MarylandDC Chapter of APT

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Maryland/DC Chapter of APT and The Counseling
Department at Gallaudet University Sand
Therapy with Diverse Populations Sand Therapy
Theory, Efficacy, Ethnocentrism Presentation
by Dee Preston-Dillon, Ph.D. June 9, 2006
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Our Task

• To clarify our path through diversity
• we must
• Define Terms and Delineate Boundaries
• for
• Theory, Technique, Application
•  
• Sand Therapy
• Culture and Diversity
• Clinical Efficacy
• Cultural Competency

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Conference Objectives

• 1. Identify two issues related to diversity,
  ethnicity, and culture in play therapy
• All sand scenes are imbued with representations
  of culture and culture-related issues
• Ethnocentrism and personal bias seep into our
  understanding and interpretation of sand scenes,
  no matter the population
• Culturally conscious interventions require skills
  to address subjectivity, complexity, overt
  covert cultural dynamics

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Conference Objectives

• 2. Identify the importance and impact of sand
  therapy use with at least two different
  populations
• Sand therapy requires little or no verbal
  explanation from the client. Hence it is useful
  with clients who are unable to speak, use a
  different language, can not trust, are unable to
  speak of their trauma, or have a world view
  unfamiliar to the therapist.
• As a powerful non-verbal, symbolic, creative
  process, sand therapy reaches levels of
  psychotherapeutic healing where we can not
  gowhere differences in cultural worlds limit
  understanding and articulation. Consider
  populations with PTSD and clients who are
  severely oppressed.

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Conference Objectives

• 3. Identify two points regarding the
  significance of culture-related
  representations in sand scenes.
• All objects in a sand scene are imbued with many
  levels of meaning. The most significant meaning
  is that given by the client through his or her
  personal associations.
• Cultural icons, artifacts, symbols and toys carry
  the meaning of the culture of origin, evolving
  cultural meanings, and merged meanings when two
  or more cultures meet.
• Gender, generation, geography, class, and social
  constructions influence interpretation.
• The arrangement of a sand scene contains
  idiosyncratic and culture specific meanings and
  sets up tensions among objects.

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Defining Diversity

• Economic Class, Gender,Sexual Orientation,
  Ability, Religion, GeographyCultural
  AssociationsHistorical Moment, Familial
  ArrangementsEducation, Power-Affiliations
  Language

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Tribute by Laverne Ross

• Ethnicity is the product of actions undertaken
  by ethnic groups as they shape and reshape their
  self-definition and culture however, ethnicity
  is also constructed by external social, economic,
  and political processes and actors as they shape
  and reshape ethnic categories and definitions.
• Joane Nagel

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• Cultural Identity encompasses unique
  constructions of
• a Self-Concept
• and
• a sense of belonging to
• Group Identification
• with
• positive and negative attitudes toward
• one's Self the Identity Group

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Dancing til Dawn by Marianne Millar

• Diversity is best understood as a dynamic,
  constantly evolving property of both individual
  identity and group dynamics.
• The construction of ethnic identity cultural
  affiliation is the result of unconscious energies
  and a dialectic played out by culture-specific
  groups and the larger society.

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Our Creative Roots

• We began our journey to bridge the internal with
  our life-world over 30,000 years ago. We
  represented culture on cave walls, monoliths
  stone artifacts.
• Story, society and cultural icons merged to
  bridge inner images and experience.
• We continue to create and redefine ourselves.
• Sand scenes reflect the sacred ritual of the
  ancestors and our innate capacity to transform
  through the symbolic.

Lascaux Cave Painting
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No Sand Scene is Malicious, Violent, or Ignorant

• It is a Container to Hold
• Our life-long emotional wounds
• Inner turmoil, confusion, and fears
• Judgments misunderstandings
• Our experience of alienation oppression
• It is a Space to Create
• Expressions of unique cultural experience
• Renewed hope for ourselves our cultural Other
• Alternative configurations for a multi-layered
  identity
• Renewal of hope, personal efficacy community
• It is a Way for
• Transformation of Cultural Being-in-the-World

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From Disenfranchisement to Understanding

• Hope lies in the efficacy of the clinician to
• Adopt Critical Thinking,
• Develop Cultural Consciousness,
• and
• Acquire Amplification Strategies
• to peel back
• Cultural Bias, Ethnocentrism, Diminishing
  Attitudes and Uninformed Suppositions.

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Culturally Conscious Ethical Sand Therapy

• Efficacy with diverse clients requires
• Cultural Knowledge, Respect for Difference, and
• the Ability to Hold the Dynamics of Cultural
  Worlds.
• To recognize Difference and Similarity . . .
• the Idiosyncratic and Universal . . . in
• Myths
• Symbols
• History
• and Evolving Culture

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Culturally Conscious Ethical Sand Therapy

• Communicate an openness to understand the
  clients unique cultural world
• What do you want me to know about your cultural
  world?
• What do you want to know about my world?
• Practice a discipline of cultural study
• Establish a Culturally Relevant Library, Engage
  in Professional Dialogues, and Actively Journal
• Make available cultural resources
• Global representations of cultural artifacts,
  diverse sand color, language, icons, signs and
  symbols
• Integrate culturally conscious strategies
• What are the complexities I assume?
• How does my worldview inform my interpretation?

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Sand Therapy

• Sandplay
• A Projective Technique
• Dora Kalff, Swiss Jungian Analyst. Originator
  Sandplay. (1930-1980)
• Applied theories of C.G Jungian Eric Neumann
  (1954). Early life-crisis disrupts manifestation
  of Self, a weak ego results.
• Emphasis on safe protected space
• Trust innate healing ability of the child
  rediscovers reintegrate split off psyche

• Sand Tray
• A generic use of sand and toys
• Use and interpretation depend on theory
• World Technique
• Child-Centered
• Filial therapy
• Developmental models Erickson
• Adlerian, Cognitive-behavioral
• Social theorists Vygotsky
• Constructionists Narrative Therapy
• Gestalt, transactional

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Psychotherapeutic Process

• Sandplay
• No intervention during sandplay Therapist
  quietly and patiently attends while child creates
  scene.
• Sand scenes are viewed as a series of
  interconnected expressions, a process driven by
  unconscious movement toward wholeness balance
  -- Individuation

• Sand Tray
• Active engagement with the client
• Therapist may give voice to a toy and dialogue
  with toy or with client
• Toys are viewed for what they actually are and as
  representations in real or imagined world.

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Containment Culture

• Sand Tray 
• Boundaries set to contain psychotherapeutic
  process depend on theoretical orientation.
• Containment related to problem-solving then
  externalized for interpersonal skills.
• Culture may or may not be included depending on
  cultural consciousness of the therapist.

• Sandplay
• Boundaries set to contain activity in the sand
  tray, between client /clinician and in the
  environment.
• Containment for unconscious activity. Symbols
  imbued with meaning from complexes archetypes
  are activated (global idiosyncratic)
• Culture always included when clinician turns to
  amplify symbols in sand scene.

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Tibetan Buddha
Because the complexity of culture is often
overlooked, multicultural research often
inadvertently strengthens the stereotypes that it
is intended to thwart. To avoid stereotypic
thinking, clinicians must critically evaluate
cross-cultural research and be thoughtfully
creative in applying it to clinical
practice. Richard B. Stuart
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The Problem
For the client, coming to terms with ethnic
identity and culture shock frequently includes
oppressive, alienating encounters and
ethnocentric interpretations of experience. The
sand box offers a safe space to express this
experience and Begin a ritual for Healing
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The Problem
Ethnic and cultural identification offers a
harbor where one can feel that some aspect of
integrity will be held, will be witnessed.
Someone present should be able to understand -
connect - empathize - see the one who for a
moment stands alone, waiting to be acknowledged.
Yet a harbor can be a trap or provide safety.
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The Problem
Identification evolves in a cycle.
Existentially, we stand-alone, then we stand
with others, and then we stand-alone. Divides
within the individual, families, generations,
tribal associations, economic strata, and
geographic domains create clusters or complexes
of cultural wounds.
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Representation through Symbolic
Inevitably representations of cultural divides,
identification wounds, multicultural,
cross-cultural complexities emerge in the
clients creative representations. Cultural
identification and wounded-ness are given voice
through multi-layered meanings of symbols.
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Misinterpretation Alienation
If we dismiss crucial identity issues and
cultural markers we risk misinterpreting ethnic
and cultural representations and alienating the
culturally different client.
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To identify oneself as a member of a group may
not be indicative of one's attitudes about the
group or how much the group membership influences
one's perceptions or life experiences. Ethnic
behaviors and practices focus on how involved an
individual is with ethnic social activities and
cultural practices (e.g., music, food).
Margaret O'Dougherty Wright Linh Nguyen
Littleford
Corrida by Fernando Botero
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The Problem with Interpretation
Clinical training in diversity and
multiculturalism may inadvertently
strengthen stereotypes increase
ethnocentrism foster inaccurate cultural
conceptions create distorted cultural
constructions and marginalize the client.
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Misunderstanding a Sand Scene
Convenient notions about difference create an
illusion of understanding and cloud
perception. Pan-ethnic labels and stereotypes
about ability dilute the moderating effects of
national origin, immigration history, religion,
traditions, and familial directives.
Uninformed or distorted pre-suppositions
distort our perception of the symbolic.
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Misunderstanding a Sand Scene
Supervision may introduce biases and invalid
beliefs that compromise sandplay process. Hence,
theory, training, clinical expectation, language,
philosophical framework, clinical supervision,
and past experience all influence and shape our
approach to culturally different clients and
culturally imbued sand scenes.
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Misunderstanding a Sand Scene
It is not safe to infer a clients cultural
orientation from knowledge of any group to which
he or she is believed to belong. Making an
inference, an interpretation, about symbolic
representations from assumptions about culture
and ethnicity is likely to contain ethnocentric
bias.
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Misunderstanding a Sand Scene
We neither want to project characteristics onto
an individual from stereotypes of a group . .
. Nor assume that the individuals experience,
perception, or interpretation is in any way a
reflection of some norm for the group.
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American ethnic groups are often thought of as
discrete categories to which people belong and
that explain some aspects of psychological
functioning. However, ethnicity is a complex
multidimensional construct that, by itself,
explains little. Jean S. Phinney
Violeta Con Flores (unknown)
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Culturally Conscious Sand Therapy
Our ability to move fluidly between self and
cultural Other is vital to authentic
communication to connect deeply with the
client, with the symbols, and with the historic
moment that is Now and reaches way Back and way
Forward.
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A vital step in the development of an equal
partnership for minorities in the academic,
social, and economic life of the United States
involves moving away from assumptions of the
linear model of cultural acquisition. Teresa
LaFromboise, Hardin L.K. Coleman, Jennifer
Gerton
Library, 1969 by Jacob Lawrence
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Culturally Conscious Counseling

• The Road to Culturally Appropriate Amplification
• CULTURAL LIFE-WORLD You likely already have the
  case context from records and interviews.
• The clients life-world, including cultural
  aspects, and your life-world what you bring to
  your practice -- provides the context for
  culturally conscious counseling.

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Culturally Conscious Counseling
ATTENDINGThe art of Attending begins as the
client begins the creative process. Attending
activates our active listening and patient,
careful observation. The therapist is watchful
and listens to any comments, musings, and
idiosyncratic culturally rich expressions from
the client.
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Culturally Conscious Counseling
ASSOCIATIONOnce the activity is completed, the
clinician may invite the client to comment, share
a story, and give initial associations to the
representation. Associations are direct
observations made by the client.
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Culturally Conscious Counseling
Associations are quite conscious and are often
related to ones experience -- the practical life
world and fantasies about the representation. Ref
lections can include cultural traditions and
elements of culture that are evolving. Essentiall
y this is a description from the point of view of
the client. Associations ground the symbolic
and mythic in the reality of the client.
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Culturally Conscious Counseling
For example, the client may say, This is my
brother, or, This is a war between the good
guys and the bad guys. A symbol means exactly
what the client says it means and Symbols also
carry many layers of meanings anchored in
history, world cultures, and literature some of
which the client has never seen.
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Culturally Conscious Counseling
Here is an Ethical Point During the phase
of associating, the therapist holds back on
naming objects in a picture, or sandplay or
story until the client has done so.
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Culturally Conscious Counseling
AMPLIFICATION Amplification is a skill and a
discipline. The clinician explores
cross-cultural symbol meanings by searching
MYTHOLOGICAL, HISTORICAL AND LITERARY
references to the symbolic.
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Culturally Conscious Counseling
Amplification helps us bring to mind a wide range
of possible influences at work in the
unconscious. . . To give meaning to what may, at
first sight, seem perplexing. Amplification can
be explored with the client except in the case of
children when amplification could be invasive.
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Culturally Conscious Counseling

• Hidden in the rich, multi-layered dimensions of
  the symbolic are
• Multi-faceted Images
• Memory of Experience
• Conflicting Emotions
• Interpretations,
• Expectations
• Cultural Associations...
• Associated with the complex surrounding identity
  and culture

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Culturally Conscious Counseling
The Symbolic content in a sand scene
contains Energies attached to Ways of Being we
can hardly imagine. The symbolic is both unique
to each client AND embedded in our humanity.
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Culturally Conscious Counseling
Amplification combining modern as well as
traditional ideas can point out destructive or
wounded components of a symbol. Through
Amplification we become aware of shades of
meaning of opposites and dynamic forces.
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Culturally Conscious Counseling
For example, if a snake lies half buried in a
sand scene amplification brings our associations
to meanings attributed to being exposed and being
partly buried, as well as representations of
snake in the ethnic heritage of the client,
general literary sources, and millenniums of
culture.
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Culturally Conscious Counseling
Amplification beyond the clients associations
helps the clinician become aware of any energy,
images, and potentialities relevant to the
clients concerns. Reflecting on the clients
cultural world we begin to see alternative ways
to view the powerful, multi-layered potentiality
of the symbolic.
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Culturally Conscious Counseling
Amplification requires research. Your search
for meaning will lead you to texts on mythology,
symbol books, modern comic books, childrens
stories, cartoons, movies, folk lore and fairy
tales from diverse cultures, and encyclopedias to
learn about geography, original peoples,
traditions, and rituals.
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Culturally Conscious Counseling
In summary, using culturally enhanced
amplification we remain mindful of the vitality
of symbols and become informed about the
implications of 1) a clients membership in a
group, 2) dynamic, evolving cultural phenomena,
and 3) the rich tapestry of the clients
individuality.
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Culturally Conscious Counseling
Reflecting on your own cultural suppositions and
experience through journaling.
Analytic skills and amplification research alone
will not eliminate ethnocentric bias. Like
meditation or a martial art, this practice
includes rigorous self-evaluation by the
clinician.
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Culturally Conscious Counseling
Culturally conscious counseling requires
continued, serious, comprehensive reflection on
your heritage, development, beliefs, traditions,
values, experience, and ancestors.
The following questions are meant to assist you
with the practice of culturally conscious
reflection.
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Culturally Conscious Counseling

• Develop skills to inquire about each
  clients life-world.
• What stereotypes permeate the clients culture
  -- positive and negative?
• How did you become aware of those stereotypes?
• What knowledge do you have about the cultureof
  origin?
• What is the clients unique cultural outlook?

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Culturally Conscious Counseling

• What are the clients preferred thematic
  gestalts that explain or justify ethnic and
  cultural identification?
• How do these gestalts emerge in the
  representation?
• How do we ask? What do we research? What do
  specific objects, symbols, stories, color, and
  icons mean to the client?

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Culturally Conscious Counseling
What about the symbol is significant? How
would significant others explain the symbols? If
an ancestor were to enter the room what would
they say or do with the objects, symbols,
narrative?
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Culturally Conscious Counseling
How is the arrangement culturally relevant?
What might a traditional healer or another
faction of this cultural group say or do with the
representation? What would you do? Your
ancestors?
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Culturally Conscious Counseling
What are the major cultural myths in the clients
culture (traditional and current)? Are there
particular symbols that seem powerful and what do
they represent? (for examplea building, place
of worship -- pyramid -- statue, a flag, a wall,
a mountain) What are the salient historic
moments for each culture represented?
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Culturally Conscious Counseling
When timing, concern, and clarity
open a space for you to connect about cultural
issues, acknowledge your own worldview in
appropriate self-disclosure. This disclosure
should not imply rigid limitation to your
perception but simply recognize an obvious
awareness for you and the client. (E.g.
acknowledging you are not well informed about the
clients culture/ethnicity and you are open to
learn his or her view).
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Culturally Conscious Counseling
Work outside the hour with colleagues
or in your journaling on personal beliefs,
values, suppositions, expectations, assumptions,
and intuitions (about your own heritage and
cultural Others) to evaluate where these might be
anchored in your home culture. How might these
manifest as projections in your clinical work
with sand?
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Culturally Conscious Counseling
How might ethnocentrism and unwarranted
assumptions impose themselves on your perception
of and response to creative representations?
Develop a library that provides a wide view of
history, religions, indigenous biographies,
music, poetry, art, fairy tales, and myths
especially of the cultural groups you see in
therapy.
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Culturally Conscious Counseling
Develop a cluster of objects and icons that
represent aspects of an array of different
cultural groups since your clients act in a world
of many cultures, religions, and ethnicities.
How might culture be mediating or moderating the
sand scene?
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Culturally Conscious Counseling
Make a list of the existential
moments for all humanity and keep those in mind
when balancing awareness of culture with
observation of deep universal human meaning.
For example, the archetypes of birth, death,
healing, alienation, community, cosmology, power,
survival, etc. What are some traditions and
rituals from very different cultures to meet
these moments?
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Culturally Conscious Counseling
Make a list of historic events,
myths, migrations, and legends for the specific
populations you work with as well as your own.
Examine the wars of nations, genocides and
holocausts. Examine the role of your ancestors
in human welfare.
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Culturally Conscious Counseling
Ask the client what they accept as relevant to
his or her life world. e.g. Acceptance of
peer group, traditions, cultural beliefs, values,
interpretation of historic events, religious
associations. Determine the sources of the
clients perspective. Are there expressed
identifications with particular ethnic or
religious groups? What are the salient issues
aligned with association and identification?
Taboos, social approval or rejection? Shame?
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Culturally Conscious Counseling
Culturally Relevant Sandplay ArtifactsSuggestion
s Diverse ethnic human figures -
developmental and ethnically obvious
Representations of world religions (people,
objects, structures) Figures from history
from non-Western, Western, and Indigenous
groups
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Culturally Conscious Counseling
Objects representing varied historic
life-ways (farming, hunting, housing)
Symbols from cultural monuments (pyramids,
temples, mounds) Music and artistic devices,
containers, toys, tools Domestic and
wild animal families
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Culturally Conscious Counseling

• Housing of every sort and foods of the world
• Generic people who represent evolutionary
  stages
• Objects of war and ethnic and religious conflicts
• Locate cultural material from
• Museum stores, tourist shops, second-hand stores
  and antique stores, cultural fairs, airport
  shops, and specialty stores for particular
  groups.
• Try making them by hand.

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Brief Bibliography
Brittan-Powell, C. S., Liu, W. M., Pope-Davis, D.
B., Toporeck, R. L. (2001). What's
missing from multicultural competency research
Review, introspection, and recommendations.
Cultural Diversity and Ethnic Minority
Psychology, 7(2), 121-138. Brown, C. F., Chae,
M. H., Kelly, D., Utsey, S. O. (2002). Effect
of ethnic group membership on ethnic
identity, race-related stress and quality of
life. Cultural Diversity and Ethnic Minority
Psychology, 8(4), 366-377. Ferdman, B. M. (2000).
Why am I who I am Constructing the cultural self
in multicultural perspective. Human
Development, 43(1), 19-23. Kim-ju, G. M., Liem,
R. (2003). Ethnic awareness as a function of
ethnic group status, group composition, and
ethnic identity association. Cultural Diversity
and Ethnic Minority Psychology, 9(3),
289-302. LaFromboise, T., Coleman, H.L.K.,
Gerton, J. (1993). Psychological impact of
biculturalism Evidence and theory. Psychological
Bulletin, 114(3), 395-412. McNeill, B. W. (2001).
An exercise in ethnic identity awareness. Journal
of Multicultural Counseling Development,
29(4), 284-298. Nagel, J. (1994). Constructing
ethnicity Creating and recreating ethnic
identity and culture. Social Problems,
41(1), 152-176.
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Brief Bibliography
Negy, C., Shreve, T.L., Jenson, B.J., Uddin, N.
(2003). Ethnic identity, self esteem, and
ethnocentrism A study of social identity versus
multicultural theory of development.
Cultural Diversity and Ethnic Minority
Psychology, 9(4), 333-344. Phinney, J. (1990).
Ethnic identity in adolescents and adults Review
of research. Psychological Bulletin,
108(3), 469-479. Phinney, J. (1996). When we talk
about American ethnic groups, what do we mean?
American Psychologist, 51(9),
918-927. Signell, K. (1996). Silence and
sandplay. Sandplay Therapy, 4(2), 69-86. Stuart,
R.B. (2004). Twelve practical suggestions for
achieving multicultural competence.
Professional Psychology Research and Practice,
35(1), 3-9. Sussman, N. (2000). The dynamic
nature of cultural identity throughout cultural
transitions Why home is not so sweet.
Personality and Social Psychology Review,
(4), 355-374. Wright, M. O., Littleford, L. N.
(2002). Experiences and beliefs as predictors of
ethnic identity and intergroup relations.
Journal of Multicultural Counseling
Development, 30(1), 2-21. All artwork
included can be found at www.allposters.com
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Dance of Africa by Ivey Hayes
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Creative Consultant LK Hunsakerwww.lkhunsaker.co
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