ACQ_Vol_11_no_3_2009

piece of paper on the floor (Luzzatto, Sereno, & Capps, 2003) began in the second session. If the group members did not feel comfortable enough to have someone trace around their body, they also had the option to use a pre-traced life-sized outline of a body. After the tracings were complete the psychologist conducted a mindfulness exercise in which the focus was on developing awareness of tensions within the body. Once a participant identified a bodily tension, he or she was asked to think of a colour to connect with that feeling. At this point, the art therapist directed the group members to represent these tensions, using the colours that represented them by making marks with a paintbrush and acrylic paint on the body tracing, specifically in the areas of tension in their “bodies”. Discussion about this followed and further painting about similar emotions, such as anxiety, fear, loneliness, stress, etc. also depicted with colour and marks. Once more, “emotion cards” were used to give a visual (words) tied to these emotions. In the third session, participants put their body tracings up on the wall. Some group members had been working on these tracings horizontally and the act of placing them vertically provided a very different perspective for viewing their work. Participants stood in front of their art and quietly observed, mindfully absorbing what they had created. A group discussion followed in which the art therapist asked the group members to identify colours that evoked feelings of being calm and relaxed recalling previous group reflections from the progressive relaxation. The group members were then asked to apply these colours, as much or as little as they wanted, on the parts of the tracing. The final processing of this intervention occurred with group discussion about the In the day program, each member of the team has case management (Rapp & Goscha, 2004) responsibilities for one or more clients. During the intake process, each new client is assigned to a case manager who develops a therapeutic relationship with the client and provides the linkage between the client and his or her family and the wider multidisciplinary team. This section will examine two ways in which the art therapist as case manager uses art work to assist in the development and maintenance of a successful relationship with the client. The case as visual metaphor in the development of a collaborative relationship One of the challenges in the development of an effective case management relationship is helping the young client to understand what the relationship involves. Case management is an abstract and organisationally oriented concept that may have little meaning to children and adolescents. The young person knows he or she has a “case manager” but what is this? To assist with the process of entire process over the previous three sessions. Art therapy in case management

between their minds and bodies. This included promoting heightened self-awareness and reflection, practising relaxation techniques, developing better communication skills, sharing experiences and insights, relating to others, and discovering coping strategies. The psychologist utilised mindfulness meditation techniques to help the adolescents find new techniques to be calm and gain insight into their own behaviours. The art created in the group enabled an external expression of these young peoples’ internal experiences. This group comprised 8 one-hour sessions conducted over a period of eight weeks with six adolescent participants with varying mental health diagnoses, such as somatoform pain disorder, anxiety with school refusal, depressive symptoms, and eating disorder. Each session included mindful breathing and a “visual check-in” whereby each member selected an image that caught their attention and verbally shared with the group something about the image they chose. Both the consistency and practice of these weekly interventions were designed to give the group of young people a sense of security, inner calmness, and connection with one other. In addition, each group included specific activities that may run over more than one session. Two of these specific activities are described in more detail. Water colours In this activity, the meta-message was “explore your potential”, using this flexible, yet sometimes unpredictable medium. Initially the group worked on a collective artwork. Although a brief demonstration of the medium was given by the art therapist as well as a reminder to be respectful of each others’ work, no specific form was required. The exercise was simply about each participant learning about what he or she could do with the paint while interacting with others. Specifically, participants needed to actively communicate with each other if they wanted to add to someone else’s art and were not to obliterate anyone else’s work by painting over it. Following the collective activity, the psychologist conducted a mindful breathing exercise (with eyes closed). At the end of the exercise, participants opened their eyes and were asked to identify an emotion or feeling they had become aware of or were experiencing at the time. Using colour, lines, and marks they were asked to depict that particular feeling “emotion cards” were placed around the room for the group members to refer to, if they required a further visual and vocabulary prompt. The group members easily engaged in the art making and were subsequently invited to guess what feeling each group members’ image was depicting, as well as to guess a possible reason for their interpretation of their peers’ image. The original artist then had an opportunity to clarify (if needed) what their image represented and share their image’s meaning with the rest of the group. This sharing encouraged a more natural, conversational group process and engagement through the artwork that contributed to group cohesion. Body tracing The initial session of the body tracing intervention included the visual check-in and mindful breathing. The main focus was on relaxation with both group discussion about participant experience of relaxation and a progressive muscular relaxation exercise. The body tracing, in which each participant had another member trace the outline of their body while they were either standing up against a large piece of paper taped on the wall or laying down on a large

engagement and alliance building at the beginning of a case management relationship, the art therapist has developed some visual tools to assist the young person to engage in a dialogue about case management. These tools consisted of simple line drawings (Figure 1) depicting a suitcase.

Figure 1. The “cases”

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ACQ Volume 11, Number 3 2009

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