Action Therapy With Families and Groups: Using Creative Arts Improvisation in Clinical Practice

Activity-Based Group Psychotherapy
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http://congdong.bancongxanh.com/5086.php The mechanisms of this success are yet to be fully understood. It is commonly agreed that while speech is lateralized mostly to the left hemisphere for right-handed and most left-handed individuals , some speech functionality is also distributed in the right hemisphere. While results are somewhat contradictory, studies have in fact found increased right hemispheric activation in non-fluent aphasic patients after MIT. A meta-analysis on the effects of music therapy in schizophrenic patients showed that the treatment in patients who underwent music therapy was more effective than patients who did not undergo music therapy with their treatments.

Some of the positive effects that resulted from the music therapy sessions include decreased aggression, as well as less hallucinations and delusions. A Cochrane review found that moderate-to-low-quality evidence suggests that music therapy as an addition to standard care improves the global state, mental state including negative and general symptoms , social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders.

However, effects were inconsistent across studies and depended on the number of music therapy sessions as well as the quality of the music therapy provided. A review of studies of music therapy for children and adolescents with major depressive or anxiety disorders found that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents.

Michael J. Silverton Ph. Silverman is published extensively in peer-reviewed journals and is the author of scholarly texts as well. He works in music therapy, special education rehabilitation and research. The purpose of this work is to discuss the need for additional research in the field of controlled psychiatric music therapy. A theoretical review on the use of music therapy in post-traumatic stress disorder suggests that music therapy may be a useful therapeutic tool to reduce symptoms and improve functioning among individuals with trauma exposure and PTSD, though more rigorous empirical study is required.

Music has been looked upon for centuries as an accompaniment to rituals and cultural traditions. In , the first program for music therapy in Africa opened in Pretoria, South Africa. Research has shown that in Tanzania patients can receive palliative care for life-threatening illnesses directly after the diagnosis of these illnesses. This is different from many Western countries, because they reserve palliative care for patients who have an incurable illness.

Music is also viewed differently between Africa and Western countries. In Western countries and a majority of other countries throughout the world, music is traditionally seen as entertainment whereas in many African cultures, music is used in recounting stories, celebrating life events, or sending messages. One of the first groups known to heal with sound were the aboriginal people of Australia. The modern name of their healing tool is the didgeridoo, but it was originally called the yidaki. The yidaki produced sounds that are similar to the sound healing techniques used in modern day.

For at least 40, years, the healing tool was believed to assist in healing "broken bones, muscle tears and illnesses of every kind". Archaeological studies of rock art in Northern Australia suggest that the people of the Kakadu region of the Northern Territory have been using the didgeridoo for less than 1, years, based on the dating of paintings on cave walls and shelters from this period.

A clear rock painting in Ginga Wardelirrhmeng, on the northern edge of the Arnhem Land plateau, from the freshwater period [60] that had begun years ago [61] shows a didgeridoo player and two songmen participating in an Ubarr Ceremony. Her group 'The Wheelchair Players' continued until , and is considered to be the first music therapy group project in Canada.

Two other music therapy programs were initiated during the s; one by Norma Sharpe at St. Thomas Psychiatric Hospital in St. The roots of musical therapy in India can be traced back to ancient Hindu mythology, Vedic texts, and local folk traditions. In the s, another dimension to this, known as Musopathy, was postulated by Indian musician Chitravina Ravikiran based on fundamental criteria derived from acoustic physics.

Dinesh C. Sharma with a motto "to use pleasant sounds in a specific manner like drug in due course of time as green medicine". Suvarna Nalapat has studied music therapy in the Indian context. Her books Nadalayasindhu-Ragachikitsamrutam , Music Therapy in Management Education and Administration and Ragachikitsa are accepted textbooks on music therapy and Indian arts. The Music Therapy Trust of India is another venture in the country. It was started by Margaret Lobo. Norway is recognized as an important country for music therapy research.

The former was mostly developed by professor Even Ruud, while professor Brynjulf Stige is largely responsible for cultivating the latter. The centre in Bergen has 18 staff, including 2 professors and 4 associate professors, as well as lecturers and PhD students. The origins of Musical therapy practices in Nigeria is unknown, however the country is identified to have a lengthy lineage and history of musical therapy being utilized throughout the culture.

The most common people associated with music therapy are herbalists, Witch doctor s, and faith healers according to Professor Charles O. Another practice involving music is called "Igbeuku", a religious practice performed by faith healers. In the practice of Igbeuku, patients are persuaded to confess their sins which cause themselves serve discomfort. Following a confession, patients feel emotionally relieved because the priest has announced them clean and subjected them to a rigorous dancing exercise. The dancing exercise is a "thank you" for the healing and tribute to the spiritual greater beings.

The dance is accompanied by music and can be included among the unorthodox medical practices of Nigerian culture. While most of the music therapy practices come in the medical field, musical therapy is often utilized in the passing of a loved one. The use of song and dance in a funeral setting is very common across the continent but especially in Nigeria. Songs allude to the idea the finally resting place is Hades hell. The music helps alleviate the sorrows felt by the family members and friends of the lost loved one.

Along with music therapy being a practice for funeral events it is also implemented to those dying as a last resort tactic of healing. Nigeria is full of interesting cultural practices in which contribute a lot to the music therapy world. Music therapy has existed in its current form in the United States since when the first undergraduate degree program in the world was begun at Michigan State University and the first graduate degree program was established at the University of Kansas.

Music therapists use ideas from different disciplines such as speech and language, physical therapy , medicine , nursing , and education. A music therapy degree candidate can earn an undergraduate, master's or doctoral degree in music therapy. Many AMTA approved programs offer equivalency and certificate degrees in music therapy for students that have completed a degree in a related field. Some practicing music therapists have held PhDs in fields other than, but usually related to, music therapy. Recently, Temple University established a PhD program in music therapy.

A music therapist typically incorporates music therapy techniques with broader clinical practices such as psychotherapy, rehabilitation, and other practices depending on client needs. Music therapy services rendered within the context of a social service, educational, or health care agency are often reimbursable by insurance and sources of funding for individuals with certain needs. Music therapy services have been identified as reimbursable under Medicaid , Medicare , private insurance plans and federal and state government programs.

A degree in music therapy requires proficiency in guitar, piano, voice, music theory, music history, reading music, improvisation, as well as varying levels of skill in assessment, documentation, and other counseling and health care skills depending on the focus of the particular university's program.

The current credential available is MT-BC. To become board certified, a music therapist must complete a music therapy degree from an accredited AMTA program at a college or university, successfully complete a music therapy internship, and pass the Board Certification Examination in Music Therapy, administered through The Certification Board for Music Therapists. To maintain the credential, either units of continuing education must be completed every five years, or the board exam must be retaken near the end of the five-year cycle. The units claimed for credit fall under the purview of the Certification Board for Music Therapists.

North Dakota, Nevada and Georgia have established licenses for music therapists. In , Hamda Farhat introduced music therapy to Lebanon, developing and inventing therapeutic methods such as the triple method to treat hyperactivity, depression, anxiety, addiction, and post traumatic stress disorder. She has met with great success in working with many international organizations, and in the training of therapists, educators, and doctors.

Psychotherapies

Live music was used in hospitals after both World Wars as part of the treatment program for recovering soldiers. Clinical music therapy in Britain as it is understood today was pioneered in the s and s by French cellist Juliette Alvin whose influence on the current generation of British music therapy lecturers remains strong. Mary Priestley , one of Juliette Alvin's students, created "analytical music therapy".

Practitioners are registered with the Health Professions Council and, starting from , new registrants must normally hold a master's degree in music therapy. There are master's level programs in music therapy in Manchester , Bristol , Cambridge , South Wales , Edinburgh and London , and there are therapists throughout the UK. Crawford and his colleagues again found that music therapy helped the outcomes of schizophrenic patients. According to Evan Andrews, reporting on the History Channel , ancient flutes, carved from ivory and bone, were found by archaeologists, that were determined to be from as far back as 43, years ago.

The find, of the oldest known melody, Hurrian Hymn No. Scientific research shows that humans have been evolving over a period of millions of years. Music has been used as a healing implement for centuries. Aesculapius was said to cure diseases of the mind by using song and music, and music therapy was used in Egyptian temples. Plato said that music affected the emotions and could influence the character of an individual. Aristotle taught that music affects the soul and described music as a force that purified the emotions.

Aulus Cornelius Celsus advocated the sound of cymbals and running water for the treatment of mental disorders. Music therapy was practiced in the Bible when David played the harp to rid King Saul of a bad spirit 1 Sam In the thirteenth century, Arab hospitals contained music-rooms for the benefit of the patients.

The rise of an understanding of the body and mind in terms of the nervous system led to the emergence of a new wave of music therapy in the eighteenth century. After books on music therapy often drew on the Brunonian system of medicine , arguing that the stimulation of the nerves caused by music could directly improve health. For example, Peter Lichtenthal's influential book Der musikalische Arzt The Musical Doctor was also explicitly Brunonian in its treatment of the effects of music on the body.

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Using Creative Arts Improvisation in Clinical Practice Action Therapy With Families and Groups introduces clinicians to innovative therapeutic options that can. Action Therapy with Families and Groups: Using Creative Arts Improvisation in Clinical Practice [Daniel J Wiener, Linda K Oxford] on tacidysaze.tk *FREE*.

Lichtenthal, a musician, composer and physician with links to the Mozart family, was mostly positive about music, talking of 'doses of music', which should be determined by someone who knows the "Brunonian scale". Music therapy as we know it began in the aftermath of World Wars I and II, when, particularly in the United Kingdom, musicians would travel to hospitals and play music for soldiers suffering from war-related emotional and physical trauma. Even as recent as , music therapy has shown the ability to provide emotional relief to the members of our society.

Music therapy finds its roots in the military. The United States Department of War issued Technical Bulletin in , which described the use of music in the recuperation of military service members in Army hospitals. Although these endorsements helped music therapy develop, there was still a recognized need to assess the true viability and value of music as a medically-based therapy.

Walter Reed Army Medical Center and the Office of the Surgeon General worked together to lead one of the earliest assessments of a music therapy program. The first university sponsored music therapy course was taught by Margaret Anderton in at Columbia University. These two signature injuries are increasingly common among millennial military service members and in music therapy programs.

A person diagnosed with PTSD can associate a memory or experience with a song they have heard. This can result in either good or bad experiences. If it's a bad experience, the song's rhythm or lyrics can bring out the person's anxiety or fear response. If it's a good experience, the song can bring feelings of happiness or peace which could bring back positive emotions. Either way, music can be used as a tool to bring emotions forward and help the person cope with them. Music therapists work with active duty military personnel, veterans, service members in transition, and their families.

Music therapists strive to engage clients in music experiences that foster trust and complete participation over the course of their treatment process. Music therapists use an array of music-centered tools, techniques, and activities when working with military-associated clients, many of which are similar to the techniques used in other music therapy settings.

These methods include, but are not limited to: group drumming, listening, singing, and songwriting. Music therapy in the military is seen in programs on military bases, VA healthcare facilities, military treatment facilities, and military communities. Music therapy programs have a large outreach because they exist for all phases of military life: pre-mobilization, deployment, post-deployment, recovery in the case of injury , and among families of fallen military service personnel. Resounding Joy, Inc. Its Semper Sound program specializes in providing music therapy services to active duty military service members and veterans diagnosed with PTSD, TBI, substance abuse, and other trauma-related diagnoses.

Walter Reed Army Medical Center located in Bethesda, Maryland, is another pioneer for the use of music therapy in the military. All patients at the medical center are eligible to receive music therapy services; therefore, the range of clients is wide: TBI, stroke, psychological diagnoses anxiety, depression, PTSD , autism spectrum disorder, and more.

The Exceptional Family Member Program EFMP also exists to provide music therapy services to active duty military families who have a family member with a developmental, physical, emotional, or intellectual disorder. Music therapy programs primarily target active duty military members and their treatment facility in order to provide reconditioning among members convalescing in Army hospitals. S Marines Corp. Individuals exposed to trauma benefit from their essential rehabilitative tools in order to follow the course of recovery from stress disorders. Music therapists are certified professionals who possess the abilities to determine appropriate interventions to support one recovering from a physically, emotionally, or mentally traumatic experience.

In many cases, self-expression through songwriting or utilizing instruments help restore emotions that can be lost after suffering trauma. By working with a certified music therapist, marines undergo sessions re-instituting concepts of cognition, memory attention, and emotional processing.

S Air Force are eligible for treatment as well. For instance, during a music therapy session, a man begins to play a song to a wounded Airmen. From Wikipedia, the free encyclopedia. Music therapy Power of Music by Louis Gallait. A brother and sister resting before an old tomb. The brother is attempting to comfort his sibling by playing the violin, and she has fallen into a deep sleep, "oblivious of all grief, mental and physical".

Main article: Nordoff-Robbins music therapy. Further information: Orff Schulwerk. Main article: Music therapy for non-fluent aphasia. Affective neuroscience Biomusicology Chronobiology Eloise psychiatric hospital Embodied music cognition Expressive therapies Melodic intonation therapy Music as a coping strategy Musical analysis Music cognition Music therapy in Canada Music psychology Psychoacoustics Psychoanalysis and music Psychoneuroimmunology.

American Music Therapy Association, November 9, Retrieved April 24, The Arts in Psychotherapy. Receptive methods in music therapy: Techniques and clinical applications for music therapy clinicians, educators, and students. In essence because reintegration of artistic processes within a social context can help promote the growth of a healthy Introduction 5 individual and a healthy society. Unfortunately modern industrialised societies have excluded many people from their right to indulge in these artistic processes. In using the creative arts in health care, rehabilitation and special education settings, and seeing the resulting growth in self-image, self-esteem and healthy social interactions, society as a whole is being handed a mirror concerning what is possible for all its members if only they are given the opportunity.

This diversity reflects the wide application and power of simply participating in a creative activity. However, it also reflects the diversity of theoretical frameworks and approaches that arts specialists hold, and the wide range of professional conditions within which they must practically implement their skills. However, it is beyond the scope of this book to deal in detail with the many and varying philosophical and theoretical frameworks that creative specialists make use of, implicitly or explicitly, in their working lives.

Writers and speakers on the creative therapies 4 have stumbled over definitions for more than thirty years. Much of the problem has been caused by attempting to define what individual creative therapies are, rather than looking at what they do. In addition, many creative specialists have tried to demonstrate just how much they are like psychotherapists and psychoanalysts. However, few creative specialists accentuate their greatest strength, the thing that makes them different, their expertise in their art form.

It is little wonder that despite many protestations to the contrary, creative therapy remains firmly under the grip of the medical community! Throughout this book a switch of focus is suggested from the arts as therapy to the arts for health: a switch from assessing the product to indulging in the process. I am certainly not alone in the conviction that 6 Why creative therapy?

I am a great believer in working towards demystification. As already mentioned, the act of creation of expressing self through a creative activity is part of both our heritage and our birthright. There is nothing mystical about it. Each of us can create something unique and meaningful to ourselves. However, so that we may make use of creative experience, we each need to understand the techniques and ideas that allow us to be creative. Professional artists always look towards expanding their knowledge and understanding of the skills, techniques and processes that allow them to be creative in their own medium.

The problem is that creativity cannot be switched on like a light bulb. You have to have the right power circuit, the right environment in which to create. In creative therapy the starting point for the development of a supportive and creative environment is always the leader. The leader is usually the most important factor in the direction and development of each individual involved in any session.

For the leader sets the tone, provides direction and chooses the material in which individuals will participate. This is true of any leader and is particularly true of the leader employing the creative process in health care, rehabilitation and special education settings. In employing creative activities in special settings, leaders have to know and understand three basic factors. They should know themselves, their creative medium and the members of their group both as individuals and as members of their group. The first factor is probably the most difficult.

Very few people know themselves totally. The external stimuli to which we are all exposed change constantly. We are always having to cope with new pieces of information, some that threaten our beliefs and some that reinforce them. Not everyone can be centred or achieve perfect harmony; however, most leaders can become aware of their strengths and weaknesses, and I believe that this Introduction 7 awareness is crucial to being a successful leader.

It is unlikely that any of us will ever be perfect. However, becoming aware of the many facets of our character and working towards increasing the quality and quantity of our positive characteristics and reducing our negative points help to build an awareness of ourselves. In simple terms, the group have to trust the leader before they can trust themselves. It is only when they have confidence that the leader will not subject their creative work to unnecessary and negative criticism and that all of their work will be treated confidentially that they will feel fully secure in investing part of themselves in their creative work.

When individuals are able to do this they start to grow in confidence and self-esteem. Ultimately being content with who we are at any given moment in our lives, feeling secure in our self goes a long way towards being a successful leader for our focus remains on individuals in our group rather than on ourselves. In working with any group of individuals,8 an understanding of our own working style and favourite medium is particularly important. The creative process actively engages the senses and the emotions and must be experienced—it cannot simply be reproduced.

We each have to have experienced the challenge of being faced with a blank piece of paper, or an empty stage, or the request to improvise around a theme to understand the problems it can present for others. The root of creation is in experience: not only experiencing the act of creation, but also allowing that act to recreate previously experienced emotions, events, feelings—channelling them through that creative expression.

Individuals have differing needs. This is as true for creative expression as it is in any other area. These may change from time to time. I work primarily in the performing arts. Whenever I attempt to work with paint or charcoal or even clay my hands are unable to create what my mind is asking them to produce.

As a result, I become frustrated very quickly. Yet the more I work with each visual medium, the easier it becomes for me. This is true for many other people. A slow and patient approach is often necessary. This may be the result of physical restrictions, or simply, as in my case in the visual arts, a limited experience in that medium. Part of the job of a leader is to provide members of a group with the skills, the vocabulary if you like, with which to express themselves in that medium. Over the past few years I have come to believe that it is necessary for leaders of creative therapy sessions to help individuals learn the language of the creative medium.

Each creative art has a different set of grammars its technical rules and structure and vocabulary forms of expression that we need to acquire if we are not to be frustrated when we try to express inner thoughts or feelings. It is important that leaders take the time to become familiar with the inner forms of their discipline and create an environment where each individual can learn the language of the creative medium.

This learning of the language is crucial to long-term success in creative therapy; or to put it another way pre-packaged fast foods can sustain an individual for a short while but there is really no substitute for good home-cooked meals. Knowing ourselves and our art forms are essentials, but these need to be linked to the needs of the individuals within the group. We need to structure our sessions so that everyone, individually and collectively, feels secure, that they feel we can and do provide them with the vocabulary, inner structures and the materials by which they can express themselves.

In the next chapter I will address myself to the fundamental question of how these basic ideas can be transformed by the inexperienced leader into practical realities. One example of this is the effect of humour and laughter in the process of healing. So clear is the value of laughter that some Canadian and American hospitals have humour rooms to promote self-healing particularly in stress and auto-immune related illnesses, for example cancer, heart disease and stroke.

Introduction 3 4 5 6 7 8 9 For the reader interested in this area, I suggest they look first at Feder and Feder This term is used in this context as a catch-all for the multitude of other subdisciplines within this area of study and activity, for example, art therapy, music therapy, drama therapy, poetry therapy, dance therapy, play therapy, bibliotherapy, etc.

This is equally important for leaders of creative therapy sessions; particularly in terms of the needs for members of their group to learn the language of an art form. See discussion later in this chapter. I have long been fascinated by my observations of professional colleagues whom I admire. They seem to have the capacity, irrespective of their medium, to extend a circle of energy around the group that acts as a support—as a comforter and friend.

This is something for which I strive constantly. Most of the discussion of group work applies just as well to working with an individual. Moss, L. Most are employed by public health authorities, hospitals, schools, social work departments, rehabilitation centres or other similar public or private institutions, to work within very specific limits with a particular group.

It is very important that you clarify the conditions of your contract before starting work with your group. In particular, the who, why and what of the agreement are essential. These questions are: Who Why What will I be working with? Subsidiary but nevertheless crucial questions are: When Where are we expected to meet?

The answers to the first three questions will enable you to form some ideas concerning how the goals set for you and the group might be achieved. The answer to the last two questions will provide a thousand organisational problems, which will make the why, the what and the how more difficult. The starting point for any creative session is to find out who is in your group.

In the initial stages your employer or supervisor will probably present you with a very sketchy outline of the people with whom you are expected to work. In many cases this will provide you with little or no useful information. This is often unintentional and occurs because of an unfamiliarity with the sort of information that will prove useful in running the session.

It is important that you find out the information you feel is important. The kinds of basic questions one needs to ask are: How many people will be in the group? Does anyone use a wheelchair or other ambulatory aids? Do any individuals have difficulties with speaking, hearing, seeing? Does anyone have epilepsy? A heart condition? Will I have any professional or voluntary assistance in my sessions?

Wherever possible, try to get specific information. Try to find out if the members of the group have similar abilities and ages. The age of the participants is particularly important, as this will be a factor to be considered when choosing your material. Also, try to find out under what circumstances these specific behaviours occur. Having said all of this, try to leave yourself room to make your own judgments. It is surprising how happy, co-operative and creative some individuals, whom others see as aggressive, withdrawn or disturbed, can be when given a warm and friendly environment in which they have a chance to express themselves.

Usually, the composition of a group the number, ages and abilities of the individuals within it is resolved over the first two or three sessions. After the session is over, I compare my perceptions of the group members, based on my observations during the session, with those given to me before I started.

I always keep my first session simple and fairly undemanding. In it I use activities that are relatively non-threatening and which act, for me, as a gauge of the abilities of the members of that group. These I refer to as diagnostic tools, and in the sections on dance and drama I give examples of some of these activities. It is for this reason that the contributing authors lay great store on the activities in a session being, above all, enjoyable. There are times when this rule may be broken as some of the material that may surface might be anything but pleasant.

However, there is little benefit to be gained from applying the creative therapies if they are viewed in the same light as having to take medication! Enjoyment is an essential motivating factor in enabling individuals to overcome their limitations. So often when working with the creative process, individuals will do something that is not only unexpected but also is beyond their previously exhibited capabilities.

The arts have that extraordinary power to engage the emotions and so motivate individuals to strive beyond their limits because they are enjoying themselves. However, it is important to know why you are working with the group and what your supervisor or employer is expecting from you and the group. It is here that creative specialists are often trapped by a belief that it is necessary to label their work as therapy so that it can be seen to be valuable and therefore defensible in monetary terms. However, this extension of the now rather dated debate about the arts as recreation, education or therapy has in large part been blunted by the move towards Arts for Health.

Nevertheless, it will be important for you to clarify your position to your employer within the context of your contract. There are many creative specialists working with people with special needs in the fields of rehabilitation, education and health care. Only a small percentage of such specialists have been trained in psychology, psychotherapy or medicine; yet many are employed as specialists.

At the other extreme, individuals with professional training in psychology or psychotherapy or occasionally medicine and one or more art forms are employed to introduce the arts as recreation within institutions. It is always important to recognise and state clearly, both to yourself and to your employer, the limits to your training, experience and expertise. Make sure, in establishing the why and what of your contract, that you are willing and able to do what is asked of you.

There is no point pursuing a contract where you are doing something beyond your experience and training or where it is just not your way of working. In both cases you, your group and your employer are unlikely to benefit from or be satisfied with the situation. The result is that your contract is likely to be a short and unhappy one. The where and when of the contract are possibly the biggest problems facing any leader of creative therapy.

All too often we meet with our groups too infrequently and in surroundings that do not satisfy our needs. It is important that you attempt to secure the most suitable room in the building. It is quite likely that fourteen other people will be wanting to Practical approaches to creative therapy 13 use that room at exactly the same time. I strongly suggest you do not attempt to share it with them. If you are unable to secure the most suitable room, at least attempt to get one that meets some of your needs. Each of us will have specific needs, but whatever else happens, try to get a room that is not a thoroughfare or shared by another group.

This is very important in generating a sense of security for your group. Another factor in establishing the security of a room is to check on its other uses. Try, where possible, to avoid rooms that group members associate with less pleasant activities. Again, this may be impossible; however, it is worth the effort. A major factor in establishing trust is the continuity and scheduling of your sessions.

Avoid requests to change the timing of the sessions in midstream. Also, try to avoid time slots that occur just after group members have had a meal. The frequency of your group sessions is often out of your hands, but you should decide what the optimum number of sessions is each week—two or three sessions is probably a good number to aim for. The length of the session will depend on the activities you plan to engage in and the age and ability of your group. The reality is that you will have very little say in the where or when of your contract.

The room and the time slot for your sessions were probably decided before you were hired. It is important that when you do find yourself in an environment or a timetable that is all but unworkable, you strive towards changing these to satisfy your needs more adequately. In the meantime, you simply have to make the best of a bad job. Sometimes the knowledge gained from working in unsuitable conditions can be a valuable learning experience. At others it will be a nightmare, which will stay with you all your working life. The how of the contract is a dynamic experience. It occurs in relationship to the why, where, when, what and who of the contract.

There is no single or simple answer to it and consequently it is the most difficult aspect of the contract to discuss. While there are a few excellent books2 that make suggestions about how to cope with this volatile area, ultimately each individual has to find their own way of negotiating the moment by moment problems that are faced by creative specialists working in this field.

Clinical Mobile Resources

It is almost impossible to use a plan that has been created before the session, for this is too static and cannot make allowances for dynamic changes within the group. Leaders have to rely a great deal on their training, past experience and intuition to help guide and plan sessions. The how of the contract is essentially the sum of knowing who you are, knowing your art form and knowing your group.

It is about making use of your material to meet the needs of your group. This will not only mean different things to different people, but will also mean different things to the same person at different times or with different groups. I strongly recommend that you attempt to gain role-flexibility as a leader. Even if you only work with one group, at different times the needs of the members will be different. For example, sometimes they will want you to be a parent figure telling them what to do, at others they will want you to be an impartial observer, and at still others they will want you simply to be part of the group.

It is important that you do not get stuck in an inflexible style, which does not allow room to move. On occasion, what the group wants from you is not what you see as their needs at that time, or the role they cast you in may not be suited to you or you may feel unable to carry it off. It is important that you work within your limits but try to meet the needs you identify in the group. Working on role-flexibility can be difficult. One way of learning roleflexibility is to try to get experience of working with other groups.

Try to work with other group leaders, observe their style but always remember who you are. It is important not to move simply from one extreme to the other. Make changes one small step at a time, for any sudden changes can be very threatening to the group.

The problem is that leadership style and role-flexibility are particularly personal. They are learned and not taught. Personal creativity can be stifled if you constantly tell individuals exactly what to do. Yet some groups need clear, concise and constraining instructions in the early stages of their development. Remember, the more directions you give, the less room you allow for personal creativity. This chapter dealt with the basic problems of contract that a leader faces.

The contract represents the framework in which you have to operate. A great deal of the contract is initially beyond your control. The content of your session and your style of leadership are uniquely your own. In Chapter 3 I will outline some hints for the smooth running of a session—a checklist of ideas that may prove useful. NOTES 1 2 What follows may seem obvious to many readers nevertheless it is alarming just how many people do begin sessions without considering basic planning.

For example two books written for drama teachers, J. Morgan and J. Saxton Teaching Drama, Hutchinson, London, may be helpful in this area and I strongly recommend anyone working in a clinical setting read M. Chapter 3 Checklist of preparations and practical hints for leaders Bernie Warren Below I have outlined some observations and questions that I feel are important to the running of a successful session of creative therapy.

I feel the questions are relevant to anyone leading a creative session, irrespective of their background, experience, style s of leadership or the groups with which they are working; however, these factors will obviously affect the answers that each of us gives to these questions. The checklist below reflects my personal concerns, namely: being clear on my responsibilities as leader; treating the people I work with, irrespective of age or ability, as unique human beings;1 and providing a structure in which people can enjoy themselves, be creative and work towards overcoming the mental, physical or emotional conditions that they face in their daily lives.

The checklist, which is annotated, covers the three basic phases of running a practical session of creative therapy, that is before, during and after each session. Many of the points may be obvious to you, some you may think about only occasionally and others you may not have thought about before. Will this number be constant? Often this number will fluctuate. Someone may be ill, need to go to surgery, X-ray, dentist, hairdresser or a million and one other places. Be patient and be prepared for these changing numbers.

RC 500-509: Psychoanalysis

Are they approximately the same age? Can they all walk? Is there 15 16 Why creative therapy? For example, are all the individuals in the group recovering from a stroke? It is always important to plan specifically for your group. No two groups are ever exactly the same, but obviously experience gained with similar groups is very valuable.

The key is in choosing activities that allow group members to succeed. For example, are any members of the group on medication that will limit their creative potential e. It is highly unlikely that you will know everything you would like to know before the start of the first session. You will almost certainly gain valuable information from your own work. Is my job to engage the group directly in creative activities, or am I employed to seek actively to change specific behaviours?

Is this realistic? If your job description and your duties clash, there is a need to clarify exactly what is expected of you. There is a vast difference between accepting a challenge and misrepresenting your abilities. Often you may need to re-educate your employer or supervisor about why you work creatively and what skills you possess in relation to the perceived needs of your group. How often do I see the group and for how long each session? Do the other professional staff who work with them also know this information?

Often you will have no say in the frequency or timing of your sessions. If your sessions are too long, allow time for simply talking and being with the members of the group. Does the space I have been allocated meet these needs? For example, does it have running water and enough chairs? Is it comfortable? If not, how can I make do with the space allocated? It is essential that you make clear to the person dealing with scheduling and administration exactly what your needs are. Demand the impossible— go for what you would want ideally and barter from there!

Will they be volunteers or professionals? Do they know the group members? Do they know my way of working? Do they know what my goals are? It is not unusual for your assistants to know the group better than you. This can be an extremely valuable asset. Make use of these people. Wherever possible, run workshops for them before working with your group. Take them into your confidence; share ideas and information with them. One word of caution—always remember that, no matter what happens, you are responsible for the running of the creative sessions, consequently when push comes to shove you must have the final word.

These may be different from those suggested by your employer or supervisor. Much of this may have to be left open until after your first session. Try to provide, in the first few sessions, activities, structures and language systems that allow you room to change direction without breaking the trust and security you are developing.

Is this to be provided for me? Am I expected to take my own art supplies? Tape recorder? Musical instruments? Many creative specialists always carry their own materials around with them. It is perhaps the one way of ensuring you have exactly the materials you need. Try to be reimbursed, or given an equipment budget to cover these costs. Do I need to negotiate another space?

Bibliography of Psychodrama: Search Results.

This may be difficult, but always try to get the room that suits you. If you need a sink for art work, or a piano, or a clean space to roll on, keep on pressing for your needs. It may be difficult explaining to someone unfamiliar with your creative medium why you need these facilities but keep on trying. What is the general mood of the group? Is it in keeping with my plans for this session? In some cases you may want to keep that mood. In others, you may wish to dispel it. Either way, you may feel the need to change your plans. Flexibility of approach is one of the keys to successful and creative leadership.

Does the group know why I am here and what we will be doing together? How do they react to this? Every group is different. Every individual in every group is unique. Each makes their mark differently. The medium in which they are most creative differs. All too often, leaders do not even consider asking a group what they would like to do. The warm-up sets the tone for the rest of the session.

If imagination is to be the focus of the session, exercises to warm up the imagination will be needed. Who is outgoing? Who is shy? Am I working at their pace? Am I aware of changes occurring in these needs throughout the session? Preparations and practical hints for leaders 19 Throughout the session, no matter how actively involved you are, you must be sensitive to the needs of all the group.

This requires tremendous amounts of concentration and, in particular, paying close attention to all the observed behaviours of your group. Make sure you are using language that the group understands. As to the structure, you will have to sense if you need to let go of the reins or pull them in even more. This is something one learns with experience and unfortunately experience can not be gained from any book. If you are not enjoying yourself, it is almost certain that no one else will be. However, be careful that you are not the only person enjoying yourself.

Remember who the session is for; it is often important to remind your assistants about this too. Lying on the floor, listening to tranquil music, gentle rocking in pairs, telling the group a story, while they lie on the floor with their eyes closed, working with a parachute—are all examples of examples of ends to a session that are both relaxing and positive.

Do I need to send notes back with certain individuals? Water turned off? Is the room in reasonably the same state I found it? This is particularly necessary as janitors and cleaners are possibly the most important professionals we encounter. To me? To my material? To other members of the group? Was this as I expected? Can I pinpoint a reason for this? The room? My presentation? My contract? My material? Did I identify new goals during the session? I feel it is extremely important to keep written records.

These should not just be a clinical account of what happened.

They should include observations of what went on, how the group members participated and how you felt the session went. I have kept a journal of every session I have ever run and these have proved invaluable, not only during but also after the sessions have finished. Do I need to change my approach? My medium? Do I need to renegotiate my contract? How can I best meet these needs without disturbing other members of the group? How can I link it to what we have already done so that it builds on these experiences? The answers to these questions will be extremely specific.

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The only observation I will make is that it is essential that you link your material to your own personality and to the personalities in your group! You cannot pour from an empty cup. The most important thing to remember is that everyone in the room is a human being. You, your assistants and the members of your group all have good and bad days.

All of you will experience frustration and elation, failure and success. If you can bear that in mind, you will be a long way down the road to allowing the people you work with the opportunity to expand their own horizons through creative activity. The rest of this book is devoted to practical activities that will allow you to share the power of the arts with others. NOTE 1 It is important to remember that individuals in any group, irrespective of their ability or disability, should be encouraged to take responsibility for their own Preparations and practical hints for leaders 21 lives.

This requires that the leader treat each individual with respect. It is this quality that enables creative activity to provide the opportunity to empower individuals. One book that has been very useful to me in this context is H. Exley ed. Part II Practical activities Chapter 4 Folklore and ritual as a basis for creative therapy Rob Watling Folklore is that part of any culture that is transmitted by word of mouth or by custom and practice.

It includes folk literature folktales, poems, songs, dramas , folksay proverbs, riddles, rhymes, dialect , customs and beliefs, music, dance and ethnography the study of arts, crafts and the manufacture and use of artifacts. It is important to realise that modern industrialised societies have folklore in the same way as American Indians or Australian aborigines. Qualitative Health Research, 9, Edwards, David J.

Cognitive therapy and the restructuring of early memories through guided imagery. Journal of Cognitive Psychotherapy, 4, Edwards, Jay. Creative abilities of adolescent substance abusers. Efimova, I. Dividing by self or existential multiplied by psychodrama. Egg, Rudolf. Aus- und Weiterbildung in Psychotherapie. Basic and advanced training in psychotherapy. In: W. Egg, Eds.

Psychotherapie: Ein Handbuch. Stuttgart: Kohlhammer. Ehrenwald, Jan. Psychoanalyst vs. Group Psychotherapy, 13, Ehrlich, P.

Photodrama: apprenticeship and transmissability. Bulletin de Psychologie, 34, Eibach, Hannelore. Der Einsatz des Psychodramas bei Psychosomatikern in bezug auf die Kriterien der analytischen Kurztherapie. The use of psychodrama with psychosomatic patients in relation to the criteria of analytic brief therapy. Ejido, Maria Angeles. Psychodrama techniques. In: T. Madrid: Oskar Pfister. Psychosomatic conditions and psychodrama. Elefthery, Dean G. Our psychodrama demonstration in the permanent theater of psychodrama.

Group Psychotherapy, 19, Psychodrama, 5, Elias, Karin. Psychodrama in Kombination mit analytischer Einzel- oder Gruppentherapie in der Klinik. Psychodrama in combination with analytic individual or group therapy in the clinic.

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In: K. Oberborbek, Ed. Sozialpsychiatrische Informationen. Eliasoph, Eugene. A group therapy and psychodrama approach with adolescent drug addicts.