Week 7: Starting to stitch up loose ends

As is always the case, just as I feel like I'm settled in and got the rhythm down, it's almost time to leave.

A drop in the bucket
It's wild to think I have 4 days left of my internship, as I just got here. In the world of Creative Arts Therapy and psychotherapy in general, I've been here for a blink of an eye. Eight weeks is enough time to make some kinds of progress, sure, but in the long haul, psychological progress is slow and steady. Long standing therapeutic relationships are important for clients to really dig into their goals. 

The neurodevelopmentally disabled population is no exception- when there are neuron pathways being reprogrammed,  it takes some reinforcement. It's like learning a new dance move. You may have to try it over and over again, concentrating really hard each time, before that move becomes automatic.  Albeit on a different scale, a lot of the clients I am fortunate to interact with are learning new "moves": how to say hello, pressing a switch that acts as a communication device, sitting in a chair when they are asked, learning to shake hands without squeezing too hard.   For some, they are developing skills that are for them the same level of difficulty as learning a double pirouette-developé-arabesque ballet combination would be for me.  I can't learn that overnight, or even in 8 weeks (excuse the lack of ballet knowledge in that analogy).

The same may be said of the geriatric population I'm working with.  Their group goals for a group may be, for example, something like this: creating positive associations with the physical space, developing positive interpersonal relationships with others in the program, and working in physical and mental activity when possible.   The Drama Therapy sessions are meant to create a safe space where the clients will healthily activate their minds and bodies and ideally generalize their good experiences within session to the rest of their time in the facility/ the rest of their lives.  Again, that doesn't happen overnight.

Note: This is not all to say therapy must be long term. Plenty of groups happen on a drop-in basis, especially in hospital settings or day programs.   Those groups are effective, too, they are just shorter term.   Even  the example of a geriatric group I just talked about could be helpful and valuable to a senior who's only around for one session.  Impacts of the therapy, of course, are deeper and more potent when a client attends multiple sessions in a series. 

Termination
In any therapeutic relationship, stability and continuity is important, and the sense of both those things may be disturbed in someone leaves the group with little to no notice. Though my relationship with the clients has been relatively short, or perhaps it is even more important for that reason, this week I started the termination process.  In the case of the groups I'm observing, that process is short, a two week preparation for my absence involving telling the clients how much time I have left, reminding them at least a few times throughout a session that I will be leaving.



Snapshot: flexibility


Just a quick snapshot from one of our sessions this week. The day had already started out funky,and then one of our clients in an early session had a pretty urgent medical issue.  Everything stopped- music stopped, the nurse came in and all the aids turned their attention to him. In this particular case, there wasn't much anyone could do, just wait for it to pass. The experience shook me up for a few minutes, but mostly just made me think about the importance of flexibility.  Everyone was right there, ready to drop everything they were doing to make sure he was taken care of.  After the issue was resolved, we continued with the session.  The energy/pace had changed, so the therapist was flexible and adjusted.

Bring it back around
My big non-clinical project this week was a volunteer orientation. There is a nice arc/timeline to the volunteer coordinating part of my internship:
-Sent out emails to past volunteer inquiries/learned to respond to new ones
-Those inquiries became email correspondence, which became scheduling interviews
-Shadowed a volunteer interview
-Conducted a few volunteer interviews
-Coordinated volunteers for our Open House event
-Gathered and created tasks/projects for volunteers
-Created a volunteer orientation schedule/structure
-Conducted a volunteer orientation
-As follow up, I will be passing on my ongoing admin projects to incoming volunteers

I say it's a nice arc for one of the same reasons I loved rep-ing ITA at the resource fairs: teaching is the best way to learn. As I created the plan for orientation, I tried to ask myself what I'd want from this orientation. A way to make it meaningful for me (and hopefully for the volunteers being oriented) was a time to ask questions about creative arts therapy. When I first thought about adding that to the schedule, I thought "I can't answer questions on my own." But then I thought about how silly that was- I've been gathering answers to basic questions about CAT for seven weeks. Of course I can answer the basics, and refer out if anything I don't know comes up.  Turns out I've absorbed enough information over the course of the last two months that I knew all the answers to the questions the volunteers asked.   It felt great, as always, to lead a group, and even better because it was an experience for which I was given permission to create in a meaningful way.

Skills in all areas, for all areas
Though the orientation was entirely separate from my clinical observation, all experiences are interconnected. The other key part of the orientation is very what couldn't be written on paper- creating a comfortable environment where people feel empowered.  That is just as important in a volunteer orientation as it is in the therapy sessions I'm observing. 




Group Sup(ervision)
Remember how I was invited to bring a DT intervention to our Group Sup this week? I did. First the other two MT interns tried out what was on their mind. The first wanted to talk through how to create a song with a particular client group.  A lot of the fun leadership training/workshop/devising/strategic planning formats I've worked with were very helpful in that brainstorming session. Then the second intern tried out a music intervention she was developing that could be used with clients with apraxia. That was cool to see, too.  Then it was my turn.
 I talked to both of ITA's drama therapists about the national DT conference in Yosemite last week, and they both talked about a great workshop they went to about using the Hero's Journey in therapeutic practice. I talked to one of them about the details, and used that to create an abbreviated version to "test out" on the other interns. It went smoothly, and it was awesome to be offering something new to everyone the group. It felt great, as always, to lead a group, and even better because it was an experience for which I was given permission to create in a meaningful way.

The finishing touch
My wrap up project will be a presentation delivered during next week's supervision time slot. I got to choose my topic and I'm given any or all of the one hour time slot...I plan to talk about what I've learned from clients, supervisors, other staff members, the whole internship experience, and a slice of my current understanding about the field of DT. Stay tuned- I'll let you know how it goes!