Everyone Breathes: A mixed methods evaluation of a combined Feldenkrais and vocal improvisation group within an adult mental health Recovery College setting

Megan Cartier^1*Jhian Cadimas^1*David Sulkin²Owen Reilly¹Joanna Harries²Jenny Hill²Lucas Robson²Sophie Harris²Catherine Carr^3*

• ¹South West London & St. George's Mental Health NHS Trust, London, United Kingdom
• ²National Opera Studio, London, United Kingdom
• ³Queen Mary University of London, London, United Kingdom

Background: A range of singing interventions exist for mental health contexts, but few have incorporated group-based body, breathwork and vocal improvisation. The Feldenkrais method has potential to support singing interventions by raising attention to body and breath. This study aimed to describe practice and evaluate experiences and outcomes of a Feldenkrais and group vocal improvisation workshop provided by professional musicians and a Feldenkrais practitioner in a Recovery College setting. Methods: We used an observational mixed methods design. The workshop was held by a Recovery College for adults living with mental health challenges. All group attendees were invited to participate in the evaluation. Those who consented completed questionnaires at the workshop beginning, end, and two weeks later. We assessed mental wellbeing alongside goals, emotions, group appraisal, un/helpful and important events. Researchers attended as participant observers and conducted a focus group on the third day. We used interpretive content analysis to understand group content and evaluations. Quantitative data were analysed descriptively. Results: Eight service users (4 male, 5 white British, mean age=43) consented to participate. Group practice was summarised following TIDieR principles and emphasised equality and collaboration. Service users were attracted to the unusual course content, with a strong wish to connect with others and learn. Feldenkrais movement facilitated authentic vocal exploration, expression and creativity. This was experienced initially with some anxiety, but later supported bonding, enjoyment and fun. Experiences were positive, with benefits relating to capacity to breathe, connection to the body, ability to express themselves and find an authentic voice, as well as gain group support. Wellbeing improved on average by 3.14 (range 1-8) to a moderate wellbeing score of 25.9 with a standard deviation (SD) of 2.9. The workshop intensity and course focus were highlighted as areas for future development. Discussion: The Everyone Breathes workshop offers an intensive, creative, and supportive experience within the Recovery College context. The pilot evaluation suggests the group was well-received, safe and has potential to improve wellbeing in a relatively short timeframe. Future research should explore how to develop content and broaden opportunities for wider implementation to enable formal assessments of effectiveness.