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CREATING SPACE FOR CONNECTION: A COLUMN FOR CREATIVE PRACTICE

This column is designed to underscore relationally based creative inter- ventions used by counselors and psychotherapists in their practices. Our intention is to provide examples of novel, innovative ways of working with clients in their efforts to deepen self-awareness and their connections with others. Although the interventions within this column will be presented in a linear “how to” manner, an essential premise of this column is that inter- ventions submitted for publication have a contextual and relational basis. Basic to this column is the therapeutic focus of working through latent hurts and impediments to our clients’ health and happiness. Client goals generally involve creating the requisite emotional space needed for genuine relational choice for connection to manifest. If you have created a useful therapy tool, or if you have adapted an existing creative tool that you would like to share with readers, please follow submission guidelines in the author infor- mation packet available at http://www.creativecounselor.org/Journal.html.

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ArtBreak: A Creative Group Counseling Program for Children

KATHERINE ZIFF, LORI PIERCE, and SUSAN JOHANSON Athens City School District, The Plains, Ohio, USA

MARGARET KING Ohio University, Athens, Ohio, USA

This article describes the pilot of a school-based creative group-counseling program for children called ArtBreak, a choice-based studio art experience based on the restorative pos- sibilities of art making delineated in the expressive therapies continuum (ETC; Hinz, 2009; Kagin & Lusebrink, 1978). The ETC features a developmental hierarchy in relation to how art is cre- ated and the therapeutic properties of associated media. Learning from the pilot suggests the ETC is a valuable framework for support- ing groups of children in kinesthetic, affective, and cognitive ways. The article also includes suggestions regarding logistics, commu- nity, and future documentation and research.

KEYWORDS children, art, group counseling, expressive therapies continuum, creative counseling, creativity

Schools offer art making to students in a variety of formats and for mul- tiple purposes. Art educators teach children about techniques, materials, processes, art appreciation, and art history; they also encourage play, cre- ativity, and imagination (Szekely, 2006). Art making can be a support to classroom teaching: The ateliers of Reggio Emilia schools and the curricula of Waldorf schools are art based (Gandini, Hill, Cadwell, & Schwall, 2005; Pelo, 2007). Also, North Carolina and Oklahoma’s system of A+ Schools is a reform model of arts integration (President’s Committee on the Arts and the Humanities, 2011). School counselors use visual art to provide creative counseling in individual or themed group settings (Allan, 1988;

Address correspondence to Katherine Ziff, Athens City School District, 25 S. Plains Road, The Plains, OH 45780, USA. E-mail: [email protected]

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Gladding, 2011; Somody & Hobbs, 2006/2007). Art therapists sometimes practice in schools, their work supporting student mental health (Essex, Frostig, & Hertz, 1996; Malchiodi, 1996; Pleasant-Metcalf & Rosal, 1997; Rosal, McCulloch-Vislisel, & Neece, 1997). Visual arts in schools is valuable in encouraging school engagement and community, creativity, collabora- tion, innovative thinking, and attention (Kosik, 2009; President’s Committee on the Arts and the Humanities, 2011).

ArtBreak, a program grounded in the therapeutic use of studio art, is a choice-based studio art experience for children based on the restorative possibilities of art making delineated in the expressive therapies contin- uum (ETC; Kagin & Lusebrink, 1978). The pilot program took place in two elementary schools in rural Southeastern Ohio from 2009 through 2011. ArtBreak was planned and facilitated by an elementary school counselor in consultation with school psychologists and administrators and a university professor.

RATIONALE

ArtBreak shares boundaries with both art therapy and art education, although it is neither. It incorporates the ETC as a guide for choosing mate- rials for the studio, offering them to children, and thinking about what children are accomplishing as they choose and work with various media. Grounded in the ETC and studio art, ArtBreak is a group-based creative counseling program designed to help students build social skills, develop problem-solving abilities, and relax and express feelings.

The ETC is a theoretical framework for engaging the expressive and integrative potential of creativity through the use and properties of visual art. Art therapists Sandra Kagin and Vija Lusebrink introduced the ETC in 1978; it has been elaborated by Lisa Hinz (2009). The ETC features a developmental hierarchy associated with how information is processed in relation to how art is created in a therapeutic context. ETC delineates three general restorative goals of associated media: (a) Fluid media like watercolor, chalk pastels, and finger paint support kinesthetic/sensory goals such as relaxation and expression of feelings; (b) more resistive media like colored pencils, crayons, markers, clay, and tempera paint support perceptual/affective goals such as improving cognition, increasing empathic understanding, identifying emotions, and cause and effect; and (c) resistive media like collage, sculpture with found and recycled materials, and illus- trated books support cognitive/symbolic goals such as developing problem- solving skills and identifying and integrating strengths (Hinz, 2009). The third cognitive/symbolic area of the ETC is further differentiated by Project Zero research, which identifies eight habits of mind supported by studio art, including development of craft, ability to engage and persist, envisioning,

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TABLE 1 The Expressive Therapies Continuum: Therapeutic Goals and Suggested Materials

Continuum Level Therapeutic Goals Suggested Materials

I. Kinesthetic/Sensory Relax Soft clay Express feelings Finger paint

Watercolor Chalk pastels

II. Perceptual/Affective Improve cognition Tempera paint Empathic understanding Crayons Identify feelings Oil pastels Improve social skills Drawing materials Improve attention Understand cause and effect

III. Cognitive/Symbolic Develop problem-solving abilities

Identify and integrate strengths

Collage Sculpture with repurposed

materials Clay Mask making Markers Art making with two or more

steps Illustrated books and narratives

Note. Adapted from Hinz (2009).

expression, observation, and reflection (Winner, Hetland, Veenema, Sheridan, & Palmer, 2006). Table 1 shows the three levels of the ETC.

Studio art has long been associated with psychological healing and regeneration (Adamson & Timlin, 1990; Essex et al., 1996; Moon, 2002). Douglas and Jaquith (2009) associated choice-based art in the classroom with building skills of problem solving, working habits, reflecting, connect- ing, constructing knowledge, and problem finding. Boldt and Brooks (2006) described how art making by groups of students builds community, supports social skills, and fosters belonging, mastery, independence, and generosity. Art making can reduce stress, and for children experiencing cognitive, physi- cal, or emotional stress, a source of relaxation at school can support learning (DeLue, 1999).

In studio art therapy, art making is central to the theoretical approach, conceptual understanding of clients and their art making, design and cre- ation of therapeutic work space, and interactions and communications about the process (Moon, 2002). Likewise, an art studio orientation in which stu- dents are supported in their ideas, intentions, decisions, and choices is different from the use of art-based protocols for assessment, diagnosis, and treatment. In such an environment where work is facilitated rather than directed, authentic growth and learning can take place (Adamson & Timlin, 1990; McLennan, 2010; Rogers, 1989). ArtBreak offers students an opportu- nity to pursue independent, choice-based art making according to their own

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interests, in a studio furnished with materials and media that reflect and support all three levels of the ETC framework.

ASSUMPTIONS

ArtBreak is based on the following assumptions:

1. Art making supports children in expressive, affective, and cognitive ways as delineated in the ETC.

2. Art making in a group builds community and develops social skills. 3. Art making in school increases student engagement. 4. Art making supports creativity and divergent thinking.

ARTBREAK PILOT OBJECTIVES

Our pilot program included five objectives:

1. Learn whether the ETC is applicable to a school-based group studio art format and, if so, how.

2. Provide an opportunity for students to build social skills, develop problem-solving abilities, and relax and express feelings as they choose.

3. Learn whether the logistics of ArtBreak (weekly 30-minute groups) are feasible in a school setting.

4. Create forms and documentation systems for ArtBreak. 5. Identify other learning from the pilot.

PILOT PROJECT

In its 1st year, the program served 36 children in six groups in one school. The following year, ArtBreak expanded to serve 44 children in two schools in a total of eight groups. Each group, composed of kindergarten through sixth-grade students of diverse ages, genders, and skills, worked together for 30 minutes per week throughout the school year in an open art studio format.

Process

We followed a simple framework for implementing ArtBreak, available to any practitioner in the field wishing to implement the program.

1. Begin by setting up the art studio; the size and facilities of the space determine the parameters of what can be offered. A room with a sink and

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shelves can accommodate many options. A very small space can work by having students build sketchbooks to work in and keeping handy a bucket of clean water, damp rags, and a pan for things to be washed later.

2. Using the ETC (see Table 1) as a guide, stock the studio space with at least two kinds of materials from each of the three areas of the ETC, choosing media with which you are familiar. For ideas on acquiring and setting up materials, consultation with a school art educator is helpful. Douglas and Jaquith (2009) also provide advice on how to set up art centers.

3. Introduce teachers, families, and administrators to the ArtBreak pro- gram by inviting teachers to visit the studio and offering art materials as door prizes, hosting an open studio for families at fall parent– teacher conferences, and/or announcing the program in the school newsletter.

4. Invite teachers to refer students and obtain written parent/guardian per- mission for students to participate. We developed a referral form (see Appendix) based upon the ETC.

5. Begin the groups by introducing new materials and processes as students ask or seem ready for them. An ongoing list of “things we need” posted in the studio is a helpful guide for introducing new materials. Daily written reflections by the practitioner are also a good support for deciding about new materials and problem solving.

Our ArtBreak groups were organized and facilitated by the school counselor whose role was to model problem solving; demonstrate the use and care of materials; teach skills such as clean-up; introduce new tools; encourage and model supportive behavior, supportive language, and other prosocial skills; keep time; and make decisions about introducing new materials and processes.

Students were referred to the groups by their teachers, a school- based intervention team, community mental health professionals, or families. Students were introduced to ArtBreak in a contained format to help them learn the choice-based format. For the first two sessions, the counselor placed an appealing object (e.g., a toy dragon, a clay turtle, an orchid in bloom) on the table and invited students to create an image of it with media of their choice. Students then continued with their own choice of media and projects. More art materials, tools, and processes at all three levels of the ETC were introduced to the ArtBreak groups when students seemed ready or when students asked for them. Some students began making art on cafe- teria trays and chose from a basic set of media from all three sections of the ETC: fluid media such as finger paint, more resistive materials such as oil pastels and colored pencils, and very resistive media such as markers. Other groups began by building sketchbooks from repurposed cardboard, filling them with papers of their choice, and using media from all levels of the

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ETC such as finger paint, water color, chalk pastels, tempera paint, crayons, markers, collage, and “pop-up” creations.

Documentation of ArtBreak included the counselor’s weekly notes on each child’s work, including choice of media, the child’s description, and group process. Notes were taken by hand during ArtBreak and transcribed on a laptop. At the end of the day, the counselor wrote reflections about materials, questions, problems and challenges, ideas for improvements, com- munications, and collaborations. The counselor also photographed student work. Some parents requested electronic portfolios of their children’s work, which was accomplished via e-mail.

Each ArtBreak session had its own rhythm and challenges. Following are composite vignettes illustrating two very different sessions. The fol- lowing scenario occurred during the ninth session while children worked independently with different media.

Six children, ages 5 through 11 years, rush into the school counselor’s room and dive into the apron box for smocks. It is time for ArtBreak in this rural elementary school. Two students head for the back table where their robots are ready for them; they have been under construction for several weeks now, and today the students would decide to work on the problem of how to create and attach moveable arms. A second grader circles the room a time or two before settling on finger paint, choos- ing glossy paper and a selection of paints, dampening the paper with a sponge, and carefully squeezing out globs of paint, while exclaim- ing over the bright hues and the satisfyingly squishy feel of the paint. A fourth grader reaches for her cardboard and duct tape construction and continues to grapple with how she will make a sturdy and mean- ingful object. Another child walks about the room eyeing paints, boxes of collage materials, and the construction corner stacked with cardboard and other repurposed objects. This child selects a 5-gallon plastic jug, mixes tempera paint, and covers the jug with a turquoise and green under-the-seascape. Filling the jug with water makes it hard to handle, so a handful of glass pebbles serves as sea water. A sixth child works carefully on a valentine collage for a sibling. ‘Where’s the music?’ one child shouts. Oops—the counselor forgot to turn it on, and she hits the start button for the jazz CD the group has become accustomed to. The children work steadily for half an hour, talking among themselves and occasionally offering announcements to the group. The counselor moves around the room, supporting problem solving by offering tools, assistance with hole punching, towels when water spills, and a basket of new string and yarn. The counselor occasionally pauses to make notes about what the children are doing and saying. The children try to eke out a few more minutes past the half hour of allotted work time and then help with a whirlwind clean-up. Art is stacked on a rack to dry, and the counselor takes 5 minutes to write down notes about the group’s process and reminders about materials or room rearrangements needed.

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Morning ArtBreak ends; the counselor gets the room ready for the rest of the day, which will include an afternoon session with a different group.

In the next scenario, upper-elementary boys are in their 12th week of ArtBreak. By this time, the group had formed a working community, and all elected to embark on sewing projects.

Six boys enter the room and walk around, examining the latest addi- tions to the cardboard sculpture center and plunging their hands into the giant bowl of buttons. The counselor points out a shelf newly stocked with fabric, and there are exclamations—the boys have been anxious to sew for 2 weeks, ever since one of them fashioned large pieces of fleece scraps into a lap blanket for his teacher. All of them decide to work on fabric projects and they rummage through wool remnants, flan- nel yardage, cotton batting, threads, and needles. They decide to make pillows of varying sizes, and chaos ensues with cries such as: ‘How do you thread the needle?’; ‘How do I knot the thread?; ‘Will you help me straighten out my pillow?’; ’I need help! These scissors won’t cut this material’; ‘I asked first for help!’; and ‘No, I did!’ One boy has an outburst of impatience and retreats to the counselor’s desk to recover, rejoining the sewing table after a few minutes. The counselor gives a brief demon- stration of a running stitch (wishing she had purchased thicker thread that would tangle less easily). Ten minutes of calm descend upon the room, the boys carefully stitching. ‘I thought sewing was girly but it’s not,’ one of them offers to the group. ‘We like this,’ a few boys reply. ‘So shorter stitches make the sewing stronger, don’t they?’ notes another student. ‘You know, this is relaxing,’ declares the student who had the impatient outburst. Then, another rush of calls for assistance occurs as the boys hurry to finish up their projects so they can take them home that day. A bag of polyester batting is passed around, and pillows of cotton flannel, calico, and fake fur ranging in size from 6 to 18 inches long are stuffed, stitched, and tried out. One boy shouts with frustration about finding a way to bring his completed cardboard structure from the previous week safely home on the bus; another student comes to his aid, rummaging in the sculpture center for just the right size box. The boys rush back to their classrooms to get ready to go home for the day. The counselor sits down and thinks about how she might have created a more orderly introduction to sewing. The next day, the school psychologist, after listening to an account of the sewing group, reflected that the session was a model for the boys in moving from chaos to calm productivity.

ADAPTATIONS

ArtBreak could be offered to children by classroom teachers and in other settings such as libraries and mental health centers. ArtBreak could also be

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adapted for middle and high schools. During the pilot, teachers requested an ArtBreak for themselves, which could be offered on a drop-in basis. The counseling center of George Washington University offered to students an ArtBreak program of structured art-based activities to support creativity and mental health (Gladding, 2011). Campus programs could include an ongoing ArtBreak in a studio format based on the atelier model offered by the Medical College of Pennsylvania (Bartley, 1997) to its students in a course entitled Medicine and Art.

REQUIREMENTS AND LIMITATIONS

ArtBreak is situated in a school-based group-art studio environment facili- tated by a school counselor; participating students have been referred for support with goals listed on the referral form (see Appendix) aligned with the ETC. Therefore, ethical considerations addressed included (a) necessity for written parent/guardian permission for students to participate; (b) pri- vacy and confidentiality related to student work; (c) written parent/family permission for use of student work in public presentations; (d) considera- tions for managing requests from education professionals to visit an ArtBreak group; and (e) a working knowledge of the ETC and its associated art- making materials by the ArtBreak facilitator. Space is also a consideration. A space with no running water needs cleaning, a container of water for watercolor paints, and a bucket for used brushes. A small room can accom- modate ArtBreak with groups of three to four children and creative use of space. Funds are necessary for many of the art supplies needed, though construction/sculpture and collage materials can be obtained free from a variety of sources.

DISCUSSION

ETC

Learning from the pilot program encompassed three areas: the ETC, com- munity, and logistics. In regard to the ETC, ArtBreak students worked at all three levels of the ETC. Figure 1 shows kinesthetic enjoyment of paint. In Figure 2, a student has used collage and pastels to express a relationship, a function of the perceptual/affective level of the ETC. Figure 3 illustrates use of construction materials and multistep problem-solving processes at the cognitive end of the ETC.

Some children spent months using the same medium. Others began at one end of the continuum and moved to the other end (e.g., from chalk pastels to multistep sculptures or from markers and construction to finger paint). Teachers referred students to ArtBreak for reasons at all three levels

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FIGURE 1 Fluid media can encourage tactile expressiveness. The Garden of Rain, watercolor spattered on paper. Printed with permission.

FIGURE 2 Media with some resistiveness can encourage exploration of relationships and cause and effect. Earth With Ocean, Fish, and Moon, collage with paper and chalk pastels. Printed with permission.

of the ETC. Referral reasons for the 44 students in the 2010–2011 program were: kinesthetic/sensory reasons, such as relaxation, for 14 students; perceptual/affective reasons, such as improving attention and social skills, for 25 students; and cognitive/symbolic support, such as integrating personal strengths or improving problem-solving skills, for 5 students. Of the 44 stu- dents, 31 were boys and 13 were girls. ArtBreak supported some students in making progress on referral goals. Some, referred to ArtBreak for a needed break from the academic or social demands of the classroom, found the group a relaxing experience. Several children with social skills goals became more comfortable with new processes and new people, and they later

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FIGURE 3 Resistive media can encourage creative problem solving. School of the Future With Roof That Opens, cardboard, tempera paint, yarn. Printed with permission.

demonstrated the ability to engage in meaningful social interactions in the group and in the classroom. In several cases, students made great improve- ments in prosocial behaviors in both the group and classroom settings. A child with behavior goals became positively engaged in ArtBreak— completing work and offering to help others—as well as in the classroom. A child who was referred to develop skills of concentration worked with steady focus in ArtBreak, carefully making cardboard constructions meaningful to him. His teacher later noted increased focus in the classroom.

Community

In regard to community, the ArtBreak groups became supportive commu- nities where students felt safe to explore pursuits of their own choosing. Students helped each other solve problems, practiced and developed pos- itive social skills in the groups, learned how to be flexible and tolerate frustration, and made friends. We found that mixing ages in the groups offered advantages by freeing students from preexisting classroom-based expectations and friendships.

The ArtBreak pilot flourished with the support of a community of adults inside and outside the school district. Teachers, the school intervention team, community mental health specialists, and families referred students for

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participation. Students also referred themselves, and ArtBreak participants referred their friends. School art educators helped identify resources for sup- plies, and students brought to ArtBreak the skills they learned in their art classes. Principals and school district administrators provided funds for key supplies and materials. School psychologists collaborated during all steps of the ArtBreak pilot. A university faculty member provided consultation and served as a writing and research collaborator. School staff as well as local business establishments donated materials for students to use for art making.

Logistics

With regard to logistics, we learned that although the half-hour format fits well within the context of a busy school day, it is a bare minimum amount of time for students to decide upon and begin a project. Some students embarked on complex projects requiring multiple sessions, but no matter what the project, a half hour seems to be a minimum for students to have a satisfying experience. Though students are taught clean-up skills, there is usually little time for thorough clean up in a 30-minute period. Therefore, the counselor needs additional time after each group to complete the cleaning process. Some students, though, seemed to find cleaning up meaningful, especially when it involved running water. Finding time in the counselor’s day to offer enough ArtBreak sessions to meet demand was a challenge. Finally, acquisition of materials, especially keeping the sculpture center well stocked with cardboard boxes and other repurposed items, is a continuing process requiring time and ingenuity.

CONCLUSION

The ETC is a valuable framework for selecting and providing media in our ArtBreak studio. It is also a useful guide for reflecting upon art made by students and deciding about materials that should be introduced. The ETC provides a practical structure for referring students for participation in ArtBreak. ArtBreak also seems to support sensory, affective, and cognitive development of its participants.

Our documentation of the ArtBreak pilot generated a considerable quantity of materials: photographs, hand-written reflections, and notes on conversations with teachers and administrators, children, and families. This process of reflection and documentation helped guide the work through the school year. Counselors or others setting up a similar program should plan for daily time to reflect and document their work. It would be helpful also to set up a structure for assessing each student’s progress on referral goals.

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REFERENCES

Adamson, E., & Timlin, J. (1990). Art as healing. Boston, MA: Coventure. Allan, J. (1988). Inscapes of the child’s world. Dallas, TX: Spring Publications. Bartley, M. (1997). Creativity and medicine: An atelier in medical school.

International Journal of Arts Medicine, 5(2), 36–39. Boldt, R., & Brooks, C. (2006). Creative arts: Strengthening academics and building

community with students at risk. Reclaiming Children and Youth, 14, 223–227. DeLue, C. H. (1999). Physiological effects of creating mandalas. In C. Malchiodi,

(Ed.), Medical art therapy with children (pp. 33–49). London, UK: Jessica Kingsley.

Douglas, K., & Jaquith, D. (2009). Engaging learners through art making: Choice- based art education in the classroom. New York, NY: Teachers College Press.

Essex, M., Frostig, K., & Hertz, J. (1996). In the service of children: Art and expressive therapies in public schools. Art Therapy: Journal of the American Art Therapy Association, 14(1), 181–190.

Gandini, L., Hill, L., Cadwell, L., & Schwall, C. (2005). In the spirit of the studio: Learning from the atelier of Reggio Emilia. New York, NY: Teachers College Press.

Gladding, S. T. (2011). Counseling as an art: The creative arts in counseling (3rd ed.). Alexandria, VA: American Counseling Association.

Hinz, L. (2009). Expressive therapies continuum: A framework for using art in therapy. New York, NY: Routledge.

Kagin, S. A., & Lusebrink, V. B. (1978). The expressive therapies continuum. Art Psychotherapy, 5, 171–180.

Kosik, K. S. (2009, May). Creativity, the arts, literature and learning. In M. M. Hardiman & K. S. Kosik (Chairst), Creative brain: Using brain research on cre- ativity & the arts to improve learning. Symposium conducted at the meeting of Learning and the Brain, Washington, DC.

Malchiodi, C. A. (1996). Art therapy in schools. Art Therapy: Journal of the American Art Therapy Association, 13(2), 2–4.

McLennan, D. (2010). Process or product: The argument for aesthetic explo- ration in the early years. Early Childhood Education Journal, 38, 81–85. doi:10.1007/s10643-010-0411-3

Moon, C. (2002). Studio art therapy: Cultivating the artist identity in the art therapist. London, UK: Jessica Kingsley Publishers.

Pelo, A. (2007). The language of art: Inquiry-based studio practices in early childhood settings. St. Paul, MN: Redleaf Press.

Pleasant-Metcalf, A., & Rosal, M. (1997). The use of art therapy to improve academic performance. Art Therapy: Journal of the American Art Therapy Association, 14(1), 23–29.

President’s Committee on the Arts and the Humanities. (2011). Reinvesting in arts education: Winning America’s future through creative schools. Washington, DC. Retrieved from http://www.pcah.gov/publications.

Rogers, C. R. (1989). Personal thoughts on teaching and learning. In H. Kirschenbaum & V. Henderson (Eds.), The Carl Rogers reader (pp. 301–304). Boston, MA: Houghton Mifflin.

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Rosal, M., McCulloch-Vislisel, S., & Neece, S. (1997). Keeping students in school: An art therapy program to benefit ninth-grade students. Art Therapy: Journal of the American Art Therapy Association, 14(1), 30–36.

Somody, C., & Hobbs, M. (2006/2007). Paper bag books: A creative intervention with elementary school children experiencing high-conflict parental divorce. Journal of Creativity in Mental Health, 2(3), 73–87. doi:10.1300/J456v02n03_07

Szekely, G. (2006). How children make art: Lessons in creativity from home to school. New York, NY: Teachers College Press.

Winner, E., Hetland, L., Veenema, S., Sheridan, K., & Palmer, P. (2006). Studio think- ing: How visual arts teaching can promote disciplined habits of mind. In P. Locher, C. Martindale, L. Dorfman, & D. Leontiev (Eds.), New directions in aesthetics, creativity, and the arts (pp. 189–205). Amityville, NY: Baywood.

Katherine Ziff is a School Counselor at Athens City School District, The Plains, Ohio.

Lori Pierce and Sue Johanson are School Psychologists at Athens City School District, The Plains, Ohio.

Margaret King is Professor Emerita in the Patton College of Education and Human Services at Ohio University, Athens, Ohio.

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APPENDIX

ArtBreak Referral Form

Student’s Name: ________________ Classroom Teacher: _______________

Primary Reason for Referral Other Reasons

(check one) (check as many as apply)

Kinesthetic/sensory reasons for referral Express feelings: is sad......................

..................................................( ) ( )........................................................ Express feelings: is angry.................

..................................................( ) ( )........................................................ Express feelings: is upset.................

..................................................( ) ( )........................................................ Needs a chance to relax....................

..................................................( ) ( )........................................................ Needs a break from academic

demands...................................( ) ( )........................................................ Needs a break from social

demands...................................( ) ( )........................................................

Perceptual/affective reasons for referral Develop empathic understanding

for self or others.......................( ) ( )........................................................ Identify feelings in self and

others........................................( ) ( )........................................................ Understand cause and effect.............

..................................................( ) ( )........................................................ Support social skills...........................

..................................................( ) ( )........................................................ Support attention and focus..............

..................................................( ) ( )........................................................

Cognitive/symbolic reasons for referral Support problem-solving

skills..........................................( ) ( )........................................................ Identify and integrate personal

strengths...................................( ) ( )........................................................

Details or other reason for referral:

Note. Referral form developed by Katherine Ziff based upon the ETC framework as presented in Hinz (2009).

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