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Enhancing Your Therapy with Gestalt Approaches
Gestalt Therapy continuing education counselor CEUs

Section 25
Gestalt Techniques in Dance Therapy

CEU Question 25 | CEU Answer Booklet | Table of Contents | Gestalt
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

Theories in psychology that have been most influential in the field of dance therapy include Reichian, psychoanalytic, Gestalt, object relations, humanistic, family systems, and Adlerian. Levy (1988) noted a trend toward increasing theoretical eclecticism and integration in the field of dance therapy. However, there are some key conceptual themes that are common to most dance therapy approaches. Human beings are assumed to have unconscious memories, feelings, and motivations that need to be introduced and integrated into individuals' conscious awareness (P. L. Bernstein, 1986). Furthermore, it is assumed that some unconscious material, especially memories formed during preverbal stages of development and bodily trauma, are stored in the body and are more easily accessed through physical expression (Levy, 1988). Within the holistic conception of the individual conscious intellect, the emotions, the unconscious, and the body are considered interconnected, with the experiencing and processing of physical experiences believed to positively affect emotional and cognitive growth and functioning (P. L. Bernstein, 1986; Espenak, 1981).

We undertook this qualitative study in an attempt to begin to understand how dance therapy effects change in clients' lives. The purpose of this phenomenological exploration was to explore the lived experience and meaning of dance therapy for women who found that this form of therapy contributed to their personal growth and healing. The question that guided this research was, "What is the lived experience and meaning of dance therapy for individuals who found it to be facilitative of their personal growth and healing?"

Participants were required to have been involved in individual or group dance therapy that was facilitated by a certified dance therapist. Individuals were screened through telephone conversations, and the first 6 women who met the inclusion criteria were included in the study. However, when it became apparent during the data collection that 5 of the 6 participants had histories of child sexual abuse, we decided to limit our analysis to the 5 abuse survivors.

Six themes that were common to the participants emerged from the data analysis. The words of the participants are used in the following descriptions of the themes and subthemes to more accurately capture the essence and meaning of their dance therapy experiences. To enhance reporting, each subtheme is italicized within the thematic descriptions.

Theme 1: Reconnection to Their Bodies
All of the women in this study mentioned having felt disconnected to varying degrees from their bodies. Some spoke about a rejecting attitude they had toward their bodies, either because it seemed fragile or because it had attracted a child abuser. As one participant put it, "I thought of my body as this unfortunate accessory … it has just caused me trouble … it always felt like the enemy." Others talked about a general sense of not having been present in their bodies. At the extreme were various descriptions of dissociation, which seemed to be related to experiences of childhood sexual abuse. For example, one participant reflected on her sense of having been a collection of pieces: "I always felt sort of fractured, fragmented, like parts of my body are on different planes and they're not connected to me personally." In fact, having experienced various other forms of more traditional "talk" therapies, these women specifically sought dance therapy as a means to help them reconnect to their bodies. It is not surprising, then, that a sense of bodily reconnection was an extremely prominent theme running through the transcriptions of each of the participants. All of the women talked about how dance therapy involved a process of getting back into their bodies. By becoming more connected to their bodies, the women were able to become more "present" in and more comfortable with the range of energetic and emotional sensations in their bodies. In reestablishing a connection with their bodies, the participants reported feeling an increased sense of acceptance and care of their bodies.

The participants also talked about their previous tendencies to cope with physical and psychological discomfort by "going into their heads" through intellectualizing, minimizing, and denying. The participants reported that, unlike traditional talk therapies, dance therapy offered them a way to bypass this defensive reaction to discomfort, because this therapeutic process was rooted in bodily expression. As one participant observed, "I think the moving repeatedly helps you to stay in your body, and not go back into your head."

Theme 2: Permission to Play
The women in the study had experienced talk-based therapies as sometimes serious and hard work and were surprised that play was encouraged as an integral part of the dance therapy process. One woman found that, contrary to her expectations, she really enjoyed the dance therapy sessions. She remarked, "I thought, aren't we supposed to be crying and upset and angry?" The women described the playful element of this therapy as "delightful" and "exciting." They experienced it as a means of recapturing a sense of carefree youth that had been lost to them over the years. This aspect was particularly significant for some women who remembered childhood years in which play and fun were lacking or forbidden. Through dance therapy, these women were able to experience, as adults, a sense of the type of playfulness that is characteristic of childhood. The participants noted especially, how the playfulness of dance therapy provided a balance to and a relief from some of the emotionally heavier aspects of therapeutic work. As one participant said, "There was at least one moment every time I went where I just had a good time. And that was a neat thing to learn, that I could do some healing work and it didn't have to be totally serious and really hard all the time." Indeed, that play and work could coexist and, in fact, that both together could lead to healing and growth was considered a significant new insight by the women in this study.

Theme 3: Sense of Spontaneity
Spontaneous movement was mentioned as an important aspect of the dance therapy experience by the women in the study. When they spoke about spontaneous body movement, the participants described movement that was free, self-determined, natural, and uncontrived. They spoke about a progression during their dance therapy experiences toward increased spontaneity in their body movements and toward overcoming the various obstacles they encountered along the way. One obstacle that emerged from the women's stories of their group dance therapy experiences was what one participant referred to as having an "outer focus." They reflected on how, at times, their concern with "what others might think" about they way they moved led to self-conscious and constrained body movement.

Theme 4: Sense of Struggle
All of the women in this study reported that their experience of dance therapy was infused with a sense of struggle. Initially this involved the unfamiliarity of this type of therapy. Many found dance therapy to be new and strange and used words like "challenging," "difficult," and "uncomfortable" to describe their experiences. Some felt inhibited and embarrassed at the idea of dance itself, whereas others felt apprehensive because this approach to therapy was non-traditional and represented uncharted territory. As discussed previously, the women struggled with the discomfort of being seen by others. They felt self-conscious and worried about looking foolish. For some, the experience went beyond embarrassment to a more acute sense of vulnerability and exposure. One woman's metaphor poignantly conveyed this feeling: "Moving is like opening the book … it wasn't just like opening the book, it was like ripping the book open. It was really difficult." Some of the women also reported that they struggled with how to deal with painful memories and feelings that arose during their dance therapy sessions. Many talked about how their bodies contained information about past traumas and about how that powerful and sometimes shameful material surfaced while they were engaged in the therapeutic movements. Anticipating the emergence of new and potentially painful material contributed to the women's sense of apprehension. This was dramatically captured in one woman's metaphor: "Being in my body always feels like walking through a minefield … you know that there's danger out there, you just don't know where … you're waiting for the inevitable." The women also reported their struggle to cope with the fact that particular aspects of the dance therapy process (e.g. music, certain movements, structured activities) could trigger physical and emotional responses associated with past trauma. Certain kinds of music triggered in one woman a deluge of emotion and frightening mental images related to the ritual abuse she had experienced as a child. An exercise that involved holding still reminded another woman of being bound and confined as a small child, and these memories resulted in considerable emotional and physical distress during the session. Although these women struggled to keep from being overwhelmed by body memories and emotional triggers, they were also aware that this material was necessary "grist for the therapy mill," the identification and working through of which was critical to their own growth and healing. As such, these women considered it essential to develop a sense of safety in the group. They reported that the therapist and other group members helped create a safe environment in which they were able to challenge themselves to explore difficult and painful issues.
Despite these struggles, the women said they continued in dance therapy because they saw their hard work actually helping them to grow and heal.

Theme 5: Sense of Intimate Connection
The women in this study reflected on their experience of a unique kind of emotional connection with others while engaging in dance therapy. They remarked on how this intimacy was created without words, simply by moving together and at times, physically connecting with each other. The women talked about how the sense of intimacy they experienced with other participants during dance therapy was uncontrived. It seemed to emerge spontaneously through the wonder of simple gestures, playful moments, and dances that conveyed trust and caring. The women also spoke about factors like music and synchronized movement that contributed to a feeling of unity in the group. The participants believed that this connection and intimacy added greatly to their growth and healing through dance therapy, because they felt supported by others and accepted both physically and emotionally within the group.

The participants in this study remarked that observing another person being vulnerable while dancing was also a meaningful aspect of their dance therapy experience. They called this observation "witnessing" and said it was important for them in several ways. Seeing others taking risks and being vulnerable made them more willing to risk and to open up and share more of themselves and their struggles. The women also felt "honored" to receive the gift of another's dance and said this contributed greatly to their own sense of self-worth. The women also discovered that during group sessions, they gained insights about themselves and were engaged in their own work, even when bearing witness to the struggles of other members or when others were working individually with the therapist. As one participant said, "My experience was that things always came up for me. It never stayed feeling like it was the other person's time; it was always my time as well."

Theme 6: Sense of Freedom
The word freedom appeared repeatedly in all of the women's stories in many different contexts. The participants reflected on how they appreciated the freedom of choice that characterized dance therapy. They talked about having their choice of the activities that were presented and about feeling free to adjust their participation according to their own needs, agendas, and comfort levels. One woman explained, "It was clear to me that I could choose not to do any exercise, which was very important, or I could choose to do it in my own way." For one woman, this freedom of choice and control over the therapeutic process was especially significant and meaningful in light of her past abuse experiences:" For most people that have been sexually abused, that's one thing that was taken away from them, their ability to move, emotionally, physically, mentally, everything. So you've got this freedom that is so important." This woman described the sense of personal freedom as entitlement—reclaiming her right to be in charge of her body and her experience. All of the women told stories of emotional release, which they experienced to some degree in more traditional forms of therapy. What the women believed was unique to dance therapy, however, was the opportunity to discharge some of the physical energy that accompanied these powerful emotions. As one woman put it, "When stuff comes up in dance therapy you've got some way to expend the energy that's involved … to deal with it in terms of your body, and to get the energy out of your body, not just out of your mouth."
- Mills, Letty J.; Daniluk, Judith C.; Her Body Speaks: The Experience of Dance Therapy for Women Survivors of Child Sexual Abuse;  Journal of Counseling & Development, Winter2002, Vol. 80 Issue 1
The article above contains foundational information. Articles below contain optional updates.

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Personal Reflection Exercise #11
The preceding section contained information about Gestalt techniques in dance therapy.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 25
What were six themes regarding dance therapy discussed by sexual abuse survivors? Record the letter of the correct answer the CEU Answer Booklet.

 
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The article above contains foundational information. Articles below contain optional updates.
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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