last of which is an apparently very limited program at Stanford University. Since there are no links to the remaining three, there is no way to evaluate them. Of course most programs of any distinction would have Web pages appearing on searches; none of which have appeared in my searches.

  37. Thus, having far less than one percent of the market for arts in hospitals, Shands' brand of arts for hospitals is simply totally insignificant. Consequently way over 99 percent of the arts in hospitals is being administered by the therapy professions and others; with all indications that it will remain so.




  38. Even though Shands Arts in Medicine is still largely limited to Shands Hospital while its competing therapy professions have grown considerably, it has been promoted far beyond the efforts expended on behalf of its competing professions. For example, I haven't come across information about the therapy professions with anything approaching the promotional hype and claims of effectiveness employed in the following pages out of AIM co-founder Mary Lane's Web site and an Alachua Freenet site (Arts in Medicine Symposium '95) promoting Arts in Medicine:

    1. The Exciting New Field of Art and Healing

    2. Advice for someone who wants to work with patients making art

    3. The New arts in healing program procedure manual.
      This promotional material would lead one to believe that setting up a successful Arts in Healing program at a hospital can be done with just about any recruits out of the local arts community. However, whether this is true or not, what it fails to mention is that virtually all of the people it talks about who started the program in this hospital were the same people who were currently in the program at Shands Hospital, with on the order of twenty or more years collective experience with the Shands Arts in Medicine program.

    4. Arts in Medicine Symposium '95

    5. Be included in the first Ph.D. on art and healing.

    6. Doing ritual on sacred sites to heal

    7. Art Programs in Hospitals

    8. At the same time, one is hard put to find scholarly work or research to support the broad claims made or implied, that would prove acceptable by conventional academic or scientific standards:

    9. There are some articles by John Graham-Pole on the Shands Hematology and Oncology for Kids page which appear to relate to AIM and not knowing otherwise, I would assume meet such standards; and of course there may be more on the Web or otherwise that I just haven't come across.


  39. An Arts in Medicine program has recently been set up at a hospital in the Tallahassee, Florida, area under the auspices of the Florida State University Music Department. They have an excellent Web site entitled Arts in Medicine, Medical Music Therapy.

  40. From what appears from the extensive information about it on the Web, this program is substantially different from the Arts in Medicine program at Shands Hospital; and thus worthy of examination. For it is solidly under the FSU Music Therapy department where FSU is funding a full time position for a person with a masters degree in music therapy and board certification in music therapy. And the university and hospital have had an ongoing program of medical research for a long time. This contrasts sharply with the Shands program which rejects both therapy and medical research and is heavily involved with supernatural phenomena (not appearing in the FSU program.)

  41. Thus, in announcing the program in Features Online , it is stated:

    1. "It was a great day for getting well this past spring when the Tallahassee Memorial HealthCare Foundation and Florida State University formalized an ongoing learning project involving music, art and medicine. The healing arts took on new meaning thanks to the Arts in Medicine (AIM) Program and a unique partnership. FSU has funded a permanent position to TMH which will coordinate music therapy, the visual arts, creative writing, computer-based therapies, and dance within the hospital. Musical concerts for patients in long term or extended care can reduce pain, anxiety and surgical stress."

    2. "Patients similarly respond to bedside instrument playing, reading aloud and painting. Actual therapy techniques vary. Newborns might receive multi-stimulations of sound, touch, visuals which can increase weight gain and reduce length of hospitalization and stress behaviors. Heart patients respond to mental exercise and mood elevations often necessary for prolonged hospitalization."

    3. "TMH and FSU Music Therapy Program have a long-standing, successful history of combining resources and talents for community service to patients, training of students, and innovative medical research. We are excited to have finally achieved a full-time partnership said Dr. Jayne Standley, Director of Music Therapy at FSUs School of Music."

    4. "While many patients referred for music therapy services require a trained clinician, the volunteer program augments these services in order that AIM might reach more patients, more frequently, with a wide variety of creative experiences."

    5. "AIM Coordinator, Jennifer Whipple, brings with her a Masters in Music Therapy and Board Certification, which allows her to supervise the Music Therapy interns and students. With the collaboration from Dr. Gay Drennon, Executive Director of VSA-Arts Florida (formerly Very Special Arts) and participation of the local artistic community, the AIM Program at TMH is setting a precedent, providing a model for implementation in other hospitals and health care facilities."

    6. "This program was to create a positive environment for both patients and staff", said Dr. Larry Abele, Provost at FSU. "We enrich the art environment of the hospital through music therapy and by doing so turn possibly difficult times into a more human atmosphere for patients, staff and visitors."

  42. And, indeed, an examination of this site suggests the program may meet academic and research standards otherwise, where the Shands program doesn't. Note in particular the sections Definition , Purpose , Established Medical Programs , Medical Programs in Development and particularly the extensive information found at Clinical Internships , and within this section, the section entitled Philosophy of the Music Therapy Program.

  43. At the bottom of the FSU Arts in Medicine: Medical Music Therapy site is a link to the FSU Music Therapy Degree Program site . Within this site is a link to the Philosophy of music therapy and to about 15 pages of references to published articles, etc. (for both music education and music therapy) by faculty. This compares with about one page of references to articles for Shands Arts in Medicine.


  44. It is worthy of note that the future plans for the FSU Arts in Medicine program branch out significantly beyond just art and the programs otherwise at Shands Arts in Medicine. For instance, while I was in Arts in Medicine, I wasn't aware of Bereavement programs, memorial services, music during surgery, interactive closed circuit TV, and some of the other things mentioned here.

  45. In general, these things require a higher degree of both organization and education than Arts in Medicine people have. It is also much broader than just art. I would assume recreation therapists come substantially closer to fulfilling these requirements than AIM people can. These issues pose some questions that beg answers:

  46. What is the most efficient and effective delivery system for a hospital or other health care facility. Should it have a separate organization to deliver the "arts" and another organization to deliver everything beyond the arts as represented, for instance, in the scope of Recreation Therapy (or indeed beyond Recreation Therapy) or should it have a single functionally broad based organization?

  47. My experience with the Recreation Therapy section of the VA Hospital suggests that a single organization managed by recreation therapists in charge of untrained volunteers and working with specialists in music therapy, art therapy, dance therapy, physical therapy, occupational therapy, etc., would function well; however I am no expert and would readily defer to others on the point.

  48. Also it is worthy of note that recreation therapists are trained in managing volunteers and it is probable that the music therapists operating the FSU program are also. However the people operating the AIM program have no such training as far as I know. Indeed, the Gainesville VA hospital recreation therapy department is operated by four recreation therapists, all graduates of the UF recreation therapy program; and the entire VA program is totally dependent upon the assistance of untrained volunteers to function.

  49. Lending further credence to a distinction between the two arts in medicine programs and considering all of the self aggrandizing promotion and hype promulgated by the Shands Arts in Medicine program, it is worthy of note that nowhere in these extensive FSU sites have I noticed any mention of the Shands Arts in Medicine Program or its founders.

  50. At the same time, with further searches, I haven't come across such things as the commercialism, unsubstantiated claims of effectiveness, pop culture and new age rhetoric, anti-science ideology, and supernatural leanings that characterize the Shands program. Thus it strikes me as being a good program within the bounds of conventional academic, scientific and research standards.

  51. Thus, all things considered, this program appears to be quite independent of the Shands program; relating to it for the most part in name only.


  52. Recreation Therapy is a growing profession and there is a degree program in Recreation Therapy through the Ph.D. level at the University of Florida. (Note however there is no degree program in Music Therapy, Art Therapy or Dance Therapy at UF.) As of January, 2000, there are about 16,000 certified recreation therapists in the United States and 830 in Florida. The number in Florida has grown over the past three years at about 7%/yr.

  53. An overview of Recreation Therapy is found at its UF site, and the masters program at another UF site. Note that it is broader based than Arts in Medicine encompassing the same scope as Arts in Medicine-- arts and crafts and the expressive arts-- as well as many other modalities of healing therapy. Also in contrast to Shands Arts in Medicine, it is an established discipline functioning and progressing through the collective efforts of its world wide practitioners, faculty, researchers, and students within more or less universally accepted professional norms and conventions.

  54. The UF Recreation Therapy faculty that have Web pages are professors Anderson (Chair. Dept. of Recreation, Parks and Tourism), Ashton, Beland, and Frazer. A brief review of their pages reveals a strong commitment to research and development that totally dwarfs anything produced by the founders of Shands Arts in Medicine or anyone else in support of Arts in Medicine I have come across. And of course the UF effort is only a small fraction of what is being carried out Nation wide. As noted below, the R and D effort in Music Therapy carried out at Florida State University is also much more substantial than that carried out at the Shands Arts in Medicine program.

  55. At the same time, with a modest amount of searching on recreation therapy, nothing has so far surfaced (relating to any institutions) that appears on its face to be outside of academic, scientific or research norms, such as appears with the Shands Arts in Medicine program; even though recreation therapy is taught at many universities across the country.

  56. Lastly, it is important to note that the need for credible research in the area of employing the arts in healing is substantial. For example, see Music Therapy Helps Alzheimer's Patients .


  57. As a vehicle for promulgating the ideology and professional aspirations of its founders, Arts in Medicine had to be presented to the world as having unique social/cultural/market values above and beyond that of competing professions that the world, including volunteers, paid staff, funding sources, hospitals and patients would readily find more desirable. Two of the more important elements of this are reviewed here:


  58. Since the core of Arts in Medicine is "art" the Arts in Medicine founders needed to differentiate their product from all other professions in the arts; the closest being the "therapy" professions-- Art Therapy, Music Therapy, Dance Therapy and Recreation Therapy.

  59. In the past they attempted to accomplish this through the simple expedient of vilifying "therapy". Thus, therapists were portrayed as asking patients embarrassing questions and putting them through emotionally draining diagnostic procedures; whereas Arts in Medicine people only used their art in a positive supporting way.

  60. The fallacy here of course is that although therapists must at times employ difficult procedures with patients they presumably do so only when the benefits outweigh the cost; and of course, therapists are better qualified than untrained Arts in Medicine staff, Artists in Residence, or volunteers in delivering positive support through art. For, Arts in Medicine staff who manage volunteers are usually artists without any of the training in organizational administration, how to deliver their art to patients, how to manage volunteers, or how to manage projects etc., that I would assume most (above specified) therapy graduates obtain in their training. See for instance the therapeutic recreation undergraduate courses (scroll down to the therapeutic recreation link to see the required curriculum).

  61. And specifically concerning volunteers, as mentioned above, the VA recreation therapists must be well trained and experienced in managing them, for they are totally dependent upon them merely to function; as is Arts in Medicine to a large degree.

  62. At the same time, it might be wise to be somewhat skeptical of AIM's promotional material reviewed above and on co-founder Mary Lane's site, Advice for someone who wants to work with patients making art suggesting that one need only assemble a group of local artists without any education or background in administration, patient psychology, working with patients, project management, fund raising, etc., if they wish to operate an effective Arts in Medicine program at a hospital.

  63. More recently, toward the end of 1999, the anti-therapy rhetoric has been toned down significantly but the Shands Arts in Medicine founders are still attempting to make a hopelessly strained argument that Arts in Medicine people function in a manner that therapists in the arts either can't, don't or won't.

  64. See for instance, AIM co-founder Mary Lane's home page , 2nd paragraph stating: "Going into existing programs, and taking courses in art therapy, or expressive arts therapy, are other ways to get into this work. In art and healing, no interpretation or therapy is necessary. The creative process is the healer. Here, art is transformational in itself. -- They are wonderful fields and are usually different from art and healing as discussed on this site."

  65. See also her page entitled Advice for someone who wants to work with patients making art , 6th paragraph stating: "Going into existing programs, and taking courses in art therapy, or expressive arts therapy, are other ways to get into this work. The choice of art therapy as a licensed discipline or expressive art therapy is up to you. They are different from art and healing and the path in life is different. In art and healing we work in a model where everyone is their own healer, where people engage in their own creative process as primary healing."

  66. Thus, the core of founder Mary Lane's argument that Arts in Medicine is different from the therapy professions is simply falacious. For, to suggest that therapists in the arts don't practice healing where "The creative process is the healer", or where "art is transformational in itself", or where "everyone is their own healer, or where "people engage in their own creative process as primary healing" as the Web site maintains, is simply a gross falacy according to the therapists I have talked to as well as my experience volunteering at the VA. Indeed, therapists are trained in facilitating this very kind of healing. See for instance, the UF site Recreational Therapist stating "Therapists utilize activities in areas such as -- arts and crafts -- expressive arts, to meet patients' needs, capabilities, and interests". Or have a look at the FSU site, Definition of Medical Music Therapy . Although the terminology is more technical in these sites, they clearly include what founder Mary Lane is talking about.

    Hopefully, my Web site Mainstreaming Arts in Medicine, that was launched in April of 1999, had something to do with toning down the rhetoric but Arts in Medicine still has a long way to go in addressing its relationship with the therapy professions. For their attempts to establish some kind of functional differentiation between what they do and what the therapy professions do is at best strained. And thus the bottom line to the issue may well be that Arts in Medicine is merely dancing around the fact that the nich they wish to occupy may already be filled by more acceptable professions.

  67. Also, few if any therapists are going to think they are "healing the earth" (end of last paragraph) -- rhetoric suggestive of the organization's anti-science supernatural leanings.

  68. Thus the short of it is any attempt to differentiate Arts in Medicine functionally from the therapy professions just doesn't wash; for the fact is, due to their education, therapists are going to do anything Arts in Medicine can do, only better. And this is true, whether "the creative process is the healer", working with patients otherwise, motivating and managing volunteers, managing projects, or functioning in an administrative capacity.

  69. To look at it another way, both arts in medicine people and artistically inclined recreation therapists prior to their education in recreation therapy could be expected to have about the same talents. However, once recreation therapists have invested in their education, they can be expected to have improved healing abilities unless one should argue that somehow their education has diminished their healing abilities in some way; at best a very strained argument. But even should such an argument have validity, it should be laid out before educators in the field with appropriate educational modifications anticipated. And this would of course hold for any of the related therapy professions.

  70. At UF, a good combination would be a major in therapeutic recreation with a minor in art. Also see the schedule of therapeutic recreation undergraduate courses (scroll down to the therapeutic recreation link to see the required curriculum).

  71. However, in view of the propensity of the FSU Arts in Medicine program to move beyond just art, one might consider for instance a minor in computer science; or indeed many other areas as well.


  72. In order to justify an arts only organization and obtain dedicated artists, the healing power of art tends to be raised above the healing power of all other competing modalities such as bingo, movies, computers, etc. Descriptive terms I have often heard (such as employed in AIM co-founder Mary Lane's Home Page ) in this regard is that art is "creative" and thus "transformational", above other modalities of healing.

  73. To the best I can determine, the founders of Arts in Medicine also appear to view this superior ability of art to heal as having somewhat of a supernatural quality that elevates it above the reach of scientific investigation. However, to what extent this is the case or that scientific investigation is avoided due to an anti-science mind set of some sort or because they don't want to see their modalities of healing discredited by science, is problematical. I've never heard a discussion of the issue by either of the founders.

  74. In any event, this second cornerstone of AIM's ideology is on equally shaky ground. Is for instance only what AIM views as art the only art that is "creative' or "transformational"? Is what AIM views as art the only thing of any nature that is "creative" as Mary Lane's home page suggests-- "By art, we always mean storytelling, poetry, music, dance, visual arts, painting, sculpture, everything that is usually thought of as creativity."

  75. Can playing cards, bingo or trivia, as practiced at the VA be "creative" or transformational" for some people? Can practicing anthropology, designing automobiles, studying history, sky diving, practicing medicine or practicing psychology be "creative" or "transformational" as well? And what is "transformational" anyway?

  76. Moreover, if art healing is more productive than other competing forms of healing, why is FSU Arts in Medicine branching out into modalities of healing beyond art?

  77. And is the first positive publicity many hospitals ever receive due to AIM, as founder Mary Lane claims (5th paragraph)? Indeed, the three hospitals with AIM programs discussed in this site, Shands, Alachua General and Tallahassee Memorial Health Care Facility, probably all existed on the order of twenty or more years before they had AIM. This is clearly a long time to have to wait for AIM to come along so they could get some positive publicity. I haven't run across any literature from any of the therapy professions making this claim.

  78. In summary, Shands Arts in Medicine's claim of a superior competitive position within its family of related professions rests on patently insupportable assumptions. The fact is, there is no area of any significance where Arts in Medicine has any competitive lead over its competition although there are massive areas, as mentioned above, where the competition has a lead over Arts in Medicine.


  79. The evidence suggests that the Arts in Medicine founders view the healing capabilities of art as a largely supernatural phenomenon.

  80. For instance, co-founder Mary Lane's Home Page Art As a Healing Force Web, states:

    1. For many of us, healing art is a spiritual path, a transformational process, a way of being.

    2. We see ourselves as a center of art and healing energy on the web, to help heal you, others, and the earth.

  81. And in her page entitled The Web As A Healing Force , it states:

    1. The web is a way we can all focus our psychic energy at one place at once. If we all picture an image or picture healing the earth, in the traditions of shamanic artist healers, it will happen.

    2. Imagine that you are in the center of an immense field of healing energy. As one of the minds on the web you are a star in an immense constellation that is the living being evolving towards God. The energy comes to you in lines as part of a field that is alive. As it enters your body it fills you and you light up in each of your energy centers. You then radiate the energy outwards to the whole universe.

    3. We believe that if everyone on the web pictured a healing form at once, we and the earth would heal. That is the goal of the healing web.

  82. These and other discussions on healing throughout the site appeal on their face to supernatural forces. As well, and to its credit, the site makes no pretense of furnishing references to articles or information otherwise attempting to establish any scientific foundations, at least for these particular claims. Thus it is fair to say that co-founder Mary Lane is promoting supernatural perspectives on healing without concern for any scientific basis for their validity.(Further information on this subject including some perspectives on science by founder Graham-Pole, may be found at Mainstreaming Arts in Medicine, paragraphs 12-24, as well as other areas of that site) .

  83. However, when patients appear at Shands who have been exposed to such highly hyped supernatural or otherwise unproved modalities of healing on the Web, legal and moral issues abound. For, although the sites carrying most of the supernatural healing perspectives are not official Shands sites, they clearly speak for the AIM founders carrying the credibility of a Shands doctor and Ph.D. nursing candidate. It was in part to address this issue that I offered to write something for Shands to put on the Web explaining relevant aspects of the philosophy of science to assist patients in making informed decisions in such complex areas.

  84. My assessment of AIM's scientific component is addressed in paragraph 3 . AIM needs to determine how its artistic, supernatural and scientific components relate to each other, the hospital, patients, etc., so that they may function in ideological, moral and legal harmony.

  85. Moreover, if AIM wishes to have credibility with the scientific community, it needs to delineate its scientific components/investigations as noted above from its supernatural components/investigations. For of course they don't mix. And confusing them only leads to discrediting what you are doing from the standpoint of both the adherents of science and the supernatural. This is of course not to say that supernatural phenomenon should not be studied scientifically with a view to bringing them into the framework of natural law. Indeed, when I joined AIM, I looked forward to the possibility of joining some investigations of this nature.

  86. However my view now, after having attempted unsuccessfully on many occasions to engage founder Graham-Pole in such a discussion, is that the AIM founders probably prefer to leave such issues somewhat confused and undefined because they don't want to see some of their favored healing modalities/perspectives thus scrutinized and possibly discredited.

  87. At the same time, I think it has to be said that probably any organization that tries to encompass such a broad ideological spectrum, might anticipate credibility problems from both ends. AIM might well do better by openly declaring its supernatural character and competing as a private institution, rather than being attached to a state university with all the ideological juggling this has involved.

  88. These are complex issues which again would not seem to be a problem for the therapy professions because they don't institutionalize supernatural modalities of healing or hype the value of their modalities of healing beyond reasonable expectations, at least to the degree Arts in Medicine does.

  89. As well, Arts in Medicine's supernatural leanings and belief structure are almost certainly one of the principal reasons that it has done virtually no credible research over the past nine years of its existence while the therapy professions (at least as measured by the UF Recreation therapy department) have pursued a vigorous program allowing them to continually expand their horizons and improve their effectiveness. Here again, I think this may have to do with AIM's preference not to get themselves in the position of having to scientifically discredit favored healing modalities.

  90. As mentioned above, the character and general perception of Arts in Medicine in this regard is further complicated by the fact that John Graham-Pole is a medical doctor and Mary Lane is a Ph.D. nursing candidate. Thus, many people, including many Artists in Residence, assume as I did when I first came into AIM, that good scientific and academic standards would be followed as a matter of course.

  91. Due to the program's various recruiting biases, it is not uncommon for AIMers to hold beliefs that are contrary to various aspects of mainstream medicine. Indeed, I think there is a much higher incidence of such beliefs than there is in the general population. And this of course poses the issue as to what degree AIMers might induce patients, hospital staff, or other AIMers to forgo established medical practice and treatment in favor of various modalities favored by AIMers (for instance those presented on the Web by founder Mary Lane.)

  92. AIMers very often work alone with patients so it would be difficult to obtain much on the subject. For my part, I have prostate cancer and I could have been induced to ignore both diagnosis and treatment of it by another AIM person who was symptomatic of the disease but favored ignoring diagnostic procedures and treatment. In general I suspect it is probably less of a possibility in casual relationships with patients or others but could be more of a possibility where relatinships are more extended.

  93. It is also worthy of note that a great deal could have been accomplished since the program's inception in 1991 in the way of research had the founders been inclined to do so. For, Shands is the state's premier research and teaching hospital and many resources are available that are not available at most other hospitals including of course an established research culture with the availability of intelligent well motivated student volunteers.

  94. In this regard, had the AIM founders been inclined to work within the framework of the faculty, staff and students of recreation therapy (with a Ph.D program for the past two years) rather than essentially stonewalling them at Shands as they have; without question the cause of employing the arts to heal could have been greatly advanced over the past nine years.

  95. Having played the piano in the Shands Atrium for over a year and talked to many people, I am certain many very talented and well motivated people and students out of many disciplines, backgrounds, and interests could have been recruited during this period to advance the cause of healing through the arts under the more progressive conventional research environment that the recreation therapy profession would have provided.


  96. The majority of AIM volunteers have little knowledge or interest in the ideological nature of the organization. Most of them are students who are volunteering to gain experience around the hospital and/or are simply interested in helping patients including children deal with their diseases. And of course, those who don't care for AIM, just volunteer elsewhere. Also students are at the university to get an education; so for the most part it isn't worth their time and effort or possible repercussions to make an issue of something peripheral to it.

  97. The core of the organization is made up of 7 Artists who are called Artists in Residence. These artists receive a modest income to practice their art at the hospital and they are chosen by the founders for beliefs and perspectives consistent with their own.

  98. People of various backgrounds and interests otherwise, drift in and out of the program at various times; as I would assume is the case with many charitable organizations. However because the founders are pushing the limits of academic acceptability in their program, it is likely they have had their problems with critics since the program's inception.

  99. Thus they have probably developed somewhat of a profile of the kind of people they want to encourage and those they wish to discourage in the organization; whether it is people for the Artists in Residence program or the more serious volunteers. Thus either as a result of the preferences of the founders, the preferences of prospective volunteers or prospective Artists in Residence, the following demographic profile was the situation when I was last active at rounds meetings, at the beginning of 1999:

  100. Although there are about seven hundred doctors and many nurses at Shands, with many retired doctors and nurses in the community, there were no such people (retired or otherwise) active in the organization outside of the founders.

  101. People in the hard sciences-- mathematics, physics, chemistry, engineering, etc., were also entirely missing, even though there are many such people in the community; employed or retired from UF.

  102. There was no one with a background in institutional research of any kind outside of the founders; even though there are numerous such people in the community; employed or retired from UF.

  103. However, the lack of breadth extended way beyond the medical community, hard sciences and researchers. There were only a very few people with a background in the social sciences (psychology, sociology, anthropology, economics, mental health, etc.)

  104. Thus, one is hard put to find people with backgrounds in addition to an arts background seriously involved in Arts in Medicine; such as, for instance, a physicist/musician. In short, I think the founders have found that women with a more strictly arts background are the most compatible with their ideological perspectives. Indeed, all of the Artists in Residence are women; and indeed on one occasion co-founder Mary Lane said she preferred to have only women in the program (although AIM's "official" policy is to accept men and women equally.)

  105. Thus, the founder's unique narrow ideology and perspectives drastically limit the populations out of which staff, Artists in Residence and serious volunteers may be recruited largely to women, and moreover to women with a more purely arts background; the result being over seventy five percent of AIM people (outside of the founders and casual volunteers) fit this narrow demographic profile.

  106. I need to explain a little about myself in this regard. I have a background in some of these areas, and as a volunteer was looking forward to assisting with AIM research. But as time went on, it became increasingly apparent such interests and inquiries weren't appreciated, and I was ultimately forced out of the program and the hospital in a considerably less than enlightened manner ( Cult Characteristics of Shands Arts in Medicine Program Continue II) . Indeed, my request to have the circumstances reviewed were totally ignored even though I'm informed the VA hospital across the street would have honored such a request.

  107. At the same time however, it appears that lack of fairness and objectivity are more the rule than the exception for dissenters or whistleblowers who pursue their causes within their universities (as well as elsewhere) in general. See for instance Advice for Dissident Scholars . Thus those who pursue such issues must be prepared for a long protracted affair with most likely little accomplished after it all. This in turn leads one to wonder how many other whistleblowers and dissenters have been abused or forced out of the hospital without any opportunity to be heard.

  108. Indeed, this "AIM can do no wrong" mentality of Shands hospital coupled with its propensity to suppress dissenting opinion is of course one of the main reasons AIM has such low standards, even in the face of interests to improve professionalism (last 8 paragraphs) and increased regulatory control in the hospital brought on by an allegation of just such lax standards. For of course an enlightened policy toward whistleblowing and dissenting opinion is the best insurance that the policies, projects, and general modus operandi of an institution meet acceptable standards.

  109. I am thus a better example of the type of person that doesn't fit into AIM than one that does. The flip side however is that I have always felt I fit well in the VA recreation therapy program (just a few minutes walk away from the Arts in Medicine office) while the other Arts in Medicine people must not feel they fit into the recreation therapy program very well because none of them have been around it for years (including many years before I volunteered in either program).

  110. Artists often have supernatural leanings and producing good art is most often viewed as a matter of intuition (rather than of course through scientific means). As well, in this country and our materialistic male oriented western culture, both the arts and women tend to be the underdog; thus a call to women to make their art shine in the very heart of the largely male dominated high tech world of a teaching hospital can have an understandably strong appeal to many.

  111. This also raises the issue as to whether some AIM artists are being exploited. For the founders and most AIM people present the perception (as I did in the past) to potential recruits that they will be joining a very unique cause and mission that will ultimately spread around the world with its unique powers of healing. Those who join may thus gain the little bit of immortality that goes with such a pioneering undertaking. No attempt is made to explore with AIM people the controversial aspects of the program such as presented in this and my other Web site on AIM.

  112. Thus it is not surprising that people from a more purely arts background might feel more comfortable in AIM than those from the therapy professions, social sciences, physical sciences and business backgrounds more prone to being uncomfortable with its supernatural leanings, unsubstantiated claims of effectiveness, and lack of scientifically credible ongoing research; among other things.

  113. Indeed, my own experience has been that every attempt was made to suppress and discredit any such examination no matter how politely I presented it (see for instance Mainstreaming Arts in Medicine, paragraphs 41-75, including links to papers I wrote with a view to help broaden the organization's capability and appeal). All of which suggests the founders realize the difficulties they would encounter in maintaining their program as it is should they open it up to broadly based discussion and debate. (Paradoxically, while one of these papers on how AIM might use the Web was ignored when I presented it to AIM, after my critical Web site above came out, they appear to have taken it to heart, because then many more AIM pages than previously seemed to appear on search returns with formats roughly following my recommendations. Of course, more Web pages about AIM could be expected to replace other Web pages on AIM, such as mine, to a certain extent in search returns.)

  114. In summary, most casual AIM volunteers take little interest in the ideological make up of the organization. However those who may wish to participate in the program on a more fundamental level as Artists in Residence or volunteers, are generally limited to a very small percentage of the general population-- women with a more purely arts background. This is either because most others find themselves uncomfortable with AIM, the founders make them uncomfortable with it; or both.

  115. This compares with the broad based recruiting efforts that could be carried out if the program were run by one of the therapy professions where it may be reasonably assumed few such problems exist. Indeed, the population out of which AIM can successfully recruit is probably only a few percent of the population out of which its competing therapy professions could successfully recruit. Consequently, many new people with a broad spectrum of talents and interests would enter the program opening up many new vistas of opportunity for working with patients and research and development of the arts for healing impossible in the present environment.


  116. Viewing global prospects for the use of the arts in healing and therapy, probably the most pronounced global economic/cultural/technological dynamics in the contemporary world is the knowledge transfer from West to East.

  117. For instance there are about 400-500 graduate students in the UF Department of Electrical Engineering, the largest UF graduate engineering department. Of those, over 60 are from Korea and far more than that from each of China (total population 1.2 billion) and India (total population 1 billion). And there are of course many from other eastern countries so that something like 90% of UF EE graduate students are from the East.

  118. Of these countries, Korea probably has the highest density of UF EE graduate students per capita in Korea which has a little less than one percent of the world's population while having 15 percent of UF EE grad students. Other broader indices of westernization include the fact that Korea is over 40 percent Christian, it either has or is close to having the world's largest shipbuilding industry as well as the largest semiconductor industry and the number of automobiles on Korean roads has doubled in the past eight years.

  119. These statistics are in spite of the fact that Korea was one of the last countries to westernize; having been known for 5,000 years as the hermit kingdom for its desire to be left alone by other countries (both East and West) and in spite of the fact that in the 20th century it was conquered and ruled by Japan from 1910 to 1945.

  120. Korea has a highly developed long standing tradition of music as do of course many eastern cultures. And it may be due in large part to this fact, that here to, Korea is forging ahead into new "western" arts/medicine territory; possibly even faster than the US. For Korean students tell me that the majority of educated prenatal Korean mothers play recordings of western classical music as therapy for their unborn children. I would assume this is a much higher percentage than in the United States but off hand I don't have any hard figures on either country. (At the same time, it isn't my intention to portray Korea as any paradise for of course it has many serious problems.)

  121. However, whatever the actual figures, they are sufficiently high to almost guarantee that at some point in the future, if not currently, there will be pressure for significant Korean scientific research into this and many related phenomenon in music healing/therapy. And of course as the technological and cultural transfer accelerates with respect to the other eastern nations the same might be said for them as well. Indeed, one need only contemplate the fact that if South Korea with a population of 45 million now has the largest semiconductor production and shipbuilding production, what might China be capable of as this knowledge transfer continues in the future, considering China has a population over twenty five times larger than South Korea?

  122. The point is that the use of the arts for therapy and healing is simply part and parcel of the rapid pace of West/East knowledge transfer. And if American universities such as UF are to remain viable over the longer term, they must be serious about all modalities of healing that show promise; and at least do better than squandering their precious resources on pet programs of favored medical staff having such limited merit compared to other readily available programs.


  123. The following are some of the major reasons AIM has not grown while its competing therapy professions have:


      Shands Arts in Medicine is the creation of a doctor and nurse at Shands Hospital where it has been provided with a protected environment and effective monopoly since its inception in 1991. It was subsequently brought to Alachua General Hospital, owned by Shands, in 1998, where a similarly sheltered environment is provided. This protected monopolistic position in an uncritical environment has allowed AIM to maintain its unattractive competitive characteristics.


      However beyond Shands and Alachua General Hospital, the market niche occupied by Shands Arts in Medicine is shared in whole or in part by the competing disciplines of recreation therapy, art therapy, music therapy, and dance therapy, and to a lesser extent, a number of other professions; wherein Arts in Medicine is at a serious competitive disadvantage. Thus Arts in Medicine has spread very little beyond its host institution at Shands.


      In an attempt to expand beyond its sheltered environment at Shands and AGH, Arts in Medicine has attempted to differentiate itself from its competing professions by vilifying them, making insupportable claims that AIM functions differently and better than they do, making claims that "art" has healing qualities above other competing healing modalities such as bingo or "outings", and promoting their perception of "art" as having supernatural healing powers. However, the end result has been to decrease its appeal rather than increase it.


      It has been too heavily hyped and promoted with too much commercialism to fit within conventional academic/research/scientific norms and standards; thus rendering it unattractive to educational institutions, healthcare and other organizations/institutions.


      In deference to its anti-science supernatural leanings and fear that its favored modalities of healing might be thereby discredited, it has discouraged research people from taking active roles in the organization and commensurately undertaken almost no research and development. At the same time however, its competing professions have little or no such compromising ideology and have undertaken substantial ongoing efforts in this regard.


      This is a real possibility although difficult to evaluate. However, due to their higher standards, education, research, and less emphasis on supernatural phenomenon, it is clearly less of a possibility regarding the therapy professions.


      Its various shortcomings effectively limit the populations out of which it may recruit staff and serious volunteers to only a few percentage of those from which its competing professions may recruit staff and volunteers; thus seriously limiting its growth, flexibility, and potential, compared to them.


      AIM has a very complex ideological character-- artistic, scientific, medical, supernatural, commercial, academic, legal, promotional, research, etc. However there is no attempt by its founders to explain how many of these traditionally disparate elements may be expected to function in ideological or practical harmony in AIM. This problem is far more negligible for AIM's competing disciplines because for the most part, they limit their character to elements that traditionally function well together. Examples of such relationships requiring examination and explanation are: commercialism v. academic reserve, supernatural v. scientific, legal requirements v. promotional hype, legal requirements v. supernatural, and academic v. supernatural.


      Arts in Medicine has no ongoing university educational degree program to produce professional practitioners as do its competing professions. It has a research arm called CAHRE that was set up to explore research and education. however, I have not been able to locate any comprehensive site on education and courses such as are maintained by the therapy professions and the various academic disciplines in general. The best I could locate is a CAHRE Curriculum site that discusses some courses but for the most part it doesn't state just what subjects they cover, how many there are, who teaches them, what credits are given for them, or what degree programs they would apply to; information that would of course be very helpful.


      Of course such low standards for any health care discipline in a hospital will tend to drag the entire hospital as well as other medical disciplines in the hospital down in the eyes of the public and medical profession; including those programs that are conscientious about maintaining standards.

      And of course, such low standards are an open invitation for other disciplines to follow suit. Indeed, why bother with all the tedium and expense of clinical trials to prove your effectiveness when others don't?

      And these problems might be expected to be the most pronounced regarding other "alternative medicine" modalities of treatment. For instance, Shands has an acupuncture unit. Why shouldn't this unit just follow suit, avoiding research while at the same time making broad insupportable claims as to its effectiveness?

      There are alternative modalities of health care that are both effective and doing credible research to establish their value in the face of a skeptical public and medical profession. This applies just as well of course to AIM's competing "therapy" professions who even without AIM already have to deal with numerous charlatans out to confuse the public for personal gain.

      In short, an alternative modality of healing such as Arts in Medicine needs to do just the opposite of what it is doing. That is, it needs to be making reasonable claims of effectiveness based on the best most credible research obtainable; far more so than established medical disciplines if it is to gain the respect and support of the medical profession and public.

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