Let me describe my work:

I make an appointment with my client. The client arrives. We talk, and we talk. And we laugh.
And we share information, until we reach a common understanding why the client is here and
what we can do together. We have to bond first, share a little something, have a cup of tea, find a
common something, 'we'.

Most of my clients have been diagnosed with schizophrenia, psychotic disorders, personality
disorders, or severe depression. Several of my clients have more than one diagnosis, and this
'pisses them off'. They do not know what is going on. Their medication is going up and down.
They want to come off their medication. They are angry, and feel let down by the psychiatric
system. Many of them have been trapped in the 'revolving door' syndrome, but with
SACMHA'S help are beginning to get on their feet. A few of the clients accept their diagnoses,
along with the shame it brings their way.

4. Case studies

My first client A. I had known her on a previous placement. She was an elder, severely
depressed, and unable to attend the community mental health centre. At 11.30 I rang the
doorbell, and was greeted gently by the client's husband. Client A was lying on the couch in her
front room. She looked a bit nervous at seeing me. I was also nervous, so I relied upon my
training. I am a therapist here, and the room has to be made ready for therapy. I politely asked
client A if she would switch of the television. She did. I asked her husband if he would close the
kitchen door, so that we could have some privacy. He was surprised, but he did as he was told. I
asked client A if she would switch off the radio. She did. Then, I set up my art stuff on her main
table

In a previous session with A and her key worker, I had prepared her for my needs as a visiting
therapist. We went through the code of practice together, and in theory she was happy to
accommodate a visiting art therapist.

Let's just say, this first session ended fifteen minutes later. Client A said she was tired. We were
working together on a drawing, like Winnicott's squiggle. She had drawn a cup and I had drawn
a lid on it, and the lid had effectively been put on this session. I have not seen this client since,
but the feedback from her key worker was, 'She felt like a child'. And I felt like a fool.

With my further home visits, I learned to be more adaptable, and not worry about being 'the
visiting therapist'. I set up when my client wanted me to set up. I was trying to build up a client-
therapist relationship using a Yoruba technique of letting the client invite me into her world. As
a trainee art therapist, I had been warned of the dangers of being manipulated. I wasn't worried.

Visiting the homes of clients allows the clinician to see the other side of the client, the
neighbourhood, the home, the conditions in which the client lives all help the clinician
to understand the client's plight more clearly. Meeting the client at his or her home also
facilitates the valuing of the client and in building trust (Boston and Short [1998] p40).

Client X. was a woman who had been diagnosed with psychotic delusions and hallucinations. I
visited her at her home, arriving at 10.30, greeted the client and marvelled at her new table. This
was the fourth session. The client invited me to sit down on a new chair. What a chair! It was a
wooden throne. Her previous table had been a white plastic garden table and chairs. The client's
daughter saw me coming from the bathroom window, and I greeted her before entering the
kitchen.

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