Together and apart: using Plasticine as a sensory therapeutic intervention for a service user diagnosed with severe learning disabilities

IF 2.3 Q2 PSYCHOLOGY, CLINICAL International Journal of Art Therapy: Inscape Pub Date : 2021-03-01 DOI:10.1080/17454832.2021.1889627
Loukia Chaidemenaki
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引用次数: 4

Abstract

ABSTRACT Background The prevalence of mental illness among people diagnosed with severe learning disabilities is well documented, however limitations in verbal, cognitive, emotional and social skills are often used as reasons to withhold referrals for psychotherapeutic interventions within this client group. Context This paper describes the one-year art-therapy informed psychotherapeutic work carried out with Ioanna, a 61-year-old lady with a dual-diagnosis that took place in a Residential Unit providing psychosocial support for people with severe psychiatric disorders and/or learning disabilities in Athens Greece during 2018. Approach Within the case-vignette the use of Plasticine as a therapeutic medium is presented. Concepts from psychodynamic and object-relations theory are also used as a framework for understanding the course of this therapeutic intervention. Outcomes The contribution of sensory materials appeared valuable in this psychotherapeutic intervention with an apparently ‘untreatable’ institutionalised service user, helping to build a trusting psychotherapeutic relationship, and enable Ioanna to regulate some of her challenging behaviours. Conclusions The use of Plasticine and play, and the development of a ‘together and apart’ game within a psychotherapeutic intervention, appeared to modify Ioanna's challenging behaviour, and improve her ability to relate and communicate with the therapist and her carers. Implications for research Research into the use of Plasticine as part of an art therapy programme for people with severe learning difficulties, would provide a useful addition to the knowledge in this area. A review of the current psychiatric services in Greece and of what constitutes ‘clinical progress’ also seems necessary. Plain-language summary This paper describes the one-year art-therapy informed psychotherapeutic work I undertook with Ioanna, a 61-year-old lady with a diagnosis of severe learning disabilities and mental illness. This took place in a Residential Unit providing psychosocial support for people with severe psychiatric disorders and/or learning disabilities in Athens Greece during 2018. At this time, I was also undergoing my art therapy training. The practice description in this paper describes the contribution of Plasticine as a sensory, therapeutic medium. Theories related to the relationship that a baby or child develops with its primary care giver are used as a framework for understanding the course of this therapeutic intervention. The relationship between learning disabilities and mental illness is well documented in clinical literature, however people with dual diagnosis or severe learning disabilities are often overlooked where referrals for psychotherapy are concerned, as it is believed that they cannot take part due to a perceived lack of communication skills. This paper describes how the use of Plasticine and playing a ‘together and apart' game appeared to contribute to Ioanna’s development of a trusting therapeutic relationship, the modification of challenging behaviour, and improved communication through the medium of Plasticine and play. Research into the use of Plasticine and the ‘together and apart game' with this client group is recommended. It is also important to rethink and reflect on the provision of psychotherapeutic services within the current psychiatric services in Greece for this client group, and consider what constitutes clinical ‘progress' from the client’s perspective.
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一起和分开:使用橡皮泥作为一个被诊断为严重学习障碍的服务用户的感官治疗干预
摘要背景在被诊断为严重学习障碍的人群中,精神疾病的患病率有充分的记录,但言语、认知、情感和社交技能的局限性往往被用作拒绝在该客户群体中转介进行心理治疗干预的原因。背景本文描述了2018年,在希腊雅典一家为患有严重精神障碍和/或学习障碍的人提供心理社会支持的寄宿单元,对61岁的双重诊断女性Ioanna进行的为期一年的艺术治疗知情心理治疗工作。方法在病例小插曲中,介绍了塑化剂作为治疗介质的用途。心理动力学和客体关系理论的概念也被用作理解这种治疗干预过程的框架。结果感官材料的贡献在这种心理治疗干预中显得很有价值,这种干预针对的是一个明显“无法治疗”的机构化服务用户,有助于建立信任的心理治疗关系,并使Ioanna能够调节她的一些挑战性行为。结论塑化剂和游戏的使用,以及在心理治疗干预中“一起和分开”游戏的发展,似乎改变了Ioanna的挑战行为,提高了她与治疗师及其护理人员建立联系和沟通的能力。对研究的影响研究将塑化剂的使用作为严重学习困难人群艺术治疗计划的一部分,将为这一领域的知识提供有益的补充。对希腊目前的精神病服务以及“临床进展”的构成进行审查似乎也是必要的。简明语言摘要本文描述了我与61岁的Ioanna进行的为期一年的艺术治疗知情心理治疗工作,Ioanna被诊断为严重学习障碍和精神疾病。2018年,这项活动在希腊雅典的一个寄宿单元进行,为患有严重精神障碍和/或学习障碍的人提供心理社会支持。此时,我也在接受艺术治疗训练。本文的实践描述描述了塑化剂作为一种感官和治疗介质的贡献。与婴儿或儿童与其初级护理人员发展的关系相关的理论被用作理解这种治疗干预过程的框架。学习障碍和精神疾病之间的关系在临床文献中有很好的记录,然而,在心理治疗的转诊中,患有双重诊断或严重学习障碍的人往往被忽视,因为人们认为他们由于缺乏沟通技能而无法参加。本文描述了使用塑化剂和玩“一起和分开”的游戏似乎有助于Ioanna发展信任的治疗关系,改变具有挑战性的行为,并通过塑化剂和游戏改善沟通。建议研究塑化剂的使用以及与该客户群体的“一起和分开的游戏”。同样重要的是,要重新思考和反思希腊目前为该客户群体提供的精神治疗服务,并从客户的角度考虑什么是临床“进步”。
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CiteScore
5.40
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19
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