Snowflake Directive

For supervision last week, I had everyone cut out a snowflake. I provided instructions on how to fold a six pointed snowflake, and to cut small shapes out of it so it stays intact. After everyone cut out their snowflake, I asked them to write things on it that made them unique, reminding them that it was a combination of all their qualities, characteristics, and experiences that made them unique. This directive could also be used with patients as a self esteem directive or the snowflake making process as a problem solving directive. It was nice to hear what people thought of themselves and how they felt they were special.

Mask Directive

For Halloween, we decorated masks during supervision. The directive was to represent your scariest self. This exercise served to help the therapists be more aware of all aspects of themselves. When working in forensics with patients with very dark sides, it's important to be in touch with one's own darker places. This can offer some insight into ourselves as well as our patients, and may help us deal with them more effectively. Exploring what drives us, triggers us, or angers us can help us understand ourselves better, feel empathy for our patients, and formulate ways to interact with them. 

Group Scribble Drawing

During a recent supervision, we made a group scribble on a long piece of butcher paper. Each person chose a different color marker and we took turns making a scribble to fill up the page. Then everyone was invited to walk around the paper to see what images they could find in the scribble. Then, everyone could use whatever media they wanted to bring out that image. It took a few minutes to get going, but soon images were being pulled out all over. This is a good exercise to get people to loosen up and use their imagination. It can also be good for clients to address problem solving or boundaries. 

Setting professional goals

In a recent art therapy supervision, I asked everyone to think about their professional goals as an art therapist, either short or long term. Sometimes setting specific goals and/or talking about them can help us motivate ourselves and enable us to help and support each other in our endeavors. One therapist talked about working on some personal issues that would help her interactions with others. Other therapists talked about working toward their ATR or other licensure. One shared about an interest in play therapy while another said he would like to become a psychoanalyst. Attending trainings, presenting at conferences, and doing research were also discussed. It was a good way to learn about each other, and I talked about the importance of helping our patients set and meet their goals as well. 

Boundaries workshop

At a recent conference in a forensic setting, another art therapist and I had the opportunity to offer an art therapy experiential on boundaries. We asked participants to think of a time that a patient crossed their boundaries and to create an image about that. Participants were invited to show their art work and talk about their experience. One person talked about a patient who grabbed her, another shared about a patient who was being manipulative with him, and another new staff told of a patient trying to intimidate her. Discussion included ways to develop rapport with patients without physical touching and setting clear verbal limits as well as other ways to deal with patients with poor boundaries. Participants were able to offer each other feedback and tips. The group discussion illustrated that we were not alone in our challenges in dealing with boundary issues with a difficult population, and were indeed able to support one another. 

Remembering your strengths

In a recent art therapy supervision, I asked the group to think of a time when they felt physically and/or mentally strong and create an image about that. People shared various experiences from being forced to do sports to learning how to ride and train horses to coping with a child's illness. Then I asked them to think about a time they had to be strong since they started working at the hospital, and how they have used their strength to manage in their jobs here. Some of the situations we face with the patients, and even other staff, require us to use mental strength, and it is important to remember that we all have strengths to call upon when needed. 

Termination issues

We have an art therapist who is retiring soon, and he is concerned with how to terminate with patients at the hospital--on his unit, and in his groups. I asked everyone in the supervision group to create an image about a time they had to say goodbye to someone, and then asked them to think about the feelings they had at the time. These feelings are comparable to what the patients feel when they have to say bye to therapists who leave the facility, but because they are patients with various issues, their feelings may be amplified, difficult to identify, and harder to express. We discussed how it is the therapist's responsibility to give the patient enough time to process his feelings and still have the opportunity to talk to the therapist about those feelings. 

Self-disclosure directive

One of the art therapists suggested this topic, so in supervision, I had everyone make a collage of info or topics they felt comfortable sharing or talking about with patients, and those they were not comfortable with. One therapist said she talked about her dogs in the pet therapy group while another therapist said she never talks about her pets with the patients. We discussed times we revealed too much, we overheard other staff disclosing too much, and what to do if you felt your co-facilitator was sharing personal information during a group. We also talked about how to deal with patients who ask personal questions, as sex offenders commonly do. Everyone has his or her personal boundaries, and the therapists were asked to think about theirs, and when sharing personal information to think how or if it is therapeutic and beneficial for the patients to know. 

Bob Ross and mural making with patients

When I first started working at the hospital, I ran a mural group to help the patients with their interpersonal skills as well as make a group mural that could be displayed in the hospital. Each group that I ran had difficulty making decisions in order to actually complete a group mural. Recently, a patient became interested in learning to paint via Bob Ross DVDs. He became proficient in the techniques and got peers interested in painting. A small group of patients decided to paint a mural using a Bob Ross instructional DVD. They were able to work together and complete a 4'x6' mural in about 10 hours. They got a couple of other patients interested in mural painting, and they recently completed their 3rd mural. The first one is hanging in the Visiting Room as a backdrop for photos. The use of the DVDs ensured success and prevented the need for a group leader to make compositional or technical decisions. The patients worked companionably, helping and supporting each other. This was a helpful tool to use with populations that are narcissistic or otherwise have difficulty working with others.