Spirit Series and its related teacher training are about to reach their 50,000th student – grades 4 to 8 – and 1000th teacher. Harvard educator Howard Gardner, PhD – the multiple intelligences guru – called the NEH-supported program “powerful and impressive – a blend of the true, the beautiful and the good.” In a private meeting with Spirit Series’ founder Richard Strauss, a former musician, co-founder of the first rock-and-roll school, screenwriter and cranialsacral therapist, Gardner “looked over his glasses and said ‘you have a very idiosyncratic background for this work.'” As creative arts therapy rises at the NIH National Center for Complementary and Integrative Health, this deeply integrative program has data to prove that it gets to the heart of the whole child and to the development of social-emotional intelligence.

The program is intriguing through the integrative health lens. It could nestle nicely into the Whole Health ED initiative developed by Taylor Walsh and integrative pediatrician Larry Rosen, MD (see #4 here). It’s a group delivered, client-engaged, multi-modal intervention. It directly engages core determinants of health like self-efficacy, the ability to collaborate, and higher order thinking. And at its heart is a version of “practitioner heal thyself” – transformation in educators.is required fort “transformative outcomes in students.”

Strauss is a friend since university. Back in the day we both hung out with campus rock-and-rollers, each of us dropped out, then nearly a half decade later separately returned and struck up a friendship then. Strauss made his return decision from a storied recording studio in Los Angeles’ Laurel Canyon. Life as a session musician wasn’t for him. Since graduation he had two decades of getting paid – sometimes well – for writing screenplays for movies that never got made, marriage, birth of a daughter, development of a cranialsacral therapy practice in part for additional income. Then the loss of his first wife to breast cancer shook his world. He re-launched at nearly 50 on what has become the Spirit Series journey.

Strauss’ founding idea 18 years ago was to give pre-teens and early adolescents the opportunity to engage with the wisdom of the ages through the study, co-writing, staging and performing of plays, during regular school hours. These one-act “inspirational biographies” focus on the values, struggles and heroic life choices of Buddha, Harriet Tubman, Socrates, Sitting Bull, Galileo and others. The promise of the program is to “awaken, confront, challenge, empower and inspire.”

The present context of the work – which he leads in partnership with his present spouse, Leslie Rachel Strauss – is one in which the average attention span of children is 8.5 seconds. Strauss shares how the program requires kids to extend their frame. “I didn’t really think it through on this level when we started,” Strauss admits, “but how can you perform drama if you can’t comprehend it? One of the biggest increases we’ve seen is in authentic literacy. Its because they have to do it – they are going to be in front of their friends – for some the whole school. They have a million questions. What is my character feeling now? They need to explore the history. It’s often one of the first times, especially in impacted inner city schools, that they have ever really understood a piece of literature.”

Over the past 2 years, in most of the schools the program has included pre-post measurement along a set of 9 program values that encompass the whole child. These range from “engagement” to “team work” to “presentation skills” to “self-efficacy”. His synopsis: “The key quantitative outcomes are ‘higher order’ skills authentic literacy together with non-cognitive measures like teamwork, self-efficacy and self-reflection.” They boast a 25% positive change across all of the programs 9 goals, with 90% of students rating the program positively and 73% of all faculty responses after the Series noting real change in students and the classroom after.

While Strauss may have moved into this turf intuitively when he got started, he was headed for a double bullseye in today’s education. In the course of the program’s run “whole child education” and now “social emotional learning” have become “the biggest buzzwords in education.” These are the program’s strengths. While Strauss finds the year-by-year trajectory of decreasing student ability to hold focus dismaying, these findings have prompted teachers and administrators to go so far out of the box to the point of exploring a curriculum with “spirit” in its title.

I asked if they had evidence that the program is actually shifting the culture of schools. “The best evidence is many of our school partnerships are 13, 14, and 15 years long. They are seeing the change in their culture in a way that we can’t – because we re itinerant. The program is becoming an institution in the school. Second and 3rd and 4th graders are watching play every year and by the 5th grade they are on fire to do it,” says Strauss. He adds: “It’s a right of passage.” The website holds a quote from 5th grade teacher: “There is not a single student in my class who did not cheer when I announced the Spirit Series would soon begin.”

The backbone of the program, and its expansion, is the parallel offering for teachers.  “Spirit Works” is a train-the-trainers intensive and certification that prepares teachers to self-deliver the program. The core value is an integrative precept: “Transformative outcomes with students must begin with transformation in ourselves.” Thus the goal of the training program: “Develop your innate capacity for inspiration, empowerment and mastery, thereby becoming more fulfilled in your work…and in your life.” He drills down: “Ultimately for these teachers to teach about the Buddha’s compassion, they must practice it. To teach about Galileo’s courage, they must practice it.”

The program and outcomes are fascinating. Reflecting on this Spirit Series program delivered for children in schools from the vantage point of a medical clinic serving adults,  requires an opening of the normal aperture for what may be in, and out, of the work to move the medical industry toward a system that focuses on creating health. The integrative health community has yet to fully embrace creative arts. Nor has it routinely incorporated social prescribing as is being seen in the UK. And is “spirit” the right word?

Strauss says he and his team have been advised more than once to rebrand themselves because some people have problems with the “spirit” term. Certainly regular medicine and even the integrative health community choose not to routinely connect the “spirit” to mind and body to elevate attention to this challenging concept and complete the mind-body-spirit trinity. It’s not referenced, for instance, in the most widely accepted definition of integrative medicine. Does it belong there?

The struggle to shift the burnout-and-suicide theme in regular medicine toward well-being and resilience is beginning to put something like spirit on the regular medical industry’s table. An American Hospital Association writer’s reflections on the top trends at the December 2018 Institute for Healthcare Improvement conference provides some evidence: “Resilience and well-being continue to be a challenge. The leading health care organizations acknowledged that if their staffs are not operating on fully-charged batteries, it is difficult provide top quality patient care.” Considering the problem one of “fully-charged batteries” is a reductive, mechanistic way of acknowledging that this is a population that is dis-spirited. The acknowledgement is a step in the right direction.

One begins to see something close to spirit in integrative health’s effort to engage patient’s to locate a sense of purpose or self-mission as a motivator for health and healing. Many integrative practitioners – I suspect more often the females than males – routinely attend to this terrain in their integrative intake and treatment. The transformative Whole Health model at the Veterans Administration is an exemplar for systematically building the spirit that is “purpose” into elevating the whole health of veterans.

In 2009, in the midst of the Obama reform effort, David Rakel, MD led the what is believed to be the first public discussion in the integrative health community of the elements of an ideal integrative patient-centered medical home (PCMH). Participants in the dialogue with which I had a chance to witness quickly rephrased the goal as a patient-centered “health home.” The re-frame of the accountable care’s core community health implementation concept didn’t stop there.  The focus of the session at the top international research meeting in the field quickly left the clinic and engaged the idea of connecting to community resources – social prescribing (though not named as such). The role of schools was viewed as key. On the Spirit Series website, one parent offers a suggestion that would have fit right into the health creating, whole system that was being ernvisioned: “[Spirit Series]  should be in every school in America.”