Journal of Creativity in Mental Health

ISSN: 1540-1383 (Print) 1540-1391 (Online) Journal homepage: https://www.tandfonline.com/loi/wcmh20

Encouraging Connections: Integrating Expressive

Art and Drama Into Therapeutic Social Skills
Training With Adolescents

A. Stephen Lenz , Rachel L. Holman & Denise L. Dominguez

To cite this article: A. Stephen Lenz , Rachel L. Holman & Denise L. Dominguez (2010)
Encouraging Connections: Integrating Expressive Art and Drama Into Therapeutic Social Skills
Training With Adolescents, Journal of Creativity in Mental Health, 5:2, 142-157

To link to this article: https://doi.org/10.1080/15401383.2010.485086

Published online: 16 Jun 2010.

Submit your article to this journal

Article views: 574

View related articles

Citing articles: 6 View citing articles

Full Terms & Conditions of access and use can be found at

https://www.tandfonline.com/action/journalInformation?journalCode=wcmh20
Journal of Creativity in Mental Health, 5:142–157, 2010
Copyright © Taylor & Francis Group, LLC
ISSN: 1540-1383 print/1540-1391 online
DOI: 10.1080/15401383.2010.485086

Encouraging Connections: Integrating

1540-1391
1540-1383
WCMH
Journal of Creativity in Mental Health
Health, Vol. 5, No. 2, May 2010: pp. 0–0

Expressive Art and Drama Into Therapeutic

Social Skills Training With Adolescents

A. STEPHEN LENZ
Therapeutic
A. S. Lenz etSocial
al. Skills Training

Texas A&M University–Corpus Christi, Corpus Christi, Texas, USA

RACHEL L. HOLMAN
South Texas Center for the Arts, Corpus Christi, Texas, USA

DENISE L. DOMINGUEZ
Antonio E. Garcia Arts & Education Center,
Corpus Christi, Texas, USA

The effective use of social skills has been positively associated with
career success, romantic involvement, academic achievement,
and mood. In response, counselors often integrate social skills
training into counseling interventions with adolescents to encour-
age authentic and effective interactions with others. We illustrate
some therapeutic social skills training interventions developed in
community mental health and educational settings that feature
the expressive aspects of art and drama using the cases of Sarah
and a teen peer group. The activities included target basic proso-
cial behaviors, interpersonal communication, and problem-solving
skills development. Necessary considerations when using these
activities are noted.

KEYWORDS social skills, social competency, creativity, adolescents

Social skills and relational behaviors are tied to one’s professional and
personal development. There is a positive association between engaging

The authors wish to acknowledge Varunee Faii Sangganjanavanich, PhD, for her
guidance during the revision and restructuring of this manuscript.
Address correspondence to A. Stephen Lenz, Department of Counseling and Psychology
Education, Texas A&M University–Corpus Christi, 6300 Ocean Drive ECDC 222, Corpus
Christi, TX 78412, USA. E-mail: SLenz@Islander.TAMUCC.edu

142
 Therapeutic Social Skills Training 143

positively with others and career success, romantic involvement, academic

achievement, and day-to-day happiness (Utay & Utay, 2005). Conversely,
ineffective social skills in adolescents have been negatively correlated with
diagnosed emotional disturbance (Lane, Carter, & Pierson, 2006), juvenile
delinquency (Coll, Thobro, & Haas, 2004), loneliness and despondency
(Utay & Utay, 2005), attention-deficit hyperactivity disorder (ADHD), oppo-
sitional defiant disorder (ODD), and conduct disorder (Dowd & Tierney,
1995; Holmes, 2001).
Relational-cultural theorists have proposed that individuals strive to
grow through connection with others in a way that provides a sense of
meaning and well-being (Jordan, 2001). Contemporary proponents of this
contention have suggested that meaningful connection with others empow-
ers mutual understanding among members of a relational network
(Comstock, Duffey, & St. George, 2002; Jordan & Dooley, 2000; Stiver,
Rosen, Surrey, & Miller, 2001). Comstock et al. (2008) suggested that when
moving toward mutuality through social engagement with others in com-
plex and diverse relational networks, the relational competence of a mar-
ginalized individual increases. As a consequence, individuals may be
liberated from the ineffective strategies that have limited their meaningful
connecting with others. From this perspective, we propose that effective
social skills promote connection within relational networks.
For many teenagers who are receiving counseling, some degree of
social skills development may be warranted. A review of evidence-based
counseling curricula used by community and state mental health agencies
indicated a growing trend of social skills training focused on communica-
tion and problem solving (Clarke, DeBar, Ludman, Asarnow, & Jaycox,
2002; Kendall, Choudhury, Hudson, & Webb, 2002; Kendall & Hedtke,
2006; Stark et al., 1996). Although traditional didactic training models are
being implemented to a high degree, creative and multisensory social skills
development strategies may engage adolescents in a way that is more
meaningful than dialogue and repetition. Some authors have suggested indi-
viduals learn best when multiple senses are engaged (Dale, 1969; McAuliffe,
2000; Sangganjanavanich & Lenz, 2009). Interventions that integrate the arts
frequently employ multiple senses thereby facilitating self-awareness of feel-
ings and behaviors that are required to positively influence social relations
(Glass, Guli, & Semrud-Clikeman, 2000).
The use of creative approaches in counseling allows counselors to
access a variety of modalities to enlist the clients in the change process.
Recently, Gladding (2008) commented that creativity has been a driving
force behind much of the innovative theory and practice characterizing the
counseling profession. The emergence of creativity in counseling is founded
on efficacy studies supporting creative interventions (Karakelle, 2009;
Paone, Malott, & Maldonado, 2008; Walsh & Wilfred, 1990), on counselor
training courses supporting creative expression (Davis, 2008; Ziff &
144 A. S. Lenz et al.

Beamish, 2004), and is articulated in the mission statement of the Associa-

tion for Creativity in Counseling.
We propose that integrating art and drama into social skills training
with adolescents enhances the educational and therapeutic value of this
approach. Several empirical studies have been provided to support the
effectiveness of art and drama in developing the social skills of individuals
diagnosed with mental health disorders that may limit relational connecting
with others, such as ADHD, ODD, and conduct disorder. For example,
individual and group art therapy interventions have been demonstrated as
efficacious for increasing the use of social skills in youth diagnosed with a
variety of internalizing and externalizing disorders (Epp, 2008; Gersch &
Conçalves, 2006; Safran, 2003; Wright et al., 2006). Watts and Garza (2008)
suggested that art media provides a familiar avenue for this age group to
use their creativity and imagination to explore and express perspectives
about relational qualities with significant others. Similarly, the use of cre-
ative dramatics and therapeutic theatre techniques have been indicated by
some authors as having a therapeutic value for individuals with identified
deficits in social skills and emotional regulation (McCaslin, 2006; Moreno,
1994; Snow, D’Amico, & Tanguay, 2003).
In this article, we describe creative social skills training strategies that
we developed during our counseling practices in community-based and
educational settings. We will describe activities that we have used in the
cases of Sarah and a teen peer group to encourage teenagers to interact
with others in a meaningful, authentic way. Although we have illustrated
these activities using individual and group exemplars, all the activities pre-
sented here can be adapted to accommodate either format, the client’s
unique cultural influences and current stressors, and time limitations.

CASE ILLUSTRATION

Sarah is a 17-year-old Hispanic female attending a new school after transi-

tion from living with grandparents to living with a biological parent follow-
ing their release from incarceration. Prior to this transition, her family
referred her to counseling following an episode of depression in which she
attempted to harm herself and a cousin. Since receiving counseling services,
Sarah has developed a number of strategies that have encouraged her to be
more active, consider alternative perspectives, make attainable goals, and
celebrate her successes. Many of these activities included the use of walks,
playing games, reading, crafting, drawing, and journaling to reflect on her
feelings. Although Sarah had become more active, she was not meaning-
fully relating with others and continued to experience a significant
disengagement from peers at school and rarely left the house despite the
goading from her parent and older sibling. Her interactions with others
 Therapeutic Social Skills Training 145

were self-reported as “awkward” and “stupid.” Sarah expressed interest in

continuing to develop her ability to establish and maintain meaningful
relationships with others.

Family of Flowers
During our first session addressing this new objective, the counselor pre-
sented a social skills hierarchy which identified basic social skills. This hier-
archy provided a foundation for effective communication and problem
solving. Sarah was told we would be working on skills such as taking turns,
sharing, cooperating, telling others about oneself, and listening to others.
The counselor and client both provided examples of these skills in action
from previous experiences. The counselor then introduced Sarah to the
Family of Flowers activity as an opportunity to identify and discuss poignant
family characteristics in an expressive way while practicing these skills. This
activity was adapted from the floratherapy work introduced by Cantrell
(1997) and extended by Perryman and Keller (2009) to meet the context of
an overt skills training activity.
Next, Sarah was introduced to the concept that families share common
elements and are unique at the same time. She was asked to create an
abstract model of her family. The counselor elaborated on this premise
using premade examples of paper flowers noting how each is recognizable
and distinguishable as a flower yet distinct. The counselor also highlighted
that making flowers to represent family members would provide an oppor-
tunity to practice taking turns while sharing the materials, cooperating, tell-
ing others about herself, and listening to others. After reaching an
understanding about the task, the counselor and Sarah sorted through the
materials and began to construct a family bouquet. During the process,
Sarah questioned what constitutes a family and if she could include a close
friend. The counselor replied it was up to her to define what family is and
whether a close friend can feel like family. She was encouraged to make her
bouquet as large or small as she wanted. Although the counselor engaged
with the task in a parallel way, the primary function was to model the skills
listed above while reinforcing her participation through encouraging state-
ments and attending and dialoguing about other instances when these skills
have been a resource. At times, Sarah commented on the overt nature of the
task in practicing the skills; however, her fondness of crafting provided a
conduit for authentic engagement in the task.
She arranged the individual flowers into a bouquet that represented her
family structure while the counselor facilitated a discussion on how the
characteristics of these flowers represented her identified family members.
She described past and present beliefs, feelings, and meanings about these
characteristics and their position in the arrangement. Helpful invitations to
explore the activity included variations of, “What was your experience using
146 A. S. Lenz et al.

the skills we practiced to create something with a deeper meaning attached

to it?”; “In what situations do you think you will notice these skills work-
ing?”; and, “How do you think these skills might help when connecting with
others?” Prompts that engaged the client in reflection of the familial meta-
phor included, “How did you decide to place this person here?”; “If you
could add one flower to the bunch, who would that be?”; or, “If this flower
had a smell to it, what would that smell be?” The counselor’s demonstration
of caring, authenticity, and encouraging dialogue provided Sarah with the
space to describe changes, hopes, and perspectives about her new family
arrangement. She agreed to continue journaling about the experience and
sharing with her parent about the individual flowers and bouquet.

Art Talk
The next skills-oriented session was proposed as an opportunity to use the
previous session’s content to practice communicating thoughts and feelings
effectively with others. Specifically, the purpose of the task was to provide a
chance for Sarah to practice the particular communication skills she had
described as limiting the quality of her relationships with peers while appre-
ciating art. Sarah was engaged in discussion on the usefulness of active lis-
tening, making eye contact, responding appropriately to verbal and physical
cues from others, using appropriate tone of voice, telling others about one-
self, and respecting others’ thoughts and ideas. The counselor modeled, col-
laborated, and modified these behaviors to provide clearer understanding of
communication in the client’s context.
Following this introduction, Sarah was informed that we would be
using these concepts to practice communication skills while viewing a
collection of art. Sarah was briefly educated on concepts related to art
appreciation, such as balance, warm and cool colors, contrast, movement,
and texture, and was provided with a handout defining these for reference.
Once these concepts were defined, the counselor chose a piece of art and
modeled it applying these concepts while practicing communication skills
and expressing personal thoughts and feelings about the art. Although this
activity can be implemented using photo books, digital images, or an art
museum, we often use a LCD projector system to display images from our
local museum that are saved on a computer for discussion. Sarah and the
counselor took turns describing the art and encouraging personal opinions
about the pieces. The counselor noted that some of the pieces were more
suggestive and engaging than others for Sarah and used this as a talking
point to explore these observations. Additionally, the counselor provided
encouragement and attended to verbal and nonverbal reactions as Sarah
engaged in the task until the end of the slide show.
After viewing the slide show, the counselor facilitated a dialogue about
using the skills overtly for a lengthy time and on the personal meaning and
 Therapeutic Social Skills Training 147

understanding of the experience. Sarah described how the principles of art

appreciation can apply to her school, neighborhood, and relationships as
metaphors. For instance, associations with her peers were described as
either warm, cool, or blended, balanced, or having movement. She
appeared empowered by not only being able to acquire a pedantic skill and
practice using it but also that she had exercised a new skill within the
session. Questions such as, “How does this piece of art make you feel?”;
“What were some thoughts that came to mind?”; or, “Which was your favor-
ite piece of art? Why?” encouraged dialogue between counselor and client
inherently reinforcing the use of more effective communication. For home-
work, Sarah stated she would practice the skills at home and school with
others and self-monitor her experiences in her journal.

Problem-Solving Field Guide

The Problem-Solving Field Guide was introduced as our final skills-oriented
opportunity for Sarah to illustrate and identify solutions to problems using
the skills that she had developed and practiced in previous sessions. The
next session would be with the family to evaluate progress and readiness to
reduce or conclude services. The counselor introduced that identifying
problems, listing possible solutions, rating these options, choosing one to
try, evaluating success, and considering alternatives can be helpful in a vari-
ety of contexts. Sarah was asked to create a list of her top five conflicts in
order of perceived distress, describe each briefly, and implement these
problem-solving steps. Therapeutic role-plays with the counselor were used
for Sarah to test her possible solutions, reflect on her physical, affective, and
cognitive responses to these options, and identify the “best solution” for
each dilemma.
After this process, Sarah was told that she would be creating a reference
guide much like the one that she used in Art Talk; however, this one would
be more personal and tailored to meet her needs with her available resources.
She was provided with a sketchpad, paints, crayons, colored pencils, markers,
glue, glitter, a hole punch, and yarn. Starting with her least intimidating prob-
lem, she created a picture of the problem in action and another of the “best
solution” being applied. Atop these pictures, a brief summary of the problem
and solution were described. While Sarah portrayed conflicts about boredom,
completing chores, and enduring stigma at school, the counselor demon-
strated supportive attending to previously practiced skills in addition to dis-
cussing her perspectives associated with the contextual variables, history, and
affective responses related to problem-solving choices. As the session time
was nearing, Sarah created a cover, back, and table of contents for her field
guide and was provided with yarn and a hole punch for binding.
Following the session activity, the counselor enlisted Sarah to process
the meaning of the activity by discussing how solutions to problems may be
148 A. S. Lenz et al.

influenced by contextual factors and available resources. Additionally, her

physical, affective, and cognitive reactions to the role-plays of these situa-
tions were also reviewed and framed as useful practice. Planning for future
use and describing how this guide may be useful in maintaining preferred
connections with her peers were explored using prompts such as, “Describe
how you thought/felt while negotiating the best strategy”; “When do you
think is the first opportunity that you will have to use your field guide?”;
“What are some ways that you will use the skills you learned in this activity
and when will you use them?”; “Who will be the first to notice that you are
finding solutions in a new way?”; or, “What are some ways that this field
guide can help you connect with others?” While engaging in this dialogue
the counselor noted a distinct enthusiasm in Sarah regarding the prospect of
being more effective with others and being her own guide. Sarah was
assigned the final two unaddressed problem-solution chapters for her guide
as a homework assignment. Additionally, she committed to practicing her
problem-solving skills and monitoring her experience in her journal.

CASE OF A TEEN PEER GROUP

A group of 10 court-referred male students participated in a 7-week life

skills program at a community arts and education center. This program
began with a general rapport-building orientation to the group including
purpose, structure, and addressing obligation and best hopes for engage-
ment and was followed by five “work” sessions and a wrap-up. All the
group members were between 12 and 15 years old and all were from low
socioeconomic households. Many of the group members have been
diagnosed with an externalizing disorder (i.e., ADHD, ODD, and conduct
disorder) by mental health professionals. Although these students were not
identified as being in a gang, they reported being influenced by this culture
in their neighborhoods and frequently feeling like they have to dress a
certain way, “stick up” for themselves, and engage in behaviors that thwart
intimidation from others. As a consequence, hypervigilence, distraction, low
self-esteem, anxiety, and ineffective social behaviors were attributed to the
group members by caregivers, school staff, and self. The co-counselors
noted the group members’ relational style tended to restrict authentic and
meaningful connections with peers as evidenced by their consensual feeling
that parents and school administrators do not understand the pressures of
their lives.

Mural, Mural on the Wall

The counselor began by educating the group on basic social skills such as
taking turns, sharing ideas and materials, cooperating, and following
 Therapeutic Social Skills Training 149

directions as a starting point for connecting with others. The peer group
was told they would be practicing these skills while completing a collabora-
tive creative project in which they would create a mural of something
important to the group. Additionally, Mural, Mural on the Wall was an
opportunity for them to discover and define themselves in relation to others
through expressing life experiences. Conversation was also provided about
how spontaneous and creative forms of expression can facilitate the group
members’ ability to express ideas in a new way. The counselor provided
supportive facilitation during planning to identify themes relevant to trans-
formations hoped for or made by group members during the counseling
process and to choose one theme to represent with the project. The peer
group decided to choose the theme of distinguishing between positive and
negative peers in their neighborhoods.
The counselor provided the peer group with large paper, paint, mark-
ers, paint brushes, texture sponges, magazine/news clippings, and glue to
complete the task. On a grander scale, counselors in school or community
settings may be able to provide larger canvases such as a wall, bench, shelf,
or other object for decoupage. It is noted that a paucity of supplies should
be provided so that clients have to emphasize the target skills of taking
turns, sharing ideas and material, cooperating, and following directions.
Next, the counselor asked the group to create their mural. As the group
sorted through the supplies and collectively decided how to express their
thoughts, feelings, behaviors, and meaning associated with their theme, the
counselor provided supportive encouragement. The group worked together
to create the mural through drawings, painting, coloring, texturing, gluing,
and stamping media until they collectively decided that a finishing point
had been reached. The counselors paid positive attention to successive
approximations and effective use of skills.
The peer group depicted a group of teens leading others away from
the negative influences of the neighborhood and toward positive opportuni-
ties. The counselor facilitated a discussion related to other times when cli-
ents have used these micro-level social skills to achieve larger goals and
how completing a task as a team offers meaning to self and others. Particu-
lar attention was given to statements about flexibility and spontaneous
moments between group members. The group also identified times in
which they had struggled to use these basic skills when interacting with
others not in the group. Useful prompts for this discussion included, “Tell
me some ways that using these skills helped complete the project”; “What
are some of the challenges you experienced with using these strategies to
complete a goal?”; and, “Can you describe how others in the group
responded to this special theme in your life?” Any nonconstructive com-
ments made by group members were positively reframed, and supportive,
encouraging statements were provided. In addition, the counselor dia-
logued on the meaning of the chosen theme. For instance, “What were your
150 A. S. Lenz et al.

thoughts/feelings while expressing meaning in this medium?”; “In what

ways have your perspectives on this theme been changed or developed
during this process?”; or, “What do you think others may know from view-
ing the mural you completed here today?”

COMMUNICATION SKILLS
Parrot in the Mirror
The following skills-oriented session began by opening with a dialogue
regarding what it feels like to say what you mean and be understood by
others. Parrot in the Mirror was introduced as an opportunity to practice
effective communication skills such as listening to others, using eye contact,
responding appropriately to verbal and physical cues from others, using
appropriate tone of voice, telling others about self, talking in a brief man-
ner, and awareness of self and others. In addition, the activity would pro-
vide the opportunity for the group to reinforce and practice the skills used
in the previous session such as taking turns, cooperating, and following
directions. The skills introduced in this session would prove to be challeng-
ing, as the group had previously voiced their difficulty in communicating
effectively with peers. Members of the group had described communication
with peers as superficial and often inappropriate (i.e., using curse words,
provoking, and insulting as means of relating).
Next, the counselor and co-counselor modeled the skills related to
effective communication by demonstrating the activity. The leader began by
providing a statement about themselves which was then “parroted” by their
partner using similar voice quality, cadence, and inflection. Simultaneously,
the partner also “mirrors” the physical movements of the leader such as
hand gestures, body posture, or facial expression. Following, group mem-
bers were instructed to self-select a partner and complete the About Me
worksheet that describes their feelings and opinions about themselves in
relation to others. We found that providing this worksheet facilitated
engagement from group members who might otherwise abstain from
involvement or impose an inappropriate strategy (e.g., drug abuse) to be
removed from session. The dyads chose who would lead and who would
partner, face each other in a standing position, and complete the activity.
Once the first person completed all the statements on their worksheet, the
other completed the activity their partner parroted and mirrored them. To
facilitate discussion and promote constructive feedback on the communica-
tion skills being learned, each dyad was instructed to practice the task in
front of the group.
This activity encouraged participants to see how others view them
while practicing being attentive and responsive to the verbal and physical
cues of their partner. To process the skills learned, the counselors facilitated
 Therapeutic Social Skills Training 151

a discussion about the communication patterns observed and deepened the

session with exploration of each person’s experience. Questions such as,
“What did you notice about how others viewed your communication pat-
terns?”; “What contributed to effective communication between you and
your partner?”; “How did you feel being the parrot in the mirror?”; “How did
you feel leading the other person?”; “What did you learn from yourself and
others?”; or, “Were there similar themes among the statements?” were
explored. For their homework, the group members were instructed to prac-
tice these communication skills with a family member and a peer. They
would describe the similarities and differences of each interaction and any
personal reflections in their group notebook.

PROBLEM-SOLVING SKILLS
Problems-Solved Art Gallery
In the final session, the counselors reviewed the group’s progress and high-
lighted their flexibility while completing tasks. They reinforced how basic
social skills and communication skills would help them complete the
Problems-Solved Art Gallery task. The counselor introduced that identifying
problems, listing possible solutions, rating these options, choosing one to
try, evaluating success, and considering alternatives can be helpful in a
variety of contexts. The counselors described this process of problem
solving, modeled using these skills, and illustrated their “best solution”
using a brief psychodrama. This demonstration depicted problem solving as
a way to collaboratively verbalize, value, and choose solutions to their
specific difficulties.
Following this introduction, the counselors led the group in identifying
problems, applying the strategy as a team, and rank ordering them in terms
of which ones were most oppressive. Brief psychodrama was used to help
the group visualize what their solutions might look like in action. As appro-
priate, strategies were fine-tuned until they concurred about a “best
solution.” Once agreed upon, the group was instructed to paint or draw the
solution, thereby commemorating their ability to resolve conflicts. The group
was provided with art supplies and an area to work in. Once the expressive
media were completed, the group was instructed to write the problem state-
ment as a header and describe the solution steps portrayed in the footer
area of the work. Group members were encouraged to create an informa-
tion card to accompany the art pieces with the name of the problem, a brief
description of the troubles associated with the problems, and the steps
portrayed in the picture to solve the problem. Although these media can be
displayed in photo albums or taken home, these problems-solved art pieces
were displayed in gallery form anonymously in the lobby of our counseling
center. The group members expressed a notable enthusiasm at the notion
152 A. S. Lenz et al.

that their solutions would be prized and that others would be able to see
their work.
The counselors discussed the relationship between problem solving
and perceiving self as effective in a variety of other situations during post-
activity processing of content. Specific attention was given to the affective
responses associated with the psychodrama activity and the prospect of
helping others because of the session’s work. The counselors facilitated
dialogue using questions such as, “What are some benefits associated with
problem solving in this case?”; “What are some possible negative out-
comes if the problem went unsolved?”; and, “How could you describe
the problem-solving process to others?” Additionally, the group committed
to implementing these problem-solving skills at home or at school and
journaling on the similarities and differences of the actual and perceived
outcomes.

DISCUSSION

In general, social skills training is a directive, goal-oriented process. From

this approach, the counselor assumes that clients have patterns of relating
with others that can be changed for the better. In an effort to assume a rela-
tional therapeutic stance, we suggest that counselors observe some neces-
sary assumptions to enhance a client’s overall experience. These
considerations include use of the core conditions, attention to contextual
factors, individual versus global processing, and personalization of these
activities in the counseling setting.
We believe that genuineness, empathy, and unconditional positive
regard (Rogers, 1957) set the stage for a growth-promoting counseling
relationship. The powerful association of these conditions with positive
counseling outcomes has been consistently identified in the instructional
counseling literature (Carkhuff, 1993; Gladding, 2007; Peterson & Nisenholz,
1999). We have noticed that engaging our clients in art and drama
activities, from an empathic stance seems to enhance their experiences of
catharsis and connection. While developing and adapting these tasks, we
have continually affirmed the value of conveying these conditions with
diverse populations as illustrated in the cases of Sarah and the teen peer
group. That is, without this growth-promoting relationship, the client
engagement in these activities may be characterized by rigidity and defen-
siveness. In addition, in the absence of this relationship, therapeutic
processing may also be limited and characterized by superficial respond-
ing. Finally, we believe that this relationship is the counselor’s greatest
asset for positively influencing the flexible and fluent thinking ability noted
previously with dramatic and creative interventions (Karakelle, 2009) with
our clients.
 Therapeutic Social Skills Training 153

In addition to establishing an environment in which a growth-promot-

ing relationship is present, helping professionals will increase success with
these strategies by attending to the contextual factors that influence their cli-
ent’s perspectives and choices. Given that context has been associated with
personal wellness (Myers & Sweeney, 2005) and effectiveness in a dynamic
environment, consideration of the milieu in which social learning and action
occurs is instrumental for personalizing these activities with clients. This is
noted in our stance that the results and opinions expressed in the activities
described here are unique and determined not as “right or wrong” but as
formulas that can be added to or subtracted from, given the range of avail-
able responses between counselor and client or group. This approach is
dependent upon counselor sensitivity to the diversity and cultural issues
that influence client circumstances. For instance, an activity that emphasizes
making eye contact may have to be adapted for individuals from a particu-
lar background or level of acculturation. Additionally, strategies to resolve a
similar problem faced by individuals in a rural and inner city setting may be
different.
Another important consideration is associated with the methods coun-
selors use to process these activities. Each of the activities presented has the
potential to be interpreted individually or in terms of a global experience.
For example, in the Family of Flowers activity, each flower can be consid-
ered alone and the meaning extrapolated; however, the importance and
psychological valence associated with the bouquet can also be investigated.
In addition, when engaging in the Art Talk task, each piece of media
observed can be processed therapeutically on its own, but also the entire
experience can function as a poignant stimulus for introspection, reflection,
and discussion. Importantly, when facilitating these idiographic and nomo-
thetic moments of meaning, the counselor’s task is to function as a lynchpin
between the concrete skills that are practiced and the insights available
through participation in abstract, expressive tasks.
A final consideration for counselors involves personalization of the
tasks. While the authors have presented a general framework for these
tasks, there is no one way to complete them successfully. Similar to other
interventions used in the counseling setting, these activities are best
employed when the helping professional has made it their own. Personal-
ization of any therapeutic task while including the basic fundamental ele-
ments is a familiar charge for counselors. After all, if professionals are to
breathe life into their intervention strategies as recommended by previous
authors (Kendall, Chu, Gifford, Hayes, & Nauta, 1998; Podell, Martin, &
Kendall, 2009), that breath should be their own. In this instance, we suggest
that engaging in creative and therapeutic skills training should be
approached as a skill itself that needs to be practiced and internalized by
the professional, not as a gimmick or technique to be showcased out of
frustration or when at an impasse with a client or client group. If this
154 A. S. Lenz et al.

approach is observed along with care to the other considerations noted pre-
viously, counselors are more likely to shift social skills training from the
implicit to the overt, while encouraging some positive changes in the ways
client view their abilities to interact with others in their social context.

CONCLUSION

In times when communication, problem solving, and basic prosocial

behaviors are increasingly mediated by technology, it is progressively
important for counselors to develop and implement strategies that are not
solely learning through repetition but meaning as well. What is at stake
for individuals, families, and communities is noted in the negative associa-
tions of social skills development with special education assignments,
juvenile delinquency, despondency, and the prevalence of mental health
diagnoses, including ADHD, ODD, and conduct disorder. Therefore, a
need has been identified for counselors and others in helping professions
to continue thinking divergently about how those we work with can be
engaged in a manner that demonstrates longitudinal effects on the behalf
of our clients. We have proposed that creative interventions using the
expressive aspects of art and drama may be one valuable resource for pro-
fessionals to reference when working with the adolescent population. Our
best hopes are that when counselors select one or more of these tasks in
their practice, within a growth-promoting relationship, they too will be
met with the successes that we have observed in our own therapeutic
efforts.

REFERENCES

Cantrell, N. (1997). A descriptive study of the impact floratherapy had on the feelings
and attitudes of adults in counseling sessions. Unpublished seminar paper,
Southwest Missouri State University, Springfield, MO.
Carkhuff, R. R. (1993). The art of helping (7th ed.). Amherst, MA: Human Resource
Development Press.
Clarke, G., DeBar, L., Ludman, E., Asarnow, J., & Jaycox, L. (2002). Steady project
intervention manual: Collaborative care, cognitive-behavioral program for
depressed youth in a primary care setting. Retrieved from http://
www.kpchr.org/public/acwd/acwd.html
Coll, K. M., Thobro, P., & Haas, R. (2004). Relational purpose development in youth
offenders. Journal of Humanistic Counseling, Education, and Development,
43, 41–49.
Comstock, D. L., Duffey, T., & St. George, H. (2002). The relational-cultural model:
A framework for group process. Journal for Specialists in Group Work, 27,
254–272. doi:10.1177/0193392202027003002
 Therapeutic Social Skills Training 155

Comstock, D. L., Hammer, T. R., Strentzsch, J., Cannon, K., Parsons, J., & Salazar, G.
(2008). Relational-cultural theory: A framework for bridging relational, multi-
cultural, and social justice competencies. Journal of Counseling & Development,
86, 279–287.
Dale, E. (1969). Audio-visual methods in teaching (3rd ed.). New York, NY: Dryden
Press.
Davis, K. M. (2008). Teaching a course in creative approaches in counseling with
children and adolescents. Journal of Creativity in Mental Health, 3, 220–232.
doi:10.1080/15401380802389469
Dowd, T., & Tierney, J. (1995). Basic social skills for youth. Boys Town, NE: Boys
Town Press.
Epp, K. M. (2008). Outcome-based evaluation of a social skills program using art
therapy and group therapy for children on the autism spectrum. Children &
Schools, 30, 27–36.
Gersch, I., & Gonçalves, S. S. J. (2006). Creative arts therapies and educational psy-
chology: Let’s get together. International Journal of Art Therapy, 11, 22–32.
doi:10.1080/17454830600674050
Gladding, S. T. (2007). Counseling: A comprehensive profession (5th ed., rev.).
Upper Saddle River, NJ: Pearson.
Gladding, S. T. (2008). The impact of creativity in counseling. Journal of Creativity
in Mental Health, 3, 97–104. doi:10.1080/15401380802226679
Glass, K. L., Guli, L., & Semrud-Clikeman, M. (2000). Social competence intervention
program: A pilot program for the development of social competence. Journal of
Psychotherapy in Independent Practice, 1(4), 21–33. doi:10.1300/J288v01n04
Holmes, D. S. (2001). Abnormal psychology (4th ed.). Boston, MA: Allyn and Bacon.
Jordan, J. V. (2001). A relational-cultural model: Healing through mutual empathy.
Bulletin of the Menninger Clinic, 65, 92–103. doi:10.1521/bumc.65.1.92.18707
Jordan, J. V., & Dooley, C. (2000). Relational practice in action: A group manual.
Wellesley, MA: Stone Center Publications.
Karakelle, S. (2009). Enhancing fluent and flexible thinking through the creative
drama process. Thinking Skills and Creativity, 4, 124–129. doi:10.1016/
j.tsc.2009.05.002
Kendall, P. C., Choudhury, M., Hudson, J., & Webb, A. (2002). ‘The C.A.T. Project’
manual for the cognitive behavioral treatment of anxious adolescents.
Ardmore, PA: Workbook.
Kendall, P. C., Chu, B., Gifford, A., Hayes, C., & Nauta, M. (1998). Breathing life
into a manual: Flexibility and creativity with manual-based treatments. Cogni-
tive and Behavioral Practice, 5, 177–198. doi:10.1016/S1077–7229(98)80004–7
Kendall, P. C., & Hedtke, K. A. (2006). Cognitive-behavioral therapy for anxious
children: Therapist manual (3rd ed.). Ardmore, PA: Workbook.
Lane, K. L., Carter, E. W., & Pierson, M. R. (2006). Supporting transition-age youth
with and at risk for emotional and behavioral disorders at the secondary level:
A need for further inquiry. Journal of Emotional and Behavioral Disorders, 2,
108–117. doi:10.1177/10634266060140020101
McAuliffe, G. (2000). Constructivist teaching and learning principles. In G. McAuliffe &
K. Erikson (Eds.), Preparing counselors and therapists: Creating constructivist and
developmental programs (pp. 14–41). Virginia Beach, VA: Donning Company.
156 A. S. Lenz et al.

McCaslin, N. (2006). Creative drama in the classroom and beyond (8th ed.). Boston,
MA: Pearson.
Moreno, J. L. (1994). Psychodrama & group psychotherapy (4th ed.). McLean, VA:
American Society of Group Psychotherapy and Psychodrama.
Myers, J. E., & Sweeney, T. J. (2005). The indivisible self: An evidence-based model
of wellness. In J. E. Myers & T. J. Sweeney (Eds.), Counseling for wellness: The-
ory, research, and practice (pp. 20–38). Alexandria, VA: American Counseling
Association.
Paone, T. R., Malott, K. M., & Maldonado, J. M. (2008). Exploring group activity
therapy with ethnically diverse adolescents. Journal of Creativity in Mental
Health, 3, 285–302. doi:10.1080/15401380802347962
Perryman, K. L., & Keller, E. A. (2009). Floratherapy as a creative arts intervention
with women in a retirement home. Journal of Creativity in Mental Health, 4,
334–342. doi:10.1080/15401380903372653
Peterson, J. V., & Nisenholz, B. (1999). Orientation to counseling (4th ed.). Boston,
MA: Allyn & Bacon.
Podell, J. L., Martin, E. D, & Kendall, P. C. (2009). Incorporating play within a
manual-based treatment for children and adolescents with anxiety disorders. In
A. A. Drewes (Ed.), Blending play therapy with cognitive behavioral therapy:
Evidence-based and other effective treatments and techniques (pp. 165–178).
Hoboken, NJ: Wiley.
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic person-
ality change. Journal of Consulting and Clinical Psychology, 21, 95–103.
doi:10.1037/h0045357
Safran, D. S. (2003). An art approach to attention deficit/ hyperactivity disorder. In
C. A. Malchiodi (Ed.), Handbook of art therapy (pp. 181–192). New York, NY:
Guilford Press.
Sangganjanavanich, V. S., & Lenz, A. S. (2009, October). Transformational leader-
ship: Experiential consultation training model as a service to local community
agencies. Roundtable presented at the Association for Counselor Education
and Supervision Conference, San Diego, CA.
Snow, S., D’Amico, M., & Tanguay, D. (2003). Therapeutic theatre and well-being.
Art Psychotherapy, 30, 73–82. doi:10.1016/S0197–4556(03)00026–1
Stark, K., Kendall, P. C., McCarthy, M., Stafford, M., Barron, R., & Thomeer, M.
(1996). ‘TakingAction’ therapist manual. Ardmore, PA: Workbook.
Stiver, I. P., Rosen, W., Surrey, J., & Miller, J. B. (2001). Creative moments in
relational cultural therapy (Work in Progress, No. 92). Wellesley, MA: Stone
Center Working Paper Series.
Utay, J., & Utay, C. (2005). Improving social skills: A training presentation to
parents. Education, 126, 251–258.
Walsh, R. T., & Wilfred, L. (1990). A creative arts program in social skills training
for early adolescents: An exploratory study. The Arts in Psychotherapy, 17,
131–137. doi:10.1016/0197-4556(90)90023-J
Watts, R. E., & Garza, Y. (2008). Using children’s drawings to facilitate the acting ‘as
if’ technique. Journal of Individual Differences, 64, 113–118.
Wright, R., Lindsay, J., Ellenbogen, S., Offord, D. R., Duku, E. K., & Rowe, W.
(2006). Effect of a structured arts program on the psychosocial functioning of
 Therapeutic Social Skills Training 157

youth from low-income communities: Findings from a Canadian longitudinal

study. The Journal of Early Adolescence, 26, 186–205. doi:10.1177/
0272431605285717
Ziff, K. K., & Beamish, P. M. (2004). Teaching a course on the arts and counseling:
Experiential learning in counselor education. Counselor Education & Supervi-
sion, 44, 147–159.

A. Stephen Lenz is the Clinic Director of the Corpus Christi Counseling &
Training Clinic at Texas A&M University, Corpus Christi, Texas.
Rachel L. Holman is an Arts Educator at the South Texas Center for the
Arts, Corpus Christi, Texas.
Denise L. Dominguez is an Associate Psychologist at Nueces County Mental
Health and Mental Retardation Youth Services Program, Corpus Christi,
Texas.