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The Parent Coach

Recently, I was listening to the Wise Counsel podcast (available on iTunes or through mentalhelp.net), hosted by Dr. David Van Nuys. The May 15th episode includes an interview with Steven Richfield, PsyD, on the Parent Coach method of working with children, especially those who carry a diagnosis of ADHD and/or Asperger’s. What caught my attention most about the Parent Coach program is the inclusion of 20 pictorial/verbal cards that educate both child and parent on issues of socialization, emotional regulation and self-esteem, etc… And then, the potential art therapy application at the end of the interview:

David: Are you continuing to generate new cards? Is this evolving? Will there be a second deck or an enlarged deck?

Steven Richfield: I have countless other cards. What I haven’t done is I haven’t taken the next step, which is to publish them as I did the first 20 cards, but what I have is maybe another 100 that I’ve written with children since then.

David: Oh, wow.

Steven Richfield: And I find that having the first 20, if it’s in your office as a psychologist, gives your child patients the inspiration to develop their own and take ownership that way.

David: Oh, that’s fascinating. I like that idea.

Steven Richfield: I think it’s actually more valuable for the child when they see their own artwork.

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Positive Identity Development and Individuals with Intellectual Disabilities

I recenlty listened to a telephone seminar by Karyn Harvey, PhD, regarding positive identity development with people with intellectual disabilities. Based on positive psychology (the work of Seligman) and Erikson, Karyn offers a wonderful treatment meathod that can easily be meshed into the Recovery Model, as well as more “traditional” models used with DD clients, such as the Behavioral Model.

In her seminar, Karyn spoke briefly about her book, Positive Identity Development: An alternative treatment approach for individuals with mild and moderate intellectual disabilities, published through the NADD. She also offers free downloadable worksheets, which are excellent. Here are the topics available:

  • Psychological Needs Survey
  • Happiness Assessment
  • Change Inventory
  • Behavior Planning Template
  • My Book About Myself!
  • My Goodbye Book
  • My Book About Recovery!
  • My Book About Solving My Problem
  • My Book About Making a Difference!
  • My Book About My Relationship
  • My Book About My Addiction




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    Find Artx Directives

    Carol McCullough-Dieter recently came out with a new website/service called, Find Art Directives, which allows professionals to browse and organize art therapy directives. What a great idea! I checked it out recently, and noticed that the information available on the site is rather sparse, but as people begin using the site and imputing the directives they know of and use, the site will certainly become more useful.

    That being said, the usability of the site still needs a bit of work. For example, looking around, it was difficult to figure out how to add a directive to the database, which is a bit of an issue for a database driven website! Here’s how you do it: once you’re logged in (you must request a user name and password to enter the site), go to My Favorites, and in green you’ll see Create a New Directive. Personally, I think Create a New Directive should be it’s own tab, on the top of the website, since without people adding info to the database, the website will be inadequate.

    I’m also disappointed with how limited the choices are when adding an art directive. For example, the media types offered (in a check box format) is limited to traditional media only. No photography. No digital media. No fiber art. Also, the number of diagnoses available to check off is extremely minimal. Only substance abuse/dependence, PTSD, borderline, depression and sexual abuse. What about developmental disability? Bipolar? Schizophrenia? OCD? Maybe the answer to covering a wide range of topics is allowing the person who is imputing the info about the art therapy directive to had his/her own tags manually, while a list of commonly used tags are available just below—similar to what’s found on a WordPress blog when you’re writing a post.

    With a few tweaks to the website, I think Find Art Directives will be a useful resource for art therapists. I remember one of my art therapy internship supervisors had a box of index cards with art therapy directives written on each, making it easier to keep the group ideas coming. This is especially important when working with the same population over a longer period of time, keeping art therapy groups fresh and exciting.

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    Spotlight on Judy Weiser

    Judy Wieser R.Psyc, ATR is a pioneer of PhotoTherapy, an art therapy technique that unfortunately too many art therapists don’t know about or understand (and she’s a fellow Canadian!). Ginger Poole from the Digital Art Therapy Group on LinkedIn conducted a brief written interview with Judy about PhotoTherapy. Judy discusses her techniques along with why it’s important for art therapists to understand and think about the impact of digital media on our lives. She points out that many art therapists over 30 are unaware of how prolific digital media and pictures are, as well as how easily they’re manipulated– blurring the boundaries of fantasy/wish and reality. Furthermore, she touches upon the idea of accessibility of one’s pictures, artwork, privacy and copyright issues.

    Part of Judy’s message, is my opinion as well— Art Therapists! Don’t get left behind! It’s getting to the point that knowing about new technology/digital media and how to integrate it into one’s art therapy practice is not an option. It’s a must. As we become more technologically dependent and integrated, not having these skills will set you apart from your younger clients, causing a schism between your understanding of your world versus theirs.

    How is it that many art therapy graduate programs are uncomfortable with exploring the use of digital media and it’s applications in terms of artx interventions? We are not doing ourselves any favors sticking to the study of structured versus unstructured media and not including digital media in the spectrum. I agree that for many organizations getting funding for new technology is difficult, but that doesn’t change the fact that on our younger client’s spare time they interact with digital and social media almost as much as they interact with the physical world (this is my observation, not taken from a statistical study). For better or for worse this is their reality. Thinking about it’s impact and discussing your observations on open forums, like the Digital Art Therapy Group is one way to keep in touch with the realities of living in a digital age.

    You’re on LinkedIn but are not a member of the Digital Art Therapy Group on LinkedIn? Go here to join.

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    Online Games to Boost Self-Esteem

    self esteem



    Researchers at McGill University have created several online activities called Self Esteem Games, helping people build self confidence and stay on the positive side of life. The games force you to recognize happy faces and/or your own name, creating a positive association to yourself and others in your mind. In other words, the exercises foster an individual’s ability to recognize and focus on positive environmental stimuli (i.e., smiling people) rather than the negative, allowing the players to practice having a positive or more optimistic attentional bias.

    The games are easy, fun, fast and somewhat meditative…something that would be appropriate for pretty much anyone to do on their own, or perhaps at the beginning or end of a therapy session…or even as homework after a therapy session is over. Homework that’s fun? Well, that IS something to be excited about!

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    Sewing Dolls and Pillows

    Running Stich

    For clients with developmental disabilities, an important goal of art therapy is to foster successful art making experiences they can subsequently feel proud of. I am flexible during 1:1 or group art therapy sessions, allowing the clients to choose what they would like to work on, while keeping my ears and eyes open for any suggestions they may have for art projects they would like to work on in the future. So, when a client happened to mention how she used to watch her mother sew dolls when she was a child, I asked her (and later the group) if they’d like to begin a sewing project. The group, which is mainly young females in their early 20s, enthusiastically replied “yes”- especially after they began to see some of the projects their peers were working on.

    Materials:

    – Felt (rectangular pieces of various colors) – felt is good because when you cut it, it doesn’t fray
    – Embroidery floss (sometimes split in half to make it more like regular thread)
    – Sewing needles
    – Plastic sewing needles
    – Hand held hole puncher 1/8″
    – Yarn
    – Buttons
    – Scissors
    – Pipe cleaners
    – Fabric Glue
    – Fluff/Stuffing

    Directives:

    I am hoping that in the future I’ll have some photos to put alongside this post, which may help following my instructions a little easier.

    – Clients chose which they would like to work on; a pillow or a doll.

    – If the client does not have the fine motor skills to use a regular sewing needle (for example if the client has cerebral palsy), or if the client may become self injurious with the needle, I offered to punch small holes along the edge of the felt so that they could sew using a plastic needle and thread.

    – For clients that were comfortable using a needle, I reviewed threading and how to make a running stitch, practicing on a test piece of felt.

    Pillows

    – Clients making a pillow chose 2 pieces of rectangular felt. They were asked if they wanted to embroider a design on their pillow. If they said yes, I asked them to draw an outline on one piece of felt using a dark colored pencil. Then, using the running stitch (or an embroidery stitch) the client sewed along the outline they created. After the design is complete, the client can begin sewing their 2 pieces of fabric together into a pillow. Remind the clients to leave one side unsewn so that the pillow can be stuffed and sewn closed.

    Dolls

    – For clients making a doll, I begin by asking them to make a sketch of what they would like their doll to look like.

    -Many DD clients have low frustration tolerance, and difficulty cutting accurately. Since one of the goals is to make this project successful, I suggest the therapist cut the shapes needed for the head, body, arms and legs for the client, allowing the client to focus on the task of sewing and stuffing. This helps the project to be less overwhelming for some. However, higher functioning clients (especially adolescents who are trying to master separation and individuation) may ask that the therapist not help. In this case, respect the client’s wishes, while reminding them that you are there if they have any questions.

    – Most clients opt to begin with the head. I have multicultural skin toned felt, which is great for the head, hands and feet. I precut 2 circles for the client, in the color of their choice, to be sewn together as the head. However, before the sewing begins, I suggested to the clients that they may want to work on the face, for example, by sewing on buttons for eyes or gluing yarn for a mouth. Once the face is completed, the 2 round felt pieces can be sewn together, again, leaving an unsewn part to stuff the fluff into and then close. Hair can be added by gluing pieces of yarn on the finished head with some fabric glue.

    – While the client works on the head, the therapist can cut 2 pieces of felt intended to be the body according to what the client has drawn in their sketch. This may be a simple shape, such as a triangle or rectangle, or it may be more complex, like a dress that has a neck, shoulders and arms. They may want to choose felt of a different color so they body looks like clothes. Again, the client will sew the 2 pieces of felt together, leaving an unsewn part to stuff. Before the stuffing takes place, the client may want to add a pipe cleaner (folded into a “w” shape) into the body, so that it acts like a spine- holding the doll in place. Once the pipe cleaner is inserted, the client can stuff and close.

    – For simplicity’s sake, I opted to not have 3 dimensional arms and feet, but rather cut one piece of felt into the hands and legs of the doll.

    – The client can now sew the head to the body, as well as the arms and legs.

    Tip– For the pillows/dolls made by clients who did not sew their piece well enough to last (it looks like it will fall apart), the therapist may ask if the client would like some extra reinforcing sewing to be done by the therapist so the pieces will last longer. While many DD clients are excellent sewers, some are not. Helping to support the longevity of a project that the clients intend to keep over the long term because they are proud of their piece, can be validating to the client and demonstrate that their work, ideas and creativity is valued.

    Observations

    This is an ongoing project, so there will be no doubt more information about this directive to come. In any case, here are some interesting dynamics that have surfaced so far with the individuals participating in group art therapy 4x per week (sessions are voluntarily attended, so many do not participate as much as this). All information shared is in generalities to protect the identities of the clients.

    – As the group members sewed, almost immediately a discussion began about mom’s. It seems that many of these clients were taught to sew by their mothers or maternal figures, and the act of sewing itself evoked strong memories of their mothers.

    – Many of the clients who chose to create a doll are in the process of working through body image issues. Doll making may open another avenue of exploring such issues with the therapist.

    – The participants are proud of their work, and proud that they were able to remember or learn new skills.

    – Many clients remarked on how relaxing hand sewing is, and wanted to create more than one piece.

    – Some clients wanted to use their own fabric, for example from old clothes, to make their pieces. In many of these instances the fabric used were from clothes that have meaning to the client. For example, one client saved a hospital robe from a involuntary psychiatric hospitalization, and used this robe to make a pillow as a reminder to herself that she does not want to be involuntarily hospitalized again.

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    Graffiti Art Therapy

    What does tagging, bombing and writing have to do with art therapy? A whole lot, according to Abdallah Ezekiel Rothman LPC, ATR…especially if you work with adolescents.

    In 2004, Ezekiel wrote his thesis on the topic of Graffiti Art Therapy while studying at Antioch University in Seattle. His thesis includes two parts- a written research portion and a 20 minute documentary, which can be seen in full at http://www.graffitiverite.com/graffitiartTherapy.htm. Ezekiel also has his own website where his research is posted, although only a clip of the documentary is available here. I find Ezekiel’s website an easier read than the graffitiverite site due to the way the website was formatted and designed.

    If this all seems familiar, it may be because Ezekiel presented his video at the 2008 AATA conference in Cleveland. He also is an adjunct professor at George Washington University’s Art Therapy program and will be teaching a class titled “Graffiti Art Therapy” this summer.

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    Tele-Therapy (Cyber Counseling)

    The latest Creative Therapy Session podcast featured a topic that I have always been interested in, but always felt hesitant to bring up during my schooling. I felt that the idea of conducting art therapy sessions online would have been a taboo topic in a program that emphasized the presence of the therapist with the client in order to foster a therapeutic relationship, not to mention the fact that I had no idea how one could go about making artwork online.

    In this fourth episode of the podcast, Melissa Solorzano, ATR, interviews Kate Collie, PhD, ATR, RPsych, about the work she does in the emerging field of cyber counseling and the way she combines tele-therapy with art therapy. During the interview, Melissa and Kate discuss many of the questions described above and more.

    Thank you Melissa for getting this interview! I believe that cyber therapy is a field that is not only emerging, but is here to stay and will only grow bigger, and for this reason its something that needs to be addressed and talked about extensively amongst the psychological community. Like it or not, there therapists like Kate who offer online group therapy services for people who live in remote areas, and there are also therapists who have set up shop in virtual communities like Second Life. Not only must we begin exploring the effect working virtually has on the therapeutic alliance, transference, picking up nuances during sessions, curative factors in therapy, socialization etc…, but we must also remember issues such as confidentiality and technological limitations (i.e., whether someone has a computer, speed of internet, malfunctioning software). Other questions to consider; is there a difference between being present in a therapy session as an avitar versus through a webcam where the therapist and client can see each other’s faces? What are the differences between text forms of communication (email, instant messaging) versus hearing someone’s voice through a microphone during an online therapeutic session? Are there populations that online sessions are more suited for than others? Is online therapy more effective than no therapy at all?

    Its certain that a new frontier in therapy is already here and cannot be ignored. To quote Heidi Klum from Project Runway, “either you’re in or you’re out!”. I certainly don’t want to be left behind by technology, if in fact there are ways to work around all the issues discussed above and more.

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    Photography

    A few months ago I watched the Oscar winning movie called Born Into Brothels and I’ve been meaning to write about it ever since. Its a documentary on a photographer from NYC, Zana Briski, who goes to Calcutta to photograph the red light district, when she discovers that the children of the prostitutes are interested in learning how to photograph pictures. She sets up a photography workshop for a number of these children, gives them cameras, and in turn these children photograph their everyday lives.

    I wont get into much more detail so that I don’t spoil the movie for anyone who hasn’t seen it…but the line between being a photographer/teacher begins to blur for the NYC photographer, and the film began bringing up similar feelings for me as working within a therapeutic/social-work context. That is to say, the photographer seemed to learn from her experience that although we may want to save others from a life that we may view as tragic or that we would not want for ourselves, we must recognize this wish and our limitations where we can do no more than offer support and opportunity (to learn, to explore, to grow). I also have to give Zana credit for going above and beyond what many would have done or thought they were capable of doing for these children. At the very least, the children discovered a part of themselves that allowed them to be creative, explore themselves and their environment, as well as become empowered through the use of creative expression.