The following case study looks at the initial therapeutic experience of Shaun, who joined Gesher at the age of 9 years old having been permanently excluded from his two previous school environments. His joint diagnosis of autism and ADHD had impacted significantly on his ability to learn in a mainstream environment, with numerous incidents of challenging behaviours being noted by the professionals working with him. Shaun was unable to read or write, and demonstrated clear signs of post-traumatic stress when faced with any academic pressures or placed within a school environment.
Shaun began attending weekly Dramatherapy sessions from his second day at Gesher. He was struggling to engage with the school environment, and when we spoke, he alluded to feeling very distrustful of schools in general, and stated that he was fed up with being told what to do. I was aware of Shaun’s previous experience in a school where he had been improperly restrained by several adult members of staff, and he had disclosed to an educational psychologist that he had felt physically violated and endangered during these incidents. I believed that the Dramatherapy space could have a significant role to play in addressing that distrust, and being the foundation for the emotional healing that Shaun had yet to experience. However, I was very aware that it Shaun should have choice to share with me the information about his previous experience at school, and would likely only serve to further his institutional distrust if I was to broach it first.
One of the huge benefits of a Dramatherapy intervention is that it’s very nature allows for flexibility in responding “appropriately to each child’s needs, with the aim of maximising their potential” (Godfrey & Haythorne, 2013:21). For a child such as Shaun this was incredibly important in helping him to feel safe by not feeling metaphorically constrained by the process, and therefore helping to diminish the association he felt between education institutions and being constrained physically. With the disclosure of his previous school-based trauma yet to be forthcoming, I instead focussed on ensuring Shaun felt welcomed into the therapy space and allowed the initial couple of sessions to be almost completely child-led; as with many individuals with learning difficulties who had “suffered vilification for their incapacities…the straightforward acceptance of who they are, in the present moment, can of itself by reparative” (Haythorne & Seymour, 2017). The sessions were going well although I still sensed a high level of anxiety from Shaun and a reticence to expose himself and be emotionally vulnerable. I was curious as to what the catalyst would be to enable this to happen.
Then suddenly, towards the end of his first three weeks at Gesher, Shaun demonstrated some challenging behaviours in response to being asked to come in promptly from the playground. A colleague came to inform both myself and the class teacher that Shaun was extremely upset and asked if we could come and support with his emotional state. As we arrived in the playground area, we witnessed Shaun attempt to climb the fence so as to leave the school, and when his class teacher intervened to ensure his safety, he began to lash out physically and verbally, and screamed loudly in distress. After we both tried unsuccessfully to de-escalate Shaun’s emotional state, and ensure both his and our physical safety, his class teacher ultimately had to restrain him using the TeamTeach technique. She held him gently by the forearms for a minimal amount of time, tucking his arms and legs in whilst encouraging him to move away and take space in the playground to calm himself once she felt he was calmer. Shaun reluctantly agreed to do this and spent around 15 minutes walking around the perimeter of the playground, seemingly looking for a way out but not acting upon it any further. After a while he appeared significantly calmer, and so I approached him. He began to share quite quickly what had happened; he had been upset by being asked to come inside several times as it had reminded him of his old school, where there were lots of rules and where he had been physically “choked” by the headteacher reasons unknown to him, prior to them “kicking him out” of the school. This experience was obviously dwelling on Shaun, and despite the bravado he was demonstrating, he was clearly anxious that he was going to be asked to leave yet another school. I thanked Shaun for sharing this with me, and asked if he wanted to have a Dramatherapy session to talk through what had happened, which he readily accepted.
As we sat and reflected on the incident, Shaun appeared at a loss for words. I observed aloud how his teacher had restrained him briefly and asked how he felt about it in comparison to what had happened at his old school. He acknowledged how different the two experiences had been, and through the use of emotion cards and drawings, I was able to facilitate a more conscious understanding of Shaun’s emotional state and what the triggers were for his distress. It was apparent from this work that Shaun was experiencing significant conflicting emotions around what had happened at his previous school: shame, confusion, anger, sadness, rejection. These feelings clearly had the potential to overwhelm him, and as such I was welcoming of them so that they could be “regulate[d] within the therapeutic process to ensure mutuality and authentic connection in which to explore…without judgement and humiliation” (Sanderson, 2015). Moving forward, we began to utilise various Dramatherapy techniques such as role-play, embodiment, and Neuro-Dramatic-Play (Jennings, 2011) as a way of helping Shaun to rediscover trust in others and belief in himself. The ingrained negative experiences that he had experienced previously began to be transformed with the support of the therapeutic intervention. Specifically, the automatic neurological reactions that had been previously been demonstrated began to change as the new positive experiences Shaun partook in within the therapy environment “strategically stimulate[d] the brain’s firing…to voluntarily change a firing pattern that was laid down involuntarily” (Siegel, 2011).
Being a full-time presence in the school was an incredible assistance in enabling me to support Shaun during these moments. I was able to witness the incident and therefore talk openly with him about it, and demonstrate that I didn’t hold him to blame or judge for it – in doing so, it allowed Shaun to open up at last about his previous traumas around being restrained, and I could confidently and compassionately discuss what I had seen as a neutral witness to the safe restraint that was used on him. My first hand perspective of the situation was able to support greatly with Shaun’s healing, and we continued to build upon this in our sessions to come. This wasn’t to say that Shaun always found it easy to share how he felt moving forward, but our shared experience of his traumatic response enabled us to develop a clearer and easier level of understanding; when the words wouldn’t come, Shaun would use mime and art, or we would jointly create something out of Lego or Play-Doh or cardboard as a way of processing his feelings on a more symbolic and metaphorical level. The fundamental premise of the use of metaphor as a process in Dramatherapy is that “it is a way of encapsulating human experience that is accessible to everyone” (Haythorne & Seymour, 2017); for children such as Shaun whose needs may make it difficult to communicate their feelings at times, metaphor therefore proves to be an invaluable asset in giving them a voice that is often ignored within our society. Thankfully, the broad range of resources available at Gesher only served to make these non-verbal communications more nuanced and easier to interpret.
Being able to respond to Shaun almost immediately after his challenging moment also meant that he was able to accurately reflect on how he was feeling rather than allowing it to build into a shameful memory akin to his previous experience of being restrained. Although there is much to be said about the importance of ensuring therapy is kept to a designated timeslot each week, within the school environment it has instead felt beneficial to respond to the children relatively soon after experiencing challenging emotions as they can work through feelings that they would otherwise find difficult to recall and reflect upon due to their emotional processing difficulties.
However, it must also be noted that when working alongside a child with ADHD, there is still a need for “clear, boundaried work that helps to contain their behaviour and structure their thought processes” (Dix, 2012). Appropriate use of Dramatherapy can also help to “create natural chemical changes in the brain and allow the child to develop new strategies for developing calmness managing behaviour” (Dix, 201). To address this and ensure that the use of adhoc support provided outside of regular planned therapy sessions remained safe and productive, I ensured that like with all the other children I work with, Shaun and I had a ritual that we would use at the start and end of each session to serve as the clear transition between his Dramatherapy process and his social/academic interactions around the school. We ultimately devised a special handshake that has acted as “a container for change, for the journey, for the adventure” (Jennings, 1990:62) in Shaun’s therapy throughout his time at Gesher.
After several months of working with Shaun, the use of Dramatherapy continues to evolve. Having demonstrated huge emotional growth and being able to reflect upon his previous traumas with an insightful level of maturity, Shaun has presently moved on to accessing the sessions as a way of processing his interpersonal relationships and the interactions he has within these. I continue to be privileged to support him with his wellbeing in such a well-supported environment, and have found it extremely rewarding to see how Shaun has used his sessions as a means of facilitating such a significant level of personal growth and healing.
- Dix, A. (2012) Whizzing and whirring: Dramatherapy and ADHD. In: Leigh, L., Gersch, I., Dix, A. & Haythorne, D. (eds.) Dramatherapy with Children, Young People and Schools: Enabling Creativity, Sociability, Communication and Learning. London: Routledge. pp. 51-58
- Godfrey, E. & Haythorne, D. (2013) Benefits of Dramatherapy for Autism Spectrum Disorder: a qualitative analysis of feedback from parents and teachers of clients attending Roundabout Dramatherapy sessions in schools. Dramatherapy. 35(1) pp. 20-28. Available at: http://www.tandfonline.com (Accessed 12/06/2019)
- Haythorne, D. & Seymour, A. (eds.) (2017) Dramatherapy and Autism. UK: Routledge
- Jennings, S. (1990) Dramatherapy with Families, Groups and Individuals: Waiting in the Wings. London: Jessica Kingsley Publishers
- Jennings, S. & Gerhardt, C. (2011) Healthy Attachments and Neuro-Dramatic-Play. London: Jessica Kingsley
- Sanderson, C. (2015) Counselling Skills for Working with Shame. London: Jessica Kingsley Publishers.
- Siegel, D. (2011) Mindsight. UK: Oneworld