Sandtray Therapy With Adolescents

Sandtray therapy is an effective intervention with adolescents (Flahive & Ray). Depending on the age of the adolescent, therapists may need to modify the processing phase of sandtray because many adolescents are not able to think abstractly. As a general rule of thumb, fifteen is accepted as an age at which most adolescents have reached Piaget’s formal operational stage of development (Wadsworth, 1996). With older adolescents, sandtray therapist should be able to use many of the facilitative responses that they use with adults but with young adolescents, they may need to respond in a more concrete manner. For example, when I do sandtray with an older adolescent, I typically ask, “What is it like to think about that right now?” This response helps clients to focus on feelings and stay out of their heads. But young adolescents may not be able to respond to such a question because it is too abstract. A reflective response such as, “You seem sad when you think about that,” would probably be much more helpful to younger clients.

With young adolescents who appear to be in the concrete operational stage of development, I would recommend the following.

· Pay close attention to gestures, facial expressions, and tone of voice. Nonverbal cues are even more important with this age than verbal content because children this age typically express their feelings nonverbally. As I discuss throughout the book, being able to read nonverbal cues is very important in the humanistic approach to sandtray therapy.

· The processing time is much shorter with concrete operational children. Therapists should not expect a deep processing experience.

· Communicate a nonjudgmental attitude. Even though this is important with any age, I think that it is especially important with this age. Children need to feel safe before they will feel comfortable enough to explore feelings or issues.

· Focus more on the physical layout of the scene and comment on specific objects and their location and relation to other objects. “This one is over here by itself.”

· Stay with the metaphor or symbol. If the client says, “The dog is over here by itself,” respond by saying something about the dog. I might say, “The dog looks lonely.” Allow the child to own the symbol or maintain the safety of the symbol. The child doesn’t have to talk about how any of the symbols relate to her. Do not be in a hurry to shift the focus from the symbol to the child.

Counseling with young adolescents is similar to play therapy: activity tends to be more important than words. Many young adolescents will be much more comfortable talking if they are doing something at the same time.

Most older adolescents are capable of longer sandtray processing and many are quite comfortable talking at length with therapists if the therapeutic relationship is strong. Like adults but probably more so, trust is very important in the relationship. If the relationship is strong, many older adolescents are willing to talk about and focus on core issues, which is not typical of younger adolescents. This willingness allows humanistic sandtray therapists to facilitate awareness much like they would with adults.

Regardless of age, a good therapeutic relationship is much more important than any technique or facilitative response. Research clearly demonstrates that regardless of theoretical orientation, the quality of the relationship is more important in client outcomes than specific techniques. Humanistic sandtray therapists stress a deep and trusting relationship and a climate that promotes growth. If adolescents feel like they can be themselves, it is much more likely that they will grow and change in therapy. Sandtray can be one modality that is a part of this growth process.

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