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A creative arts program in social skills training for early adolescents: An exploratory study
The Arfs in Psychotherapy, Vol. 17 pp. 131-137.
A CREATIVE
0 Pergamon
ARTS PROGRAM ADOLESCENTS:
Press plc, 1990. Printed in the U.S.A.
IN SOCIAL SKILLS TRAINING AN EXPLORATORY
RICHARD
T. WALSH,
0197-4556/90
$3.00 + .OO
FOR EARLY
STUDY
PhD”
solving conflicts, and understanding others’ feelings (Walsh & Swanson, 1988). Early adolescence is a crucial developmental milestone particularly with respect to peer relations and friendships (Sullivan, 1953). Clinical research, in fact, indicates that poor peer relations during this stage are predictive of mental health problems in later adolescence and adulthood (Achenbach & Edelbrock, 1981). Boys as well as girls have an intense desire to be accepted and valued by their peers, for which the skills of cooperation and compromise are the barest essentials (Buhrmester & Furman, 1986). Shifting from elementary to junior high school presents additional interpersonal, organizational, and academic pressures (Hirsch & Rapkin, 1987), especially for students who might have a history of conflictual peer relations whether due to avoidance or aggression. One way to meet the needs of specially identified early adolescent students for social-emotional growth is for mental health professionals and trainees to conduct creative arts support groups in schools rather than clinics to maximize the therapeutic impact (e.g., Walsh & Swanson, 1988). But from a community mental health framework the number of identified students will always far outstrip the number of interested and available professionals. An alternative approach to student needs is to employ paraprofessionals in the schools; paraprofessionals have proven to be as effective as professionals in some therapeutic functions (Berman & Norton, 1985). Just as social skills
The following is a description of a secondary prevention program based on creative arts conducted from September 1987 to June 1988 at a local, rural senior public school (junior high). The program was a short-term intervention in social skills training for early adolescent students identified by school staff as delayed in social-emotional development. The intention was, from a community mental health perspective (Wager, 1987), to prevent further delay and possible mental health referrals by intervening at an early stage directly in the school, hence, the term secondary prevention; primary prevention refers to interventions directed at large groups before problems develop (Caplan , 1964). The intervention was derived from previous clinical and educational ones reported elsewhere (Smith, Walsh, &Richardson, 1985; Walsh, Richardson, & Cardey, 1986; Walsh & Swanson, 1988) in which the use of creative drama was effective in improving the social-emotional development, particularly the peer skills, of referred children and youth. The premise of the intervention was that a similar small-group experience in the creative arts would enable referred students to cope better with their developmental stresses, inasmuch as participation in artistic activities is inherently therapeutic (Kivnick & Erickson, 1983). The drama therapy literature, for example, shows that guided regression in groups facilitates emotional growth and inner resources (Landy, 1986) and strengthens interpersonal competencies , such as cooperating, listening,
*Richard Walsh is Assistant Professor in the Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada. He is grateful to the students, their parents and teachers, school staff, and the Waterloo County Board of Education for their cooperation and to Gary Edwards, Sheila Gatensby, and Heather Hair for their research assistance in this study which was supported by Wilfrid Laurier University initiatory and short-term research grants.
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researchers have relied on undergraduate psychology students as volunteer group leaders (e.g., Nelson & Carson, 1988), it is possible that undergraduate group leaders, untrained in mental health or counselling but trained in drama and/or music, can provide beneficial experiences for children and youth by virtue of enthusiastic involvement in creative expression through artistic media. Another important aspect of community mental health is consultation with and training of frontline caregivers, such as school counsellors and special education teachers, so that they can prevent referrals to specialized mental health services while developing more confidence in their own helping skills (Caplan, 1964). In addition to providing the early adolescents with a useful experience, the purpose of the present study was to train the on-site school counsellor and two consultants from the school board who observed the sessions in leading creative arts support groups. In this report I describe how the intervention operated and what its impact was on the early adolescent participants and the school as a community. I also discuss the role and success of the paraprofessional leaders, noting implications for community mental health applications of the creative arts.
The Intervention Entry Phase Negotiations to introduce a secondary prevention program began in Spring 1987, when the guidance counsellor requested a support group based on drama. The plan was for me to lead in Fall 1987 an eight-session drama group with the counsellor and a PhD candidate in clinical psychology as trainees and for these two to take over leadership in the following term. By Summer 1987 one drama student and one music therapy student at Wilfrid Laurier University volunteered to co-lead the students through music and drama exercises and to meet with me for weekly supervision. In January 1988 two additional drama students and another clinical psychology doctoral student joined the team, enabling me to double the intervention to two groups of each type (professional and paraprofessional). By this time three consultants for the school board, a youth worker from a local mental health agency, and an undergraduate research assistant were available to serve as observers of the group sessions.
T. WALSH Participants The group members were students enrolled in a Grade 6-8 senior public school located in a rural area within a primarily suburban school district in southwestern Ontario. In consultation with her teachercolleagues, the counsellor identified 24 students with moderate to severe difficulties in peer relations. Based on teacher reports of their behavior, the students represented the range of oversocialized to undersocialized tendencies; in addition, many were receiving some type of special education. No student, however, was identified as emotionally disturbed. We assigned the Grade 6 students to their own groups due to their physical and psychosocial development relative to the advanced students. However, one extremely distractible and socially inappropriate Grade 6 boy, who had also participated in the Fall sessions, joined the group of the most experienced leader. Although another boy withdrew, five boys and six girls from Grade 6 and six boys and six girls from Grade 7 or 8 participated in mixed-gender groups for 11 sessions. As a result, there were four groups: one Grade 6 and one Grade 7-8 group led by paraprofessionals and the same led by professionals. The parents gave their written consent for the children’s participation. Also, the counsellor and the other leaders held a “Parent Information Night” to describe the intervention and address any concerns. Lastly, the leaders interviewed the students assigned to their respective group to obtain their consent and review mutual expectations for group membership. The students had the right to withdraw at any time and to receive the usual school support services during the intervention. In March staff nominated 11 other students whose social skills were not as problematic as the original participants for group involvement. One of the drama students and I co-led a five-session drama group during May and June for the seven girls and one boy who agreed to participate. The outcome and processes of this brief group were positive. Procedure Group leadership. There were two leaders and at least one observer for each group. The leader-observer teams met after every session for review and planning. One of the professional leaders was the school counsellor, a woman in her thirties, who has group counselling experience and who is also the
CREATIVE
ARTS FOR SOCIAL SKILLS
director of the annual school musical. She led a group of Grade 6 students with the aforementioned female doctoral candidate in clinical psychology in her twenties. Because they had worked together in the Fall, these co-leaders did not receive formal supervision during the intervention proper. The second professional group, for Grade 7-8 students, was led by me, a male psychologist in his forties experienced in this modality and in drama, and by another female doctoral candidate in clinical psychology, in her twenties, who had observed a previous school drama group. The paraprofessional leaders for the Grade 6 students were two young-adult, advanced undergraduate students in drama who had no mental health training but who did have experience in directing recreational drama activities for children and youth. These two women had acted together in student theatrical productions and met with me and their group observer for weekly supervision. The Grade 7-8 paraprofessional group was led by the two undergraduate women who participated in the Fall training. Creative arts methods. The 11 weekly sessions were approximately 80 minutes long, spanning two school periods. The format and procedure for the professional groups followed the model described by Walsh et al. (1986). Each session began with a brief group discussion about tasks and current interpersonal issues for the group. In the first several sessions the leaders introduced theatrical warm-up exercises, such Then the as “the magic box” and “mirroring.” leaders encouraged the members in planning, rehearsing, performing, and observing the skits that each created. When the performances were done and if time permitted, the group watched video playback of the skits, if available. The final phase of each session consisted of a brief discussion about immediate problems in the group, whether instrumental or affective, as well as plans for the next session. In every session the leaders encouraged the members to choose their own storylines and characters and to play their roles with conviction. Besides reinforcing character exploration, the leaders attended to basic group dynamics, including the need for the members to develop a sense of belonging to the group, to build teamwork, and to solve immediate problems arising in the sessions. Whenever possible, the leaders attempted to promote group responsibility for interpersonal problem-solving and behavior control by regularly eliciting peer feedback. No creative activity proceeded until the members were satisfied that everyone was attentive to the group’s task.
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Through trial and error the members soon realized that a cooperative group was critical for a creative effort of which they could be proud. Thus, it was in this context of interpersonal learning that development of individual social skills (like taking turns, listening without interrupting, expressing anger appropriately, voicing one’s opinions, etc.) took place. An equally important operational principle of group leadership was empathic evocation of the members’ feelings about their immediate experiences in the sessions, such as convincing portrayal of a role, and about their progression through the group’s stages of development. For example, members usually had strong conflicting feelings about impending termination. The paraprofessional groups basically relied on a similar session-format of a beginning discussion period, activities, and a closing discussion. But the leaders of these groups, in contrast to the professionals, did not initially focus on group dynamics, such as peer problem-solving. As the sessions unfolded, the leaders had to deal with interpersonal issues because the members increasingly disclosed personal matters and confronted each other’s group behavior. Nevertheless, the leaders concentrated on guiding the members through structured activities. In the Grade 6 group the leaders used music sparingly, relying instead on drama warm-up exercises, culminating in fairy tale enactments and in improvisations. In a few sessions the leaders introduced art activities, such as crayoned body outlines. For the Grade 7-8 group, during early sessions the leaders tended to alternate music with drama in structured exercises. For example, the members acquainted themselves with various simple musical instruments, then individually invented rhythmic sounds to represent their name, which they later developed into name-melodies. In another exercise the leaders encouraged the students to play their instruments while visualizing with closed eyes a story for themselves and then “tuning in” to the other musical sounds coming from the group in a collective improvisation. By the final sessions of this group the members integrated musical and dramatic expression in skits they created and became keenly interested in videotaping and reviewing their performantes . Group Climates The leaders of the two Grade 6 groups observed that their members seemed to be experiencing a great
RICHARD deal of academic pressure. As the students’ work habits and organizational skills were being put to the test, their anxiety about the quality of their school work escalated, spilling over into the group sessions. For instance, the Grade 6 groups had greater difficulty sharing, taking turns, conversing, and understanding nonverbal communication than the older ones. The leaders of the professional Grade 6 group had to contend with an external problem that impinged on the normal development of group cohesiveness; several unavoidable changes in the regularly scheduled session-time upset the members’ need for a predictable weekly routine. Consequently, this group was slower to develop a sense of mutual trust; in fact, by the time of the final session the group had just congealed. Exacerbating the problem of building cohesiveness was the aforementioned difficulty these Grade 6 members had in moving from egocentricity to group cooperation. The leaders found that their members needed greater leader-modelling of appropriate behavior and more frequent use of video playbacks by which to judge the impact of their behavior on other members. The leaders of the paraprofessional Grade 6 group similarly reported that their members were initially reluctant to share and tended to become obsessed with details. But this group quickly in its history had to face a serious internal problem-one boy elected to leave the group ostensibly due to perceived academic pressure. However, his participation had been ambivalent at best, often influencing the other members negatively. But all the members were troubled by his withdrawal, especially the two remaining boys who then gradually relied more on one another and became more invested in the group. Overall, the leaders observed the girls to be more responsive to drama than the boys. Yet the girls were just as displeased with the music activities employed. Furthermore, all the members needed more structure and guidelines to facilitate their participation than the leaders originally provided. Another hallmark of this group was a sense of trust and cohesiveness that emerged to such a degree that, unsolicited by the leaders, several members in the final sessions began to freely disclose intense feelings about their fractured families. The leaders encouraged an atmosphere of respectful listening and then assisted the members in the termination ritual of designing group mementoes and devouring party snacks. The leaders of the paraprofessional Grade 7-8
T. WALSH group observed a similar resistance to participation in less structured drama exercises that require relatively sophisticated imaginative play. On the other hand, the members of this group, after some early hesitation, became intrigued with the musical exercises. Over time the leaders relied increasingly on eliciting peer feedback to balance the group process, since in the beginning phase one girl tended to dominate whereas two boys with expressive language difficulties seemed particularly passive. In this group, too, emerging trust and cohesiveness stimulated lengthy personal disclosures about family life. This verbal openness reached its climax in the final sessions as the members rehearsed and enacted a successful family-related skit. Interestingly, by this point one of the inexpressive boys exercised considerable peer leadership. The group concluded with party snacks while watching playbacks of their productions. The professional older group made little use of the video equipment, relying almost exclusively on drama exercises and on building consensus on solving group problems. As in the other groups, the girls seemed more comfortable with dramatic and emotional expression, but two of the boys eventually participated with greater spontaneity. The third boy, the highly impulsive and distractible Grade 6 student noted earlier, learned to blend in more with the group, as described below. Although the three girls cooperated on a superficial level, there seemed to be some barrier among them, especially as the group ended; one girl, usually inexpressive and very shy except during enactments, missed three of the sessions due to illness. Her absences and the behavior of the Grade 6 boy served to inhibit group cohesiveness. Social Skills Development Examples from two of the groups will illustrate how creative arts activities can facilitate improvements in early adolescents’ social skills. In the closing sessions of the Grade 7-8 music and drama group the members viewed video playbacks and discussed the content and interpersonal processes of the skits they had created. On one occasion the passive participation of one boy became quite evident on the videotape, which the group commented on. The following week he made an active effort to participate. In fact, under the protection of the dramatic metaphor, he referred to his previous behavior in character and said “I’m sorry” to the other characters, thereby apologizing to
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the group. The members of the other older group had to contend with the disruptive noises and comments from the impulsive Grade 6 boy placed in it. In the first session, with the leaders’ prompting, the members urged him to contain himself, which he tried to do with increasing success; then he chose to play “Baby Bear,” appropriately regressing with infantile sounds in “Goldilocks.” By the fifth session he accepted acting directions from the members, while improvising the part of a more mature sibling in the group’s radically modernized version of “Little Red Riding Hood.” By blending in with the group’s effort he contributed to a highly cooperative unit, pleasing him and his peers. In the ninth session during closing discussion time, the members favorably acknowledged that this was the first time the boy had not used inappropriate strange voices. He concluded his membership in a positive vein, having developed more competency in directly expressing himself. Evaluation To gain a more objective perspective on the impact of this intervention I administered several standardized questionnaires on a pre-test, post-test basis. (Details of the evaluation are available on request of the author.) The students completed a measure of confidence in dealing with cooperative and conflictual peer situations and one of social-emotional adjustment in school. Classroom teachers completed a comparable measure of school adjustment. In addition, leaders and observers rated members’ group participation skills on a pilot measure after the third and final sessions. The evaluation, however, was not a systematic controlled experiment because the leaders could not be balanced with respect to gender, experience, age, level of supervision received during the intervention, and area of creative talent; the music and drama components differed across the groups, and there was no comparison group that did not receive the intervention. Accordingly, I focused on individual differences in responsiveness to the intervention by examining the scores for each member on each measure in relation to its group mean and standard deviation. This summary showed that one girl progressed to an extreme degree; another made a great deal of progress; five girls and two boys, a moderate amount; three girls and four boys, some degree of progress; two girls and four
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boys, no progress on balance; and one boy regressed. Thus, for the 23 members evaluated, 16 improved to a greater or lesser degree, and the 12 girls made more progress than the 11 boys. After the intervention, when the group leaders interviewed their respective participants individually, the members almost without exception reported that they had enjoyed their participation, wished the sessions to be extended in number, would have liked to participate again if they could, and would recommend the experience to other students. The School Community Although secondary prevention programs in the schools can sometimes entail staff conflict with program workers (Walsh & Swanson, 1988), in this case there was no discernible friction. The principal and his staff were warmly supportive for the intervention’s duration despite such mutual irritations as school schedule changes at the last minute. The counsellor and I presented information during regularly scheduled staff meetings in September, January, and June; also in June I provided school personnel with a two-page summary report, and the following September I sent a copy of the complete report to the principal. One of the major outcomes of this intervention was the increased desire on the part of the counsellor and two school board consultants who served as observers for additional training in this modality. Subsequently the counsellor and I devised a training program for 1988-1989. In addition, she introduced in September 1988 a primary prevention program of classroom training in peer skills relying on creative drama for all entering Grade 6 students, so as to minimize adjustment problems arising from the transition from elementary school to junior high. The leaders held Information Nights for the parents in February and May. Although the attendance was low (about 25%), those parents present strongly favored the program and wished to see it extended to other schools. All parents received a written feedback report in June. Discussion The use of creative arts in a secondary prevention program for early adolescent students seems to have been partially successful. Because this intervention
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was neither a controlled field experiment nor a systematic qualitative study, conclusions can only be tentative. But the overall findings suggest that most of the group members made some gains in social skills development. These improvements are consistent with clinical findings (Nahme-Huang, Singer, Singer, & Wheaton, 1977; Smith et al., 1985; Walsh et al., 1986) and a school experiment in creative drama (Walsh & Swanson, 1988). The current findings also complement other empirical work in the use of drama with children and youth (Dequine & Pearson-Davis, 1983; Schattner & Courtney, 1981). Accordingly, this study provides further support for a creative arts approach to social skills development in children and youth with special needs. The opportunity to regress under the protective guise of pretend and musical expression and to explore dormant aspects of the personality in a small-group format seems to enable the participants to experience both intrapersonal and interpersonal growth. Guided explorations with dramatic and musical activities are particularly valuable for early adolescents. In this age group boys and girls can still experience pretend play as enjoyable provided they do not regard it as “babyish. ” Furthermore, creative expression in cohesive small groups strengthens peer acceptance and trust, crucial psychological milestones in early adolescents’ self-esteem (Sullivan, 1953). In addition, through peer feedback naturally stimulated by group improvisations boys and girls can improve such social skills as listening to each other, understanding others’ feelings, taking turns, negotiating conflicts, and working cooperatively (Walsh & Swanson, 1988). However, a short-term intervention usually has limited effects, and many of the students in these groups would benefit from follow-up intervention in their school to ensure that the improvements are maintained. In fact, both the members and the leaders in this intervention regarded 11 sessions as inadequate. Programs spanning at least five months of the school year could provide the necessary ongoing support for students with special needs, their parents, and teachers. Furthermore, the leaders reported that the younger participants needed a great deal of training in fundamental social skills and required considerable structure during the creative activities. Perhaps an intervention at the Grade 6 level might have more impact if the leaders guide the participants through basic rather than sophisticated exercises in drama and music.
T. WALSH The leaders trained in music and drama appear to have been at least as successful as the leaders trained in counselling or psychotherapy. The former were animated and confident in their artistic media, their youthful enthusiasm being contagious. They likely served as easy models for the girls at least to identify with. Although the paraprofessionals were uncertain about group dynamics, they were quite responsive to suggestions made in supervision; consequently, their groups developed cohesiveness and a high degree of emotional involvement. In contrast, the professional leaders were less spontaneous and energetic, tending to rely more on discussions about solving group problems. This factor, coupled with the absences and scheduling disruptions noted above, probably inhibited the development of cohesiveness comparable to the paraprofessional groups. From a community mental health perspective the results underscore the potential for greater involvement by creative artists in school social skills and mental health programs (Wager, 1987). The success of the student leaders is analogous to the clinical finding that professional training in verbal psychotherapy does not necessarily make a therapist more effective than a paraprofessional (Berman & Norton, 1985). One possibility is that creative arts therapists or school mental health workers could supervise undergraduate drama, music, or dance students in leading school support groups for children and youth with special needs. Other community volunteers skilled in the creative arts, such as advanced high school students, also might be suitable as leaders. But a caveat is necessary concerning leaders’ competency, whether professionals or not. Just as creative artists involved in prevention programs should have knowledge of small group dynamics with children and youth, so educators and mental health professionals need to develop skills in the particular creative art employed, be it drama, music, or dance. Successful creative arts groups depend as much on the leader’s creative use of self and the ability to promote spontaneity in children and youth as on knowledge of social-emotional development. The literature on creative drama in education (e.g., McCaslin, 1984; Way, 1967) and the arts in psychotherapy (e.g., Landy, 1986; Schattner & Courtney, 1981) attests to this point. References Achenbach, T. M., & Edelbrock, C. S. (1981). Behavioral problems and competencies reported by parents of normal and
CREATIVE disturbed children aged four through sixteen. Monograph Sociery
for Research
in Child Development,
46,
ARTS FOR SOCIAL SKILLS of the
l-82.
Berman, J. S., &Norton, N. C. (1985). Does professional training make a therapist more effective? Psychological Bulletin, 98,
opment, 58, American
Journal
J. M. (1983). The arts as healing.
of Orthopsychiatry,
53, 602-618.
Landy, R. J. (1986). Drama therapy. Springfield, IL: Charles C Thomas. McCaslin, N. (1984). Creative drama in the classroom (4th ed.). New York: Longman. Nahme-Huang, L., Singer, D. G., Singer, J. L., & Wheaton, A. B. (1977). Imaginative play training and perceptual motor
disturbed hospitalized
of Orthopsychiatry,
children.
47, 238-249.
of Community Psychology,
16, 79-99.
Schattner, G., & Courtney, R. (Eds.). (1981). Drama in therapy (Vol. 1). New York: Drama Book Specialists. Smith, J. D., Walsh, R. T., & Richardson, M. A. (1985). The Clown Club: A structured fantasy approach to group therapy with the latency-age child. International Journal of Group Psychotherapy,
35, 49-64.
H. S. (1953). The interpersonal theory of psychiatry. New York: Norton. Wager, K. M. (1987). Prevention programming in mental health: An issue for consideration by music and drama therapists. The Sullivan,
Arts in Psychotherapy,
Walsh, R. T., Richardson, Structured
1235-1243.
H. Q., & Erikson,
with emotionally
Journal
Nelson, G., & Carson, P. (1988). Evaluation of a social problemsolving skills program for 3rd and 4th grade students. American Journal
401-407.
Buhrmester, D., & Furman, W. (1986). The changing functions of friends in childhood: A neo-Sullivanian perspective. In V. J. Derlega & B. A. Winstead (Eds.), Friendship and social interaction (pp. 41-62). New York: Springer-Verlag. Caplan, G. (1964). Principles of preventive psychiatry. New York: Basic Books. Dequine, E. R., & Pearson-Davis, S. (1983). Videotaped improvisational drama with emotionally disturbed adolescents: A pilot study. The Arts in Psychotherapy, 10, 15-21. Hirsch, B. J., & Rapkin, B. D. (1987). The transition to junior high school: A longitudinal study of self-esteem, psychological symptomatology, school life, and social support. Child DevelKivnick,
interventions American
137
fantasy
14, 135-141.
M. A., & Cardey, R. M. (1986, May).
approaches
to children’s
group
therapy.
Paper presented at the meeting of the Society for the Exploration of Psychotherapy Integration, Toronto, Canada. Walsh, R. T., & Swanson, L. (1988, May). Creative drama promotes social development in children and youth Mzithspecial needs. Paper presented at the fifth biennial meeting of the
University of Waterloo Conference on Child Development, Waterloo, Ontario, Canada. Way, B. (1967). Development through drama. London: Longman.
A CREATIVE
0 Pergamon
ARTS PROGRAM ADOLESCENTS:
Press plc, 1990. Printed in the U.S.A.
IN SOCIAL SKILLS TRAINING AN EXPLORATORY
RICHARD
T. WALSH,
0197-4556/90
$3.00 + .OO
FOR EARLY
STUDY
PhD”
solving conflicts, and understanding others’ feelings (Walsh & Swanson, 1988). Early adolescence is a crucial developmental milestone particularly with respect to peer relations and friendships (Sullivan, 1953). Clinical research, in fact, indicates that poor peer relations during this stage are predictive of mental health problems in later adolescence and adulthood (Achenbach & Edelbrock, 1981). Boys as well as girls have an intense desire to be accepted and valued by their peers, for which the skills of cooperation and compromise are the barest essentials (Buhrmester & Furman, 1986). Shifting from elementary to junior high school presents additional interpersonal, organizational, and academic pressures (Hirsch & Rapkin, 1987), especially for students who might have a history of conflictual peer relations whether due to avoidance or aggression. One way to meet the needs of specially identified early adolescent students for social-emotional growth is for mental health professionals and trainees to conduct creative arts support groups in schools rather than clinics to maximize the therapeutic impact (e.g., Walsh & Swanson, 1988). But from a community mental health framework the number of identified students will always far outstrip the number of interested and available professionals. An alternative approach to student needs is to employ paraprofessionals in the schools; paraprofessionals have proven to be as effective as professionals in some therapeutic functions (Berman & Norton, 1985). Just as social skills
The following is a description of a secondary prevention program based on creative arts conducted from September 1987 to June 1988 at a local, rural senior public school (junior high). The program was a short-term intervention in social skills training for early adolescent students identified by school staff as delayed in social-emotional development. The intention was, from a community mental health perspective (Wager, 1987), to prevent further delay and possible mental health referrals by intervening at an early stage directly in the school, hence, the term secondary prevention; primary prevention refers to interventions directed at large groups before problems develop (Caplan , 1964). The intervention was derived from previous clinical and educational ones reported elsewhere (Smith, Walsh, &Richardson, 1985; Walsh, Richardson, & Cardey, 1986; Walsh & Swanson, 1988) in which the use of creative drama was effective in improving the social-emotional development, particularly the peer skills, of referred children and youth. The premise of the intervention was that a similar small-group experience in the creative arts would enable referred students to cope better with their developmental stresses, inasmuch as participation in artistic activities is inherently therapeutic (Kivnick & Erickson, 1983). The drama therapy literature, for example, shows that guided regression in groups facilitates emotional growth and inner resources (Landy, 1986) and strengthens interpersonal competencies , such as cooperating, listening,
*Richard Walsh is Assistant Professor in the Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada. He is grateful to the students, their parents and teachers, school staff, and the Waterloo County Board of Education for their cooperation and to Gary Edwards, Sheila Gatensby, and Heather Hair for their research assistance in this study which was supported by Wilfrid Laurier University initiatory and short-term research grants.
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researchers have relied on undergraduate psychology students as volunteer group leaders (e.g., Nelson & Carson, 1988), it is possible that undergraduate group leaders, untrained in mental health or counselling but trained in drama and/or music, can provide beneficial experiences for children and youth by virtue of enthusiastic involvement in creative expression through artistic media. Another important aspect of community mental health is consultation with and training of frontline caregivers, such as school counsellors and special education teachers, so that they can prevent referrals to specialized mental health services while developing more confidence in their own helping skills (Caplan, 1964). In addition to providing the early adolescents with a useful experience, the purpose of the present study was to train the on-site school counsellor and two consultants from the school board who observed the sessions in leading creative arts support groups. In this report I describe how the intervention operated and what its impact was on the early adolescent participants and the school as a community. I also discuss the role and success of the paraprofessional leaders, noting implications for community mental health applications of the creative arts.
The Intervention Entry Phase Negotiations to introduce a secondary prevention program began in Spring 1987, when the guidance counsellor requested a support group based on drama. The plan was for me to lead in Fall 1987 an eight-session drama group with the counsellor and a PhD candidate in clinical psychology as trainees and for these two to take over leadership in the following term. By Summer 1987 one drama student and one music therapy student at Wilfrid Laurier University volunteered to co-lead the students through music and drama exercises and to meet with me for weekly supervision. In January 1988 two additional drama students and another clinical psychology doctoral student joined the team, enabling me to double the intervention to two groups of each type (professional and paraprofessional). By this time three consultants for the school board, a youth worker from a local mental health agency, and an undergraduate research assistant were available to serve as observers of the group sessions.
T. WALSH Participants The group members were students enrolled in a Grade 6-8 senior public school located in a rural area within a primarily suburban school district in southwestern Ontario. In consultation with her teachercolleagues, the counsellor identified 24 students with moderate to severe difficulties in peer relations. Based on teacher reports of their behavior, the students represented the range of oversocialized to undersocialized tendencies; in addition, many were receiving some type of special education. No student, however, was identified as emotionally disturbed. We assigned the Grade 6 students to their own groups due to their physical and psychosocial development relative to the advanced students. However, one extremely distractible and socially inappropriate Grade 6 boy, who had also participated in the Fall sessions, joined the group of the most experienced leader. Although another boy withdrew, five boys and six girls from Grade 6 and six boys and six girls from Grade 7 or 8 participated in mixed-gender groups for 11 sessions. As a result, there were four groups: one Grade 6 and one Grade 7-8 group led by paraprofessionals and the same led by professionals. The parents gave their written consent for the children’s participation. Also, the counsellor and the other leaders held a “Parent Information Night” to describe the intervention and address any concerns. Lastly, the leaders interviewed the students assigned to their respective group to obtain their consent and review mutual expectations for group membership. The students had the right to withdraw at any time and to receive the usual school support services during the intervention. In March staff nominated 11 other students whose social skills were not as problematic as the original participants for group involvement. One of the drama students and I co-led a five-session drama group during May and June for the seven girls and one boy who agreed to participate. The outcome and processes of this brief group were positive. Procedure Group leadership. There were two leaders and at least one observer for each group. The leader-observer teams met after every session for review and planning. One of the professional leaders was the school counsellor, a woman in her thirties, who has group counselling experience and who is also the
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director of the annual school musical. She led a group of Grade 6 students with the aforementioned female doctoral candidate in clinical psychology in her twenties. Because they had worked together in the Fall, these co-leaders did not receive formal supervision during the intervention proper. The second professional group, for Grade 7-8 students, was led by me, a male psychologist in his forties experienced in this modality and in drama, and by another female doctoral candidate in clinical psychology, in her twenties, who had observed a previous school drama group. The paraprofessional leaders for the Grade 6 students were two young-adult, advanced undergraduate students in drama who had no mental health training but who did have experience in directing recreational drama activities for children and youth. These two women had acted together in student theatrical productions and met with me and their group observer for weekly supervision. The Grade 7-8 paraprofessional group was led by the two undergraduate women who participated in the Fall training. Creative arts methods. The 11 weekly sessions were approximately 80 minutes long, spanning two school periods. The format and procedure for the professional groups followed the model described by Walsh et al. (1986). Each session began with a brief group discussion about tasks and current interpersonal issues for the group. In the first several sessions the leaders introduced theatrical warm-up exercises, such Then the as “the magic box” and “mirroring.” leaders encouraged the members in planning, rehearsing, performing, and observing the skits that each created. When the performances were done and if time permitted, the group watched video playback of the skits, if available. The final phase of each session consisted of a brief discussion about immediate problems in the group, whether instrumental or affective, as well as plans for the next session. In every session the leaders encouraged the members to choose their own storylines and characters and to play their roles with conviction. Besides reinforcing character exploration, the leaders attended to basic group dynamics, including the need for the members to develop a sense of belonging to the group, to build teamwork, and to solve immediate problems arising in the sessions. Whenever possible, the leaders attempted to promote group responsibility for interpersonal problem-solving and behavior control by regularly eliciting peer feedback. No creative activity proceeded until the members were satisfied that everyone was attentive to the group’s task.
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Through trial and error the members soon realized that a cooperative group was critical for a creative effort of which they could be proud. Thus, it was in this context of interpersonal learning that development of individual social skills (like taking turns, listening without interrupting, expressing anger appropriately, voicing one’s opinions, etc.) took place. An equally important operational principle of group leadership was empathic evocation of the members’ feelings about their immediate experiences in the sessions, such as convincing portrayal of a role, and about their progression through the group’s stages of development. For example, members usually had strong conflicting feelings about impending termination. The paraprofessional groups basically relied on a similar session-format of a beginning discussion period, activities, and a closing discussion. But the leaders of these groups, in contrast to the professionals, did not initially focus on group dynamics, such as peer problem-solving. As the sessions unfolded, the leaders had to deal with interpersonal issues because the members increasingly disclosed personal matters and confronted each other’s group behavior. Nevertheless, the leaders concentrated on guiding the members through structured activities. In the Grade 6 group the leaders used music sparingly, relying instead on drama warm-up exercises, culminating in fairy tale enactments and in improvisations. In a few sessions the leaders introduced art activities, such as crayoned body outlines. For the Grade 7-8 group, during early sessions the leaders tended to alternate music with drama in structured exercises. For example, the members acquainted themselves with various simple musical instruments, then individually invented rhythmic sounds to represent their name, which they later developed into name-melodies. In another exercise the leaders encouraged the students to play their instruments while visualizing with closed eyes a story for themselves and then “tuning in” to the other musical sounds coming from the group in a collective improvisation. By the final sessions of this group the members integrated musical and dramatic expression in skits they created and became keenly interested in videotaping and reviewing their performantes . Group Climates The leaders of the two Grade 6 groups observed that their members seemed to be experiencing a great
RICHARD deal of academic pressure. As the students’ work habits and organizational skills were being put to the test, their anxiety about the quality of their school work escalated, spilling over into the group sessions. For instance, the Grade 6 groups had greater difficulty sharing, taking turns, conversing, and understanding nonverbal communication than the older ones. The leaders of the professional Grade 6 group had to contend with an external problem that impinged on the normal development of group cohesiveness; several unavoidable changes in the regularly scheduled session-time upset the members’ need for a predictable weekly routine. Consequently, this group was slower to develop a sense of mutual trust; in fact, by the time of the final session the group had just congealed. Exacerbating the problem of building cohesiveness was the aforementioned difficulty these Grade 6 members had in moving from egocentricity to group cooperation. The leaders found that their members needed greater leader-modelling of appropriate behavior and more frequent use of video playbacks by which to judge the impact of their behavior on other members. The leaders of the paraprofessional Grade 6 group similarly reported that their members were initially reluctant to share and tended to become obsessed with details. But this group quickly in its history had to face a serious internal problem-one boy elected to leave the group ostensibly due to perceived academic pressure. However, his participation had been ambivalent at best, often influencing the other members negatively. But all the members were troubled by his withdrawal, especially the two remaining boys who then gradually relied more on one another and became more invested in the group. Overall, the leaders observed the girls to be more responsive to drama than the boys. Yet the girls were just as displeased with the music activities employed. Furthermore, all the members needed more structure and guidelines to facilitate their participation than the leaders originally provided. Another hallmark of this group was a sense of trust and cohesiveness that emerged to such a degree that, unsolicited by the leaders, several members in the final sessions began to freely disclose intense feelings about their fractured families. The leaders encouraged an atmosphere of respectful listening and then assisted the members in the termination ritual of designing group mementoes and devouring party snacks. The leaders of the paraprofessional Grade 7-8
T. WALSH group observed a similar resistance to participation in less structured drama exercises that require relatively sophisticated imaginative play. On the other hand, the members of this group, after some early hesitation, became intrigued with the musical exercises. Over time the leaders relied increasingly on eliciting peer feedback to balance the group process, since in the beginning phase one girl tended to dominate whereas two boys with expressive language difficulties seemed particularly passive. In this group, too, emerging trust and cohesiveness stimulated lengthy personal disclosures about family life. This verbal openness reached its climax in the final sessions as the members rehearsed and enacted a successful family-related skit. Interestingly, by this point one of the inexpressive boys exercised considerable peer leadership. The group concluded with party snacks while watching playbacks of their productions. The professional older group made little use of the video equipment, relying almost exclusively on drama exercises and on building consensus on solving group problems. As in the other groups, the girls seemed more comfortable with dramatic and emotional expression, but two of the boys eventually participated with greater spontaneity. The third boy, the highly impulsive and distractible Grade 6 student noted earlier, learned to blend in more with the group, as described below. Although the three girls cooperated on a superficial level, there seemed to be some barrier among them, especially as the group ended; one girl, usually inexpressive and very shy except during enactments, missed three of the sessions due to illness. Her absences and the behavior of the Grade 6 boy served to inhibit group cohesiveness. Social Skills Development Examples from two of the groups will illustrate how creative arts activities can facilitate improvements in early adolescents’ social skills. In the closing sessions of the Grade 7-8 music and drama group the members viewed video playbacks and discussed the content and interpersonal processes of the skits they had created. On one occasion the passive participation of one boy became quite evident on the videotape, which the group commented on. The following week he made an active effort to participate. In fact, under the protection of the dramatic metaphor, he referred to his previous behavior in character and said “I’m sorry” to the other characters, thereby apologizing to
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the group. The members of the other older group had to contend with the disruptive noises and comments from the impulsive Grade 6 boy placed in it. In the first session, with the leaders’ prompting, the members urged him to contain himself, which he tried to do with increasing success; then he chose to play “Baby Bear,” appropriately regressing with infantile sounds in “Goldilocks.” By the fifth session he accepted acting directions from the members, while improvising the part of a more mature sibling in the group’s radically modernized version of “Little Red Riding Hood.” By blending in with the group’s effort he contributed to a highly cooperative unit, pleasing him and his peers. In the ninth session during closing discussion time, the members favorably acknowledged that this was the first time the boy had not used inappropriate strange voices. He concluded his membership in a positive vein, having developed more competency in directly expressing himself. Evaluation To gain a more objective perspective on the impact of this intervention I administered several standardized questionnaires on a pre-test, post-test basis. (Details of the evaluation are available on request of the author.) The students completed a measure of confidence in dealing with cooperative and conflictual peer situations and one of social-emotional adjustment in school. Classroom teachers completed a comparable measure of school adjustment. In addition, leaders and observers rated members’ group participation skills on a pilot measure after the third and final sessions. The evaluation, however, was not a systematic controlled experiment because the leaders could not be balanced with respect to gender, experience, age, level of supervision received during the intervention, and area of creative talent; the music and drama components differed across the groups, and there was no comparison group that did not receive the intervention. Accordingly, I focused on individual differences in responsiveness to the intervention by examining the scores for each member on each measure in relation to its group mean and standard deviation. This summary showed that one girl progressed to an extreme degree; another made a great deal of progress; five girls and two boys, a moderate amount; three girls and four boys, some degree of progress; two girls and four
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boys, no progress on balance; and one boy regressed. Thus, for the 23 members evaluated, 16 improved to a greater or lesser degree, and the 12 girls made more progress than the 11 boys. After the intervention, when the group leaders interviewed their respective participants individually, the members almost without exception reported that they had enjoyed their participation, wished the sessions to be extended in number, would have liked to participate again if they could, and would recommend the experience to other students. The School Community Although secondary prevention programs in the schools can sometimes entail staff conflict with program workers (Walsh & Swanson, 1988), in this case there was no discernible friction. The principal and his staff were warmly supportive for the intervention’s duration despite such mutual irritations as school schedule changes at the last minute. The counsellor and I presented information during regularly scheduled staff meetings in September, January, and June; also in June I provided school personnel with a two-page summary report, and the following September I sent a copy of the complete report to the principal. One of the major outcomes of this intervention was the increased desire on the part of the counsellor and two school board consultants who served as observers for additional training in this modality. Subsequently the counsellor and I devised a training program for 1988-1989. In addition, she introduced in September 1988 a primary prevention program of classroom training in peer skills relying on creative drama for all entering Grade 6 students, so as to minimize adjustment problems arising from the transition from elementary school to junior high. The leaders held Information Nights for the parents in February and May. Although the attendance was low (about 25%), those parents present strongly favored the program and wished to see it extended to other schools. All parents received a written feedback report in June. Discussion The use of creative arts in a secondary prevention program for early adolescent students seems to have been partially successful. Because this intervention
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was neither a controlled field experiment nor a systematic qualitative study, conclusions can only be tentative. But the overall findings suggest that most of the group members made some gains in social skills development. These improvements are consistent with clinical findings (Nahme-Huang, Singer, Singer, & Wheaton, 1977; Smith et al., 1985; Walsh et al., 1986) and a school experiment in creative drama (Walsh & Swanson, 1988). The current findings also complement other empirical work in the use of drama with children and youth (Dequine & Pearson-Davis, 1983; Schattner & Courtney, 1981). Accordingly, this study provides further support for a creative arts approach to social skills development in children and youth with special needs. The opportunity to regress under the protective guise of pretend and musical expression and to explore dormant aspects of the personality in a small-group format seems to enable the participants to experience both intrapersonal and interpersonal growth. Guided explorations with dramatic and musical activities are particularly valuable for early adolescents. In this age group boys and girls can still experience pretend play as enjoyable provided they do not regard it as “babyish. ” Furthermore, creative expression in cohesive small groups strengthens peer acceptance and trust, crucial psychological milestones in early adolescents’ self-esteem (Sullivan, 1953). In addition, through peer feedback naturally stimulated by group improvisations boys and girls can improve such social skills as listening to each other, understanding others’ feelings, taking turns, negotiating conflicts, and working cooperatively (Walsh & Swanson, 1988). However, a short-term intervention usually has limited effects, and many of the students in these groups would benefit from follow-up intervention in their school to ensure that the improvements are maintained. In fact, both the members and the leaders in this intervention regarded 11 sessions as inadequate. Programs spanning at least five months of the school year could provide the necessary ongoing support for students with special needs, their parents, and teachers. Furthermore, the leaders reported that the younger participants needed a great deal of training in fundamental social skills and required considerable structure during the creative activities. Perhaps an intervention at the Grade 6 level might have more impact if the leaders guide the participants through basic rather than sophisticated exercises in drama and music.
T. WALSH The leaders trained in music and drama appear to have been at least as successful as the leaders trained in counselling or psychotherapy. The former were animated and confident in their artistic media, their youthful enthusiasm being contagious. They likely served as easy models for the girls at least to identify with. Although the paraprofessionals were uncertain about group dynamics, they were quite responsive to suggestions made in supervision; consequently, their groups developed cohesiveness and a high degree of emotional involvement. In contrast, the professional leaders were less spontaneous and energetic, tending to rely more on discussions about solving group problems. This factor, coupled with the absences and scheduling disruptions noted above, probably inhibited the development of cohesiveness comparable to the paraprofessional groups. From a community mental health perspective the results underscore the potential for greater involvement by creative artists in school social skills and mental health programs (Wager, 1987). The success of the student leaders is analogous to the clinical finding that professional training in verbal psychotherapy does not necessarily make a therapist more effective than a paraprofessional (Berman & Norton, 1985). One possibility is that creative arts therapists or school mental health workers could supervise undergraduate drama, music, or dance students in leading school support groups for children and youth with special needs. Other community volunteers skilled in the creative arts, such as advanced high school students, also might be suitable as leaders. But a caveat is necessary concerning leaders’ competency, whether professionals or not. Just as creative artists involved in prevention programs should have knowledge of small group dynamics with children and youth, so educators and mental health professionals need to develop skills in the particular creative art employed, be it drama, music, or dance. Successful creative arts groups depend as much on the leader’s creative use of self and the ability to promote spontaneity in children and youth as on knowledge of social-emotional development. The literature on creative drama in education (e.g., McCaslin, 1984; Way, 1967) and the arts in psychotherapy (e.g., Landy, 1986; Schattner & Courtney, 1981) attests to this point. References Achenbach, T. M., & Edelbrock, C. S. (1981). Behavioral problems and competencies reported by parents of normal and
CREATIVE disturbed children aged four through sixteen. Monograph Sociery
for Research
in Child Development,
46,
ARTS FOR SOCIAL SKILLS of the
l-82.
Berman, J. S., &Norton, N. C. (1985). Does professional training make a therapist more effective? Psychological Bulletin, 98,
opment, 58, American
Journal
J. M. (1983). The arts as healing.
of Orthopsychiatry,
53, 602-618.
Landy, R. J. (1986). Drama therapy. Springfield, IL: Charles C Thomas. McCaslin, N. (1984). Creative drama in the classroom (4th ed.). New York: Longman. Nahme-Huang, L., Singer, D. G., Singer, J. L., & Wheaton, A. B. (1977). Imaginative play training and perceptual motor
disturbed hospitalized
of Orthopsychiatry,
children.
47, 238-249.
of Community Psychology,
16, 79-99.
Schattner, G., & Courtney, R. (Eds.). (1981). Drama in therapy (Vol. 1). New York: Drama Book Specialists. Smith, J. D., Walsh, R. T., & Richardson, M. A. (1985). The Clown Club: A structured fantasy approach to group therapy with the latency-age child. International Journal of Group Psychotherapy,
35, 49-64.
H. S. (1953). The interpersonal theory of psychiatry. New York: Norton. Wager, K. M. (1987). Prevention programming in mental health: An issue for consideration by music and drama therapists. The Sullivan,
Arts in Psychotherapy,
Walsh, R. T., Richardson, Structured
1235-1243.
H. Q., & Erikson,
with emotionally
Journal
Nelson, G., & Carson, P. (1988). Evaluation of a social problemsolving skills program for 3rd and 4th grade students. American Journal
401-407.
Buhrmester, D., & Furman, W. (1986). The changing functions of friends in childhood: A neo-Sullivanian perspective. In V. J. Derlega & B. A. Winstead (Eds.), Friendship and social interaction (pp. 41-62). New York: Springer-Verlag. Caplan, G. (1964). Principles of preventive psychiatry. New York: Basic Books. Dequine, E. R., & Pearson-Davis, S. (1983). Videotaped improvisational drama with emotionally disturbed adolescents: A pilot study. The Arts in Psychotherapy, 10, 15-21. Hirsch, B. J., & Rapkin, B. D. (1987). The transition to junior high school: A longitudinal study of self-esteem, psychological symptomatology, school life, and social support. Child DevelKivnick,
interventions American
137
fantasy
14, 135-141.
M. A., & Cardey, R. M. (1986, May).
approaches
to children’s
group
therapy.
Paper presented at the meeting of the Society for the Exploration of Psychotherapy Integration, Toronto, Canada. Walsh, R. T., & Swanson, L. (1988, May). Creative drama promotes social development in children and youth Mzithspecial needs. Paper presented at the fifth biennial meeting of the
University of Waterloo Conference on Child Development, Waterloo, Ontario, Canada. Way, B. (1967). Development through drama. London: Longman.