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The Practice and Ethics of Using Expressive Therapies with Traumatized Clients. Scott Pelking, MFA, MA, LPCC. Why Use Expressive Therapies?. Expressive therapies often provide unexpected insight to the client and the therapist.
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Scott Pelking, MFA, MA, LPCC
Expressive work should be taken for what it is, nothing more. Some clinicians read more into the products of expressive work than is prudent.
“Your initial inclination will be to glance at a sketch and start interpreting….Don’t. The one reliable thing you can do is to see how it feels to you. Then put it in a spot where you will see it often for a few days. “If you notice yourself placing phallic references all over or negativity about one area consistently, stop and consider yourself. Are you inserting your experiences into the interpretation?”(Coles, 2003)
Use digital photo to document sand tray scenes, art work, and even play room constructions.Include color prints of the photos with session documentation. Be careful to keep the client out of the picture.
Be watchful for abreaction, and be prepared to address it. Sometimes expressive therapy can be surprisingly overwhelming in its effect on the client—and the therapist.
Know what you’re doing. As with any other therapeutic approach, get sufficient training and/or supervision before using expressive therapy interventions.
Dynamic Posttraumatic Play• Affect becomes available• Physical fluidity becomes evident• Interactions with play become varied• Interactions with clinician become varied
Dynamic Posttraumatic Play• Play changes, or new elements are added.• Play occurs in different locations• Play includes new objects• Themes differ or expand.
Dynamic Posttraumatic Play• Outcomes differ, and healthier, more adaptive responses emerge.• Rigidity of play loosens over time• After-play behavior indicates release or fatigue.
Stagnant Posttraumatic Play• Affect remain constricted.• Physical constriction remains.• Interactions with play remain limited.• Interactions with clinician remain limited.
Stagnant Posttraumatic Play• Play is precisely the same.• Play is conducted in the same spot.• Play is limited to specific objects.• Themes remain constant.
Stagnant Posttraumatic Play• Outcomes remain fixed and nonadaptive.• Play remains rigid.• After-play behavior indicates constriction/tension.• Out-of-session symptoms are unchanged or increase.