There are numerous resources supporting the arts of therapy or which address the issue of therapeutic alliance, therapeutic self, relating. Here are a few I find easy and accessible.
Foundational Pilars and theoretical orientation framework
it is generally agreed that therapist competency includes attitudes or personal values and biasis; knowledge which is usally acquired formally; and skills or techniques often the expression of practicum. One of the components of attitudes is theoretical orientation. They often reflect some basic core value of the therapist, a point of reference for reading and interpreting the world. Theoretical orientations can also be understood as systems that outline two basic elements :
°conceptualization of health (e.g., distinguishing between healthy versus unhealthy behavior, elaborating upon an etiology of unhealthy behavior)
°mechanisms of therapeutic change (e.g., theory- supported models illustrating movement toward health, specific interventions or techniques that facilitate healthy change).
As an horticultural therapist, there are the foundational pilars describing mechanisms of therapeutic change but also other theoretical frameworks from which we may borrow, that best help us to express how we perceive of our professional offerings as a human service provider.
Here a a few of those theoretical frameworks:
-PsychoEvolutionary theories such as ART, Kaplans Attention restoration theory or Ulrichs SRT, Stress recovery theory. This group of theories demonstrates the workings of stress and attentional flexibility. In this category we must include of course the biophilia thesis claiming the human affinity for living creatures.
-The occupational or activity theory which is based in the idea of experiencing and hands on witnessing of the vitality of life/living beings. This is not far from the Gestalt approach of experiencing in order for change to occur.
-A model of communication and meaningfulness that helps us to engage symbolic thinking has been proposed as another domain of theory refering to how we relate to the environment. This may recall Cultural models of psychotherapy.
-Ecological models which allow us to think about embeddeness, kinship, web of life, very diffrent from purely egological models that dwell on the individually solely. This group of theories is related to Systems theories in psychotherapy..
-Borrowing from psychodynamic psychotherapy we may have reason to be aware of object-relations theories and attachment theories where Nature is treated as transitional object, or considered a third party, a co-therapist onto which symbolic or other transferences are made.
-Secular Mindfulness Approaches. THis is actually an educational model which suggest that learning to pay attention to Emergence or Emerging phenomena has healing benefits.
-And finally psychology or Anthropology of religion allows us to gingerly interrrogate the spritual and transcendental expressions that may arise in session. Concepts such as Awe or neo-animism have their theorists, writers and philosophers.
We must of course begin with something form the father of patient centered humanistic counseling Carl Rogers. The short article gives a good overview of some essentials.
One of the primary concerns is creating a safe place for clients. Supporting safe therapy. This is one of the basic skills to bolster competence in since gains are maximized when a client feels safe enough to engage.
Here is the blog of a counsellor that I have found worth following
Otherwise a website with some group icebreaker tips
An ethically motivated website Businessballs with interesting tips, games handouts for group work
There are several group therapy process models available. And each will be coloured by the theoretical orientation guiding the counselor. Theoretical framework remains an important issue to reflect upon continuously, revising as one grows as a therapist, in order to remain authentic to self. This is partly the reason for continued supervision.
More importantly, a therapist should be aware of the possible adverse effects of group therapy. Here is an article that gives a good overview of issues of which one must be aware.
Empathy and Compassionte care
Models and approches to caregiving abound. Here is the Humanitude model developed by French Yves Ginette. It reposes on a few key pillars such as touch and voice when working with challenged patients or clients.
On the very dense concern of empathy, the empathy library, founded by Roman Krznaric is certainly a good place to snoop around.
Here is an article on the attuned therapist which includes a brief history of attachment theory and a short review of the move away from behavioural approaches towards a rehabilitation of emotions (via neuroscience) in some psychotherapeutic currents.
The Sensory Based Montessori methods usually associated with children’s education is also a good place to learn about compassionate and caregiving.
Writing goals is a skill that can be learned and exercised. Using precise language is important. Here is a cheat sheet that may be useful. Although it comes from another discipline there are a number of good, clear indications.
Improved Self esteem is one of the positive beneficial changes horticultural therapist may cite frequently. However, it is important to have a sense of what we are talking about and how it may or may not matter. In which case other more specific more measurable goals might deserve our attention. A classic approach to goal setting in therapy can be read in this article.
Here is a short article about the Rosenberg self esteem scale RSES, which HTs may come across.
A critical approach to goal setting in therapy can be found here
A short but succinct article on goals can be read here. Also very critical of the problematic of goal-setting, the article refers to coaching, management and psychology of work, but is also pertinent for therapy work in general.
Some psychosocial issues
Although horticultural therapists are expected to have university training in human development theory, abnormal psychology and theories of counseling, many tend to practice in the humanistic (rogerian) or pragmatic traditions (cognitive behavioural). HTs may tend to rely less on the psychoanalytic/psychodyamic traditions (freudian unconcious). It is however necessary to be aware of several psychosocial issues relating to the psychodynamic tradition. The more attentive and attuned we are to our patients and clients the better we can tailor an activity that is meaningful and engaging and as challenging as the team goal objectives demand.
Transference/Counter-transference. Although straight out of the psychodynamic cannon, an essential understanding of how clients/patients and therapists/facilitators relate to one another is important for creating and maintaining a space where the therapeutic process of change can occur. For non psychodynamic therapists an excellent resource is this online course.
Complexifying the matter of “transferences” is of course the fact that horticultural therapists or other Nature based therapists are working with mediators or co-therapists as Martin Jordon or Ronan Berger are fond of underlining. This would require some additional thought, réflexion and recognition, good for discussion in a supervisory meeting.
Mechanisms of Defense
Le groupe et l’inconscient -l’imaginaire groupal. Didier Anzieu
The American Horticultural Therapy Association has yet to formulate an explicit position on this issue. But it is definitely one that requires attention. Many forward looking institutions are adept at making certain that staff has been made aware of issues surrounding cultural sensitivity. Afterall this is not a new concern but one that started surfacing in the 1990s.
Here is a text that words the priorities for Art Therapists. It was meant as a revised point to be included in the ethics statement of the American Art Therapy Assiciation. I find that it is a helpful guide to reflect on.
For more on some Anthropological considerations you can read more here.
Self Care and self-compassion
Self care is not about individualistic, self centered indulgence. Neither is it a luxury or a privilege tied to bubble baths and chocolates. It is a type of personal sustainability, a personal trauma stewardship that becomes necessary if we want to remain effective therapists or active community members.
Counsellors and therapists must take heed of self care concerns, a part of this may resolve by putting themselves in the supervised or client position. There are equally other approaches to living well and fostering wellness for the helping professional. Self care and self reflection are certainly not to be overlooked.
An excellent source on self care including assessments, activities and an extensive bibliographic can be found at this university department of social work.
Self compassion, while not self esteem as Dr. Kristin Neff reminds us, is related to mindfulness. It is however the moment when we as servie providers, but also active but flawed human beings allow ourselves to come to terms with our shortcomings. Here is an article and a video on self compassion that takes on the criticisms usually levelled against it. You can discover some exercises to improve self compassion. And here are some videos clips.
A good knowledge of attachment theory helps a therapist to better grasp and attune to their clients and patients but also helps therapeutic self evolve as it encounters issues of counter transference. There are several authors who work around attachment from the inner child approach of art therapist Art Therapist, Dr. Lucia Capacchione, in 1976 and documented in her book, Recovery of Your Inner Child (1991) to mindfulness neuroscientist Dan Siegel. Here however are a series of sound clips by Dr. Richard Lannon based on his book covering attachment theory, A General Theory of Love
Guided Imagery is a fabulous tool well worth learning to use competently and safely . Training and practice will go a long way to making your horticultural therapy visualisation exercises more authentic and genuine. I have written a blog post about the Kaplan “being away” from this angle.
Writing and storytelling. Timeslips, a creative storytelling approach promoted by Anne Davis Bastings, professor of theatre, turns reminisence therapy for dementia sufferes on its head. Instead of focusing on exercising memory lost, the approach encourages imaginative group storytelling using prompts or props like photos or sensory objects. Bolstering self esteem, communication, interest, Timeslips even provides an easy enough protocol for caregivers to learn and practice one-on-one with their loved ones. This playful therapy is well worth experimenting with other groups suffering from communication or cognitive issues, and horticultural therapists are certain to find inspiration in the invitation to engage clients or patients imaginatively. Rather than worrying about what is, or managing the frustration of what was…creating “making it up” opportunities to say what might be is proving to be exceptionally meaningful.
Critical theories of psychology
Psychology, psychoanalysis and psychiatry are not without their critics. The history of the many currents and rifts, theoretical orientations and treatment approachs are beyond the scope of this post. However, it would be unfair not to not that there is also a type of radical criticism that interrogates the entire idea of the need for psycho-practitioners. Here is a blog that takes seriously a good number of issues well worth investigating and thinking on.
The Wellness Industry
From a trending perspective and what to look forward to as prevention and well being become more and more important factors in maintaining quality of life, it is worthwhile to be aware of debates in the wellness industry