The clinical and artistic aspects of dance/movement therapy.

goal

Lately at work I’ve been buried in all things clinical, specifically goals.  For example, at the beginning of January the creative arts team outlined new goals for clients.  We then discussed new goals with clients to make sure everybody was on the same page for the upcoming year.  Now we are in the process of tracking those goals for goal achievement percentages.  And just this week I took an employment training course on how to write goals and objectives.

Goals are great (I set many for myself like trying to blog once every two weeks) because they give us a light at the end of the tunnel, something to strive for.  Goals guide us to where we’d like to be.  However, sometimes goals can become daunting or stray us away from the present moment, from what’s happening in the here and now.   Although goals are an important component of the clinical environment, where many dance/movement therapists work, sometimes just showing up to dance/movement therapy group is a big deal.

Let me tell you a story.  When I began my internship, where I now work as a full-time dance/movement therapist, at a day rehabilitation center for adults with Developmental Disabilities (DD) I was completely lost.  I was lost and I had no clue what I was doing.  Ultimately, I was frustrated because in my second year of graduate school I thought I had dance/movement therapy figured out.  I explored my frustration with my then supervisor, telling her I felt confused in dance/movement therapy groups and that I didn’t know which dance/movement therapy interventions to use.   I told my supervisor that if I only knew each clients’ behavioral plan and goal I would THEN know which therapy techniques to use.  Upon saying that, she replied, “Why does that matter?  Why do you need to know the clients’ behavioral plans and goals?”

Mind.Blown.

In my utmost confusion (and defense) I began to rattle off that if I knew clients’ plans/goals then I’d know what interventions to use…. then I would know how to relate to them… then I’d be a better dance/movement therapist… and then I began to cry.

And when my tears settled my supervisor said, “Why not just try to be in the present moment with the clients during group?”  What she was telling me was that although education on clients’ diagnoses, behavior plans, and goals is certainly important, why not try to relate to the clients on the most basic level?  While goal setting is important for clients, and most likely important for program funding, what really matters is being present.

Now might be a good time to explain what I mean by “being present.”  To me, that phrase means that when I walk into the dance/movement therapy room I am present both in the room and with my clients.  When I walk into the dance/movement therapy room I do not have a fixed agenda of what that particular group is going to do.  Sure, I have a general idea or theme as suggested by the group’s name, such as Dance Fundamentals (a group that focuses on Barteneiff Fundamentals) or Space Harmony (a group where we explore Laban’s Space Category).  Instead of defining a fixed agenda or a fixed structure (Marian Chace, ahem) that will supposedly address clients’ goals, I allow the group to happen organically.  More importantly, I let the clients decide what they would like to do in group.  Instead of posing a structure, an activity, or an idea on them, I let the group choose what the group does.  Their choice might be verbalized or might be more subtle and suggested by their body movements.  My ability to facilitate in this style is, of course, due to my education in dance/movement therapy.

goal 2

My intention is not to set-up focusing on goals v. being in the present moment, or that these two concepts fight against each other.  Because, honestly, it’s when these two concepts coalesce that the opportunity for change is at its highest.  Maybe the bigger idea that I am getting at is my own personal debate between being a clinician and being an artist (I wonder if other dance/movement therapists feel this internal debate).   Dance/movement therapists’ marriage of the clinical and artistic environment to promote therapeutic change is the beauty of our work.  However, this marriage is also the bane of our work, often times leaving us feeling a sense of identity confusion.  At least it has for me.

What is certain is that if I am present with my clients in the dance/movement therapy room and create a safe container for them to create, dance, and explore, well then I bet an opportunity for clients to work on their goal will present itself.  In some way that goal or behavior will manifest and the client will have a chance to work on it through movement.

Personally, I approach dance/movement therapy as an art form.  Each time I invite clients into the dance/movement therapy room I am inviting them to create something and to express themselves artistically.  And although from the outside that might look like a big old dance party, therapy is happening.   All of the clinical aspects of my work are being addressed during that dance party, especially client goals.  Clients are working on impulse control, practicing interpersonal skills, exploring new ways of moving, like sustained use of time or working on the Upper-Lower Pattern of Connectivity.  The latter is especially apparent when looking through the lens of a Certified Movement Analyst (CMA), which I am.

Like today, in my Effort Elements group a client asked if we could meditate and focus on breath.  Sure, I said, honoring the client’s request.  And when I looked in my binder for today’s group theme it was to explore the effort element of flow.  How perfect, I thought.  What the client wanted to do was one way to explore this theme and I didn’t have to suggest a thing.  And because the client suggested it, it might have been a more meaningful experience for him.

Engaging in the present moment is especially important for the clients I work with (adults with DD) because I have found this is my client’s only interpretation of time or they are ruminating over past/future events (that latter sounds more like normal neurotics, eh?).  Although I can sit down and make an action-plan with my clients or discuss goal objectives with them, they would rather be focused on what is happening in the present moment.  Some of my clients have a hard time tolerating the energy created in the dance therapy group or even dancing.  Some of my clients have a hard time making eye contact.  And yet, these clients still come to dance/movement therapy group.  These clients sit quietly in a chair and observe the group…. which is a big deal because this is how THEY engage in the overall group process.  Personally, I find that group attendance is a large factor in goal achievement and that just showing up to group is a big deal.

I am not trying to step onto a soap box about goals and being a clinician verses an artist.  Trust me, I realize that creating goals and goal achievement is very important in therapy.  Yet, sometimes I feel bogged down a bit by the overall emphasis that the mental health community puts on goals.  I am suggesting that thinking about clients’ goals can take a therapist out of the therapy room; the place where the therapist needs to be to help assist with therapeutic change.  I feel as though our obsession with goals may cause us to forget that progression towards goals can be slow and change can be hard.  As a new dance/movement therapist I feel a strange pressure, like I am supposed to be more of a clinician rather than an artist when it was my artistic self that brought me to this work to begin with.  Although my work may look like a dance party or just hanging out on yoga mats, I have this secret therapeutic arsenal that is complex and nuanced.  It’s a secret wealth of knowledge that I only know because I am a dance/movement therapist.  And that makes me BOTH an artist and a clinician.

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About emilyadannunzio

Board Certified-Dance/Movement Therapist. Movement Analyst (GL-CMA). Researcher. Dancer. Bartender. Detroit, MI.
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