The use of creative arts in adolescent group therapy
The creative process is a positive experience for young people, and benefits derived from participation in the arts are manifold (Emunah, 1990). In recognition that adolescents often possess dormant or untapped creative potential, many mental health professionals are turning to the expressive arts therapies as part of their multi-modal treatment of these exceptional individuals.
When the introspective and profoundly personal nature of the creative arts is combined with the social experience of group therapy, a powerful therapeutic setting is created as new lines of communication and avenues for change emerge. For young people grasping for some understanding, some method of communication, or some kindred spirit in their world, this blending of therapeutic modalities may provide the necessary environment for psychological growth and movement. While the combination seems natural, expressive arts groups have yet to emerge as an established specialty.
An adolescent can be reluctant and uncomfortable with verbalizing feelings. However, in the art process, "diagrams, symbols and metaphors allow the adolescent to distance . . . from the potential anxiety" of "feeling" tasks in the immediacy of the group process (Linesch, 1988, p. 142). "A form of expression is desperately needed, one which matches the intensity and complexity of (the adolescent) experience, is direct but nonthreatening, is constructive and acceptable. The creative arts provide this means of expressing the inner explosiveness of adolescence" (Emunah, 1990, p. 102).
For the adolescent in therapy, adolescent group work can offer a safe environment where a wide variety of concerns (e.g., substance abuse, social skills) can be addressed. The dynamics of group therapy allow for interpersonal and intrapersonal growth with one's peers and is uniquely different from one-to-one interactions with a counselor. Teens may also find safety in numbers and become more involved at the encouragement and example of their peers.
Adolescent Creative Arts Groups
"Since the very struggles of the adolescent revolve around self expression and peer interaction, it seems obvious that a combination of art and group therapy techniques will be particularly effective with this population" (Linesch, 1988, p. 135). Counselors find it is a complementary process with the group interactions addressing the therapeutic needs of the adolescent (e.g., providing a testing ground for self-perceptions and behaviors) and the creative work directing and sustaining the group process (Linesch, 1988). The creative arts can also facilitate group cohesion and offer adolescents the chance to regress and discover hidden skills or aspects of their personality (Walsh, 1990). In his work addressing social skills training for early adolescents, Walsh reported that "through trial and error the members soon realized that a cooperative group was critical for a creative effort of which they could be proud" (p. 133).
While effective counselors must provide a safe and secure therapeutic environment with enough rules and structure to maintain order, they must also avoid the role of judge or policeman (Emunah, 1985). For example, in drama therapy the counselor can stop action and ask the group about alternative ways a member could react to a situation. This effective process takes advantage of the importance of peers in the teen's life while allowing everyone to examine situations from different perspectives (Emunah, 1985). The therapist can also utilize directorial privileges to ensure that group members are aware of consequences that can arise from their "fictitious" dramas; e.g., police can be instructed to arrest drug dealers. The group is thus confronted with continuing their play and dealing with realistic issues. Many counselors find that videotaping sessions can give concrete evidence of interactions and immediate feedback to the group.
Procedures and Techniques
Adolescent groups addressing more "internal" issues such as grief and withdrawal may achieve good results with the more introspective arts such as painting and poetry; more interpersonal goals can be reached via collaborative activities generally found in drama, movement and music (Emunah, 1990). One must remember that it is unnatural (and unwise) to restrict group members to any one creative modality. Regardless of which medium is used, respect for each member's artistic talent should be emphasized to the group and modeled by the therapist.
Following is a sample list of strategies and activities. Statements in quotations reflect a counselor's comments to the group members:
The first few group sessions should feature nonthreatening activities which can be used to help address any self-consciousness or art anxiety a teen may feel about dealing with "kids' stuff." The counselor should emphasize respect for each other's creative work.
Inclusive group art tasks (e.g. passing of piece of clay around for individual manipulation) can gauge and encourage group cohesiveness (Liebmann, 1986).
"Introduce yourself (e.g., likes, dislikes) by drawing a self-portrait" (Liebmann, 1986). A collage from magazines can also be used (Linesch, 1988).
"Take an imaginary journey down under the sea, swimming through an underwater cave and coming up at an island where you meet someone who gives you a gift. Present the gift and the person who gave it to you" (Liebmann, 1986).
Similar to the empty chair technique, but perhaps more appropriate for the teen-age population, is the use of a pretend telephone conversation; e.g., use a tape recording to have a prop telephone "ring" and then let the teens proceed from there - they are sure to answer it (Emunah, 1985).
Draw the group's facilitator (Liebmann, 1986). This is sure to stimulate discussion.
Have different group members perform different tasks in the manner of a selected adverb, while other group members try to guess the adverb by observing the behavior. For example: Don, a very rigid, angry teenager, was asked to hand some food to another person, "warmly". After he did so, Karen guessed "lovingly." Don's eyes welled up with tears, and he said, "That's the way it looked? I didn't think I could ever show love again after what has happened to me." He later talked about his experiences of being abused at home (Johnson & Eicher, 1990, p. 160).
Near the end of a treatment program or termination of a group, the counselor can have two or three group members enact a future scene in which they run into each other and talk about what has and has not changed for them and in their lives (Johnson & Eicher, 1990).
Research has shown that the creative arts therapies work well in the group setting and with diverse age groups and clientele. Creative arts groups can be particularly useful in facilitating insight, self-awareness, and behavioral change with adolescents. However, one should bear in mind that the effective counselor must help the adolescent move beyond artistic and verbal expression and into the area of applying skills learned in the group to their everyday lives; for example, an adolescent's control over directing and enacting a scene set in the future needs to be explored and carried over to possible reality in the present. If counselors can provide a protected and safe therapeutic group environment, they create the chance for the wonders of art to play a vital role in the multi-modal treatment of adolescents.
Emunah, R. (1985). Drama therapy and adolescent resistance. The Arts in Psychotherapy, 12, 71-79.
Emunah, R. (1990). Expression and expansion in adolescence: The significance of creative arts therapy. The Arts in Psychotherapy, 17, 101-107.
Johnson, D. R. & Eicher, V. (1990). The use of dramatic activities to facilitate dance therapy with adolescents. The Arts in Psychotherapy, 17, 157 164.
Liebmann, M. (1986). Art therapy for groups: A handbook of themes, games and exercises. Cambridge, MA: Brookline Books.
Linesch, D. G. (1988). Adolescent art therapy. New York: Brunner/Mazel.
Walsh, R. T. (1990). A creative arts program in social skills training for early adolescents: An exploratory study. The Arts in Psychotherapy, 17, 131 137.
This feature is an ERIC Digest. Tim D. Rambo, M.A. Ed., is a graduate of the Counselor Education Program at Wake Forest University, Winston-Salem, N.C.