Practicum Learnings for Counseling and Art Therapy Students: the ...

Int J Adv Counselling DOI 10.1007/s10447-016-9263-x O R I G I N A L A RT I C L E

Practicum Learnings for Counseling and Art Therapy Students: the Shared and the Particular Theresa Van Lith 1 & Lorelei Voronin 1

# Springer Science+Business Media New York 2016

Abstract Practicum experience in counseling and therapy training can be an anxiety-inducing time as students begin to apply their acquired theoretical knowledge. On-site supervisors closely monitor students’ development by making use of example-based involvements to provide valuable insights and learning opportunities. This paper examines the findings from a pragmatic inquiry, where seven on-site supervisors were interviewed about their experiences supervising counseling and art therapy practicum students. By using qualitative analysis, the authors were able to elicit themes that demonstrated important qualities for all counseling and therapy students during this learning stage, as well as for art therapy students in particular. Keywords Professional development . Counseling . Art therapy . Practicum . Qualitative inquiry

Introduction Becoming a mental health professional involves an integration of expertise, skills, and attitudes with one’s personal values and interests (Ducheny et al. 1997). Training to be a professional not only requires learning specific expertise, but also involves acquiring a demonstrative and interpersonal skill-set in order to know how to be and act in a specialized manner. Much research has explored counselor and therapist development. For example, previous studies (e.g., Furr and Carroll 2003; Hill et al. 2007; Koltz and Champe 2010) have explored the practicum experience from the student perspective, whereby critical incidents were identified as key moments that helped to inform the students’ professional identity. The perspective of the educator has also been used to provide validation to students needing reassurance and direction during their developmental process (e.g., Hazler and Kottler 2005; McNiff 1986; Stoltenberg et al. 1998).

* Theresa Van Lith [email protected]

1

Department of Art Education, Florida State University, William Johnston building, 143 Honors Way, Tallahassee, FL 32306-1231, USA

Int J Adv Counselling

To explore common struggles for beginning counselors and therapists, Rønnestad and Skovholt (2003) identified how students undertake the transition from a lay helper phase to a beginning student phase, and then to an advanced student phase during their training. Notable obstacles were found to include performance anxiety, feelings of being scrutinized by professional gatekeepers, impermeable or unbounded emotional boundaries, a sense of being fragile and incomplete as a practitioner, insufficient conceptual maps, unreachable expectations, and a feeling of neediness for mentors. These findings led Skovholt and Rønnestad to conclude, that the Bthe novice journey can be arduous^ (p. 45), where students fluctuate through periods of uncertainty and feelings of being a fraud.

Training Practices for Art Therapists Training toward becoming an art therapist is similar to more general counseling training, as it does involve completing a specialized masters degree through an approved educational institution. However, within the particular therapeutic milieu, art creating is integrated with counseling approaches to help address client issues. As explained by the American Art Therapy Association (2013), art therapy is, [a] mental health profession in which clients, facilitated by the art therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase selfesteem. A goal in art therapy is to improve or restore a client’s functioning and his or her sense of personal well-being. Art therapy practice requires knowledge of visual art (drawing, painting, sculpture, and other art forms) and the creative process, as well as of human development, psychological, and counseling theories and techniques. (p. 1) Undertaking the practicum component in training means that students commence transitioning from being a beginner to an advance student, which can be an especially stressful and anxiety-inducing time (Orkibi 2010, 2012a, 2012b, 2014). While there are many similarities between the training of counseling students in general compared to art therapy students in particular, previous studies have also found some differences. In art therapy, students learn how to integrate their artistic selves with therapeutic skills and practices to help form their particular professional identity (Feen-Calligan 2005). Robbins and Seaver (1994) noted how through practicum, art therapy students are able to fuse their pre-existing personal beliefs about helping others by guiding clients through art making experiences in a therapeutic way. As a consequence, the art therapy student strives to learn how to freely move between reflection and communication, all the while being consciously aware of the dynamic among the client, therapist and the image (Moon 2003; Schaverien 2000).

Supervision as Guidance during Training In Westernized countries, where art therapy programs usually exist, individual on-site supervision typically occurs for approximately 1 h per 10 client contact hours and group class supervision for approximately 2 h per week throughout the practicum component


(Potash et al. 2012). Similar as in counseling training, the role of supervision in art therapy training is seen to provide continuous support, as students learn how to conceptualize the client-therapist relationship, as well as how to reflect upon client progress through the integration of academic and civic learning (Gussak and Orr 2005). Therefore, the supervisor and the supervision process tend to play a particularly influential part in guiding professional development in art therapy training (FeenCalligan 2005). As Elkis-Abuhoff et al. (2010) argued: Supervision is important for the growth and development of the art therapy profession as a whole because it supports the next generation in becoming well rounded, knowledgeable, and defined as art therapists. (p. 126)

Objectives of the Current Study Counseling students proceeding through practicum have noted it be a particularly anxietyinducing phase, reporting that they often lose focus or feel that they have not been given enough direction (Orkibi 2014). Encouraging counseling and art therapy students to be proactive in their learning is essential, because it encourages resourcefulness and prepares them for professional settings. As Skovholt and Rønnestad (2003) stressed in regard to student training, the need is to be: Bpraemonitus, praemunita forewarned, forearmed^ (p. 56). Nevertheless, little research to date has explored practical advice for counseling and in particular art therapy students during this early stage of career development. Therefore, this inquiry aimed to explore the question: ‘What qualities could better prepare students as they progress towards becoming professional counselors and art therapists?’

Method Guiding Philosophy This study came out of a discussion between the first author (an instructor of an art therapy practicum supervision class) and the second author (an art therapy practicum student) realizing a practical need to explore how students can be better equipped to manage the stressful practicum component of their training. As supervisors use different styles of supervision we wanted to gain a mixture of perspectives to incorporate a combination of experience, preferences and personalities that could influence the supervisory experience for students. We were also wary that this study did not just focus on past experience, but also held a future-oriented ontology. Subsequently, the study became a pragmatic inquiry, which followed Rosiek’s (2013) philosophy that Bpragmatism locates meaning in the way our inquiries transform the relationship between present and future experience^ (p. 696). As this inquiry was driven by the objective of gathering practically oriented knowledge, the analysis process followed the pragmatic premise Bto seek practical and useful answers that can solve, or at least provide direction in addressing, concrete problems^ (Patton 2015, p. 152). Therefore, the emphasis was to Baim at utility for us^ (Rorty 1999, p. xxvi), which called for a


reflexive and realistic research practice by asking: ‘What it is for?’ ‘Who it is for?’ and ‘How do the researcher’s values influence the research?’

Participants An email was sent out to mental health practitioners who supervised both counseling and art therapy students in the North Florida area of the United States. Subsequently, a total of seven supervisors replied that they were interested in participating and could potentially provide rich and meaningful knowledge to this current line of inquiry. They subsequently formed the participant pool. Within the seven were three licensed Mental Health Counselors (LMHC). The first, Greg, had supervised numerous mental health counseling students and approximately 15 art therapy practicum students. He currently worked as the director of a disability outreach community center. The second LMHC, Katherine, worked as a counselor for at-risk children and adolescents and had been supervising counseling and art therapy practicum students on a regular basis for the past 13 years. John worked as the director of a residential center for veterans where, for the past three years, counseling and art therapy students had been undertaking their practicum placements. There were two licensed Social Workers. Marie was a director of a counseling program for at-risk youth. She had supervised counseling and art therapy practicum students on a regular basis for the previous five years. Siobhan worked with John at the residential center for veterans and had supervised approximately 4 art therapy practicum students. Finally, there were also two licensed Clinical Psychologists. Rachel provided counseling at a women’s prison. She had been supervising counseling and art therapy practicum students on a regular basis for the previous seven years. Don had supervised several psychology students and one art therapy practicum student. He was currently working at a mental health hospital that offered inpatient, outpatient and community based services.

Data Collection The first author interviewed each of the participants for approximately one to one and half hours, with this length being gauged to be appropriate for gathering focused but intensive responses (Patton 2015). Each interview was audio recorded and notes were also taken as a form of reflection. The following questions were used as a guide:

& & & &

Are there any knowledge areas or therapeutic skills that counseling and art therapy practicum students should be further trained in? In what ways are the art therapy practicum students similar to and different from counseling practicum students? What benefits do you think art therapy practicum students provide to the clients? Are any limitations to what art therapy practicum students provide?

Following the pragmatic lens, the participants were encouraged to provide descriptions that were based on action-oriented real-world accounts. This was in keeping with the Bpragmatic maxim^ (Peirce, 1878, cited in Patton 2015, p. 436), which calls for concentrating on the practical effects of attitudes and behaviors. As a result, the supervisors’


perspectives were regarded as being formed through seeing, hearing and developing an interpersonal connection with the counseling and art therapy students over the period of the students’ practicum experiences.

Data Analysis A traditional practice of analysis was used to structure and provide systematic practices to the pragmatic form of inquiry (Rosiek 2013). Therefore, the first phase of analysis followed a conventional thematic analysis process, according to the steps outlined by Braun and Clarke (2006) to identify commonalities as well as individual differences. The first author read the interview transcripts several times and then began looking for emergent patterns in the data. A table was devised with a new column added for each reading of the data to help refine and note key phrases. Each immersion into the data involved a reduction process to extract key concepts. This involved looking for the most critical and significant structures that made up each participant’s experience (Braun et al. 2014). Sub-themes were created by extracting key recurring phrases out of the data and keeping to the exact wording where possible to try and preserve the participant’s original intentions. Themes across the interviews were then established using a table to compare and contrast the sub-themes with the participants’ key concepts. Reoccurring concepts, or those with similar meanings from two or more participants, were determined to be sufficient to identify a common theme. Using a color-coding system, data were referenced in a manner that allowed findings to be traced back to the original source in the transcripts. The analytic process was conducted until the data had reached a ‘saturated’ point, where interpretations and theoretical underpinnings had been developed into a comprehensive conceptualization.

Reducing Bias and Enhancing Trustworthiness Several steps were integrated into the analysis process for bias reduction and enhancement of the study’s trustworthiness. First, once a set of sub-themes had been created for each participant interview, the first author sent these back to the participant for member checking and verification (Elliot et al. 1999; Lincoln and Guba 1985). The participants all provided agreement that the identified themes accurately represented their beliefs and perceptions. Next, the second author reviewed the first author’s analysis of themes across the data set. Both authors then used a process of abstraction to identify resonant qualities of the themes that were seen to have applicable benefits for supervisors and students alike. This took on a course of reality-based unfolding, as Strübing (2007) articulated: “Reality becomes such only insofar and as long as it is part of the environment within which actors act. Through action, obduracy is transformed from its state of opaque resistance into meaningful objects” (p. 555). Notes were taken during this phase, which helped to acknowledge how the findings could be applied back into practicum settings. Finally, when the research-based themes had been established, it was considered that a dialectic opinion was needed to enhance the practical application of the findings. Accordingly, the second author added a reflective stance by responding to the findings based upon her personal experiences as an art therapy practicum student. This step was seen as assisting the researchers to engage in a well-rounded discussion about different ways of seeing and knowing, which, in turn, created an enhanced or reframed understanding of the findings.


Findings The themes were divided into categories that were found to be important for career development. These were: Essential professional and training qualities for counseling and art therapy practicum students (see Table 1), Recommended professional qualities for counseling and art therapy practicum students (see Table 2), and particular training qualities for art therapy practicum students (see Table 3). These themes were underpinned by participant accounts and quotes to indicate this connection. Additionally, second author responses to the themes most relevant to her art therapy practicum experience are provided in italics.

Essential Professional and Training Qualities for Counseling and Art Therapy Practicum Students Perceptual Abilities The theme ‘perceptual abilities’ referred to the importance of practicum students being attuned to the client’s present state. Participants described this theme as the students’ ability to Bbe aware of the issues affecting the client^ (Don) and to Bquickly assess what is going on in order to work out how to get… [the client] further [in the clients’ treatment progress]^ (Marie). Katherine coined the term Bperceptual flexibility^ to describe how practicum students need to use a high level of attentiveness to observe the client’s current emotional state and then determine what the best intervention would be for that client. She explained how the students needed to Btry to see in their [the clients’] internal world. It is empathy, but it’s even one step more, as it’s about being able to shift what you are doing to fit; which takes behavioral flexibility^. The participants also regarded being perceptive during the therapy sessions as involving students being able to partake in empathetic listening with their clients. The participants explained empathetic listening as involving the therapist being fully engaged with a client, demonstrated by the therapist practicing open body language and accurately repeating key phrases back to the client. Empathetic listening was seen to help the clients feel heard by the therapist in an individualized way. Nevertheless, Katherine described a recent experience with an art therapy student where this did not occur. She explained: Bwhile the client was drawing, she [the student] was doing something else… that displays a lack of interest… also just the fact that you are not attentive to the process is important^. Katherine added that the student was not there to judge the artwork or interrupt the process, but to notice and be engaged with the client. Having perceptual abilities was also described through Rachel’s account with a recent art therapy student. She stated: BI referred one of my most challenging clients to her because I felt that through therapy this girl [client] had gotten into a good place, but this student was able to move in there and take her to a great place^. Rachel attributed these observed changes with the client through the art therapy student knowing how to use the art materials in order to Bgain a quicker and a more insightful window into what was going on with them [the client]^. The majority of the participants noted how imperative perceptual abilities were for any practicum student, and they also commented on how well most practicum students were at this skill. However, Greg suggested that the area where art therapy practicum students could develop most was being able to distinguish between whether a therapeutic session was suitable or if crisis management was needed instead. He noted that art therapy students could improve

Int J Adv Counselling Table 1 Essential qualities Overarching Theme

Themes

Professional Qualities Perceptual Abilities

Relationship Building Skills

Sub-Themes • The practicum student must be attuned and sensitive to seeing how deep to go with the client. Katherine. • An important skill of a practicum student is to be able to quickly assess what is going on and how to get furthest with them. Marie. • A practicum student needs to be able to case conceptualize that is, get to the nuts and bolts of the issue while still being aware of the contextual and systemic factors. Marie. • The students need to listen and give the clients feedback about what is going on. John. • The students’ ability to be flexible involves both the ability to change intentions as well as change perception by looking through the client’s eyes. Katherine. • Successful students use their initiative and capture opportunities where they can help their clients. Greg. • Art therapy students must be present with the client by noticing their artwork in a non-judgmental way. Katherine. • Art therapy students could develop further in their ability to see the immediacy of an issue through being present with the client. Greg. • Determining whether art therapy will be helpful or not is based on being able to assess the client. Don. • The way that the practicum student interacts with the clients significantly influences how successful the therapeutic outcomes are. Marie. • A successful practicum student firstly works on relating to their clients. John. • For practicum students to have a beneficial experience they need to be able to integrate well with the rest of the staff team. Greg. • An important part of the practicum student building a relationship with the client is flexibility. Rachel. • Practicum students that work with children need to give off a ‘warm and fuzzy’ vibe. Marie. • Being well accepted indicates that the children find the practicum student to be enjoyable, engaging and welcoming. Marie • Art therapy students can have difficulties with their needs being understood by the staff. Don.

Personal Experiences • Practicum students who incorporate the insights gained from their life experience tend to be more empathetic with their clients. Greg. • A lived experience can help practicum students connect with the clients as the trust is almost immediately there. John. • Art therapy students tend to be willing to explore their own issues in order to help others. Greg. Training Qualities

Ethical Awareness

• In order to be successful as a practicum student you need to be mature enough to be able to maintain professional boundaries. Marie. • Art therapy students tend to have a good awareness of the potential for harm using art materials. Greg. Art therapy students tend to have a good awareness of how appropriate the mediums are that they choose. Greg.

Int J Adv Counselling Table 2 Recommended professional qualities Overarching Theme

Themes

Sub-Themes

Professional Qualities

Personality Characteristics

• The practicum students’ compassion is important for how they initially relate to and connect to the client. Katherine. • Important characteristics for a practicum student are flexibility, openness and being able to accept feedback. Katherine. • Practicum students who are defensive, rigid and lack compassion are very difficult to teach. Katherine. • Practicum students require a certain level of maturity. Marie. • A flexible personality is one of the key pieces that make a practicum student successful. Marie.

Motivational Factors

• The most successful practicum students are super motivated and try to get as much out of their experience as possible. Marie. • Practicum students would benefit from thinking about their expectations and their intentions beforehand. John. • Practicum students need to be willing to dedicate themselves and soak up every experience possible. Marie.

at being able to quickly assess if a client was not managing their daily life skills before applying any therapeutic techniques. In considering this theme of perceptual abilities, the second author/art therapy practicum student reflected: As a second year art therapy student, I have come to understand the unique perceptual skill-set that I can offer my clients through the therapeutic process of art making. My ability to be empathetic and be present with the client has been gained through an amalgamation of my lived experience, education, prior practicum experiences, as well as through self-exploration and constructive criticism from supervision.

Relationship Building Skills The majority of the participants described the theme ‘relationship building skills’ as a central quality for any practicum student. According to the participants, therapists firstly become attuned to the client and then sensitively help the client to feel at ease with them. The on-site supervisors noted that they could quickly pick up if a student was not building rapport with the clients and referred to this lack as, Bnot being nurturing^ (Marie) and Bnot caring^ (Katherine). John emphasized the importance of building the relationship in a negotiated and flexible way. For example, art therapy practicum students could provide clients with options for an art experiential activity or provide directions to explore art materials during the session. Marie described how practicum students’ willingness to engage with the hard-to-reach clients significantly influenced how successful the therapeutic progress was. Rachel concurred by discussing her observations with how the practicum students developed rapport: Being able to pull out the clients’ strengths and tell them something about themselves that they hadn’t heard before. Giving the clients reasons why their behavior does not indicate that they are a bad person, but that it just indicates they had a hard time dealing with stuff that was going on.

Int J Adv Counselling Table 3 Particular training qualities for art therapy practicum students Overarching Theme

Themes

Sub-Themes

Training Qualities

Site Readiness

• The art therapy students [typically] represent as strong clinically trained and well prepared to do therapy, but [often] require more knowledge about case management. Greg. • Art therapy students would benefit from more awareness of the community they are working with and the resources available to help them. Greg. • Art therapy students strong in the arts can [at times] tend to be flakey with administrative tasks. Greg. • Art therapy students [often] do not have as much knowledge in job specific skills. Rachel. • Art therapy students would benefit from awareness about substance abuse issues. Siobhan. • I would like to see art therapy students have a better understanding of what we are all doing here, as they seem to be on the periphery a bit. Siobhan. • Art therapy students seem to lack knowledge in diagnostics, which would enable them to have better dialogue with the clinical staff. Don. • Most art therapy students do not come with much experience in suicide and risk assessments. Marie.

Application of Knowledge

• Successful art therapy students have been able to incorporate life management concerns within the therapeutic process. Greg. • It is unclear whether art therapy students try to establish therapeutic goals. Siobhan. • I would like to see art therapy students teach the clients tools to use once they have left. Siobhan. • Art therapy students need to be flexible with how art therapy directives are applied. John. • Art therapy students offer other interns new techniques to try. Rachel. • An effective art therapy student is able transition into other creative techniques if the art is not getting anywhere. Katherine.

Two supervisors particularly noted how relationship building was not just important for art therapists to develop with their clients, but also with regard to staff as well. For example, Greg recommended trying to integrate with the other staff in order to be team-oriented: BJump in and ask ‘how can I be of help?’ or ‘Give me what you want and I’ll take it, I’ll work on it’^. He added that you could tell how well a practicum student developed rapport with the team by how many staff would come to the student’s farewell gathering. In considering this theme of relationship building, the second author/art therapy practicum student reflected: I agree with the participants’ comments that art therapy students could improve on how they work as part of a treatment team. Communicating with the treatment team was especially important in acute in-patient mental health settings, where it was essential to work with other mental health professionals to be able to quickly assess clients’ presenting issues and then provide appropriate forms of intervention. Although this aspect didn’t come easily to me, and was dry compared to client interactions or creating


art, I realize it is necessary to give the client the best support for their particular situation.

Personal Experiences The theme of ‘personal experiences’ referred to how the practicum students were aware of potential counter-transference issues with their clients. Two supervisors stressed that for personal sharing to be therapeutic to the client, the student had to be aware of their own vulnerabilities. For example, Greg highlighted the necessity to have Bself-insight^ by stating: BBecause your stuff will come out here. You will get stuck with someone in the same places that you are stuck. You will get triggered by things that are unresolved within yourself^. In considering this theme of personal experiences, the second author/art therapy practicum student reflected: While, I found that sharing some of my personal interests was a way to put my clients at ease and help create personal connections, I was also mindful of not over-disclosing. I also found that besides supervision, personal reflection about client encounters helped greatly in processing how certain client issues were triggering me at times.

Ethical Awareness The participants discussed the theme of ‘ethical awareness’ in terms of how practicum students could maintain professional boundaries, as well as understand the potential for harm when using art materials and other tools for treatment. Greg explained ethical practices as: “know[ing] how to ground people; making sure they are not leaving the client with an open wound to walk out [with] and leave them to deal with [it] on their own”. The participants also noted how all practicum students needed to have an interpersonal awareness, as well as have a mature understanding of the policies and procedures at the site. They were concerned when students did not use supervision to explore these issues or were not upfront with asking questions rather than risking making a mistake. In considering this theme of ethical awareness, the second author/art therapy practicum student reflected: When confronted with a problematic situation at my practicum site, I consulted both my on-site supervisor and course supervisor for support. Based on their feedback I decided on a solution that felt right to me because I knew I had an ethical obligation to provide the best care for the clients under my care.

Recommended Professional Qualities for Counseling and Art Therapy Practicum Students Personality Characteristics The participants discussed how certain ‘personality characteristics’ were necessary for working in a counseling-related field. Some of these traits were seen as possible to develop through experience, which included developing maturity and self-awareness. On the other hand, there


were also characteristics that students needed to have already developed before being able to work with certain client populations and agency settings. These were identified as flexibility, compassion, open-mindedness, and an ability to accept feedback. As Katherine explained: I used to think that a lot of it had to do with experience, but I have had some very young students… who were incredibly mature and effective even though they didn’t really have the life experience… just open to see people with clean eyes; it was refreshing. In considering this theme of personal characteristics, the second author/art therapy practicum student reflected: Through self-reflection, I realized that I was attracted to fast-paced and energetic environments. I knew that I could use my creative problem-solving skills and energetic temperament to work with people experiencing an acute life crisis and helping them find positive solutions in order to rehabilitate back into the community.

Motivational Factors The theme of ‘motivational factors’ focused on how students used the practicum opportunity to learn more about their interests and personal strengths. The participants clearly indicated that the students who had rewarding experiences were those who were interested in working with the population of the practicum site. If students were passionate it was also a satisfying experience for the on-site supervisors. Marie and John explained how they could transfer their skill-set in a tangible way to the students who were driven to learn and integrate feedback into their practice. In considering this theme of motivational factors, the second author/art therapy practicum student reflected: I received valuable advice from my practicum on-site supervisor who told me that a student’s practicum experience primarily depends on the student’s motivation. I noticed with my peers that the students who had the most positive experiences were passionate about the population at their practicum site.

Particular Training Qualities for Art Therapy Practicum Students Site Readiness The theme ‘site readiness’ was explained in terms of how prepared the art therapy students were for functioning professionally in the workplace. Two participants affirmed students’ readiness in this regard, with Rachel stating that the art therapy students she had supervised were Bskilled at the very delicate complexities of trying to understand people right off the bat, … I see the best groundwork for someone to go out and do some really effective deep therapy^. Greg concurred with this view when he suggested that the art therapy students he had supervised represented some of the best clinically trained practicum students at his agency. However, participants also noted certain limitations to the skill-set that the art therapy practicum students often brought with them. The participants felt the need to teach many of these skills during the students’ practicum, but noted that these were mainly specific to their


particular site. The skills included: suicide and risk assessment (Marie), case management and community resources (Greg), substance abuse issues and bio-psychosocial assessments (Siobhan), and diagnostics (Don). At the same time, however, Siobhan and Rachel indicated that the students were often conducting art therapy in a site where no professional art therapists were employed, thereby creating an additional challenge for the students to understand their role in that particular service. In considering this theme of job readiness, the second author/art therapy practicum student identified a notable difference between her role as an art therapy practicum student and the other practicum students: As an art therapy practicum student, I found that a large part of my role was to first educate mental health professionals, staff and clients on what art therapy was, before I was able to provide art therapy services at the site. This education was essential in securing my place as part of the treatment team and creating a practicum environment that was open and supportive of art therapy.

Application of Knowledge The theme of ‘application of knowledge’ encompassed the participants’ views about how art therapy practicum students’ practiced their in-class training, and, in particular, their ability to adapt theoretical knowledge to a specific context or situation. This seemed to partly depend on how far along a student was in their training, as well as their ability to move beyond classroom taught techniques. For example, John noted that flexibility was required with how art therapy directives are applied. Katherine echoed this by adding that an art therapy student needed to know when to transition to another creative technique if the client was not responding to the art activity. This theme also referred to how the art therapy students could case-conceptualize in team meetings, as well as offer proactive advice to clients when appropriate. In considering this theme, the second author/art therapy practicum student reflected: An important component to ‘application of knowledge’ was developing a personal therapeutic style, based on the theoretical approaches I had learned in class. Initially, I tried to take on a theoretical style that didn’t fit with my personality, unknowingly setting high expectations for myself. Consequently, I found that my own expectations resulted in creating the same expectations on my clients. Upon reflection, I thought I was an imposter. I felt a persistent sense of inadequacy and of being found out by my professors and supervisors, despite conflicting evidence of achievement through receiving good grades. Self-reflection helped me to find a sense of equilibrium, by allowing room for mistakes and valuing myself as a Bgood enough^ (Winnicott 1964) therapist.

Discussion The participants were all in agreement that the practicum component in training encourages a greater awareness of what it is to come to know distress and suffering in others. This stance aligned with Skovholt and Rønnestad (2003) who added that engagement in the practicum experience involves an intensive investigation into the emotional side of humanity. They also offered many constructive and practical suggestions for qualities that they perceived as


important for the practicum experience to be both rewarding and challenging for student development.

Knowing how to Tune in and Perceive with Flexibility As echoed in previous studies, the participants noted that being thoughtful and conscientious were key motivational factors for why students typically pursued counseling training (Feen-Calligan 2012; Oppegard et al. 2005). Nonetheless, possessing the quality of having ‘perceptual abilities’ was not just about having a desire to help, but, rather, the participants regarded it as when students could quickly recognize clients’ issues and then determine the best way to offer support. However, the participants did not just expect enhanced awareness, but also for students to have an open outlook, or Bperceptual flexibility^ (Katherine). This could be demonstrated through students being malleable to the present state, situation and cultural context of the practicum site. While, this may be an important quality for all counseling and therapy students, a sense of elasticity was found to be especially crucial in preventing art therapy practicum students from feeling marginalized, because they were often the only person practicing art therapy at that site. As art therapist Kapitan (2012) said, flexibility is Ba key factor in how art therapists negotiate complex professional identities in response to external pressures of the mental health provider system^ (p. 149).

Understanding Intrapersonal and Interpersonal Dynamics Combining the insights gained in regard to the theme ‘perceptual abilities’ ‘relationship building’ and ‘personal experiences’ reverberates with established conclusions about the importance of the therapeutic alliance (cf., Flückiger et al. 2010; Hersoug et al. 2009; Orlinsky et al. 2004; Wampold 2001). As Duncan (2010) emphasized, becoming a therapist necessitates openness to experiencing encounters from both an intrapersonal and interpersonal view. Through supervision, the supervisors discussed with students how to foster client strengths and internal resources. They also declared that some students lacked understanding about how forming a client-therapist alliance took time. Yet, the students who persevered with developing a therapeutic relationship with the ‘hard-to-reach’ were seen to make the most gains with their clients, as well as being the most satisfied with their practicum experience (Duncan 2010). The participants’ indication that the formation of certain personal characteristics was vital during practicum has previously been explored in art therapy research, with Orkibi (2011) and Feen-Calligan (2005) underscoring benevolence, tolerance and empathy as being essential in forming quality client-therapist encounters. Moreover, the participants also recommended that students should consider the match of their personality with the client population and practicum setting. For example, Katherine worked with a prison population, where compassion and sensitivity are vital, as well as having a non-judgmental attitude when reflecting clients’ stories. On the other hand, Marie expressed that working with at-risk children and teens required being warm and humorous, which needed to be coupled with maturity, in order for the clients to feel comfortable and at ease with the therapeutic process.

Demonstrating an Integration of Practice As noted earlier, students can find the process of translating theory into practice demanding (Orkibi 2012a, 2012b, 2014). Those at the beginning stages tend to adopt cookie-cutter or


formulaic type approaches, which Orkibi (2014) regarded as imitating, until the student moves to a more nuanced and integrated style of practice; while students in the advanced stages of their training tend to take a more constructive outlook to practicum. The participants saw the early application of theories as being a natural part of the students’ development, and only noted concern when a student appeared too rigid or not open to receiving constructive criticism. An example of this common transition in learning was reflected in the second author/art therapist’s personal response to the theme ‘applied knowledge’, where she noted becoming more tolerant towards her own limitations and valuing these as areas where further learning could occur. Participants noted that besides gaining confidence and familiarity with their sites, students that used an ‘outside the box’ type of outlook to situations, where creative problem-solving was integrated with intuition and theoretical knowledge, had more success with overcoming this obstacle.

Being Prepared for Practicum The theme ‘site readiness’ combined with ‘motivational factors’ seemed to greatly influence how equipped students were for engaging with clients and staff at the practicum site. The participants noted anecdotally that students who were least prepared for the practicum site seemed to be more stressed, with this being in keeping with Elkis-Abuhoff et al.’s (2010) claim that students without prior exposure to vulnerable populations have a challenging, as well as complex learning curve during their graduate studies. Elkis-Abuhoff et al. (2010) also emphasized the importance of the supervisory relationship in order for the student to have a Bsafety net^ (p. 125) in working through such challenges. Particularly important for art therapy students was the need to be prepared for entering a new culture, where art therapy may not be part of the mainstream services offered to clients. Orr and Gussak (2005) emphasized that art therapy practicum students needed to learn how to connect and build partnerships with other helping professionals. An example of how to do this was demonstrated in the second author/art therapist’s personal response to the themes, where she found that providing in-service training about art therapy in the agency setting helped to expand staff understanding, which made her feel more established in the setting.

Implications Through synthesizing the data and identifying key insights derived from the inquiry, core qualities were identified as being important for students to attain and develop during their practicum. The first considerations identified were those that the on-site supervisors valued in counseling and therapy students in general. The second considerations were those that stood out as being specifically important for art therapy practicum students.

Important Qualities for Counseling and Art Therapy Practicum Students in General & &

Developing self-awareness - using introspective reflection to understand how personal values influence practice, as well as being willing to learn and be shaped by experiences. Developing boundary awareness - establishing the necessary psychological and social parameters in order for the client/therapist relationship to be one of mutual respect.


& &

Understanding and containing ambiguity - seeing the nuances in circumstances, as well as being flexible or malleable to change. Understanding the paradoxes of humanity - becoming aware of the complexities and contradictions involved in working with the emotional side of humanity.

Important Qualities for Art Therapy Practicum Students in Particular & & &

Understanding the role of art therapy within the system - seeing art therapy as part of a larger system that intersects through communication with other mental health professionals and that centers around the clients. Understanding the role as a professional art therapist - encompassing and embodying characteristics that represent art therapy professionalism. Continuation and evolution of the art therapy role - being open to seeing art therapy as being continuously shaped by client encounters, therapy experiences, the art making process, as well as life lessons.

Limitations and Areas for Future Research A potential limitation to the study is likely to have been that the sample of participants was obtained through the first author having prior relationships with those involved (as the instructor of an art therapy practicum class). However, the supervisors who participated were not skewed towards being those who might have been particularly satisfied with the art therapy students they had supervised. In fact, one of the participants noted that a specific art therapy student had difficulty in taking feedback and accepting constructive criticism, and some of the other participants also openly discussed examples where the art therapy students had not been a good fit for their site. As this was an exploratory study, the sample size was relatively small in scope. However, through the findings gathered, areas for potential research emerged. For example, while the study considered how counseling and therapy students in general could become more effective at graduate level learning and practice, research is still scant on the ingredients required to make a highly successful professional level art therapist. While prior research has already focused upon essential qualities for being an able therapist in general (cf., Duncan 2010; Skovholt and Jennings 2004; Wampold 2001), additional investigation could explore how art as a medium offers another dimension and challenges to these essential qualities. Finally, while research has previously explored the career projection of counselors, few studies have specifically explored career development of art therapists. Conducting longitudinal studies to track graduate art therapy students’ career progression, along with retrospective studies to examine the career trajectory of experienced art therapists would contribute greatly to this issue.

Conclusion This was a pragmatic inquiry, which the authors saw as potentially offering insights to the professional development of counseling and art therapy students. While certain considerations


were identified that can prompt discussions in regard to supervision, these findings can also assist on-site supervisors in helping students’ training progress towards becoming competent professionals. The practicum experience creates opportunities for students to confront internal tensions, learn about uncertainty, and validate whether they have chosen the right career path. By the same token, it is a time of transformation where students come to understand how to be aware, flexible and self-reflexive in practice. For art therapy students, it is particularly important that they come to see art therapy as being part of the larger mental health system, come to learn about the unique aspects that comprise art therapy as a profession, and appreciate how art therapy practice is shaped by client encounters, therapy experiences, the art making process, as well as life lessons. On-site supervisors can assist practicum students by providing opportunities for growth and self-insight in a tangible way. As stated by Kegan (1994): BPeople grow best when they continuously experience an ingenious blend of support and challenge; the rest is commentary^ (p. 42).

References American Art Therapy Association. (2013). What is art therapy. Retrieved from http://www.arttherapy.org/ upload/whatisarttherapy.pdf. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. doi:10.1191/1478088706qp063oa. Braun, V., Clarke, V., & Terry, G. (2014). Thematic analysis. In P. Rohleder & A. Lyons (Eds.), Qualitative research in clinical and Health Psychology (pp. 95–113). Basingstoke, UK: Palgrave MacMillan. Duncan, B. (2010). On becoming a better therapist. American Psychological Society: Washington D.C. Ducheny, K., Alletzhauser, H. L., Crandell, D., & Schneider, T. R. (1997). Graduate student professional development. Professional Psychology: Research and Practice, 28(1), 87–91. Retrieved from http:// dx.doi.org/10.1037/0735-7028.28.1.87. Elliot, R., Fischer, C., & Rennie, D. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology, 38(3), 215–229. doi:10.1348/ 014466599162782. Elkis-Abuhoff, D., Gaydos, M., Rose, S., & Goldblatt, R. (2010). The impact of education and exposure on art therapist identity and perception. Art Therapy: Journal of the American Art Therapy Association, 27(3), 119–126. doi:10.1080/07421656.2010.10129666. Feen-Calligan, H. (2005). Constructing professional identity in art therapy through service-learning and practica. Art Therapy: Journal of the American Art Therapy Association, 22(3), 122–131. doi:10.1080/07421656. 2005.10129490. Feen-Calligan, H. (2012). Professional identity perceptions of dual-prepared art therapy graduates. Art Therapy: Journal of the American Art Therapy Association, 29(4), 150–157. doi:10.1080/07421656.2012.730027. Flückiger, C., Wüsten, G., Zinbarg, R., & Wampold, B. (2010). Resource activation: Using clients’ own strengths in psychotherapy and counseling. Cambridge, MA: Hogrefe Publishing. Furr, S. R., & Carroll, J. J. (2003). Critical incidents in student counselor development. Journal of Counseling and Development, 81(3), 483–489. Gussak, D. E., & Orr, P. (2005). Ethical responsibilities: Preparing students for the real art therapy world. Art Therapy: Journal of the American Art Therapy Association, 22(2), 101–104. doi:10.1080/07421656.2005. 10129445. Hazler, R., & Kottler, J. (2005). The emerging professional counselor: Student dreams to professional realities (2nd ed.). Alexandria, VA: American Counseling Association. Hill, C. E., Sullivan, C., Knox, S., & Schlosser, L. Z. (2007). Becoming psychotherapists: experiences of novice trainees in a beginning graduate class. Psychotherapy: Theory, Research, Practice, Training, 44(4), 434– 449. doi:10.1037/0033-3204.44.4.434. Hersoug, A. G., Høglend, P., Havik, O., von der Lippe, A., & Monsen, J. (2009). Therapist characteristics influencing the quality of alliance in long-term psychotherapy. Clinical Psychology & Psychotherapy, 16(2), 100–110. doi:10.1002/cpp.605.

Int J Adv Counselling Kapitan, L. (2012). Educating the future practitioner of art therapy. Art Therapy: Journal of the American Art Therapy Association, 29(4), 148–149. doi:10.1080/07421656.2012.735930. Kegan, R. (1994). In over our heads: The mental demands of modern life. Cambridge, MA: Harvard University Press. Koltz, R., & Champe, J. (2010). A phenomenological case study: The transition of mental health counseling interns from students to professionals. Ideas and Research You Can Use: VISTAS 2010. 1–11. Retrieved from http://counselingoutfitters.com/vistas/vistas10/Article_31.pdf. Lincoln, Y., & Guba, E. (1985). Naturalistic inquiry. Newbury Park, CA: Sage. McNiff, S. (1986). Educating the creative arts therapist: A profile of the profession. Springfield, IL: Charles C. Thomas. Moon, B. (2003). Essentials of art therapy education and practice (2nd). Springfield, IL: Charles C Thomas. Oppegard, K., Omaha, N., Elkins, D., Abbenante, J., & Bangley, B. (2005). Choosing art therapy as a career. Art Therapy: Journal of the American Art Therapy Association, 22(2), 92–100. doi:10.1080/07421656.2005. 10129444. Orkibi, H. (2010). Creative art therapies students’ professional identity and career commitment: A brief pilot study. The Arts in Psychotherapy, 37(3), 228–232. doi:10.1016/j.aip.2010.04.008. Orkibi, H. (2011). Creative arts therapies students’ professional development: Mixed methods longitudinal research (Unpublished doctoral dissertation). Massachusetts: Lesley University. Orkibi, H. (2012a). A field training model for creative arts therapies: Report from a 3-year program evaluation. Art Therapy: Journal of the American Art Therapy Association, 29(4), 174–179. doi:10.1080/07421656. 2012.730930. Orkibi, H. (2012b). Arts therapies students’ scores in profession related variables: Quantitative results of a longitudinal study. Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice, 7(2), 129–144. doi:10.1080/17432979.2012.659678. Orkibi, H. (2014). The applicability of a seminal professional development theory to creative arts therapies students. Clinical Psychology & Psychotherapy, 21(6), 508–518. doi:10.1002/cpp.1851. Orlinsky, D. E., Rønnestad, M. H., & Willutzki, U. (2004). Fifty years of psychotherapy process outcome research: Continuity and change. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (5th ed., pp. 307–389). New York: Wiley. Orr, P., & Gussak, D. (2005). Getting tangled in the web: A systems theory approach to supervision. Art Therapy: Journal of the American Art Therapy Association, 22(3), 161–163. doi:10.1080/07421656.2005.10129494. Patton, M. Q. (2015). Qualitative research and evaluation methods (4th ed.). Los Angeles, LA: Sage. Potash, J. S., Bardot, H., & Ho, R. (2012). Conceptualizing international art therapy education standards. The Arts in Psychotherapy, 39(2), 143–150. doi:10.1016/j.aip.2012.03.003. Robbins, A., & Seaver, L. (1994). Becoming an art therapist. In A. Robbins (Ed.), A multi-modal approach to creative arts therapy (pp. 18–30). London, UK: Jessica Kingsley. Rønnestad, M., & Skovholt, T. (2003). The journey of the counselor and therapist: research findings and perspectives on professional development. Journal of Career Development, 30(1), 5–44. doi:10.1023/ A:1025173508081. Rorty, R. (1999). Philosophy and social hope. New York, NY: Penguin. Rosiek, J. (2013). Pragmatism and post-qualitative futures. International Journal of Qualitative Studies in Education, 26(6), 692–705. doi:10.1080/09518398.2013.788758. Schaverien, J. (2000). The triangular relationship and the aesthetic countertransference in analytical art psychotherapy. In A. Gilroy & G. McNeilly (Eds.), The changing shape of art therapy: New developments in theory and practice (pp. 55–84). London, UK: Jessica Kingsley. Skovholt, T., & Jennings, L. (2004). Master therapist: Exploring expertise in therapy and counseling. Needham Heights, MA: Allyn & Bacon. Skovholt, T., & Rønnestad, M. (2003). Struggles of the novice counselor and therapist. Journal of Career Development, 30(1), 45–58. doi:10.1023/A:1025125624919. Stoltenberg, C. D., McNeill, B. W., & Delworth, U. (1998). IDM: The integrated developmental model of supervision. San Francisco: Jossey-Bass. Strübing, J. (2007). Research as pragmatic problem-solving: the Pragmatist Roots of Empirically-grounded Theorizing. In A. Bryant & K. Charmaz (Eds.), The Sage handbook of grounded theory (pp. 580–602). London, UK: Sage. Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Erlbaum. Winnicott, D. W. (1964). The child, the family, and the outside world (2nd ed.). Harmondsworth, UK: Penguin Books.