“If you ever find yourself in the wrong story, leave.”
Mo Willems, Goldilocks and the Three Dinosaurs

Saturday, April 22, 2017

Sand Therapy Case Consultations

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Saturday, January 21, 2017

The Clinician's Journey Pt.2: A Series on Sand Therapy

A Series on Sand ... The Clinician's Journey


Each installment of this miniseries addresses some aspect of the series questions posed in part 1.  This episode touches on potential problems, differences in theory and practice, and hence has relevance for ethics, competency, and training differences. The scope of these briefs is limited to allow exploration of essential features rather than being a comprehensive, in-depth exploration.


Series Questions to Consider

What should we consider regarding ethical use of sand, principles and best practice guidance?
What is the role of the clinician using sand and symbols with clients?
What clinician preparation; professional-theoretical preferences, attitudes, and perceptual ability are essential for clinician use of sand?
What are the key distinctions in theory and practice among sand therapies?

Sand therapy and its various theoretical approaches add a rich and beneficial component to a clinician’s ability to conceptualize, comprehend, and respond to his/ her clients. Competency with specific approaches to sand therapy will vary significantly. Because of this preparation, attitude, clinical insights, interventions, and training will vary in quite significant ways. Clinician ability with sand relies on theory, philosophical roots, a specific skill set, and a clearly defined role of the therapist. The enormous difference in clinician ability is one reason we must be careful with terminology, claims of efficacy, training, ethical parameters, and use.

Theory provides the framework that defines therapist perspective and interventions which can make a substantial difference in client experience.  Work with sand and symbols often complements a therapist’s primary theoretical leaning which may include trauma work, family systems, mindfulness, positive psychology,  therapeutic metaphors, analytic analysis, and various cognitive, humanistic, and post-modern approaches.  However, a therapist schooled solely in pre-mindful cognitive-behavior interventions must be exceptionally careful to avoid defaulting to behavioral directives, questioning, attitude, and interventions since work with sand therapy, a projective technique, is complex requiring special boundaries and safety from therapist projections.  Clinician curiosity, sense of power, and the drive toward instruction can easily cause the therapist to cross appropriate boundaries. On the other hand, many will handle this more gracefully, such as a trained art therapist, a practitioner of Milton Erickson’s therapeutic metaphors, clinicians who are well-practiced in mindfulness, and those skilled in Jungian process will have perhaps greater ease. This flows from a practiced intuitive resonance with symbol meanings, and well-honed witnessing and containment abilities when using sand.

Sand therapy is a wonderful play therapy approach that engages the imagination of clinician and client, and is fairly flexible regarding theoretical leaning. However, nomenclature is sometimes confusing. The terms Sandplay and sandtray are often used interchangeably and this is problematic if we wish to keep the integrity of the process. For example, Sandplay therapists take extensive training in Jungian conceptualization of symbols in sand, and they complete a series of personal sand scenes often taking a year or two. To use the term Sandplay implies that one has this specialized background. Sandtray, an American appropriation of Sandplay, most often relies on Rogerian Person-Centered or Adlerian perspectives to conceptualize the client’s work in sand. No training or personal process is required with sand but the clinician may be highly skilled in Person-Centered therapy.

One particular problem, more serious than nomenclature is authority. For example, too often clinics and mental health agencies encourage masters’ level interns to use sandtray with clients without prior training. There are several issues. An intern’s early perception and experience with one population will have no comparative basis for grasping important differences with other populations and problems; lack of a well-informed foundation gives ways to bias and assumptions about the purpose and process for using sand; open-ended permission from clinical authority (supervisors, licensing agencies, clinical directors) can leave the impression that use of sand without significant training is acceptable and efficacious. Permission once given to encourage intern exploration without authorial stipulations to obtain real grounding in the use of sand leaves open the door to use sand in future practice with no challenge to clinician suppositions and clinical habits. We’ve set a precedent for potential misuse.

Besides nomenclature and misjudgment of authority another gap to address is the practice of continuing education. Clinicians, pressed with an exhausting schedule, intense cases, and little self-care must organize their quite limited time to obtain required credits toward their license. The rich array of offerings in conferences and local trainings are a great support for continued growth. It all makes sense if we don’t look too closely at the implications. Continuing education courses, online and face-to-face, are supposed to support professional development within certain parameters. The ideal centers on therapists learning new interventions, ethics and best practices, obtain needed credits, and leave the experience rejuvenated. Presenters have an opportunity to offer emerging ideas, and professional associations bring in a financial base to continue. Everyone should be happy. But there is a gap in this process when it comes to sand therapy. A one-day conference presentation or workshop can be an excellent introduction. However, time is simply not available to present critical aspects of theory, ethics, complex practice skills, and a safe private in-depth experience of their own. When using sand therapy much more is involved, and essential to support clinician competency and his/her capacity to conceptualize, comprehend, and respond to clients and their sand scenes.

Sand and symbols opens the way for representations trauma, of client grief and loss, especially those experiences most difficult to share with others; the experience and emotions for which one is unable to speak. The client places images in the sand tray while the facilitator keeps a mostly silent, safe, mindful presence, a highly tuned resonance with the emerging images and the client. If the client chooses to share parts of his/her sand scene the facilitator must be a trusted witness, listen with care for layers of meaning, remain in the present, honing immediacy to resonate more fully -- in a stillness that attends to the tone and tenor of the sand scene and client story. The clinician is witness and guardian, acknowledging the deeply felt experience of the client – and ways they themselves are moved. The process is empowering, honoring grief and layers of loss as well as the client’s special strengths and unique story. We are the gatekeepers for the integrity and safety of this process. It is through our own immersion we gain insight, the ability to resonate with client and sand scene, strengthen our boundaries, and validate the healer within.

Dee Preston-Dillon, Ph.D.
The Center for Culture and Sandplay, Brandywine Studio
dee@thecreativeclinician.com


The Center for Culture and Sandplay Brandywine Studio
A Space Created for clinicians . . . . 
Staff Retreats . . . .  Small Cohort Group Training . . . . Self-Care Consultations . . .  Private and On-Site Consultations . . . . Graduate Student Groups


©Dee Preston-Dillon, Ph.D. All Rights Reserved.
To share article, please use a link directly to this site. Other sharing prohibited.

Wednesday, October 12, 2016

The Relevance of Symbols in Sand Therapy: Heroines and Cultural Tenor


The Relevance of Symbols in Sand Therapy: Heroines and Cultural Tenor
                     

Dee Preston-Dillon, Ph.D. 



·         What is the relevance of figurines in a sand scene beyond the story the client shares?

·         Why should a therapist research symbols?

·         How can we study symbols and avoid concretizing meanings or unethically project our own assumptions onto the client?


Nomenclature: I use the overarching term sand therapy to refer to a general use of sand no matter one’s theory lens. A bibliography is available at the end.


Imagination, and all forms of creativity -- art, icons, poetry, music, myths, storytelling, dance, and rituals -- are an integral part of our humanity, our shared cultural connections steeped in the symbolic.

We create symbols that serve our neurological, cultural, idiosyncratic, and aesthetic needs.

We bring this capacity to sand therapy, and, when the process is kept safe for unbounded imagination, spontaneous play, and witnessed with full, respectful presence

We have healing.


Download full article from Google Drive

Download Bibliography from Google Drive

©2016 Dee Preston-Dillon, Ph.D. All Rights Reserved. Download for educational purposes only.

Wednesday, May 18, 2016

The Clinician's Journey: A Series on Sand Therapy

A Series on Sand Therapy  . . .  The Clinician’s Journey

What should we consider regarding ethical use of sand, principles and best practice guidance?
What is the role of the clinician using sand and symbols with clients?
What clinician preparation; professional-theoretical preferences, attitudes, and perceptual ability are essential for clinician use of sand?
What are the key distinctions in theory and practice among sand therapies?

These are a few of the questions I will address in a series of mini briefs on clinical use of sand and symbols in the Maryland/ DC Play Therapy Newsletter. These are critical questions, especially given the easy access to sand trays and objects. To understand an ethical context we have to unpack presuppositions that come with licensure across the mental health disciplines, the presumed authority and power that comes with various career positions, assumptions embedded in certifications, and careful discernment regarding training-marketing-CE features. We should consider purpose, power, and potential for both healing and devastation.

Problems with this remarkable projective process, sand therapy and its various approaches include where sand is situated within institutions and the authority related to its use, how we match theory with practice (this is a source of considerable client damage), clinician competency and preparation, and dilution of content in training/CEs. Too often we assume too much, rushing to use a projective technique, using sand as a promotional feature, dismissing potential problems, and remain unaware of the inappropriate, damaging use of sand. These are a few of the serious distortions in knowledge, skills, and practice that become problematic for clients, clinicians, sand specialists, and the profession.

There is a tremendous need for non-verbal clinical approaches such as sand that are healing for trauma, vital for non-verbal clients, and nourishing for clients with complex developmental issues. There is a need for the powerful healing, repairing capacity of sand therapy. However, if we do not slow down and examine this precious resource, what clinicians should be doing and should not be doing, we will continue to foster damaging unethical uses.

Reflecting on over thirty five years studying sand therapies and decades consulting with clinicians who use sand I see the exceptional compassion and healing qualities therapists bring to clients – the remarkable healing power of sand and symbol when the therapist is prepared – skilled in the use of interventions that follow the lead of the client, clinicians who invest time to hone their perceptual ability with a keen self-awareness. Unfortunately, I also hear the stories of children and adults who had the painful, re-wounding experience of sand – the therapist had his or her own agenda, the therapist tried to make the scene into something it was not, the therapist was more interested in the tray than the client, the therapist’s curiosity took precedence, the therapist did not know what to do with the scene and forced an issue. These stories reflect damage resulting from inappropriate use of sand and symbols. Hope rests on the integrity of all of us, graduate student to seasoned clinicians, to respect the power and preparation for using sand.

It is our responsibility to examine and set straight the misinformation and distortions resulting from diluted training and preparation, uninformed directives from management or supervision, implied readiness from internship/course instructors, and our own lack of self-awareness – presumed competencies. And there is also the waste of time with exasperating professional competition. Unfortunately we could inadvertently perpetuate these problems, generate misunderstanding, disregard the importance of clinician insights, blindly follow power or status, opt for convenience, and dismiss the vulnerabilities entailed in engagement with such depth when we choose to not question, when we avoid a reasoned unpacking. Better that we examine our rational, our reasons and practices – in training, clinical work, graduate education, and licensure.

I hope to strike a balance in this mini-series between offering tips for competent use of sand and still unpack the presuppositions, distortions, and alienating aspects of the use of sand. My goal is discernment. I hope to distinguish marketing objectives (toys, training) and implied permissions embedded in license, from essential attitudes-skills-insight – to offer light for attunement to the healing process.


©Dee Preston-Dillon, Ph.D. All Rights Reserved.
To share article, please use a link directly to this site. Other sharing prohibited.

Symbols in the Sand - June 10-12, 2016

Dr. Preston-Dillon will be presenting Symbols in the Sand: An Interactive Exploration for Play Therapists and Others at the 4th annual Mid-Atlantic Play Therapy Training Institute, June 10-12 in Arlington VA. For details and registration, see www.playtherapytraining.org or https://www.smore.com/usttq

Saturday, May 09, 2015

Friday, March 01, 2013

Upcoming Presentations, Retreats, and Training

March 6 – 10
West Virginia Clinician Retreat - Clinician Self-Care: Competency Grounded in Permission, Protection and Empowerment

April 12 – 14  
Alexandria, VA  First Annual Play Therapy Training Institute -- Nurturing the Clinician: Re-Energizing through Sand, Symbols, and Narrative

May 2 - 3  
Baltimore, MD  Advanced Psychotherapy Institute – Trauma and Countertransference: Through the Lens of Sand Therapy

 
Email sandplayvoices[at]gmail.com for more info.