Reaching the Tough Adolescent through Expressive Arts Therapy Groups
Poppy K. Moon, NCC, LPC
Poppy Moon, NCC, LPC is in private practice in Tuscaloosa, Alabama where she specializes in psychotherapy with children, adolescents, young adults, and their families. Currently Ms. Moon is completing her doctorate in sand play therapy at the University of Alabama in Tuscaloosa.
Our group of teens stared at us with angry eyes and hands crossed tightly across their chests. One girl primped and applied lipstick while another adjusted her hot pink thong so it showed just over the top of her jeans. “So”, Brad, my group co-leader said to the group, “what’s up with you guys today?” No one answered. It looked like the group had an unspoken agreement that we would be getting the silent treatment. “Well Brad,” I said in my sweetest voice, “I guess since no one is talking then we need to make puppets.” The kids looked dubious. Brad agreed, “Poppy, what a great idea! The puppets can talk for the kids!” Brad and I started pulling out supplies – felt, hot glue, sparkles, google eyes, shells, marbles, Mardi Gras beads, yarn, markers, and scissors. We spread the materials out on the floor and went to work making puppets. Slowly, our surly group of adolescents slid out of their seats onto the carpet, fingering the materials with interest. “Can I use these black sparkles to make a pimp puppet?” one teen asked. “Whatever you think is cool.” I replied. The boy quickly grabbed up the black sparkles before anyone else could claim them. Brad and I glanced around the room. Now instead of a room full of angry adolescents, we had a room full of industrious teens busily creating puppets. The girl with the thong was happily adding a pink thong to her puppet. Another teen was deep in discussion with another group member about how he could add a do-rag and braids to his puppet with the hot glue gun. Ah, the magic of art therapy works again!
Adolescents are perhaps the most difficult group to counsel. Neither child nor adult, teens are in a kind of developmental limbo. They are too old for time out, yet too young to shoulder grown-up responsibility. Many therapists are reluctant to work with adolescents in therapy because they require a great deal of personal energy and patience. This is unfortunate, because adolescents benefit greatly from therapy with a counselor who understands the special needs of this unique group of young people. This paper will (1) describe how group therapy is an ideal therapy to use with adolescents, (2) demonstrate how expressive art therapy groups can be used effectively with teens, and (3) give hands-on examples of art activities that can be used with different adolescent groups.
Adolescents and Group Therapy
Teenagers are used to being in groups. In school they learn in groups, most sports are played in groups, and they hang out with groups of friends. Therefore, group therapy is an ideal choice of therapy because it is a setting that is safe and familiar. Bandura (1989) believes that social interaction is key to the developmental process. Adolescents learn by watching each other interact and seeing the results of these interactions (Bandura, 1989) . Most teens are referred to therapy because they are having trouble with interpersonal relationships (e.g. parents, peers, teachers, authority figures) (Leader, 1991) . The group setting provides a safe space where the adolescent can learn and practice social/interpersonal skills, such as cooperation, turn taking, and anger management.
Selecting Group Members
When creating adolescent groups, the therapist should consider the needs, abilities, and diagnosis of the potential members. Kymissis (1996) notes in his book Group Therapy for Children and Adolescents that groups that are matched according to issues and development bond faster than groups that are simply created on the basis of age.
Art Therapy with Teens
Teens, unlike adults, often need more innovative ways to express themselves than through “talk therapy”. Expressive art therapy groups are a perfect way to allow teens to communicate difficult thoughts and feelings through various artistic mediums. Art therapy assists teens in solving problems, increasing self-esteem, building social skills, and behavior management. The process of art therapy helps adolescents chart their therapeutic journey from start to finish, helping them see where they have been and how far they have come. Many counselors have to work with open groups, groups where new members are continually accepted and there is no set starting point or completion point. Art therapy is excellent for these types of groups because it allows members to participate at their own level, rather than forcing them to “catch up” with other group members.
When creating art therapy groups, the counselor should try to limit the group to six to twelve members. Groups of this size allow members to gain a sense of kinship and togetherness. In smaller groups each member is guaranteed time to share their thoughts, feelings, and artwork. Members can maintain visual contact with other members at all times, thus creating a safe space for therapeutic work. For teenagers, structured art therapy groups are best (Liebmann, 1986) . Structured groups have planned activities for each session that revolves around a theme, such as “painting your depression” or “creating a personal portrait with string”. Unstructured groups, which allow members to create random art, are not suitable for teens. Teens, although they are almost young adults, still need limits and thrive in supported environments (Riley, 1997) .
Planning for Art Groups
Art therapy groups require much more preparation than talk therapy groups. The group leader is responsible for planning the session topic, obtaining the necessary materials, and structuring the session so that members can complete their artwork with time for discussion. Expressive art therapy groups run from 1 1/2 to 2 hours. A typical session usually begins with 15-30 minutes of “warm-up” time. During warm-up members meet and greet each other and briefly check in with their current feelings and problems. The next 20-45 minutes are devoted to the art activity. The group ends with the follow-up and discussion, where members can share their creations, discuss feelings about the activity, and recenter before they go back into the real world.
When selecting art activities the therapist should consider not only the logistics of the room, but also the level of mess they can handle. For example, paint and paper mache are both very messy media. A roomful of teens armed with wet glue and paint might end up worrying the counselor so much that she is unable to be fully present in a therapeutic sense (because she is concerned about paint on the lovely white carpet!). Of course, the more open the therapist can be to messy media allows teens to have a much broader experience with art materials. Therapists may have to come up with novel solutions to deal with group room situations. Group rooms with carpet can be covered with tarps purchased at the local hardware store. If there is not a sink in the room, buckets of water can be brought in to wash brushes, activate watercolor paints, and to clean sticky hands. Another dilemma is if the room must be immediately cleaned up for the next group where will group members place their wet artworks to dry? When planning activities, the therapist should be sure that all members have enough personal space in which to work. Teens with anger management and boundary issues sometimes become upset if another member is “intruding” in their work space (even if it is accidental).
Most teens will want to have a snack or at least a soda during group. Is the room suitable for food or can you set up a space where snacks and open drinks can be kept? Since you are dealing with teens, the issue of music will come up. Teens enjoy listening to music while they are creating. If you can stand it, let them listen to their favorite music – this will automatically give you instant “cool points” with the kids. One counselor who does art therapy dislikes most rap and heavy metal music because of their explicit lyrics and derogatory remarks towards women. She tells her clients that art and jazz are a classic combination. Not only do the kids love the music, they are probably the only teens on the planet who know the music and identities of Charlie Parker, Etta James, Billie Holiday and Miles Davis. In fact, they ask for Miles Davis when they are working on art relating to depression and request Ella Fitzgerald for more upbeat sessions!
When setting up your initial space you will most likely want to have the following materials on hand at all times:
Group warm-up should be a fun time where members reconnect with each other and transition from the outside world into the safety of the group. A basic warm-up activity is to have the members introduce themselves and tell one good or bad thing that happened to them during the previous week. This is especially important in open groups where new members are present at each meeting. To help the members remember each other’s names, use a simple name association game. For instance, have each member describe him/herself using the first letter of their name. Hello! My name is Poppy and I like popcorn, my favorite dessert is popsicles, and my favorite animal is the panda. Teens feel more included and in control when other members address them by name instead of “Hey you – the new kid”.
Once the group has completed the warm-up activity the group leader should spend a few minutes going over group rules and boundary issues. The rules and boundaries need not be lengthy or set in stone. However, it is important to give teens limits for their behavior within the sessions so they know what is and is not expected of them. Common group rules include: (1) attending sessions on time, (2) no talking when the leader or another member is talking, and (3) not interrupting other members. Most teen group leaders need to set limits on bathroom and phone use, otherwise members will either use the bathroom as an excuse to go call a friend or smoke a cigarette, or they will accept personal calls on their cell phones during the session. The best rule of thumb is to have all members visibly turn their cell phones off at the start of the session, where the therapist monitors to ensure that the phones are actually being turned off. The therapist can emphasize that in doing this the group is creating a “safe space” where they can let go of outside pressures and focus on their own therapeutic goals. Most teens are in therapy because they have problems with interpersonal issues. Group leaders should remind members that scapegoating, name calling, and rudeness will not be tolerated.
When new members are present, group leaders will want to remind members of the purpose of the group. “This is an expressive art therapy group for teens that are having problems with depression. Sometimes it is hard to talk about our feelings. Creating art is a form of communication that allows you to express your feelings. If you are having a hard time communicating your problems to others, art is a real way to express what is going on inside you. Even if you feel your art doesn’t mean anything in particular, the act of making something helps to quiet the mind and allows you to get in tune with your inner self and what is going on inside you. Remember that in art there is no right and wrong or good or bad. You don’t have to have any special art ability. Just feel free to create and see what happens.”
During the activity members should be totally engaged in the process of creating art. Often teens will open up and begin talking about personal problems while they are creating. This is good, especially if the members are talking about therapeutic issues. On the other hand, if members are socializing rather than working, the leader must intervene and redirect. Members should be aware from the start how much time they have to work on the activity. As they are nearing the end of the activity time, it is helpful for the group leader to point out “10 minutes left”, “five minutes left”, “one minute left” and “stop”. Following the activity is the group discussion. This is a time where members share their artwork. Each member should have adequate time to discuss their piece. If time is running out, the leader can choose to continue the discussion during the next session. A round-robin turn taking approach works best with teens. Adolescents are often reluctant to share their artwork, so this approach ensures that all members will speak. Each member should discuss for at least five minutes, this encourages quieter members to have equal share time. Teens may be superficial in their discussion of their artwork. Leaders may want to point out deeper meanings they see in the art and encourage individual and group contemplation.
The sky is the limit in terms of art activities for teens. With a little imagination group leaders can come up with a wide range of wonderful art therapy activities. These are activities that have been used successfully with teens in a variety of settings.
In the mask making activity, teens are asked to create two masks. One mask represents the self they show to society and the other mask represents their inner self. These masks can be created out of paper mache or cardstock. Additional materials to have on hand are feathers, sequins, glitter, paint, glue, scissors, etc. The leader can explain how we act a certain way in society in order to fit in, but really feel differently on the inside. This statement can open discussion where members (1) describe how they feel when they wear each mask, (2) discuss reasons they have to wear a different mask in society, (3) ponder if they are being true to themselves if they act differently in one mask as opposed to the other.
In the self-portrait activity members are asked to make a self-portrait on the side of a brown paper bag. The portrait can be created with crayons, markers, colored pencils, or paint. Teens can glue on hair, fabric for outfits, etc. The group leader should instruct the members to put things that “make them who they are” inside the bag. Members might put in pictures of their family, a favorite book, a CD, a picture of a pet or best friend. On one side of the bag they can list their fears, on the other side their greatest hopes. On the back of the bag they can create a tombstone with a eulogy that describes what they want to be remembered for.
There are many other group art activities that are excellent for teens. The following books can help therapists in planning expressive art therapy groups:
Although teen groups may take a little extra work, they are deeply fulfilling in a personal way. A counselor who patiently helps adolescents through this difficult and chaotic part of their lives will be remembered by the teen as someone who believed and supported them when they needed it the most.
Bandura, A. (1989). Social cognitive theory. In V. R. Greenwitch (Ed.), Annals of child development (pp. 1-60). Greenwich, CT: Jai Press.
Kymissis, P. (1996). Developmental approach to socialization and group formation. In P. K. D. A. Halperin (Ed.), Group therapy with children and adolescents (pp. 21-33). Washington, DC: American Psychiatric Press.
Leader, E. (1991). Why adolescent group therapy. Journal of Child and Adolescent Group Therapy, 1, 81-93.
Liebmann, M. (1986). Art therapy for groups. Cambridge, MA: Brookline Books.
Riley, S. (1997). Contemporary art therapy with adolescents. London, England: Jessica Kingsley Publishers.