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Title: The Virginia and MarylandDC Associations

The Virginia and Maryland/DC Associations for
Play Therapy Winter Conference Cultural
Dimensions of Creative Arts and Sandplay in
Clinical Practice with Children Presentation
by Dee Preston-Dillon, Ph.D. February 5, 2005
Efficacy with culturally different clients
requires sensitivities to cultural dimensions of
the symbolic, historic, and mythic.
Purpose Culturally conscious counseling in the
creative arts begins with 1. Self-Reflection Trac
ing and reaching back to explore ones heritage
and developing an awareness of ones evolving
cultural world (Who am I)
  • 2. Partnering-In-Safety
  • Exploring Identity with others in a safe
    context (What are the complexities I am not aware
  • 3. Practicing a discipline of culturally
    consciousness perception (Professional dialogues
    and personal journaling)
  • 4. Integrating cultural strategies in your

Facing the Mirror by Ito Shinsui
Learning Objectives
1. Identify representations of ethnicity and
culture-related issues in creative approaches to
psychotherapy 2. Understand how ethnocentrism
and personal bias seep into our understanding and
interpretation of the symbolic
3. Gain insight into personal suppositions about
ethnicity and culture as a dynamic in
psychotherapy 4. Increase competency with
diversity issues in play therapy
Tribute by Laverne Ross
Ethnicity is the product of actions undertaken
by ethnic groups as they shape and reshape their
self-definition and culture however, ethnicity
is also constructed by external social, economic,
and political processes and actors as they shape
and reshape ethnic categories and
definitions. Joane Nagel
Our Creative Roots - Our Identity
ARCHETYPESforCulturally Conscious Counseling
  • I Art
  • Identification AlienationReclamationTransforma

  • To Give Voice To Embrace
  • Heritage Roots
  • Associate Turn to
  • Perspective of self and others
  • Attachment Acceptance

Ethnic identity encompasses self-concept and
self-identification, a sense of belonging, and
positive and negative attitudes toward one's
ethnic group. Brian W. McNeill
  • Separate Cut off
  • Divide Shame
  • Separate Oppress
  • Fragment Dichotomize
  • Grief and Loss Wounded-ness
  • Genocide

  • Search for
  • Rediscover Re Examine
  • Take Back To Bridge
  • Reflexive Re Construct
  • Fluid, Timeless, Situational
  • Present Past . . . Space TimeCollapse in

  • Self Conscious Cultural Construction
  • Dynamic Symbolic
  • Interpretive Redefine
  • Dialectical Invention
  • Conscious and Unconscious Model of Past
    Life Ways
  • Evolving Traditions
  • Shaped Shaped by Individual Group

Dancing til Dawn by Marianne Millar
Ethnicity is best understood as a dynamic,
constantly evolving property of both individual
identity and group organization. The construction
of ethnic identity and culture is the result of
both structure and agency - a dialectic played
out by ethnic groups and the larger society.
Joane Nagel
  • Trace
  • Reflect
  • Acknowledge
  • Integrate into practice

  • Trace to research the salient historic,
    mythic and symbolic relevant elements
  • Reflect
  • Acknowledge
  • Integrate Into Practice

  • Trace
  • Reflect to respect, to reflect on how the
    traditions relate to the clients
    world and to you
  • Acknowledge
  • Integrate Into Practice

  • Trace
  • Reflect
  • Acknowledge awareness, ask about what
    you learn, and amplify
  • Integrate Into Practice

  • TraceReflectAcknowledge
  • Integrate intervene in culturally
    conscious ways, individuation
    includes cultural dynamics

White Mans Moccasins by Lee Marmon
Theoretical Ground
Hope lies in the efficacy of the clinician to
adopt critical thinking and amplification
strategies to peel back covert, unintentional
Theoretical Ground
Hope lies in the efficacy of the clinician to
adopt critical thinking and amplification
strategies to peel back covert, unintentional
bias.A rich possibility to address the complex
dynamics of ethnocentrism is suggested with
linking a culturally anchored interpretation with
the clients culturallife-world.
Theoretical Ground
Framework Our cultural world is accessible
through nonverbal, symbol-reliant projective
processes. The creative process includes the
interplay of personal experience, unconscious
activity,and familial, socio-political,
cultural, and historic moments.
It may be that having an integrated ego identity
allows for a sense of connectedness to various
groups of people, because self-definition would
involve an integration of various and perhaps
diverse sources of identification. Such would
allow for comfort with and appreciation of
Jay C. Wade Chris Brittan-Powell
Flamenco Dancer I by Caroline Gold
Theoretical Ground
Presuppositions Culture is complex and
evolving with permeable boundaries. Culture is
idiosyncratic as well as a social phenomenon.
It is a code of conduct and an interconnected
web of symbolic creations.
Theoretical Ground
Presuppositions Culture is a socially
constructed constellation of meanings consisting
of such things as practices, traditions, schemas
and familial arrangements, myths and emotionally
charged symbols, values, norms, institutions,
internalized rules, artifacts, rituals, and
modifications of the environment.
Theoretical Ground
Presuppositions Ethnic and cultural
identities are socially constructed. Aspects of
ethnic and cultural identity emerge from cultural
constellations and are embedded in and
interpenetrate our entire life-world.
Theoretical Ground
Presuppositions Cultural constructs and
Identification (conscious and unconscious)
covertly influence behavior, values, language,
interpersonal relating, and perception. In the
creative arts in therapy they influence selection
and arrangement of the symbolic.
Theoretical Ground
Presuppositions Efficacy with culturally
different clients requires insight into the
cultural dimensions and the interconnected nature
of the symbolic, historic, and mythic.
Theoretical Ground
Presuppositions Efficacy with culturally
different clients requires insight into the
cultural dimensions and the interconnected nature
of the symbolic, historic, and mythic. Culturall
y conscious counseling acknowledges individual,
archetypal, and culture-specific representations.
Theoretical Ground
Presuppositions Culture-specific practices
that most effectively mediate culture and
ethnicity include An informed awareness
of, Proficiency integrating, and
Competence responding to historic markers
myths symbols rituals traditions and
evolving cultural representations.
Tibetan Buddha
Because the complexity of culture is often
overlooked, multicultural research often
inadvertently strengthens the stereotypes that it
is intended to thwart. To avoid stereotypic
thinking, clinicians must critically evaluate
cross-cultural research and be thoughtfully
creative in applying it to clinical
practice. Richard B. Stuart
The Problem For the client, coming to terms
with ethnic identity and culture shock frequently
includes oppressive, alienating encounters and
ethnocentric interpretations of experience.
Theoretical Ground
The Problem Ethnic and cultural
identification offers a harbor where one can feel
that some aspect of integrity will be held, will
be witnessed. Someone present should be able to
understand - connect - empathize - see the one
who for a moment stands alone, waiting to be
acknowledged. Yet a harbor can be a trap or
provide safety.
Theoretical Ground
The Problem This identification evolves in a
cycle. Existentially, we stand-alone, then we
stand with others, and then we stand-alone.
Theoretical Ground
The Problem Divides present within the
individual, family lines, generations, tribal
associations, economic strata, and geographic
domains create clusters or complexes of cultural
Theoretical Ground
The Problem Inevitably representations of
cultural divides, identification wounds, and
multicultural, cross-cultural complexities emerge
in the clients creative representations.
Cultural identification and woundedness are
given voice through obvious and hidden meanings
in the symbols.
Theoretical Ground
The Problem If we dismiss crucial identity
issues and cultural markers we risk
misinterpreting ethnic and cultural
representations and alienating the culturally
different client.
To identify oneself as a member of a group may
not be indicative of one's attitudes about the
group or how much the group membership influences
one's perceptions or life experiences. Ethnic
behaviors and practices focus on how involved an
individual is with ethnic social activities and
cultural practices (e.g., music, food).
Margaret O'Dougherty Wright Linh Nguyen
Corrida by Fernando Botero
Theoretical Ground
The Problem Yet, Clinical training in
diversity and multiculturalism may
inadvertently strengthen stereotypes.
Theoretical Ground
The Problem Yet, Clinical training in
diversity and multiculturalism may inadvertently
strengthen stereotypes. Convenient notions
about difference create an illusion of
understanding and cloud perception.
Theoretical Ground
The Problem Pan-ethnic labels dilute the
moderating effects of national origin,
immigration history, religion, traditions, and
familial directives. They distort the symbolic
and over-generalize.
Theoretical Ground
The Problem Supervision may introduce biases
and invalid beliefs that compromise sandplay
process. Hence, theory, training, clinical
expectation, language, philosophical framework,
clinical supervision, and past experience all
influence and shape our approach to culturally
different clients.
Theoretical Ground
The Problem It is not safe to infer a
clients cultural orientation from knowledge of
any group to which he or she is believed to
belong. Making an inference, an
interpretation, about symbolic representations
from assumptions about culture and ethnicity is
likely to contain ethnocentric bias.
Theoretical Ground
The Problem We neither want to imbue
characteristics to an individual from stereotypes
of a group, nor assume that the individuals
experience, perception, or interpretation is in
any way a reflection of some norm for the group.
American ethnic groups are often thought of as
discrete categories to which people belong and
that explain some aspects of psychological
functioning. However, ethnicity is a complex
multidimensional construct that, by itself,
explains little. Jean S. Phinney
Violeta Con Flores (unknown)
When using creative approaches to psychotherapy
such as drawing, music, sandplay, poetry or other
modalities . . . Our ability to move fluidly
between self and other is vital to authentic
communication to connect deeply with the client,
with the symbols, and with the historic moment
that is Now and reaches way Back and way Forward.
A vital step in the development of an equal
partnership for minorities in the academic,
social, and economic life of the United States
involves moving away from assumptions of the
linear model of cultural acquisition. Teresa
LaFromboise, Hardin L.K. Coleman, Jennifer
Library, 1969 by Jacob Lawrence
Culturally Conscious Counseling
  • The Road to Amplification
  • CULTURAL LIFE-WORLD You likely already have the
    case context from records and interviews.
  • The clients life-world, including cultural
    aspects, and your life-world what you bring to
    your practice -- provides the context for
    culturally conscious counseling.

Culturally Conscious Counseling
2. ATTENDINGThe art of Attending begins as the
client begins the creative process. Attending
activates our active listening and patient,
careful observation. The therapist is watchful
and listens to any comments, musings, and
idiosyncratic expressions from the client.
Culturally Conscious Counseling
3. ASSOCIATIONOnce the activity is completed,
the clinician may invite the client to comment,
share a story, and give initial associations to
the representation. Associations are direct
observations made by the client.
Culturally Conscious Counseling
Associations are quite conscious and are often
related to ones experience -- the practical life
world and fantasies about the representation. Ref
lections can include cultural traditions and
elements of culture that are evolving.
Retrato de Ignacio Sanchez by Diego Rivera
Culturally Conscious Counseling
Essentially this is a description from the point
of view of the client. Associations ground the
symbolic and mythic in the reality of the client.
Culturally Conscious Counseling
For example, the client may say, This is my
brother, or, This is a war between the good
guys and the bad guys. A symbol means exactly
what the client says it means and Symbols in
drawing, narratives, and sand scenes carry many
layers of meanings anchored in history, world
cultures, and literature some of which the client
has never seen.
Culturally Conscious Counseling
Here is an Ethical Point During the phase of
associating, the therapist holds back on naming
objects in a picture, or sandplay or story until
the client has done so.
El Mercado (The Market)
Culturally Conscious Counseling
4. AMPLIFICATION is a part of TRACING Amplificati
on is a skill and a discipline. The clinician
explores meaning by searching MYTHOLOGICAL,
Culturally Conscious Counseling
Amplification helps us bring to mind a wide range
of possible influences at work in the unconscious
. . . To give meaning to what may, at first
sight, seem perplexing. Amplification is
co-constructed with the client except in the case
of children when amplification could be invasive.
Culturally Conscious Counseling
  • Hidden in the rich, multi-layered dimensions of
    the symbolic are
  • Multi-faceted Images
  • Memory of Experience
  • Conflicting Emotions
  • Interpretations, Expectations
  • Complex Associations...

Culturally Conscious Counseling
The Symbolic Contains Energies attached to Ways
of Being we can hardly imagine. The symbolic is
both unique to each client AND embedded in our
Flower Festival Feast of Santa Anita by Diego
Culturally Conscious Counseling
Amplification combining modern as well as
traditional ideas can point out destructive or
wounded components of a symbol. Through
Amplification we become aware of shades of
meaning of opposites and dynamic forces.
Culturally Conscious Counseling
For example, if a snake lies half buried in a
sand scene or is part of a drawing or story
amplification brings our associations to meanings
attributed to being exposed and being partly
buried, as well as representations of snake in
the ethnic heritage of the client, general
literary sources, and millenniums of culture.
Culturally Conscious Counseling
Amplification beyond the clients associations
helps the clinician become aware of any energy,
images, and potentialities relevant to the
clients concerns.
Culturally Conscious Counseling
Reflecting on the clients cultural world we
begin to see alternative ways to view the
powerful, multi-layered potentiality of the
Cherished One by Marianne Millar
Culturally Conscious Counseling
Amplification requires research. Your search
for meaning will lead you to texts on mythology,
symbol books, modern comic books, childrens
stories, cartoons, movies, folk lore and fairy
tales from diverse cultures, and encyclopedias to
learn about geography, original peoples,
traditions, and rituals.
Culturally Conscious Counseling
In summary, using culturally enhanced
amplification we remain mindful and sensitive to
the implications of 1) a clients membership in
a group, 2) dynamic, evolving cultural
phenomena, and 3) the rich tapestry of the
clients individuality.
Culturally Conscious Counseling
Reflecting on your own cultural suppositions and
experience through journaling.
Analytic skills and amplification research alone
will not eliminate ethnocentric bias. Like
meditation or a martial art, this practice
includes rigorous self-evaluation by the
Culturally Conscious Counseling
Culturally conscious counseling requires
continued, serious, comprehensive reflection on
your heritage, development, beliefs, traditions,
values, experience, and ancestors.
The following questions are meant to assist you
with the practice of culturally conscious
Culturally Conscious Counseling
  • Develop skills to inquire about each
    clients life-world.
  • What stereotypes permeate the clients culture
    -- positive and negative?
  • How did you become aware of those stereotypes?
  • What knowledge do you have about the culture
    of origin?
  • What is the clients unique cultural outlook?

Culturally Conscious Counseling
  • What are the clients preferred thematic
    gestalts that explain or justify ethnic
    and cultural identification?
  • How do these gestalts emerge in the
  • How do we ask? What do we research? What do
    specific objects, symbols, stories, color, and
    icons mean to the client?

La Noche de Las Pobres by Diego Rivera
Culturally Conscious Counseling
What about the symbol is significant? How
would significant others explain the symbols? If
an ancestor were to enter the room what would
they say or do with the objects, symbols,
Culturally Conscious Counseling
How is the arrangement culturally relevant?
What might a traditional healer or another
faction of this cultural group say or do with the
representation? What would you do? Your
Culturally Conscious Counseling
What are the major cultural myths in the clients
culture (traditional and current)? Are there
particular symbols that seem powerful and what do
they represent? (for examplea building, place
of worship -- pyramid -- statue, a flag, a wall,
a mountain) What are the salient historic
moments for each culture represented?
Culturally Conscious Counseling
When timing, concern, and clarity
open a space for you to connect about cultural
issues, acknowledge your own worldview in
appropriate self-disclosure. This disclosure
should not imply rigid limitation to your
perception but simply recognize an obvious
awareness for you and the client. (E.g.
acknowledging you are not well informed about the
clients culture/ethnicity and you are open to
learn his or her view).
Culturally Conscious Counseling
Work outside the hour with colleagues
or in your journaling on personal beliefs,
values, suppositions, expectations, assumptions,
and intuitions (about your own heritage and
cultural Others) to evaluate where these might be
anchored in your home culture. How do these
manifest as projections?
Culturally Conscious Counseling
How might ethnocentrism and unwarranted
assumptions impose themselves on your perception
of and response to creative representations?
The Calabash Girls (unknown)
Culturally Conscious Counseling
Develop a library that provides a
wide view of history, religions, indigenous
biographies, music, poetry, art, fairy tales, and
myths especially of the cultural groups you see
in therapy.
Culturally Conscious Counseling
If you are using Sandplay Develop a
cluster of objects and icons that represent
aspects of an array of different cultural groups
since your clients act in a world of many
cultures, religions, and ethnicities. How
might culture be mediating or moderating the sand
Culturally Conscious Counseling
Make a list of the existential
moments for all humanity and keep those in mind
when balancing awareness of culture with
observation of deep universal human meaning.
For example, the archetypes of birth, death,
healing, alienation, community, cosmology, power,
survival, etc. What are some traditions and
rituals from very different cultures to meet
these moments?
Culturally Conscious Counseling
Make a list of historic events,
myths, migrations, and legends for the specific
populations you work with as well as your own.
Examine the wars of nations and the genocide,
feminine and holocausts. Examine the role of
your ancestors in human welfare.
Culturally Conscious Counseling
Ask the client what they accept as relevant to
his or her life world. (e.g. Acceptance of
peer group, traditions, cultural beliefs, values,
interpretation of historic events, religious
associations). Determine the sources of the
clients perspective. Are there expressed
identifications with particular ethnic or
religious groups?
Culturally Conscious Counseling
What are the salient issues aligned with
association and identification? Taboos, social
approval or rejection? Shame?
Culturally Conscious Counseling
Culturally Relevant Sandplay ArtifactsSuggestion
s Diverse ethnic human figures -
developmental and ethnically obvious
Representations of world religions (people,
objects, structures) Figures from history
from non-Western, Western, and Indigenous
Culturally Conscious Counseling
Objects representing varied historic
life-ways (farming, hunting, housing)
Symbols from cultural monuments (pyramids,
temples, mounds) Music and artistic devices,
containers, toys, tools Domestic and
wild animal families
Culturally Conscious Counseling
  • Housing of every sort and foods of the world
  • Generic people who represent evolutionary
  • Objects of war and ethnic and religious conflicts
  • Locate cultural material from
  • Museum stores, tourist shops, second-hand stores
    and antique stores, cultural fairs, airport
    shops, and specialty stores for particular
  • Try making them by hand.

The perception of racial bias can also result in
a protective, guarded stance toward Caucasians in
the educational environment, leading to increased
social distance between ethnic groups. This
raises the issue of the possible role that social
support may play in ethnic identity development
and openness to intergroup interaction. Margaret
O'Dougherty Wright Linh Nguyen Littleford
Jodhpur, Rajasthan, 2001 by Morandi
Brief Bibliography
Brittan-Powell, C. S., Liu, W. M., Pope-Davis, D.
B., Toporeck, R. L. (2001). What's
missing from multicultural competency research
Review, introspection, and recommendations.
Cultural Diversity and Ethnic Minority
Psychology, 7(2), 121-138. Brown, C. F., Chae,
M. H., Kelly, D., Utsey, S. O. (2002). Effect
of ethnic group membership on ethnic
identity, race-related stress and quality of
life. Cultural Diversity and Ethnic Minority
Psychology, 8(4), 366-377. Ferdman, B. M. (2000).
Why am I who I am Constructing the cultural self
in multicultural perspective. Human
Development, 43(1), 19-23. Kim-ju, G. M., Liem,
R. (2003). Ethnic awareness as a function of
ethnic group status, group composition, and
ethnic identity association. Cultural Diversity
and Ethnic Minority Psychology, 9(3),
289-302. LaFromboise, T., Coleman, H.L.K.,
Gerton, J. (1993). Psychological impact of
biculturalism Evidence and theory. Psychological
Bulletin, 114(3), 395-412. McNeill, B. W. (2001).
An exercise in ethnic identity awareness. Journal
of Multicultural Counseling Development,
29(4), 284-298. Nagel, J. (1994). Constructing
ethnicity Creating and recreating ethnic
identity and culture. Social Problems,
41(1), 152-176.
Brief Bibliography
Negy, C., Shreve, T.L., Jenson, B.J., Uddin, N.
(2003). Ethnic identity, self esteem, and
ethnocentrism A study of social identity versus
multicultural theory of development.
Cultural Diversity and Ethnic Minority
Psychology, 9(4), 333-344. Phinney, J. (1990).
Ethnic identity in adolescents and adults Review
of research. Psychological Bulletin,
108(3), 469-479. Phinney, J. (1996). When we talk
about American ethnic groups, what do we mean?
American Psychologist, 51(9),
918-927. Signell, K. (1996). Silence and
sandplay. Sandplay Therapy, 4(2), 69-86. Stuart,
R.B. (2004). Twelve practical suggestions for
achieving multicultural competence.
Professional Psychology Research and Practice,
35(1), 3-9. Sussman, N. (2000). The dynamic
nature of cultural identity throughout cultural
transitions Why home is not so sweet.
Personality and Social Psychology Review,
(4), 355-374. Wright, M. O., Littleford, L. N.
(2002). Experiences and beliefs as predictors of
ethnic identity and intergroup relations.
Journal of Multicultural Counseling
Development, 30(1), 2-21. All artwork
included can be found at
Dance of Africa by Ivey Hayes
Creative Consultant LK Hunsaker of