Institute Inbrief - 19/02/2014
Welcome to Edition 197 of Institute Inbrief! In our previous edition we examined the chief issues for counsellors working with intellectually disabled clients. In this edition we explore a specific approach or technique to support intellectually disabled clients: sand tray therapy.
Also in this edition:
- Free video: Spot the Narcissist
- Articles and CPD updates
- Blog and Twitter updates
- Upcoming seminar dates
Enjoy your reading!
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It’s rare these days to hear people talk about their work with true passion. You hear so many stories of people working to pay the bills; putting up with imperfect situations; and compromising on their true desires.
That’s why it’s always so refreshing to hear regular stories from graduates living their dream to be a Counsellor. They’re always so full of energy, enthusiasm and passion. There’s no doubt that counselling is one of the most personally rewarding and enriching professions.
Just imagine someone comes to you for assistance. They’re emotionally paralysed by events in their life. They can’t even see a future for themselves. They can only focus on their pain and grief. The despair is so acute it pervades their entire life. Their relationship is breaking down and heading towards a divorce. They can’t focus on work and are getting in trouble with their boss. They feel they should be able to handle their problems alone, but know they can’t. It makes them feel helpless, worthless. Their self-esteem has never been lower. They’re caught in a cycle of destruction and pain.
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Learn more here: www.aipc.net.au/lz
Free video: Spot the Narcissist
In Narcissistic Personality Disorder (NPD) individuals have an inflated sense of their own importance and a deep need for admiration – whether they have done anything to be admired for or not! A person with NPD is preoccupied with issues of power, personal adequacy, prestige, and vanity. Such a person lacks empathy and exudes a sense of superiority, but beneath the mask of super-confidence rests an extremely fragile self-esteem.
In the second of ten episodes of the AIPC Video Lecture Series, Richard Hill explores the symptoms that characterise narcissism, how the disorder initially develops, and why we often let narcissists get away with their behaviour. The consequences of someone acting narcissistically are huge; Richard explores those and also provides a few survival tips for dealing with a narcissist.
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Loneliness twice as unhealthy as obesity for older people, study finds
Loneliness can be twice as unhealthy as obesity, according to researchers who found that feelings of isolation can have a devastating impact on older people.
The scientists tracked more than 2,000 people aged 50 and over and found that the loneliest were nearly twice as likely to die during the six-year study than the least lonely.
Compared with the average person in the study, those who reported being lonely had a 14% greater risk of dying. The figure means that loneliness has around twice the impact on an early death as obesity. Poverty increased the risk of an early death by 19%.
The findings point to a coming crisis as the population ages and people increasingly live alone or far from their families. A study of loneliness in older Britons in 2012 found that more than a fifth felt lonely all the time, and a quarter became more lonely over five years. Half of those who took part in the survey said their loneliness was worse at weekends, and three-quarters suffered more at night.
Click here to continue reading the original article via The Guardian.
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Sand Tray Therapy for the Intellectually Disabled
In the first half of the last century, British paediatrician and child psychiatrist Margaret Lowenfeld utilised sand and water in combination with small toys to help children express “the inexpressible” after reading H.G. Wells’ observation that his two sons would work out family problems playing on the floor with miniature figures (Zhou, 2009).
Lowenfeld added miniatures to the shelves of her therapy rooms, and the first child who came to use them took the figurines over to the sandbox, playing with them there. Thus, it was a child who “invented” what Lowenfeld came to call “The World Technique” (Zhou, 2009). In the 1950s, Jungian analyst Dora Kalff (Zhou, 2009) extended the use of the sand tray to adults, realising that the technique allowed not only the expression of fears and anger in children, but also processes of transcendence and individuation (in adults) which she had been studying with Jung. She called it “sandplay” (Zhou, 2009).
Sandplay has been defined as a psychotherapeutic technique which invites clients to arrange miniature figures in a sandbox or sandtray to create a “sandworld” corresponding to various dimensions of their social reality (Dale & Wagner, 2003).It involves the use of one or two sandtrays and any number of small objects or figures from categories including: people, animals, buildings, vehicles, vegetation and other natural objects, and symbolic objects.
Using sand and the miniatures gives clients a symbolic way of expressing their feelings and their worldview. Because it does not depend heavily on communicative proficiency, it can be used with a wide range of people with varying verbal and cognitive abilities. It provides a safe way to explore the unconscious, along with overwhelming feelings and life situations. Because it allows the deeper aspects of the psyche to be worked with naturally and in a non-threatening environment, it is highly effective in reducing the emotional causes of difficult behaviours. Sandplay thus helps to strengthen a client’s connection between the inner and outer worlds (Campbell, 2004; WWILD, 2012; Zhou, 2009).
It commonly consists of two central stages, the first involving the construction of the sand picture. Here the perceived need for the counselling session and the specific intentions of the therapist guide the instructions given to the client. Generally, the person is invited to create a sand picture using any of the therapist’s miniatures.
While there can be many therapeutic orientations with varying means of interpreting what the client creates, the sandplay pictures are generally considered to be a projection of the child’s internal subjective world and a representation of his or her worldview (Dale & Wagner, 2003). Because they give the client the opportunity to express negative feelings and unconscious memories which impact on their choices, bringing these to consciousness can be the first stage of disempowering them and allowing their release (Campbell, 2004).
The second stage involves sharing a story or narrative about the created sand picture. Here clients can clarify personal meanings and integrate new feelings and insights that may have emerged through the creation of the sand picture. While the issue of whether or not to interpret the scene is strongly debated, many experts on sand play argue that the therapist’s role is to sit quietly beside the client while the picture is created, sketching what is created (or taking photographs) and making notes on any utterances the client makes while doing it.
The proponents of this method claim that, in this way, the client is safe and free to explore his/her own meanings, leading naturally to the person’s inbuilt movement toward wholeness (Campbell, 2004; WWILD, 2012).
What the research says
Although sandplay is often presented as a robust assessment and treatment tool, there is little research to show with scientific rigour whether the approach is effective with the population in general, let alone with the much smaller group of the intellectually disabled (Zinni, 1997). Campbell (2004) reviews the use of the technique with various subpopulations, such as those with language and communication difficulties, attention deficits, the culturally different, or those who have experienced trauma.
Because of its non-verbal nature, the sandplay process is likely to be useful with clients who have language and communication or cognitive deficits (the intellectually disabled are probably most similar of those she described to this group). Campbell cites a study which demonstrated the ability of sandplay to improve concentration and peer relations in speech- and language-disordered clients (Carey, 1990, in Campbell, 2004). Those with attention deficits are said to be able to achieve greater kinaesthetic involvement with sand than with mere “talk therapy”, and so were shown to achieve a more concentrated focus, with the sand tray minimising distraction and promoting a focusing effect (Carey, 1990 and Vinturella & James, 1987: both in Campbell, 2004).
Abuse experiences are particularly tough for clients to acknowledge, let alone verbalise; thus, sandplay is seen to be highly appropriate for abused individuals, a population which includes most intellectually disabled clients. To them it offers a safe place to express through play and symbolic activity the complex emotions related to the abuse (Grubbs, 1994, in Campbell, 2004).
One of the few studies conducted in this area used sandplay therapy as an assessment tool with 52 abused and non-abused children. The results showed significant differences in the sandtray constructions between the abused and the non-abused subjects. The differences centred on the content, theme, and approach, reflecting the emotional distress of the abuse (Zinni, 1997).
Because the fields of counselling and psychology consider evidence-based or empirically-supported therapies to be the “gold standard”, limitations on potential scientific research will continue to hamper the demonstration of effectiveness. Rather, it seems for the moment, clinicians using sandplay will have to be content with the wealth of case studies accumulating, which preclude (comparative) conclusions regarding technique effectiveness.
How to best use this therapy with the intellectually disabled
In selecting figures for the sandtray, intellectually disabled clients normally can choose items to represent themselves. Where some of this client group have stalled is in picking figurines to represent others in their lives. The problem, according to sandtray therapists, is the tendency of the intellectually disabled to view things in a concrete, literal way. Therapists can help such clients compensate for this tendency by engaging them in conversations about some of the person’s more abstract qualities, such as whether the person is, say, affectionate and cuddly (the client could choose a teddy bear to represent them) or whether the person criticises and “growls” at them a lot (the client could choose a mean-looking dog).
The therapist does not choose the object or ascribe their own associations to, say, a family member the client is trying to represent. Rather, the therapist supports the client to understand the person and the client’s relationship to them in less literal, more symbolic terms. When sandplay figurines take on symbolic meaning, the client is connecting to the unconscious, which supports emotional healing and personal development (WWILD, 2012).
Potential enhancements
As noted above, sandtray therapy works in well as an adjunct to many other therapies, although some strong proponents of sandtray therapy might prefer to think of the sandtray work as the main therapy and other approaches as the supplementary ones!
This article was adapted from the upcoming Mental Health Academy course “Counselling the intellectually disabled: A look at what works”. The aim of this course is to examine which approaches and ways of working with the disabled may be more fruitful.
References:
Campbell, M.A. (2004). Value of Sandplay as a therapeutic tool for school guidance counsellors. Australian Journal of Guidance and Counselling (14(2): 211-232.
Dale, M., & Wagner, W. (2003). Sandplay: An investigation into a child’s meaning system via the self-confrontation method for children. Journal of Constructivist Psychology, 16, 17-36.
WWILD. (2012). How to hear me: A resource kit for counsellors and other professionals working with people with intellectual disabilities. WWILD Sexual Violence Prevention Association Inc: Disability Training Program. Department of Justice and Attorney General Building Capacity for Victims of Crime Services Funding Program. Retrieved on 3 December, 2013, from: hyperlink.
Zhou, D. (2009). A review of sand play therapy. International Journal of Psychological Studies; 2009, 1 (2), 69-72.
Zinni, R. (1997). Differential aspects of sandplay with 10- and 11-year-old children. Child Abuse & Neglect, 21, 657-668.
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Also referred to as “food addiction” and “binge-eating disorder” (BED), compulsive overeating is characterised by an obsessive-compulsive relationship to food. This condition is not only manifested by abnormal (amount of) food intake, but also by the intake and craving for foods that are, in themselves, harmful to the individual.
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Ineffective Options when Dealing with Workplace Harassment
Defining ineffective options is really difficult because there is not a lot of research evidence to guide people about what are effective and ineffective responses to workplace harassment and bullying in context (Commonwealth Department of Health and Aged Care, 2000: 35).
Obviously, becoming mentally ill and suicidal should be considered as ineffective responses and a person severely affected clearly requires urgent medical and mental health care attention. Some people argue that the victim should stand up, speak out and fight, but this is unlikely given the person’s low or shattered self-esteem, fear and so on, and is more likely to worsen their stress levels, sense of dread and being a victim personality.
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Have you visited the Counselling Connection Blog yet? There are over 600 interesting posts including case studies, profiles, success stories, videos and much more. Make sure you too get connected (and thank you for those who have already submitted comments and suggestions).
Employment Opportunity for Counsellors
The following is an employment opportunity that exists for counsellors who wish to experience working in a rehabilitation setting in Malaysia.
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"Strive not to be a success, but rather to be of value."
~ Albert Einstein
Many students of the Diploma of Counselling attend seminars to complete the practical requirements of their course. Seminars provide an ideal opportunity to network with other students and liaise with qualified counselling professionals in conjunction with completing compulsory coursework.
Not sure if you need to attend Seminars? Click here for information on Practical Assessments.
Below are upcoming seminars available during the first semester of 2014.
BRISBANE (9.00am – 5.00pm)
The Counselling Process: 15-16/03, 24-25/05
Communication Skills I: 05/04, 21/06
Communication Skills II: 01/03, 11/05
Counselling Therapies I: 22-23/02, 31/05-01/06
Counselling Therapies II: 12-13/04
Legal & Ethical Framework: 04/05
Family Therapy: 02/03, 15/06
Case Management: 08-09/03
GOLD COAST (9.00am – 5.00pm)
The Counselling Process: 04-05/04
Communication Skills I: 17/05
Communication Skills II: 15/03, 21/06
Counselling Therapies I: 21-22/03
Counselling Therapies II: 23-24/05
Legal & Ethical Framework: 13/06
Case Management: 10-11/03
SUNSHINE COAST (9.00am – 5.00pm)
The Counselling Process: 31/05-01/06
Communication Skills I: 08/03
Communication Skills II: 09/03
Counselling Therapies I: 22-23/03
Counselling Therapies II: 12-13/04
Legal & Ethical Framework: 22/02
Family Therapy: 03/05
Case Management: 21/06
MELBOURNE (9.00am – 5.00pm)
The Counselling Process: 28/02-01/13, 08-09/3, 05-06/04, 09-10/05, 13-14/06, 28-29/06
Communication Skills I: 22/02, 02/03, 11/04, 11/05, 15/06
Communication Skills II: 23/02, 07/03, 12/04, 17/05, 21/06
Counselling Therapies I: 08-09/03, 12-13/04, 17-18/05, 27-28/06
Counselling Therapies II: 15-16/03, 26-27/04, 24-25/05
Legal & Ethical Framework: 22/03, 26/04, 31/05
Family Therapy: 23/03, 27/04, 01/06
Case Management: 29-30/03, 03-04/05, 07-08/06
DARWIN (9.00am – 5.00pm)
The Counselling Process: 05/04
Communication Skills I: 15/03, 14/06
Communication Skills II: 15/03, 14/06
Counselling Therapies I: 12/04
Counselling Therapies II: 21/06
Family Therapy: 29/03
Case Management: 24/05
ADELAIDE (9.00am – 5.00pm)
The Counselling Process: -06/04, 28-29/06
Communication Skills I: 29/03, 17/05
Communication Skills II: 30/03, 18/05
Counselling Therapies I: 24-25/05
Counselling Therapies II: 01-02/03, 21-22/06
Legal & Ethical Framework: 03/05
Family Therapy: 04/05, 24/08
Case Management: 22-23/03, 14-15/06
SYDNEY (9.00am – 5.00pm)
The Counselling Process: 27-28/02, 14-15/03, 07-08/04, 02-03/05, 26-27/05, 27-28/06
Communication Skills I: 20/03, 29/04, 29/05, 25/06
Communication Skills II: 21/03, 29/04, 30/05, 26/06
Counselling Therapies I: 27-28/03, 09-10/05
Counselling Therapies II: 24-25/02, 10-11/04, 23-24/06
Legal & Ethical Framework: 24/03, 12/05
Family Therapy: 26/02, 30/04
Case Management: 07-08/03, 16-17/05
LAUNCESTON (9.00am – 5.00pm)
The Counselling Process: 08/03, 13/06
Communication Skills I: 16/05
Communication Skills II: 16/05
Counselling Therapies I: 21/02, 27/06
Counselling Therapies II: 11/04
Legal & Ethical Framework: 21/03
Family Therapy: 05/04
Case Management: 02/05
HOBART (9.00am – 5.00pm)
The Counselling Process: 06/04
Communication Skills I: 16/03, 15/06
Communication Skills II: 16/03, 15/06
Counselling Therapies I: 13/04
Counselling Therapies II: 22/06
Family Therapy: 18/05
Case Management: 23/03
PERTH (9.00am – 5.00pm)
The Counselling Process: 08-09/03, 03-04/05, 07-08/06
Communication Skills I: 15/03, 10/05
Communication Skills II: 16/03, 11/05
Counselling Therapies I: 05-06/04, 14-15/06
Counselling Therapies II: 12-13/04
Legal & Ethical Framework: 18/05
Family Therapy: 24/05
Case Management: 22-23/02, 31/05-01/06
Important Note: Advertising of the dates above does not guarantee availability of places in the seminar. Please check availability with the respective Student Support Centre.
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