Exploring Expressions: Therapists’ Use of the Creative Arts in Therapy
8.7 The Counselling Process
Therapy can be seen as a process—one where there is an initial contact with a purpose and moving towards achieving that purpose or goal. This progressive movement is guided by the theoretical orientation of the therapist. Cormier and Hackney (1987) have conceptualized the counselling process as a series of stages through which the counsellor and client move—Rapport or relationship building, Assessment or definition of the problem, Goal setting, Initiating interventions, and Termination and follow-up. The following section discusses themes that emerged through data analysis and organizes them into the stages mentioned. This is not to say that the therapy moved through these discrete phases in a linear fashion, but points to a tentative flow of sessions in creative art(s) therapies.
8.7.1 Publicity and Referral Mechanisms
Given the fact that the use of creative arts therapies is in a nascent stage in India and is therefore not widely available and accessible, the researcher asked thera- pists to talk about ways in which they publicized their services and ways in which clients got to know about them. Their answers showed that it clearly depended upon the nature of settings in which the therapists worked. For those who were in private practice, the clients learned about their services through ‘word of mouth’.
Some therapists had their own websites which gave an account about their pro- grammes, the nature of the services, the methods used, the prognosis, along with some client statements about efficacy. For therapists working with schools or other organizational settings, the clients were referred through the organization. Some therapists approached organizations to offer their services. The therapists who were in private practice provided services other than therapeutic services in their spaces, such as dance lessons, Reiki healing or talk therapy, which in turn brought in new clients.
8.7.2 Preparation for the Therapeutic Session
Before the therapist and the client met for the therapy session, there was a stage of preparation which facilitated the therapeutic session. Preparation involved the therapist readying themselves, and readying the space to be used, before meeting the client in a therapeutic encounter.
Readying the Self
Preparatory self-work referred to work that the therapists engaged in, in order to orient themselves to the session. It involved work with one’s personal self. Many therapists talked about creating the right energy or bringing in positive energy in order to perform better as a therapist. Some spoke about themselves as ‘carriers of energy’. It was through this preparatory work that they could understand deeper issues of the client rather than the superficial ones. Aahna, an art therapist, who was influenced by the theory of subtle energy, emphasized the need to meditate and bring in a certain mental state which she felt helped in the therapy session.
She also talked about doing spiritual practices, using mantras, Reiki, crystals and aroma oils. Some of the other therapists spoke about breathing or meditative prac- tices. Many of these therapists had a theoretical orientation based on the ‘theory of subtle energy’.
This idea of ‘centring’ oneself is recommended to help the therapist focus and be more sensitive to the therapeutic session. It helps a therapist remain in the here and now and become more aware of what one is feeling in relation to the client
(Moursund 1985). Atkins and Williams (2007) talked about the therapeutic rela- tionship as a ‘container’ for the artistic exploration to take place and emphasized the need for the therapist to be fully present in the session.
Space
The space referred to the physical environment created by the therapists; which included not only the room but also the materials that the therapist used in the session. While preparing for a session where more than speech was required, the space and the materials to support the techniques became a part of the therapeutic process (Wadeson 2010). The process was not limited to only the verbal transac- tion between the therapist and the client but was equally facilitated by the envi- ronment and the products the client utilized. As a story was expressed differently when one used dance, drama, music or art, one took into consideration the fact that even the ‘materials themselves have lessons to teach us’ (Atkins and Williams 2007, p. 22).
One of the art therapists, Aahna, conducted her therapy sessions in the liv- ing room of her apartment where her artwork was displayed on the walls. Before beginning a session, she created a space that was conducive to the needs of the client. This required her to have an array of materials ready in her space—differ- ent aromas and music. These had to be matched with the client’s energy levels.
The products she used to create the space depended on what she felt could create the right ‘energy’ for the person. This was in tune with the sensory experience of the arts—visual, tactile, auditory, etc. She drew upon her knowledge of colour and aroma therapy and integrated it into the physical space to create a therapeutic envi- ronment for the client.
The preparatory work done by Claire, also an art therapist, before an art therapy session was elaborate and specific to the techniques she used. This required each individual to have several materials in front of him or her, such as a flat board, wide blank white sheets of paper, bowls of specific colours, glasses of water, brushes, tissue paper, etc. In her studio space, she arranged the tables and chairs to facilitate a particular style of group interaction. This was based on the theory of human nature conceptualized by Anthroposophy.2 Based on this understanding, she had spaces where the lighting was milder, where chairs were close to the door;
while in other spaces the chairs were in the centre of the room. This helped clients sit in spaces that appealed to their temperament. While, a choleric person might prefer the centre of the room with more lighting, an individual with a melancholic temperament might prefer a corner. Before the clients entered the session, the art materials were laid out for individual use. For clients who had already been to a session, their files with previous artwork were placed in front of them. Their place
2Anthroposophy is a spiritual philosophy that addresses the spiritual questions of humanity, the artistic needs, the need to relate to the world, and develop a relationship with it. It is based on the philosophy of freedom.
was predetermined by the therapist. The space that was created by the therapist was as much a part of the therapeutic process as the interactions that transpired in the later part of the session.
In dance or movement therapy, ‘physical space’ was required to explore one- self. The dance therapists talked about other preparations such as music—recorded or live (with the help of musical instruments)—that needed to be ready as they were seen as important components of the therapeutic process.
Props, music, costumes and space were part of the stage. Hence, these elements are included in drama therapy as well. Chesner (1995) mentioned that physical environment in drama therapy should be conducive to risk taking and experimen- tation. To facilitate this a few factors that needed to be kept in mind while prepar- ing for a session were privacy of the studio, flexibility in structuring the space and atmosphere, and ethos of the work space.
Kimiya, a drama therapist, mentioned how privacy was an important aspect.
She worked in a school setting. She had to see that the manner in which activities were conducted did not interfere with other activities occurring in spaces around her. Size of the space was important to encourage physical movement—a crucial aspect in drama therapy. Flexibility in terms of creating a space where imagination and creative processes could be stimulated was also considered. Kimiya stressed several aspects of the physical environment which were required when using drama processes in therapy; she says
An open set up … an open space which is not cramped by other things. I set up things such as when children come in they can say ‘aaj hum jungle mein jayengey’ (today we will go to the jungle) so I will put up props and things. A lot of artistic creativity and those kinds of things such as instruments…. I have to ensure that we are not near other classes… Even room temperature shouldn’t be too hot and sweaty. (Kimiya, drama therapist)
The music therapists worked primarily in hospital settings. Anjali had a room of her own, which was provided by the hospital. When asked if she engaged in any kind of preparatory work, she said that she did not have the time to do so as the
‘patient’ just came in and she had to ‘prescribe’ the type of music that could help them.3 Vijay performed concerts for particular groups in hospitals and corporate settings. He needed to get equipment to support his performance. These were pro- vided by the hospital and the organizations.
Expressive therapists used multiple modalities and hence their space had to be flexible enough to shift from one modality to the other along with the materials needed to do so. Theresa said, ‘I have organized my room such that everything I want is there; including water, if I want to paint in that room. It just takes me a matter of 5 min to understand what medium we should use’. The therapeutic space created should communicate a sense of support—both physically and psychologi- cally (Atkins and Williams 2007). The space created should be such that there are certain expectations that the therapist creates for the client (Beier and Young 1998).
3The words ‘patient’ and ‘prescribe’ were words used by the respondent.
This encourages emotional experience and exploration. Theresa said that the pres- ence of art work and art material, mentally prepared clients for what was going to happen next. This reduced their fear and resistance for the therapist’s later sugges- tions to use arts during the therapeutic process.