ArticlePDF Available

Counseling Through Images: Using Photography to Guide the Counseling Process and Achieve Treatment Goals


Abstract and Figures

Creative approaches to counseling help counselors to meet the needs of diverse populations. The utility of photography in counseling has been demonstrated through several case studies; however, clear implications of how photography relates to the counseling process have not been well delineated. The existing literature on phototherapy is reviewed and connected to specific photo directives within the counseling process and common psychotherapeutic techniques.
Content may be subject to copyright.
Journal of Creativity in Mental Health, 7:310–329, 2012
Copyright © Taylor & Francis Group, LLC
ISSN: 1540-1383 print/1540-1391 online
DOI: 10.1080/15401383.2012.739955
Counseling Through Images: Using
Photography to Guide the Counseling
Process and Achieve Treatment Goals
Southern Connecticut State University, New Haven,
Connecticut, USA
State of Connecticut Department of Mental Health,
Connecticut, USA
Creative approaches to counseling help counselors to meet the needs
of diverse populations. The utility of photography in counseling
has been demonstrated through several case studies; however, clear
implications of how photography relates to the counseling pro-
cess have not been well delineated. The existing literature on
phototherapy is reviewed and connected to specific photo direc-
tives within the counseling process and common psychotherapeutic
KEYWORDS phototherapy, creative counseling, photography,
Joining with a client on the counseling journey begins with the client painting
a picture with words so that the counselor can capture the essence of the
client’s life experience. The words used to illustrate that picture must be
descriptive enough for the counselor to feel or see what the client brings into
the counseling relationship. For many clients, this may be a major obstacle.
For other clients, it may be impossible to use words to convey an adequate
picture, requiring the counselor to use nonverbal approaches.
Counselors may incorporate artistic methods in therapy to assist
clients through nonverbal techniques to illustrate their feelings and issues
Address correspondence to Misty M. Ginicola, Department of Counseling and School
Psychology, Southern Connecticut State University, 501 Crescent St., Davis Hall 126, New
Haven, CT 06515, USA. E-mail:
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
Counseling Through Images 311
(Buchalter, 2009; Junge & Levick, 2010; McNiff, 2004). Through the process
of art making and creative expression, counselors can assist in the reduction
of a variety of distressing psychological symptoms. Because these methods
are nonverbal, clients can reveal as much or as little as they are comfortable
with, providing the counselor the opportunity to build rapport and trust.
Clients also experience a cathartic release by viewing their situations, prob-
lems, feelings, or difficulties in a concrete format that they can physically
experience and manipulate. In addition, having a creative object to reference
allows both the therapist and client to understand each other consistently
beyond the use of words (Star & Cox, 2008; Stevens & Spears, 2009).
One such creative method is the use of photographs, a medium that
does not require artistic ability or extensive training in art therapy. A photo-
graph is a nonthreatening method that can allow a client to convey meaning,
struggle, and emotions that cannot easily be verbalized. Along with providing
a supportive avenue to discuss an issue and express emotions in a creative
way, a photograph may provide a way to work around defense mecha-
nisms. Therefore, photographs provide concrete representations of personal
struggles that may not be readily perceived (Star & Cox, 2008).
Although the advantages to utilizing photography in therapy may
be numerous, counselors may encounter some challenges in using this
approach (Pillay, 2009; Stevens & Spears, 2009). Counselors may not
have specific methods for utilizing photography in a counseling session.
Additionally, little empirical research exists to support the use of photogra-
phy as therapy. However, reported case studies seem to indicate that these
approaches are effective for many clients. In this article, we seek to present
phototherapy as a clinical tool and present methodology that could be uti-
lized within a counseling session based upon existing reliable and validated
counseling techniques.
Phototherapy captures the therapeutic nature of images; it is concerned with
the taking, viewing, manipulating, presenting, and interpreting of the image
as a primary or supplementary form of counseling (Krauss & Fryrear, 1983).
The counselor views the photograph as having a window into the client’s
subconscious and unconscious, thereby providing both utility in clinical
assessment and treatment. Within a counseling setting, the directives given to
the client are as important as the viewing and analyzing of the photos (Hayes,
2002). The directives provide a context to assess specific characteristics or to
provide specific treatment. For example, if the counselor would like clients
to think about their role within their family, they may prompt the client to
review family photographs to discuss what they see. It is important that the
counselor provides support and concrete directions for the entire process,
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
312 M. M. Ginicola et al.
which includes selecting content and format for the picture, manipulating
the images in a desired manner, and reviewing the image for content and
themes (Hayes).
Phototherapy has been shown efficacious in several settings with multi-
ple populations. Images have been used successfully with students in school
settings (Goessling & Doyle, 2009; Goodhart et al., 2006; Schudson, 1975),
senior citizens (Zwick, 1978), veterans (Stevens & Spears, 2009; Studley,
2006), and individuals with disabilities and their families (Glover-Graf,
2000; Rampton et al., 2007; Reynolds, Lim, & Prior, 2008). Photography in
counseling has also shown utility in group settings (Craig, 2009), as well as in
couples and family counseling (Star & Cox, 2008). In addition, phototherapy
has been used successfully with clients with a variety of presenting con-
cerns including substance abuse (Glover-Graf & Miller, 2006; Graf, 2002),
depressive disorders (Hanieh & Walker, 2007), posttraumatic stress disorder
(Stevens & Spears, 2009), eating disorders (Wessells, 1985), anxiety disor-
ders (Stewart, 1979), and other chronic mental illness (Hubbard, Romero,
& Thomas, 1987). Although the vast majority of these research findings are
from case studies, they support the efficacy of this strategy with a wide array
of clients and a variety of counselors.
Counselors from various therapeutic orientations can utilize
phototherapy. Photographs can be used to investigate thinking and
behaviors using a cognitive-behavioral platform; delve into unconscious
symbolism using Jungian thought; identify rationalizations and defense
mechanisms as defined by psychodynamic theory; investigate relationships
according to systems theories; and provide an alternate form of expression
and communication as a coping skill, which increases adaptability as
described by resiliency theories (Stevens & Spears, 2009; Weiser, 2004).
Photography does not have therapeutic utility with every client. Clients
must have the cognitive capacity to understand the directions, have access to
still-photography equipment, and enjoy creating images or artwork. Beyond
these initial requirements, however, phototherapy can work with children,
adolescents, and adults, as well as individuals with developmental delays
and disorders.
Counselors can utilize images to supplement therapeutic techniques within
the spectrum of their theoretical orientation throughout the stages of
counseling. The sections and the table that follow highlight a) traditional
counseling strategies, b) how phototherapy has been or can be used within
each stage of counseling in relation to therapeutic goals, and c) examples and
directives based on our experiences in using photographs in a therapeutic
context (see Table 1).
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
TABLE 1 Phototherapy Directives Associated With Traditional Therapeutic Goals and Techniques
Therapeutic Goal Traditional Therapeutic Technique Phototherapy Technique
Elicit verbal responses Encouragers, Attending Behavior,
Verbal Tracking, Paraphrasing,
Summarizing and other Microskills
1. Photos the client has found or created
2. Photos of the client
3. Family albums
Identify symptoms and presenting
problems in order to assign a diagnosis
Clinical Interviewing, Open and
Closed Questions, Surveys and
Measures, Clinical Observation,
Third Party Reports
1. Content: abstract, recognizable, social relation,
focused on artistic quality, people/pets/nature
2. Format: perspective, color, focus, composition, depth
of field, manipulations
3. Meaning for both content and format
Explore emotions, increase identity of
emotions, assist in understanding
emotions and causes, learn how to
exert control over emotions
Feeling Reflections, Open & Closed
1. Assign a photo directive:
a. with any symbolic content which represents a) how
the client currently feels or b) a specific feeling or
b. finding existing photos of the client to demonstrate
different emotional states
c. to create a self-image or portrait where client is
reflecting a specific emotion
d. to identify something (event, object or person) which
evokes a certain emotional response
2. Investigate with the client the emotion, meaning and
expression of the emotion, as well as themes
represented within the picture
3. Help the client connect the internal emotional
experience to his or her internal cognitive processes and
external experiences
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
TABLE 1 (Continued)
Therapeutic Goal Traditional Therapeutic Technique Phototherapy Technique
Explore thoughts, decrease negative
self-talk, confront cognitive distortions,
improve positive thinking
Cognitive and Cognitive-Behavioral
Strategies, Self-Talk, Rerraming,
1. Assign a directive exploring an issue, event or story
2. Help client explore his or her thoughts and provide a
narrative surrounding the images
3. Assist client in confronting inconsistencies or
incongruence, as well as cognitive distortions
4. Help client to restructure and reformat memories and
Increase social functioning, improve
social interactions with family, friends
and romantic partners
Communication Strategies, I Messages,
Empty Chair, Role Play
1. Assign a directive exploring an issue, event or
relationship or collect already existing photographs
evidencing the relationship
2. Help client explore his or her feelings and thoughts
surrounding the images and the expressed relationship
within the photograph
3. Assist client in taking the perspective of others by
providing an alternate view of the image
1. Assign a directive where the client attempts to take
photos from the perspective of another individual
2. Discuss the difference between the client’s perspective
and the ‘other’ perspective highlighting the differences
and promoting empathy and understanding for others
Improve coping skills, replace a negative
behavior, understand the function of a
negative behavior
Behavioral Interventions, Modeling,
Behavioral Rehearsal, Spitting in the
Soup, Relaxation Training
1. Assign a directive where the client attempts to take
photos of coping skills or a replacement behavior
2. Assign a directive where the client creates a narrative
surrounding a positive behavior
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
3. Assign a directive where the client captures images of
relaxing or safe spaces
4. Assign a directive where images are taken to describe a
behavior in steps or stages
5. Discuss the images and use them in conjunction with
the behavioral techniques
Find solutions to specific problems Brief Solution-Focused Interventions,
Scaling, Exceptions, Miracle
Question, Acting as If
1. Assign a directive where the client selects or creates self
images reflecting a scale of intensity of
2. Assign a directive where the client selects or creates
images that reflect the absence of the problem
3. Assist the client in analyzing images for potential
solutions to his or her problems
Find existential meaning, hope and
Exploring Meaning and
Spiritual/Religious Significance,
Expanding Coping Skills and
1. Assign a directive where the client selects or creates
images to explore an issue or reflect his or her voice on
an issue
2. Assign a directive where client takes images of what
gives him or her hope or purpose
3. Have clients put together a personal record or memory
book to tell their story or aspects of their struggle
4. Assist the client in analyzing images for strength,
survival, resistance and meaning
End counseling appropriately,
understand coping skills, identify
future action for problems which may
Termination techniques, including
Flagging the Minefield
1. Ask client to create or select images which reflect his or
her current state
2. Assign a directive to create a memory/scrap book
either in or out of the counseling session
3. Reflect on the change in the pictures, highlighting the
coping skills and strengths the client has developed/
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
316 M. M. Ginicola et al.
Building Rapport
The initial stage of therapy, building rapport, is the foundation for counseling
interventions (Cormier & Hackney, 1993; Ivey, Ivey, & Zalaquett, 2009). The
goal within this stage is to increase client comfort, trust toward the coun-
selor, motivation and participation within counseling, and the production of
verbal responses. Utilizing counseling microskills, such as attending, provid-
ing encouragers, paraphrasing/summarizing, and providing verbal tracking,
serve as both rapport builders and a focusing tool (Ivey et al., 2009).
Problem-free talk is another tool for building rapport; it allows the coun-
selor to get to know the client and his or her personality by inquiring about
hobbies, likes, and dislikes (George, Iveson, & Ratner, 1990).
If the counselor finds that the client is interested in using phototherapy,
using photos can fit well into this stage of counseling. The initial stages
of counseling can be difficult for some clients who may have anxiety about
sharing intimate thoughts and feelings with a stranger. Using images is partic-
ularly helpful if the client is resistant to this type of verbal interaction (Hayes,
2002). Photography can function as dialogue in a visual language, serving as
an alternative form of communication, which can lower anxiety surrounding
verbal communication by using an enjoyable format for the client (Goodhart
et al., 2006; Hunsberger, 1984; Krauss & Fryrear 1983; Reynolds et al., 2008;
Weiser, 1988). Within this stage, the counselor should establish the clients’
enjoyment of photography, what images they prefer, what photographic
techniques they are familiar with, and what types of content they enjoy
photographing. Directives center on the exploration of photographs that the
clients have found to be appealing to them or created themselves to elicit ver-
bal responses (Henry, 1984; Weiser, 2004). Clients could also bring in pictures
of themselves and family photos to share personal history (Schudson, 1975;
Star & Cox, 2008). The counselor may use traditional counseling microskills
within this exploration, as well as appropriate questioning techniques. The
use of the image allows for the client and counselor to offer discourse over
a concrete image rather than shifting the direction onto the client directly,
which some clients may experience as confrontational or threatening. It is
important to note that while building rapport, counselors should not engage
the client in analysis of the image or confrontations as that is not typically an
appropriate strategy for this stage of counseling.
When faced with an adolescent female client who had difficulty express-
ing emotions, frequently shut down from interactions, and had suicidal
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
Counseling Through Images 317
ideations, I (MMG) struggled to find a way to help this client begin engag-
ing in a way that was nonthreatening. Verbally discussing problem-free
issues did not seem helpful; the client’s responses were restricted to one-
or two-word responses. Finally, I (MMG) asked if the client would be
willing to share her social networking Web page where she had publicly
compiled her thoughts and pictures. She agreed and as she viewed the pic-
tures on the computer, the adolescent opened up about what each photo
meant, why she took the picture, and who was in the pictures. This tech-
nique allowed me (MMG) to build rapport with the client, engage her in
problem-free talk, and identify the utility of phototherapy as a potential
Assessment and Diagnosis
Following or concurrent with building rapport is the stage where counselors
assess the client’s presenting symptoms and underlying and presenting prob-
lems and provide a diagnosis typically using the Diagnostic and Statistical
Manual of Mental Disorders (American Psychiatric Association [APA], 2000;
Cormier & Hackney, 1993; Ivey et al., 2009). This process is typically
accomplished through clients’ verbal responses to open-ended and closed
questions, clients’ written reports through surveys or measures, clinical
observation, and third-party reports.
Although phototherapy should not replace these methods, it can be used
as a tool in concordance with traditional strategies. Using the images the
client selects as significant, the counselor can explore the client’s cultural
influences, values, beliefs, and spirituality by reviewing the content and dis-
cussing its importance for the client (Goessling & Doyle, 2009; Hays, Forman,
& Sikes, 2009). The symbols used may provide insight into the psyche, help-
ing the counselor identify the client’s overt and hidden meanings (Fryrear
& Corbit, 1992; Hayes, 2002; Loewenthal, 2009; Reynolds et al., 2008). The
images and the client’s explanation of the images can also reveal thought
perceptions and distortions, which are important to target in therapy (Hays
et al., 2009).
Content should be reviewed: Are the images abstract, recognizable,
varied in quantity (alone vs. among others); human, animal, or nature
objects; artistic or creative in nature? Although it is useful to assess the
content specifically for meaning as identified by the counselor, it is more
accurate and reliable to obtain the meaning as identified by the client to
understand the image’s construction, thought, feeling, and behavioral signif-
icance. The image itself can capture the client’s inner world, perceptions,
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
318 M. M. Ginicola et al.
and contextual experiences, which are key to assessment, diagnosis, and
the formulation of treatment goals (Hays et al., 2009). Therefore, review-
ing the perspective (level vs. tilted), color (black and white vs. color),
focus (narrow vs. wide zooming; sharp vs. blurry), composition (bal-
ance within the image), depth of field (only some content is sharply
focused), and any manipulations to the photo (as seen in digital) can
further illuminate specific symptomatology and change in symptoms. For
example, someone who is depressed is likely to have black-and-white
images with blurry or unfocused and constricted content (Hanieh & Walker,
I (MMG) saw a client who presented with depressive symptoms and sui-
cidality. Through formal assessment, I (MMG) diagnosed her with major
depressive disorder. After I (MMG) suggested she take pictures of things
that appealed to her or spoke to her emotions, she captured and shared
several photos. Her photos seemed congruent with her depression diag-
nosis; they were all taken in black-and-white and from a tilted viewpoint,
indicating a disruption in typical mood functioning and cognitive perspec-
tive. However, several photographs had themes of abuse or trauma; the
content included broken objects, strangled dolls, and themes of loss of inno-
cence. Because this was early in the counseling relationship, I (MMG) did
not press the client when she only vaguely described the depictions and
did not reveal any history of trauma. After a few weeks of treatment and
reviewing photos, the client finally opened up about a recent rape that
had preceded her suicidal attempt. In this case, although I did not deem
the photographic analysis to be sufficient as a lone assessment strategy,
it prompted me (MMG) to be vigilant for trauma symptoms. Later clini-
cal assessment revealed that the client had comorbid posttraumatic stress
Intervention and Treatment
Thousands of specific therapeutic interventions and treatment strategies con-
nect to varied theoretical orientations. The purpose of this article is to
match phototherapy directives with counseling techniques to illustrate the
efficacy of phototherapy within counseling. We will only be using those
counseling techniques recommended by Erford, Eaves, Bryant, and Young
(2009). For the purposes of this article, these treatment strategies are sep-
arated into interventions focused on a) emotions, b) cognitions, c) social
relationships, d) behavior, e) solutions, and f) existential meaning and/or
spiritual significance.
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
Counseling Through Images 319
Support and nonjudgmental exploration of feelings have been considered
an important component of effective therapy (Rogers, 1957). Reflecting and
exploring clients’ emotional experiences and presentations often are at the
core of many therapeutic interventions. With these techniques, it is impor-
tant to identify how clients display different emotions, what they understand
about their emotional states, how they constrict or exaggerate emotion, and
how they connect them to their external realities.
Photographs, because of their ability to communicate emotion, are ideal tools
for this type of therapeutic goal. Specific photo activities may be to take
pictures of symbols that represent the client’s emotions or to find existing
photos of the client in varied emotional states (Ginicola, Smith, & Trzaska,
2012; Hanieh & Walker, 2007). In addition, the counselor could suggest that
the client take a self-portrait photo in an emotional state or capture an exter-
nal event that evokes specific emotions for the client, such as sadness or
anxiety (Ginicola et al., 2012; Hanieh & Walker, 2007). The counselor may
follow up these interventions with assisting clients to explore the emotion,
meaning, and expression of the emotions as clients see them within the
images. The counselor can look for specific themes of pain, trauma, or heal-
ing, which may be useful to explore. Additionally, the counselor may guide
clients to an understanding of the connection between external experiences,
their internal emotional experiences, and their internal cognitions.
In a treatment group composed of adult clients with comorbid mental illness
and substance abuse, I (JT) provided instructions for all clients to take a
black-and-white self-portrait, which they graphically altered into an outline
using a computer program. They then printed out nine of these outlines and
colored each a different color according to mood. The clients selected their
colors and identified to the group why they chose certain colors to reflect
certain moods. This strategy led to a group discussion and processing of the
impact of emotion on their ability to stay sober, including which emotions
were the hardest for them to process on their own.
The exploration of thoughts and their connection to feelings and behav-
iors have been a prominent component of therapy and counseling strategies
(Beck, 1997). Although many techniques deal with changing client’s thought
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
320 M. M. Ginicola et al.
patterns and distorted thinking, some of the most common address cognitive
self-talk (Seligman, 2001), reframing (Watzlawick, Weakland, & Fisch, 1974),
and restructuring (Doyle, 1998). All of these techniques allow for the dis-
covery, interpretation, and reinterpretation of thoughts and meaning that are
negative and/or harmful to the client.
Photographs can be helpful in assisting the client to examine and ana-
lyze content, memories, and experiences (Goodhart et al., 2006; Hanieh &
Walker, 2007; Krauss & Fryrear, 1983; Star & Cox, 2008). Within phototherapy,
techniques that center on cognitions typically involve the client telling nar-
ratives about the images or using the image as a metaphor (Pillay, 2009).
Counselors may use memory books (Pillay, 2009) in the same manner as
the cognitive strategy of mutual storytelling to assist clients in developing
new, more adaptive narratives to replace negative and distorted narratives
(Gardner, 1986). Counselors may also use self-portraits or images that repre-
sent the self as effective ways to confront negative self-images or cognitive
distortions (Glover-Graf, 2000; Glover-Graf & Miller, 2006; Hunsberger, 1984;
Pillay, 2009; Reynolds et al., 2008; Star & Cox, 2008). The key to using these
tools in a successful manner is allowing for self-confrontation (Henry, 1984)
and assisting clients in the confrontation of incongruence between their per-
ception and reality (Zwick, 1978). Additionally, investigating the themes,
conflicts, and contradictions in the images can assist clients in exploring
conflicting feelings and thoughts (Schudson, 1975).
In a case of an adult female client struggling with familial conflict, the client
revealed a history of parental abuse and neglect. However, the client had a
distorted view of her family; she saw herself to blame for the abuse and felt
guilt for her inability to fix her family’s issues. The counselor (MMG) asked
the client to explore family photographs as a way to identify specific issues
the family faced throughout time. Because the client had often compared
her fiancé’s family to her own, I (MMG) asked if she, with the permission of
her partner, felt comfortable bringing in one of their photo albums as well.
As the counselor (MMG) and client reviewed the photographs, the client was
able to identify specific times in her life when the abuse occurred, starting
with her first memory at 3 years of age. Exploring these events, the counselor
(MMG) was able to assist the client in identifying that this abuse could not
possibly be her fault. The client was able to objectively see herself as a child
who should have never been physically harmed. Additionally, in comparing
her photo album with her fiancé’s photo album, she commented on how
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
Counseling Through Images 321
much happier his family seemed with each other. The counselor (MMG)
asked her to make a list of the positive attributes she identified in each set of
parents; after finding numerous positive attributes in her fiancé’s family, she
identified very few in her own. When asked by the counselor (MMG) how
the lack of those attributes could possibly be her fault, she sat in the session,
looking shocked. For the first time, she was able to truly confront the abusive
family system and her lack of control, as a child, to influence her parents.
The client was then able to move on to healing from the abuse, ultimately
forgiving her parents and reidentifying her role in her family as an adult.
Many counseling strategies focus on the clients’ interactions with others
within their social environment. Whether it is to facilitate a greater degree
of socialization in pursuit of a stronger support network, improve commu-
nication skills, or help clients understand the perspective of those close to
them, counselors have a variety of techniques to choose from to assist their
clients. Among these techniques are helping clients to own their thoughts
and feelings in communication with others by using I-messages (Gordon,
1974). Counselors may also help clients explore the perspectives of others
by using techniques such as empty chair, role reversal, and role-play (Coker,
In phototherapy, the exploration, awareness, and sensitivity to emotional
issues helps build a vocabulary as well as perspective (Schudson, 1975;
Weiser, 1988). As the counselor assists the client in viewing the photograph
from several perspectives, the client uses the image to build an awareness of
how others may view the same issue (Schudson, 1975; Weiser, 1988). In addi-
tion, photography has been used to understand and explore both positive
and negative familial, romantic, and social relationships (Goessling & Doyle,
2009; Hays et al., 2009; Krauss & Fryrear, 1983; Loewenthal, 2009; Reynolds
et al., 2008; Star & Cox, 2008; Weiser, 2004; Wessells, 1985).
I (MMG) used this strategy with a female adolescent client who was expe-
riencing family mental illness and conflict. The client took a picture of a
weathered tree in black-and-white. She identified that the tree had been
through a major storm, and many of the branches were broken. With
prompting, she identified the tree as her family: The branches at the top
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
322 M. M. Ginicola et al.
were her parents, she was in the middle, and her younger siblings were at
the bottom of the tree. I (MMG) asked her to take the perspective of each
of the branches. What did they see about themselves? What did they see
about the middle branch? She described the top branches of the tree as the
ones hit most by the storm and said they were worried about the bottom
branches the most because of their fragility. The bottom branches, she said,
were scared by the storm so they were hanging on as hard as they could.
When asked how they both saw her, as the middle branch, she paused in
thought. She then described that everyone probably thought she was fine
because she hid all her fear and resentment; she thought that as the middle
branch, she needed to stay strong to hold the tree together. I (MMG) was
then able to explore with the client why her family members did not think
she needed help and how to communicate to them otherwise.
In the case of a client needing assistance in developing a new skill or replac-
ing a negative behavior, the counselor may guide the client by targeting the
problem behaviors, brainstorming appropriate replacement behaviors with
the client, and using behavioral techniques to increase or decrease behav-
iors as needed. Common counseling techniques include modeling (Bandura,
1971) and behavioral rehearsal (Thorpe & Olsen, 1997). An additional strat-
egy is to understand the function of the behavior to provide replacement
behaviors. Counselors may support the client in evaluating the behav-
ior, or they may use the technique of “spitting in the soup” (Ansbacher
& Ansbacher, 1956); both ways highlight the fact that negative behav-
ior may have some positive function that keeps it from being completely
extinguished. Behavioral training, such as teaching deep breathing and pro-
gressive muscle relaxation through guided imagery, can decrease anxiety
and be useful as a coping skill (Giordano, Everly, & Dusek, 1990; Jacobsen,
1987; Schoettle, 1980).
The counselor can use photographs to supplement these traditional thera-
pies when exploring behavior (Rhodes & Hergenrather, 2007). Clients could
take images of problem or replacement behaviors, as well as obstacles to
behavioral change. If the counselor is using deep breathing or progres-
sive relaxation, images could either be literal representations of behavioral
steps, metaphorical representations of relaxation, or simply images of their
“safe space.” Using photography may in itself represent mastery of a skill,
which functions as a replacement behavior, a coping skill, and evidence of
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
Counseling Through Images 323
While working with a male client with high-functioning autism, I (MMG)
created pictures with the client performing behaviors that would lead to
rewards, per his behavior plan, as well as breathing strategies to self soothe.
All steps to complete a certain behavior were captured and reviewed with
the client. This was found to be a useful strategy, as he used the pictures in
school and in his residential setting, where staff members were able to refer
him to the picture rather than just verbalize their expectations. As a result, his
behavior problems decreased and the strategy was identified as efficacious
for this client.
In counseling settings that require brief interventions, solution-focused ther-
apy has been utilized with several effective strategies. Counselors may ask
clients to quantify their problem with scaling (De Jong & Miller, 1995), con-
sider and analyze exception circumstances (i.e., when their problem does
not occur; Presbury, Echterling, & McKee, 2002), answer the miracle ques-
tion (i.e., what would it look like if your problem was suddenly gone?; de
Shazer, 1988), and “act as if” their problem was no longer there (Carlson,
Watts, & Maniacci, 2005). All of these techniques allow the client to visualize
the goal and to identify concrete steps to reach the goal.
Although empirical research has not identified specific photographic direc-
tives, it is easy to identify how phototherapy could supplement these
traditional therapeutic techniques. Clients could take or find images of dif-
ferent levels of the problem, reflecting the scaling technique. For example, if
the client was assessing his or her mood, several pictures could be taken in
various mood sequences, from completely depressed to feeling ecstatic. This
technique could be particularly helpful for children or those with cognitive
limitations to choose a visual image to reflect their problem or emotional
state. Second, clients may find or create self-images that reflect the absence
of the problem. By analyzing these images with the client, the counselor can
assist the client in arriving at possible solutions to the problem.
In a weekly treatment group of children with identified problem behaviors,
I (JT) targeted a lack of self-esteem and a perceived connection to a special
adult as potential contributors. Rather than explore lack of self-esteem and
relationships, the children were directed to identify something meaningful,
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
324 M. M. Ginicola et al.
special, and positive about themselves. After each child identified something,
they helped each other take pictures symbolizing what was special (i.e., the
attribute, characteristic, or ability). Then, each child was asked to identify
a special adult within their life to whom they felt closest. Solution-focused
treatment was used at this point as well to help the children explore current
realities (if there was an adult that cared about them) and to create a plan
of how to find an adult that could provide that relationship. After each child
had identified either a current or potential adult, they created one photo to
give as a gift to their identified adult.
The importance of exploring client meaning and spirituality has been high-
lighted throughout the counseling literature (Cashwell & Young, 2005; Ivey
et al., 2009). Exploring themes of resiliency, strength, creativity, expression,
hope, and purpose can assist clients in developing higher meaning for their
struggle and presenting problems. Achieving this can help clients signifi-
cantly in the perception and reality of expressed control over their symptoms
and their eventual resolution.
Phototherapy can be instrumental in this regard. Using photography for
any purpose allows for creativity, expression, and communication. Finding
a message and using photography to express one’s voice can be incredi-
bly powerful and therapeutic (Rhodes & Hergenrather, 2007; Wang, 1999).
Photographs are evidence of a personal record and struggle, which can
highlight themes of survival, strength, and resistance (Reynolds et al., 2008;
Rhodes & Hergenrather, 2007). Finally, using photography as a coping mech-
anism can lead to feelings of pride, mastery, and accomplishment (Krauss &
Fryrear, 1983; Schudson, 1975).
For me (MMG), working with a terminally ill senior male client seemed
very difficult at the onset. The client did not want to discuss his cancer,
nor did he wish to discuss his family. I (MMG) found that a traditional life
review might not be possible. When exploring photographs with the client,
however, I (MMG) realized that the client was more willing to talk about
his experiences. Together, we then created an album of the pictures that
represented the most important times of his life and those of which he was
most proud. After putting the pictures together, I (MMG) assisted the client
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
Counseling Through Images 325
in telling the story of each picture, with the ultimate goal of giving copies of
the picture book to all of his grandchildren and great grandchildren.
At the conclusion of counseling, appropriate termination techniques are uti-
lized to assist clients in transitioning back into their life without the support
of the counselor (Ivey et al., 2009). Summarizing and reflecting on the expe-
rience of counseling are important during this stage. A technique known as
“flagging the minefield” also requires the counselor and client to explore
potential problems that may arise and make a plan for future solutions to
prevent a reoccurrence of symptoms or the occurrence of a crisis (Sklare,
Reflecting on the images used within counseling and the developmental
differences in the images from the beginning to the end of counseling can
be helpful in this regard. Images reflect concrete proof and documentation
of change, which are crucial to reflect upon during this stage (Krauss &
Fryrear, 1983). The client could review the pictures individually or create a
memory book with the images. The creation of this book could be part of
the counseling session, and the therapist could guide the client in reflections
during the creative process of making the book. Because phototherapy has
been associated with feelings of empowerment and achievement, this proof
of change may help clients leave counseling with positive feelings about their
experience (Goessling & Doyle, 2009; Goodhart et al., 2006; Krauss & Fryrear,
1983; Reynolds et al., 2008). In addition, counselors who use phototherapy as
a primary or supplemental tool in their practice report that they experience
both professional and personal significance with this effective, enjoyable,
and powerful tool (Young, 2010).
I (MMG) found that the use of a memory book with my client was one of
the most meaningful experiences I had with phototherapy. My (MMG) client
compiled pictures from the beginning of our counseling sessions to the end
and highlighted the realizations she had made about herself along the way.
She began the book with a picture of herself looking down, forlorn, and
depressed. She finished the book with a letter to me (MMG) detailing her
journey, thanking me for my role, and speaking of how far she had come.
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
326 M. M. Ginicola et al.
The final picture in the book was a self-portrait of the client looking at the
camera, smiling with the integrity and pride that was missing in her first
photo. The client left a copy of the book with me (MMG); not only did
the memory book remind the client of how far she had come, it is a daily
reminder to me of the benefits of phototherapy.
Photography can be utilized as a supplemental or direct counseling strat-
egy. Although the empirical research is limited, its utility can be seen when
identifying the link between treatment goals, traditional interventions, and
phototherapy instructions. As illustrated in Table 1, the counselor should
focus first on the goals relevant to the counseling stage. These goals link
to traditional strategies, which are not abandoned but rather are expanded
with the assistance of images. The counselor may consider how an image
could assist a particular client with a specific treatment goal. If an image is
seen as useful to treatment, the counselor can either choose from the sug-
gestions described in the table or create personalized directions based upon
the needs and qualities of the particular client and presenting problems. The
client’s selection and creation of images, coupled with the counselor’s ability
to assist the client in reflection and empowerment to change is a powerful,
efficacious, and healing partnership. This intervention and alliance is cap-
tured in images, so that clients can reflect on their experience long after
counseling had been completed. A quote by Aaron Siskind, perhaps, says it
best: “Photography is a way of feeling, of touching, of loving. What you have
caught on film is captured forever . . . it remembers little things, long after
you have forgotten everything” ( Quotations, 2011, para. 1).
American Psychiatric Association. (2000). Diagnostic and statistical manual of
mental disorders (4th ed., text rev.). Washington, DC: Author.
Ansbacher, H. L., & Ansbacher, R. R. (1956). The individual psychology of Alfred
Adler: A systematic presentation in selections from his writing.NewYork,NY:
Basic Books.
Bandura, A. (1971). Psychological modeling: Conflicting theories. Chicago, IL: Aldine-
Beck, A. (1997). The past and the future of cognitive therapy. Journal of
Psychotherapy Practice and Research,6(4), 276–284.
Buchalter, S. I. (2009). Art therapy techniques and applications: A model for practice.
London, UK: Jessica Kingsley.
Carlson, J., Watts, R. E., & Maniacci, M. (2005). Adlerian theory and practice.
Washington, DC: American Psychological Association.
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
Counseling Through Images 327
Cashwell, C. S., & Young, J. (2005). Integrating spirituality and religion in
counseling: A guide to competent practice. Alexandria, VA: American Counseling
Coker, J. K. (2004). Using Gestalt counseling in a school setting. In B. T. Erford (Ed.),
Professional school counseling: A handbook of theories, programs, and practices
(pp. 123–130). Austin, TX: Pro-ed.
Cormier, L. S., & Hackney, H. (1993). The professional counselor: A process guide to
helping (2nd ed.). Englewood Cliffs, NJ: Prentice-Hall.
Craig, C. (2009). Exploring the self through photography: Activities for use in group
work. London, UK: Jessica Kingsley Publishers.
De Jong, P., & Miller, S. D. (1995). How to interview for client strengths. Social Work,
40, 729–736.
de Shazer, S. (1988). Clues: Investigating solutions in brief therapy.NewYork,NY:
W. W. Norton.
Doyle, R. E. (1998). Essential skills and strategies in the helping process (2nd ed.).
Pacific Grove, CA: Brooks/Cole.
Erford, B., Eaves, S. T., Bryant, E., & Young, K. A. (2009). Thirty-five techniques every
counselor should know.NewYork,NY:PrenticeHall.
Fryrear, J. L., & Corbit, I. E. (1992). Photo art therapy: A Jungian perspective.
Springfield, IL: Charles C. Thomas.
Gardner, R. A. (1986). The psychotherapeutic techniques of Richard A. Gardner.
Cresskill, NJ: Creative Therapeutics.
George, E., Iveson, C., & Ratner, H. (1990). Problem to solution. London, UK: BT
Ginicola, M., Smith, C., & Trzaska, J. (2012). Using photography in counseling:
Images of healing. The International Journal of the Image, 2(2), 29–44.
Giordano, D. A., Everly, G. S., & Dusek, D. E. (1990). Controlling stress and tension:
A holistic approach (3rd ed.). Englewood Cliffs, NJ: Prentice Hall.
Glover-Graf, N. M. (2000). Student-produced photography: A constructivist approach
to teaching psychosocial aspects of disability. Rehabilitation Education,14(3),
Glover-Graf, N. M., & Miller, E. (2006). The use of phototherapy in group treatment
for persons who are chemically dependent. Rehabilitation Counseling Bulletin,
49(3), 166–181. doi:10.1177/00343552060490030401
Goessling, K., & Doyle, C. (2009). Thru the lenz: Participatory action research, pho-
tography, and creative process in an urban high school. Journal of Creativity in
Mental Health,4(4), 343–365. doi:10.1080/15401380903375979
Goodhart, F., Hsu, J., Baek, J. H., Coleman, A. L., Maresca, F. M., & Miller, M. B.
(2006). View through a different lens: Photovoice as a tool for student advo-
cacy. Journal of American College Health,55(1), 53–56. doi:10.3200/JACH.55.1.
Gordon, T. (1974). T.E.T., Teacher effectiveness training. New York, NY: Peter H.
Wyden Inc.
Graf, N. M. (2002). Photography as a therapeutic tool for substance abuse clients
who have a history of sexual abuse. Counselling & Psychotherapy Research,
2(3), 201–207. doi:10.1080/14733140212331384835
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
328 M. M. Ginicola et al.
Hanieh, E., & Walker, B. M. (2007). Photography as a measure of constricted constru-
ing: The experience of depression through a camera. Journal of Constructivist
Psychology,20(2), 183–200. doi:10.1080/10720530601074739
Hayes, D. (2002). Photography: Snapshots out of the unconscious. Psychodynamic
Practice: Individuals, Groups and Organisations,8(4), 525–532.
Hays, D. G., Forman, J., & Sikes, A. (2009). Using artwork and photography to
explore adolescent females’ perceptions of dating relationships. Journal of
Creativity in Mental Health,4(4), 295–307. doi:10.1080/15401380903385960
Henry, W. P. (1984). Phototherapy: Exposed but underdeveloped. PsycCRITIQUES,
29(9), 714. doi:10.1037/023179
Hubbard, J. T., Romero, D. H., & Thomas, S. B. (1987). A guide to photography
in educational and counseling settings. Perspectives in Psychiatric Care,24(1),
Hunsberger, P. (1984). Uses of instant-print photography in psychother-
apy. Professional Psychology: Research and Practice,15 (6), 884–890.
Ivey, A. E., Ivey, M. B., & Zalaquett, C. P. (2009). Intentional interviewing and
counseling: Facilitating client development in a multicultural society (7th ed.).
Belmont, CA: Thomson Brooks/Cole Publishing Co.
Jacobsen, E. (1987). Progressive relaxation. American Journal of Psychology,100,
Junge, M. B., & Levick, M. F. (2010). The modern history of art therapy in the United
States. Springfield, IL: Charles C. Thomas.
Krauss, D. A., & Fryrear, J. (1983). Phototherapy in mental health. Springfield, IL:
Charles C. Thomas.
Loewenthal, D. (2009). Can photographs help one find one’s voice? The use of
photographs in the psychological therapies. European Journal of Psychotherapy
and Counselling,11(1), 1–6. doi:10.1080/13642530902745804
McNiff, S. (2004). Art heals: How creativity cures the soul. Boston, MA: Random
Pillay, Y. (2009). The use of digital narratives to enhance counseling
and psychotherapy. Journal of Creativity in Mental Health,4(1), 32–41.
Presbury, J. H., Echterling, L. G., & McKee, J. E. (2002). Ideas and tools for brief
counseling. Upper Saddle River, NJ: Pearson Education.
Rampton, T. B., Rosemann, J. L., Latta, A. L., Mandleco, B. L., Roper, S., & Dyches,
T. T. (2007). Images of life: Siblings of children with Down syndrome. Journal
of Family Nursing,13(4), 420–442. doi:10.1177/1074840707308580
Reynolds, F., Lim, K., & Prior, S. (2008). Images of resistance: A qualitative enquiry
into the meanings of personal artwork for women living with cancer. Creativity
Research Journal,20(2), 211–220. doi:10.1080/10400410802060059
Rhodes, S. D., & Hergenrather, K. C. (2007). Recently arrived immigrant Latino men
identify community approaches to promote HIV prevention. American Journal
of Public Health,97(6), 984–985. doi:10.2105/AJPH.2006.107474
Rogers, C. (1957). The necessary and sufficient conditions of therapeutic personality
change. Journal of Consulting Psychology,21(2), 95–103.
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
Counseling Through Images 329
Schoettle, U. C. (1980). Guided imagery: A tool in child psychotherapy. American
Journal of Psychotherapy,34, 220–227.
Schudson, K. R. (1975). The simple camera in school counseling. Personnel &
Guidance Journal,54(4), 225–226.
Seligman, L. (2001). Systems, strategies and skills of counseling and psychotherapy.
Upper Saddle River, NJ: Merrill Prentice Hall.
Sklare, G. B. (2005). Brief counseling that works: A solution-focused approach for
school counselors (2nd ed.). Thousand Oaks, CA: Corwin Press.
Star, K. L., & Cox, J. A. (2008). The use of phototherapy in couples and
family counseling. Journal of Creativity in Mental Health,3(4), 373–382.
Stevens, R., & Spears, E. H. (2009). Incorporating photography as a therapeutic tool
in counseling. Journal of Creativity in Mental Health,4(1), 3–16.
Stewart, D. (1979). Photo therapy: Theory & practice. Art Psychotherapy,6(1), 41–46.
Studley, J. (2006). Rehabilitation through photography: Therapy through the
lens. Photo Reporter, 14. Retrieved from
asp?vol=14&num=15 Quotations. (2011, July). Aaron Siskind quotes.
Quotations Online. Retrieved from
Thorpe, G. L., & Olsen, S. L. (1997). Behavior therapy: Concepts, procedures and
applications (2nd ed.). Boston, MA: Allyn & Bacon.
Wang, C. (1999). Photovoice: A participatory action research strategy applied to
women’s health. JournalofWomensHealth,8, 185–192.
Watzlawick, P., Weakland, J., & Fisch, R. (1974). Change: Principles of problem
formation and problem resolution. New York, NY: W. W. Norton & Company.
Weiser, J. (1988). ‘See what I mean?’: Photography as nonverbal communication
in cross-cultural psychology. In F. Poyatos (Ed.), Cross-cultural perspectives
in nonverbal communication (pp. 245–290). Ashland, OH: Hogrefe & Huber
Weiser, J. (2004). Phototherapy techniques in counselling and therapy—Using ordi-
nary snapshots and photo-interactions to help clients heal their lives. Canadian
Art Therapy Association Journal,17(2), 23–53.
Wessells, D. T. (1985). Using family photographs in the treatment of eating disorders.
Psychotherapy in Private Practice,3(4), 95–105. doi:10.1300/J294v03n04_15
Young, B. (2010). The integrative power of the creative spirit. Psychoanalytic
Inquiry,30(3), 276–283. doi:10.1080/07351690903206249
Zwick, D. S. (1978). Photography as a tool toward increased awareness of the aging
self. Art Psychotherapy,5(3), 135–141. doi:10.1016/0090-9092(78)90003-0
Misty M. Ginicola and Cheri Smith are Associate Professors in the
Department of Counseling and School Psychology at Southern Connecticut
State University, New Haven, Connecticut.
Jessica Trzaska is a Rehabilitation Therapist II with the State of Connecticut
Department of Mental Health, Connecticut.
Downloaded by [Misty M. Ginicola] at 13:18 18 December 2012
... Graphic elicitation or drawing has been found useful in enabling young people with challenges to communicate their thoughts (Coad, 2007). Personal photos and other images are also widely used in therapeutic dialogue and counselling (Ginicola, 2012;Stevens & Spears, 2009;Weiser, 2004). Visual methods such as photovoice and digital storytelling have been found to be beneficial in public health contexts (Gubrium, Hill, & Flicker, 2014;Wang & Burris, 1994). ...
... A new search with the search terms 'school nurse' AND 'health dialogue' resulted in 260 articles, including articles II and I in this study (Laholt et al., 2017;Laholt et al., 2018). The reference list of Ginicola (2012) was used to find articles on how images and other visual tools were used in counselling and therapeutic dialogue (Ginicola, Smith, & Trzaska, 2012;Riley & Manias, 2004;Weiser, 2004). My reading and following useful leads resulted in several articles focusing on visual methods used as a public health strategy (Gubrium et al., 2014;Lambert, 2013;Wang & Burris, 1994). ...
... Such tools can create insight into how people understand illness and how they make sense of their world, especially regarding sensitive issues, emotions and taboos. The use of visualization tools can allow the professional and young person to understand each other beyond the use of words (Ginicola, 2012). Using visualization in dialogue creates a more complete communication process and allows people to communicate meanings and emotions that cannot easily be verbalized. ...
... In addition, images offer up the possibilities of a slippery surface of meanings and potential narratives for the viewer, which are the rich veins that phototherapy explores (R. Martin, 2009). Through the process of art making and creative expression, counsellors can assist in the reduction of a variety of distressing psychological symptoms (Ginicola, Smith, & Trzaska, 2012). ...
... The process of expression through art media and the products created in an art therapy session engage and are perceived predominantly through the tactile-haptic and visual sensory and perceptual channels, and Ageing and Technology | 15 FUSION 2020 2 nd National Symposium on Human-Computer Interaction 2020 USI then are processed for their effect, associations, and meaning through cognitive and verbal channels (Lusebrink, 2004). The image could be a nonthreatening methodology that may permit the users to convey that meaning, struggle, and emotions that cannot simply be spoken (Ginicola et al., 2012). Along with providing a helpful avenue to converse a difficulty and express emotions in an artistic and abstract way, a picture might offer the simplest way to figure around defence mechanisms (Ginicola et al., 2012). ...
... The image could be a nonthreatening methodology that may permit the users to convey that meaning, struggle, and emotions that cannot simply be spoken (Ginicola et al., 2012). Along with providing a helpful avenue to converse a difficulty and express emotions in an artistic and abstract way, a picture might offer the simplest way to figure around defence mechanisms (Ginicola et al., 2012). The image itself can capture the user's inner world perceptions, and contextual experiences. ...
... In addition, images offer up the possibilities of a slippery surface of meanings and potential narratives for the viewer, which are the rich veins that phototherapy explores (R. Martin, 2009). Through the process of art making and creative expression, counsellors can assist in the reduction of a variety of distressing psychological symptoms (Ginicola, Smith, & Trzaska, 2012). ...
... The process of expression through art media and the products created in an art therapy session engage and are perceived predominantly through the tactile-haptic and visual sensory and perceptual channels, and Ageing and Technology | 15 FUSION 2020 2 nd National Symposium on Human-Computer Interaction 2020 USI then are processed for their effect, associations, and meaning through cognitive and verbal channels (Lusebrink, 2004). The image could be a nonthreatening methodology that may permit the users to convey that meaning, struggle, and emotions that cannot simply be spoken (Ginicola et al., 2012). Along with providing a helpful avenue to converse a difficulty and express emotions in an artistic and abstract way, a picture might offer the simplest way to figure around defence mechanisms (Ginicola et al., 2012). ...
... The image could be a nonthreatening methodology that may permit the users to convey that meaning, struggle, and emotions that cannot simply be spoken (Ginicola et al., 2012). Along with providing a helpful avenue to converse a difficulty and express emotions in an artistic and abstract way, a picture might offer the simplest way to figure around defence mechanisms (Ginicola et al., 2012). The image itself can capture the user's inner world perceptions, and contextual experiences. ...
Conference Paper
Full-text available
The purpose of this study is to examine the perceptions of students and educators using mobile learning student-generated activities in robotics technology subjects. Early observations found that students' motivation to study STEM fields including robotics technology is still low. Despite the current robotics technology is using mobile learning student-generated activities in robotics technology, there is limited research that examines the perceptions of students and educators. Therefore, this research was conducted to identify the perceptions of students and educators by using mobile learning student-generated activities in robotics technology. Besides, this study aimed is to examine the usability of the software for robotics technology subject. Therefore, the proposed methods of data collection used in this study are student focus group discussions, teacher interviews, and heuristic evaluation.
... Photo therapy mampu membantu proses konseling bagi orang yang membutuhkan kesembuhan (Ginicola et al., 2012a;Ginicola et al., 2012b). Photo therapy membantu konseli dengan perilaku self-injuring (Briggs, 2013). ...
Full-text available
Studi didasarkan pada pentingnya keterampilan konseling guru Bimbingan dan Konseling di masa COVID-19. Tujuan penelitian adalah memaparkan hasil studi empirik mengenai keefektifan pelatihan insight photo therapy untuk meningkatkan keterampilan konseling Guru Bimbingan dan Konseling (BK) di masa pandemi COVID-19. Penelitian ini menggunakan metode eksperimen single-group pretest-posttest design melalui analisis paired samples t-test. Hasil pengujian hipotesis dari masing-masing aspek keterampilan konseling diketahui nilai sig. (2-tailed) sebesar 0,000 < 0,05, artinya ada perbedaan mean pretest dan posttest keterampilan konseling melalui insight photo therapy. Hal ini bermakna bahwa pelatihan insight photo therapy efektif secara signifikan dalam meningkatkan keterampilan konseling Guru Bimbingan dan Konseling.
... Phototherapy (not to be confused with the physical treatment involving exposure to light) is used in counselling to enhance the therapy process by using photos by, or of, the patient as a way to evoke memories and feelings [12]. Reflecting upon photographs can also be a method to recognise and document development during an intervention [13]. In these approaches, photos are used as artefacts that can enhance the counselling process, performed by an expert. ...
Momentary photography is enjoyed by many smartphone users, especially with the popularity of apps such as Snapchat and Instagram. Many traditional positive psychology interventions focus on lengthy writing tasks to express positive emotions experienced during past events, acts of kindness and gratuitous situations. In this work we developed SnapAppy, a smartphone application to integrate momentary photography with traditional intervention methodologies to conduct a month-long positive psychology intervention to improve emotional well-being. A study involving 74 participants aimed to assess whether photo-taking, photo viewing and image contents are correlated with improvements in certain aspects of the participant’s emotional well-being including their mood, affect and satisfaction with life. The results indicated that features including the number of photos, the variety of categories, the effort applied to annotating photos, the number of photos revisited and photos taken of people were positively correlated with an improvement in the participant’s mood and positive and negative affect (PANAS).
... This is a testament to one of the most influential tenets of metaphor theory over the past decades -that metaphors help us talk and think about the abstract in terms of the experientially concrete (Lakoff, 1993). This single observation has underpinned a wide range of metaphor studies in mental healthcare, across diverse mental conditions, therapy paradigms, contexts, and even non-verbal mental healthcare resources like art, film, photography, and dance (Ginicola et al., 2012;Samaritter, 2009;Sharp et al., 2002). ...
... For example, photos have been used to promote empowerment in marginalized populations, to assist clients in expressing their emotions, to process mental health concerns and trauma, and to promote self-identity (Quaglietti, 2018;Teti et al., 2017). This nonverbal technique not only aids the client in their own understanding, but also provides the counselor with a window into the client's perspective, which informs treatment planning (Ginicola et al., 2012). Photovoice is another extension of the similar use of photography in a therapeutic setting. ...
The loss of a loved one to suicide is a devastating event that results in a complicated grief experience for those survivors left behind. This specific bereavement experience consists of three challenging obstacles: the unanswered question of why, the stigma concerning the manner of death, and the forced isolation of the grievers. These obstacles complicate the ability to make meaning of the loss, which is an important part of the healing process. Therefore, counselors can target meaning-making as an intervention by utilizing photovoice because it can provide survivors with the opportunity to create new meaning and thus work through these obstacles. This article discusses practical applications of a photovoice intervention with a loss by suicide support group and addresses the implications for clinical mental health counselors.
Full-text available
Individuals who experience chronic homelessness are at a greater risk of experiencing social anxiety. Phototherapy helps individuals reduce social anxiety by serving as a barrier between subject/object. This session looks at research and discusses the impact of phototherapy on social anxiety with people who are chronically homeless.
In this chapter, the authors describe creative supervision using play therapy and expressive arts modalities that offer a need driven alternative to the traditional supervisor-driven stage models of supervision. Play therapy and expressive arts supervision strategies are effective at increasing supervisee's awareness of self and others, supporting “out-of-the-box” thinking, opening supervisees' to their own strengths and intuition, and enhancing the supervisory relationship. In an attempt to illustrate the rationale and benefits of using play therapy strategies and expressive arts techniques in supervision, descriptions of various techniques are presented with examples, followed by a discussion on ethical and cultural considerations.
Hope is critical for mental health recovery. The study evaluated a program using photography and writing to explore hope in recovery and analyzed psycho-social-spiritual themes related to hope. Veterans (n = 89) from multiple war periods completed a 4-week photography workshop. Hope photo book narratives were created using 10 photographs that were paired with 10 hope words used in a descriptive sentence. Questionnaire mean differences for class efficacy and hope status were statistically significant using paired samples t-test. Of 890 hope words categorized by thesaurus definition, 5 multidimensional themes emerged. Love, support, strength, future, and focus were the most chosen words within each theme. Creating a hope photo book narrative can help build hope and improve hope during recovery.
Full-text available
PhotoTherapy Techniques use therapy clients' own personal snapshots and family photos (and the feelings, memories, thoughts and information these evoke) as catalysts for therapeutic communication and healing. This article discusses this flexible system of interactive techniques and demonstrates how they can be used by any kind of trained Therapist regardless of conceptual orientation, professional affiliation, preferred intervention model or approach (or degree of prior familiarity with photography itself), as well as how these techniques can be of particular benefit in Arts Therapies practices. After a brief review of theoretical underpinnings, comparisons of similarities and differences with Art Therapy (and Therapeutic Photography), and an introduction to the techniques in general, each of the five major PhotoTherapy techniques is presented and illustrated with anecdotal examples from the author's professional practice as an Art Therapist, Psychologist and Trainer of these techniques.
The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.
Book reviewed in this article: Craig S. Cashwell and J. Scott Young, Eds. (2005). Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice.
This study used photography as a therapeutic tool and a present-focused approach in a 12-week group intervention to treat adults with chemical dependence enrolled in an outpatient treatment program. A qualitative analysis identified themes related to the topics of trust, honesty, self-worth, power, and abuse. Self-esteem, abuse, and trauma-related symptoms were also assessed using the Multidimensional Self-Esteem Inventory (MSEI), the Trauma Symptom Inventory (TSI), and an abuse questionnaire. Pre- and posttests on the MSEI showed increases in self-esteem for all but one participant. The majority of participants also reported trauma-related symptoms, and all participants reported past abuse victimization.