Sculpting with people — an educational experience

WORK Sculpting with people - an educational experience John Fowler and Paul Rigby

This paper explores the technique known as ‘sculpting’ and examines its application to the education of nurses. It identifies the therapeutic origins of sculpting, the processes and techniques involved and other requirements necessary for its application to nurse education. The experiences of both facilitator and participant are also described. It is argued that experiential learning methods in many cases continue to be met with anxiety and distrust often being carried out by facilitators who lack the skill and expertise to provide for the psychological safety of participants. The neglect or improper use of experiential learning methods denies students a valuable ‘educational experience’.

INTRODUCTION Sculpting has its roots as a therapeutic technique used predominantly in the field of family therapy. The principle of sculpting is to represent family dynamics visually. This article is a description of the application of these principles for use as an educational experience within nurse education. In its application to education people are posed into various positions, the positions are then held for a short period of time.The sculptor/facilitator then re-positions the people as if time had moved on a number of days, weeks or years. A number of John Fowler BA RGN RMN RNT, Assistant Director Continuing Education, Charles Frears College of Nursing and Midwifery, 266 London Road, Leicester LE2 IRQ, UK, Paul Rigby MA BA RMN DipAEd, Nurse Tutor Continuing Education Department, Charles Frears College of Nursing and Midwifery, Leicester, UK Contributions from: Roger McLeod-Marchant RMN DMS MIMgt, Sue Wharton BSc RGN CertEd (Requests for offprints to JF) Manuscript accepted 1 February 400

1994

these sculpts can be built up into a particular scenario reflecting human experience or nursing practice. This paper looks firstly at the place of experiential learning in nurse education and then briefly describes the roots of sculpting as a therapeutic tool. The application of sculpting to education as a learning experience is then described and finally the accounts of two nurses who were participants in a sculpt are presented.

THE PLACE OF EXPERIENTIAL LEARNING IN NURSE EDUCATION Burnard (1989), identifies three types of knowledge; propositional, practical, and experiential. Propositional knowledge is described as textbook knowledge of facts and theories. Practical knowledge is that knowledge that is demonstrated through practice. Finally, experiential knowledge is personal knowledge, which is gained through a direct encounter with people, places, objects etc. To follow on from this, Burnard (1989) defines

401

NURSE EDUCATION TODAY

experiential

learning as any learning which devel-

ops experiential

knowledge. Whilst it is important

for both practical and propositional be developed,

and traditional

and methods

have tended

these; it is also important to be developed A constant

knowledge

teaching

to

require While

upon

their training

of our

of sculpting

is the facility of ongoing leagues

‘someone tive,

if

opportunity

to stand

in

else’s shoes’ and to view their perspeconly

Development

briefly,

is

inherently

valuable.

of self awareness is crucial if we are

to understand

ourselves better and, therefore,

training

to conductlearning

foundation

for the

skills under the super-

vision of a skilled sculptor. Essential to this process

nursing

The

in relation

as a good

beliefs, values and attitudes is essential to dynamic practice.

and skilled

designed

in the use of experiential

served

development

too. and reappraisal

specially

courses for nurse teachers

methods

for personal knowledge

recognition

a knowledgeable

ing sculpts are rare, the authors have found that

practices

to concentrate

sculpting, facilitator.

involved

supervision between col-

in the

process.

Nevertheless,

used carefully and skilfully by trained facilitators, experiential

learning

stimulating

methods

and meaningful

can provide both

learning.

as

nurses care for others more effectively. Reflecting upon experiential

learning

opportunities

the individual to make adjustments of personal experience’

knowledge (Burnard

enables

to their store

and so to ‘learn

SCULPTING -ITS ROOTS IN FAMILY THERAPY

from

1991 a).

Family sculpting

as a therapeutic

technique

was

Whilst experiential learning methods have been recommended for the teaching of a wide

developed in the later part of the 1960s by Duhl et

variety of interpersonal

owes its origins to the field of psychodrama

nursing

and practical skills within

(ENB 1982) certain experiential

methods,

role play and simulation

learning

tutor alike (Pulsford and the changing

1993a).

al (1973)

and

As a result of this

nature of pre-registration

ing and midwifery education, resurgence,

particular

in particular,

are often treated with caution by the learner

there

nurs-

has been

a

often borne of necessity, of more tra-

ditionally perceived

classroom

teaching

methods.

However, even with larger groups of students it is possible with creative innovation, experiential

learning

methods

to reintroduce (Burnard

al (1973))

1993,

Pulsford 1993b).

at the Boston Family Institute, to the work of Moreno used sculpting techniques

For Duhl et al (1973) loss, replacement either

nurse

tutors felt experiential

could be very important

learning

activities

in relation to developing

effective aspects of their curricula, concern was expressed about the possibility that these activities

dimensional

and

space, but are surrounded

within

of such an environment and the skilled management of such emotionally charged activities as

though

As a technique,

within

a three

by a functional meaningful

family sculpting

used for solving problems

space

boundary’ is primarily

in families who are in

therapy. It can also be used by a therapist to create an idealised thereby

view of a situation/scenario

and

help both the family and the therapist

is a particularly

environment

displayed

space. ‘All systems not only inhabit

teed,

and ‘secure’

by

terms.

therapy, the concept of both power and status can

generate

a ‘safe’

in spatial

Further to this, and of particular importance to the field of family dynamics and therefore family

could cause emotional upset. Whilst the prevention of emotional upset cannot always be guaranwhich to be so, should be assured. The provision

there are aspects of rela-

or closeness

(Duhl et al 1973).

Research

that whilst many

to depict

etc, that can be represented

distance

such methods for life (Pulsford

1993a).

in their work

tionships within families, such as loving, fighting,

and an invisible

(1991)) has indicated

Duhl et

family dynamics in both visual and spatial forms.

untrained facilitators with little experience, has led many to be put off participation in, and use of, by Burnard

and in

(1953).

with families in therapy, in an attempt

also be located

The abuse of role play in particular by poorly or

USA. It

options

for new and hopefully

satisfactory ways of functioning.

Further

useful tool for breaking

more

to this it through

the resistance to change that family patterns of functioning often display. Finally, it is often a useful technique

to use when a therapist

feels stuck

402

NURSE EDUCATION

in terms of facilitating inevitably generates

progress with a family, as it movement

and a metaphorical (1984),

TODAY

sense.

both in a literal

According

to Papp

‘The major goal of therapy, as of art, is to

change a basic perception

so that one sees differ-

ently’. Family sculpture,

it is claimed, speaks a univer-

sal language both of sight and of movement comprehensible

that is

to any family, and further to this

it is also an excellent

technique

to use with fami-

lies who do not verbalise easily.

used with have been predominantly on

Post-Registration

Courses. nursing

English

They have come although

qualified staff

National

Board

from all branches

the majority

have come

of

from

adult nursing. On both formal and informal evaluation the technique has a consistently evaluation by all participants. Many of the groups experiential

learning

previous

techniques

ed. It has usually consisted

high

experience

of

have been limit-

of role play exercises

that many found unpleasant

and of little educa-

tional or practical value. The first part of this session is a reassurance

SCULPTING - ITS PRACTICAL APPLICATION TO NURSE EDUCATION

experience psychological

authors

using the technique

The authors

use of their own

to create such safety is vitally impor-

of

tant. Confident,

non-authoritative,

control,

method

with stu-

up the authors

classroom

although

dents for over four years. The technique

of sculpt-

acknowledged

‘sculpting’

have been

as an educational

ing can be used at any point within the curriculum, provided that the subject being examined

by

The

safety of each member of the group

is very important. personality

The

that any previous negative

of role play will not be repeated.

that

ethos,

other

their own personalities

‘facilitators’

it is

will use

in different ways.

The session is normally scheduled with groups

experience

times and larger groups have been used success-

Burnard

draw

upon.

suggests that different

the concept within

to

of experiential

the curriculum

(Burnard

1989).

learning

methods

knowledge

work

good

depends

of

tutors interpret

learning

and its use

in widely differing

of the techniques,

the potential

ways

use of experiential upon

the

tutors

their awareness of

and their skills at using them effec-

tively. Keltner sculpting

The

The

and Gillett document

their use of

within the nurses curriculum

as being

particularly

of use within the community

placements,

when emphasis upon the family takes

prominence

(Keltner

& Gillett

1984).

health It is the

people,

for 2-3 hours

the sculpt is one which the student has had some of,

of B-10

sums

However

shorter

fully. The subject of the session is often timetabled ‘A Family’

Reaction

Disability’. Although

to

Sudden

other scenarios

Illness

and subjects

have been used this is the one that we shall focus on here. The scene is set by briefly explaining nique and giving participants

the tech-

the opportunity

opt out of any active part in the sculpture. involved

in

the

sculpture

observers or participants.

whether

they

that provided that the group feel

point that he will be sculpting

safe’ with the tutor and with each

stages in its life cycle. The group participants

the technique

of sculpting

can be

used at any time within the students course with a

a family at various

tion which they will hold for a short period

a particular subject not only allows the students to ‘experience’ that subject but also develops group

time. It is emphasised

and specifically during, ‘a period of ill health or disability’. The groups, that this sculpt has been

will

be used to take the part of the family members and the author will ‘put’ them into a physical posi-

wide variety of subjects. Using a sculpt to examine

cohesion and enhances its dynamics. One of the subjects taught for which the authors have often used a sculpting technique is, ‘a families growth and development over time’

be

The author states at this

‘psychologically then

to It is

stressed from the start that all of the group are

authors opinion other,

as and

which participant

of

that the authors choice of

for which part is purely ran-

dom. This it is felt reduces any false interpretations that the participants may put onto the authors actions. Apologies are also given for the somewhat stereotyped family that will be portrayed. This is not to say that other family strurtures are not equally valid, but with a single sculy

NURSE EDUCATION TODAY

ture a stereotype

‘family’ introduces

rather

403

less

variables. Prior to the sculpture

commencing

the author

states that he will not embarrass anyone, or ask them to do anything that they would not be comfortable doing. He states that normally in the first few minutes degree

of the

sculpture

ter. This, it is reassured, after

there

will be a

of mild anxiety often expressed about

is normal

five minutes

as laugh-

and will pass

as participants

‘enter

into’ the sculpture. The

sculpture

characters,

then

starts with two or three

a young adolescent

ents. The characters

with his/her

a way to reflect the family interactions 2). Participants

par-

are physically spaced in such (Figs 1 &

are then asked to hold the pose

for a short period of time. The rest of the group are then

encouraged

members

in turn how they felt about the pose,

and the relationship members.

to ask each of the family they had with other family

Actual feelings

are encouraged

rather

in terms of ‘comfort’

than any attempt

to ana-

lyse the situation.

The author

the second

This may take the family for-

scene.

Fig. 2

then moves onto

ward one or two years. The author may move one

their own family structure.

or all of the family members,

move through

a period of about 10 years. In this

scenario

two adolescents

held and the remainder encouraged

the positions

are

of the group are again

to ask the family

members

about

A third scene is then sculpted again moving on in time a year or so. This time another into the scene,

adults, form a relationship,

the scenes

become

young

have their own chil-

dren etc. Then into this scenario one of the family

their feelings of comfort.

is introduced

the

Gradually

adolescent

they also having

members tion).

suddenly departs the scene (hospitalisa-

The

dramatic, another

effects

on the family

‘Family members

structure

are

seldom surprise one

by what they say, since they have heard it

all before. choreograph,

They

are

surprised

by what

they

because they haven’t seen it before’

(Papp 1976). Final scenes could have the option the missing member

permanently

of leaving

away (death),

returning to his/her former position (full recovery) or returning to a different position (disability). Throughout the scenario the author gives only minimal background information to the situation. The communication

takes place through the

use of space and time, ‘The power of the choreography comes through seeing and physically moving through Fig. 1

the situation’

(Papp 1976). The role

of the author/facilitator is truly that of a sculptor, an artist. Using the medium of people, simple fur-

404

NURSE EDUCATION

niture,

space

and

TODAY

time,

the

author

creates

dynamic family model ‘. . through questions comments,

following

with therapeutic

a

and

clues and communications

sensitivity but without imposing

his own perceptions’

see the reaction

of each course member

came to realise the differing ‘family’ member

and the understanding,

a word being spoken,

S-10, the family sit down in a semi-circle

and sum-

marise the feelings that they experienced.

Prompt

those experiences

it was one of

that no one wished to end. A

year on from the experience, the technique

without

as to why those views were

held. So fascinating was the outcome

(Duhl et al 1973).

At the end of the various poses, usually about

as they

views held by each

I am about to use

as part of a team building exercise

questions such as ‘Who do you think was most vul-

for staff in a psychiatric community

nerable

I see it as a way of allowing the staff to see each

in the family?’ can then lead to a discus-

sion.

others

All the

group

acknowledges

then

de-role.

The

facilitator

that feelings may have been gener-

ated or memories

awaked regarding

family interactions.

None of the participants

as yet been ‘upset’ by the experience authors acknowledge

have

although the

that the potential

exists. In

in that it should allow both the stu-

dent and the facilitator

time following the session

to express any further emotions

and gain any sup-

port required.

together

The view of a general nurse As a participator

in the sculpting exercise I found

the strength of this technique is that through just a few ‘snapshots’ of family life over a period of time, the dynamic nature of family relationships graphically.

quite

‘mother’

of a ‘family’ I quite literally felt that I

afternoon. closeness

sidering

interaction

to take shape in front of my eyes that I

realised

the

full impact

of sculpting

and

the

strong image it could convey. All course participants role,

the background freedom

information

of choice.

for the sce-

In turn, each mem-

ber of the ‘family’ was asked to display their feelings by appropriate

placing

bers. The actual placing then

done

in silence.

of the other

mem-

of the individuals

The

experience

the

in one

feelings of sadness when distant from me,

when I visited my ‘son’ in hospital and when my ‘son’ became

closer to me

I never spoke a word in my character

role. I think this teaching technique lead one to have a better complexity

definitely can

understanding

and changeability

of the

of human relation-

ships over time, and how illness in a family can

were given an individual

nario was provided and the room cleared to give absolute

playing

after his illness. These were powerful feelings con-

The view of a psychiatric nurse began

a life-times

I experienced

contentment

of human

Whilst

is

revealed

I felt my ‘son’ was becoming

EXPERIENCE

It was not until a picture

understand-

as a team.

had experienced

SCULPTING -THE FROM WITHIN

thus developing

ing of each others problems and hopefully growth

their own

this respect the timing of the session is particularly important

perspective,

home setting.

impact

was

was tremen-

affect different

members of the family in different

ways. The de-briefing

exercise

at the end of the

session was also important to help one de-role, having been tied up quite strongly in my role I appreciated the necessity of this. I needed to not only remember who I really was but also who the other ‘family members’

really were, as I had had

some negative feelings toward one or two of them.

dous. At the end of the session, each contributor was taken out of role by the facilitator by a clear

However,

and precise procedure. No-one was left in any doubt as to who they actually were. At the time of the-session I became only too well

time they left.

aware at the intense portrayal of feelings made possible by such simple actions of placing people in relation to each other. It was also interesting to

FUTURE APPLICATIONS

seemed

by the

end

of the

to have any unresolved

This is a powerful,

effective

session feelings

no

one

by the

and well evaluated

NURSE EDUCATION TODAY

technique for developing experiential

learning. It

can be used as a method for critical incident analysis

and

reflective

practice

hands of skilled practitioners

In

generally.

the

it can be used in the

clinical areas to analyse situations, view them from alternative

perspectives

thus

work and multi-professional all techniques

enhancing

cooperation.

which involve people’s

team As with

emotions

the facilitator should be skilled and be supported by a supervisor.

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(ed) Techniques of familypsychotherapy.Grune &

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