Description of the Working Model
The model presented in this chapter combines arts therapist-teacher work in parallel with therapeutic work. Its aim is to maximize the effectiveness of the therapeutic process for students within the school setting, and to develop an awareness of their feelings and behaviors by bridging between the therapeutic and classroom experiences. The novelty of this model lies in its routine integration of collaborative work between the arts therapist and the teacher, and the impact of these exchanges on individual arts therapy sessions between the therapist and the student.
In the first stage, before the therapeutic process commences, I hold an intake session with the student’s parents. The purpose of this session is to obtain information about the student’s medical, emotional and developmental condition, as well as information about their integration in family life and in their social surroundings. During the intake session, the parents sign a consent form allowing their child to receive arts therapy in the school setting.
Soon afterwards, the first session with the teacher takes place. In this session, I outline my rationale for the importance of our collaborative work and emphasize its significance to the therapeutic process. Throughout this discussion, the importance of the teacher’s role is highlighted as the student’s main accompanying figure during the week who can be a fulcrum for change in the student’s behavior. Acknowledgment of the importance of the teacher’s role and understanding the implications of the teacher’s engagement in the process and contribution to the fulfillment of the therapeutic goals are ways of confirming the teacher’s commitment to the process. During this first meeting, we agree to a contract which outlines our collaborative working model. This includes setting a regular time slot for future meetings and deciding on the nature of our exchanges about the student. Special emphasis is placed on the importance of maintaining confidentiality.
Ensuring the teacher’s awareness of the issue of student privacy is crucial. Teachers often share complex stories and experiences in the staffroom about specific students who exhibit challenging behaviors. The teachers’ need to share and unload their daily interactions and experiences is an obvious one, since most of the time they have to deal with classroom behavior on their own. However, with respect to students who are in therapy, the collaborative model provides teachers an opportunity to use these meetings as a place to speak out about experiences and difficulties which also prompts them to avoid talking about the students in public spaces such as the school corridors. The first meeting also explores initial ideas that can lead to a common goal, starting from becoming aware of the student and showing empathy until a therapy plan can be formulated.
During the first therapy session with the student, I assess his/her difficulties in different frameworks, including the school setting. I define a contract which emphasizes the rules of conduct in the arts therapy room, including issues such as mutual respect, using the art equipment properly and a pledge to maintain confidentiality. Upholding the confidentiality of therapy is one of the pillars of the professional code of ethics that arts therapists must adhere to and is essential to maintaining trust between the student and the therapist. However, working within the educational system places the arts therapist in a position where he/she also needs to share information with the multidisciplinary staff who referred the student to therapy. I ask all students in therapy how they would feel about my talking to their teachers. I discuss what is shared and with whom in terms of the content that emerges during the sessions. I emphasize that the arts therapy room is a safe place for them and that the content and behavior that emerges during therapy will remain in the therapy room and between us. I also note that working with the teacher enables further support for the therapeutic process and the student’s optimal integration into the classroom and the educational setting. Students are informed that they will meet individually with the teacher and may also use these sessions to strengthen the educational experience. In addition, we agree on behavior and reactions in times of crisis. For example, if students feel they want to leave the classroom, they need to say so and try to find an acceptable solution with the teacher or the therapist (a number of alternatives are suggested such as comfort blankets, taking a few minutes to calm down in the bathroom or returning to class). I inform the students that I will meet with their teachers and inquire whether there is anything that they would like me to ask or if they would like me to convey a message from them.
In the conversations when both the teacher and the student are present, the basis for behavior change is also examined and the client’s experience as a student in the classroom and as part of a peer group are discussed in detail. Student and teacher also enter into a contract that ensures that all content will remain confidential. This type of conversation helps the teacher observe all the qualities of the student and not just classroom behavior, and thus creates a more secure space between the two.
The meetings with the teacher are held once every two weeks in conjunction with the therapeutic work. These exchanges help create a consistent language for use when responding to the student, and also ensure that the therapeutic and the educational efforts are in sync. The goal is to help the teacher adjust and formulate different responses to different students. Our work sessions are in fact comparable to training sessions: I try to explain the reasons for specific behavior and reflect the students’ feelings, which are at times hidden behind their mode of conduct (for example, aggressive or confrontational behavior). In addition, I guide the teacher and recommend specific responses to the students’ behavior. For example, if students start fidgeting, the teacher can approach them, touch their shoulders and look into their eyes. If the student misbehaves, the teacher can respond: “I can see that you’re angry, but you can’t kick the chair.”
In the sessions with the teacher, the exchange of information focuses on the core elements of the student’s particular issues, as well as coping methods and insights gained from the arts therapy room. The arts therapist avoids emphasizing direct content that exposes the therapeutic process that could potentially undermine progress and is not necessarily required to clarify the central themes. The arts therapist’s objective is to consult, resolve and make decisions, and clarify methods of intervention to understand the student and the progression of the related educational/therapeutic goals. For example, in cases of bullying or social ostracism, family difficulties or manifestations of emotional distress, the message to the teacher is that the student currently requires more empathy than usual and is experiencing difficulty.
This multipronged work evolves out of the outward-oriented learning process and the inward-oriented arts therapy process (Case & Dailey, 2002). In my experience, cases in which the students’ learning ability is compromised due to internal conflicts requires work that merges individual therapeutic sessions along with building a positive student-teacher relationship to achieve a successful outcome. The model enables systemic work and expands the therapeutic space to occupy more hours while jointly considering the needs of the student and communicating with the school staff in order to maximize these clients’ functioning as students and as social beings.
This model can be enacted in individual therapy sessions with the student’s teacher or in a group session with the entire team that works with these students in the school. It is also possible to develop and present the therapeutic work to the multidisciplinary school staff in cases where one student’s reason for referral to arts therapy also manifests in similar behavior in other students.