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Enhancing Your Therapy with Gestalt Approaches
Gestalt Therapy continuing education social worker CEUs

Manual of Articles Sections 15 - 28
Section 15
A Gestalt Approach to Art Therapy

CEU Question 15 | CEU Answer Booklet | Table of Contents | Gestalt
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

Experience, says Webster's, is "the act of living through an event or events; personal involvement in or observation of events as they occur." Each time you and I draw, paint, or model we are actively living through an event, our own experiential event. Every line you draw is uniquely yours; the ones I draw are individually mine; each of us is involved in a personal happening. As the lines and shapes emerge from our activity, we can observe how we are forming a visible graphic record of some thing or sensation that we perceive. Having recorded that perception we each have a tangible reality to use as we prefer. You can denigrate your drawing with "Oh well, it's not very good. I never could draw, anyway." You can deny your expression with "That drawing doesn't mean anything to me." You can disown the form you've made with "It just came out that way. I didn't have anything to do with it. That's not the way I see and feel."  But your drawing does have a lot to do with you--with the way you see and feel and think and with the way you perceive. When you engage in an art activity, you are experiencing yourself; what you produce comes not from a depersonalized "it" but from a very personal you. Your personal art expressions deserve your attention.

Perhaps you've never known an art activity as a real experience--not since you were a child, anyway, and maybe you don't remember scribbling lines and smearing shapes on any handy surface. That was a real experience, but maybe you were punished or persuaded out of that kind of expression. And so you've forgotten that you once knew how to draw freely and experience your delight, anger, and all kinds of living rhythms without self-consciousness. If so, think of the kinds of unself-conscious things you still do--dancing, singing, arranging furniture, choosing your clothes, and all the other ways you express your personal self. And think of your dreams, both sleep-time and daytime weavings of your fantasies. All of these are events that involve you personally and that you can observe as they occur.

So that's how I use the word experience: dreaming, feeling, thinking, acting, expressing, and being aware at the same time that you are the person who is doing all of this.

How am I using the word art? I turn to Webster's again and find "human ability to make things; creativity of man as distinguished from the world of nature."  Making things is natural to man; perhaps we became human as we made things. Like our primitive ancestors, we make ourselves shelter, food, clothes, and transportation. Like the cave people, we use a lot of time and energy providing ourselves with more or less of those basics according to our experiences and perceptions of what our basic needs are. How need-satisfactions--physical, cultural, and psychological--evolve from direct survival necessities to luxurious desirables is too complex to discuss here. Very simply, all cultures and the individuals in them have needs beyond survival needs; these additional needs are often called "wants." I make no clear distinction between need and want because when I want something strongly enough, I presume that I need it.

I am presuming, then, that humans both need and want to make things--to engage in art. That desire is an inherent part of our humanity. We use that desire in many different ways, with varying degrees of facility and for various ends, but we all do it in one way or another. I believe that we want to and need to if we are seeking our fullest humanity. There are those who disagree; they say, "You are just believing that because you want to. You need some sort of idealism, so you put your faith in man's basic creative urge. You can't prove it!" I hear their arguments--sometimes smugly, thinking I know better, sometimes with sadness, fearing that they are right. However, until some of the "if you can't measure it, you can't believe it" adherents can come up with a better answer, I'll trust my own perceptions and observations. From prehistoric times until today, we have made things that didn't exist before; we have put things and ideas together, presenting a synthesis; we have created symbols and communicated meanings.

I don't know why we do this; I do know that we do. So I start from that assumption and find excitement in exploring how we can perceive and create and communicate better through the media of the forms that we make. So, by art, I mean the forms that emerge from our individual creative experiencing.

I originally used the word gestalt to relate my orientation in art experience to the assumptions of gestalt psychologists.  I discovered gestalt psychology after years of working in art--years that involved much experimenting and exploring and trusting in my own perceptions. My discovery of the theories of gestalt psychology was very exciting because it created a theoretical bridge between what I knew of my processes in art-making and what I perceived in other people's art and life processes. I had known that various schools of psychotherapy had used art as an auxiliary method for diagnosis, for expression of so-called unconscious material, for emotional release, and as occupational therapy. Not until I encountered gestalt psychology did I find support for my belief that the art experience could be a primary, direct, conscious mode of acting out that often integrated fantasy and reality into actuality immediately and constructively.

Basically, "gestalt psychology originated as a theory of perception that included the inter-relationships between the form of the object and the processes of the perceiver .... Gestalt thinking emphasized 'leaps' of insight, closure, figure-ground characteristics, fluidity of perceptual processes, and the perceiver as an active participant in his perceptions rather than a passive recipient of the qualifies of form."

The kinship between gestalt theories of perception and their applications in art experience is obvious to me. The psychologist speaks of perceiving whole configurations as being more than the sum of the parts that make up that whole. The artist knows that it is the relationship of the parts within the whole of any art form that create the meaningful effect; looking at each part separately gives an entirely different impression from perceiving the patterned whole. The gestalt psychologist says that we tend to see similar shapes, lines, and colors as belonging together, so we perceive them as creating a visual group and thus form a figure that stands out in awareness from a less figural background. We tend to perceive continuity in lines and shapes even when there are gaps in the actual visual material that we see; we naturally seek to make wholes out of parts. We feel frustrated when we see things that seem incomplete. When we look at a form that is almost a circle, we tend to perceive a complete circle--that is, our perceptions tend to complete a shape, thus creating closure of that form.

These principles of gestalt perception become easily comprehensible when we experience their application in the process of creating our own art forms. Experientially we can perceive immediately that a number of colored shapes seen as unrelated parts have little effect; if we put them together into an integrated composition, we see a whole that is obviously greater than the sum of the parts. Similarly, when we represent imagery with graphic media, we naturally create figures and backgrounds. In using art media we discover, too, our own tendency toward completing wholes and effecting closure of unfinished parts of wholes. We become aware of the patterns within the configuration, too. We recognize that we are visually selective, since we are more likely to perceive clearly some forms than others. In the art experience, we gain insight into how we perceive generally and how our perceptions are influenced by our individual personalities.

The way we perceive visually is directly related to how we think and feel; the correlation becomes apparent when we represent our perceptions with art materials. The central figures we depict emerge from a diffuse background and give us clues as to what is central in our lives. The way we use lines, shapes, and colors in relationship to each other and to the space we put them in indicates something about how we pattern our lives. The structure or the lack of it in our forms is related to our behavior in living situations.

Realizing how we use our visual perception in creating art forms can give us new insights into how we can use our perceptiveness to create more integrated lives.

So, gestalt, as I use it here, means the ability to perceive whole configurations--to perceive your personality as a totality of many parts that together make up the reality of you.

Gestalt art experience, then, is the complex personal you making art forms, being involved in the forms you are creating as events, observing what you do, and, it is to be hoped, perceiving through your graphic productions not only yourself as you are now, but also alternate ways that are available to you for creating yourself as you would like to be.
- Rhyne, Janie; The Gestalt Approach To Experience, Art, And Art Therapy; American Journal of Art Therapy; Aug2001, Vol. 40 Issue 1

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Personal Reflection Exercise Explanation
The Goal of this Home Study Course is to create a learning experience that enhances your clinical skills. We encourage you to discuss the Personal Reflection Journaling Activities, found at the end of each Section, with your colleagues. Thus, you are provided with an opportunity for a Group Discussion experience. Case Study examples might include: family background, socio-economic status, education, occupation, social/emotional issues, legal/financial issues, death/dying/health, home management, parenting, etc. as you deem appropriate. A Case Study is to be approximately 225 words in length. However, since the content of these “Personal Reflection” Journaling Exercises is intended for your future reference, they may contain confidential information and are to be applied as a “work in progress.” You will not be required to provide us with these Journaling Activities.
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #1
The preceding section contained information about a Gestalt approach to art therapy.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 15
According to Rhyne, in what three ways does the correlation between the way we perceive visually and how we think and feel become apparent when we represent our perceptions with art materials? Record the letter of the correct answer the Answer Booklet.

 
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Work and well-being in TGNC adults: The moderating effect of workplace protections. - September 13, 2018
The present study used a psychology of working theory (PWT) framework to test the direct and indirect relations of perceived social status and transgender and gender nonconforming (TGNC) marginalization (i.e., victimization, nonaffirmation of gender identity, negative expectations for the future) with work volition, overqualification, and vocational and emotional well-being outcomes (i.e., job satisfaction, meaningful work, satisfaction with life, depression) in a sample of 175 TGNC working adults. This study also tested the moderating effect of one form of structural marginalization (lack of legal protections from employment discrimination) on the overall pattern of results. Participants were recruited using online social media and discussion forums and completed the study survey online. For the full sample, perceived social status and nonaffirmation of gender identity were associated with vocational and emotional well-being outcomes through the mediating role of work volition, and for some paths, overqualification. Significant differences emerged in the overall pattern of results for those without protections, suggesting that protections from discrimination buffer the adverse links of some forms of TGNC marginalization with work volition and vocational outcomes. Implications of study findings for research, counseling, and advocacy are provided. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
The development and psychometric evaluation of the Trans Discrimination Scale: TDS-21. - July 23, 2018
[Correction Notice: An Erratum for this article was reported in Vol 66(1) of Journal of Counseling Psychology (see record 2018-66276-001). In the article “The development and psychometric evaluation of the Trans Discrimination Scale: TDS-21” by Laurel B. Watson, Luke R. Allen, Mirella J. Flores, Christine Serpe, and Michelle Farrell (Journal of Counseling Psychology, 2018, Advance online publication. http://dx.doi.org/10 .1037/cou0000301), there were two errors in the Methods section of the article. In Study 1, Participants paragraph of The development and psychometric evaluation of the Trans Discrimination Scale: TDS-21 for the Methods section, the gender listed at birth was incorrect in the following sentence, The majority of participants in this study identified as trans women and along a trans feminine spectrum, were assigned male at birth, White, had attained some college but no degree, and were employed full time. The correct gender assigned at birth was predominantly female. In addition, the gender coding procedures was incorrectly described. Specifically, those who identified as FAAB and AFAB were actually coded as trans men or along a transmasculine spectrum, whereas those who identified as MAAB and AMAB were coded as trans women and along a trans feminine perspective. In Study 3, Participants paragraph of The development and psychometric evaluation of the Trans Discrimination Scale: TDS-21 for the Methods section, the gender identity listed in the following sentence was incorrect, The majority of participants identified as trans women and along the trans feminine spectrum, were assigned female at birth, White, had attained some college but no degree, and were students. Rather, participants primarily identified as non-binary trans.] To date, researchers assessing the role of discrimination in trans peoples’ lives have relied upon measures that were developed and normed on LGB populations, culled specific items from large-scale survey data, or used more generalized measures of discrimination that do not specifically assess the unique forms of discrimination that trans people may encounter. Thus, the purpose of this three-part study was to develop and provide psychometric support for a measure of trans peoples’ discrimination. In Study 1, a five-factor model emerged, which included: Microaggressions and Harassment, Restricted Career and Work Opportunities, Maltreatment in Health Care Settings, Harassment by Law Enforcement, and Bullying and Harassment in Educational Settings. Internal consistency estimates for subscale and total scale scores ranged from acceptable to excellent. Results from Study 2 revealed that a bifactor model provided the best fit to the data, revealing that the scale is essentially unidimensional. In addition, convergent and concurrent validity was supported, demonstrating significant positive correlations with another measure of trans discrimination, internalized transphobia, nondisclosure, negative expectations for the future, psychological distress, and perceived stress. In Study 3, results revealed excellent test–retest reliability up to a three-week period. Collectively, results suggested that the Transgender Discrimination Scale-21 (TDS-21) is a psychometrically sound measure that may be used to advance research on the role of discrimination in trans peoples’ lives. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
“The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21”: Correction to Watson et al. (2018). - January 03, 2019
Reports an error in "The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21" by Laurel B. Watson, Luke R. Allen, Mirella J. Flores, Christine Serpe and Michelle Farrell (Journal of Counseling Psychology, Advanced Online Publication, Jul 23, 2018, np). In the article “The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21” by Laurel B. Watson, Luke R. Allen, Mirella J. Flores, Christine Serpe, and Michelle Farrell (Journal of Counseling Psychology, 2018, Advance online publication. http://dx.doi.org/10 .1037/cou0000301), there were two errors in the Methods section of the article. In Study 1, Participants paragraph of The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21 for the Methods section, the gender listed at birth was incorrect in the following sentence, The majority of participants in this study identified as trans women and along a trans feminine spectrum, were assigned male at birth, White, had attained some college but no degree, and were employed full time. The correct gender assigned at birth was predominantly female. In addition, the gender coding procedures was incorrectly described. Specifically, those who identified as FAAB and AFAB were actually coded as trans men or along a transmasculine spectrum, whereas those who identified as MAAB and AMAB were coded as trans women and along a trans feminine perspective. In Study 3, Participants paragraph of The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21 for the Methods section, the gender identity listed in the following sentence was incorrect, The majority of participants identified as trans women and along the trans feminine spectrum, were assigned female at birth, White, had attained some college but no degree, and were students. Rather, participants primarily identified as non-binary trans. (The following abstract of the original article appeared in record 2018-35350-001.) To date, researchers assessing the role of discrimination in trans peoples’ lives have relied upon measures that were developed and normed on LGB populations, culled specific items from large-scale survey data, or used more generalized measures of discrimination that do not specifically assess the unique forms of discrimination that trans people may encounter. Thus, the purpose of this three-part study was to develop and provide psychometric support for a measure of trans peoples’ discrimination. In Study 1, a five-factor model emerged, which included: Microaggressions and Harassment, Restricted Career and Work Opportunities, Maltreatment in Health Care Settings, Harassment by Law Enforcement, and Bullying and Harassment in Educational Settings. Internal consistency estimates for subscale and total scale scores ranged from acceptable to excellent. Results from Study 2 revealed that a bifactor model provided the best fit to the data, revealing that the scale is essentially unidimensional. In addition, convergent and concurrent validity was supported, demonstrating significant positive correlations with another measure of trans discrimination, internalized transphobia, nondisclosure, negative expectations for the future, psychological distress, and perceived stress. In Study 3, results revealed excellent test–retest reliability up to a three-week period. Collectively, results suggested that the Transgender Discrimination Scale-21 (TDS-21) is a psychometrically sound measure that may be used to advance research on the role of discrimination in trans peoples’ lives. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Testing intersectionality of race/ethnicity × gender in a social–cognitive career theory model with science identity. - October 04, 2018
Using social–cognitive career theory, we identified the experiential sources of learning that contribute to research self-efficacy beliefs, outcome expectations, and science identity for culturally diverse undergraduate students in science, technology, engineering, and math (i.e., STEM) majors. We examined group differences by race/ethnicity and gender to investigate potential cultural variations in a model to explain students’ research career intentions. Using a sample of 688 undergraduate students, we ran a series of path models testing the relationships between the experiential sources, research self-efficacy beliefs, outcome expectations, and science identity to research career intentions. Findings were largely consistent with our hypotheses in that research self-efficacy and outcome expectancies were directly and positively associated with research career intentions and the associations of the experiential sources to intentions were mediated via self-efficacy. Science identity contributed significant though modest variance to research career intentions indirectly via its positive association with outcome expectations. Science identity also partially mediated the efficacy-outcome expectancies path. The experiential sources of learning were associated in expected directions to research self-efficacy with 3 of the sources emerging as significantly correlated with science identity. An unexpected direct relationship from vicarious learning to intentions was observed. In testing for group differences by race/ethnicity and gender in subsamples of Black/African American and Latino/a students, we found that the hypothesized model incorporating science identity was supported, and most paths did not vary significantly across four Race/Ethnicity × Gender groups, except for 3 paths. Research and practice implications of the findings for supporting research career intentions of culturally diverse undergraduate students are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Construction and validation of the Multicultural Orientation Inventory—Group Version. - July 12, 2018
Given the continued racial/ethnic diversification of the United States, it is not uncommon for therapy groups to consist of members with diverse racial/ethnic backgrounds and various cultural identities. Scholars have underscored how this cultural diversity can directly impact many processes and outcomes of group-based interventions (Chen, Kakkad, & Balzano, 2008). However, there is presently a paucity of empirical research testing the relationship between cultural processes of therapy groups and members’ outcomes. Moreover, no psychometrically sound measure of the cultural process that unfolds in group therapy currently exists. As such, this study sought to adapt the Multicultural Orientation Inventory to develop and validate the Multicultural Orientation Inventory—Group Version (MCO-G), a measure assessing the cultural humility, cultural comfort, and cultural missed opportunities in therapy groups. Data for this validation study consisted of 208 members of 49 therapy groups across 10 university counseling centers. Confirmatory factor analyses supported a 3-factor structure of the MCO-G Inventory, wherein the 3 factors corresponded with the underlying constructs of cultural humility, cultural comfort, and cultural missed opportunities. This study provides initial evidence for the estimated internal and convergent validity of the MCO-G, as measured by clients’ perceptions of a higher-order group therapeutic factor and improvement in therapy. Results provide initial support for the psychometric properties of the MCO-G. Moreover, groups’ cultural humility and cultural missed opportunities were related to members’ improvement in therapy. Clinical implications and future research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

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