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Running Head: REFLECTION CARDS FOR OPENING CIRCLE
1
REFLECTION CARDS AS AN OPENING CIRCLE ACTIVITY
Dianne B. Shannon
A Thesis
In
Art Therapy
Presented in Partial Fulfillment of the Requirements
for the Diploma of Art Therapy at the Kutenai Art Therapy Institute Nelson, B.C., Canada
April, 2013
©Dianne B. Shannon, 2013
REFLECTION CARDS FOR OPENING CIRCLE
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APPROVAL SHEET
Name: Dianne B. Shannon
Degree: D.K.A.T.I.
Title of Thesis: Reflection Cards as an Opening Circle Activity
A THESIS SUBMITTED IN PARTIAL FULFILMENT
OF THE REQUIREMENTS
FOR THE
DIPLOMA KUTENAI ART THERAPY INSTITUTE.
D.K.A.T.I.
Approved by:
_________________________________________________
Monica Carpendale B.F.A., D.V.A.T.I., R.C.A.T., B.C.A.T.R.
Executive Director of the Kutenai Art Therapy Institute
_________________________________________
Nicole LeBihan, B.A., D.K.A.T.I., R.C.A.T.
Thesis Supervisor
__________________________
Date Approved
REFLECTION CARDS FOR OPENING CIRCLE
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ABSTRACT
This research explores the use of reflection cards that the researcher created to help
support the therapeutic goals of the special education program for adults who have
developmental disabilities and who attended weekly group art therapy sessions. The research
approach follows the cycle of first-person action research. This approach is a qualitative
methodology through which the researcher sought change by introducing actions in response to
behaviour and communication concerns that arose during the opening circle activity. The
research follows the use of the reflection cards as an opening circle activity over the period of
eight months. The data gathered consists of the researcher’s observations of the group, as well as
feedback from the group participants, the co-facilitator, and from supervision. The researcher
gained important insights about her therapeutic approach and, in particular, her sense of efficacy
leading a group art therapy session for adults with developmental disabilities. The research will
also inform next steps regarding the future design and use of the reflection cards as a therapeutic
tool.
REFLECTION CARDS FOR OPENING CIRCLE
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ACKNOWLEDGEMENTS
I am forever grateful to the students whose participation in this research brought me closer
to understanding my way of being an art therapist. Thanks also go to Monica Carpendale and
Nicole LeBihan for their insights and support and Millie Neufeld-Cummings who introduced me
to the here-and-now.
REFLECTION CARDS FOR OPENING CIRCLE
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TABLE OF CONTENTS
Approval sheet ........................................................................................................................................................ 2
Abstract ..................................................................................................................................................................... 3
Acknowledgements ............................................................................................................................................... 4
Table of contents ................................................................................................................................................... 5
List of figures ........................................................................................................................................................... 7
List of charts ............................................................................................................................................................ 8
Reflection cards as an opening circle activity for adults with developmental disabilities ........ 9
Chapter 1: Theoretical and contextual foundations .............................................................................. 15
Facilitating communication to support therapeutic goals ..................................................................................... 16
The metaphoric image and emotional vocabulary .................................................................................................... 18
The art therapy group and the facilitator’s role ......................................................................................................... 20
Chapter summary ....................................................................................................................................................................... 23
Chapter 2: Action research methodology .................................................................................................. 24
History of action research ...................................................................................................................................................... 25
The action research cycle ....................................................................................................................................................... 27
First-person action research ................................................................................................................................................. 28
Reflection card research protocol ...................................................................................................................................... 29
Description of the group art therapy sessions .............................................................................................................. 30
The general idea ......................................................................................................................................................................... 31
Action research cycle: Planning .......................................................................................................................................... 32
Action research cycle: Action ................................................................................................................................................ 33
Action research cycle: Fact-finding.................................................................................................................................... 34
Research limitations ................................................................................................................................................................. 34
Ethical considerations .............................................................................................................................................................. 35
Chapter summary ....................................................................................................................................................................... 36
Chapter 3: Research results ............................................................................................................................ 37
Opening circle disruption ....................................................................................................................................................... 37
The general idea ......................................................................................................................................................................... 38
Session 1: Reflection cards are introduced ..................................................................................................................... 38
Planning .......................................................................................................................................................................................... 38
Action ............................................................................................................................................................................................... 39
Fact-finding ................................................................................................................................................................................... 41
Session 4: Hearts and Animals ............................................................................................................................................. 42
Planning .......................................................................................................................................................................................... 42
Action ............................................................................................................................................................................................... 43
Fact-finding ................................................................................................................................................................................... 44
Session 8: Turtle .......................................................................................................................................................................... 45
Planning .......................................................................................................................................................................................... 45
Action ............................................................................................................................................................................................... 45
Fact-finding ................................................................................................................................................................................... 46
Session 11: Dealing the cards ............................................................................................................................................... 46
Planning .......................................................................................................................................................................................... 46
Action ............................................................................................................................................................................................... 47
REFLECTION CARDS FOR OPENING CIRCLE
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Fact-finding ................................................................................................................................................................................... 47
Session 12: Adding back a measure of choice ............................................................................................................... 48
Planning .......................................................................................................................................................................................... 48
Action ............................................................................................................................................................................................... 49
Fact-finding ................................................................................................................................................................................... 49
Sessions 13 and 14: Back to choosing cards .................................................................................................................. 50
Planning .......................................................................................................................................................................................... 50
Action ............................................................................................................................................................................................... 50
Fact-finding ................................................................................................................................................................................... 50
Chapter summary ....................................................................................................................................................................... 51
Chapter 4: Discussion ........................................................................................................................................ 53
Facilitating communication to support therapeutic goals ..................................................................................... 53
Expanding emotional vocabulary with metaphor ...................................................................................................... 56
My way of being an art therapist ........................................................................................................................................ 60
Chapter summary ....................................................................................................................................................................... 68
Conclusion ............................................................................................................................................................. 69
References ............................................................................................................................................................. 72
Appendix I ............................................................................................................................................................. 77
Appendix II ............................................................................................................................................................ 78
REFLECTION CARDS FOR OPENING CIRCLE
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LIST OF FIGURES
Figure 1: Social research foundations of action research .................................................................... 26
Figure 2: Action research cycle ...................................................................................................................... 27
Figure 3: Card 1, ocean waves ........................................................................................................................... 39
Figure 4: Card 2, blue sky and clouds .............................................................................................................. 39
Figure 5: Card 3, sunflower ............................................................................................................................... 39
Figure 6: Card 4, mountain peaks .................................................................................................................... 39
Figure 7: Card 5, frosty trees ............................................................................................................................. 39
Figure 8: Card 6, garden door ........................................................................................................................... 39
Figure 9: Card 7, flames ...................................................................................................................................... 40
Figure 10: Card 8, caterpillar on gravel .......................................................................................................... 40
Figure 11: Card 9, sand dunes .......................................................................................................................... 40
Figure 12: Card 10, peonies ............................................................................................................................... 40
Figure 13: Card 11, tornado .............................................................................................................................. 40
Figure 14: Card 12, rainbow ............................................................................................................................. 40
Figure 15: Card 13, single tree in fog .............................................................................................................. 40
Figure 16: Card 14, lightning ............................................................................................................................ 40
Figure 17: Card 15, rain on window ................................................................................................................ 40
Figure 18: Card 16, cave interior ..................................................................................................................... 40
Figure 19: Card 17, flower heart ...................................................................................................................... 40
Figure 20: Card 18, owl ...................................................................................................................................... 43
Figure 21: Card 19, mouse ................................................................................................................................. 43
Figure 22: Card 20, tiger .................................................................................................................................... 43
Figure 23: Card 21, elephant ............................................................................................................................. 43
Figure 24: Card 22, dog ...................................................................................................................................... 43
Figure 25: Card 23, kitten .................................................................................................................................. 43
Figure 26: Card 24, turtle ................................................................................................................................... 45
REFLECTION CARDS FOR OPENING CIRCLE
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LIST OF TABLES
Session 1: Cards Chosen and Notes .............................................................................................................. 41
Session 4: Cards Chosen and Notes .............................................................................................................. 44
Session 11: Cards Chosen and Notes ............................................................................................................ 48
Participant metaphoric and literal associations of images ................................................................. 52
REFLECTION CARDS FOR OPENING CIRCLE
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REFLECTION CARDS AS AN OPENING CIRCLE ACTIVITY FOR
ADULTS WITH DEVELOPMENTAL DISABILITIES
The art therapy program at the Kutenai Art Therapy Institute has its roots in
psychodynamic theory, as noted in the institute’s website section, What is Art Therapy and
described in detail in Executive Director Monica Carpendale’s Essence and Praxis in the Art
Therapy Studio (2009). Psychodynamic theory describes and explores the psychological
influences on behaviour including the interplay of the conscious and unconscious aspects of the
mind as well as past experiences and our reactions to those experiences (Wikipedia). Another
aspect important to my training and this research is the rhythm of therapeutic sessions that are
also framed around Carpendale’s process that describes how each session and each therapeutic
relationship will “have a beginning, middle, and an ending” (2009a, p. 10). My experience at the
institute was that each group session opened and closed with the participants gathering in a circle
to share experiences or take part in an activity.
During my first weeks as a student at the Kutenai Art Therapy Institute, Carpendale
described practicum opportunities to first-year art therapy interns. She explained how working
with adults with developmental disabilities would teach us important lessons about art therapy
and being art therapists. I was curious what those lessons would be.
An opportunity became available for me to co-facilitate weekly group art therapy sessions
at special education program for adults with developmental disabilities. The term developmental
disability will be used in this research in keeping with the Canadian practice of using the term to
describe the condition of someone who experiences mental or physical impairments in childhood
that last for the duration of their life (British Columbia Ministry of Health, 2007). The students
who attend the special education program receive additional supports for academic, life, and
REFLECTION CARDS FOR OPENING CIRCLE
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social skills. The group art therapy sessions were intended to support the program’s goals for the
students. For example, making choices regarding art materials and the subject matter of the art
are intended to provide opportunities to experience self-sufficiency and independence. The group
sessions also provide opportunities for self-expression that contributes to the development of
social skills and improved self-confidence.
The co-facilitator and I began each session with an opening circle during which
participants, including us, could provide a verbal check-in with how they were doing. I observed
that participant contributions to opening circle varied significantly. Some participants did not
speak more than one or two words while others spoke at length about how they were doing as
well as ongoing concerns that would often be repeated from week to week. I also observed
discomfort among participants when others spoke out of turn or when contentious issues about
relationships with other participants were voiced. People would shift in their chairs, look around
the room or up at the ceiling and sigh, or talk to others at the table during someone else’s turn. I
noticed my discomfort because I wasn’t sure how to facilitate the process in a way that better
supported the group’s therapeutic goals such as social skill development while still encouraging
the expression of emotion.
The incident that initiated this research occurred when a participant was taking their turn
during opening circle and speaking about someone else in the group. The person to whom the
comments were directed slid off her chair and sat under the table. I had difficulty understanding
the pronunciation of the individual whose turn it was to speak so was unable to understand what
was said to the person now under the table. I did have a sense that the person under the table was
very uncomfortable, so I went to her to see if there was something I could do to help. I suggested
REFLECTION CARDS FOR OPENING CIRCLE
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to her that we try something different for opening circle, to which she nodded her head in
agreement.
I wondered how I could increase my capacity to moderate the opening circle discussion
that would encourage openness and the expression of feelings while ensuring a sense of safety
among participants. I considered how reducing the length of time taken by participants for their
turn may diminish the opportunity for issues to be discussed in such detail as to cause discomfort
among other participants, either through personal association to the issue or by trying to meet the
expectation of listening while others took their turn to speak. The incident also raised my
awareness of personal challenges as a developing art therapist. A very apparent challenge was
my need to better understand what some participants were saying due to speech patterns
associated with Down syndrome. Another more complex challenge was my sense that I was not
effectively facilitating the interactions during opening circle in a way that supported the group’s
therapeutic goals such as social skills and the safe expression of emotion.
I decided to find an activity for opening circle that would provide a focus for discussion. It
was my intention to avoid another incident of what I perceived was the cause of hurt feelings
while facilitating my ability to understand what was being said. I also hoped the activity would
reduce the time some participants took for their turn, which was causing discomfort among other
participants. I made a deck of reflection cards using nature images that I hoped would provide
more structure for opening circle, and therefore reduce the discomfort among participants, while
encouraging participation. My initial intention was to provide a concrete object on which
participants’ comments could be focused, which would then reduce the time some individuals
took for their turn. Ultimately, using the reflection cards as an opening circle activity contributed
to my development and way of being an art therapist, which inspired this research that focuses
REFLECTION CARDS FOR OPENING CIRCLE
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on how I used reflection cards as an opening circle activity to help me support the therapeutic
goals of the special education program for adults with developmental disabilities.
The theoretical and contextual foundations for the research are outlined in Chapter 1.
Therapeutic goals for adults with developmental disabilities, in particular the development of
social skills and expression of emotion, provide the context within which to explore
communications issues that impeded the group’s work towards those goals. Caroline Case and
Tessa Dalley, Shirley Riley, Carl Rogers, Carpendale, Robin Tipple, Meyer Williams and the
authors included in Drawing on Difference (1998) and Art Therapy and Learning Disabilities
(2012) help describe how the role of an art therapy group can support the therapeutic goals of
the education program in which the research took place. The opening circle aspect of the weekly
sessions is described in the context of the Kutenai Art Therapy Institute program and the First
Nations’ practice of talking circles that promote respect among participants.
The importance of an emotional vocabulary for people with mental disabilities is explored
through the contributions of Cindy Caprio-Orsini, Lillie Fennell and Enfys Jones, and Suzanne
Conboy-Hill. The role of the reflection cards as a projective technique to encourage
communication as understood by Joel Walker and Judy Weiser contextualizes how the images on
the cards encourage metaphoric language, the importance of which is explained using the
insights of George Lakoff and Mark Johnson, Bruce Moon, Zoltán Kövacses, Rudolph Arnheim,
and Richard Frances Kuhn. Specific associations with the images on the cards are explored
through the understanding of Caroline Case regarding animal imagery.
My conclusions regarding my role as facilitator of the group art therapy sessions are
informed by the insights of Irvin Yalom, Moon, Merle M. Ohlsen, and Rogers regarding group
therapy generally along with the insights of art therapists who have written about their work with
REFLECTION CARDS FOR OPENING CIRCLE
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adults with developmental disabilities, namely Jane Caven, Mair Rees, Kevin O’Farrell, Hilary
Lomas and Penny Hallas, as well as Fennell and Jones.
The second chapter explains the methodology I used to collect the data for my research
when using the reflection cards for eight months as an opening circle activity. The process I
undertook when using the cards falls into a participant-observation approach; more specifically,
first-person action research. This qualitative research approach was used to address personal
concerns regarding my efficacy when leading the opening circle activity. This thesis is written in
the first-person as a reflection of the spirit of first-person action research. Action research is
historically associated with Lucey Sprague Mitchell’s education research during the early 1900s,
the work of John Collier who used action research to address racism and social inequities of First
Nations people in the 1940s as well as the contributions of social psychologist Kurt Lewin who
is known for his research of group dynamics. I also draw from the more recent work in the area
of action research of Peter Reason, Hillary Bradbury, and Danny L. Jorgensen along with the
perspectives of Lynn Kapitan and Andrea Gilroy who speak to the function of action research in
the field of art therapy.
I conclude Chapter 2 with a description of the research protocol I followed using a first-
person action research cycle. It begins with my idea to bring an activity to the group that I hope
will help me better support the therapeutic goals of the special education students. This first step
in the cycle includes my reflections about the presenting issues, designing the reflection cards
and planning the use of the cards. The second step in the cycle is the implementation of the cards
during opening circle. In the third step of the first-person action research cycle, I evaluate the
outcomes of the activity by reflecting on the behaviour and responses of the participants,
REFLECTION CARDS FOR OPENING CIRCLE
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including my own, how I plan to adjust the use of the cards in response to the group’s dynamics.
The limitations of my research are identified at the end of Chapter 2.
The data for my research comprises Chapter 3 and includes vignettes chosen from the
seven sessions in which significant situations related to my research arose out of the use of the
cards, the planning I undertake in response to the situations, the action I take as a result of the
planning, and the results of the fact-finding that inform my next cycle of inquiry. The data is
from the session notes written by myself and the co-facilitator for the eight months the cards
were used including which cards were picked by which participant as indicated in Appendix I.
The data informs the discussion of results in Chapter 4.
Chapter 4 will position the data of my research within the context of the theory outlined in
Chapter 1. In keeping with the tenets of first-person action research that are grounded in the
experience of the researcher to create change, the discussion will include my perceptions of, and
responses to, the group’s dynamics and my perception of my efficacy facilitating the group. My
perceptions of participant interactions is informed by Riley with respect to group art therapy and
Fennell, Jones, and Caprio-Orsini and their experiences of people who have learning disabilities.
I explore my development as an art therapist facilitating a group within the context of theorists
such as Rogers, Yalom, Williams, and Caven whose insights resonated with my experience.
In conclusion, I describe the outcome of my research with respect to how the use of
reflection cards as an opening circle activity helped me support the therapeutic goals of adults
with developmental disabilities. I also reflect on how my use of the cards and the group’s
reaction to them by contributed to increased self-awareness and my way of being an art therapist.
Future research and applications for the reflection cards with other populations are also
considered.
REFLECTION CARDS FOR OPENING CIRCLE
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CHAPTER 1: THEORETICAL AND CONTEXTUAL FOUNDATIONS
This research focuses on the use of reflection cards for an opening circle activity that took
place at the beginning of each art therapy group session with the students of a special education
program. The disabilities experienced by the individuals varied. Some individuals had Down
syndrome, which occurs when there is abnormal foetal cell division in the 21st chromosome
(Mayo Clinic). People with Down syndrome often have a speech pattern that I found difficult to
understand that is related to their physiology and anatomy such as hearing problems, smaller
mouth, larger tongue and weak facial muscles (Stoel-Gammon, 2001). The disabilities of some
participants could also be attributed to a trauma during or after birth. A research participant self-
identified as having a nuchal cord at birth, which is when the umbilical cord is wrapped around
an infant’s neck during birth (Wikipedia).
Although I was not aware of any other diagnoses, my understanding is that the
participants, who ranged in age from late 20s to mid 50s, had mild to moderate levels of
disability (British Columbia Ministry of Health, 2007) based on my observations of written and
verbal language competency and because they require community and family supports for day-
to-day living. The levels of cognitive and physical abilities of the participants vary in degree for
learning, behaviour, fine motor skills, and communicating.
I follow a first-person action research method to explore how the reflection cards helped
me to support the therapeutic goals of the special education art therapy group and to develop as
an art therapist. There is certainly more theoretical background under the general subjects of
adults with developmental disabilities, metaphor, and group therapy, but for the purpose of this
research, I have chosen to narrow the theoretical scope within the subject areas of facilitating
communications to support the therapeutic goals for adults with developmental disabilities, how
REFLECTION CARDS FOR OPENING CIRCLE
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metaphor in art therapy can help expand emotional language, which also supports some of those
goals, and the role of the facilitator in group therapy. These subject areas are the most relevant to
the data gathered from the group sessions and my understanding of the research outcomes in
relation to the therapeutic goals of the group and to my development as an art therapist.
Facilitating communication to support therapeutic goals
The data collected for this research was drawn from the opening circle activity that
occurred at the beginning of each art therapy group session. Opening activities, as explained by
Carpendale (2009a) and described in the spirit of First Nations tradition (SaskSchools), provide a
structured activity that offers opportunities for participants to develop social skills, express
emotions, and develop a sense of belonging and safety in the group. Carpendale (2009b)
provides ideas for opening activities intended to, among other goals, build relationships and
establish safety and trust among group members. During opening circle, there is an expectation
that participants listen as each person takes their turn to speak, a process that can be facilitated by
an object, such as the deck of reflection cards, that is passed from person-to-person to signify
whose turn it is to speak.
The web page for the special education program (no source is provided to protect the
identity of the research participants) and Carpendale’s Kutenai Art Therapy Institute Practica
Resource Book (2009b) identify goals when working with people who have developmental
disabilities that include development of social skills, independence, and expression of emotion,
all of which align well with the description of opening circle activities. Considering that a factor
for gauging independence is the extent an individual is controlled by others, the opportunity to
make independent choices is important for people with developmental disabilities.
REFLECTION CARDS FOR OPENING CIRCLE
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During their turn in the opening circle, participants chose a reflection card from the deck
that had a variety of images. In their art project study published in The American Journal of
Occupational Therapy (1993), occupational therapist Kathy L. Lamore and David L. Nelson, a
professor of occupational therapy, emphasize how providing options is important for developing
self-efficacy, motivation, and human development for adults with developmental disabilities who
experience control in their lives primarily from external influences. Rees worked for 15 years as
an art therapist and is editor of Drawing on Difference (1998), which is devoted to art therapy
approaches and people with developmental disabilities. She notes in her introduction how having
little choice in life can contribute to people with developmental disabilities being infantilized,
which in turn can lead to their emotions and experiences not being taken seriously by people in
their life who are not disabled. Counsellors Fennell and Jones (1998), who are the founding
members of Counselling Interest Group in South-East Wales that supports service provision to
people with learning difficulties, also note that creating opportunities to make choices can “begin
to contradict feelings of helplessness” (p. 193).
Addressing communication challenges for adults with developmental disabilities and for
those who work with this population is an underlying issue associated with choice-making that is
identified in art therapy literature. Stephanie Bull is a British art therapist and editor of Art
Therapy and Learning Disabilities (2012) identifies “communication difficulties” (p. 27) as one
of the factors that impedes the ability of people who have developmental disabilities to make
choices. The design and use of the reflection cards were intended to facilitate communication
among opening circle participants by providing a focus for discussion and an alternative to, or
visual support for, verbal communication.
REFLECTION CARDS FOR OPENING CIRCLE
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According to Fennell and Jones (1998), finding alternatives for verbal communication can
ease client anxiety. Art therapists, teachers, and authors Case and Dalley (2006) explain that art
therapy group work offers an opportunity for participants to learn from each other and develop
social skills, and in which a concrete object for discussion is provided with the art.
Noted art therapist and author Riley (2001), in her book Group Process Made Visible,
emphasizes the importance of communication in a group that provides clarity and emotional
distance from participants and that visual imagery has protective factors. Robin Tipple (1994)
has worked with people with developmental disabilities since the early 1990s. His insights that
appeared in the journal Inscape are often cited in art therapy literature, such as how speech-
related problems for people with developmental disabilities can be alleviated by the use
psychotherapy and art materials.
The metaphoric image and emotional vocabulary
The simple imagery on each reflection card was intended to serve as a focal point of
communication for the participant who chose a card during opening circle. Joel Walker (1982) is
a psychiatrist who recognized early in his career the therapeutic potential of photographic
imagery. Walker contends that photographs serve as a catalyst for communication in the
therapeutic environment because the images are not directly associated with the client, and are
therefore less threatening, and that the client’s response to the images serves as a springboard
into their unconscious. Noted Canadian phototherapist expert Judy Weiser (1988) explains in
her article about photography and non-verbal communication that the projective technique of
phototherapy provides the viewer an image from which they create their own meaning.
According to Weiser, this meaning arises out of the individual’s response to the image as
“therapeutic catalysts, symbols, confrontations, metaphors” (p. 256).
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There is a long history of the role of metaphor in literature and linguistics, however,
according to social psychologist Karin S. Moser (2000), the role of metaphor in psychology has
not received a lot of attention. Moser defines metaphor as an analogy where similarities of one
experience can be understood using the terminology of another experience. Arnheim (1969) is a
perceptual psychologist and author who describes how an image functions as a symbol by
representing concepts an individual associates with what is portrayed. The metaphoric
associations and self-identification, particularly with the animal imagery in the reflection cards,
can be understood within the context of Case (2005), in her book Imagining Animals: Art,
Psychotherapy and Primitive States of Mind, in which she describes how people make
associations with the characteristics of animals.
Professor Emeritus of Philosophy at Columbia University, Richard Francis Kuhns (1983),
who published Psychoanalytic Theory of Art, argues that the interpretation of objects (art) can be
contextualized in the Freudian understanding of the function of symbols as substitute
representations of repressed unconscious material that appears in the “manifest content of
objects” (p. 24). Linguist and professor Kövacses (2000), who researched metaphor with fellow
linguist Lakoff, describes how conceptual metaphor provides concrete expression to abstract
concepts. Carpendale (2009a) speaks to the relationship between perception, language, and
metaphor that is the primary means that individuals are socially constructed, that is to say, the
most influential societal experiences on the development of self. I chose the images on the cards
for their simplicity and for their potential to represent aspects of self, for example, Case’s (2005)
exploration of aspects of self in animal imagery.
Lakoff and philosopher Johnson (1980), in their book Metaphors We Live By, explain the
role of metaphor to represent one concept by another, which can transform experience and
REFLECTION CARDS FOR OPENING CIRCLE
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understanding that in turn provide insights regarding larger metaphorical concepts of everyday
life. In his book The Role of Metaphor in Art Therapy, Moon (2007), American art therapist,
educator, author and Honorary Live Member of the American Art Therapy Association, explains
how metaphoric communication, verbal and visual, helps reduce client resistance to discussing
issues by presenting situations or experiences in new ways. Moon also asserts that metaphors
also encourage client independence because the client identifies the metaphor in the work and its
meaning in their life.
Former lead clinical psychologist for Brighton & Hove learning disability services and
researcher Conboy-Hill (1992) asserts that people with learning disabilities need an emotional
vocabulary to express their feelings. In her book, A Thousand Words: Healing through Art for
People with Developmental Disabilities, Caprio-Orsini (1996) explains that people with
developmental disabilities have a limited range of language for expressing how they feel and that
art therapy helps to expand an emotional vocabulary. The images on the cards provided
participants an alternative means for expressing feelings and self-concepts.
The art therapy group and the facilitator’s role
Improving communication among participants and reducing feelings of discomfort,
including my own, was at the heart of my intentions for using the reflection cards to support the
group’s therapeutic goals. I hoped the reflection cards would support my efforts to facilitate the
group in a way that aligned with Rogers (1970) person-centred approach. Considered to be one
of the founders of humanistic psychology, Rogers emphasizes the importance of understanding
what an individual is communicating. The capacity for listening and respect aligns with the
purpose of therapeutic group work to provide an environment in which to give and receive
empathy, according to Dave Mearns and Brian Thorne (1998), best-selling co-authors of two
REFLECTION CARDS FOR OPENING CIRCLE
21
titles about person-centred counseling. Moon (2010) suggests that ritual contributes to a sense of
safety in a group and that emotional safety.
The acceptance of others and the cohesiveness of the group are valued by clients and
considered to be especially therapeutically helpful according to Yalom (1985), psychotherapist,
author, and Emeritus Professor of Psychiatry at Stanford University who is well-known for his
book The Theory and Practice of Group Psychotherapy. Marion Liebmann (1986), author of
numerous books on art therapy and mediation, notes in her book Art Therapy for Groups: A
Handbook of Themes, Games, and Exercises the importance group interactions for providing
support to individuals with similar needs and to learn from group feedback. Kevin O’Farrell is a
British art therapist who, in the introductory chapter of Art Therapy and Learning Disabilities
(2012) describes how important it is for the art therapist facilitating a group for adults with
developmental disabilities to be, in the words of Yalom, a “fellow traveler” (p. 10) on the
therapeutic journey who, in addition to providing a safe therapeutic environment, learns
participant’s language through all modes of communication including words, mannerisms,
images in addition to offering ways for participants to “express and understand themselves” (p.
10).
O’Farrell also notes the importance of the therapist to learn someone’s language through
transference, which can be understood as an unconscious transferring of emotions rooted in early
childhood experiences onto a new relationship in a way that is repetitive and inappropriate to the
situation and counter transference, which refers to the therapist’s projected response, conscious
and/or unconscious onto the client in response to the transference (Schaverien, 1992). Hillary
Lomas and Penny Hallas (1998) share their experience with transference and counter-
transference when co-facilitating an art therapy group for adults with developmental disabilities
REFLECTION CARDS FOR OPENING CIRCLE
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in “It’s a Mystery: Accounts of an art therapy group for people with learning difficulties.” Jane
Caven (2012) reflects on her work as an art therapist with people who have developmental
disabilities along with the experiences of Lomas, Hallas and Rees to conclude that counter-
transferences offer insights into the feelings and experiences of clients.
In his description of the basic encounter group, Rogers (1967) explains that the leader’s
primary responsibility is to facilitate group member’s expressions of thoughts and feelings and
provide a focus on process and personal interactions as they occur in the group. Ohlsen (1970) is
known as a counselor, teacher, and researcher whose in-depth account of group sessions, Group
Counseling, emphasizes the importance for members to have the attention of the other members
for the group to function effectively and that the leader of the group facilitates the “action or
change” (p. 52). Moon (2010) asserts that clients need to experience “emotional safety and
anxiety” (p. 11) for them to experience advantages of being in group.
According to Yalom, the therapist’s commentary must focus the group’s interactions on
the here-and-now, interactions that mirror life outside the therapeutic environment. The ability to
focus the group is a skill that may not be well-honed by the beginning art therapist. Williams
(1966) describes the inexperienced group psychotherapist who develops from having fantasies
about losing control of the group and fears of being assertive and of confrontation to an
experienced facilitator who is able to bring about group cohesion by being “firm and frank” (p.
106). However, cohesion for the art therapy group in this research was expressed through the
participant’s collective rejection of the reflection cards. The rejection of the cards is explored
within the context of scapegoat transference, a term coined by Jungian psychotherapist Joy
Schaverien in her book The Revealing Image (2nd ed. 1999).
REFLECTION CARDS FOR OPENING CIRCLE
23
Chapter summary
The literature for this research focuses on three subjects related to the use of the reflection
cards. These include the facilitation of communications to support therapeutic goals for adults
with developmental disabilities, the metaphoric potential of the cards to expand participant’s
emotional vocabulary, and my role to facilitate the group’s work toward the therapeutic goals.
There is an underlying principle in the research that comes from a person-centred approach to
therapy that has its roots in the work of Rogers. This approach aligns with my use of a first-
person action research methodology described in the next chapter.
REFLECTION CARDS FOR OPENING CIRCLE
24
CHAPTER 2: ACTION RESEARCH METHODOLOGY
I had hoped to create a tool that would help me better support the therapeutic goals of the
special education students when I introduced the reflection cards as an opening circle activity.
My intention was to increase my capacity to moderate the discussion among the students in a
way that would encourage openness and the expression of feelings while ensuring a sense of
safety among participants. From the time I introduced the reflection cards until eight months
later when the sessions ended, I would adjust how the cards were used in response to feedback or
observations of the group’s or my own behaviour. About four months into using the reflection
cards, I began to consider their use in the group as an opening circle activity as a thesis topic. I
noticed that my protocol for using the cards followed an action research cycle that is a qualitative
approach in which the inquirer seeks change through a collaborative, cyclical process of inquiry.
What distinguishes the methodology from other research approaches is that the research is
undertaken with people, not ‘on’ people and that the perspectives of the subject and the
researcher are not mutually exclusive (Heron and Reason, 2001). The collaborative nature of
action research is a key aspect of this methodology. First-person action research emphasizes the
importance of democratic participation that invites the input of all participants in the work
toward positive change (Merry, 2002). This research approach is also conducive to supporting
the therapeutic goals of the students with developmental disabilities because it encourages
independence and the expression of emotion by inviting feedback from participants.
When engaging in action research, the inquirer undertakes the research within the
environment out of which the idea arose and includes feedback from the other participants
associated with the issue. Action research seeks change within an art therapy group because the
research is undertaken in the group where the idea for change arises. The approach also provides
REFLECTION CARDS FOR OPENING CIRCLE
25
an opportunity for the researcher to invite feedback from participants throughout the course of
research that takes place over the period of time in which the group art therapy sessions are held.
The approach begins with an idea for change followed by a plan to create that change,
putting the plan into action, and then reflection on the outcome of the action. The cyclical nature
of action research occurs through the reflection of outcomes that leads into another cycle of
inquiry that further informs the researcher in their pursuit of an outcome that addresses the initial
idea for change.
History of action research
Action research has its roots in the collaborative approach of Mitchell in 1916 for
researching education practices and by Collier in the 1940s while he was the United States
Commissioner for Indian Affairs when he researched and wrote about ways to address racism
and discrimination (Pine, 2010). Social psychologist Lewin (1946), who founded the Research
Center for Group Dynamics in 1944, introduced the term action research in his response to his
dissatisfaction with the reliance of surveys and diagnosis to inform social research. Lewin
articulated the cyclical process of the methodology while identifying the important role of the
researcher’s knowledge and self-reflection that informs action-based theory and its application
beyond the initial area of inquiry.
Lewin’s (1946) work was embedded within a social research framework that he asserted is
concerned with two types of questions, namely “the study of general laws of group life and the
diagnosis of a specific situation” (p. 36). The researcher should be aware of the general laws of
relationships between the possible conditions and possible results of a research question. Lewin
(1946) goes on to explain that the researcher must also have an understanding of the “specific
REFLECTION CARDS FOR OPENING CIRCLE
26
character” (p. 37) of the situation. I created the diagram below to illustrate Lewin’s explanation
of social research out of which action research arises.
Figure 1: Social research foundations of action research
On the one side are the possible conditions and results of a situation that inform the
general laws of relationships. The other side of the diagram shows the formation of the second
type of question that begins with a conclusion reached by an analysis of a situation rising up to a
diagnosis that informs the specific character of a situation. Together, the general laws of
relationships and the specific character of a situation form the intent of action research.
According to Lewin (1946), the character of the situation is derived at by “scientific fact-
finding called diagnosis” (p. 37). Lewin (1946) distinguishes the difference between survey-
based fact-finding, which he asserts is “superficial” (p. 37) with descriptive, scientific fact-
finding that “evaluates the action,” offers opportunities for learning or insights, informs the
planning of the next step in the process, and “serves as the basis for modifying the ‘overall plan’”
(p. 38) This fact-finding process is followed by the next cycle of action research for the research
idea.
Social
Research
General laws
of
relationships
Possible
conditions Possible
results
Specific
character of
situation
Diagnosis
REFLECTION CARDS FOR OPENING CIRCLE
27
The action research cycle
Lewin’s action research cycle of planning, action, and fact-finding is illustrated below by
another diagram I created to aid in understanding the research protocol. The cycle begins with a
general idea of a specific objective that the researcher wants to examine. The researcher then
undergoes a fact-finding process that will inform the development of an overall plan and
articulation of the first step of action to be undertaken. The next step is the action the researcher
has developed to address the general idea. The researcher then evaluates the outcomes of the
action to inform the next cycle of action or a modification of the overall plan. The diagram below
illustrates my understanding of the action research cycle.
Figure 2: Action research cycle
Planning
•general idea
•examination of idea
•fact-finding
•overall plan
•first step of action
Action
Fact-Finding
•evaluate the action
•gather insights
•basis for planning next step
•basis for modifying overall plan
REFLECTION CARDS FOR OPENING CIRCLE
28
Gilroy (2006), in her book Art Therapy, Research and Evidence-based Practice, notes that
action research operates on two levels, the cyclical process described previously, as well as “the
active participation in a project that takes place over time in a group, community or organisation
which changes and learns” (p. 109). She also points out that there are two different approaches to
action research. One approach is initiated in what she calls a “top-down” way when managers of
an organization identify an issue then initiate a project that involves researchers or consultants
(p. 109). The other approach is initiated by a practitioner who identifies an issue in their work
and seeks change. It is the latter approach that is relevant for this researcher who identified an
issue during the opening circle of the group art therapy sessions and sought change by
introducing the reflection cards as an opening circle activity.
First-person action research
The resulting inquiry regarding personal change directed me toward identifying with first-
person action research. First-person action research focuses on the individual whose research is a
personal, reflective process in which the action is planned, implemented and the results analyzed
within the context of the environment in which the researcher is working. According to Lynn
Kapitan (2010), an important aspect of this research approach involves “listening and reflecting
on one’s own behaviours and actions” (p. 103) along with changes in practice with the intention
of becoming more effective. The context of my research was within group art therapy sessions
during which I observed and reflected on group behaviour, including my own. According to
Jorgenson (1989), conditions that are conducive to research as a participant in a group are those
in which the individual “is concerned with human meanings and interactions” (p. 13) within a
natural setting. The environment should be small enough to lend itself to a case study in which
qualitative data can be gathered “by direct observation and other means pertinent to the field
Lewin 1946
REFLECTION CARDS FOR OPENING CIRCLE
29
setting” (p. 13). The group art therapy sessions took place in a room that allowed me to
comfortably observe and interact with all participants in the class.
Jorgenson describes participant observation methodology as “a logic and process of
inquiry that is open-ended, flexible, opportunistic, and requires constant redefinition of what is
problematic, based on facts gathered in concrete settings of human existence” (p. 14). As a
participant observer, the reflection card activity during opening circle served as an opportunity
for me to participate in the opening circle activity and observe interactions among group
participants, including myself, in a way that was reflexive and responsive to the changing
dynamics of the group and the use of the reflection cards. Mala Gitlin Betensky (1995) explains
how the art therapist as a participant observer who “unobtrusively” (p. 25) gets to know the
client by noticing the dynamics of the client at the same time as being aware of personal
responses to the client. As a result of my observations of the participants and of myself, I
implemented changes to the activity in response to group behaviour, including my own, as well
as to feedback from participants and supervision.
Reflection card research protocol
I collected the data for this research at a special education practicum for adults with
developmental disabilities that I co-facilitated while working toward the completion of the
required practicum hours for the Kutenai Art Therapy Institute’s program. I was in my first year
of studies at the Kutenai Art Therapy Institute and this practicum was the first time I facilitated
group art therapy, which I did with a co-facilitator who was a second-year art therapy intern. The
research represents a journey of self-inquiry that informed my way of being an art therapist
through my observations and reflections of, and responses to, individual behaviour and group
dynamics during the opening circle activity at the art therapy practicum.
REFLECTION CARDS FOR OPENING CIRCLE
30
The special education program is administered through a community college and teaches
adults with special needs or disabilities skills that will help them live more independently or to
be employed. Students of the special education program participated in the research for this
thesis through their attendance of weekly group art therapy sessions that were delivered in their
classroom. Of the eight participants who regularly attended the weekly art therapy sessions,
seven were chosen for this research. A student attending the adult basic education program
participated in the sessions is not included in this research because the goals for his participation
in the group were different from the goals of the other participants who have developmental
disabilities.
Description of the group art therapy sessions
The sessions were held in a room on the lower level of a college building. The far side of
the room has large windows that look up at the surrounding mountains. Cupboards and shelves
line the walls of the room and there is a kitchen area with a counter, sink, fridge, and stove along
the wall under the windows. On the opposite side of the room a row of coat hooks hang on the
wall over a couch with an upholstered chair to the side. Rectangular office-style tables, usually
five in number, are pushed together in the centre of the room with chairs around the perimeter
where the students are seated and doing homework or talking among themselves or with the
special education program instructor.
The co-facilitator and I took turns leading the 22 weekly group art therapy sessions. Each
session followed a similar format beginning with an opening circle during which the co-
facilitator and I invited participants to briefly share what was on their mind or how they were
feeling that day. Participants were also offered the choice of not speaking for their turn.
Participants were asked to listen and not speak while someone took their turn out of respect for
REFLECTION CARDS FOR OPENING CIRCLE
31
the person and the information they were sharing with the group. The art therapy intern who
facilitated the group that day thanked each person after they were finished for sharing then
invited the next person to take their turn. If an individual spoke at length during their turn about
issues beyond the subject of the circle, specifically how they were doing, I would respectfully try
to interject by commenting on how the person had a lot on their mind that they could use as a
subject for art making.
Opening circle was followed by art making. Participants could choose between following
a directive suggested by myself or the co-facilitator, such as a group mural or using a new art
material or technique, or they could choose to make spontaneous art using the materials
provided. Once the time for art making concluded, participants, myself, and the co-facilitator sat
around the table and the participants were invited to show their work to the group and tell
something about the art or their art making process. The session would end with me and the co-
facilitator taking photographs of the art, participants putting their art in folders and all of us
cleaning up the room.
The general idea
As the sessions progressed, my attention was particularly drawn to group dynamics as
well as individual participation during opening circle at the start of each session. I reflected on
issues of concern for me that arose during the first eight weeks. One issue was that of
participants speaking while others took their turn. Another was when participants spoke at length
and directed their comments at other participants or to subjects that arose out of a shared history
of friendship and dating. These subjects typically took longer than hoped for to explain during a
participant’s turn. Other participants would share no more than a single-word comment about
how they were doing such as “good,” from week-to-week. I also found it difficult to understand
REFLECTION CARDS FOR OPENING CIRCLE
32
what some participants were saying because of my unfamiliarity of articulation patterns
associated with Down syndrome.
I reflected on how I could better facilitate opening circle so participants would listen while
others spoke. Another consideration was to encourage quiet participants to expand on how they
articulated feelings either with more diverse expressions or by providing more information. I also
wanted to find a way to respectfully limit how much others were saying to alleviate the
discomfort of the participants who found it difficult to listen for another’s turn that was
particularly lengthy. And there was the issue of how to discourage hurtful comments from being
directed at another participant.
This issue of comments being shared by a participant that appeared to be hurtful to
another participant was exemplified during opening circle of the eighth session when an
individual reacted to what was being said by another participant by slouching off her chair to sit
under the table. The individual who was speaking has Down syndrome so I was not entirely able
to understand what was being said. Given the reaction of the other participant, I assumed the
comments caused extreme discomfort. I wondered how I could be respectful of participant’s
opportunity to speak during opening circle while maintaining the safety of the group. Would the
therapeutic goals of the group be better supported if I introduced a structured activity to opening
circle around which participant contributions could be made?
Action research cycle: Planning
I considered options for an activity that would mitigate the behaviour that contradicted the
therapeutic goal of developing social skills while encouraging expression of emotion. The First
Nations practice of talking circles will include the use an object such as a stick or rock that is
passed among participants when taking turns to speak. I thought that if participants had an object
REFLECTION CARDS FOR OPENING CIRCLE
33
to pass among those taking turns, the object would provide a focus for the subject being shared
and help to contain the content of the information. I also remembered tarot cards used by an art
therapist helped encourage self-disclosure by providing a visual stimulus for discussion. The
aspect of art as a vehicle for reflection and communication in art therapy led me to design a deck
of reflection cards that would be passed along the group as each person took a turn and from
which participants could choose an image to speak about.
Each of the 17 cards made initially had an image from nature that was chosen for its
potential to represent a particular emotion, for example a rainbow for hopeful, flames for anger, a
sunflower for happiness. The images were found on the Internet and from my personal
photography.
Action research cycle: Action
The deck of reflection cards was introduced to the group as an opening circle activity in
the eleventh session. I explained that each card had a different image from nature and that each
participant could choose a card for their turn during opening circle. I suggested options for using
the cards that included speaking about the image and what they thought about it, choosing a card
and showing it to the group with no explanation. After a participant’s turn was done, they would
place the card they chose back in the deck and pass the deck of cards to the person seated beside
them until each person had a turn. After each session, I noted which card was chosen by a
participant as well as a summary of any comments shared during opening circle.
REFLECTION CARDS FOR OPENING CIRCLE
34
Action research cycle: Fact-finding
Each session the cards were used, I reflected on the observations noted about the cards
chosen, of individual or group behavior including my own to reflect on the effectiveness of the
cards to address the issues of concern that compelled me to create the cards as a tool to facilitate
communication during opening circle. I included feedback from supervision and the co-
facilitator to inform changes that were made to the cards or their use over the research period.
Research limitations
Limitations of this research protocol includes incomplete data collection due to reliance
on the capacity for me and the co-facilitator to write complete notes that recorded what card was
chosen and what each participant said. This limitation was minimized because we wrote notes
together after each session and would support each other to remember the outcome of the
opening circle activity. Another limitation to consider was the recording of sporadic incidents
that would inform the research but was dependent on the whether or not the incident was
considered to be significant enough to note by me or the co-facilitator.
Comparisons between opening circle behaviour and comments prior to and after the
reflection cards were introduced is limited because participant contributions to opening circle
were not always recorded prior to the cards being used. As a result, some comparisons rely on
my memory of events and behaviours. My capacity to respond constructively to criticism of the
activity from participants is also important to consider with respect to an objective account of
how and why changes were made and the outcome of the change. I was also aware that I may
have internalized stereotypes of adults with developmental disabilities and would have to be able
REFLECTION CARDS FOR OPENING CIRCLE
35
to put aside assumptions that could impinge on her ability to facilitate the group as well as record
and interpret the research data.
One of the five primary characteristics of action research, according to Reason and
Bradbury (2001), is participation and democracy. Research limitations related to the democratic
involvement and engagement of participants may occur because of lack of engagement and
interest to take part in the reflection card activity. Limitations could also stem from participants’
perception of the relationship with the researcher as not being democratic, a perception
influenced by a personal and social history of disempowerment that can be experienced by
persons with developmental disabilities (Areili, Friedman & Agbaria, 2009). Limitations
regarding my participation and ability to maintain a democratic perspective include the potential
for me to take on a more egalitarian attitude because I initiated the design and use of the
reflection cards, which could also limit my capacity to accept challenges to personal views and to
be self-critical (Gilroy, 2006).
Ethical considerations
Ethical considerations focused on ensuring the group members who have varying degrees
of developmental disability were aware of and understood their participation in the research.
When the practicum first began, the Kutenai Art Therapy Institute release form (Appendix II)
was explained to the group. The co-facilitator and I answered questions from the group members
and provided one-on-one assistance for anyone who asked for help understanding or filling out
the form. Each participant of this research signed their consent on the form. When I was
considering using the reflection cards as my thesis topic, I also provided a verbal explanation to
the program contact and the group participants regarding the purpose of my thesis research,
which was to report on which cards the participants chose, what they said during opening circle,
REFLECTION CARDS FOR OPENING CIRCLE
36
and that I would use this information to write my thesis. The program contact and the group
participants verbally responded they understood my description of the research and agreed to
their participation. I provided ongoing verbal reminders to the participants regarding the use of
feedback from, and observations of, the use of the reflection cards for research.
Chapter summary
I chose a first-person action research protocol because the action research cycle was how I
adjusted the use of the reflection cards to respond to the needs of the group as expressed to me
by the participants or through my observations. I was aware of the need to reflect on my
behaviour and intentions throughout the research period and when writing the thesis to ensure I
was respectful of participants and responsive to the group’s therapeutic goals and needs. Using
first-person action research helped me honour these intentions because the methodology is
focused on my efficacy to facilitate the group rather than being focused on the participants as test
subjects for my reflection card idea. By following an action research methodology, I reflect on
insights regarding group dynamics and my own behaviour during opening circle within the
context of the group’s therapeutic goals. These insights are informed by data collected during
sessions. This data is described in the following chapter.
REFLECTION CARDS FOR OPENING CIRCLE
37
CHAPTER 3: RESEARCH RESULTS
The research data was taken from the notes written after each of the 14 sessions that the
reflection cards were used as an opening circle activity, additional notes I made specific to my
research, and feedback from participants or supervision. Participants are identified by
pseudonyms to protect their identity. The information is organized according to the session in
which a situation occurred to which I responded using the action research cycle that begins with
a general idea and plan, action taken, and fact-finding to evaluate the action and form the basis
for the next step of action or to modify the overall plan. Using a first-person action research
protocol to collect the data helped me to maintain my focus on how my use of the reflection
cards helped me support the therapeutic goals of the students.
Opening circle disruption
The group art therapy sessions began each week with an opening circle during which each
participant took a turn to check-in with the group. Two individuals in particular would speak at
length, up to five minutes, and would sometimes direct comments at other participants that
appeared to make those participants uncomfortable. I was reluctant to comment directly on the
information being shared for two reasons. One reason was that I had difficulty understanding
most of what was being said and I was concerned my potential misinterpretation of the words
being spoken might further aggravate the situation by frustrating or insulting the individuals
speaking. I was also conscious of my reluctance to know when or if it would be appropriate for
me to interrupt someone’s turn.
During the ninth session, Jan took a long time to speak during her turn and at least some
of what was being shared appeared to be directed at Gary. When Gary spoke, he also had a lot to
say and expressed feeling hurt, possibly in response to Jan’s comments. Jan reacted to what Gary
REFLECTION CARDS FOR OPENING CIRCLE
38
was saying by slouching off her chair to sit on the floor under the table. I got up from my chair
and sat on the floor beside Jan and tried to alleviate her obvious discomfort by telling her some
other approach would be used for future opening circles.
The general idea
I reflected on the incident and began considering what I could do as an art therapist and
group facilitator to reduce the amount of time taken by participants to share during opening
circle, which would potentially serve three purposes:
increase the possibility of my understanding of what was being said because there
would be fewer words to try and understand and less-complex sentences;
reduce the discomfort of participants who were having difficulty waiting for long
periods of time while others spoke; and
help me facilitate comments shared during opening circle in such a way as to
ensure the safety of the group while still allowing for the expression of emotions.
Session 1: Reflection cards are introduced
Planning
I wondered what action I could take to achieve the three goals I identified and began
considering an activity that could be used each week that would provide a focus for discussion.
Remembering a comment by an art therapist who used tarot cards to facilitate client self-
reflection, I considered how cards with imagery might serve this group of adults with
developmental disabilities as an opening circle activity. I thought the imagery often found on
tarot too complex to facilitate the quick responses I hoped for during opening circle. I was also
REFLECTION CARDS FOR OPENING CIRCLE
39
aware of the possibility that cards created by artists, such as tarot or OH cards that I learned
about later on in my research (http://www.oh-cards.com/index.php?article_id=1&clang=1), may
embody the artist’s conscious or unconscious material in the representation of the image that
could influence a participant’s response. I decided to create a deck of cards with a single
photographic image on each card that was a simple representation of a subject that participants
might have associations.
Action
I chose images of nature that I thought would have the potential to be associated with a
specific feeling, for example, rain on a window for sadness or a rainbow for hope. I printed the
images and applied each one to a large playing card to make a deck of 17 cards. The nature
images used when the reflection cards were first introduced to the group are shown below:
Figure 3: Card 1, ocean
waves
Figure 4: Card 2, blue sky and
clouds
Figure 5: Card 3, sunflower
Figure 6: Card 4, mountain
peaks
Figure 7: Card 5, frosty trees
Figure 8: Card 6, garden
door
REFLECTION CARDS FOR OPENING CIRCLE
40
Figure 9: Card 7, flames
Figure 10: Card 8, caterpillar
on gravel
Figure 11: Card 9, sand
dunes
Figure 12: Card 10, peonies
Figure 13: Card 11, tornado
Figure 14: Card 12, rainbow
Figure 15: Card 13, single
tree in fog
Figure 16: Card 14, lightning
Figure 17: Card 15, rain on
window
Figure 18: Card 16, cave
interior
Figure 19: Card 17, flower
heart
I introduced the reflection cards with an explanation that participants take turns choosing a
card and showing that card to the group. The participant could also then tell the group what the
image they chose meant to them. Below is a chart showing the card chosen by each participant
during Session 1 and their association with the image. Karen was the only individual who did not
choose a card and also chose not to speak during her turn.
REFLECTION CARDS FOR OPENING CIRCLE
41
Fact-finding
Table 1: Session 1 Cards Chosen and Notes
Participant
Card Chosen
Participant comment
Researcher note
Sarah
Lightning
It is like when there is a lot
going on in your mind, it can
give you a headache.
Card image and reflection
different from art that has
been more positive in tone
e.g. bright colours, happy
imagery.
Jan
Rainbow
Karen
Rob
Peonies
Gary
Flames
Made growling sounds.
Tom
Waves
Hawaii, a place where I’ve
been.
Brent
Sunflower
I was pleased the cards helped focus the participants’ comments during opening circle, as
the number of cards chosen and the quantity of associations made for each card indicates. The
comments were also focused on the individual’s experience who chose the card and not on
another participant. I was also interested in how the responses varied from a literal connotation
for Tom to a metaphorical representation of how Sarah felt. Gary’s growling sounds that he
made when he held his card up for the group to see seemed to indicate an emotional response to
the image. I was interested in how the activity unfolded so did not comment on the information,
or sound, shared in association with the card or the choice of card other than thanking each
individual for sharing. The following week, Karen participated in the activity by choosing a card
and telling the group how the image made her feel. All other participants chose cards for their
turn as well. I decided to continue using the cards each week for opening circle because they
appeared to be serving their intended purpose of facilitating communication and because
everyone was now participating in the activity.
REFLECTION CARDS FOR OPENING CIRCLE
42
Session 4: Hearts and Animals
I spoke at supervision about the reflection cards I introduced three weeks previously at the
special education practicum. I described why and how the cards were made and used as an
opening circle activity with students of the special education program. I explained how I was
pleased with the positive results with respect to the topics for sharing during opening circle that
were more focused on the individual and provided the group broader insights about participant’s
feelings and perspectives. The cards also appeared to broaden the range of topics shared by
individuals, particularly those who often did not speak or who shared a single word.
The images on the card of choice provided a concrete object from which to speak either
verbally or by simply sharing the image with the group. I found it helpful to have a visual frame
of reference for what was being said by the participants I had difficulty understanding. For the
most part, the length of time for the activity, by individuals and by the group overall, had also
evened out so each participant took a similar length of time for their turn, as indicated in the
chart by the number of cards chosen by each participant and the quantity of associations made
by each participant. The one exception was the card with the heart-shaped flower.
Planning
I explained in supervision that I was going to remove the card with the flower-shaped
heart because the image activated participants to speak at length about people they know and
love and to direct their comments to other people in the group, an issue I had hoped to address
with the introduction of the cards. I also had difficulty understanding the entirety of what Jan and
Gary said when they chose the flower heart image.
Another art therapist intern who attended my supervision group, and who co-facilitated a
similar practicum at another college campus, suggested I include animal imagery in the deck. I
REFLECTION CARDS FOR OPENING CIRCLE
43
could immediately imagine the potential associations with animal imagery that would build on
the options for metaphoric and literal associations for participants.
Action
I removed the card from the deck in an effort avoid a similar incident between the two
participants that inspired the creation of the cards in the first place. As a result of supervision
feedback, I added the following six images of animals to the deck for which I thought there
would be readily made associations by the participants, for example the characteristic of loyal for
dog and timid for mouse. I was also hoping that the addition of the animal imagery would
distract participants from the absence of the flower-shaped heart card that I removed from the
deck.
Figure 20: Card 18, owl
Figure 21: Card 19, mouse
Figure 22: Card 20, tiger
Figure 23: Card 21, elephant
Figure 24: Card 22, dog
Figure 25: Card 23, kitten
REFLECTION CARDS FOR OPENING CIRCLE
44
Fact-finding
Table 2: Session 4 Cards Chosen and Notes
Participant
Card Chosen
Participant comment
Researcher note
Sarah
Owl
Always looking out for her
friends.
Jan
Dog
Reminded her of her friend
who is also a participant.
Karen
Rainbow
Friends and family.
Rob
Dog
Gary
Tiger
My favourite animal.
Tom
Peonies
Reminded him of spring.
Brent
Elephant
Staying in the area because
his friends need him.
Difficulty remaining quiet
while others spoke.
All but two participants chose an animal image when the cards were introduced. I
considered the preference for the animal cards could be because they were new and therefore
their novelty made them more interesting. My assumption was affirmed when the animal cards
were not preferentially chosen over the nature images after their introduction (see Appendix I).
The animal imagery appeared to illicit symbolic associations with characteristics of
people. Sarah made a personal association with the owl as having the shared aspect of being
watchful, which she described for herself as “always looking out for her friends.” Jan was
reminded of a friend in the group when she spoke about the image of the dog she chose. Gary
chose the tiger image and told the group it was his favourite animal. None of the participants
mentioned that the flower-shaped heart card was not in the deck. I also chose to not bring up the
missing card since I was satisfied the contentious issues would be less likely to be brought up in
the card’s absence.
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45
Session 8: Turtle
Planning
During the seventh session after the cards were introduced as an activity, Sarah asked me
if a turtle image could be included in the deck. In a previous session, she had added collage
images of turtles to her art and had told me of a dream in which she held a baby turtle in her
hand. I was glad to have an opportunity to include an image at the suggestion of a participant. I
interpreted her request as an indicator of interest in the activity and an expression of her comfort
to make a request for a change in the cards.
Action
I added an image of a turtle into the reflection cards for the following week’s session. I
was pleased that one of the participants was taking enough interest in the cards that they would
make a request for a particular image. I was also interested that the request for the image came
out of Sarah using turtle images in her art making and from her dream. I was curious about the
possible connections being formed among art making, dreams, and the reflection cards.
Figure 26: Card 24, turtle
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46
Fact-finding
I was surprised the following week when Sarah did not overtly acknowledge the addition
of the turtle image but she did choose the card during her turn. I was unsure if I should say
anything and draw attention to my adding the image if she did not point out the card’s inclusion.
As a result, I did not mention the card and remained curious about her silence.
Session 11: Dealing the cards
The reflection cards had been used for 10 sessions with what I considered to be successful
outcomes overall. The visual reference of the image gave me clues regarding the issue that was
being shared by the participants I had difficulty understanding. The cards were providing a focal
point for expressing emotions through metaphoric associations that did not extend to other group
members in a way that caused discomfort among others. The cards initially reduced the amount
of time people took for their turn, however, Sarah was choosing increasingly more cards each
session. During the sixth session she chose four cards, rather than the one or two chosen in
previous sessions. Jan chose the same cards and was told by Sarah that she was copying her. This
would be the last time Jan would choose more than three cards. No other participant chose more
than three cards during their turn.
Planning
The number of cards Sarah chose escalated until the ninth session when she chose more
than seven cards. I noticed growing discomfort among the group with the length of time Sarah
was taking for her turn and concluded the cards were not being used in the spirit of the original
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47
intent despite the direction to the group from me or the co-facilitator to choose one card or by
example of others in the group who chose no more than three cards.
It was becoming apparent that Sarah wanted to share using an ever-increasing number of
reflection cards during opening circle. Though the description for each card chosen by Sarah was
typically brief, the time it took to choose more than two cards was defeating one of the purposes
for which the reflection cards were made and that was to alleviate discomfort among participants
by reducing the amount of information shared during opening circle. I noted that Karen had not
been taking part in opening circle since Sarah had begun choosing more than six cards. Two
participants voiced their concern that the activity was taking too much time. I considered options
for how to limit the choice for each participant to one card.
Action
I introduced a new procedure the following week, Session 11, which would ensure each
participant would have just one card to share. I told participants I wanted to try something
different by dealing one card to each participant and they could tell the group their associations
with the image.
Fact-finding
Some clients appeared pleased with the quicker pace of the activity. Three participants
initially abstained from taking part until other participants began switching cards, which they
also did. The cards dealt and (cards received in trade) and related participant comments appear in
the chart on the following page.
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Table 3: Session 11 Cards Chosen and Notes
Participant
Card Dealt
Participant comment
Researcher note
Sarah
Mountain
Expressed displeasure at
receiving the card and said
she was “tired of snow.”
Gave this card to Gary, but
then took it back.
Jan
Desert
(Rainbow)
Spoke about the sky and
weather in relation to the
rainbow card.
Switched desert card with
Brent, who is known to be her
boyfriend, with the card dealt
to him (rainbow).
Karen
Peonies
Rob
Elephant
Gary
Clouds
(Mountain,
Peonies)
Looking forward to spring.
Mountain card was eventually
returned to Sarah.
Tom
Owl
Being protective then being “a
night owl” and staying up
late.
Appeared to use Sarah’s
language for the owl card,
which is one she often chose.
He then shared his own
association with the image.
Brent
Rainbow
(Desert)
Friends and being “a good
guy.”
Traded card with Jan, who is
known to be his girlfriend,
with the card dealt to her
(desert).
Session 12: Adding back a measure of choice
Planning
I reflected on the resistance of some participants to the new method of card distribution. I
was curious why they initially abstained from the activity even though the new method of
distribution would reduce the amount of time people would take for their turn. Although my
intention was to alleviate concerns about the length of time Sarah was taking for her turn by
choosing so many cards, I had hoped the manner in which I introduced the new approach for
distributing the cards would not be perceived as a means to mitigate the behaviour of a particular
REFLECTION CARDS FOR OPENING CIRCLE
49
person in the group. I decided to try an approach for distributing the cards that offered more
choice to the participants but that might still limit the number of cards each person could choose.
Action
For opening circle in Session 12, I explained that participants could keep the card that
was dealt to them or discard the card into the middle of the table and request a new card to be
dealt from the deck. I suggested that participants could discard up to three images.
Fact-finding
The reaction of the group was again mixed. Sarah, Karen, and Gary chose not to take part.
Karen had not taken part in opening circle since before the new distribution approaches were
tried so it was not clear to the co-facilitator or me if she was rejecting this particular approach.
Sarah told me she did not want to do the activity in this way and tossed the card dealt to her in
the middle of the table. Later in the session, Sarah told me she liked to choose at least five cards
and that she didn’t take part this week because of the limit placed on the quantity of cards a
participant could have.
Gary indicated he did not want a card. He did, however, share his thoughts for the day
during opening circle and suggested more animal images should be added to the deck. It was also
noted that Brent, who chose different images from week to week but spoke of the same issues
each week that did not appear to relate to the image chosen, returned the first card dealt to him
but kept the second. I wondered if this was an indication that he had been consciously choosing
images all along or if he was copying the behaviour of others in the group when he rejected the
first card and then kept the second card.
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I was surprised by the varied response from the group when I changed the distribution of
the cards, particularly the participants who chose to not take part in the activity at all. As I
reflected on the increasing resistance of some participants when the cards were dealt during the
last two sessions, it seemed to me that changing the way people received the cards was becoming
more disruptive than to have people take a long time for their turn.
Sessions 13 and 14: Back to choosing cards
Planning
There remained two sessions until the end of the semester, so I decided to return to the
initial practice of each participant choosing from the deck in response to the growing resistance
of participants to take part in opening circle since I changed the way the reflection cards were
distributed. I hoped that returning to the familiar routine of passing the deck rather than trying
yet another new approach would invite participants to engage in the opening circle activity again
for the short time we had remaining together.
Action
At the beginning of the following week’s group session, I suggested we return to the
initial method for distributing the cards by passing the deck from one person to the next so each
participant could choose a card for their turn.
Fact-finding
Karen and Tom did not choose cards, however, they did speak for their turn. Sarah chose
five cards but did not speak about each one, saying only “this is how I feel today.” I was
encouraged by the increased participation in opening circle and decided to use the cards the
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51
following week, which was the last group art therapy session. The cards were passed among the
group and all participants, except Brent who was absent that day, chose a card. I was relieved
that our last session together using the cards was uneventful so the session ended on a positive
note for all the participants.
Chapter summary
I introduced the reflection cards as an aid to help with what I perceived as disruptive
behaviours during opening circle and to provide a tool that might help me facilitate the group and
thereby ease my discomfort when situations arose that I did not feel prepared to respond to
therapeutically. What became immediately apparent was that the images created an opportunity
for participants to make a symbolic association between an image and a feeling. The images also
opened up opportunities to share literal, personal experiences. The chart on the following page is
a summary of the literal and metaphoric associations made during opening circle by participants
in response to the images.
The data gathered reflects the cycle of action research while the reflection cards were used
as an opening circle activity. Each research cycle is initiated by my response to an incident or an
awareness of how the use of the cards could affect positive change and better support the group’s
therapeutic goals. Because the research is from a first-person perspective, the data also includes
my responses to suggestions or observations of how the use of the cards could be adjusted. The
next chapter explores the benefits of using the reflection cards as an opening circle activity for
the special education program students as well as lessons I learned regarding my way of being an
art therapist.
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Table 4: Participant metaphoric and literal associations of images
Image
Associations
Metaphoric
Literal
1) Ocean waves
“light as a feather”
Hawaii, beach, Mexico, summer
2) Blue sky and clouds
3) Sunflower
4) Mountain peaks
How she felt that day
Tired of snow/winter, looking
forward to spring
5) Frosty trees
6) Garden door
7) Flames
Growling sounds, feeling in
stomach, nerves, anger
8) Caterpillar on gravel
9) Sand dunes
10) Peonies
Spring
11) Tornado
Work, lots going on in her head,
“storm”
Loss of family member, sad
feelings about family member,
emotional impact of seeing
destruction e.g. Haiti, houses
being blown apart in the movie
Twister, hockey playoffs
12) Rainbow
Friends and family
The rainbow comes after the rain
13) Single tree in fog
Wanting friends
14) Lightning
“When there is a lot going on in
your mind,” sky, anger
Don’t go in water when there is
lightning (said along with wave
image), wanting winter to be
over so as to not slip and fall
15) Rain on window
Positive association with rain,
melting snow
16) Cave interior
Strong
17) Flower heart
Relationships
18) Owl
Watching, “watching out for
friends,” protective, being a “night
owl,” “looking out for everyone”
19) Turtle
sly
20) Tiger
Protective, ready to pounce
Favourite animal, was referred
to as a “lion”
21) Elephant
22) Dog
Not having a dog, dogs owned
23) Kitten
Having a cat, having a kitten
24) Mouse
Careful, cautious, alert, quiet
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53
CHAPTER 4: DISCUSSION
I introduced the reflection cards as an opening circle activity to help me support the
therapeutic goals of the special education students. My hope was that the cards would provide a
focus for discussion that might shorten the time people would take for their turn. I also hoped
the cards would be a more structured activity that would help participants self-regulate enough to
be patient while waiting for their turn. The cards did help to focus discussion, but their use also
facilitated communication for participants that often did not say more than one word during
opening circle. The images on the cards also helped expand participants’ emotional vocabulary
by providing a metaphoric representation of their feelings. Ultimately, the use of the reflection
cards helped me learn about my way of being an art therapist, particularly in a group setting.
Facilitating communication to support therapeutic goals
The special education program’s goals for the students attending the program are social
skill development and increased independence through improved self-mastery of life skills.
Additionally, the goals of the art therapy sessions for people with developmental disabilities, as
identified in the Kutenai Art Therapy Institute Practica Resource Handbook (Carpendale,
2009b), include:
expression of emotion;
improved self-esteem;
reversal of learned helplessness;
sensory, cognitive and perceptual stimulation; and
pleasure and relaxation.
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54
In her book Art Therapy for Groups, Liebmann (1986) notes that group work provides an
environment in which “people with similar needs can provide mutual support for each
other…group members can learn from the feedback of other members…” and “group members
can try new roles” and depending on the group’s reaction, their behaviour can be reinforced or
discouraged (p. 7). The opening circle activity offered a weekly opportunity to experience the
environment described by Liebmann in which participants could share issues, concerns and
experiences related to having developmental disabilities. The opening circle has similarities to
the First Nations’ practice of the talking circle in which everyone is considered equal and respect
is demonstrated by listening to each person as they take their turn to speak about the subject of
the circle (Saskschools). Waiting for a turn to speak during opening circle would be a way for
participants to experience equality and respect. The interactions among participants during
opening circle also offered opportunities for participants and the co-facilitators to support or
discourage behaviour.
Each time a participant held the deck of reflection cards they were able to pick an image
of their own choosing and choose to share with the group what associations they had with the
image on the card. The ability to choose is, according to LaMore and Nelson (1993), “important
for the long-term development of an internalized sense of self-efficacy” (p. 397), which supports
the therapeutic goal of increased independence. But, as Bull (2012) notes, there are many factors
that impede the ability of a person with developmental disabilities from making choices in their
day-to-day life such as directive support staff, limitations on resources or services, “fear of
consequences” (p. 27), inflexible routines, and “communication difficulties” (p. 27). The act of
choosing a card without concern for external controls or direction may have supported the goal
of increased independence.
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The images on the reflection cards also offered an alternative to verbal communication
that had the potential to cause difficulties or conflict among participants during opening circle.
Alternatives for verbal communication can also take “the emphasis off the struggle to speak and
reduce any anxieties of the client, which in itself can facilitate spontaneous verbal expression”
(Fennel & Jones, 1998, p. 190). Participants responded to the images on the cards with
expressions of how they felt emotionally or physically, or of memories of pets or events. The
images chosen by the participants whose speech I had difficulty understanding provided a visual
clue regarding the information being shared. During the 10th session for example, Gary chose
cards 13 (single tree in fog), 15 (rain on window), and 12 (rainbow) to share with the group his
perception that after it’s rainy and foggy, as it was that day, a rainbow will appear, a narrative I
felt I understood better because I had the images Gary chose to refer to as he spoke.
Rogers identifies his “most important and frequent behaviour, and that is to understand the
meaning of what a person is communicating” (p. 51). Because I had difficulty hearing what
Gary was saying, the images on the cards provided a visual cue for the narrative he was
communicating to the group. Participants whose verbal contributions during opening circle were
typically limited to single word responses had a wider range of expression through the variety of
images they chose. For example, Rob spoke very little at any time during the sessions but chose
a different card each week. I compared his choices to the other participants and noted that he
chose a different card than anyone else for the majority of sessions, which may be an indicator of
independent decision-making. He did not use words to describe his association with the cards
chosen until the sixth session when he said “sky” in relation to the image of lightning. I wonder
if this is an example of what Fennell and Jones suggested that when working with people who
have learning difficulties, taking the pressure off of having to communicate verbally may
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eventually lead to verbal expression. Perhaps holding up the images of the reflection cards he
chose gave Rob the time he needed to ease into participating during opening circle until he was
ready to verbally share with the group.
Expanding emotional vocabulary with metaphor
The images on the reflection cards elicited responses from participants that varied from
literal to metaphoric from the first day the cards were used. The range of participant expression
when responding to the images exceeded my expectations regarding the potential benefits of
using the reflection cards. Caprio-Orsini (1996) explains how art therapy provides people with
developmental disabilities a way to expand their emotional vocabulary, which was my
perception of the participant’s experience when responding to the images on the reflection cards
even if their response was limited to choosing a card and holding it up for the group to see the
image.
As a projective technique in the spirit of Walker and Weiser, the images seemed to
encourage participants to share memories of holidays, pets and family that expanded my
understanding of participants’ lives not unlike how Case and Dalley (2006) describe how art is a
concrete object from which participants can learn more about each other. Weiser explains “in
looking at others photos, we actively take part in the meaning we perceive (based on our own
personal and cultural filters for interpretation) and we subconsciously take the meanings we need
at that time emotionally” (1988, p. 259). The images functioned as symbols that represented
concepts for which participants had associations (Arnheim, 1969), thereby expanding the range
of topics shared with the group. That these associations might be filling an emotional need at the
time a participant chooses the image adds yet another potential layer to my understanding of the
cards’ benefits for participants.
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The metaphoric associations also provided insights that might otherwise not have been
shared with the group, or at least I was not aware of similar insights to that point in the sessions.
As Kövacses (2000) explains, “conceptual metaphors bring two distant domains (or concepts)
into correspondence with each other…the correspondence is established for the purpose of
understanding the more abstract in terms of the more concrete” (p. 4). Participants who might
have difficulty describing complex emotions or states of being were able to use an image that
corresponded with those feelings. During the first opening circle in which the cards were used,
Sarah chose Card 14 with an image of lightning to describe the feeling in her mind. The image
and the description of what the card represented to her was in contrast to her affect that was
typically calm and happy and her art that I remember as having bright colours and stereotypic
images of flowers, sun, blue sky and puffy white clouds. Moser (2000) defines metaphor as an
analogy where similarities of one experience can be understood using the terminology of another
experience. The image Sarah chose provided a visual metaphor that was analogous with her
experience when there is a lot going on in her mind. According to Lakoff and Johnson, “the
essence of metaphor is understanding and experiencing one thing in terms of another” (p. 5), a
process that expands our way of knowing.
In the example of Sarah, the image of lightning provided a visual metaphor of the feeling
in her mind that others in the group could see and have an increased understanding because of a
shared experience of lightning. Conboy-Hill (1992) asserts that to facilitate the capacity to be
understood, people with learning disabilities require an emotional vocabulary to describe how
they feel. The image of lightning provided Sarah with a visual means to expand her emotional
vocabulary of an internal experience through which, according to Kuhns (1983), the symbol of
lightning may represent repressed unconscious material expressed through her association with
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the image. I wonder if the use of the cards helped Sarah reduce her resistance to discussing
repressed or uncomfortable issues by presenting the experience she has of inside her head in a
new way (Moon, 2007).
Caprio-Orsini (1996) asserts that a wider range of expression for emotions for people with
developmental disabilities “aids in facilitating appropriate discharge of their internal chaos” (p.
15). Other cards that facilitated expressions of internal chaos were the images of a tornado that
was said to represent the feeling of a lot going on in the participant’s head. The image of flames
chosen by other participants to describe what they felt in their stomach or nerves. Having images
that may represent “internal chaos” provided participants with imagery that was analogous to
feelings that could be expressed more clearly than if they had to rely on words alone. The
imagery is a representation of how an individual feels that, when described, can lead to a wider
emotional vocabulary. Carpendale (2009a) asserts “when perception informs language we get
invention and innovative creativity” (p. 22). The images on the reflection cards were used by the
participants as visual representations of emotions or characteristics that, when the image was
described, provided a metaphor from which to describe their feelings or emotions using
innovative and creative language arising from the image they chose.
The reflection cards offered an opportunity to share common associations among
participants for an image as well as learn that participants had multiple associations for the same
image. For example, more than one participant chose the owl image to signify how they watch
out for others. In this way, meaning is shared among participants and they can understand how
others feel the same way. But there were also a variety of associations expressed by participants
for the same image. Associations by different participants for Card 19 with the image of the
mouse included being careful, cautious, alert, and quiet demonstrating how the mouse image
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could have a multiplicity of meanings depending on the individual who chose the image. Caprio-
Orsini explains that “people with developmental disabilities often have limited labels for feelings
and emotions” and that “the use of art therapy is helpful to visually illustrate various language
concepts for emotions and widen the range for expressing feelings” (1996, p. 15). The card
images served as visual concepts from which the participants expanded their emotional
vocabulary by telling the group their associations to the image.
The addition of animal imagery elicited responses that provided insights into participant
self-perception. Case (2005) notes that people have “an affinity towards particular animals, they
are drawn towards a distinguishing feature or set of characteristics” (p. 32) and that “a sense of
identification with an animal, suggests a wish to come into relationship with an aspect of the
unconscious, symbolized by the animal” (p. 34). Participants expressed symbolic relationships
with the animal cards when they described the associations they had with the characteristics of
the animal whose image they chose. Sarah described how she is like the owl because she is
watchful of her friends or when Tom identified associations with the owl because he stays up
late. Jan recognized characteristics of the dog as being similar to a friend she identified in the
group, thereby extending the association of an image onto aspects of another participant.
Knowing that the images hold significant potential for supporting expression of emotion,
it is worth noting that one card was never chosen, Card 8 that is an image of a brown and black
caterpillar on gravel. This type of caterpillar is familiar to me because it is common in the
prairies where I am from, however, anecdotal evidence I gathered by asking people local to the
area suggests that this type of caterpillar is not typical where the research took place. As a result,
I came to understand the importance of having familiar images from which participants could
readily make literal or metaphoric associations and to select commonly-understood images.
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My way of being an art therapist
My initial aim to mitigate the discomfort experienced by other group members and myself
by finding a way to reduce the length of time participants spoke for their turn during opening
circle was, for the most part, achieved; with two exceptions. The first exception occurred when
Card 17, with the image of flowers formed in the shape of a heart, was chosen by participants. I
included the image because I observed that intimate relationships were on the minds of some
group members and I hoped the image would acknowledge the issue while containing the
amount of information shared. On the third week, three participants chose Card 17 and two of the
participants spoke at length about friends and relationships. I became concerned that the
increased dialogue when participants chose the card for their turn and that the number of
participants choosing the card was increasing each week were indicators that the image was
leading the group toward a similar situation that inspired me to make the cards. Attempts to curb
discussion associated with the card, such as encouragement to channel the verbally expressed
emotions into art making, were not successful and the level of unease during opening circle
seemed to me to be increasing.
The second exception was Sarah, who chose four or more cards five weeks after the
activity was introduced and then chose seven or more cards by the ninth week. The length of
time the group had to wait while she chose the cards and then share her associations of each one
contradicted one of the intentions for introducing the cards. I found Sarah’s need to spend more
time than other participants to choose and speak about the cards interesting because she was not
a participant who monopolized opening circle before the cards were introduced. I wondered why
her desire to choose more than five cards was so great that she did not to participate in the
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activity when the quantity of cards for each participant was limited by dealing the deck to the
group.
Although most participants chose different images throughout the sessions, it is apparent
after reviewing the chart in Appendix 1 that Sarah frequently chose Cards 18 and 19. I noted that
no other participant chose Card 19 with the image of the mouse and that another participant
chose Card 18 with the image of the owl only one other time. I wonder if this signifies that the
frequent choosing of one image by a single participant may create such a strong association with
that individual that others then avoid choosing the card. The aversion of others to choose a card
associated with a particular participant is most likely the reason why Card 24 with the turtle
image was chosen only by Sarah, who requested the image be added to the deck. Did the other
participants not choose the card to avoid a potential confrontation Sarah? The incident that
occurred when Jan was accused by Sarah of copying her card choices on the same day may have
served as a warning to the others in the group that they should not choose the same cards as
Sarah.
The turtle card is another possible example that demonstrates Sarah’s dominance in the
group that I may have unwittingly contributed to by making the card at her suggestion then
adding the image to the deck without introducing it to the group. Interestingly, no other
participant chose the card except Sarah. I recall wanting the card to be a pleasant surprise for
Sarah without considering the affect this action might have on her or on the group. In retrospect,
there were other ways I could have introduced the turtle image, such as adding other animals at
the same time, or extending the opportunity for other participants to request another image when
the turtle was requested. By keeping the exchange about the image between me and Sarah, other
participants may have perceived an alliance that shifted privilege to one individual in the group.
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During the fifth session after the reflection cards were introduced, I noticed behaviours
surfacing that I had hoped to contain with the use of the cards. On the sixth week, Sarah chose
four cards. Jan chose the same four cards and was accused of copying by Sarah. Jan then chose
one card to share with the group. I noted the behaviour but did not interject. On the ninth week,
Sarah chose more than seven cards and Karen sat by herself to the side of the table, waiting until
after opening circle to join the group. Opening activities, according to Carpendale (2009b), help
build relationships among group members while establishing safety and trust. I wonder if the
safety and trust established in the group eroded because some participants were exploring the
boundaries of the activity by choosing more cards than the one for each turn as described when
the activity was first introduced to the group.
When the new card distribution method was introduced, the group’s cohesion appeared to
disintegrate with some members choosing to not participate in opening circle and leaving the
circle entirely. Moon explains that “one way to create a safe milieu is by establishing group
rituals” and that “ritual actions communicate information and reinforce social cohesion” (2010,
p.12). It would appear that group cohesion broke down when the ritual of how the reflection
cards were shared among the participants changed. Or, did some members of the group stop
participating in the activity because I removed the opportunity to make choices. Once I re-
established the option to choose cards, all participants once again took part in the activity.
It is worth noting that I suggested using the cards during opening circle the following year
at the same practicum where five of the same students were again attending the special education
program. The students told me they did not want to use the cards any more. The rejection of the
reflection cards as an activity provided an important personal insight for me. The unexpected
benefits were significant with respect to how the reflection cards appeared to expand the
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emotional vocabulary of participants and offer opportunities for the group to learn more about
each other’s experiences. However, the behaviour among participants that inspired the creation
of the cards eventually resurfaced and I learned that the reflection cards alone could not help me
maintain the emotional safety of the group. According to Moon (2010), the art therapist group
leader’s attitude “must include concern, acceptance, and willingness to engage with clients in
their pain and creative risk-taking as they struggle to find meaning in their lives” (p. 112). An
area of growth for me was to be more proactive to engage with participants when they expressed
pain or anxiety, or when group interactions seemed to cause discomfort during opening circle so
that feelings could be expressed and the emotional safety of the group was maintained.
Another area of growth I recognized through the use of the reflection cards was to reflect
back more to the individual in response to the card they chose. For example, Brent did not
verbally share his associations with the card he chose each week. He instead brought up the same
issues week after week about his relationships with his friends. I realize that I did not take the
opportunity to directly ask Brent about his association with the image he chose. If I had taken the
initiative to ask about the connection between the comments and the image, I may have been
able to direct the participant in a manner described by Yalom (1931) in which the therapist
focuses the group on the here-and-now of the therapeutic moment and illuminates the therapeutic
process by reflecting on what is happening in the therapeutic moment, which in this
circumstance was the participant’s choice of reflection card. Rogers (1967) echoes this sentiment
when he explains that the leader (of a basic encounter group) is primarily responsible for
facilitating group member’s expressions of thought and feelings and to provide a focus on
process and personal interactions as they occur in the group. Reflecting back to the participant on
the present, vis-á-vis the image chosen, would have supported my intention of using the cards to
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help focus participant comments on how they were doing at the time of opening circle rather than
expect the use of the reflection cards alone to achieve the intended purpose.
I came to realize that my therapeutic presence and capacity to ensure the safety of the
group could not be supported by a communication aid alone. Ohlsen (1970) describes the
effective leader as someone who “tries to understand forces within his group that contribute to
and interfere with the group’s goals” (p. 49). My incentive to create the reflections cards arose
out of my inexperience facilitating a group session, which played out in my imagination as
Williams (1966) described as the fantasy of losing control of the group along with an aversion to
be assertive and possibly appear confrontational. Although the reflection cards initially addressed
the issues of concern for me, the behaviour manifested in the group once again because I had
depended on the use of the cards to manage behaviour rather than seeking an understanding of
the group’s dynamics and my own responses.
Another important realization for me was that the discomfort experienced among
participants, including myself, is important emotional material to work with. In his book Art-
based Group Therapy: Theory and practice, Moon (2010) explains that for art-based group
therapy to be most advantageous for clients, “two qualities that must be present: emotional safety
and anxiety” (p. 11). The reflection cards were a way for me to help establish an environment of
emotional safety, but what I came to learn was that the cards also needed to facilitate the anxiety
that arose among participants. But in order for the cards to be helpful as a tool to work with the
group’s anxiety, I first had to learn how important the feelings of discomfort were to the
emotional growth of participants and become comfortable working with participant anxiety for
the art therapy group experience to be of most benefit.
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65
I initially attributed the group’s rejection of the reflection cards the following year to my
inexperience facilitating the group rather than on the efficacy of the activity. It is interesting to
note Riley’s (2001) observation that the “spontaneous and unpredictable” nature of a group
requires a “mode of communication that does not distort information but provides enough
distance that it may be received without rejection” (p. 2). I believe I was not confident or
experienced enough as a facilitator to ensure enough distance between the reflection cards and
the group, including myself. Participants became allied to particular cards and the way in which
the cards were distributed. As a result, the reflection cards became too closely associated with
the group dynamics that were initially an issue, and, as a result, were ultimately rejected by the
group.
It may also be the case that the opportunity to make choices was more important for
participants than I realized. When I removed the aspect of the activity that allowed participants
to make a choice of card or cards from the deck, I was taking away a ritual in the group that
offered participants an opportunity to exert independent will. This insight makes me wonder if
the cards supported the therapeutic goal of independence more than I had thought. Moon (2007)
points out that the client chooses the meaning of a metaphor in the artwork, or in this case the
image on the card, and its meaning in their life. By removing participant’s ability to choose, I
became an external locus of control directing which card they should have and make associations
with.
I remember having mixed feelings when the participants rejected my suggestion at the
beginning of the following year that we use the reflection cards. There was a sense of
disappointment that the group did not want to use the cards, but I also had a sense of relief. I had
created the cards to mitigate feelings among the group of confusion and powerlessness. My relief
REFLECTION CARDS FOR OPENING CIRCLE
66
may have arose out of not having to continue trying to make the cards work for their originally
intended purpose: I was ready to give up. When Lomas and Hallas (1998) reflected on their
experience of the art therapy group they facilitated for adults with developmental disabilities,
Lomas noted how she felt “stupid” (p. 52) and Hallas describes her feelings of “uselessness” (p.
53) in response to the discord they describe among participants. Hallas wonders, in the context of
handicap, if these are emotions experienced by the participants in their day-to-day life but held
by the therapists during the group sessions. This counter-transference experience is also
documented by Mair Rees, who considers feelings of inadequacy as “a telling insight into the
client’s self-perception” (1998, p. 240). Did I similarly experience a counter-transference and
hold the confusion and powerlessness of the participants attending the art therapy group I co-
facilitated? Did that counter-transference shift by the end of the sessions to a feeling of giving
up?
I created the cards in an effort to mitigate behaviour during opening circle that caused
discomfort among the group and resulted in my own feelings of confusion and powerlessness,
only to have the cards rejected by the group. I reflect again on the experience of Hallas who
expected the art made in the sessions to serve as “appropriate containers for the scapegoat
transference, and thus diminish the scapegoating of individuals in the group” (1998, p. 54).
Although I did not have in mind that the cards would serve as a vessel for scapegoating
transferences, I intended the same outcome as Hallas did for the art, and that was to direct
attention to the reflection cards to minimize confusion and my sense of powerlessness when the
incident that initiated my research occurred.
Hallas concludes that it was the group sessions, “the activity itself that became the
scapegoat” (1998, p. 54). I would extend Hallas’ observation to the activity of the reflection
REFLECTION CARDS FOR OPENING CIRCLE
67
cards that became the container for the participant’s experiences of confusion and powerlessness
arising out of communication difficulties with people who do not share their disabilities. When I
directed the participants to take the card dealt to them, group cohesion faltered and resulted in
some people in the group refusing to participate in the activity until the option to choose was
restored. When I asked the group the following year if they would like to use the reflection cards
again, the group rejected the cards, and in so doing, perhaps rejected the assertion of someone
without a developmental disability, to “take the card dealt to them.” Perhaps the reflection cards
served as the scapegoat for feelings of confusion and powerlessness and were not wanted back in
the group.
Perhaps by taking away the option of choice in the activity, my behaviour triggered a
transference for some participants who felt confused and powerless in relationships with other
people in their lives such as support workers or family. As a result, I experienced a counter-
transference to participants. The first counter-transference was to behave like other people in the
participants lives who assert control over their choices because of their disability, an aspect that
did not align with my training or humanist aspirations for being an art therapist. Perhaps
participants were able to use the reflection cards as a scapegoat for feelings of confusion and
powerlessness related to their disabilities and associated communication challenges, feelings that
I had experienced as a counter-transference while facilitating the group that led to me creating
the cards.
Jane Caven refers to her own experience and that of Lomas, Hallas, and Rees to conclude
that “common counter-transference responses …can ultimately help us as therapists understand
how clients with learning disabilities feel” (2012, p. 41). Given that communication is often a
challenge for people with developmental disabilities and, as a result, it may be difficult for them
REFLECTION CARDS FOR OPENING CIRCLE
68
to express their feelings, I realize the importance of paying attention to how my difficulties
understanding participants and my feelings of confusion, powerlessness, and giving up may
illuminate, through counter-transference, my understanding of the feelings and experiences of
participants in the group art therapy sessions. My increased understanding has contributed to,
and will continue to inform, my way of being a person-centred art therapist.
Chapter summary
The use of the reflection cards for opening circle succeeded in helping reduce the length
of time participants took for their turn and to focus their subject for sharing on themselves. What
I hadn’t anticipated was how the images on the cards facilitated communication by revealing
participants’ feelings and interests that had not as yet been shared in the sessions. The images
also created an equitable starting point for communication because all participants chose an
image. The reflection cards also helped expand the emotional vocabulary of participants through
the metaphoric associations they made in relation to the images. I perceived the developments
that arose out of the use of the reflection cards as an indication of my success as a developing
therapist until the final three sessions and then the group’s rejection of the cards in the following
year of the practicum placement. The potential counter-transferences helped me better
understand the experiences of the participants and my way of being an art therapist. The
following chapter explores how this research provided me a better understanding of my strengths
as an art therapist and the areas I needed to develop so I can better support the therapeutic needs
of adults with developmental disabilities.
REFLECTION CARDS FOR OPENING CIRCLE
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CONCLUSION
This research explored the use of reflection cards as an opening circle activity to help me
support the therapeutic goals of the students of a special education program who have
developmental disabilities. Using first-person action research to gather the data supported a
research approach that I intended to be egalitarian and that invited the input of all participants.
Positioning the action research from a first-person perspective helped me conclude the research
had more to do with my efficacy as a developing art therapist and less to do with finding a tool to
manage behaviour of the students during opening circle. My research focus instead shifted to
how I could better facilitate communication in the group to support the therapeutic goals of the
program in a way that was empathetic and respectful of the participants.
The use of the reflection cards as an opening circle activity was a helpful communication
tool for the adults with developmental disabilities attending the group sessions. The reflection
cards provided a focus for discussion for those who might otherwise use opening circle as a
personal forum and speak at great length. The cards also provided a starting point from which to
speak for those who appeared to be intimidated and spoke only little or not at all. For those who
preferred not to speak, choosing a card as others had done before them allowed them an
opportunity for expression they could share with the group and be part of the shared ritual.
Additional benefits included insights into participant feelings that were inspired by an image and
that may not have been otherwise expressed to the group and the development of metaphoric
language.
Although there are decks of cards that are used in therapy, or art therapy specifically, that
are used to enhance communication, for example tarot and OH cards that have complex images,
REFLECTION CARDS FOR OPENING CIRCLE
70
the reflection cards in this research use a simple photographic image on which participants can
project meaning. As a result, participant response to the image may be quicker because there is
less chance of the participant getting caught up in a card that has more detailed imagery. The
illustrated images of tarot and OH are also an artist’s representation of a concept and therefore
already imbued with another’s perception of that concept. Although the images on the cards still
run the risk of containing the photographer’s intention, I hoped the simplicity of the image would
reduce that risk.
As a result of this research, it became evident to me that the reflection cards alone could
not replace the need for me to be more active as a facilitator so that group interactions supported
the program’s therapeutic goals related to the development of social skills. I have also come to
understand that the therapeutic goals of the group are not necessarily those expressed by the
participants. I will take the lessons learned in this research about the here-and-now approach in
group therapy so future use of the reflection cards can facilitate greater therapeutic benefits for
participants. I will also strive to be more person-centred when working with people who are in
therapy under the auspices of a program that has goals identified for the participants. No matter
how beneficial those goals may be, I think it is important to not assume that participants share
those goals. Another way to support the goal of increased independence is to provide participants
the opportunity to identify their own goals. I also have come to respect the opportunities for
improved self-awareness that arise if I pay attention to the transferences and counter-
transferences that arise during group art therapy sessions.
Further research could explore how the reflection cards used during the opening circle
activity encourage metaphorical expression in the art making that follows. Another area of
research could study the use of the cards in other populations where expanding an emotional
REFLECTION CARDS FOR OPENING CIRCLE
71
vocabulary could be beneficial for expression of feelings, such as at-risk youth and seniors. More
research to ensure the images have commonly-understood associations could improve the
efficacy of the reflection cards, including the addition of more animal images as suggested by
Gary.
REFLECTION CARDS FOR OPENING CIRCLE
72
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APPENDIX I
1. The number of cards chosen was noted but not the specific images, only that they were similar images chosen on
previous occasions.
2. One (card) was dealt to each participant.
3. Cards were dealt one at a time to each participant. Individual could keep their card or discard to the middle of the
table and continue to do so until they received a card they wanted.
4. Chose the same four cards as another participant, told by another participant she was copying that participant, then
chose a different card.
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APPENDIX II
Kutenai Art Therapy Institute
#201 - 601 Front St., Nelson, B.C. V1L 4B6.
Fax: 352 5911.Phone: 352 2264.
Release Form - Adults
Date _________________
Location ___________________________________________________
I, ___________________________________, agree that to participate in an art therapy practicum
provided by students of the Kutenai Art Therapy Institute, which I understand are
supervised by the staff of the Institute. All artwork and information is kept confidential.
The Kutenai Art Therapy Institute adheres to the Canadian and the B.C. Art Therapy Code
of Ethics.
1. I give permission for my artwork to be shown to students and professionals for
supervision & educational purposes only.
2. I give permission for slides to be taken of my artwork for a case study.
3. I agree to allow the artwork to be used by the student for research purposes.
4. I understand that at all times my identity will be kept anonymous.
5. ( ) optional: I also give permission for the artwork and pertinent comments and case
material to be used for educational case study presentations and publications. This could
include conferences, courses, articles and books. This permission is given with the
understanding that my identity will be disguised to prevent public disclosure.
6. ( ) optional: I understand that as part of the students’ training they may wish to
videotape a session and that this tape will be erased after it is viewed by the supervisor and
the student
Limits of Confidentiality:
I understand that all information will be kept confidential unless:
there is a threat of bodily harm to self or others
there is indication of child abuse
the information is requested by subpoena for court purposes
Signed __________________________________________
