Potential partners in enhancing the health and well-being of today’s youth
By Jill Maglio and Carol McKinstry, 2007
This paper describes and discusses the benefits of a project involving a community circus program developed for Victorian schools to assist in addressing students’ needs for life skills acquisition. A program logic model framework (CAOT, 1999), together with an occupational perspective, was used to develop an evaluation tool for Westside Circus’ ‘Circus in Schools’ program. The project was unique in that it introduced an occupational perspective to the evaluation of this innovative educational program. Although the project’s focus was primarily on program evaluation, it also demonstrated a connection between the core beliefs of community circus, education, occupational therapy, and health promotion.
The occupational therapy profession can play a key role in education reform, which includes working in partnership with community organisations to develop innovative programs that meet the needs of young people. Educational and allied health professionals agree that effective teaching strategies which seek to promote over- all health and well-being need to be implemented in schools to provide students with skills that will enable them to be healthy and positive contributors to society (Struthers, 2005). With an understanding of the dynamic interdependence of the person, occupation, and environment (CAOT, 1999), occupational therapists are equipped with skills that enable them to advise on educational program development, implementation and evaluation.
Research conducted by the Victorian Curriculum and Assessment Authority (VCAA) led to the establishment of a framework, the ‘Victorian Essential Learning Standards’ (VELS) that aims to promote holistic education for young people (VCAA, 2005). The success of this educational reform requires a collaboration of disciplines to meet the complex needs of young people. Occupational therapists’ knowledge of program development, service delivery and evaluation can enable them to work in collaboration with community organisations, providing varied and innovative input into educational programs.
Westside Circus is a not-for-profit community circus organisation that works in partnership with the community to provide a variety of programs, workshops, and performance opportunities for young people throughout Victoria. ‘Community Circus’, also known as ‘Recreational Circus’, ‘Social Circus’, or ‘New Circus’ (Bolton, 1999), focuses on teaching, empowering, and communicating using circus as a medium, featuring physical activities and no animals. Community circus provides an environment of personal artistic expression and group solidarity, creating opportunities for young people to forge new ties with society.
Circus in Schools
Westside Circus recently implemented the ‘Circus in Schools’ program across a range of Victorian primary and secondary schools. The program included a variety of games and circus disciplines with physical and coordination components that were pursued individually, in pairs, and within larger groups. The two-hour weekly program occurred during a school term at either the school or the Westside Circus training space. The program aimed to use circus as a constructive model to build resilience, develop life-long learning, and encourage excellence in students incorporating the VELS.
National and international research completed by the VCAA (2005) led to the development of the VELS, promoting life-long learning through curriculum design. The new approach closely links traditional subject areas to life skills such as the development of physical, personal and social skills, and the ability to apply knowledge in workplace situations and future learning (VCAA). Life skills contribute to the successful independent functioning of an individual and are needed for the transition into adulthood. A review of the literature by Cronin (1996) reported that many students do not learn life skills by themselves and require increased life skills content throughout their school careers. ‘Personal and Social Skills’ and ‘Interdisciplinary Skills’ are new focus areas that schools are encouraged to include in their curriculum to address students’ need for life skills acquisition. Under this framework schools are given the autonomy to determine the most appropriate way for students to acquire knowledge and skills in these areas (VCAA). The ‘Circus in Schools’ program has strategies that provide multiple ways in which schools can meet the VEL standards and promotes the learning of life skills.
To assist schools implementing the VELS and increasing health promotion, an opportunity exists for occupational therapists to adopt a consultancy approach, marketing their services to schools rather than working only with individual students. Occupational therapists can assist in Victoria’s educational transition to a more holistic view of students and the skills they require. Occupational therapy skills and strategies can promote school and student success in accordance with the Ottawa Charter’s strategies for health promotion (World Health Organization, 1986) and VELS; occupational therapists can assist schools in the following ways:
- Collaborating as part of a multidisciplinary team at all levels of the education system from policy-makers to specific program delivery and evaluation (World Health Organization, 1986).
- Understanding the importance of occupational balance to overall well-being, and specifically related to learning as the main productive role of youth.
- Assessing personal components involved in occupational performance within social, cultural, institutional, and physical environments (CAOT, 2002).
- Involvement in school management and governing bodies, working in partnership with community organisations, parents, and as advocates (Struthers, 2005).
- Assisting school systems in the transition process of implementing programs like the ‘Circus in Schools’ program, that meet the VELS.
- Assessing learning environments, assisting teachers in identifying essential program components for the population, and suggesting programs to address local and social issues present that will fit with individual or group needs.
Traditionally, occupational therapists have intervened to assist individuals to meet their needs within the school context (Case-Smith, 2005). Although there is still a place for the profession to intervene directly with individuals, an opportunity now exists for occupational therapists to intervene within school systems and the wider community (Struthers, 2005) to address the VELS.
Presently, teachers and school administrators are expected to modify practices to work with students holistically, as well as develop community partnerships to meet the VELS requirements. Occupational therapists can assist in program development, enabling essential learning for students and also in evaluating these program components and student acquisition of life skills.
Although there is a lack of literature relating to circus programs, particularly in Australia, Bolton (1999) highlighted the use of recreational circus by humanitarian and peace-making groups as well as by schools and the increasing number of new circus companies emerging throughout the world. In addition, many organisations are providing circus training for various populations of people in need of social justice and support. For example, Cirque du Soleil has formed a program dedicated to allying with youth at risk (Cirque du Soleil, 2007). The Women’s Circus in Victoria prioritises working with survivors of physical and sexual abuse as well as women aged over 50 years (Andrea Ousley, personal communication, 22 February 2007). The Westside Circus outreach program also provides circus training experiences to people with emotional and mental health issues, intellectual and physical disability, as well as to mainstream society. Further research and published literature are needed to promote the effectiveness of circus programs to the overall health and well-being of individuals (Bolton).
With continued development and evaluation of community circus programs, it is proposed that evidence of the effectiveness of circus as a suitable occupational therapy intervention will aid the profession to develop future partnerships with schools, and community circus organisations. Given that this project’s evaluation was completed from an occupational perspective, the occupational elements are also clearly evident.
The overall aim of the project was to conduct a process evaluation using a program logic model framework (CAOT, 1999), in addition to developing an evaluation tool that could assess outcomes of future programs against VELS criteria.
Phase 1: Information gathering
To identify the connections between the circus program and VELS standards relating to the development of students’ life skills throughout their education, VELS documents were analysed and circus trainers were interviewed. Program sessions were also observed and school action plans were reviewed to identify program aims, objectives, components, strategies and proposed outcomes. This was also necessary to identify the connections between the circus program aims and what the VCAA believe are important life skills for youth to obtain throughout their education.
Phase 2: Process evaluation
The information gathered in phase 1 was plotted into a program logic model in order to make evident the relationship between overall program objectives and specific program practices, demonstrating the ‘Circus in Schools’ program’s ability to implement relevant strategies as intended. In this phase, the following components of the circus program strategies were identified in each session:
- Warm-up games – opportunities for team work, collaboration, verbal and non-verbal communication, increased challenges, and a mix of attainable and challenging tasks.
- Acrobatics - core, upper and lower limb strength and flexibility, body awareness, trust, positive risk-taking, giving and receiving physical support.
- Acrobalance - team work, body awareness, problem-solving, trust, safe and positive physical interaction, gender stereotypes around strength challenged, and a mix of achievable and challenging tasks promoting self-efficacy.
- Manipulation (juggling, hula hooping) – grading of tasks to increase challenge. Opportunities to improve coordination, gross, and fine motor skills. Promotion of rapid thinking, reaction, persistence and practice. Opportunities for peer education, creativity, and improvisation of combining skills learned.
- Balance-based activities – promotes reduced fear of heights and physical limits. Peer-to-peer support and trust of self and others. Taking responsibility for safety of self and others is integrated. Awareness of self in relation to others and the physical environment is continually addressed.
- Performance - promotes creativity, collaboration, breaking down of inhibitions, exploration of theatrical themes, giving and receiving social support, experience of taking on different roles, development of different characters, brainstorming, problem-solving, and various forms of communication.
These activities assist individual students and groups to improve occupational capabilities in a range of physical, cognitive and affective areas. The variety of activities enables the intervention to be more effective in meeting the diverse needs within the population.
Phase 3: Outcome evaluation
The completed program logic model enabled a data collection tool to be developed that assessed the program from the perspective of the trainers, participants, and school representatives. The evaluation tool consists of a before and after design with the intervention being two circus activities that incorporate a wide range of the program’s strategies. Each program strategy is linked to a different VELS component; therefore, demonstrating the programs ability to address and meet the VELS.
In addition to the development of this tool, observations made by the project manager, school representatives, and journal entries from the participants resulted in subjective data which also supported the ‘Circus in Schools’ program’s overall aim of satisfying VELS criteria.
The project found that the ‘Circus in Schools’ program objectives and values are congruent with principles that underpin VELS education reform initiatives and occupational therapy practice. The implementation of the program strategies was also shown to be consistent with VELS criteria. Observations made by the project manager, in addition to qualitative perspectives of the students and school representatives, highlighted the positive benefits of the ‘Circus in Schools’ program in the following program objectives:
- Increases positive risk taking both physically and emotionally, in a safe and supported environment.
- Promotes physical health and body awareness through activity.
- Enables participants to acquire a broadened skill base relating to circus as well as more generic ‘life skills’.
- Increases self-confidence and self-efficacy.
- Improves social connectedness, teamwork, and leadership skills within the group.
- Provides opportunities for calming rhythmic activities, increased sensory feedback, a focus on balance, and coordination.
- Creates a space in which participants feel a sense of belonging.
Implications for occupational therapy, education, and circus in future practice
The experience of working with Westside Circus highlighted many parallels between the ‘Circus in Schools’ programs and occupational therapy practice. The program was innately client-centred and structured to meet participants’ individual needs while capturing the essence of the programs’ main objectives and VELS criteria. Occupational therapists are well placed to take a broader-based advisory role, working at a policy or program development level in education, in addition to working with individual children to meet their specific needs. In order for a successful partnership among community circus facilitators and occupational therapists to emerge, a number of key things are required. Open dialogue among both disciplines is needed to enable understanding of each others role and how they can work together to ensure that the programs meet the needs of each individual participant. Occupational therapists and circus facilitators also need to create opportunities to attend each others’ forums, events, and workshops. This would enable a richer understanding of the community circus and occupational therapy culture and how they can contribute to creating optimal health for specific populations of people who utilise the service.
Although this project focussed on life skill acquisition for youth, occupational therapists can continue to work in partnership with circus organisations and schools to address the needs of individuals in relation to sensory processing, coordination and tone, and physical, emotional, and mental health. In assessing the capacities of individuals and planning programs to improve function and occupational performance, circus trainers and occupational therapists have complementary skills. Occupational therapists and circus trainers can work together under a health promotion focus to meet the overall health needs of the youth population. Some specific examples of how the two disciplines can work as partners to empower individuals and communities include:
- Professional development – Occupational therapists can educate circus facilitators about the particular issues facing specific populations. For example, when dealing with groups of people who have autism, occupational therapists can share information about individuals needs for proprioceptive feedback. Therapists can help the facilitators have a better understanding of the limitations and strengths commonly faced by people with autism. This input by the occupational therapy profession can enable circus trainers to fully address the needs of the specialist groups they are working with.
- Co-facilitating – Circus trainers and occupational therapists facilitating programs together within the circus training space can enable each profession to support each other by sharing their expertise (Ous- ley, 2007). The occupational therapist provides focus on the strengths and limitations of the individuals within the group, determining appropriate grading of tasks to promote success of the participants and offering assistance where needed. The circus trainer is able to direct the session focussing on the various elements within the activity that integrate the holistic focus of community circus philosophy.
Community circus and occupational therapy both appear to have a tradition of working with people with physical and mental health needs, survivors of sexual abuse and torture, marginalised young people, and those experiencing occupational alienation within their social and physical environments. By opening dialogue and joining forces, each discipline can become more effective in their overall goal of creating global well-being within all communities for all individuals.
Utilising a partnership between occupational therapy and community circus, this project demonstrated the ability of an intersectorial health-care approach to meet the diverse needs of the primary and secondary school students. The introduction of the VELS within the Victorian education system provides occupational therapists with the opportunities to develop implement and evaluate programs that will assist schools to meet the VELS requirements, enhancing the health and well-being of students. This is the beginning of a new partnership between education, circus, and occupational therapy disciplines, with much room for expansion. This innovative project combining occupational therapy with an alternative education program is an example of how occupational therapists can utilise a health promotion approach. A collaborative intervention focussed on a community provides a more effective and sustainable way of building healthier communities.
We would like to acknowledge the assistance provided by Stephanie Urruty, project sponsor and general manager of Westside Circus, Andrea Ousley, the Westside Circus trainers, the Yarra Youth Rotary Project, and all the schools and participants within the programs observed. This project was completed in partial fulfilment of the graduate entry Master of Occupational Therapy Program, at La Trobe University.
* Bolton, R. (1999). Circus as education. Australian Drama Studies, 35.
* Canadian Association of Occupational Therapists (CAOT) (1999). A program evaluation workbook for occupational therapists: An evidence based practice tool. Ottawa, ON: CAOT Publications ACE.
* Case-Smith, J. (2005). Occupational therapy for children (5th ed.). St. Louis, MO: Elsevier Inc.
* Cirque du Soleil (2007). Retrieved 18 March 2007, from http://www.cirquedusoleil.com
* Cronin, M. E. (1996). Life skills curricula for students with learning disabilities: A review of the literature. Journal of Learning Disabilities, 29, 53-68.
* Struthers, P. (2005). Inclusive and health promoting schools- implications and challenges for therapists. South African Journal of Physiotherapy, 61, 28-32.
* Victorian Curriculum and Assessment Authority (2005). Victorian Essential Learning Standards. Retrieved 14 July, 2006 from http://vels.vcaa.vic.edu.au/.
* World Health Organization (1986). Ottawa Charter for Health Promotion. First International Conference on Health Promotion (Ottawa, Canada). Retrieved 14 July 2006, from http://www.ldb.org/iuhpe/ottawa.htm
Jill Maglio BA Psych, MOTherapyPrac; Occupational Therapist.
Carol McKinstry BAppSc(OT),MHlthSc; Lecturer. Faculty of Health Sciences, School of Occupational Therapy, La Trobe University, Melbourne, Victoria, Australia
Correspondence: Jill Maglio, 124 Gore Street, Fitzroy, Vic. 3065, Australia. Email: jillmaglio @ yahoo . com (remove the spaces)