Counseling Today, Cover Stories

Taking a creative approach to client change

By Laurie Meyers August 20, 2015

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Fan culture has gone mainstream. Whereas once the celebration of popular media was confined mostly to small, under-the-radar TV show and comic book conventions, today myriad fan gatherings take place — both on the Internet and off. Shows and characters that not so long ago would have been considered “niche” — think superheroes, science fiction, the supernatural — today embed themselves in the public consciousness and serve as springboards for the creativity of passionate fan bases.

The granddaddy of all fan conventions, the San Diego Comic-Con, has grown from a small gathering creative-approachof 300 comic book fans in 1970 to 130,000 attendees in 2015. These fans — many dressed in full costume as their favorite characters — gather to attend panels and events that revolve around movies, TV shows, comic books and graphic novels. There is even a multiday mini-conference that explores the psychology of comic books. Beyond the fan conventions, a plethora of blogs, online groups and sites for writers of fan fiction extend these expressions of creativity even further.

Counselors typically embrace creative expression because they say it can contribute to a person’s overall wellness. Likewise, many counselors believe that creativity is an essential part of the counseling process itself. The counseling professionals interviewed for this article use pop culture mechanisms such as books, movies, music, graphic novels and TV shows, among other creative methods, as a strategic part of their practice, teaching and supervision techniques.

Defining creativity in counseling

Some counselors automatically assume that the phrase creativity in counseling is limited to art therapy, drama therapy and certain other experiential techniques. They may even think that they need special training to incorporate creativity into their practices, but that is definitely not the case, says American Counseling Association President Thelma Duffey, who was also the founding president of the Association for Creativity in Counseling (ACC), a division of ACA.

“One of the wonderful things about creativity is that it belongs to everyone, and we can find it almost everywhere,” Duffey says. Creativity in counseling refers to the creative human capacity to effect change, she notes, and it includes a process that involves shifts in thoughts, feelings, behaviors and perspectives.

Recently, Duffey and fellow counselors Stella Kerl-McClain, Shane Haberstroh and Heather Trepal were asked to write about creativity in counseling as a theoretical framework for an upcoming theories text. They defined creativity in counseling as a shared counseling process involving growth-promoting shifts that occur from an intentional focus on the therapeutic relationship and the inherent human creative capacity to effect change.

In practice, this can take various forms, according to Duffey. “Although it is not necessary to use activities or interventions in CIC [creativity in counseling] practice, counselors may use creative resources such as music, books, journaling, film, etc., or any number of other resources to support their work,” she says. “Our creativity gives us the flexibility to look at things differently and move in a new direction. Our creativity also inspires hope. And hope is a good thing in counseling and in life.”

Telling the client’s story

Stories, whether presented through legends, poetry, prose, music or movies, offer a powerful way of connecting to clients and then encouraging them to share their own stories, says Elizabeth Hall, an ACA member who is a practicing psychotherapist in the Denver area. “For every human experience, there is a mythological story somewhere out there that examines it through a hypothetical lens,” she says.

Hall first became interested in the power of mythology and stories as an undergraduate at the University of Colorado. In addition to taking several psychology classes, she took a religious studies class with a professor who used mythology to teach. The idea of examining the mythology of various cultures for a window into the human psyche stayed with Hall as she became a licensed clinical social worker. She went on to get a doctoral degree in mythological studies with an emphasis in depth psychology. Stories have since become an integral part of her work with clients.

Hall says that incorporating stories and images from current culture is particularly effective when working with adolescents because these clients often have trouble expressing their inner experiences. Hall has found that expressing themselves through a discussion about a book, movie, song, TV show or comic book makes it easier for adolescents to share their feelings.

Hall often starts a therapeutic conversation by asking clients what music they listen to, what movies they like or what they are currently reading. “It’s an alternative to a face-to-face interview,” she says. “They can speak through the story. They may tell me that they just watched a film like Harry Potter, and I’ll say, ‘Oh, tell me about it.’”

As a client tells the story from his or her point of view, Hall takes note of what aspects of the story the individual focuses on. Bullying is a common theme among adolescent clients, she notes. Many of her clients gravitate toward comic books and superheroes, which frequently feature the hero overcoming instances of bullying.

“I’ll ask them, ‘How did Spiderman — or whomever — overcome bullying?’” Hall says. In that way, she explains, she is “interviewing the story,” which is less threatening to the adolescent than being questioned directly. Through this process, clients sometimes grow comfortable enough to talk about their own problems with Hall. But even when that isn’t the case, Hall says that mythological tales and bibliotherapy can be healing on their own, much like play therapy.

Hall, who is a professor and assistant dean at the Rueckert-Hartman College for Health Professions at Regis University in Denver, also supervises interns working in an adolescent treatment center. Some of her interns use art and storytelling to create groups centered on the hero’s journey. One group even used The Hunger Games book trilogy and movie series.

“The basic hero’s journey is that they have to leave home to go off on their own,” Hall explains. “Eventually they find allies and battle mysterious forces.”

Hall believes that the hero’s journey is symbolic of the struggle that many adolescents — particularly those in treatment centers — face. The stories surrounding this journey help adolescents to become aware of their own strengths and recognize the internal “monsters” that get in their way, she explains.

“I think we, as adults, forget how horrifically challenging adolescence is,” Hall says. “It’s a very confusing time, a time of a lot of uncertainty. … They are trying to establish who they are — separate from family and culture — and they feel the pull toward adulthood but also back toward childhood.”

Entering the client’s world is sometimes the only way for a counselor to get a response from that person, Hall says. She mentions one of her interns who was working with a 14-year-old boy who wasn’t interested in anything but one particular book that he read over and over again. The boy was also on the autism spectrum and wasn’t very good at communicating. The intern and other therapists complained that they couldn’t tear his attention away from the book. Hall advised them to use his fascination with the book to their advantage and enter his world by asking him about it. Once they did that, the boy came out of isolation and actually started putting the book down to focus on other things.

Hall also uses stories with her adult clients, although the process is not typically as elaborate as it is with adolescents. Instead, she simply likes to ask these clients if they have seen a movie recently or heard a song that has stuck with them. If so, Hall and the client talk about it.

“When you engage the imagination through story or image,” she explains, “it gets clients into a different part of the brain — [the emotional], not just the intellectual.”

Creativity and technology

Emily Dennis, an ACA member and counseling doctoral candidate at Kent State University in Ohio, became convinced of the healing power of creativity while she was an undergraduate. During her freshman year, Dennis’ father was diagnosed with cancer and she temporarily withdrew from school. She suddenly had a lot of time on her hands and had always enjoyed painting.

“I found that art was fulfilling and something I needed in my life,” she says. “That’s kind of why I chose to study art therapy — I found it to be a really powerful healing tool.”

Although Dennis went on to earn dual master’s degrees in counseling and art therapy, she identifies herself not as an art therapist but as a creative counselor. She doesn’t think counselors should need specialized training to incorporate creative methods into their practices.

“I strongly believe that creativity is for everyone,” she says emphatically. “Counselors need creative interventions.”

Dennis, who is on the board of trustees for ACC and is also chair of its graduate student committee, has discovered that technology can make it easier for counselors to use creative interventions. During her time as a doctoral intern counseling children at a community clinic in Akron, she used basic drawing and publishing apps such as Drawing Pad and iBooks to provide narrative therapy.

For instance, when children presented with anxiety, Dennis would ask them to draw a picture of anxiety with a stylus, a stylus brush or their fingers, depending on the app. She would tell them that their anxiety picture could take any form they wanted, such as a monster. Then Dennis and the client would talk about the drawing and how it felt to give anxiety a face.

After drawing the picture, certain children wanted simply to throw their anxiety out, which on the iPad was as easy as clicking on the virtual trash can. But others wanted to explore their anxiety further, so Dennis would work with them to create a story.

“We might put the monster in different scenarios,” she explains. “Was there a time when the monster wasn’t there? What was that like? What will you do if the monster comes back?”

These stories would include ways to “defeat” the monster, Dennis says, and because the stories were created with an app, they were easy to email or print out in a form that resembled a real book.

Children were typically excited to use the technology, Dennis says, and the process was faster than using a pen or crayons and paper. In addition, she didn’t have to stock a multitude of supplies.

“Sometimes using an iPad is just easier,” she says. “I think that the ‘undo’ button is a really big advantage because, for a lot of people, it takes away some of the fear of facing a blank piece of paper.”

Dennis also teaches family therapy courses at Indiana University of Pennsylvania and recently used a slightly more old-fashioned type of technology — television — to put a creative spin on her lessons. After showing episodes of the sitcom Everybody Loves Raymond, she would ask the class to diagnose the show’s family members and come up with a treatment plan. It was a fun way for the students to practice what they were learning and helped hold their attention during the five-hour classes, Dennis says.

Both in the counseling room and the classroom, Dennis experiments with technology and popular culture to tailor her creative approach to clients and students. “Creativity can augment theories and approaches,” she says. “It keeps me interested as a counselor, and it keeps the clients invested as well.”

The science of creativity

Courtney Armstrong is a licensed professional counselor with a private practice in Chattanooga, Tennessee. During her 20 years in practice, she found that experiential techniques produced better results for her clients than did cognitive therapy alone, particularly in cases involving trauma, so she set out to learn why.

“I wanted to understand the neuroscience [behind it],” says Armstrong, whose recently published book, The Therapeutic “Aha!”: 10 Strategies for Getting Your Clients Unstuck, describes creative counseling techniques and the science behind this approach.

Armstrong, an ACA member, also presents workshops for counselors on creative experiential techniques. “The main thing I teach is that when we are doing experiential counseling using art, role-play, drama and imagery, we are influencing the emotional part of the brain,” she explains.

The emotional part of the brain is separate from the verbal parts, so talk therapy doesn’t affect the emotional source of the problem, she continues. Particularly in cases of trauma, emotional reactions lay down neuropathways, she says, and these emotional memories need to be “rewritten.”

Neuroscientists believe this process requires memory reconsolidation, or reopening the memory “file” and laying down a new memory to replace the old one, Armstrong explains. Therapies that incorporate physical elements, such as eye movement desensitization and reprocessing, cultivate the rewriting and reconsolidation of memory, she notes. The research indicates that experiential counseling methods work the same way, she adds.

For instance, Armstrong had a client who was referred to her by a psychologist. The woman had come to the psychologist because she felt like her throat was closing up anytime she ate, but there was nothing physically wrong with her.

“He [the psychologist] had her do positive self-talk and exposure techniques, forcing herself to eat, and it just made her so frustrated,” Armstrong says. “He finally sent her to me because he thought there might be trauma in her background.”

Armstrong had the client close her eyes, focusing on the sensation of her throat closing and when she first remembered feeling it. Together, they traced the sensation back to her childhood. The woman’s parents often fought at the dinner table, and she remembered constantly thinking that she would do anything not to have to eat at the table.

Armstrong talked to the client about her ultimate goal — to be able to swallow and eat without difficulty. She first worked with the client to come up with an image that would replace the thought of the dinner table. Armstrong asked her to picture something that flowed, and the client came up with a waterfall. Armstrong then had the woman envision stepping back into the dinner table scene but instructed her to think of the waterfall instead of how she would do anything to not have to eat there. According to Armstrong, this method quickly led to resolution of the woman’s problem.

Armstrong also likes to use music in her counseling practice, particularly with clients who are dealing with grief. She first asks clients to come up with a playlist of songs that remind them of the loved one who is no longer there. “You have to guide them so that the list isn’t just a bunch of sad songs,” Armstrong advises, adding that these first few songs are a tangible way for clients to retain a connection to their loved one.

Next Armstrong talks with clients about how their loved one wouldn’t want them to suffer or continue to be in pain, so she directs them to pick additional songs for their playlist that represent how their loved one would want them to feel. Armstrong doesn’t recommend specific songs; she asks clients to simply pick what speaks to them.

Sometimes the healing benefit of the playlist extends beyond the client. Armstrong recalls one client who developed a playlist in counseling after his child died. “He didn’t want to share it with his wife [at first] because he thought it would be too painful,” Armstrong recounts. “But then he decided to do it, and his wife had her own songs that she wanted to add. It really helped them to reconnect” in the aftermath of the tragedy.

Armstrong traces the advent of her use of creativity in counseling to her time as an intern and young counselor working with inner-city youth in New Orleans. As part of a grant-sponsored school counseling program, she went to schools in impoverished neighborhoods to help students. Armstrong came prepared with conflict management manuals and had training in cognitive behavior therapy, but she quickly realized the students weren’t at all interested in engaging with her.

Armstrong needed to understand their world, so she started small and offered a bribe of sorts. “I said to them, ‘If you will share something about yourself, I will get up and do an awkward white girl dance,’” she remembers. “They loved that.”

As Armstrong learned more about the adolescents, it became obvious that their biggest concern was getting to and from school and in and out of their neighborhoods without getting shot. They didn’t have many goals or expectations beyond that.

“They didn’t believe that they had any options or that they would ever leave the projects,” she recounts. “[They said,] ‘We can either work at McDonald’s, sell drugs or by some miracle get recruited by the NBA.’ I needed to have them believe they could have a life outside of the projects.”

Over time, and in addition to her “awkward dance,” Armstrong used more humor, music and other creative techniques to cement her relationship with the group. “They were really creative, so we used a lot of art,” she says, “not just to express how they felt but to depict how they wanted to feel.”

The youth used their art to explore lives and careers outside of the projects. Armstrong also gave them practical challenges by having them create a mock design business, and she appointed the students to various roles — designer, CEO and so on. She thinks this creative approach taught them more about how to work together than any of the traditional conflict resolution techniques she was originally prepared to apply.

“We had some good successes in the group,” Armstrong says. “Some of the kids left the gangs.”

In fact, a decade later, Armstrong was in the airport in New Orleans, and one of the girls she had counseled — now a young woman — was working there. She recognized Armstrong and stopped to thank her, telling her that Armstrong had genuinely helped her believe that she could change her life trajectory.

Approaching controversial topics

Counselor educators and co-researchers Tina Paone and Krista Malott, members of ACA, believe that using creative methods to teach can make it easier for counseling students to learn about and discuss controversial topics. Paone, an associate professor at Monmouth University in West Long Branch, New Jersey, and Malott, an associate professor at Villanova University outside of Philadelphia, are both longtime proponents of creativity and experiential learning. They have recently been studying the effects of using sand trays, journaling, photojournaling and other creative techniques in their classes on racism and white privilege.

“The reason we became so interested in this topic is that we found students would have strong emotional reactions [to classes on racism and privilege] and sort of shut down emotionally,” Malott recalls. “I thought, ‘What can we do?’” She notes that issues such as racism and privilege are essential parts of a counselor’s diversity training.

The counselor educators say that it can feel confrontational to students to be lectured on these topics and uncomfortable to be forced to sit and have open discussions on the subject matter. Sometimes, Malott notes, students get defensive about the concept of white privilege or, conversely, discouraged at how thoroughly entrenched racism is in society. When learning about microaggressions, students may also feel guilty or upset upon realizing how often they have participated in those small acts of racism.

Malott and Paone have their students write journal entries about what they are thinking and what they have learned after each lecture. Although they hold group discussions, they also like to add a physical element to the students’ learning. For example, Paone positions students in poses that she thinks reflect how they have reacted verbally. She also acts out how she feels the students are reacting to her — for instance, by posing with her back to the class if she thinks they are not really listening. Paone uses experiential and physical techniques in part because she believes they can be more engaging. In addition, she thinks it is important to use multiple teaching styles because students learn in different ways — some are predominantly verbal learners, whereas others are more visual.

Malott agrees. “Kinesthetic learning is another way to experience information,” she says. “When I teach, moving and talking while [the students also] move seems to work best.”

For instance, Malott has her students engage in various physical or almost gamelike activities. “I have a microaggressions activity where I will post common microaggressions on the wall,” she offers as an example. “The students have several cards with them, and they go around and look at each post and put down a card if they feel the behavior really is a microaggression. … The students are excited to move because it’s not just me talking at them.”

The class then discusses which items should or should not be defined as microaggressions and why. Placing the most cards correctly becomes almost like a competition, further engaging the students in learning.

Malott also directs students to form groups for some of the activities so they can problem-solve together. Talking about what they see helps reinforce what they are learning, she says. For example, Malott might put up statistics related to racism and quotes from counselors about best practices to support diversity. Students then walk around, read the information and decide which topics they want to dig into at a deeper level. The activity offers students an almost museumlike experience, but enhanced, she says.

“I find that when I wander and look at things in a museum, I still sometimes miss things,” she says. “I think it’s useful to talk with people.”

Malott says that creativity also makes her a better, more engaged teacher. “I’ve always been a creative person, so it appeals to me,” she says. “I also get bored [just] standing up in front of a classroom and giving a traditional lecture.”

Malott points out that some research indicates that students learn more when they are actively engaged. Paone adds that when students learn more, they make better counselors.

Although their study of the efficacy of using experiential techniques to teach students about racism and privilege has covered various methods, Paone and Malott are particularly excited by the prospect of photojournaling. Paone used the technique this past school year in a group experience class, and Malott is considering incorporating it into her classes.

Photojournaling is similar to written journaling, but instead of writing a long entry, students select or take a photo that represents what they have learned from the past week’s class. Students then submit the photo with a short paragraph about why they picked that particular image.

Paone and Malott thought that working with images might provoke a deeper understanding and exploration among counseling students than just reading or writing about racially related topics. Not all of the students were comfortable with the exercise, Paone notes, but many of them indicated that they thought they had learned more by selecting the images.

Students selected some truly powerful and insightful images, according to Paone. For instance, one student submitted a picture of her young nephew screaming while sitting on Santa’s lap. The student called it “raw irrational fear,” explaining that the image of Santa is powerful and magical to some children, yet scary to young children who don’t know quite what to believe or believe only what they have been told. The student said she felt like the image was analogous to her own racial awareness. Up until that point, she said, she had believed only what she was told and had never truly realized that white privilege existed.

Overall, the feedback from students was positive, Paone says. “Students said that they started to pay more attention to what was in the media and would compare it to what they learned in class,” she says. Students also said that photojournaling helped them express how they were feeling and made what they were trying to say more meaningful.

Paone, a licensed professional counselor and national certified counselor, also owns her own counseling practice, the Counseling Center at Heritage, in Montgomeryville, Pennsylvania. She has encouraged her staff to learn about photojournaling, and they often use it in sessions with clients.

Photojournaling can be particularly useful with children, she says, because they typically have trouble fully expressing themselves verbally. It can also be useful with adolescents and adults who have trouble expressing themselves or prefer not to verbalize their feelings.

“It [photojournaling] allows a safety barrier,” Paone says. “They can be as surface or as deep as they want to be [with the images they select].”

If counselors want to dig deeper into an issue that is presented through photojournaling, they can ask questions about the photo itself. This is typically less threatening to clients than if the counselor asks questions directly about them, she points out.

Getting unstuck

“People come to counseling because they want to effect some change in their lives,” Duffey says. “Perhaps they want to see a situation differently or they want to move past some hurt. People hurt over injuries, challenges and lost dreams every day. And, unfortunately, they can sometimes feel stuck in these experiences.”

“The reality is that it can take a lot of work to get past [these negative experiences],” she says, “but the good news is that connecting to our creativity can help us do this.”

 

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Additional guidance and resources

  • The Association for Creativity in Counseling (ACC), a division of the American Counseling Association, was founded in 2004. ACC’s mission is to create a forum for counselors and counselor educators to celebrate the therapeutic power of music, art, theater, storytelling and other creative processes. In addition, it promotes greater awareness and understanding of diverse and creative approaches to counseling. For more information, visit its website at creativecounselor.org.
  • The American Counseling Association and ACC collaborated to develop the ACA-ACC Creative Interventions and Activities Clearinghouse. The database showcases innovative activities and interventions developed for counselors by counselors. The clearinghouse also serves as an idea and information exchange focused on creative and relational interventions for counselors working with diverse populations. Access the clearinghouse at counseling.org/knowledge-center/clearinghouses/activities-clearinghouse.
  • Other resources include the ACA on-demand webinar “Creative Counseling When You Don’t Have Time to Be Creative,” presented by Samuel Gladding, and ACA podcast “Counseling Using Creativity: Facing the Fear,” presented by Krylyn Peter. To access these resources, go to the Knowledge Center section of ACA’s website (counseling.org) and click on “Podcasts” and “Webinars.”
  • Check out Counseling Today‘s online exclusive, “Geek therapy: Connecting with clients through comics, video games and other ‘geeky’ pursuits.

 

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To contact the individuals interviewed for this article, email:

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org

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