Building Bridges of Understanding: the use of embodied practices with older people with dementia and their care staff as mediated by Dance Movement Psychotherapy


This study investigates the use of Dance Movement Psychotherapy (DMP) on people with dementia, on care-staff, on embodied practices and the author’s own reflections and developing understanding about their use and importance. Embodied practices mean engaging with a person through the lived experience of their own body in relationship to self and others, thus people with dementia can be more effectively reached and communicated with. Embodied practices contributed to: improving mobility; affirming identity; supporting affective communication; increasing observed ‘well-being’ and extending the range and quality of care relationships.

This study proposes care-staff need to be better informed psychologically about how to engage, how to ‘build bridges of understanding’ between the ‘known’ and the ‘not yet known’. Care-staff need to be more accepting that communications and behaviours expressed through ‘strangeness’ and ‘otherness’ can be better understood and related to as having meaning and importance. This is a paradigm shift away from bio-medical thinking, placing the onus on care-staff becoming more adept at communicating and finding meaning in so-called ‘non-sense’. Embodied practices support remaining individual capacities and communication skills and by way of this, ‘Personhood’ (Kitwood and Bredin, 1992a: 274).

The fieldwork was within a mental-health hospital ward in England. A single DMP session was studied using a qualitative and quantitative methodology, regarding impact on the patient, on care-staff, and on the use of embodied practices. It was recorded on video (VTR), mapped using Dementia Care Mapping (DCM) with the impact on care-staff studied using questionnaires. Analysis of the VTR transcript yielded thirty-three linked themes leading to five further meta-themes. DCM results indicated significant effects on raising and supporting observed ‘well-being’, consistent with other sessions of a similar type (Crichton, 1997, Perrin, 1998).

Contribution to knowledge concerns the development of a more creative, more expressive and embodied approach to the care of people living with dementia as presented here by the development of a new approach called ‘Creative Care’.

Aims of research

To elucidate the ways in which the neurological insult of the dementia condition may be diminished by DMP, as mediated by care-staff, as a creative and and embodied means for improving communication and quality of life for some people who develop dementing conditions. It covers a detailed critical account of embodied DMP implemented by the Researcher/Practitioner with a group of four older people living with dementia in an in-patient setting of an NHS hospital including ten members of their care staff. It situates DMP theory and practice within a succinct yet comprehensive review of wide-ranging multi-disciplinary literature.

Principal research question(s)

1) To observe the effects on well/illbeing of people with dementia participating in a DMP session.
2) To identify the embodied practices occurring during the the session and their impact on both people with dementia and their care staff.
3) To identify the impact of the DMP session on the care-staff

Principal findings

Builds on a very detailed knowledge of earlier work concerning psycho-social interventions within a person-in-relationship paradigm and makes an original and important contribution to understanding what it is like to have dementia from the older person's perspective as revealed through the use of DCM8, as well as to the actual and potential use of of embodied activities and approaches designed to enhance communication and well-being. Evidence provided of the importance for staff carers to have opportunities for experiential and practical learning opportunities spread over a number of weeks and designed to assist in extending their tolerance, lessen their anxiety and increase their capacity for responding to "difference", "strangeness" and "otherness". It also draws out the importance of care staff being supported in acknowledging their own vulnerability, so often exacerbated by the challenges presented by people living with dementia, and the necessity for having effective learning opportunities for developing various creative means of caring.

Research Supervisors
Professor Jen Coates, Dr Janek Dubowski, Dr Galfid Congreve, Mrs Penelope Best, Mrs Gabrielle Parker, Professor Andree Grau
Client group
Older people living with dementia in an in-patient hospital setting and their care staff.
Nature of data collection
VTR made of one hour long session, VTR analysis in relation to movement patterns, Independent Movement Analysis carried out (LMA & KMP elements)Dementia Care Mapping (DCMv.8), care-staff questionnaires, identification & analysis of themes & meta-themes
Ethical board approving research
Leeds University Ethics Committee
Research design
Registered Academic Institution
Roehampton University, London
Academic level of research
Related publications by members of research team
Parker, I., Coaten, R., & Hopfenbeck, M. (2022) The Practical Handbook of Living with Dementia, PCCS Books, Monmouth.
Coaten, R. (2020) ‘Movement and Dance – Movement Matters!’ in Swift, R. (Curator) ‘Creative and Sensory Activities for People and Families affected by Dementia (Booklet 2)’, University of Worcester, p.6-7. Accessed online:

Tischler, V, S. Schneider, S. Morgner, P. Crawford, T. Dening, D. Brooker, C. Garabedian, T. Myers, F. Early, N. Shaughnessy, A. Innes, K. Duncan, A. Prashar, O. McDermott, R. Coaten, D. Eland, & K. Harvey (2019)

“Stronger Together: learning from an interdisciplinary dementia, arts and well-being network (DA&WN)”, Arts & Health, International Journal for Research, Policy & Practice, Vol.11, Issue 3, 272-277.

Coaten, R. and Williams, S. (2016), ‘“Going far is returning”: Dance Movement Psychotherapists find resilience and learning and call for more collaboration and dialogue’, Dance, Movement & Spiritualities, 3: 1+2, pp. 161–75, doi: 10.1386/dmas.3.1-2.161_1

Coaten, R (2015) ‘A day in the life of…Dance Movement Psychotherapist Dr Richard Coaten’, Memory Services National Accreditation Programme (MSNAP) Newsletter, Royal College of Psychiatrists, Issue 13, 4-6.

Coaten, R (2013) ‘Fleeting Moments’ in Pulse, South Asian Music and Dance, Issue 122, 18-19.

Coaten R, Heeley, T, Spitzer N (2013) ‘Dancemind’s ‘Moving Memories’. Evaluation and analysis; a UK based dance and health project for people living with dementia and their care-staff.’ UNESCO Observatory Multi-Disciplinary Journal in the Arts, Vol.3 Issue 3, 1-17

Coaten, R, Newman-Bluestein D (2013) Editorial: ‘ Embodiment and dementia – Dance movement psychotherapists respond‘ Dementia: International Journal of Social Research & Care Practice’, Vol.12, No.6, 677-681.

Jutlla K, Parsons M, Coaten R, Gardiner L, Brooker D, (2013) ‘Capturing progress in creative arts and dementia’, Journal of Dementia Care, Vol.21, No 1. 26-28.

Coaten, R. (2012) Book Review - 'The Wise Body - Conversations with experienced dancers', by Lansley, J & Early, F. The Journal of Alternative & Complementary Medicine, Vol. 18, No 6, 629-630

Coaten, R. (2011) 'Dance Movement Psychotherapy in Dementia Care', in Lee, H. and Adams, T. (eds) Creative Approaches and Communication in Dementia Care, MacMillan, Basingstoke.

Coaten, R. & Jacobson, N (2011) ‘Dance Movement Psychotherapy as a ‘Golden Thread of Remembrance’ and a key to communication’, Signpost, Journal of Dementia & Mental Health Care of Older People, Vol.16, No1, 12-16

Coaten, R, (2010) ‘Editorial: On with the dance!’ Journal of Dementia Care, Vol.18, No.5, 5.

Coaten, R. (2010) 'Case Study 5. Richard Coaten: working with older people with dementia' in Tufnell, M. (ed) 'Dance Health and Wellbeing: Pathway to practice for dance leaders working in health and care settings', Foundation for Community Dance.

Coaten, R. (2009) 'Building Bridges of Understanding: the use of embodied practices with older people with dementia and their care staff as mediated by Dance Movement Psychotherapy', PhD Thesis, Research Repository, Roehampton University, London

Coaten, R. and B. Warren (2008) ‘Dance – Developing self-image and self-expression through movement’, in Warren, B., ed. Using the creative arts in therapy and healthcare – a practical introduction, London: Routledge (3rd Edition)

Coaten, R. (2008) ‘Movement Matters’, in Sharon & Jeff (eds.), The Family Arts Recipe Book – a recipe book of creative ideas to inspire ,Verd de Gris : Calderdale,UK (22-23)

Coaten, R. (2006) Book Review of Tufnell , M. & Crickmay C. (2004) 'A widening field: journeys in body & imagination', Research in Dance Education, Vol.6, (1), 117-120

Coaten, R. (2002) 'Movement matters: revealing the hidden humanity within dementia through movement dance and the imagination', Dementia. International Journal of Social Research and Care Practice, 1, no.3, 386-392.

Coaten, R. (2002) 'Developing Learning and Play Experiences with children through Free Movement Play and Dance', Dance Therapy Association Australia Journal (Autumn), 13-17.

Coaten, R. (2001) 'Exploring reminiscence through dance and movement', Journal of Dementia Care 9, no.5, 19-22.

Coaten, R. (2000) 'Creating a little revolution - the patient as artist', in Greenland, P., (ed.) What dancers do that other health workers don’t, Leeds: Jabadao pp101-120

Coaten, R. & McMorland A., (1994) 'Using dance and music to share the experience of dementia', Alzheimer's Disease International (Edinburgh)

Coaten, R. & Warren, B. (1993) ' Dance -developing self-image and self-expression through movement', in Warren B (ed) 'Using the creative arts in therapy - a practical introduction' (2nd Edition), Routledge, London