Dockteater & Terapi

Artikel från Dockteaterdagarna på Frölunda Kulturhus mars 2009:

Dockteater i terapi & pedagogik (klicka på texten för att öppna länk)

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Hand-out från konferens i USA sommaren 2009 (OBS! copywright):

Creating & Using Healing Stories in Education & Therapy

Presented By: Joanne F. Vizzini, Ph.D., LCPC, NCC

Dissertation Abstract: To date there has been little controlled research on use of puppet therapy to facilitate psychotherapy in general and alcoholism treatment in particular. This study established a foundation for quantitative puppet therapy research. The contribution of three puppet therapy sessions compared to three sessions of regular therapy in a 12-Step inpatient chemical dependency facility on evaluation of treatment, anxiety levels, and spiritual coping were investigated. Respondents (N = 71) were patients at Hanley-Hazelden chemical dependency facility, West Palm Beach, Florida. Participants completed the Client Satisfaction Questionnaire (CSQ-8), the State and Trait Anxiety Scale, the Religious Problem-solving Scale,  and some demographic questions. Days in treatment was used as a covariate and units: women, men, and older adults were used as a stratifying variable. Results indicate that puppet therapy was evaluated significantly higher by all groups compared to regular therapy. For women and men ages 55 and below, state and trait anxiety was lower in puppet therapy groups compared to regular therapy groups and higher for state and trait anxiety for older adults, women and men ages 56 and above. Spiritual coping scores were non-significant except for the men’s unit. The self-directing style was used in both therapy groups on the men’s unit significantly more than the older adult unit. The alexithymia variable was non-significant across therapy groups and only about 30% of the sample was truly alexithymic, scores > 61. ANCOVA was used to evaluate therapy, unit and therapy x unit for each of the seven dependent variables. Further research duplicating this study as well as use of this model with clientele who have obtained longer sobriety is recommended.

An Overview of Puppet Use

Puppet Therapy:

“For the purpose of this (presentation), puppet therapy is defined as puppet use by a trained therapist in a therapeutic setting for the purposes of psychotherapy.” (Vizzini, 2003, p. 9)

W. M. Pfeiffer wrote, “Whereas it matters little if only a few readers of this annual publication   . . .  are interested in the treatment of mental disturbances, all puppeteers should know what an effective means of treatment they hold in their hands . . . . A veritable ‘hygiene of the soul’ for normal people, both children and adults” (1977, p. 30). 

Medical Use of Puppets:

These accounts are generally not puppet therapy.  See Zahr, 1998, puppets in play used to lower stressful responses to surgery for preschool children in Lebanon.

Two accounts of puppet therapy: Linn, Beardslee and Patenuade (1985) reported on children having a bone marrow transplant, and Cassell (1965) designed an experiment for children before an operation.  In both studies puppet therapy was considered successful.

Educational Use of Puppets:

Sesame Street (Children’s Television Network, 1968) provided formative and summative research.

Kids on The Block (Snart & Maguire, 1986; 1987) provided empirical evidence for increase knowledge and positive attitudes toward children with disabilities.

Theoretical Development of the Use of Puppets in Therapy

Play:

“In play we may move below the level of the serious, as the child does; but we can also move above it – in the realm of the beautiful and the sacred” (Huizinga, 1950, p.19).

“A word search in various cultural contexts to tease out the meaning of “play” took Huizinga to the word aardigkeit (from the word aard for “art”) from the Dutch language and the German word wesen meaning “essence” or “state of being.”” (Vizzini, 2003, p. 25)

“Play and humor are multidimensional, adaptable, and associated with ingenuity and the promotion of mental health (Witmer, 1985).” (Vizzini, 2003, p. 26)

Adult Play:

“Thus, play is engaged in by both children and adults because it relieves the stress of living in reality and the frustration of basic conscious and unconscious needs; it provides a mechanism for confronting a challenge and overcoming it in a gratifying manner” (Colarusso, 1993, p. 226).

“Through the arts, we try to transform not only our joys, but also our tears and anguish, paralysis and fear, and the unexplained and mysterious into images of strength, clarity, and control” (Steinhardt, 1994, p. 217).

Transitional Phenomenon:

“… Donald Winnicott, proposed the idea of “transitional space” to define the experience of the psyche which supports play. Fraser (2000) discusses object relations theory and cites Winnicott as suggesting that human psychological development is based primarily upon relationships, beginning with one’s relationship with his or her mother.” (Vizzini, 2003, p. 28)

“Adults desire objective acceptance of their subjective phenomenon. Normal adults do so in culturally acceptable means through art, religion, and philosophy (Meissner, 1984).” (Vizzini, 2003, p. 28)

Puppets as Transitional Objects:

“Dolls are probably the oldest toy in human history and have existed for thousands of years. Based on human or animal figures, they may be play objects or serve religious or ritual uses, thus becoming a transitional object between people and their Gods or between people and their emotions” (Steinhardt, 1994, p. 205).

“Puppets serve as transitional objects (Winnicott, 1951).” (Vizzini, 2003, p. 29)

God and Object Relations Theory:

“The transitional space is no longer just a meeting of the minds but a place where creativity is rediscovered by both patient and therapist working very deeply and closely with one another . . . . For instance, some patients are more effectively contacted through a . . . spiritual approach” (Robbins, 1992, p. 183).

“Beginning with Rizzuto, psychotherapists have considered the object representation of God as something that does not need to be overcome, rather as something that can support and aid in the psyche’s integration as a healthy adult.” (Vizzini, 2003, p. 32)

“The language of the heart that includes relational stories about God, self, and others, is essential … (Kurtz & Ketcham, 1992).” (Vizzini, 2003, p. 35)

Rationale for the Study’s Hypothesis

Group as Transitional Space:

“The idea of puppets as transitional objects is supported by the sense that within the context of a group transitional space, a space of safety is possible.” (Vizzini, 2003, p. 36)

“In puppet therapy, the universality of the group allows the members to bond and to regress together.” (Vizzini, 2003, p. 36)

Narrative Meaning and Spiritual Stories:

“Puppet play allows children, with relative safety, to tell their story” (Bromfield, 1995, p 438).

“Entering into the mystery of persons’ stories is the basic art of psychotherapy.” (Vizzini, 2003, p. 40)

“Narrative theory offers another way of understanding selfhood and unique identity. “Research in narrative theory, both in psychology and theology, has confirmed that human personality is storied. Human beings do not simply tell stories, or illustrate their lives with storytelling. We construct our sense of identity out of stories, both conscious stories and those we suppress” (Lester, 1995, p. 29).” (Vizzini, 2003, p. 38)

As persons we are constituted by our social interactions; we have a history, and what happens to us can be and should be integrated in our life story. As adults our sicknesses have a context and a life story (Richard, 1992, p. 105).

Twelve-Step Groups:

“…spirituality is conveyed by stories, which use words in ways that go beyond words to speak the language of the heart. Especially in a spirituality of imperfection, a spirituality of not having all the answers, stories convey the mystery and the miracle - the adventure - of being alive.” (Kurtz & Ketcham, 1992, pp. 8-9)

“In a study by Winzelberg and Humphreys (1999) that predicted substance abuse outcomes at follow-up, 12-Step meeting attendance was significantly associated with the positive outcomes of abstinence and absence of substance abuse problems in the last three months.” (Vizzini, 2003, p. 40)   

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