Self Esteem through Art Therapy

We are starting up a Self Esteem through Art Therapy group for the sex offenders and the mentally ill inmates, so during supervision, we all brainstormed directives. I asked everyone to think about the Good Lives Model and also high risk factors for sex offenders, so we could reference those when we write up the lesson plan. Everyone had great ideas from a collage of what the patient is good at to drawing himself as a superhero to puppet making and role play. The great thing about making the lesson plan a collaborative effort is that we came up with a variety of creative and effective directives for a 12 week quarter.

Art Therapy with Forensic Population

Due to a recent loss of a tool during a studio group, we've had to overhaul our procedures for handling tools in the Art Center. When I first started at the hospital when it opened, I had no experience with forensics, and did the best I could in setting up policy and procedure. Through an on going learning process, I've discovered that a good part of forensic Art Therapy includes safety and security. Every item has its place. Everything is labeled. Items must be specifically checked out to patients. Every tool has to be accounted for. Every sharp and hazmat has to be disposed of properly. Back stock inventory must be accurate. We are constantly organizing and counting items. This is obviously time consuming and frustrating, and still subject to human error.  It takes adjustment and flexibility on the part of staff and patients. However, when the environment is safe, then that creates a space where therapy and healing can take place.

Empathy through Art Therapy with Mentally Ill Inmates

I recently started an Empathy through Art Therapy group with our small population of mentally ill inmates at the hospital. In our first group, I asked them to create a picture of what empathy means. Some didn't really know, so first we discussed what empathy is, and gave some examples. We also talked about the difference between empathy and sympathy. Some still had some difficulty with the concept, but they were all willing to give the directive a try. One man drew several faces of a person trying to have empathy for another person.  Other patients drew about their own experience of feeling empathy for someone else. I hope this group can help these patients understand better what empathy is, and help them practice feeling empathy for others, in an effort to help them to not re-offend.

How patients test boundaries

I recently provided an Art Therapy directive for the Rehab Therapy department during a training to help everyone be more aware of how patients try to test or cross our boundaries. It was interesting to hear others' experiences and how they dealt with being tested.  Some of the scenarios included being asked for a loan, being told you are attractive, having a patient try to enter your office, and being asked personal questions such as favorite sexual position.  It seemed that the men were tested more for getting things, and the women were tested more for physical/sexual boundaries.  We discussed various responses to these patients, and I hope it was helpful for everyone to share, hear, or talk about this topic. It's important to stay aware and alert with the forensic population in order to prevent over-familiarity, and promote healthy boundaries.

How patients charm and manipulate

As a follow up to a previous supervision where we discussed a colleague who had an inappropriate relationship with a patient, I asked everyone to draw a time when they felt that a patient was trying to charm or manipulate them or "lure" them in somehow.  There were some general responses of feeling surrounded by tentacles or being tossed around on waves.  There were specific answers like a patient asking to be enrolled in all of one therapist's groups or how a patient will speak softly, forcing you to lean in to hear him.  Many times patients will compliment you or try to give you something, and oftentimes it's a way of grooming or testing your boundaries.  So, it's always good to be aware of different ways patients try to charm or manipulate in order to get their way. This can help staff defend against it and avoid complacency.

Inappropriate boundaries

In supervision we discussed a co-worker who admitted to having an inappropriate relationship with a patient. Working with sex offenders who are charming and manipulative, this occurrence is more common than one might think. This population preys on people who have a weakness or vulnerability that they can exploit to their advantage. The group was understandably upset. There was shock, sadness, and anger. There was hostility toward this co-worker for damaging the reputation of the department, and there was also compassion and sympathy for this person and all the issues that contributed to this unfortunate end result. There was discussion on how to prevent this kind of thing from happening, and what we can do if we see a colleague getting into a similar situation. Mainly, it was important that it was brought up, and there was an opportunity for everyone to express their thoughts and feelings if they wanted to do so.

Patient Discharge

Once, in supervision, we discussed one patient who would be discharged soon. There was some media about it, so I read an article about him to the group. Then, we all created an image about the situation based on our own impressions. The responses were varied, from a large eye representing him being under constant scrutiny, to an image about the public not wanting him in their neighborhoods, yet harboring their own secrets about the abuse that goes on in their own homes.  One image was about the stress the patient has to deal with, another about how controlled the patient is in his art work, perhaps to counterbalance all the things that are out of his control or his dislike for feeling out of control. The exercise helped staff feel empathy for the patient and illuminated ways to be supportive of him during this transitional time.