Saturday, June 11, 2011

An Adolescent Group Intervention One

Okay, back to our regular scheduled programming...

A couple of years ago when I was doing my internship with adolescents. My fellow intern and I were co-leading (unsupervised) and had a curriculum to follow (we didn't make it) and it was failing. The kids had been there long enough that many of them had already done it plus they were not ready for the work it involved in the first place or at least they weren't gonna play along on this with 1st year interns (talking about their behaviors, trauma, emotions...) It was pretty much a total nightmare and the rookies running the show (us) were getting eaten alive every single group.  We absolutely could not get to the information of the group, because following the curriculum resulted in chaos and power struggles from the first minute. It was a bad scene.

We talked about it with our supervisors and finally my supervisor (also the director of the program) said, "Drop it. Do something else until they are ready." So we did. This is what we came up with and it was AMAZING. My co-intern and I were doing high fives and body slams after this. (Okay, we didn't really do any body slamming, but I was feeling that Superbowl Sunday pumped and I think she was too.) It was the best group we had all year.

So, here's what happened: we decided we needed to talk about respect, because there wasn't a whole lot of that going on. So, we said it in song. We googled respect lyrics, looking for something other than R.E.S.P.E.C.T and got this from Train:

For reasons I don't know I treated you so cold
I wish I had those times again
Cause something that you said keeps ringing in my head
Someday you're gonna wanna come back and you're gonna wanna treat me fine

Everybody needs a little respect
Everybody needs a little time
Everybody needs a little respect
Everybody needs a little

I watched me push you down in dreams I had of you
And all I remember about those days is I would run around thinking that you'd be alright
But you lost your light along the way
And oh you were right about the things I'd say
Cause if I had it back again I know I'd treat you kind

Everybody needs a little respect
Everybody needs a little time
Everybody needs a little respect
Everybody needs a little time
Everybody got to have somebody
Everybody got to have someone

And all I ever wanted from this play
Was someone to talk to when I get down
It seems you get the things you give along the way
Now all I need is one more chance to make you feel like hanging round

Everybody needs a little
Everybody needs a little
Everybody needs a little respect
Everybody needs a little time
Everybody needs a little respect
Everybody needs a little time
Everybody got to have someone

We gave them all double-sided photocopies. One side had this, the other side had some really simple sentence completion in a poetry format. It was just something we threw together like,

To me respect is ________________________.
I feel respected when people ________________________.
I wish everyone _______________________.

We read the lyrics together and then invited them to either write their own lyrics/poem about respect or fill in the sentences. Then we had a little poetry open mic and discussion about how we all want to be treated. The gods smiled down upon the baby interns and their group that day, because the kids LOVED it. They. Loved. It. THEY LOVED IT! Words cannot express the beauty of this moment I swear to you. If it wouldn't have been poor boundaries, I would have kissed the forehead of every person in the room that day. I got so excited I said, "I am so amazed by how well you guys write (TRUE!). I think we need to make a book with this stuff!" and they thought so too and wanted to bring in more poetry, create art for the book on their own time etc... they lost interest in this later, but I think if we leaders had been a little less rookie and a little more creative, we might have been able to maintain a sense of excitement about that project and worked the curriculum we were supposed to follow into this... maybe.

After reading Contemporary Art Therapy with Adolescents, I think part of the success of this had to do with not only appealing to their interests (they like to write), but also we were not directing this at them. This wasn't about "tell me how you should be respectful and lets review group rules (snore)" but more like, "hey what do you think about respect?" According to Shirley Riley, teens do better when asked about a topic in general terms and don't do so well if asked about their own weaknesses and thoughts due to the natural narcissistic developmental stage.

The kids also noted how great the group had been which allowed us to discuss what they thought had made that happen and how we could have more awesome groups.

Friday, June 10, 2011

I Interrupt The Aforementioned Scheduled Post...

... For an announcement.

I had my first post-grad interview and I GOT A JOB!!!

Worry Person Holding My Work Worries and Working Some Art Therapy Magic!

Not only did I get a job, but I got a full-time Monday-Friday job with a salary (above my expectations) and benefits in a beautiful space with a committed staff. I will be working with adolescent boys who have developmental delays and sexual-reactive behaviors in residential care. This was not my first choice of population, but it's not an unfamiliar one and I feel stoked to take on the challenge, which I think will help me grow into one hardcore bad-ass therapist. Not only that, but they're rewriting the curriculum and wanted an expressive therapist to help with alternative interventions and finding new methods. And they're taking interns for the first time in the fall and they want a couple from my program. It sounds like an exciting time to be coming in.

Not to jinx anything, but I consider myself lucky in many areas of my life and one of them is job-getting. So, now that I scored one, here's what works for me:

First, social psychology has taught us that once a person thinks something, they will look for evidence of what they already believe. People like to be right. So, I take my resume and cover letters pretty seriously, because if I can impress someone before I am interviewed, they will look for ways to remain impressed during the interview and possibly ignore any anxiety or stupidness I might accidentally express. I rewrite portions of every cover letter for every place I send it, noting something about the position and hospital/company/residence and why I would do well there. I also adjust my resume if necessary, stressing some experience more and downplaying other as feels appropriate.

Once I have a call for interview, I research the place I am going and the available position. I brainstorm relevant questions. For this interview, I also read up on working with the population and prepared to respond to questions about how I would work with them.

When I go to my interview, I bring a bag of tricks. I have extra copies of my resume, reference letters, etc. in case the interviewer doesn't have a copy. For this interview, I also brought copies of a group curriculum I wrote for teens at my first internship and small samples of simple/neutral art therapy interventions that I made, just in case there were questions about what art therapy is. However, I am not a salesperson pushing my wares, so these are only backup should questions arise. In this interview, my props stayed in my bag. Just knowing I had them, probably helped me feel more confident though, and that's never a bad thing.

Tuesday, June 7, 2011

Working with Adolescents Part One

This past week, I have spent some time preparing for an interview to work with adolescents in residential treatment, which is something I have done for work and in my first year internship, so I feel about as okay going to this interview as one can feel going to her first post-grad interview. Behaviorally, I have prepared for this by reading Contemporary Art Therapy with Adolescents by Shirley Riley and I am glad I did, because it's super useful plus it takes a social constructionist view of working with adolescents which I can get behind, plus "social constructivism" is a cool term to throw around to make your friends feel like you are smarter than them.

Mentally, I have been thinking about what I learned from working with this population in the past: assessing what worked and what didn't. My guess is that such a conversation could arise in an interview to work with adolescents.

So, that being said, please stay with me as I organize my thoughts on this topic. Not that I am an expert, but here is my perspective of skills useful for working with this population based on my short experience. If you have other ideas or comments, feel free to post them (especially pre-interview-Thursday).

1. Begin from a person-centered theory and keep it as an umbrella covering every other theory you might employ. Acceptance and positive regard is critical, because teens in care don't get a lot of that and genuineness is even more relevant, because adolescents have a high sensitivity for adult bullshit. 

2. Knowing stuff having nothing to do with therapy is super helpful. For example: card games, gaming systems, super hero characters, slang words for street drugs, how to play basketball, rap music. Staying in touch with your inner 15-year old and the interests of current 15-year-olds can get you places (but remember to stay genuine and don't force it). I don't like professional sports or the Twilight series and I refuse to pretend I do. I do like to play wii and I know who Lil Wayne is, so that works for me.

3. Be easy-going about what you will tolerate and upfront about what you cannot. Be prepared to back it up as fast and calmly as you can. If you allow your toes to be stepped on one minute, you might be trampled to death the next.

4. Be transparent about not knowing all the answers and don't assume you have a clue about how to intervene when you don't. Ask the patient/client. I worked with some pretty tough individual cases and one of the things that surprised me was that they knew what they needed to work on and could name their goals as well as I could, if not better. Sometimes their solutions needed some tweaking and sometimes just support. Remember you're just a  tour guide in the land of options, not a magician.

5. When it comes to groups, be as flexible as possible. Go in with a plan, but if you can get away with turning the group into something relevant to the moment within a minute, do it. That's what makes art therapy awesome, by the way. " Hey, I'm hearing a common theme of feeling 'locked down.' Draw about freedom vs. constraint.".. or whatever.

6. If you do groups, figure out which teen is "the leader" and plan your groups for him/her while allowing for the needs of others. If you can "catch" the leader, it is suddenly super simple to do an amazing group with teens, because at least in my experience, they'll feed off the enthusiasm of the leader.

7. In my teen groups, check-ins at the beginning of group often got out of hand: too long and worse, led to arguments. If given the choice, at least with my particular group, I preferred a specific question to open check-in. What kind of weather pattern would you be right now? Mark and label your degree of whatever mood you're feeling on this thermometer, etc.

Part two will list my favorite directives for this population.

And... as a visual person, I am disappointed by the lack of art to go with this post, so allow me to introduce my latest sock creature:

Real Name -- Janice Finkelstein, Street Name -- Spike
(Her bio will be available on once I get around to re-establishing my shop.)