Friday, February 27, 2009

The Living Newspaper, 21st century

One of the early sociodramatic structures created by Dr. J.L. Moreno, the physician who developed the action method of psychodrama, was what he called "The Living Newspaper." Participants in Dr. Moreno's groups in Vienna, Austria, would peruse a copy of the day's newspaper, select articles that were of interest and then improvise the scenes of the story, as biographer Rene Marineau tells here. Later, Dr. Moreno enacted significant events with larger groups at professional conferences, including such issues as the 1948 race riots in Harlem, the trial of Adolf Eichmann in Jerusalem in 1961 and the assassination of John F. Kennedy in Dallas in 1963.

Now two news-loving entrepreneurs have created gaming platforms that focus on role-playing discussions with world leaders about significant issues and other interactive news events. Using audio, video and interactivity, Eric Brown and Asi Burak have created more than 100 games on "Play the News." The games are designed to help people understand complex topics that range from the U.S. election, auto mergers, big oil in Iraq and the Israeli-Palestinian conflict. The Poynter Institute reports here.

The facts of change, one stage at a time

How are you changing today?

Change is more than a buzzword, more than a political slogan – it’s a fact of life. Today’s training workshop took a look at the six stages of change as identified by psychologist James Prochaska, author of “Changing For Good” with John C. Norcorss and Carol DiClemente.

First, we borrowed Natalie Miller’s “Walking The Wheel Of Change” action structure that she used when presenting at the annual conference of the American Society of Group Psychotherapy and Psychodrama in 2006. Then, using the psychodramatic techniques of concretization, locograms and spectograms and the role-play techniques of role reversal and doubling, we explored at how these six stages can be enlivened with props -- notice the beautiful butterfly above -- metaphors and dramatic vignettes. As we proceeded, we covered examples of personal growth, psychotherapy, coaching, staff training and clinical supervision.

Some responses from today's trainees:

"I learned group activities that can be used with staff and clients."
"It was a good learning experience."
"Was helpful to have a local or near location."
"Found a sense of acceptance and patience ...."
"Short presentations are wonderful -- I like Fridays."

If you're not familiar with Prochaska’s model – developed after studying how 1,000 people significantly changed their lives in some way – here’s a quick overview:

Pre-contemplation – In this stage, people not only can’t see the solution, they can’t even see the problem. They don’t believe they have a problem so they don’t need to change. But people around them can see problems developing.

Contemplation – Here, people start to think that they have a problem. They try to understand it and learn its causes, and they wonder about how to solve it. They believe that some day they will need to change, but they think this day is sometime in the future.

Preparation – Most people in this stage are planning to take action within a month. They’re going to save money, eat less junk food, stop smoking, reduce their drinking or somehow change their lives. The point here is that they’re making plans. They may question their motives and trying to convince themselves that they need to take action soon.

Action – At this stage, people stop the unhealthy behavior or begin the behavior they want to follow. They pour out the rest of that bottle of vodka. They break or tear up their drug paraphernalia and throw it in the trash. They decide they’re not going to hang with the same old crowd. They stop going to the same old places. They start planning their meals, cleaning out the clutter or putting a part of their paycheck into a savings account.

Maintenance – At this stage, people work on maintaining new habits. They find ways to prevent lapses and relapses. They learn how to deal with cravings and how to deal with their emotions without resorting to substances or junk food. They keep the closet clean or exercise according to schedule. Often they need to rebuild family relationships and develop new friendships.

Recycling – Change is circular and sometimes people aren't able to keep their change pattern. Although your new pattern is the ultimate goal, if you have a relapse (the doughnuts your coworker brings to work, perhaps) remember that it's not an "all or nothing" proposition: you have not failed, you had one misstep; keep working at it.

Wednesday, February 25, 2009

Sex addiction and psychodrama

Sex addiction and psychodrama.

Yesterday’s request of Racine’s former mayor to attend treatment center for compulsive sexual behavior and trauma are bringing his legal charges – and discussions about sex addiction – back into the public eye.

Questions about what is effective treatment are coming forward, as well as what effective treatment involves. Many good programs are available for in-depth treatment of sex addiction and compulsivity, and a number of programs include psychodrama as an important component of their treatment structure. If you’ve been reading this blog, you know that psychodrama is a powerful action method that can bring deeper insights to an emotional difficult issue. Because addicts typically use compulsive behaviors to avoid the experience of self, experiential therapy offers opportunities to have direct experience of self, behaviors and feelings in a structured setting. It has the potential to quickly address issues, feelings and patterns that have been hidden and would take months, or even years, to discover in conventional talk therapy. Experiential treatment allows the addict to actually experience the unmanageability of their lives, the possibility of change and the promise of recovery.

Psychodrama is compatible with the 12-Step ideals that are the core of many treatment programs. J.L. Moreno, the physician who developed psychodrama, understood the healing value of the group as early as 1913 — long before 12-Step groups got their start — and coined the phrase “group psychotherapy.” Several skilled clinicians facilitate psychodrama in a number of well-known treatment centers, including:

Robert Fuhlrodt, LCSW, TEP, at Montclair STAR in Montclair, N.J.
Arlene Story, LPC, CADC III, TEP, at The Refuge-A Healing Place in Ocklawaha, Fla.
Nancy Roberts Willis, LCSW, CP, at Keystone Center Extended Care Unit, Chester, Pa.

Tian Dayton, my friend and colleague, offers background and ideas for using psychodramatic and sociometric techniques with addiction in online article here.

For information, see my online booklet, "Addiction, Action and Change: Experiential Methods Make The Big Difference In Treatment," which includes an essay on psychodrama and addiction treatment.

Monday, February 23, 2009

Annual conference coming right up

The 67th annual gathering of the American Society of Group Psychotherapy and Psychodrama is getting ready to roll.

The professional association's 2009 conference takes place in the Midwest, this year in the gateway city of St. Louis, Mo., from March 26-30. I'm proud to be co-presenting with my colleague Ron Anderson, LPC, CADC III, TEP, on the topic, "Couples Work With Systemic Family Constellation Work." See the online catalog here. There's still time to register, too.

Monday, February 16, 2009

Why warm-ups for groups are so important

Any group that gathers will move ahead in certain predictable stages.

The more that the group facilitator knows about these stages, the moreher or she will be able to facilitate a group with genuine involvement, depth and disclosure. The best group leaders follow a directed but flexible three-part process:

· A warm-up
· High involvement
· Wrap-up

The proper warm-up allows the group to create readiness for the core of the meeting, whether it is designed for education, planning or another task. The core of the meeting is the high involvement, which may take several forms depending on the task and reason for the gathering — Learning? Brainstorming? Healing? Facilitating an exploration of the participants' deepest thoughts and needs? Making plans or organizing the next step? Or something else?

Finally, the wrap-up bring closure to the meeting itself, even if more work is planned later or other needs must be addressed.

Many facilitators know the value of warm ups — sometimes popularly called "ice breakers" — but often don't know how to select the proper activity for a group. Manuals and books have lots of ideas, but veteran facilitators know from experience that what looks great on paper may not work so well in reality.

In preparing the warm-up segment, each group facilitator must always ask: what do I want to warm the group up to?