Professor Persephone (Persefoni) Sextou

Simba and the Space cave is an animated film created for sick children in hospital followed by online literacy learning resources for the teachers of Birmingham James Brindley School at Birmingham Children's Hospital NHS Trust

This website presents a summary of Persephone Sextou's 30 years of academic performance in the field of arts, health and wellbeing. It aims to offer a selection of recourses for researchers, educators, creative therapists and healthcare professionals about the therapeutic benefits of the arts in the community, especially to children, young people, families and healthcare professionals in paediatric care services. By doing that, the website contributes to (a) the training of arts-in-healthcare professionals (b) the growth of research in the field, (c) the transformation of the patients' experience during hospitalisation and (d) the improvement of paediatric care services. The website menu includes Prof Sextous' recent open access journal articles, conference proceedings, keynote conference recordings, videos, films, online activities and stories for children in hospitals. The practical resources are positioned within the author's philosophy, principles and values of community participatory arts and the meaningful role of supporting the physical, mental, emotional and social health of vulnerable groups and audiences at times of difficulty.

Mental health difficulties remain a major source of burden and distress for individuals, families, health and social care providers with stigma a key target for educational campaigns attempting to improve care pathways and access to support. Stigma is a multifaceted concept having a range of drivers including shame and is thought to act as a barrier to successful help seeking and engagement with support services. The current paper explores some of the salient themes that emerged from a British university drama project on the impact of symptoms and behaviours associated with a severe mental health condition on a young couple's relationship and reflects on the opportunities for connection with an audience provided by the medium and experience. It is suggested that enabling the impact of mental ill health to be explored in a protected environment such as theatre can allow for reflection and empathy to develop, with potential for positive impact on awareness understanding and stigma. Elements of the drama setting and narrative are explored, and analogies are made with the emerging literature on post-traumatic growth.

This book looks specifically at the place of theatre for children who are hospitalized, showing how powerfully it can enhance their social and mental well-being.

This article reports on practice-based pilot research being undertaken at Birmingham Children's Hospital in England on the impact of bedside theatre performance on hospitalised children's well-being. It discusses the process of creating theatre for sick children, connecting with the hospital and working within the hospital tight routines, dealing with ethics, working with theatre artists and performing to children bedside. It also reports on evidence collected by questionnaire and interviews about the perceived benefits of bedside theatre by children and their parent/carers. This emphasis on the process is appropriate for theatre practitioners, arts therapists and clinical staff who work with hospitalised children.

Hospitalisation can be a challenging experience for young people, including higher levels of anxiety, social isolation, and depression. In this paper we identify the possibilities of an applied theatre pilot that aimed to combine co-designed virtual reality (VR) approaches with intermedial work with young people in hospital. Within the pilot study we worked with three participants in individualised bedside workshops over a four-week period. Analysis from the pilot demonstrated the significance of the co-design process leading to greater degrees of agency for young people, and opportunities for the participants to share experiences with medical staff, carers, and siblings.

This paper explores a cross-disciplinary approach to performance studies (devised drama) and creativity, and their role in contemporary communities. Specifically, it discusses the possibilities of using drama practice and Shakespeare’s themes as a means of learning about ourselves and the world we live in. Drawing on observations and discussions conducted during an undergraduate drama programme, the authors experiment with ideas that connect drama to the students’ contexts and favourite social issues. They then examine the impact of teaching drama on students learning as both creative artists and citizens. From these accounts, the authors explore how devising new dramatic characters and scenes can develop students’ powers of critical perception and contribution to the community. Practical work based on “Othello,” a play by W. Shakespeare was used to generate examples of creative practice within the conventions of drama. The paper argues that devised drama on Shakespeare’s themes and characters can be used to address current social issues in contemporary community contexts, and intrigue undergraduate drama students to produce creative work and develop a sense of self and others in the community.

Applied theatre is not only a form of entertainment, but also a powerful tool for wellbeing for children in hospitals and older people in care homes. Specifically, I will discuss the Co-design, Patient Participation and Engagement processes that involve a collaborative approach to designing and developing healthcare services and interventions in Paediatrics. My approach aims to empower patients and their families, by giving them a voice in the research process and allowing them to contribute to the development of healthcare services and interventions that are more patient centred.

Children can experience anxiety or uncertainty when having Magnetic Resonance Imagery (MRI). Likewise, radiographers can encounter challenges when performing an MRI scan on a child, which can result in children being distressed and scans needing to be rescheduled or for sedation to be used. Research has shown that children who are prepared and understand what will happen during radiology procedures have better experiences and outcomes (Bray, Booth, Gray et al. 2022). The GLOWING STARS study addresses the specific need for testing different approaches and strategies for children aged 4 to 10 attending diagnostic MRI scans in secondary care paediatric hospital NHS Trusts. GLOWING STARS aims to assess the acceptability and reported impact of Xploro (https://xploro.health/), a digital interactive app that incorporates augmented reality, patient avatars and gamification elements. The Xploro digital app's efficacy to prepare children for surgery, x-rays and blood tests has been previously evaluated with a population aged 8 to 14, but not with this younger age group and not focussed on MRI scans. This Research Protocol describes a before- and after- digital intervention study to be carried out at ANONYMISED NHS Trust. Children will be given access to Xploro in face-to-face one-to-one conditions on the day of the child’s attendance at the radiology department. Participants will complete A4 paper proformas with questions both before and after they access Xploro. A total of 20 children aged 4-10 years and 20 parents/caregivers are expected to take part. The findings are expected to add further knowledge of how the Xploro app can best prepare young children for MRI scans. Results will be shared with families and their parents/caregivers, relevant NHS staff and researchers in the form of reports, social media posts, journal articles and conference presentations. The study gained ethical approval from the Health Research Authority (HRA & HCRW, REF: 24/SC/0129), governance approval within the NHS Trust involved R&I (REF: PA24/172552) and approval from ANONYMISED University (REF: 132843). The study started in November 2024 and the end date of the completion of any follow-up monitoring and data collection is aimed to be March 2025.

Our presentation explores the integration of applied theatre, storytelling, puppetry, story writing, and animation films in bedside creative activities for children with cancer in paediatric oncology settings. The study employs creative and arts-based methodologies to explore the impact of these activities on the physical health and psychological well-being of young patients undergoing treatment. Children with cancer face a daily struggle that affects their physical, emotional, and psychological health. Creative activities, facilitated at the bedside, offer an essential respite and therapeutic intervention. This research emphasizes the co-design approach, involving children as active participants in creating narratives and animation films, thereby fostering a sense of agency and engagement. The interdisciplinary collaboration between artists and clinicians is crucial, merging artistic expression with clinical care to address the holistic needs of paediatric oncology patients. The presentation will refer to material gathered during a Public Participation Involvement Event (PPIE) with children, young people and families, a collaboration between Leeds Beckett University, Leeds School of Arts and the Candlelighters Supportive Care Research Centre, University of York. It introduces qualitative methods, including participant observation, in-depth interviews, and analysis of the creative outputs (stories, puppetry performances, and animation films) co-produced with the children and families. The discussion will aim to engage the audience in creative interventions and highlight the potential for creative activities to contribute to the clinical research framework, offering innovative ways to evaluate and enhance young patients’ oncology care. We aim to underscore the value of arts-based methodologies in clinical settings, advocating for their integration into paediatric oncology care to support the overall well-being of children with cancer. The interdisciplinary approach exemplifies a model of care that is not only medically effective but also deeply empathetic and responsive to the lived experiences of children with cancer.

Children in hospitals face illnesses and treatments which affect their physical, emotional, and psychological health. Applied theatre performance and digital technology facilitated at the bedside offer an essential therapeutic intervention. My presentation explores the integration of arts-based methodologies using quality engagement with the child-patient as a creative participant in paediatric settings within the National Health System in England (NHS). The presentation will introduce an interdisciplinary inclusive research pedagogy across the arts and healthcare, a set of activities for the improvement of the child’s hospital experience, the physical health and psychological well-being when undertaking treatment. I will also share experience of working across two cultures, arts-health, setting up interdisciplinary research studies within NHS hospitals, involving artists, research nurses, doctors, play teams and the industry (digital tech companies). The interdisciplinary approach exemplifies a model of care that is not only medically effective but also deeply empathetic and responsive to the lived experiences of children with illness.

A cyclic performance project enabled Australian tertiary drama students and primary school students to connect through stories written by children in hospital in the UK. University drama students undertook a semester of puppetry and created performances of children’s stories from Author 2’s book. The university students’ learning process involved exploring form and movement with inanimate objects to collaboratively create puppets which they allocated to the children’s stories they selected. These stories were performed for an audience of children aged between 5 and 8 years of age. This project used participatory action research and applied theatre to facilitate the university drama students’ exploration of puppetry, storytelling and performance. While the university drama students wanted to apply logic and chronology to the hospitalised children’s stories, they were willing to be vulnerable and to accept that they may not completely understand the stories. The university drama students performed their puppet interpretations of the stories for young children. This co-presence of the university drama students with the children affected a new understanding of the stories for both groups.

Applied theatre for health and wellbeing suggests itself as an effective tool for social and emotional interaction and communication of emotions, developing creativity, imagination, and regulation of emotions during hospitalisation. In this article, we define it as a therapeutic complex artistic practice. This paper aims to explore the therapeutic value of communicating emotions through applied theatre and storytelling in paediatrics and its potential in clinical practice in a discussion through the lens of psychodynamic therapy. We will explore the intersections, synergies, and possible collaborations between the theatrical form as a condition for openness and verbalizing pain and therapy as a method of processing and dealing with emotions. We discuss fictional stories told by children during applied theatre and storytelling research interventions in hospitals as case studies through the lens of psychodynamic therapy with children. We explore these stories by using interdisciplinary, synthetic, and dialectic analysis between the researcher-artist and the psychodynamic therapist. We ask if the stories that hospitalised children create within theatrical interventions can help adults and clinical staff understand better the children's lexicon of pain, leading to sensitive healthcare. The rich narrative discussion of the case studies indicates that applied theatre in hospitals enhanced well-being support in children and gateways for improved care. The core themes that emerged include empowerment, synergies and exchanges of emotions, emotional reassurance, and imagination. This analysis of hospitalised children's stories from a psychodynamic therapist's point of view has scope for informing alternative, non-medical activities with children in the hospital and those who would benefit from clinical therapy and the performing arts.

Background: In the context of ongoing underrepresentation of disabled people and shifts in the theatre industry, this article examines the significance of personal disability understandings and how these are interpreted in relation to the wellbeing of disabled people in theatre. Methods: Findings presented are part of an Interpretative Phenomenological Analysis; an interdisciplinary study detailing experiences of theatre practice and disability among professional actors and directors in theatres that are funded by Arts Council England. Results: One of six emergent themes from interviews, Navigating Inexperience of Disability in Theatre, assists in considering disability understandings and aspects of actors’ wellbeing in this article. It details interpersonal and emotional competencies required of disabled people in day-to-day practice; these relate to confidence, risk, empathy, compromise, value, and contribution. Conclusions: Routes to building accessibility in theatre are proposed as a shared and personal endeavour; value is placed on learning from disability as crucial in preserving wellbeing, creativity, and effective arts practices across disabled and non-disabled communities. Keywords: wellbeing; theatre; disability; accessibility; arts and health

The COVID-19 has become an unpopular term, one that is associated with shattered happiness and wellbeing, loss, pain, grief and isolation. The pandemic separated us of our loved ones, isolated us from our neighbours and alienated us from our communities. Artists such as actors, storytellers, puppeteers, musicians, singers, giggling (clown) doctors, and magicians for children were not allowed to visit hospitals at that time (unfortunately this is still the case here in the UK) due to strict, but understandable, hospital controls. As a result, the facilitation of bedside interactive and participatory arts-based activities in hospitals became impossible. Loneliness increased and life had to pause, for a while. The impact of the COVID-19 pandemic on the mental and emotional health of children and young people is of serious concern (Meherali et al. 2021). The pan-demic has created an increased demand for new tools and methods of accessing and supporting vulnerable children’s emotional needs such as anxiety and de-pression. Ciara Conlon et al. (2021) argue that the pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, particularly for those with chronic conditions. As pandemics and endemics continue around the world, it is important to develop an understanding of how to support children’s emotional wellbeing during times of crisis.

This narrative literature review aims to provide a broad scope and objective analysis, by identifying and summarising published works surrounding the current research into how different forms of non-pharmaceutical and non-invasive arts-based methods can be used to reduce children’s peri-operative anxiety in paediatrics. Whilst our search focuses on the peri-operative anxiety context, we build on wider research on the role of arts in paediatrics and include representative studies from the last five-to-seven years. Our aims are to highlight the most current findings in non-invasive interventions for hospitalized children, including primarily applied theatre performance in paediatrics followed by music, and digital arts such as video games and virtual reality ((VR), hereafter). Through this, we aim to gain a better understanding of the current knowledge in to how the aesthetics as non-pharmaceutical and non-invasive arts-based methods can be further utilized in surgical procedures and treatments in paediatrics, how arts practitioners and hospital staff can better collaborate in such procedures, and what further research is needed in relation to such methods for reducing peri-operative anxiety in children.

This book explores applied theatre practice for children in environments of illness and cure and how it can powerfully normalise children’s hospitalisation experience. It is an essential tool for making meaning of children’s illness, putting it into a fictional context and developing better control of their clinical experiences. It can be central to raising the standards of care and quality of life during illness. Taken from the author’s research and participatory bedside theatre practice in hospitals before, during and after the COVID-19 pandemic, this book demonstrates new learning about aesthetics, ethics, emotions, stories, puppetry, digital arts and research methodologies about children’s health and wellbeing. It provides a selection of ten unique stories told by children inspired by applied theatre practice in paediatrics, cardiac, oncology, neurosurgery, burns units and complex and intensive care wards. Stories aid in understanding the language of children’s pain for a better assessment and management of pain by healthcare professionals through the arts. It analyses synergistic theatre performance in ‘stitched lands’ between challenging realities and safe fictionalities. This book enables artists to develop new ways of thinking and contributes to further improvements in the provision of education and reflective learning in the field. It also addresses the emotional labour of the artist in healthcare and makes recommendations for balanced training to prevent emotional exhaustion. Designed for artists, healthcare professionals, therapists, play specialists and teachers who work with children in healthcare, this text aims to help many people find creative ways of making a positive difference in sick children’s lives. It is a book for those who love and care for children.

The book offers comprehensive practical applications of theater in education, which have already been implemented by the author with children and adolescents in kindergartens, primary and secondary schools, museums, theater groups and with students of theater and pedagogical departments. These applications are accompanied by complete "theater lesson plans" that are tested, feasible and easy, with instructions, suggestions and worksheets. They have been integrated into educational programs of UNESCO, the Ministry of Culture, the Ministry of Education and Culture, such as in the IPODE (Office of Intercultural Education), in the offices of Cultural, Environmental Education and Health Education, etc. They are also integrated into the teaching of Language, Aesthetic and Social Education, History, Geography and Flexible Zone courses. A handy tool aimed at teachers of all levels, theatre scholars, theatre educators, actors, museum educators, students of pedagogical and theatre departments and teacher associations for drama and theatre in education. It contains a rich insert with colour photographs, Greek and foreign bibliography and a folder with comic cards for theatre exercises and classroom discussions. Language: Greek.

This book explores applied theatre practice for children in environments of illness and cure and how it can powerfully normalise children's hospitalisation experience.

This article aims to explore the required skills and competencies of the actor who works in health-care systems. A narrative inquiry gave the opportunity for participants to elaborate on their understandings of their direct or indirect engagement with theatre in hospitals. Data were collected in the form of ten narrative interviews with experienced actors in hospitals and drama trainees. Inductive thematic analysis of this collection of qualitative data was used to allow findings to emerge from frequent or significant themes inherent in the semi-structured interviews. The study demonstrates a defensible emphasis on key themes, including the predictable professional skills such as acting in participatory dramas, using theatre improvisation and puppetry, and interpersonal skills such as emotional intelligence and empathetic awareness.

This article examines the delivery of a theatre initiative with child audiences in a hospital context. It reports on a mixed-method evaluation of a bedside site-specific performance at high-risk wards based in a Children’s Hospital, NHS Trust in England. It acknowledges the circumstances of the children and the conditions of the location, and examines the potential of supporting children during their stay in hospital through entertainment and relaxation. The article discusses the experiences of those who participated in the performance, including children, parents and guardians. It discusses the experience of taking theatre into health care, and the strengths and challenges of using a hospital space as a ‘stage’. It concludes that a synergy between the artist and the child is important to this type of intervention, seeking to provide children with both entertainment and relaxation as an important strategy for their well-being in hospital.

Artists such as actors and puppeteers in health care face emotional challenges in their work. This article investigates the interpersonal competencies and emotional skills of the artist who uses puppets in their practice in health-care contexts and settings. We present initial findings from phase B of a wider longitudinal study. Phase A focused on actors in hospitals and drama trainees; Phase B uses qualitative research methods with actors, puppeteers and therapists as participants. Content analysis of data reveals that the main competencies the artist needs to deal with emotional incidents in health care are empathy, self- and social awareness, self-care, self-reflection, emotional resilience and active listening. These skills are needed alongside acting and puppetry skills to develop competent and professional artists in healthcare. The study offers evidence to further develop strategies of receiving, processing and communicating emotions safely and effectively within the protection of the artform. This study therefore diverts our attention from traditional training courses that are mainly about learning artistic skills to a cross-disciplinary pedagogical framework that aims to enable artists to observe, reflect and process emotions before, during and after a performance with patients as theatre ‘audience’-participants.

Applied Theatre is an inclusive term used to host a variety of powerful, community-based participatory processes and educational practices. Historically, Applied Theatre practices include Theatre-in-Education (TiE), Theatre-in-Health Education (THE), Theatre for Development (TfD), prison theatre, community theatre, theatre for conflict resolution/reconciliation, reminiscence theatre with elderly people, theatre in museums, galleries and heritage centres, theatre at historic sites, and more recently, theatre in hospitals. In this paper we are positioning the application of recreational dramatic activities with older adults (55+) under Applied Theatre and we are exploring the benefits they offer to the participants. We are concerned that their health and wellbeing in western societies is not prioritized and it is clear that loneliness in particular is a current and ongoing issue. We will present research results from a drama dissertation study that took place in a community hall in the South East England where drama is placed at the core of their practice with old populations. Data was collected by a mixed method (semi-structured interviews and semi-immersive observations) and was critically discussed amongst the authors to conclude that attending recreational drama classes brings a certain degree of happiness, social belonging and improvement of interaction with others to old people’s lives.

This paper relays the findings of the evaluation of an applied theatre project for children in hospital as perceived by hospital teachers. A mixed qualitative approach was used. Data were analysed using thematic analysis to explore the teachers’ views on children’s engagement with learning and the improvement of the hospital experience as a whole through applied theatre. The article presents examples of children’s stories that illustrate the findings. The study concludes that applied theatre in paediatrics can engage children with hospital tuition and learning during treatment; improve the management of emotions; help them relax and communicate with the outside world.

A cyclic performance project enabled Australian tertiary drama students and primary school students to connect through stories written by children in hospital in the UK. Tertiary drama students undertook a semester of puppetry and created performances of children’s stories from Persephone Sextou’s book, Applied Theatre in Paediatrics. Children, Stories and Synergies of Emotions (2023). The tertiary students’ learning process involved exploring form and movement with inanimate objects to collaboratively create puppets which they allocated to the children’s stories they selected. These stories were performed for an audience of children aged between 5 and 8 years of age. This project used participatory action research and applied theatre to facilitate the tertiary students’ exploration of puppetry, story-telling and performance. While the tertiary drama students wanted to apply logic and chronology to the hospitalised children’s stories, they were willing to be vulnerable and to accept that they may not completely understand the stories. The drama students performed their puppet interpretations of the stories for young children. This co-presence of the drama students with the children affected a new understanding of the stories for both groups.

This article is based on discussions with artistic directors and administrators of British Theatre in Education companies about past and current practice and changing funding resources. Persephone Sextou reviews developments in TiE practice since its beginnings in the 1960s, focusing upon the situation in the 1990s following the enforcement of National Curriculum requirements, the redirection of government funding to partnerships in education, and the availability of funds from the National Lottery. She describes how the remaining TiE companies are struggling not to compromise their artistic autonomy, and considers the relevance of the British TiE experience in relation to the potential for the development of the medium in other countries. Persephone Sextou is an instructor in Drama and Theatre in Education at the University of Thessaly in Greece, and is researching the transference of British TiE to a Greek context for her doctoral thesis at Goldsmiths College, University of London. Her book on School Dramatization has been published in Greece.

Witnessing illness in childhood and hospitalisation can be deeply challenging experiences for researchers, yet the emotional labour involved often remains unspoken. This article explores how one artist researcher navigated the emotional impact of conducting research in paediatrics through arts based autoethnography and reflective practice. Through drawings, journaling, and metaphor, the first author shares her emotional journey during a 4 month research period in a children’s hospital. A psychodynamic therapist offers a series of reflections on the emotional material presented, offering clinical insight into metaphors for emotional safety. Together, this dialogic format provides a model for understanding and supporting emotional wellbeing in challenging research settings. The article concludes that arts-based autoethnographic methods provide a powerful tool for reflection, emotional processing, and knowledge generation. Building on these insights, we introduce a preliminary framework designed to guide researchers working in healthcare and other emotionally sensitive environments through creative and reflective approaches.

Purpose: Children undergoing Magnetic Resonance Imaging (MRI) often experience anticipatory anxiety, which can lead to distress, rescheduled scans, or sedation. This study evaluated the acceptability and impact of Xploro, a digital interactive app designed to improve children’s understanding of MRI procedures and reduce anxiety. Design/methodology/approach: The GLOWING STARS study used a before-and-after design. Children aged 4–11 attending diagnostic MRI scans in secondary care paediatric NHS Trusts accessed Xploro one-to-one on the day of their appointment. Children and parents/caregivers completed paper proformas assessing perceived knowledge and emotional responses before and after using the app. Qualitative data were analysed thematically, and quantitative data summarised descriptively. Findings: The study indicated that Xploro was highly acceptable and effective in enhancing procedural understanding, improving preparation, and increasing emotional security before MRI scans, especially for children aged 7 to 11. This study is the first to involve children aged 4–6 years using the Xploro digital interactive intervention for MRI preparation, and the first to deliver Xploro on-site at the ANONYMISED hospital NHS Trust. This study provides valuable evidence guiding recommendations for the development of digital interventions for children under 7 years old (~3-6).