What if you could view your therapy sessions as three act performances?
What if you could guide your therapy sessions as if they were screenplays which unfold in a creative, spontaneous manner?
I have found the use of a three act arrangement to guide the therapy process to be a useful concept when working. I first learned of this when reading the book “Improvisational Therapy” by Bradford Keeney. This can be a very helpful map if your goal is to move a client out of a problem context into a resource context.
Keeney views a therapy session not unlike a script for a movie, in which the session is composed of stories with a beginning, middle and end. The role of therapy is to be a live performance in which therapist and client together move through these three acts. With the frames of the acts set in place, it is up to the performer (therapist) to engage in an improvisational performance to assist the client in maneuvering into new contexts and possibilities. This aids the therapist in scoring and keeping track of where he or she is in the session and if a session has progressed at all.
Act I of the story involves the introduction of the problem the client brings to therapy. Act I is rooted in a problem context. Unfortunately most therapists stay stuck in this part of the performance. In this context the problem is investigated in great detail. It is carefully examined and interpreted by the therapist. The problem and its etiology are ruminated upon in the hopes of changing the problem. Changing the problem is futile if the performance of therapy never moves beyond Act I. No matter what the therapist does or says, until the context of the session has changed, both therapist and client are stuck in the problem. Interpretation and diagnostic explanations for behavior are located in Act I. The goal of the therapist is to get out of this part of the performance as soon as possible.
Act II is the part of the performance linking the beginning to the end. This act is seen as the fulcrum where things can move forward or plunge backwards. This is where topics or ideas occur which are unexpected and surprising. The therapist often is working with a new theme which may have little to do with the problem the client brought into the session.
Act III is the part of the performance where the client has moved beyond the previous limitations of the problem context. The client is now in a resource context in which the problem may have been reframed or new resources have been introduced which enable the client to change his or her situation.
With this blueprint, there are no set techniques for the therapist to move his or her client out of the problem context as this way of performing therapy favors spontaneous interaction between therapist and client. The only goal is to move both the client and the therapist into a resource context in the shortest amount of time possible. To accomplish this change in context, the therapist must do whatever he or she must do to push past Act I.
This structure of performing therapy avoids interpretation and pathology, Focus on these can freeze the context of therapy in the problem-context. If therapy is focused on either the problems brought in by the client or his or her attempted solutions, therapy is still stuck in a problem context. This means that the therapy session may be cut off from any access to resources that the client can use to aid in his or her own healing. By moving out of the problem context and into a resource context, the problem itself can even appear to be a resource in itself.
Here is an example using three act therapy:
A young woman came to see me for therapy due to long bouts of depression. She also had started cutting herself in a very specific place so that no one would see she was cutting. Cutting this way allowed her to continue her self-injury behavior without those close to her being aware of it. Upon hearing her describe the structured cutting procedure she used I was struck by how much consideration and time she put into cutting herself in this manner. I asked her how she knew how to cut herself in just the right way to stay within the same specific, small area of her body. She told me she really didn’t know.
I told her it was interesting that a part of her unconsciously knew just how to geometrically cut herself to avoid serious harm and avoid detection from others. I let her know that this let me know that she was talented in the area of visual and spatial activities. We then began a discussion about her interest in art and design, which then led to a directive from me that she was to begin doing more drawing and painting to satisfy the visual and spatial part of her. I informed her that she had been denying the creative artist inside her for far too long. She told me she had always wanted to explore graphic arts but was unsure if it was a good career path. The next time I saw her, she had rapidly increased her art work and quickly decreased her cutting while feeling less episodes of depression.
interest in art
unleashing the creative artist
By moving this woman out of the problem context she was able to access the resources she needed to channel her focus into a more creative, positive outlet rather than a focus on the presenting problem. In this way of performing therapy, each session is viewed as a single session therapy. Additional sessions are treated as new cases.
Try this way of performing therapy out and let me know how it works for you. I would love to hear what results you got by using this concept.