This paper is an introduction to the theoretical and methodological assumptions of Social Therapy and its practical application as a group intervention. Developed from the post-modern Marxist approach and inspired by the Vygotksy development theory, it is a performatory therapy which is very little known in Brazil. In this paper, initially, we will present the historical background in which this approach was developed and its main authors. Later we will present its concepts and methodology and finally its practices, taking the group as the focal point of this modality of work. Having in its proposal the permanent focus in building the group and in its emancipation, the Social Therapy has been presented as a potent group intervention in the construction of social change.
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Imagery Rehearsal Therapy (IRT) is effective for trauma-related nightmares and is also a challenge to patients in finding access to their traumatic memories, because these are saved in non-verbal, visual, or audiovisual language. Art therapy (AT) is an experiential treatment that addresses images rather than words. This study investigates the possibility of an IRT-AT combination. Systematic literature review and field research was conducted, and the integration of theoretical and practice-based knowledge resulted in a framework for Imagery Rehearsal-based Art Therapy (IR-AT). The added value of AT in IRT appears to be more readily gaining access to traumatic experiences, living through feelings, and breaking through avoidance. Exposure and re-scripting take place more indirectly, experientially and sometimes in a playlike manner using art assignments and materials. In the artwork, imagination, play and fantasy offer creative space to stop the vicious circle of nightmares by changing theme, story line, ending, or any part of the dream into a more positive and acceptable one. IR-AT emerges as a promising method for treatment, and could be especially useful for patients who benefit least from verbal exposure techniques. This description of IR-AT offers a base for further research.
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Art therapy is widely used and effective in the treatment of patients diagnosed with Personality Disorders (PDs). Current psychotherapeutic approaches may benefit from this additional therapy to improve their efficacy. But what is the patient perspective upon this therapy? This study explored perceived benefits of art therapy for patients with PDs to let the valuable perspective of patients be taken into account. Using a quantitative survey study over 3 months (N = 528), GLM repeated measures and overall hierarchical regression analyses showed that the majority of the patients reported quite a lot of benefit from art therapy (mean 3.70 on a 5-point Likert scale), primarily in emotional and social functioning. The improvements are concentrated in specific target goals of which the five highest scoring goals affected were: expression of emotions, improved (more stable/positive) self-image, making own choices/autonomy, recognition of, insight in, and changing of personal patterns of feelings, behaviors and thoughts and dealing with own limitations and/or vulnerability. Patients made it clear that they perceived these target areas as having been affected by art therapy and said so at both moments in time, with a higher score after 3 months. The extent of the perceived benefits is highly dependent for patients on factors such as a non-judgmental attitude on the part of the therapist, feeling that they are taken seriously, being given sufficient freedom of expression but at the same time being offered sufficient structure and an adequate basis. Age, gender, and diagnosis cluster did not predict the magnitude of perceived benefits. Art therapy provides equal advantages to a broad target group, and so this form of therapy can be broadly indicated. The experienced benefits and the increase over time was primarily associated with the degree to which patients perceive that they can give meaningful expression to feelings in their artwork. This provides an indication for the extent of the benefits a person can experience and can also serve as a clear guiding principle for interventions by the art therapist.
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Many affective experiences and learning processes including attachment patterns from early developmental phases manifest during psychotherapy. The first 15 min in art therapy can potentially reveal clients’ preferred ways of processing information or Expressive Therapies Continuum components, attachment patterns in the material handling process, and emotion regulation strategies during art making. This article discusses how, through clients’ choice of materials and manner of interaction with those materials, information about attachment patterns and preferred emotion regulation is available in art therapy. Paying close attention to the first image and material interaction provides crucial information that will guide the goals and course of art therapy. Two case vignettes demonstrate that within the first 15 min of art therapy information is readily gathered about attachment styles, Expressive Therapies Continuum components, emotion regulation, and the course of art therapy.
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Stress is increasingly being recognized as one of the main factors that is negatively affecting our health, and therefore there is a need to regulate daily stress and prevent long-term stress. This need seems particularly important for adults with mild intellectual disabilities (MID) who have been shown to have more difficulties coping with stress than adults without intellectual disabilities. Hence, the development of music therapy interventions for stress reduction, particularly within populations where needs may be greater, is becoming increasingly important. In order to gain more insight into the practice-based knowledge on how music therapists lower stress levels of their patients with MID during music therapy sessions, we conducted focus group interviews with music therapists working with adults with MID (N = 13) from different countries and clinical institutions in Europe. Results provide an overview of the most-used interventions for stress reduction within and outside of music. Data-analysis resulted in the further specification of therapeutic goals, intervention techniques, the use of musical instruments, and related therapeutic change factors. The main findings indicate that music therapists used little to no receptive (e.g., music listening) interventions for stress reduction, but preferred to use active interventions, which were mainly based on musical improvisation. Results show that three therapy goals for stress relief could be distinguished. The goal of “synchronizing” can be seen as a sub goal because it often precedes working on the other two goals of “tension release” or “direct relaxation,” which can also be seen as two ways of reaching stress reduction in adults with MID through music therapy interventions. Furthermore, the tempo and the dynamics of the music are considered as the most important musical components to reduce stress in adults with MID. Practical implications for stress-reducing music therapy interventions for adults with MID are discussed as well as recommendations for future research.
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Background The Self-Expression Emotion Regulation in Art Therapy Scale (SERATS) was developed as art therapy lacked outcome measures that could be used to monitor the specific effects of art therapy. Although the SERATS showed good psychometric properties in earlier studies, it lacked convergent validity and thus construct validity. Method To test the convergent validity of the SERATS correlation was examined with the EES (Emotional Expressivity Scale), Emotion Regulation Strategies for Artistic Creative Activities Scale (ERS-ACA) and Healthy-Unhealthy Music Scale (HUMS). Patients diagnosed with a Personality Disorder, and thus having self-regulation and emotion regulation problems (n = 179) and a healthy student population (n = 53) completed the questionnaires (N = 232). Results The SERATS showed a high reliability and convergent validity in relation to the ERS-ACA approach strategies and self-development strategies in both patients and students and the HUMS healthy scale, in patients. Hence, what the SERATS measures is highly associated with emotion regulation strategies like acceptance, reappraisal, discharge and problem solving and with improving a sense of self including self-identity, increased self-esteem and improved agency as well as the healthy side of art making. Respondents rated the SERATS as relatively easy to complete compared to the other questionnaires. Conclusion The SERATS is a valid, useful and user-friendly tool for monitoring the effect of art therapy that is indicative of making art in a healthy way that serves positive emotion regulation and self-development.
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Depression is a highly prevalent and seriously impairing disorder. Evidence suggests that music therapy can decrease depression, though the music therapy that is offered is often not clearly described in studies. The purpose of this study was to develop an improvisational music therapy intervention based on insights from theory, evidence and clinical practice for young adults with depressive symptoms. The Intervention Mapping method was used and resulted in (1) a model to explain how emotion dysregulation may affect depressive symptoms using the Component Process Model (CPM) as a theoretical framework; (2) a model to clarify as to how improvisational music therapy may change depressive symptoms using synchronisation and emotional resonance; (3) a prototype Emotion-regulating Improvisational Music Therapy for Preventing Depressive symptoms (EIMT-PD); (4) a ten-session improvisational music therapy manual aimed at improving emotion regulation and reducing depressive symptoms; (5) a program implementation plan; and (6) a summary of a multiple baseline study protocol to evaluate the effectiveness and principles of EIMT-PD. EIMT-PD, using synchronisation and emotional resonance may be a promising music therapy to improve emotion regulation and, in line with our expectations, reduce depressive symptoms. More research is needed to assess its effectiveness and principles.
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Background: An adaptation of multisystemic therapy (MST) was piloted to find out whether it would yield better outcomes than standard MST in families where the adolescent not only shows antisocial or delinquent behaviour, but also has an intellectual disability. Method: To establish the comparative effectiveness of MST‐ID (n = 55) versus standard MST (n = 73), treatment outcomes were compared at the end of treatment and at 6‐month follow‐up. Pre‐treatment differences were controlled for using the propensity score method. Results: Multisystemic therapy‐ID resulted in reduced police contact and reduced rule breaking behaviour that lasted up to 6 months post‐treatment. Compared to standard MST, MST‐ID more frequently resulted in improvements in parenting skills, family relations, social support, involvement with pro‐social peers and sustained positive behavioural changes. At follow‐up, more adolescents who had received MST‐ID were still living at home. Conclusions: These results support further development of and research into the MST‐ID adaptation.
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Background: People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD. Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes. Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches. Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners’ expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients’ experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories.
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Introduction Physical activity levels of children with disabilities are low, as these children and their parents face a wide variety of both personal and environmental barriers. Behavior change techniques support pediatric physical therapists to address these barriers together with parents and children. We developed the What Moves You?! intervention Toolkit (WMY Toolkit) filled with behavioral change tools for use in pediatric physical therapy practice. Objective To evaluate the feasibility of using the WMY Toolkit in daily pediatric physical therapy practice. Methods We conducted a feasibility study with a qualitative approach using semi-structured interviews with pediatric physical therapists (n = 11). After one day of training, the pediatric physical therapists used the WMY Toolkit for a period of 9 weeks, when facilitating physical activity in children with disabilities. We analyzed the transcripts using an inductive thematic analysis followed by a deductive analysis using a feasibility framework. Results For acceptability, pediatric physical therapists found that the toolkit facilitated conversation about physical activity in a creative and playful manner. The working mechanisms identified were in line with the intended working mechanisms during development of the WMY Toolkit, such as focusing on problem solving, self-efficacy and independence. For demand, the pediatric physical therapists mentioned that they were able to use the WMY Toolkit in children with and without disabilities with a broad range of physical activity goals. For implementation, education is important as pediatric physical therapists expressed the need to have sufficient knowledge and to feel confident using the toolkit. For practicality, pediatric physical therapists were positive about the ease of which tools could be adapted for individual children. Some of the design and materials of the toolkit needed attention due to fragility and hygiene. Conclusion The WMY Toolkit is a promising and innovative way to integrate behavior change techniques into pediatric physical therapy practice.
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