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Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. THE EFFECT OF COLLABORATIVE WRITING ON COHESION IN
POETRY THERAPY GROUPS
by
Karina M. Golden
submitted to the
Faculty of the College of Arts and Sciences
in Partial Fulfillment of
the Requirements for the Degree
of
Doctor of Philosophy
in
Counseling and Development
Signataxfe of Committee:
Chairman 9
J t - t Dean ofi the College
Date 1994
The American University
Washington, D. C. 20016
TEE AMERICAN UNIVERSITY LIBRARY
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMI Number: 9523653
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UMI 300 North Zeeb Road Ann Arbor# MI 48103
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. THE EFFECT OF COLLABORATIVE WRITING ON COHESION IN POETRY THERAPY GROUPS
BY
Karina M. Golden
ABSTRACT
The use of poetry as a therapeutic technique has
evolved into a creative arts therapy known as poetry
therapy. Poetry therapy has been used as a therapeutic
technique to enhance cohesion. Ross (1974) and Mazza (1981)
both used the Group Environment Scale (Moos and Hanson,
1974) as a pretest and posttest measure of group cohesion
and discovered that poetry therapy scores on the posttests
were significantly greater in poetry therapy groups than
those in non-poetry groups. Mazza indicated that the use cf
collaborative writing in the poetry therapy groups was
identified by participants as an aid to feeling s of
cohesion.
The purpose of this study was to build on previous
research conducted on poetry therapy and cohesion by
isolating the variable of collaborative writing and
comparing control groups without collaborative writing and
experimental groups with collaborative writing on the Group
Environment Scale.
ii
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. The subjects in this study were 33 graduate students in
an intact Group Counseling class at an urban university were
randomly assigned to treatment and control groups. The
treatment for the control group consisted of six sessions of
poetry therapy without collaborative writing. The
experimental groups received six sessions of poetry therapy
with collaborative writing. A t-test was used to compare
control and experimental posttest scores on the Group
Environment Scale. The comparison revealed that there was a
significant difference (p < .05) between posttest scores in
poetry therapy groups with collaborative writing. Therefore
the hypothesis that there would be a significant difference
between control and experimental groups was accepted.
This study supports previous research on the effect of
poetry therapy and collaborative writing as ways of
increasing cohesion in therapy groups.
iii
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. The creative genius is never one but many, and speaks in stillness to the souls of the multitude, whose meaning and destiny he embodies no less than the artist's own.
-Carl Gustav Jung
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS
ABSTRACT...... ii
ACKNOWLEDGEMENTS...... iv
LIST OF TABLES...... vii
Chapter
I. THE PROBLEM AND ITS SETTING...... 1 Introduction Statement of the Problem Rationale for the Hypothesis Hypothesis Definition of Terms Assumptions Delimitations Importance of This Study
II. REVIEW OF THE LITERATURE...... 23 Group Therapy Group Cohesion Poetry Therapy Research in Poetry Therapy
III. METHODOLOGY...... 73 Research Design Subjects Instruments Procedure Data Collection and Analysis
IV. RESULTS AND DISCUSSION...... 93 Hypothesis Testing Discussion Other Findings Conclusion
V. DISCUSSION...... 102 Discussion of Results Implications
v
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. LIST OF TABLES
1. Demographic Characteristics of Participants 76
2. Complete List of Poems Available to Poetry Group Leaders...... 88
3. A Complete List of the Six Poems Used in This Study...... 89
4. Comparison of Mean Pretest Scores in Cohesion on the GES for Poetry Therapy Groups with and without Collaborative Writing...... 95
5. Comparison of Mean Pretest and Posttest Scores in Cohesion for Poetry Therapy Groups without Collaborative Writing...... 95
6. comparison of Mean Pretest and Posttest Scores in Cohesion on the GES for Poetry Therapy Groups with Collaborative Writing...... 97
7. Comparison of Mean Posttest Scores in Cohesion on the GES for Poetry Therapy Groups with and without Collaborative Writing...... 97
8. Comparison of Mean Pretest and Posttest Scores on the GES for Poetry Therapy Groups without Collaborative Writing...... 100
9. Comparison of Mean Pretest and Posttest Scores on the GES for Poetry Therapy Groups with Collaborative Writing...... 100
vii
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER I
THE PROBLEM AND ITS SETTING
Introduction
Counseling at its best employs an artistic quality that
allows individuals to express themselves in a creative and
unique manner (Gladding, 1992, p.9). Whether through the
use of art, dance, music, drama, or poetry, the creative
arts can enhance healing in both clinical and developmental
populations. The creative arts in counseling are, as a
group, process-oriented, empowering, authentic, and insight
focused (Gladding, p.10).
Once used only as an adjunct to traditional techniques,
the use of the creative arts in healing has evolved to the
disciplines of art, dance, music, and drama therapy. The
creative use of literature or poetry as a therapeutic
technique has evolved into the modality known as poetry
therapy or bibliotherapy.
In the 1990's, the term "therapy,” once reserved solely
for the treatment of individuals who were diagnosed as being
mentally ill, is now also being used to refer to work with
normal populations to enhance personal growth. The early
medical model of the helpless patient and the all-knowing
doctor has gradually been replaced by one in which there is
1
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. an intentional interaction between one individual, known as
the "therapist" or the "counselor, and another individual,
the "client" or the "patient, where the goal is to make that
person feel better about him or herself. Thus, the
distinction between therapy as a technique used with
clinical populations and counseling as a technique for
normal populations is no longer clear. The terms "therapy"
and "counseling" are often used interchangeably to refer to
an activity in which individuals who are not mentally ill
engage in a relationship with a therapist or counselor for
the purpose of self-improvement.
The terms "group therapy" or "group counseling" or
"group work" refer to various kinds of groups in which
individuals participate to increase their knowledge of
themselves and others, to assist in the changes they most
want to make in life, and to give them some of the tools to
make desired changes (Corey and Corey, 1987, p.9). The
goals of these groups may vary from the treatment of mental
illness to the enhancement of communication skills. Thus
the terms "therapy," "group therapy," "counseling," and
"group counseling" no longer carry the stigma of mental
illness; they can also represent activities engaged in by
normal populations for self-improvement and personal growth.
Group leaders facilitate their groups according to
their theoretical orientation, and so there are an array of
approaches to conducting groups including psychodynamic,
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behavioral, Freudian, Jungian, nondirective (Rogerian), and
eclectic. Research has shown that certain key factors,
regardless of group leader orientation or the purpose of the
group, are common to effective group process (Yalom, 1972;
Corey and Corey, 1987). Research contributing to an
understanding of these key factors in effective group
process is important to the field of therapy.
One of the most essential factors for effective group
process, regardless of leader orientation, is group cohesion
(Yalom, 1972). Group cohesion, the feeling of comfort and
safety among the members of the group, has been identified
as a necessary and curative factor in group therapy (Yalom,
1972; Corey and Corey, 1987; Hynes and Hynes-Berry, 1986).
Therapeutic techniques which can be used to increase group
cohesion, regardless of a leader's theoretical orientation,
would provide a valuable contribution to the literature on
group therapy.
One of the therapy modalities that has been used to
increase group cohesion, regardless of the theoretical
orientation, is poetry therapy (Ross, 1977; Hynes and Hynes-
Berry, 1986; Mazza, 1981). Poetry therapy is a creative
arts therapy modality employing poetry and other forms of
evocative literature to achieve therapeutic goals and
personal growth (National Association for Poetry Therapy,
1993a, inside front panel).
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Practitioners in poetry therapy make a distinction
between guided reading therapy, where a person merely reads
self-help literature, and poetry therapy, which requires the
therapist to diagnose the client's therapeutic goals and to
utilize poetry or other literature which is appropriate. A
specific work of poetry is prescribed by the therapist and
using specific therapeutic techniques, the therapist
encourages the client to respond to the work of literature.
Unlike guided reading which can be done in isolation, poetry
therapy is the dynamic interaction between a therapist, a
client, and a work of literature (Hynes & Hynes-Berry, 1986,
p.11).
Poetry therapy is sometimes referred to as
"bibliotherapy," but the latter term is an older and broader
term which is also used to refer to the less interactive
activity of guided reading, the reading of self-help
literature.
The confusion surrounding the broad use of the term
"bibliotherapy" has led to a movement by many poetry
therapists to use the terms "poetry therapy," "interactive
bibliotherapy," and "poetry/bibliotherapy" to distinguish
the triadic, dynamic interaction of therapist, poetry or
other literature, and client from the terms "bibliotherapy"
or "guided reading," which refer to a dyadic, less dynamic
interactive process between a person and a poem or other
literature (Hynes & Hynes-Berry, 1986). Thus, while poetry
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therapists make a distinction between the triad of
literature, therapist, and client from the dyad of
literature and an individual, practitioners in the field
cannot seem to agree on a term which can be accepted by
everyone.
Poetry therapists use the terms "poetry" and
"literature" interchangeably and in the broadest sense: they
include poetry, song lyrics, plays, short stories, novels,
essays, magazine articles, and film. In essence, for a
poetry therapist, poetry/literature is essentially any
material which includes language and has internal coherence
(Hynes & Hynes-Berry, 1986, p. 13). The poem/literature
evokes a response in the client, for the dynamics by which
people experience literature reveals a highly subjective re
creation of the work (Holland, 1989, p.2). There is a
necessarily incomplete quality about a poem [or a work of
literature] which allows it to be completed again and again
with each individual reader response (Mazza, 1981, p. 4).
Poetry therapy uses the subjective and incomplete qualities
of evocative literature as a catalyst to engage the client
in a therapeutic dialogue.
For the purpose of this study, the terms "poetry" and
"literature" will be used interchangeably, with a preference
for using "literature" as a broader, more inclusive term and
"poetry" as a more specific term for a type of literature
which is distinct from prose.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Populations Suitable for Poetry Therapy
Poetry therapy can be used with both individuals and
groups. It has been used in a range of settings, including
mental institutions, nursing homes, and schools (Leedy,
1973; Lerner, 1975? Hynes & Hynes-Berry, 1986). It has been
used with various clinical and normal populations including
children, adolescents, and youths (Berger, 1985 in Lerner,
1985? Mazza, 1989), alcohol and substance abuse (Leedy,
1987? Mazza, 1979), family therapy (Gladding, 1985),
forensic patients (Berger & Giovan, 1990? Denberg, 1990),
psychotics (Rossiter, Brown, & Gladding, 1988), the sexually
abused (DeMaria, 1991? Williams, 1991), and many others.
In essence, poetry therapy appears to be suitable for use
with all of the major therapeutic populations.
Training
Poetry therapy does not adhere to any particular school
of therapy. Like all therapists, poetry therapists are
trained in standard therapy conventions such as diagnosis,
establishing rapport, developing good listening skills,
understanding group dynamics, and setting therapeutic goals.
They are trained to work with both individuals and groups.
Their professional training in the use of literature as
therapy is the only factor that distinguishes them from
other therapists.
The first formal professional organization for poetry
therapists was the Association for Poetry Therapy founded in
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California in 1971. This association grew into a national
organization, the National Association for Poetry Therapy
(NAPT) in 1981. The NAPT, which promotes research, training
and credentialing in poetry therapy, is a member of the
umbrella organization for the creative arts therapies (which
includes poetry therapy, dance therapy, music therapy, drama
therapy, and art therapy), the National Coalition for Art
Therapists (NCATA).
Although any therapist can use poetry therapy
techniques as a part of therapy, the National Association
for Poetry Therapy (NAPT) encourages therapists to receive
formal training in the poetry therapy modality (National
Association for Poetry Therapy, 1993b). Individuals may
enroll in NAPT training programs such as the poetry therapy
program at St. Elizabeth's Hospital in Washington, D.C., as
well as in other programs across the country. Poetry
therapists may be awarded a certificate in poetry therapy
(CPT) if they wish to work with normal populations or as an
adjunctive therapist with the mentally ill. Additional
training may qualify them as Registered Poetry Therapists
(RPT) if they wish to work with clinical populations.
One of the most important aspects of poetry therapy
training is learning how to perform the critical task of
choosing appropriate literature in order to meet therapeutic
goals. There are several theories on guidelines for
appropriate literature selection. Leedy (1969; 1973)
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. suggests that poetry therapists should select literature
which is similar to patient moods, but contains an element
of hope. This technique, called the isoprinciple, is
borrowed from the field of music therapy where music
therapists are trained to select music which is similar to
patient moods. On the other hand, Lerner believes that
literature selection should be based solely on the
effectiveness of the literature as a vehicle for
communication (1975; 1976; 1978). Hynes and Hynes-Berry
(1986) give yet another guideline for literature selection;
they believe the best literature for poetry therapy has
themes which are universal and positive. Schloss (1976)
suggests that the literature that is most suitable for
poetry therapy is open ended rather than didactic.
Regardless of the differences in these approaches to
literature selection, they all maintain that the
effectiveness of poetry therapy depends on the facilitator's
ability to choose material that speaks to the individual
participant's needs and interests and to make accurate,
empathic interpretations of the participant's responses
(Hynes & Hynes-Berry, 1986).
Poetry therapists employ three major techniques when
working with clients: the use of preexisting literature, the
use of individual writing, and the use of collaborative
writing. Preexisting literature is literature (including
poetry and prose) which has been written before a poetry
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. therapy session. Poetry therapists choose preexisting
literature that is relevant to treatment goals and then
encourage participants to respond to the literature through
discussion (Leedy, 1969; Lerner, 1973; Hynes & Hynes-Berry,
1986; Rossiter, Brown, & Gladding, 1990).
Poetry therapists are also trained in the use of
individual writing as a way of eliciting client responses
(Hynes & Hynes-Berry, 1986). Writing has been shown to
promote self-awareness, to increase group interaction, and
to improve self-esteem (Lauer and Goldfield, 1970). The
therapist usually begins by sharing a preexisting poem with
clients and then encourages clients to discuss the work and
to respond to it in writing. Clients are encouraged to
write individual written responses to the literature.
Collaborative writing, unlike the first two techniques,
which can be used with either individuals or groups, is used
only in group poetry therapy. The poetry therapist usually
begins by sharing the preexisting literature, encouraging
participants to discuss it, and then asks them to write
individual written responses to the literature. Next the
therapist leads the group in combining these individual
written responses into a collaborative (group) poem composed
of individual words or lines contributed by each member of
the group (Mazza, 1981; Hynes & Hynes-Berry, 1986; Gorelick,
1989; Mazza, 1994). Each member therefore contributes to
the creation of the collaborative poem. The leader writes
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down the collaborative poem and then reads it aloud.
Usually the leader makes copies of the collaborative poem
and gives it to the group at the next session. Variations on
this technique include omitting the preexisting poem and
using some other prompt such as an object or a song or
omitting the individual writing and leading the group
directly into a group writing exercise.
Need for Research
The need for further research in group process,
poetry therapy, and collaborative writing has been
identified throughout the literature. The need for analysis
of group process as opposed to treatment outcomes has been
identified in the literature on group therapy (McGrath cited
in Ross, 1977; Yalom, 1972; Corey and Corey, 1987). Yalom
(1972) identified eleven curative factors in the group
process which have been shown to enhance the effectiveness
of group therapy regardless of the therapist's theoretical
orientation. Most of the research on group therapy has been
based on these curative factors (Fuhriman, Drescher, Hanson,
Henrie, and Rybicki, 1986). Research on these factors
contributes to the understanding of group therapy.
One of the factors identified as a necessary
precondition for effective group therapy, regardless of the
practitioner's theoretical orientation, is group cohesion
(Yalom, 1975, pp.45-47). When members feel that their group
is cohesive, they feel comfortable and safe and this
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environment encourages them to attend the group, to
participate in discussion, and to take risks within the
group (Yalom, 1972; Stokes, 1983; Corey and Corey, 1987).
Research on group cohesion is important to the field of
group therapy (Evans and Jarvis, 1980).
Another compelling reason for this study is the need
for research in the field of poetry therapy. Most of the
articles in the leading journal for the field of poetry
therapy, The Journal for Poetry Therapy consist of
descriptive, rather than empirical studies on the use of
poetry therapy. The majority of these articles report on
the usage of poetry therapy with different populations and
discuss the types of literature that were used in therapy
sessions. Claims are made by group leaders and by group
members about the efficacy of poetry therapy as a technique,
but there is a scarcity of empirical research on poetry
therapy (Lerner, 1978; Mazza, 1981; Cohen, 1992).
Even when empirical studies have been done, they have
focused primarily on comparing poetry therapy with other
forms of therapy such as traditional group therapy (Ross,
1977; Mazza, 1981), feminist therapy (Talbott-Green, 1988),
and other modalities (Schrank and Engles, 1981; Berry,
1978). Limited research has been done on the dynamics of
the process of poetry therapy. The need to conduct research
on the poetry therapy process, including isolating the
variables in poetry therapy which contribute to its
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effectiveness, is needed (Ross, 1977? Mazza, 1981; Lerner,
1978; Talbott-Green, 1988; Cohen, 1992).
This study would contribute to the field of poetry
therapy by 1) responding to the need for empirical research
in poetry therapy 2) contributing to understanding of the
poetry therapy process by isolating a variable in poetry
therapy which might contribute to its effectiveness. The
two dissertation studies which have been done to compare the
poetry therapy group process with traditional group therapy
(Ross, 1977; Mazza, 1981) both indicate that poetry therapy
has a statistically significant effect on group cohesion.
The need to further explore the elements of the poetry
therapy process in relationship to group cohesion was
identified.
In addition to recommending further research on poetry
therapy and group cohesion, Mazza (1981; 1994) suggested
that further research needed to be done to understand the
unique effects of the technique of using collaborative poems
in poetry therapy. In Mazza's dissertation study (1981),
the poetry therapy treatment included sessions with
preexisting poems that included the writing of collaborative
poems and sessions with preexisting poems that did not
include the writing of collaborative poems. Mazza cited
this as a limitation in his study (Mazza, 1981). He
proposed that a study could be designed on group cohesion
which would compare poetry therapy groups using
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collaborative poems and poetry therapy groups not using
collaborative poems (1975, p.120).
This study was designed to fill a gap in the literature
on therapy by measuring the effect of collaborative writing
on group cohesion in poetry therapy. It will make a
valuable contribution to the field of therapy by 1)
enhancing understanding in the field of group therapy by
focusing on group cohesion, a factor identified as essential
to effective group therapy regardless of theoretical
orientation, and 2) enhancing understanding in the field of
the poetry therapy by isolating the technique of
collaborative writing and showing whether poetry therapy is
more effective with or without it.
Statement of the Problem
In dissertation studies done by Ross (1977) and Hazza
(1981) on comparing traditional group therapy and poetry
therapy (1981), poetry therapy was shown to have a
significant effect on group cohesion as measured by the
Group Environment Scale (Moos and Hanson, 1974), an
instrument which measures changes in group process.
While both studies by Ross and Mazza used poetry
therapy and found that it enhanced group cohesion, neither
study isolated the use of collaborative poetry therapy as a
treatment variable. In Mazza's study, while the use of
collaborative poetry in poetry therapy groups was not
isolated as a treatment variable, in their narrative
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reports, participants identified the use of collaborative
poetry as a factor in developing group cohesion. In Mazza's
suggestions for further research, he recommended further
research on the effect of collaborative poetry on group
cohesion (1981, p.121), especially since he cited the
failure to isolate this technique as a limitation in his
study.
The problem which was explored in this study was to
determine whether the use of collaborative poetry makes a
statistically significant difference (p > .05) in group
cohesion in the poetry therapy group environment. The
question to be answered in this study was:
1) Does the use of collaborative writing make a
significant difference in group cohesion in a poetry therapy
group?
Rationale for the Hypothesis
The rationale for the hypothesis was based on 1)
research conducted by Ross (1977) and Mazza (1981) which
indicates that poetry therapy enhances group cohesion 2)
statements by participants in Mazza's study that identified
the use of collaborative poems as increasing feelings of
group cohesion 3) statements by poetry therapists that using
collaborative poems enhances group cohesion because creating
group poems gives the group a unique identity and a rare
opportunity to work together in a creative way (Hynes &
Hynes-Berry, 1985; Mazza, 1981; Gorelick, 1989).
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In the study conducted by Ross (1977), pretest and
posttest scores on the Relationship dimension of the Group
Environment Scale (Moos and Hanson, 1974) were compared in
traditional group therapy and poetry therapy groups in
mental hospital inpatients. The Group Environment Scale is
a standardized instrument which measures the group
environment on three sets of dimensions: Relationship,
Personal Growth and Development, and System Maintenance and
Change. The three sets of dimensions are: 1) Relationship:
Cohesion, Leader Support and Expressiveness; 2) Personal
Growth: Independence, Task Orientation, Self-discovery, and
Anger and Aggression; and 3) System Maintenance and Change:
Order and Organization, Leader Control, and Innovation. Ross
discovered that there was a significant difference between
the pretest and posttest scores on Cohesion in the poetry
therapy groups.
In the dissertation research study conducted by Mazza
(1981), poetry therapy groups were also compared to
traditional therapy groups on the Group Environment Scale
(Moos and Hanson, 1974). The subjects used in his study
were an intact college class. Again, poetry therapy was
found to have a significant effect on Cohesion in the
Relationship dimension. The subjects who participated in
the study indicated in narrative reports that collaborative
poetry enhanced group cohesion by increasing their sense of
identity and caring for their group (Mazza, 1981, p.119).
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Since group cohesion is defined as one of the necessary
preconditions for group therapy (Yalom, 1975), and two
studies (Ross, 1977; Mazza, 1981) have shown that poetry
therapy enhances group cohesion, a better understanding of
the process of poetry therapy would be useful. In addition,
in Mazza's study the use of collaborative writing was
identified by subjects as a technique that increased
feelings of group cohesion and the failure to isolate
collaborative poetry as a treatment variable was cited as a
limitation of his study.
Isolating collaborative writing as a variable in poetry
therapy would provide valuable information to therapists and
counselors about its effectiveness as a technique in poetry
therapy. This study has been designed to isolate the use of
collaborative poems as a variable and to measure its effects
on group cohesion in poetry therapy.
Hypothesis
1) It is hypothesized that there will be significant
difference between posttest scores ( > .05 probability
level) on the Cohesion subscale of the Group Environment
Scale (Moos and Hanson, 1974) in poetry therapy groups using
collaborative writing and poetry therapy groups without
collaborative writing.
Definition of Terms
Bibliotherapy- Bibliotherapy is a term which is synonymous
with poetry therapy in the therapeutic literature. The word
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"bibliotherapy” is sometimes mistakenly employed by non
clinicians to refer to guided reading, from which it is
distinguished in that guided reading is the reading of self-
help literature whereas poetry therapy/bibliotherapy
emphasizes the dynamics of the triad of therapist, poem or
literature, and client (Hynes & Hynes-Berry, 1986).
Collaborative poems- A collaborative poem is created in
poetry therapy through group writing where the therapist
asks each member in a group to contribute a single word or
line that reflects a response to the material, the dialogue,
or a specified theme (Hynes & Hynes-Berry, 1986).
Collaborative writing- Collaborative writing is the act of
working together with others to create a single written
product which in poetry therapy is referred to as a
collaborative poem.
Creative arts therapies- The use of art, dance, music,
drama, and poetry in healing.
Counseling- A term which is used interchangeably with
therapy to indicate the interaction between one individual,
the therapist or the counselor, and another individual, the
client or the patient, where the goal can be anything from
the treatment of mental illness to personal growth.
Group cohesion- Cohesion is the degree of members'
involvement in and commitment to the group, and the concern
and friendship they show for one another (Hoos, 1981).
Yalom equates the importance of cohesion in group therapy to
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the importance of relationship in individual therapy (1975).
Yalom identifies group cohesion as a necessary precondition
for counseling effectiveness (Yalom, 1975, pp.44-46).
Guided reading- Guided reading is the use of self-help
literature. It is distinguished from poetry therapy where
the emphasis is on the therapeutic interaction between the
therapist, the poem or work of literature, and the client
(Hynes & Hynes-Berry, 1986).
Group therapy- Group therapy is a therapeutic intervention
in which more than one person participates together with a
therapist or a counselor.
Group poetry therapy- Group poetry therapy is the use of
poetry therapy in group settings.
Interactive bibliotherapy- A term used synonymously with
poetry therapy. The term •'interactive11 is placed before the
word "bibliotherapy" to emphasize its dynamic interaction
between the therapist, the poem or literature, and the
client. The addition of the term "interactive" is used to
distinguish it from bibliotherapy, an older term, which is
sometimes applied to guided reading of self-help literature.
Isoprinciple- A technique in music therapy adapted to
poetry therapy in which poems are selected to match the mood
of the client (Leedy 1969; 1973).
Literature- In poetry therapy, the term "literature" is
used interchangeably with the term "poetry" to refer to
language which has internal coherence and is used to evoke a
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response for the purpose of growth or healing (Hynes and
Hynes-Berry, 1986; National Association for Poetry Therapy,
1993a, inside front panel). Literature can also be used as
inclusive term containing both prose and poetry.
Poetry- In poetry therapy, the term poetry is used
interchangeably with "literature" to refer to language which
has internal coherence and is used to evoke a response for
the purpose of growth or healing (Hynes and Hynes-Berry,
1986; National Association for Poetry Therapy, 1993a, inside
front panel). Poetry can also be used as a specific term to
distinguish it from prose.
Poetry therapy- Poetry therapy is a recognized modality
employing poetry and other forms of evocative literature to
achieve therapeutic goals and personal growth. Its emphasis
is on the dynamic interaction between the triad of
therapists, poem or work of literature, and the client. In
the clinical literature, poetry therapy is synonymous with
"interactive bibliotherapy" and "bibliotherapy" although the
latter term is easily confused with using literature for
self-help (Hynes & Hynes-Berry, 1986).
Therapy- A term which is used interchangeably with
counseling to indicate the interaction between one
individual, the therapist or the counselor, and another
individual, the client or the patient, where the goal can be
anything from the treatment of mental illness to personal
growth.
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Assumptions
It was assumed that poetry therapy would have a
significant effect on group cohesion based on research done
by Ross (1977) and Mazza (1981) with different populations.
Both studies used the same instrument being used in this
study, the Group Environment Scale (Moos and Hanson, 1974)
as a pretest and posttest to measure changes in the group
environment in traditional therapy and poetry therapy
groups. Both Ross and Mazza indicated that there was a
significant difference in the posttest scores of the
participants in the poetry therapy groups.
Furthermore, Mazza's research, in which poetry therapy
group leaders employed collaborative poetry as part of their
poetry therapy intervention, indicated that participants
cited the technique of using collaborative poems as
contributing to group cohesion. It was assumed that there
would be a significant difference between poetry therapy
groups using collaborative writing and poetry therapy groups
that did not use collaborative writing.
Delimitations
This study focuses on the use of poetry therapy with
graduate students in a group counseling class from one
particular college. Generalizations from this sample to
clinical populations or other populations cannot be made.
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Importance of ThisJStudv
Group cohesion has been identified as a necessary
precondition for counseling effectiveness in group therapy
(Yalom, 1975, pp.44-46). When group cohesion occurs,
members feel involved and committed to the group. Cohesion
in group therapy has been equated to the importance of
relationship in individual therapy (Yalom, 1975). Research
has shown that when traditional therapy was compared with
poetry therapy groups, poetry therapy had a statistically
significant effect on group cohesion (Ross, 1977; Mazza,
1981).
In addition, while there have been several studies on
poetry therapy (Shrodes, 1950; Ross, 1977; Mazza, 1981;
Talbott-Green, 1988) the need for more empirical research in
this area has been identified in the literature (Mazza,
1994). This study will contribute to empirical research in
poetry therapy.
Moreover, although collaborative poetry is a technique
that is widely used in poetry therapy (Mazza, 1981: Hynes
and Hynes-Berry, 1986; Chase, 1989; Gorelick, 1989; Mazza,
1994; Yochim, 1994), there have not been any studies which
have isolated it as a variable in poetry therapy. For
example, in Mazza's dissertation research (1981),
collaborative poetry was used in some poetry therapy group
sessions and not in others, but subjects identified it in
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cohesion.
There is a need to isolate the use of collaborative
writing as a variable to determine whether group cohesion
can be achieved more effectively with collaborative writing
or without it. In fact, Mazza's dissertation (1981)
identified this need for further research in the field of
poetry therapy in general and on collaborative poetry and
group cohesion in particular. To this date, no further
empirical studies have been done to explore the effect of
collaborative writing in poetry therapy although poetry
therapists commonly use this technique in their practice.
This study will contribute to the field of therapy by
increasing the understanding of ways to achieve group
cohesion. It will also make a valuable contribution to the
field of poetry therapy by adding to empirical research in
the field and by isolating the technique of collaborative
writing to determine its effectiveness in fostering group
cohesion.
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REVIEW OF THE LITERATURE
The purpose of this chapter is to review the literature
on group therapy, group cohesion, poetry therapy, and
collaborative writing to provide support for this study on
the effect of collaborative writing on cohesion in poetry
therapy groups. The chapter will begin with the more
general information on group therapy and cohesion and will
then address poetry therapy groups as a special form of
group therapy. Collaborative writing will be introduced as
a technique employed in poetry therapy groups.
The literature on group therapy will be divided into
foundations of group therapy, goals for group therapy, and
group process. Group cohesion, a critical element of group
process, will then be discussed in terms of its significance
to group therapy. Poetry therapy will be introduced by
describing the theoretical foundations of poetry therapy,
historical foundations of poetry therapy, procedures used in
poetry therapy, techniques used in poetry therapy, and major
research in poetry therapy. This chapter will conclude by
showing the reader the significance of this study to further
understanding of group therapy, group cohesion, and poetry
therapy.
23
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Foundations of Group Therapy
The history of group therapy can be traced to the time
after World War I when the number of veterans in need of
therapy was so great that it became impractical to see
patients on an individual basis. This led to the use of
group therapy in hospital settings (Corey and Corey, 1987).
The success of group therapy in hospital settings led to its
widespread application to other settings as well, including
schools, libraries, and community groups. Thus, in addition
to treating mental illness, groups were formed to promote
self-knowledge and discovery.
Groups which promote self-knowledge and discovery are
often called personal growth or encounter groups and they
are designed to provide experiences through which members
can drop their masks and enter into open, emotionally
intense, honest interactions with one another. In this way,
each gains a more complete and accurate awareness of the
effects of his own behavior on others and theirs on him
(Frank, 1973, p. 266). While these experiences may also
occur in groups designed to treat mental illness, the
emphasis in personal growth groups is to enhance experience
rather than to relieve symptoms (Frank, 1973).
The terms "group therapy," "group counseling," and
"group work" will be used interchangeably in this study as
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they are used interchangeably throughout the literature
(Corey and Corey, 1987).
Goals of Group Therapy
In spite of variations in size and purpose, it is
generally believed that both individual and group therapy
have the same basic goals (Corey and Corey, 1987; Frank,
1955). For example, based on his observations of therapy in
the hospital setting, Frank (1955) concluded that all
therapies share three aims; to strengthen self-respect, to
control tension, and to provide models and guidelines to
assist in creating better adaptive behaviors.
Of all of these goals, group therapy may be more
effective than individual therapy in providing models and
guidelines to assist in adaptive behaviors because the group
provides a safe situation where group members can feel
comfortable enough to try new behaviors (Rogers, 1961;
Frank, 1955; Corey and Corey, 1987). According to Frank,
this is more likely to occur in a group because on their
own, people tend to repeat maladaptive behaviors rather than
to learn by experience; this tendency erodes people's self
esteem until it becomes so damaged that people lose the
courage to try new behaviors. Group therapy is therefore
especially effective in its ability to provide new
interpersonal influences so that new ways of responding are
reinforced and the less successful ones weakened (1955,
p.2).
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Group Process
In addition to having similar goals regardless of the
size of the group or the group's purpose, all groups are
believed to go through similar stages or processes. Kaplan
(1967) compared and contrasted therapy and training groups
and concluded that there were no major differences in group
process, just differences in externally caused factors such
as purpose of the group and duration. Kaplan suggested that
groups move from dependency on the leader to intimacy with
one another. All groups go through a dependency stage, a
power phase, and an intimacy stage. In the dependency
stage, the individual members develop a sense of
togetherness as a group and they tend to idealize the
leader. In the power stage, power shifts as the leader
becomes less idealized and subgroups are formed. In the
intimacy stage, the power shifts again to interpersonal
relationships between pairs of people in the group, and the
leader is no longer seen as possessing power but power is
thought to come from one-on-one interactions. Kaplan
concludes by saying that there is no difference between
group process in training and therapy groups. The only
difference between therapy and training groups is external
factors such as group purpose and duration.
Building on this idea that all groups share similar
goals and go through similar stages, Yalom (1975) conducted
research to discover the elements common to all groups in
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which therapeutic goals have been met. Yalom reviewed the
literature on group therapy and conducted research on
different groups and concluded that there were eleven
elements, called curative factors, which were essential to
success in achieving group goals regardless of the size or
purpose of the group. These eleven curative factors are:
installation of hope, universality, imparting of
information, altruism, the corrective recapitulation of the
primary family group, development of socializing techniques,
imitative behavior, interpersonal learning, group
cohesiveness, catharsis, and existential factors. Yalom's
identification of these curative factors provided the
foundation for much of the research in the field of poetry
therapy (Fuhriman, Drescher, Hanson, Henrie, and Rybacki,
1986, p. 187). This study, which focused on the curative
factor group cohesion, contributes to that research.
Need for Research
In spite of the popularity of group therapy, the
literature suggests that there is a strong need for further
research on group therapy and more systematic research is
needed (Spotnitz cited in Ross, 1977). McGrath says that
there is a need for more attention to analysis of the
behavior of groups— their interaction — as opposed to the
products or outcomes of that behavior (McGrath cited in
Ross, p.4). Keisler also points out that in the literature
there is an emphasis on outcomes and a scarcity of research
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on group process (Keisler cited in Ross, 1977, p.4). This
study, which focused on the effects of poetry therapy on the
group process variable group cohesion, will contribute to
the literature on group therapy and answer the call for
additional research on group process.
Group Cohesion
As indicated above, in seminal research conducted by
Yalom (1975), eleven curative factors were identified:
installation of hope, universality, imparting of
information, altruism, the corrective recapitulation of the
primary family group, development of socializing techniques,
imitative behavior, interpersonal learning, group
cohesiveness, catharsis, and existential factors.
Subsequent studies (Butler and Fuhriman, 1980? Mower, 1981?
Lieberman, Yalom, and Mules, 1973? Marcowitz and Smith,
1983) ranked group cohesion as one of the most important
factors in group therapy. Fuhriman and Barlow (1982) and
Yalom (1975) have suggested that cohesion is as important to
group therapy as the client-therapist relationship is to
individual therapy. In addition, a positive correlation
between group cohesion and the achievement of therapeutic
goals has been discussed in both theory and empirical
research (Yalom, 1975? Littlepage, Cowart, and Kerr, 1989).
Yalom distinguishes between cohesion and other curative
factors by suggesting that although cohesion seems to be
therapeutic in its own right, it may also be a precursor of
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the other curative factors (Yalom, 1975; Drescher,
Burlingmae, and Fuhriman, 1985, p.12). Thus, cohesion may
be a necessary, if not sufficient, condition for the other
factors.
In spite of the importance of this concept of group
cohesion, the definition of cohesion has not always been
clear or consistent (Evans and Jarvis, 1980; Drescher et al,
1985). Group cohesion is variously defined as a feeling of
oneness among group members, as attraction to the group, and
as the combination of both of these. Evans and Jarvis
conducted a review of the literature on group cohesion and
traced the development of the term:
Although [group cohesion was discussed], no systematic work was completed before the 1950s when Leon Festinger and his associates at the Research Center for Group Dynamics ...introduced the first widely accepted definition of cohesion as "the total field of forces which act on members to remain in the group (Festinger et al, 1950, p. 164)....Gross and Martin (1952) also presented a definition of cohesion: "the resistance of a group to disruptive forces" (p. 553)... Bach (1951) defined cohesion as "the attraction which a group has for its members" (1951, p. 9)....Further theoretical refinement of the concept of cohesion was presented by Libo...[who] was the first to make the distinction between cohesion, the group's attraction for its members, and attraction to group, "the resultant of forces acting on each member to remain in the group" (p. 2). (1980, pp. 360-362)
Thus early definitions of group cohesion varied from
broad definitions of cohesion as a field of forces which act
on members to remain in a group (Festinger, 1950; Gross and
Martin cited in Evans and Jarvis, 1980, p. 361), to a
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distinction between members' attraction to members and
attraction to the group as a whole (Libo cited in Evans and
Jarvis, 1980, p.362).
Later definitions of cohesion acknowledged the
distinction between members' attraction to members and
attraction to the group as a whole, but defined cohesion as
a combination of the two. For example, Frank defined
cohesion as the members' sense of belonging to a group or
the attraction of a group to its members (1957, p. 54).
Yalom (1975) suggested that cohesion was the sum of the
relationships of member to member, member to therapist, and
member to the group. Based on a review of the literature,
Fuhriman et al (1986) defined cohesion as the collection of
forces within a group that draw it together. It involves
the attractiveness of the group to its members, and includes
the patient-therapist, patient-patient, and patient-group
relationships (1986, p. 189). This holistic definition of
cohesion has provided the foundation for most of the
instruments designed to measure cohesion including the Moos
Group Environment Scale (Moos and Hanson, 1974), which was
used in this study.
Evans and Jarvis (1980; 1986) have argued for the
separation of the concept of cohesion, a feeling of oneness
among group members, from the concept of attractiveness to
group, but current research still tends to include these
under the same concept. The variation in the definition of
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group cohesion throughout the literature poses special
problems in comparing and contrasting studies? for the
purpose of this study, the broader, more holistic definition
proposed by Yalom (1975) and included in the Group
Environment Scale (Moos and Hanson, 1974) has been adopted.
Since this study builds upon earlier work on group cohesion
and poetry therapy conducted by Ross (1977) and Mazza (1981)
which used the Group Environment Scale to measure cohesion,
the use of the same instrument for measuring cohesion will
provide consistency. This study will contribute to research
in the field by refining previous studies on poetry therapy
conducted by Ross (1977) and Mazza (1981) in which poetry
therapy was found to enhance group cohesion. Poetry Therapy The significance of group therapy and the concept of
cohesion has been discussed. One of the methods in which
group therapy can be conducted is with the use of poetry
therapy. The theoretical relationship between poetry
therapy and cohesion as one of Yalom's curative factors has
been identified by Goldstein (1989) and Cohen (1989;1992).
Empirical research on this relationship has been conducted
by Ross (1977) and Mazza (1981).
Poetry therapy is one of the creative arts therapies
which include dance, music, art, drama and poetry therapy.
Poetry therapy differs from the other art therapies in that
it involves the use of evocative literature to enhance
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therapeutic growth and change (National Association for
Poetry Therapy, 1993a).
Within the field of poetry therapy, a distinction is
made between bibliotherapy, or guided reading, and poetry
therapy, or interactive bibliotherapy, which involves a
reader, a literary work, and a therapist or facilitator
(Hynes and Hynes-Berry, 1986). McKinney defined
bibliotherapy as the dynamic interaction between the
personality of the reader and literature, which may be
utilized for personality adjustment or growth (1976,
p. 110). Poetry therapy is also defined as the use of poetry
and other evocative literature in growth and healing
(National Association for Poetry Therapy, 1993a), but it
distinguishes itself from bibliotherapy in that poetry
therapy involves the triadic relationship of a work of
literature, a client, and a facilitator (Hynes and Hynes-
Berry, 1986).
Although poetry therapy involves more than the dyadic
relationship between a person and a work of literature, this
relationship provides the foundation for the understanding
of the triadic, dynamic interaction between an individual, a
poem or other literature, and a therapist or facilitator.
Thus in a discussion of poetry therapy, or interactive
bibliotherapy as it is sometimes called, an understanding of
the interaction between an individual and a poem or other
literary work is essential. In poetry therapy, the dynamic
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interaction between the reader and a poem or other work of
literature is further developed by the therapist, or
facilitator, who guides the client into deeper levels of
self-awareness by encouraging the client to express his or
her responses either verbally or in writing.
Theoretical Foundations of Poetry Therapy
The theoretical foundations for poetry therapy are
drawn primarily from the fields of psychology and literary
criticism.
Psychology and Poetry Therapy
One of the major premises of the use of poetry in
therapy is the contention that there are significant
parallels between conscious and unconscious processes in
therapy and in poetry. The relationship between poetry and
therapy can be divided into the psychoanalytic view, as
proposed by Sigmund Freud, in which literature and other
creative endeavors are regarded as the result of sublimation
and neurosis; and the analytic view, proposed by Carl Jung,
in which creativite literature and other works of art are
regarded as the result of healthy creative instincts.
In "The Relation of the Poet to Daydreaming" Freud
(1908) noted the similarity between the poetic and
therapeutic process and compared the process of writing
poetry to the three stages patients go through in therapy:
an intense desire in the present, an early experience in
which the wish is fulfilled, and finally, an activity in
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which the wish is fulfilled. Freud suggested that writing
poetry and other literature is the result of unconscious,
neurotic impulses and conflicts, and that the writer was a
daydreamer whose creations were daydreams and whose
unconscious wishes were filled by sublimation through
[writing] (Brand, 1979, p. 54).
This belief that poetry and neurosis are closely
related has developed into a form of literary criticism
known as pyschoanalytic literary criticism. Work such as
Prescott's (1922) The Poetic Mind. Segler's The Writer and
Psychoanalysis (1950), and Felman's (1978) Writing and
Madness. are all books which use the psychoanalytic approach
in an attempt to bridge the relationship between psychology
and literature. These works profess that creative writing,
whether poetry or prose, has its roots in the unconscious,
primarily in neurotic thinking. For example, Prescott
attempts to trace the thought processes which lead to
artistic creation and seems to concur with the great
Romantic poet Shelly whom he quotes as saying that "poetry
acts in a divine and unapprehended manner, beyond
consciousness (Shelley cited in Prescott, 1922, p.l).
Carl Jung also acknowledged the relationship between
poetry and therapy, but his interpretation of artistic
creation differed from that of Freud and psychoanalytic
theory. In his work "On the Relation of Analytical
Psychology to Poetry" Jung (1931/1966) argued against
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Freud's reductionist view that artistic creation is spawned
from neurosis and the sublimation of wishes. Jung insisted
that a work of art is not a neurosis, but rather the product
of a conscious, creative will or an event originating in
unconscious nature; something which achieves its aim without
human consciousness, and often defines it by willfully
insisting on its own form and effect (Jung, 1931/1966, p.
75), or a combination of both of these. Thus, Jung removed
the notion of illness from the concept of creativity and
viewed it as a healthy process. Jung suggested that the
work of art begins as a psychic formation that remains
subliminal until its energy-charge is sufficient to carry it
over into consciousness. Its association with consciousness
does not mean that it is assimilated, only that it is
perceived; but it is not subject to conscious control...
(Jung, 1931/1966, p. 78). Thus, Jung's analytic psychology
linked the pychoanalytic with the humanistic conceptions of
art by claiming that everyone had the potential to discover
ever-deeper levels of consciousness [and the unconscious]
through an art form such as poetry (Brand, 1979 p. 55).
Therefore, in spite of their differences, both Freud and
Jung agreed that poetry and writing involved the conscious
and the unconscious mind, the provinces of therapy.
Jung said that the work of art is expressed in symbols
and an individual finds meaning in the work of art by
finding meaning in the symbols. Jung also believed that
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symbols had universal as well as individual meanings and
that analysis of a work of art would include an
understanding of both individual and collective symbolic
interpretations (Jung, 1931/1966). This belief underlies a
major principle of poetry therapy which acknowledges the
value of individual interpretations of literature as well as
the existence of symbolic meanings which may be common to
members of the group. The poetry therapist uses knowledge
of common interpretations of symbols in literature to choose
literature appropriate for the group and then encourages the
expression of individual interpretations (Hynes and Hynes-
Berry, 1986).
Another contribution to the field of poetry therapy was
Jung's distinction between art as defined by literary
critics and the creative product which is of interest to
therapists. In "Psychology and Literature" he noted that
"Indeed, literary products which are of highly dubious merit
are often of great interest to the psychologist" (Jung,
1950/1966, p.88). Poetry therapy also acknowledges any
creative output by the client as literature or poetry, even
though it may not meet a literary critic's standards. In
addition, poetry therapy draws the distinction between works
which may be deemed great literature, but which may not be
suitable for poetry therapy. Thus, the terms literature and
poetry are used in the broadest sense (Hynes and Hynes-
Berry, 1986).
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The influence of Jung's psychological theories can be
found in analytic literary criticism (Sugg, Ed., 1992).
Jung's idea of "archetypes,” the presence of universal
symbols or motifs, has evolved into a way of interpreting
literature based on archetypal patterns (Bodkin, 1951;
Jacoby in Sugg, Ed., 1992).
The unconscious regulators, the archetypes, make the human imagination possible. They are the seeds from which the unconscious mind unfolds. The work of our imagination, no matter how free it may seem, is unconsciously guided by general human principles and patterns. If this were not so, no reader would ever be able to reexperience the contents of a work of art. (Jacoby in Sugg, Ed., 1992, pp. 64-65)
Psychology, Poetry, and Emotion
Another important link between literature and therapy
is their relationship to the emotions. Chaliff (1973) says
that literature is a natural analogue of the psychological
aspects of therapy because both depend for their success on
their ability to verbalize emotions (p. 24). These words
echo Wordsworth's definition of poetry as the spontaneous
overflow of powerful emotions recollected in tranquility
(Wordsworth in Norman, Ed., 1962).
The belief that poetry and other forms of literature
express emotions has been used by poetry therapists in two
ways. First of all, poetry therapists often choose
literature to match a client's mood or emotional state.
This practice is drawn from the isoprinciple used in music
therapy in which music therapists choose music which matches
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a client's mood. Leedy (1969) believed that the
isoprinciple should be applied to poetry and maintained that
the poetry therapist should be able to assess client mood
and "prescribe" poems that match it.
In his dissertation research, Brown (1977) tested 112
students on their ability to identify emotions in emotion
laden poetry. His research supported the isoprinciple and
showed that readers were most likely to identify with poems
that expressed their current mood, and when they failed to
identify the emotions correctly, it was because they tended
to project their usual mood, a dominating emotion like
depression, onto poetry when the mood was not expressed
there. Based on these findings, Brown concluded that:
a subject (or client's) response to poetry does appear to be related both to his/her mood and to the mood expressed in the poem; matching client mood with poem mood may very well maximize the client's perceptiveness to the emotional message of the poem....An important finding was that the expressed current emotional state of the subject was related to perceptiveness while the subject's usual, or typical mood, was not. This would indicate that a poem should be matched on the basis of the client's currently experienced emotional state. (1977, p. 96)
The second way in which a therapist can use mood in
poetry therapy is to note the way in which a client's
interpretation of a poem differs from that of other members
in the group or the way a client's interpretation of the
poem seems to include an emotion not expressed in the poem.
Thus, although Brown's (1977) research tended to support the
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isoprinciple, he drew a distinction between current mood and
usual mood. While clients were able to discern poems that
matched their current mood,
It was also discovered that subjects tended to see their usual mood expressed in poems when it did not exist. In other words, subjects tended to project their own typical moods onto the poetry. It is possible then that clients can use a poem as a projective vehicle for the expression of long experienced moods. Counselors may be able to gain insight into the emotional experiences of a client by attending to his/her responses to a poems. (1977, p.96)
The client's emotional interpretation of the poem can
therefore be used as a projective technique by a skilled
poetry therapist.
Catharsis
One of the earliest and most important relationships
between literature and therapy is related to the concept of
catharsis. In Aristotle's "Poetics,” he theorized that an
audience's ability to identify with the emotions of a
character allowed the audience to experience the character
in such a way that there was a release of emotions or
catharsis. He ranked the poet high as the physician of the
psyche and described poetic drama as the cleanser of the
soul, relieving it of pity, fear, and frenzy. Indeed the
Greeks were the among the earliest people to grasp
intuitively the two ingredients fundamental to both poetry
and therapy: language and feelings (Brand, 1979, p. 54).
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Freud and Jung also acknowledged catharsis as an
Important aspect of the therapeutic experience. Yalom named
catharsis as one of the eleven curative factors in group
therapy (1975). In her dissertation research, Talbott-Green
stated that poetry, by its intense concentration on the
present moment and its specific, concrete, and associational
aspects of the poem, may bring clients quickly into touch
with repressed feelings and conflict which are pressing for
release of feelings in catharsis (1988, p. 20). Goldstein
(1989) and Hynes and Hynes-Berry (1986) also acknowledged
the role of catharsis in poetry therapy.
Creativity
The role of creativity in therapy is very important to
understanding poetry therapy. As indicated above, both Freud
and Jung acknowledged the relationship between creativity
and therapy. In Art and Artist, therapist Otto Rank (1932)
viewed artistic creation as an essential drive in humans,
tracing its origins from ancient cultures such as the
Egyptians and the Greeks to modern times. However, Rank
distinguished between the work of the neurotic and the work
of the true artist:
The neurotic, whether productive or obstructed, suffers fundamentally from the fact that he cannot or will not accept himself, his own individuality, his own personality. On the one hand he criticizes himself to excess, on the other he idealizes himself to excess, which means that he makes too great demands on himself and his completeness, so that failing only leads to self-criticism;. If we take this thwarted type and compare him to the artist, it is at once clear that he
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is the antithesis to the self-critical neurotic type. Not that the artist does not criticize himself, but by accepting his personality he not only fulfills that for which the neurotic type is striving in vain, but goes beyond it. The precondition then of the creative personality is not only its acceptance, but its glorification, of itself. (1932, p.27)
Thus, Rank believed the creative strivings of both the
neurotic and the artist were healthy, only the neurotic's
inability to accept himself stood in the way of his creating
great art. Rank thus concurred with Jung's conception of
the healthy aspects of the creative process.
The belief in the healing properties of creativity is
common to all of the creative art therapies: music, art,
dance, psychodrama, and poetry therapy. Gladding (1985;
1992) maintains that all creative arts forms are process
oriented, elicit emotional responses, promote social
interaction, highlight the nature of reality, help establish
a sense of inner control, and lead to a greater awareness of
personal identity (p.2). The relationship between the arts
and therapy has also been discussed by Rossiter (1992).
Unlike some therapeutic methods which use the medical
model and seem to focus on "correcting" the illness in the
undesirable behavior in the client,
...Creative arts therapists generally have focused on positive aspects of psychological functioning such as creativity, personal growth, self-esteem, self- actualization and personality integration. These aspects related directly to the creative processes of poetry as represented by psychologists, poets, and literary critics. In fact, psychologists and poetry therapists have viewed mental health and creativity as
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concomitant outcomes of successful therapy. Through processes of creativity, creative arts therapies may modify old ways of thinking and feeling and improve functioning. (Robbins and Sibley cited in Talbott- Green, 1988, p. 11)
Hynes and Hynes-Berry (1986) suggest that
creativity frees persons from conditioned responses,
encourages innovative problem solving, flexibility, and
spontaneity— the self-actualizing behaviors often sought as
the goal of any kind of therapy.
Poetry, by its intense concentration on the present moment and specific, concrete, and associational aspects of the poem, may bring the client quickly in touch with repressed feelings and conflicts which are pressing for expression and release of feelings in catharsis (Talbott-Green, 1988, p.20).
Literary criticism In addition to psychology, another field which has
contributed to the theoretical basis of poetry therapy is
the reader response theory of literary criticism. The
influence of psychoanalytic and analytic literary criticism
has been discussed. Another form of literary criticism
which has had an influence on poetry therapy is reader
response theory.
Throughout the history of literature, the assumption
has been that language and literature have the power to
influence personal values, emotions, and behaviors (Talbott-
Green, p.63).
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Before the twentieth century, literary criticism
suggested that a work of art could only be understood in its
historical, social, and autobiographical context; in order
to understand a Shakespearean play, for example, a reader
would need to know something about Shakespeare the man and
the politics, social customs, and history of the time in
which it was written. The Deconstructionist movement was a
backlash against this theory and suggested that a literary
work had inherent value in and of itself and should be
studied separately from the author and biographical and
historical contexts (Rice and Waugh, 1989; Beach, 1993).
Prior to the 1950's, the literary critics were text-
centered. The movement away from text-centered reading was
at first directed toward the notion of an "ideal'1 reader
(Prince, 1973). The reader was also acknowledged as the co
creator of the text (Iser, 1974). This theory, known as the
reader response theory, rebelled against the idea of the
inherent meaning of a work being in the text of literature
and suggested that meaning occurs as a result of subjective
interpretation by the individual reader.
Insofar as we divorce the study of literature from the experience of reading and view literary works as objects to be analyzed rather than as human expressions to be reacted to; insofar as we view them as providing order, pattern, and beauty, as opposed to challenge and disturbance; insofar as we favor form over content, objectivity over subjectivity, detachment over involvement, theoretical over real readers; insofar as we worry more about incorrect responses than insufficient ones; insofar as we emphasize the distinctions between literature and life rather than
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their interpretation, we reduce the power of literature and protect ourselves from it. (Slatoff cited in Talbott-Green, 1988, p. 65)
Within the theory of reader response, there are
different approaches to understanding the reader's
subjective interpretation of a work of literature.
Psychoanalytic critics emphasize unconscious processes in
reader response (Holland, 1968, 1973). In Poems in Persons.
Holland discussed the shift he made from his earlier work
The Dynamics of Literary Response. Holland moved from a
more text-centered view to an understanding of the reading
process in which he suggested that the reader's individual,
personal response to a poem was more important than
objective qualities in the poem:
It is not, as I had thought in Dynamics. the poem that embodies a mental process. It is the reader. The reader combines the materials of the poem with his or her own characteristic process of mind to build a fantasy, transform it by means of defenses, and make sense of it. It is the reader who takes the inert words-on-the-page and makes them a meaningful experience. (Holland, 1964, p.xi).
Bleich (1975) took this one step further by asserting
that there was no objective meaning in the poem but that the
meaning was created by the reader. He emphasized the
personal response by the reader and tried to help the reader
to use literature as a way to enhance personal understanding
and appreciation of life.
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While some theorists emphasized the unconscious process
in a reader's response to a work of literature, Fish (1970)
emphasized the conscious processes of reading as more
important. For Fish, the meaning of any reader/text
transaction is the function of the interpretive strategies
and conventions adopted by readers as a member of a
community (Beach, 1993, p.106). Fish called this an
"interpretive community" and felt that the reader responded
to a work based on the conventions of that community.
Poetry therapy rests on the belief that an individual
responds to a work of literature in a unique, personal way.
It acknowledges the influence of the group in interpreting a
work of literature, but ultimately it is geared toward
encouraging individual response. Lawler (1972) believed that
the ambiguous nature of poetry, primarily through metaphor,
needs to be removed from all other considerations of the
poem except the interaction between the poem and the reader.
The skilled poetry therapist uses the individual's unique
response as a catalyst for further exploration of feelings
and meanings (Hynes and Hynes-Berry, 1986).
Historical Foundations of Poetry Therapy
The historical foundation of the field of poetry
therapy can be traced to ancient times when poetry in the
form of spells was used for healing. The ancient Egyptians
used spells in the form of poetry to heal illnesses such as
headaches, burns, and skin diseases, as well as to drive
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away anger and to seduce loved ones (Brier, 1980). The
ancient Greeks acknowledged the relationship between poetry
and healing by making Apollo the god of both of these
realms.
In America there is evidence that bibliotherapy and
poetry therapy were used in the early nineteenth century.
Benjamin Rush has been credited as the first American to
recommend reading as therapy to patients in the 1800s
(Rubin, 1978). Psychiatric patients were writing poetry at
Pennsylvania Hospital in the 1840's (Leedy, 1969). Poems
written by patients were compiled in books at the hospital,
a practice still in use today at many hospitals.
In 1925, Robert Haven Schauffler published The Poetry
Cure; A Pocket Medicine Chest of Verse and provided poems
for the relief of symptoms. Shauffler also cautioned
against the indiscriminate use of poetry, citing poetry as
powerful medicine with the potential to do both good and
harm.
After WWI, libraries were used for the recreation of
the mentally ill in Army hospitals (Rubin, 1978).
Librarians working with these patients would often
"prescribe" literature to the patients and noted that this
seemed to make the patients feel better. This practice,
known as "bibliotherapy" or "book therapy" led to the
creation of the position of bibliotherapist, with Kathleen
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Jones becoming the first bibliotherapist in 1904 (Rubin,
1978).
In the 1940's The Hospital division of the American
Library Association had its first committee meeting for
reporting on research and developing bibliographies. In the
1950's, librarians worked more closely with psychiatrists
and became part of the treatment team.
Jack Moreno, the "father” of group therapy and founder
of drama therapy, began to use poetry in his group work, a
technique he called psychopoetry (Mazza, 1981).
By the 1960's, bibliotherapy was being used by nurses,
counselors, psychologists, psychiatrists, and educators
(Rubin, 1978). The use of bibliotherapy in diverse fields
has contributed to the lack of precision in defining terms
such as bibliotherapy, poetry therapy, literature and
poetry.
Simon Lesser's work Fiction and The Unconscious (1962)
suggested that reading fiction involved both conscious and
unconscious processes. Lesser believed that reading was
therapeutic in that it compensated for the deprivations and
disappointments of experience (1962, p. 189).
Eli Griefer, who has been credited with providing the
term "poetry therapy," published the book Principles of
Poetry Therapy in 1963. He and Jack Leedy led poetry
groups. In 1969, The Association for Poetry Therapy was
created to allow persons who were interested in using poetry
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therapy as a therapeutic technique to communicate with one
another and to enhance understanding of the field. Jack
Leedy became director of this association and his efforts
were instrumental in incorporating poetry into programs for
the Homebound, Project Teen-Aid, New York City Board of
Education and the Committee for the Education of Pregnant
School Age Girls (Brand, 1979).
Leedy's books Poetry Therapy (1969) and Poetry the
Healer (1973) included testimonies by therapists using
poetry therapy in a variety of settings. Leedy's approach
was psychoanalytic, directive, and prescriptive. He
believed that the poetry therapist needed to use the
technique used in music therapy known as the isoprinciple in
which the therapist matches music with patient mood. Leedy
recommended that the poetry therapist "prescribe" a poem
which matched the mood of the patient and even offered a
list of poems suitable for poetry therapy. His theory was
based on his work with a poetry therapy group at the Mental
Hygiene Clinic at Cumberland Hospital, Brooklyn, New York.
His books included testimonies by other practitioners on the
benefits of using poetry therapy in a variety of settings
including hospitals, prisons, and educational settings.
Lerner (1972) provided a different orientation. He
suggested a less directive, more Rogerian approach. He
believed that the isoprinciple was too prescriptive and that
it was not always desirable to match patient mood. Lerner
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focused on the selection of literature which enhanced
communication. Lerner believed that any work of literature
which enhanced communication between the therapist and the
client was acceptable. Thus communication, not matching
literature with mood, was considered most important. Lerner
founded the Poetry Therapy Institute in California in 1972
to provide training in the use of poetry therapy. Lerner
published Poetry in the Therapeutic Experience in 1978.
By 1972, approximately 3,500 mental patients, prison
inmates, troubled students and nursing home residents were
reading and writing poetry for its therapeutic benefits
under the guidance of some 400 psychiatrists, psychologists,
social workers, and specially trained English teachers
(Brand, 1979, p. 64).
Psvchoooetrv; A New Approach to Self-Awareness Through
Poetry Therapy was published in 1976 by Schloss, who
presented case studies on poetry therapy. Schloss also
conducted a survey of helping professionals and from the 194
surveys which were returned, he was unable to provide the
classification system of poems which had been the purpose of
his study. Schloss is credited with making the valuable
observation that the use of literature which is too didactic
may invalidate client feelings. Schloss recommended that
more open ended literature be used. Thus Schloss provided
yet another approach to poetry selection for poetry
therapists.
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In 1981, the National Association for Poetry Therapy
(NAPT) was formed. The association has become a member of
the National Coalition for Creative Arts Therapies, joining
dance, music, art, and drama therapists. It provided an
annual conference. It also began to set the standards for
certification in the field of poetry therapy. It continues
to be the organization which promotes research and training
in the field of poetry therapy.
In 1986, Hynes and Hynes-Berry published Bibliotherapy:
An Interactive Process, which has been widely accepted as
the definitive text on poetry therapy. It is used in poetry
therapy training programs throughout the country.
Articles on poetry therapy began to appear in journals
such as Specialists in Group Work and the Journal of the
Arts in Pvschotherapv. The Journal of Poetry Therapy, the
official journal of the field, published its first issue in
1987. The journal contains descriptive and research
articles in poetry therapy as well as updates on research
studies and suggested literature for use in poetry therapy.
Procedures Used in Poetry Therapy
The procedures used in poetry therapy involve the
assessment of the therapeutic goals, the selection of
appropriate literature, and the conducting of the therapy.
Poetry therapists are trained in the special application of
these procedures, for merely incorporating poetry into
therapy sessions does not constitute poetry therapy.
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The National Association for Poetry Therapy provides
training and certification in poetry therapy. A poetry
therapist may become a Certified Poetry Therapist (CPT),
trained in the developmental use of poetry therapy, or a
Registered Poetry Therapist (RPT), trained in the use of
poetry therapy with clinical populations. According to the
National Association of Poetry Therapy's training
guidelines, persons interested in training as poetry
therapists should have training in conducting poetry
therapy, supervised poetry therapy hours, didactic learning,
site work and institutional experience, as well as peer
group experience. This training prepares poetry therapists
t o venact the procedures of poetry therapy: assessment,
selection of literature, and use of poetry therapy
techniques. Proper training is recommended to reduce the
unintentional harm which could be done through inappropriate
literature selection.
Assessment
As with any kind of therapy, poetry therapy begins with
an assessment of the needs of the client and the
determination of therapeutic goals. Therefore, the poetry
therapist needs to be trained in diagnosis and setting
therapeutic goals. Many poetry therapists lead poetry
therapy groups, so an understanding of group process is also
essential to successful poetry therapy (Goldstein, 1989;
Hynes and Hynes-Berry, 1986; Chavis, 1985).
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Literature Selection
Poetry therapists use the terms "literature" and
"poetry" in the broadest sense. Poetry and literature are
essentially anything involving language which is used by a
poetry therapist as a catalyst to evoke a response in a
client or a group. This could include poems, prose, fairy
tales, or song lyrics. Lerner (Lerner cited in Lippin,
1982) explains the difference between a literary discussion
of a poem and poetry therapy by saying in the former, the
accent is on the poems, whereas in the latter, the accent is
on the person.
Leedy (1969; 1973), Lerner (1972), and Hynes-Hynes-
Berry (1986) have stated that literature selection should be
based on poetry therapist's assessment of the reader's need.
Therefore, the facilitator must be skilled in assessing the
need and choosing an appropriate poem.
Leedy (1969) was very prescriptive in his approach
toward literature selection, suggesting that the poem must
conform to the isoprinciple and match the patient's mood.
Based on Leedy's isoprinciple, Brown (1977) conducted
dissertation research on client mood and poetry and
concluded that the isoprinciple is most effective when the
poetry therapist matches the client's current mood rather
than his or her usual mood, since the client will tend to
project his or her usual mood onto literature. The poetry
therapist should therefore be skilled enough in assessment
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to distinguish between a client's current mood and his or
her usual mood. For example, the poetry therapist working
with a depressed patient should know that the client will
tend to project this mood of depression onto literature.
This knowledge is important in literature selection, for the
poetry therapist might want to be especially careful about
choosing literature which depicts depression.
Another theory of poetry section was fostered by Lerner
who was less prescriptive than Leedy (1978; 1991) and
believed that any work of literature which enhanced
communication between the therapist and the client was
appropriate for therapy.
Hynes and Hynes-Berry (1986) proposed yet another model
for literature selection, suggesting that the literature
appropriate for poetry therapy should have themes which are
both universal and positive.
The importance of choosing appropriate poems requires
the therapist to become sensitive to his or her own
unconscious processes. In other words, the poetry therapist
should not choose a work in which he or she has such a
strong emotional or intellectual investment, whether
conscious or unconscious, that he or she gets frustrated and
tries to influence the client's or the group's response
instead of letting responses flow naturally. In "Guiding
the Unconscious: The Process of Poetry Section for Poetry
Therapy Groups" (Rolfs and Super, 1988) the authors warn
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poetry therapists of the dangers of not recognizing the role
of their own unconscious in the process of literature
selection:
Experience has led to the conviction that because poetry therapy speaks to the unconscious, it evokes powerful emotional responses in therapists as well as clients. If, when choosing poems, therapists act on their unexamined feelings, they unwittingly can lead patients in harmful directions...Therefore, as therapists begin to [choose potential poems], they should include consideration of their emotional reactions to them. (p. 122)
Rolfs and Super conclude their article with guidelines
for poetry selection in groups:
1. Identify current group and individual themes. 2. Choose the therapeutic goal or goals for the next session. 3. Begin to think about categories of poems that address issues. 4. Begin to think about specific poems within these categories. 5. Do a careful reading of the poems, trying to imagine all possible meanings. 6. Reject all poems that : (a) are not clear, (b) have messages that conflict with the goal, (c) are premature in the life of the group, (d)are clinically contraindicated for any individual patient, (e) are problematic for the therapist. 7. Select a poem that meets the goal. 8. Select a complementary poem. 9. Decide upon the order of the poems, planning to end with the more optimistic one. (p.126)
Steps 8 and 9 are optional, depending on whether the
poetry therapist has time to use one or two poems. These
guidelines can be used regardless of whether the therapist
uses the methods suggested by Leedy (1969), Lerner (1973),
Hynes and Hynes-Berry(1986), or some other criteria. It is
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clear from these steps that the poetry therapist needs to be
trained in group assessment and goal setting, as well as in
literature selection. Poetry therapy, like any medicine,
can also harm if misused through ignorance or malice
(Jaskowski, 1980, p. 275).
Techniques Used in Poetry Therapy
In addition to assessment, the poetry therapist must be
skilled in the use of preexisting poems and creative writing
as well as in the unique skill of conducting poetry therapy
sessions. P.r^.ex jg t.ihg-P-Q^ g. Preexisting poems are chosen on the basis of one of the
theories of literature selection discussed above.
Preexisting poems can be poems written by renowned poets or
by clients and therapists. There have been many attempts
to compile lists of poems for use in poetry therapy
(Schauffler, 1925; Leedy, 1969). While most poetry
therapists see these lists as helpful resources, the process
of poetry selection is a very personal one since the poetry
therapist and the client both bring their own subjective
interpretations to the literature (Rolfs and Super, 1988).
A poem which might work well for one therapist or one group
might not work well for another. The process of poetry
selection is also based on the receptivity of the client or
group to a previous work, which serves as a guideline for
future selection.
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Poetry therapists vary in the literature that they will
use for poetry therapy. Harrower (1972) suggests that the
best source of material for poetry therapy is poetry written
by clients and poetry therapists themselves. Song lyrics
have also been used as literature in poetry therapy (Mazza
and Prescott, 1981; Mazza, 1988).
The lack of precision and absence of rigidity in the
selection process is what makes poetry therapy a creative
endeavor for both the client and the poetry therapist.
However, the thoughtful selection of appropriate literature
is cited throughout the poetry therapy literature as one of
the most important skills to be developed by the poetry
therapist (Leedy, 1969; Lerner, 1973; Hynes and Hynes-Berry,
1986; Rolfs and Super, 1988).
Once the appropriate literature has been selected, the
poetry therapist must decide how this material will be
presented to the client or the group. The presentation of
the material is very important, and poetry therapists are
encouraged to provide clients with clear, typed copies of
the literature. The therapist may wish to enlarge the print
for those who are sight impaired such as geriatric patients.
Sometimes the therapist will alter the original poem, using
just a fragment of it or omitting or changing words. The
therapist may choose to use colored paper or illustrations
to enhance the literature. While these practices may be
questionable from an aesthetic viewpoint, they are good
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practice from a therapeutic point. The goal of the
therapist is to present the literature in a way which is
easily accessible to the client. The therapist usually
encourages the client to keep the poem and because the poem
may be taken home and read again, it can sustain the mental
image of the therapeutic encounter (Pies, 1987, p.91).
Creative Writing and Poetry Therapy
The use of creative writing in poetry therapy can be
traced to the use of personal writing as a therapeutic
experience. Personal writing in therapy has taken various
forms including journals, autobiographies, and summaries.
Journal Writing
Many therapists such as Freud and Jung have attested to
the therapeutic value of keeping a journal. In 1963, Progoff
published an At a Journal Workshop; The Basic Text and Guide
for Using the Intensive Journal in which he discussed the
value of using journals in psychotherapy. Progoff saw the
journal as operating on two mutually reinforcing levels: a
self-balancing process that applied to the short run of life
experiences and a life-integrating process that applied to
the long run of life movement (Progoff cited in Brand, 1976,
p. 67). Journal writing has also been advocated to enhance
creativity and promote healing by Capacchione (1979; 1989)
and Adams (1990).
Autobiography
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The use of autobiography has also been cited as
therapeutic. In 1970, Lauer and Goldfield asked groups of
inpatients to write autobiographies to introduce themselves
to other group members. They also gave patients prompts of
one or two words and asked patients to respond to them in
writing. The sessions consisted of writing, reading what
was written, and discussion. Their observations of over 200
people who had met in over 100 sessions were that writing
circumvented repressive mechanisms and provided an entry
into the psyche, facilitated self-understanding, and that
writing facilitated group interaction and instruction (250).
Writing Summaries
In Every Day Gets A Little Closer. Yalom (1974)
indicated that he and his patient agreed to write something
after each session and shared their writing with one
another. They found this useful to enhance communication and
understanding. Yalom (1975) then began to use writing in
group sessions. After each meeting, every person in the
group wrote summaries of the group session and then sent
them to each other before the next session. Yalom suggests
that this practice enables the group members to re
experience and reinterpret results of the powerful emotional
experience (1975, p.607).
Writing in Poetry Therapy
Writing initiates self-encounter (Bell, 1982, p. 28).
Based on the belief that writing is therapeutic, poetry
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therapists encourage their clients to write as a response to
a prompt such as a preexisting poem or song. Unlike journal
writing, autobiography, and summaries which can be done in
isolation, poetry therapists use the interaction between the
literature, the client, and the therapist to promote healing
and personal growth. Writing is often encouraged as an
outgrowth of this interaction (Wadeson, 1981; Bell, 1982;
Silverman, 1986), and the writing itself is considered
therapeutic, even when the writing is not completely
understood. For example, Peris, Hefferline, and Goodman
suggest that the therapeutic benefits can exist without the
poet (or the therapist) necessarily grasping the poem's
latent content. The very act of writing poetry, completing
the poem with a sense of having come to a resting place, is
in itself a kind of resolution (Peris, Hefferline, and
Goodman cited in Brand, 1979, p. 56), a therapeutic endeavor
for the writer. According to Schloss and Grundy (Lerner,
Ed., 1978), for those whose anxiety makes communication with
people difficult, writing provides a way to confide, to say
what they want to say and feel in control of the process
(p.94).
Harrower (1972) stressed the healing properties of
writing and suggested that poetry is therapy and is part and
parcel of normal development. She maintained that the very
act of creating is a self-sustaining experience (1972, p.
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79). She attested to the power of writing as therapy by
saying:
I write poems because they solve a conflict, because I am ill at ease spiritually and want to clarify my thoughts and feelings... I write poems because from some inner chaos, I am driven to create order. I write poems because I am flooded, overpowered by feelings which have been provoked by some aspect of life or nature. The great bulk of feelings can only be subdued or brought under control if I allow some intellectual craftsmanship to work on it, to produce manageable thoughts which I can control in the place of all- pervading emotions which control me. (1972, p. 53)
Based on the power of poems written from emotional
experience, Harrower recommended that poetry therapists use
poems written by patients and therapists instead of formal
poetry written by great poets.
Poetry therapists may lead clients in structured or
unstructured writing. Poetry therapists can provide
structure by introducing writing prompts used in creative
writing (Koch, 1990; Bosweld, 1994) and journal writing
(Capacchione, 1979; Capacchione, 1989; Adams, 1990) such as
anagrams or "alphapoems," sentence completions, and the
modification of preexisting poems by removing key words and
leaving blanks for the client to fill in. In addition to
these techniques, poetry therapists may provide structure by
specifying forms and rhyme schemes such as haiku and tanka
(Hynes and Hynes-Berry, 1986).
Participants can also be encouraged to engage in
unstructured writing when the use of structure seems
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confining. In unstructured writing, the poetry therapist
may invite participants to respond in writing in whatever
way they feel comfortable.
When left free to choose the structure of their writing, participants tend to respond initially in ways that reflect their background. Those who are not used to writing often write very little at first; others turn to rhyming because it is a structure they strongly associate with writing....However, as time goes on, the unstructured writing tends to become more and more a simple expression of feelings or a brief personal thought that expresses free verse. (Hynes and Hynes- Berry, 1986, p. 185)
Poetry therapists provide writing materials to the
clients and may offer to type up client writings and
distribute them at the next session.
Writing Collaborative Poems
The writing of collaborative poems is a technique that
is unique to group poetry therapy. For in addition to
asking group members to write individual responses to
prompts such as poems, fairy tales, or other literature,
poetry therapists often lead their groups in the creation of
group poems. These poems, otherwise known as collaborative
poems, are written with each member contributing a few words
or a few lines (Lack, 1982; Hynes and Hynes Berry, 1986;
Chase, 1989; Mazza, 1994; Yochim, 1994). Oftentimes, they
are written based on verbal responses or individual writing
prompted by a poem or piece of music (Mazza and Prescott,
1981). Just as in individual writing, these prompts are
drawn from creative writing techniques such as the use of
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anagrams, sentence completions, and a variation of sentence
completions in which key words such as nouns and verbs are
removed from a preexisting poem and the client fills in the
blanks (Friebert in Ben and Twetchell, Eds., 1992).
In addition to structured group writing, group leaders
can encourage groups to write unstructured group poems where
each person contributes a line and the form of the poem
evolves with the addition of each line. For example, Yochim
(1994) uses a clipboard which she passes around in her
groups so that each person can contribute a line.
The collaborative poem is thus a group project which
represents the group's experience of a particular session.
The poems often reflect the current mood or the predominant
theme in the group (Mazza, 1981, p.35). The collaborative
poem can thus provide the group leader with valuable
information about the group's mood or treatment issues. This
information can be used by the poetry therapy group leader
as an aid in the selection of literature for subsequent
sessions.
In addition to providing valuable information to the
group leader, the process of engaging in a group activity
can be healing in itself. Lack (1982) described the power of
writing collaborative poems with patients, some of whom were
diagnosed as schizophrenic and manifested thought disorder.
While sharing and creating, the group merged into a
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compassionate, intelligent, alert unit. In these moments of
creating, there was lucidity (Lack, 1982, p.291).
The poetry therapist usually writes down the lines for
the group and when the poem is finished, the poetry
therapist reads it to the group. Since the poetry therapist
writes down the words contributed by the group, this
technique can even be used with clients who are incapable of
writing for themselves because of a physical or mental
disability or because they are illiterate. A less directive
variation on this theme which can be used with more literate
groups is to have group members take turns writing lines of
the poem on newsprint or on the blackboard. Once the poem
is complete, copies of the poem can then be distributed to
the group as a memory of their shared experience.
Although the writing of collaborative poems is often
used in poetry therapy groups and the technique is used in
the training of poetry therapists (Hazza, 1981: Mazza and
Prescott, 1981: Hynes and Hynes-Berry, 1986; Chase, 1986;
Yochim, 1994; Mazza, 1994) and the technique is used in the
training of poetry therapists (Hynes and Hynes-Berry, 1986),
the effects of collaborative writing need to be examined
more thoroughly (Mazza, 1981; Mazza and Prescott, 1981;
Hynes and Hynes-Berry, 1986). In Mazza's 1981 dissertation
study, group members reported that the creation of
collaborative contributed to their feelings of group
cohesion. Mazza recommended further research on the
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relationship between collaborative poetry and group
cohesion. In Mazza's article entitled "Toward A Research
Agenda for the 90's," he again pointed out the need for more
research on collaborative poems. This study addresses that
need for research by isolating the writing of collaborative
poetry from traditional poetry therapy and measuring its
effects on cohesion.
Conducting Poetry Therapy
Regardless of the approach used in literature selection
and the use of creative writing, the success of poetry
therapy depends upon the facilitator's ability to speak to
the participant's individual needs and interests and to make
accurate, empathic interpretations of the participant's
responses (Hynes and Hynes-Berry, 1986; Rolfs and Super,
1988).
The poetry therapist must learn how to work with the
literature in a therapeutic way. Unlike in a classroom
setting where the focus of the discussion of a work of
literature tends to be on the author or the work itself, the
poetry therapist focuses on reader's responses. The poetry
therapist should not try to lead the client or the group too
strongly in any one direction, but should serve as a gentle
and encouraging facilitator. Poetry therapy is not
invasive, it is subtle and
[t]he subtlety of poetry therapy is one of its most important qualities. By introducing a poem, the therapist gently suggests an agenda for the session.
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If the group isn't ready for that agenda, they will resist and evade it, but because the suggestion is gentle, the resistance is gentle. As a result, poetry seems less confrontive and threatening than other therapies, and some people in clinical settings who refuse to participate in other therapies willingly attend poetry therapy. (Rossiter, 1992)
The role of the poetry therapist is to introduce the
client or the group to material which will allow new
perceptions to form and then to seize the opportunity to
bring to consciousness what is significant for their self-
understanding without endangering their self-preservation
(Hynes, 1982, p. 238).
Yet the role of the poetry therapist also includes
working with the unconscious. The poetry therapist may also
uncover unconscious materials by responding with empathy ...
and adroitly challenging previously held ideas or feelings
while helping to form a more effective adaptation (Hynes,
1982, p. 238). This subtle dance between the conscious and
unconscious elements in the literature, the client, and the
therapist is the essence of poetry therapy.
Research in Poetry Therapy Bibliptherapy A discussion of the research in poetry therapy would be
incomplete if it did not also mention important work in the
field of bibliotherapy or guided reading which provided the
foundation for later research in poetry therapy. One of the
most important contributors to both bibliotherapy and poetry
therapy was Carolyn Shrodes. In her 1949 dissertation,
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Shrodes laid the theoretical foundation for reader response
in poetry therapy and dynamic psychology. Shrodes defined
bibliotherapy as the process of dynamic interaction between
the personality of the reader and the literature as a
psychological field which may be used for personal
assessment, adjustment, and growth (p. 28).
According to Shrodes, reading provides an intense
personal experience. Since reading involves perception,
apperception, and cognition, as well as attention and
conceptualization, it could not be separated from the
feelings of the reader (Shrodes, 1949). Shrodes suggested
that reading provided an intense cognitive and emotional
experience wherein change takes place through
identification, projection, abreaction, and catharsis. Her
later works, Patterns for Living (Campbell, Van Gundy, and
Shrodes, 1940) and Psychology Through Literature (Shrodes,
Van Gundy, and Husband, 1943) were collections of readings
arranged to assist the reader in better self-understanding.
Brown's 1977 dissertation on Poetry as a Counseling
Tool; The Relationship Between Response to Emotion Oxiented
Poetry and Emotions. Interests, and Needs provided important
information on the reader's perceptions of emotion in
poetry. Brown distributed the Chaminade Poetry
Questionnaire to 112 undergraduates at Chaminade College of
Honolulu who had already taken the Strong Campbell Interest
Inventory and the Edwards Personal Preference Scale. The 66
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respondents were asked to read fragments from eight emotion
oriented poems and asked to identify the emotions. Brown
discovered that respondents were able to correctly identify
emotions in poems that matched their present mood, but they
tended to project their usual mood onto poems that did not
express that emotion. This research was significant because
it lent support to Leedy's isoprinciple in cases where the
poetry therapist tried to match the client's current mood;
it is also significant because it showed how a poem can be
used as a projective technique to measure usual mood. £m ui?.Ja_Qe.tJrx.JIhe^apy. One of the earliest attempts to measure the
effectiveness of poetry therapy was conducted by Edgar,
Hazlit, and Levit (1969). They proposed to study the
effects of poetry therapy on hospitalized schizophrenics by
using the Rorschach, WAIS, HTP, Bender, and psychological
interview in a pretest and posttest design. Due to the
number of discharges and home visits, they were unable to
administer posttests. However, they did note that the
poetry therapy groups had more discharges and were allowed
more home visits than those in the experimental group of
conventional therapy.
In 1977 Ross published a dissertation entitled Poetry
Therapy Versus Traditional Supportive.Therapy: A Comparison
of Group Process. She used 33 patients from Cleveland
Psychiatric Institute ranging in age from 20 to 50 and
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divided them into groups of ten with 5 males and 5 females.
Both the control and experimental groups received two
sessions of therapy and therapy. She administered the Truax
Depth of Self-Exploration Scale and the Group Environment
Scale (Moos and Hanson, 1974) measuring group cohesion,
expressiveness, and self-discovery. Using one tailed t-
tests, there was a significant diffference between the means
for poetry therapy groups in both group cohesion and self-
discovery, whereas the means for self-expression were not
significant. Based on observation, poetry therapy groups
made more communicative statements to one another. When the
patients in these groups rated themselves, they reported
greater feelings of group cohesiveness and self-discovery in
the poetry therapy groups than in non-poetry therapy groups
(Ross, 1977, p. 59).
Mazza's 1981 dissertation entitled "Poetry and Group
Counseling: An Exploratory Study" consisted of 32
undergraduate students who met for six weeks and received
either traditional group therapy or poetry therapy. The
poetry therapy groups were led with both preexisting poems
and collaborative poems. The subjects were divided into two
treatment groups receiving poetry therapy and two control
groups receiving traditional supportive therapy. The
subjects received a pretest and a posttest consisting of the
FIRO-B questionnaire and the Group Environment Scale (Moos
and Hanson, 1974). There were no differences between poetry
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and traditional therapy groups on the FIRO-B, which may not
have been sensitive enough to detect changes in these
groups. However, there were significant differences on
cohesion and self-discovery in the comparison of pretest and
posttest scores on the Group Environment Scale. This study
was significant in that it supported the research found in
the study by Ross (1977) that poetry therapy enhances
cohesion and self-discovery.
Mazza's study was also important because it indicated
the need for further research. In a discussion of his
findings, Mazza reported that subjects in the poetry therapy
group cited the use of collaborative poems as increasing
feelings of group cohesion among members. Mazza recommended
that research be done on the effects of writing
collaborative poetry on group cohesion.
Talbott-Green conducted a "A Comparative Study of
Feminist Psychotherapy and Poetry Therapy as an Adjunctive
Treatment to Increase Self-Actualization on the Personal
Orientation Inventory" in 1988, In her dissertation
research, Talbott-Green used 44 adult females from a
community mental health center ranging in ages from 18-55
years old. The subjects were randomly assigned to eight
therapy groups. Pre-test and post-test measures of the
Personal Orientation Inventory consisting of 150 paired
statements related to two major scales of Time Competency
and Inner Directedness and five more scales: Valuing,
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Feeling, Perception, Synergistic Awareness, and
Interpersonal Sensitivity were administered. Both the poetry
and non-poetry groups met for 12 weeks of one-half hour
sessions. Group process and progress notes were also used
to measure observational data. Analysis of pre- and
posttest scores were mixed in that 2 out of 4 groups showed
a significant difference in pre- and posttest scores on
self-actualization. Group cohesion was often observed by
patients lingering in the waiting room based on the way the
groups seemed to look forward to the meetings and by high
attendance (Talbott-Green, 1988, p. 204). She concluded by
saying that qualitative data from group process notes and
case examples of participant's spontaneous contributions to
poetry support the assumption that poetry therapy is a
natural therapeutic technique used as a self-help measure by
persons in therapy and as a catalyst for group therapy.
This study also suggests a relationship between poetry
therapy and group cohesion, which has been shown by Ross
(1977) and Mazza (1981).
Need for Research
Although poetry therapy has been said to increase the
expressions of feelings and group processes, there has been
little controlled research in this area (Ross, 1955; Lerner,
1978; Shrank and Engles, 1981; Hynes and Hynes-Berry, 1986;
Mazza, 1994). Research in bibliotherapy tends to be
descriptive, case-specific, and "non-scientific" (Talbott-
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Green, 1988). The need for research in poetry therapy that
is precise and grounded in previous research has been
established.
This study will enrich the field of group therapy and
poetry by enhancing understanding of group cohesion, one of
the most important aspects of the process of group therapy.
It also provides valuable insights into collaborative
writing, an often used but scantily researched aspect of
poetry therapy. It builds upon previous work that has been
done on poetry therapy and group cohesion (Ross, 1977;
Mazza, 1981) and therefore refines understanding of the
process of poetry therapy. Seminary In this chapter group therapy was introduced and
discussed in terms of its foundations and the similarity of
the goals and processes in group therapy. One of the
aspects of this process, group cohesion was discussed in
terms of its importance and its development as a concept in
the literature. The need for research in group therapy and
group cohesion was discussed.
In addition, poetry therapy was distinguished from
bibliotherapy and then explored in terms of its theoretical
foundations which come primarily from the fields of
psychology and literary criticism. Freud and Jung made
major contributions from the field of psychology. The
reader response movement in literary criticism also made a
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major contribution to understanding the dynamics of poetry
therapy. The historical foundations of poetry therapy were
presented as well as the major research in the fields of
bibliotherapy and poetry therapy. The significant
procedures used in poetry therapy, including literature
selection, the use of preexisting literature, the use of
creative writing, as well as the unique skills of leading a
poetry therapy group, were also presented.
The power of poetry therapy has been summed up by
Whitaker:
I have found poetry to be a powerful psychotherapeutic modality. The poetic communication style invites integration of both the functions of the right and the left hemispheres of the brain. Poetry speaks to the imagery, intuitive, and emotional aspects of the right hemisphere as it speaks to the mathematical, logical, linguistic functions of the left. It is a blending of art and science. Writing, reading, reciting, and listening to poetry enable individuals to be aware of the universality of the human experience and help to delineate human uniqueness. Poetry speaks to the conscious and the unconscious mind simultaneously. ...It traverses the intrapsychic, interpersonal, and spiritual dimensions of human existence. (Whitaker cited in Morrison, Ed., 1987, p.203)
The need for further research in poetry therapy, which
has been shown to be an effective therapeutic technique,
has been made clear. The role of this study as a follow-up
and contribution to previous work on group poetry therapy in
general and to important research on poetry therapy and
group cohesion in particular has been established. The
relationship of this study to writing and therapy has also
been described.
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METHODOLOGY
In this chapter the research design, subjects,
instruments, and procedure will be described. In addition,
the data collection and analysis as well as the ethical
considerations will be discussed.
Research Design
The research design used for this study was a pretest
posttest experimental group design. In this research
design, subjects were randomly selected for participation in
control and experimental groups. Control and experimental
groups receive a pretest before treatment and a posttest
after treatment and can be represented by the following
(Borg & Gall, 1983):
Group Random Pretest Treatment Posttest
1 R Ox 02 experimental
2 R 0, X2 0, experimental
3 R 05 06 experimental
4 R 07 0e experimental
The pretest posttest experimental design controls for
factors which might threaten internal validity (Campbell and
Stanley, 1963; Borg and Gall, 1983). Threats to external
validity are more difficult to control, but the use of an
73
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intact classroom in which members were randomly assigned to
treatment and control groups and the cross assignment of
leaders to both treatment and control groups were used to
help reduce threats to internal validity.
Two control groups and two experimental groups were
used in this study. The two control groups received the
treatment of six sessions of poetry therapy without
collaborative poems. The two experimental groups received
the treatment of six sessions of poetry therapy with
collaborative writing. The use of collaborative poems was
the independent variable.
The Group Environment Scale (Moos and Hanson, 1974) was
used as a pretest and posttest for each treatment. A t-test
was used to show whether there was a significant difference
between pretest and posttest means for the control and
experimental groups.
Subjects
In Mazza's dissertation research (1981), he used a
sample of 32 undergraduate university students in an intact
Communication and Human Relations class to compare the
effectiveness of poetry therapy and group therapy. In his
pretest posttest experimental group design, his subjects
showed a significant increase in Group Environment Scale
(Moos and Hanson, 1974) posttest scores on the scale for
group cohesion and self-discovery. Based on the design of
his study, university students were also used for this
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study. The subjects in this study were 33 graduate students
in a Group Counseling class at an urban university.
According to the guidelines for the Association for
Specialists in Group Work, training for group leaders should
include practice in group work, including observation and
participation in the group, which could occur in a classroom
group (ASGP, 1989, p.16). Therefore, class members were
invited to participate in a poetry therapy group for
personal growth as part of their learning experience in the
Group Counseling class. According to the Ethical Guidelines fpr GtQUB.,CQungeipxg_.an^-JP.t.9.LQS.^lgja^.At^ndards_for_the
Training of Group Workers, students who participate in a
group as a partial requirement for a group course are not
evaluated for an academic grade based upon their degree of
participation in a group (ASGW, 1989, p.8). Therefore, the
subjects in this study were invited to volunteer to
participate in the poetry therapy groups, were given consent
forms (Appendix A), and were assured that group
participation would not affect their grades in any way.
All of the students taking Group Counseling classes at
the university were randomly assigned by the university to
the available counseling classes which met at the same time.
Thus, although the subjects in this study were members of an
intact class, they were randomly assigned to that class.
Using the Table of Random Numbers (Borg & Gall, 1983)
subjects from the intact Group Counseling class were
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randomly assigned into four poetry therapy groups. Two of
these groups were control groups receiving poetry therapy
without collaborative writing and two of these groups were
experimental groups receiving collaborative writing. The
two control and two experimental groups were combined to
create a total of 17 participants in the experimental group
and 17 participants in the control group. Control and
experimental groups were matched as closely as possible with
an equal number of males and females in each group. One
male participant dropped out of the experimental group,
leaving 16 participants in the experimental group and a
total of 33 subjects in the study.
In order to preserve the anonymity of the group
members, the demographic data in this study was restricted
to age and sex (Table 1). This data was obtained when
applicants completed the front of the answer sheet for the
Group Environment Scale (Moos and Hanson, 1974) which was
used as a pretest and posttest for the groups.
Table 1 Demographic Characteristics of Participants Group n Male Female Age(m)
Poetry Therapy 17 8 8 32 without Collaborative Writing
Poetry Therapy 16 8 9 34 with Collaborative Writing
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Instrumentation
The instrument used in this study as a pretest posttest
measure was the Group Environment Scale (GES) developed by
Moos and Hanson (1974). The GES is a standardized
instrument comprised of ten subscales that measure the
social-environmental characteristics of task-oriented,
social, and psychotherapy and support groups. The ten
subscales assess three underlying domains or sets of
dimensions: the Relationship dimensions, the Personal Growth
dimension, and the System Change Dimensions (Moos, 1986).
The Relationship dimensions consist of Cohesion, Leader
Support, and Expressiveness subscales. This study was
concerned solely with the Cohesion subscale, which assesses
the degree of members' involvement and commitment to the
group, and the concern and friendship they show for one
another (Moos, 1986, p.2). This dimension was found to be
significantly different for participants in poetry therapy
as compared to interpersonal group therapy in studies
conducted by Ross (1977) and Mazza (1981). The poetry
therapy groups in Ross's study used only preexisting poems.
The poetry therapy groups in Mazza's study used both
preexisting poems and collaborative writing. In this study,
both group leaders used preexisting poems, but the use of
collaborative writing was isolated as a variable in the
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experimental groups to ascertain its effect on cohesion in
poetry therapy groups.
In addition to the Relationship dimension, the GES also
includes the Personal Growth and System Maintenance and
Control dimensions. The Personal Growth dimensions measure
Independence, Task Orientation, Self-discovery, and Anger
and Aggression. In the studies conducted by Ross (1977) and
Mazza (1981), participants in the poetry therapy groups also
showed a significant increase in posttest scores on the
Self-discovery scale.
The third dimension of the GES, System Maintenance and
Change, measures Order and Organization, Leader Control, and
Innovation.
Items on the GES were constructed based on structured
interviews and observations of members and leaders in
various groups and items adapted from other Social Climate
Scales (Moos, 1974). This resulted in a 211-item form of
the GES. This was administered to 30 groups consisting of
task-oriented, social and recreational, and psychotherapy
and mutual support groups. The groups varied in size from 8
to 50 members and met from 1 week to 5 years. Five
psychometric criteria were used to create the final 90-item
form: 1) items should correlate more highly with their own
subscale than any other; 2) each of the subscales should
have an approximately equal number to items scored true and
false to control for acquiescence response set; 3) the
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subscales should have low to moderate intercorrelations; 4)
Each item and each subscale should discriminate among group
settings 5) the overall item split should be as close to 50-
50 as possible to avoid items characteristic of only unusual
group settings (Moos, 1981). These items resulted in Form R
of the test which is designed to be used to assess responses
to an actual group. The items on Form R were adapted to
create Forms I and E to measure ideal perceptions and
expectations of group environments, but statistical data on
these forms is sparse.
Norms and Reliability
The Group Environment Scale was normed on 56 task-
oriented groups, 57 social-recreational groups, and thirty-
five psychotherapy and mutual support groups. The validity
of the instrument is acceptable, for the internal
consistencies (Chronbach's Alpha) for each of the ten
subscales are all in the acceptable range, varying from
moderate for Independence (.62) to substantial for Cohesion
(.86). Ten subscale scores were intercorrelated for 246
members and leaders in a sample of 30 groups. These
intercorrelations show that Cohesion, Leader Support, and
Expressiveness are positively correlated to each other and
to Task Orientation and Discovery (Moos, 1986, p.6).
The choice of this instrument was based on several
considerations. First of all, the Group Environment Scale
has high reliability, especially the cohesion scale with its
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Chron-bach's Alpha of .86 (Moos, 1981) and high validity,
especially on the cohesion scale. Evidence for its high
validity was supported by Ross and Bednar who found that the
cohesion subscale is significantly related to the Perceived
Depth of Interaction Scale, an index of quality in group
interaction (cited in Moos, 1981, p.18). In 1985, Toro and
Rappaport found that observer's ratings on the Group
Environment Scale's subscales in 12 mutual help groups were
similar to participant's reports (cited in Moos, 1981,
p.18). Another reason for using the Group Environment Scale
is it has been used in a variety of group settings including
self-help and psychotherapy groups (Toro and Rappaport,
1985; Goetzal, 1984) counseling and consultation groups
(Mazza, 1981; Wilcox, 1980; Bernier, 1980), and staff team
climates (Menard, 1976; Duncan and Brill, 1977). Secondly,
its use by Ross (1977) and Mazza (1981) in previous
dissertations on poetry therapy in which the use of poetry
therapy had a significant increase in posttest scores on the
Cohesion subscale of the Group Environment Scale suggested
that it was suited for this study. In addition, the
instrument is easy to administer (Nezu in Buros, 1992). It
consists of 90 one-sentence items which the subject responds
to with true or false on the answer sheet. Another
advantage to using the Group Environment Scale is that it is
easy to score using a simple stencil.
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Reviews of the GES in The Mental Measurements Yearbook
(1978; 1985; 1989) as an instrument for use with groups
appear positive, with most of the criticism appearing as a
result of failure to include pertinent information in the
1974 (Moos) tester's manual. The GES is constructed from a
sound, psychologically sophisticated model; the items and
the scoring were developed using statistical analysis and
common sense; the materials and profile look reasonable
(Campbell in Buros, ed., 1978, p. 574). Items seem to have
been developed logically (Curtis in Mitchell, Ed., 1985, p.
628). Earlier reviews criticize the GES for failure to
include sufficient empirical data on validity in the 1974
tester's manual (Campbell in Buros, Ed., 1978; Dawes in
Buros, Ed., 1978). The 1981 Group Environment Scale Manual
(Moos) appears to provide this information, but while this
manual provides adequate information about Form R (the form
used in this study), it is criticized for not including
enough about the other forms of this test, Forms I & E,
which were based on Form R (Nezu in Connoley and Kramer,
Eds., 1989; Curtis in Mitchell, Ed., 1985).
Procedure
Participation in this study was presented as an
optional developmental learning experience for students in a
graduate group counseling class. In order to reduce the
halo effect, a participant bias which can occur when
participant's change behavior based on experimenter
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expectations (Borg and Gall, 1988), students were not told
that the pretests and posttests would be used primarily to
measure group cohesion. Participants were told that the
Group Environment Scale, which measures several aspects of
group experience, was being used to measure their general
perceptions of the group.
Since many students were not familiar with poetry
therapy, the group leaders met with the class as a whole to
discuss the general definition and goals of poetry therapy
(Appendix A). Participants were asked to sign a release
form (Appendix B) which outlined the voluntary nature of the
study and the option to end the group at any time.
Participants were randomly assigned, using the Table of
Random Numbers (Borg and Gall, 1988) into four groups. The
tow control groups combined resulted in a total of 17
subjects and the two experimental groups combined resulted
in a total of 16 subjects. Group leaders then met with
participants to discuss group process and ground rules and
to encourage participants to talk about their fears and
expectations (Appendix C). The GES (1974) was taken as a
pretest.
The four groups consisted of two control groups and two
experimental groups. The treatment for the two control
groups was poetry therapy without collaborative writing.
The two experimental groups also received poetry therapy,
but collaborative poetry writing was used as an independent
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variable. To ensure the confidentiality of the groups,
groups were conducted in separate classrooms. To control
for experimenter bias, each leader was cross assigned to
experimental and control groups. Each leader conducted two
groups, one control group of poetry therapy without
collaborative writing and one experimental group with
collaborative writing. The groups met once a week for six
one-hour sessions. Since the wording of the items on the
Group Environment Scale assumes that the participant has
participated in a group session, in this study, as in the
study by Mazza (1981) both leaders administered the pretest
after the first poetry therapy session in each group. The
posttest was administered at the end of the sixth poetry
therapy intervention in each group. Leaders then met with
their groups for a follow-up session.
Techniques for Poetry Therapy Groups
The treatment for each poetry therapy group began with
the use of a preexisting poem chosen before the group
session. Both leaders began control and experimental groups
with "Tattered Coat" by Stephen Crane (Dore, ed., 1970)
because it is an open ended poem that can invite
participants to imagine possibilities in their lives. Each
group leader shared a written copy of the poem with the
group, read the poem, and encouraged group responses to the
poem. Toward the end of the session, each leader passed out
a structured poetry therapy writing exercise based on the
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preexisting poem. The structured writing exercise consisted
of an modified copy of the preexisting poem in which key
words such as nouns and verbs were deleted and replaced with
blanks which could be filled in with words by the
participants. Once the participants filled in the blanks
based on their own personal responses to the session, the
leaders encouraged the participants to share their writing
with the group.
This procedure was followed in both control and
experimental groups. In the experimental groups, however,
the individual writing by participants was followed by
collaborative writing. After the group members had written
individual responses to the poem, the leader invited each
participant to contribute a word or a line from his or her
individual writing to create a collaborative poem. These
words or lines were recorded by the leader on a blank copy
of the altered version of the preexisting poem which was
given to the participants for their individual response. The
leader then read the collaborative poem created by the
collaborative writing and invited the group to respond to
the poem. Before the next session, the leader typed up
copies of the collaborative poem. The collaborative poem
was handed out to each group member at the beginning of the
next poetry therapy session. The group was invited to
comment briefly on the poem, and then the leader began the
session with a new preexisting poem.
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Poetry Therapy Groups without Collaborative Writing
In poetry therapy groups without collaborative poetry
therapy, the procedure was the following:
Pre-treatment:
1. Group leader defined the purpose of the group.
Week One: 1. Group leader passed out copies of the appropriate preexisting poem, read the poem, and invited responses. 2. Group leader administered the Moos GES.
Weeks Two through Five:
1. Group leader passed out copies of the appropriate preexisting poem, read the poem, and invited responses.
Week Six:
1. Group leader passed out copies of the appropriate preexisting poem, read the poem, and invited oral and written responses. 2. Group leader administered the Moos GES.
Poetry Therapy Groups with Collaborative Writing Therapy
In poetry therapy groups using collaborative writing, the procedure was as follows:
Pre-treatment:
1. Group leader defined the purpose of the group.
Week One:
1. Group leader passed out copies of the appropriate preexisting poem, read the poem, and invited responses. 2. Group leader invited the group to respond to the poem in writing and then led the group in a collaborative poem. 3. Group leader administered the Moos GES.
Weeks Two through Five:
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1. Group leader passed out copies of the collaborative poem from the previous session. 2. Group leader then passed out copies of the appropriate preexisting poem, read the poem, and invited oral and written responses. 3. Group leader invited the group to respond to the poem in writing and then led the group in writing a collaborative poem. Week Six 1. Group leader passed out copies of the collaborative poem from the previous session. 2. Group leader passed out copies of the appropriate preexisting poem, read the poem, and invited oral and written responses. 3. Group leader invited the group to respond to the poem in writing and then led the group in a collaborative poem. 4. Group leader administered the Moos GES.
Follow-Up Session
Group counselors make every attempt to design follow-up
procedures of their group (Association for Specialists in
Group Workers, 1989, p.9). A one-hour follow-up session was
held after the sixth session to discuss the poetry group
therapy experience for group members. Leaders also
discussed the poetry selection techniques used for the
groups (Appendix C).
Selection of Preexisting Literature
Poetry selection was based on the general criteria for
the selection of poetry therapy literature: the leaders'
comfort level with the poems, their perceptions of group
members, and whether they thought the poetry would meet
group goals (Hynes and Hynes-Berry, 1986). Based on
research by Brown (1977) and recommendations by Rolfs and
Super (1988) which indicated that poetry therapists should
be free to assign poems based on their assessment of the
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group's mood rather than through rigid preplanning of
selected poems, group leaders met prior to administering the
treatment and agreed on 12 poems (Table 1) from which they
could choose one for each of their 6 sessions. As in Mazza's
study (1981), the ability to choose the appropriate
literature, an important aspect of poetry therapy (Hynes and
Hynes-Berry, 1986; Rossiter, Brown, and Gladding, 1990), was
encouraged by providing more poems than could be used in the
sessions. In this study, group leaders were given the 6
poems which were actually used in Mazza's research plus 6
additional poems (Table 2). Since Mazza's dissertation
research (1981) provided a model for this study, the leaders
initially considered using all 12 of the poems used in
Mazza's study. Based on the guidelines for literature
selection which emphasize the importance of the leader's
comfort level with the literature (Hynes and Hynes-Berry,
1986), the leaders selected only 6 of the poems which were
actually used in Mazza's dissertation research. The 6
additional poems agreed on by the leaders (see Table 2) were
chosen based on recommended criteria for literature
selection such as the clarity of the language, the perceived
needs of the group, and the organization of the poems
(Margolis cited in Mazza, 1977). The inclusion of 6 of the
poems used in Mazza's study helped to control for the
variability in responses that could be possible with
different poems.
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Group leaders met after the first session with the
participants and before administering treatment to determine
which of these 12 poems would be used for the 6 sessions
conducted with the group (Table 3). Although poetry
selection was based on Leedy's isoprinciple which suggested
matching poems to group mood (Leedy, 1969), his suggestion
to use poems with an upbeat ending was abandoned in favor of
recommendations by Schloss (1976) that the poems selected
should be less didactic and more open ended. It was agreed
that they would begin each treatment group with Stephen
Crane's "If I Should Take Off This Tattered Coat" (Dore,
Ed., 1970) because of its non-threatening subject matter and
its open endedness. The leaders agreed to use the other
poems in whatever order they felt was appropriate based on
their perceptions of the group.
Table 2
Complete List of Poems Available to Poetry Group Leaders
Poem Author
If I should cast off Richard Addington The poison tree William Blake I'm nobody Emily Dickinson Summons Robert Francis The road not taken Robert Frost Ego tripping Nikki Giovanni Harlem Langston Hughes Two friends David Ignatow Warning Jenny Joseph This above all James Kavanaugh Ache's end Marge Piercy The meaningful exchange Marge Piercy
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Table 3
A Complete List of the Six Poems Used in This Study
Poem Author
If I should cast off Stephen Crane Harlem Langston Hughes Summons Robert Francis Warning Jenny Joseph Ache's end Marge Piercy The meaningful exchange Marge Piercy
Training of Group Leaders
The group leaders in this study were upper level
graduate students who have had over 30 graduate school
credits in the counseling/mental health field. One leader
was male, the other leader was female. Both leaders had
taken at least one group counseling class at the graduate
level and had at least 30 hours of supervised group therapy
experience.
In addition, each leader had read written training
materials on poetry therapy techniques, including copies of
articles from the National Association for Poetry Therapy's
Journal of Poetry Therapy and the standard handbook
Bibliotherapy: The Interactive Process (Hynes and Hynes-
Berry, 1986). Each leader had experience participating in
poetry therapy sessions, although one of the leaders had
completed a nine month training program in poetry therapy at
St. Elizabeth's Hospital in Washington, D.C. The researcher
served as one of the leaders. Both leaders used a
nondirective leadership style. To minimize the effect of
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leadership bias, each leader conducted one control and one
experimental group.
Both leaders were given copies of 12 preexisting poems
(Table 2) so that they could become familiar with them
before meeting with participants. The leaders then met to
decide on the 6 poems which would be best suited for
conducting poetry therapy with the members of the Group
Counseling class.
Data Collection and Analysis
This study was concerned with the following hypothesis:
1) It was hypothesized that there would be higher
posttest scores (<.05 probability level) on the cohesion
subscale of the Group Environment Scale (Moos and Hanson,
1974) in poetry therapy groups using collaborative writing
than in poetry therapy groups not using collaborative
writing.
This hypothesis was tested through four analyses,
using a pretest posttest experimental design. Pretest and
posttest scores on the Group Environment Scale were used
from four groups of graduate counseling school students
engaged in a six week poetry therapy experience. The two
control groups received the treatment of poetry therapy
without collaborative writing and the experimental groups
received the treatment of poetry therapy with collaborative
writing. To control for the small sample size and to
minimize leader bias, when the data were analyzed, the
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scores for the two experimental groups were combined. One
tailed t-tests were used to determine any significant
differences between pretest scores on the cohesion scale of
the Moos GES for the two control groups and the two
experimental groups (Table 4). One-tailed t-tests were
used to determine significant differences between posttest
scores on the cohesion scale of the Moos GES for the two
control groups and the two experimental groups (Table 5).
One-tailed t-tests were also used to determine any
significant difference on the cohesion subscale between the
means of pretest and posttest scores for poetry therapy with
collaborative writing and poetry therapy without
collaborative writing (Table 6 and Table 7).
Ethical Considerations
This study conformed to the ethical guidelines set by
the American Association for Counseling and Development and
the Association for Specialists in Group Work which makes
recommendations regarding the responsibilities of the
leaders to the group (AACD, 1988; ASGW, 1989). Group leaders
informed subjects of the voluntary nature of their
participation and the confidentiality and anonymity of their
participation in this study. Participants were assured that
their names would not be used in any reports of the findings
in this study. Participants were also made aware that group
leaders did not have any authority over participants and
that participation or lack of participation will not affect
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their classroom grades. In addition, participants were
informed that if, as a result of group interaction,
additional support was needed outside the group, both group
leaders and the university counseling center were available
to provide support.
In keeping with recommendations for good group practice
(Corey & Corey, 1987), leaders met with the participants
before treatment to introduce the study and to invite them
to participate. Leaders also met with participants after
the six treatment sessions were over to debrief them and to
discuss feelings and reactions to the poetry therapy
experience.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER IV
RESULTS AND DISCUSSION
The purpose of this chapter is to discuss the results
of the study and to discuss the findings. This chapter will
restate the hypothesis, discuss the method of gathering
data, present the data, and indicate whether the hypothesis
was supported.
This study was done to determine whether the use of
collaborative writing would have a significant difference on
cohesion in poetry therapy groups. The subjects were 33
students enrolled in a graduate Group Counseling class at an
urban university. Of these students, 18 were female and 16
were male. One of the males dropped out of the study so the
data reflects the participation of 17 females and 16 males.
Hypothesis Testing
The hypothesis of this study was that there would be a
significant difference (at the .05 level) between posttest
scores on the Cohesion dimension of the Group Environment
Scale (Moos and Hanson, 1974) in poetry therapy groups with
collaborative writing and poetry therapy groups without
collaborative writing.
To test the hypothesis that there would be a
significant difference between the posttest scores in poetry
93
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therapy groups with collaborative writing and control groups
of poetry therapy without collaborative writing, a t-test
was performed.
A t-test was done to compare the means and standard
deviations of the pretest scores in Cohesion on the GES for
the poetry therapy groups with and without collaborative
writing. The mean for poetry therapy groups without
collaborative writing was computed at 6.18 and the mean for
the experimental groups with collaborative writing was 7.38.
The obtained t-value of 1.67 did not approach the critical
t-value of 1.69. Thus there was no significant difference
in pretest scores on Cohesion. Therefore, it is concluded
that there was no significant difference between the
pretests of the control and experimental groups at the .05
level (see Table 4).
A t-test was used to determine whether there was a
significant difference between pretest scores on Cohesion in
the control group and posttest scores in the control group.
The mean for the pretest scores of the control group was
6.18 and the mean for the posttest scores of the control
group was 6.71. The obtained t-value was 1.67 which did not
approach the critical t-value of 1.69. There was no
significant difference between pretest and posttest scores
in poetry therapy groups with and without collaborative
writing (See Table 5).
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TABLE 4
Comparison of Mean Pretest Scores in Cohesion on the GES for Poetry Therapy Groups With and Without Collaborative Writing
With Collaborative Without Collaborative Writing Writing (n=16) (n=17)
t1 (31) = 1.69
Variable m s.d. m s.d. t
Cohesion 7.375 1.58 6.176 2.430 1.67
Statistically significant p < .05
TABLE 5
Comparison of Mean Pretest and Posttest Scores in Cohesion on the GES for Poetry Therapy Groups Without Collaborative Writing
t1 (31) = 1.69
Pretest Posttest
Variable m s.d. m s.d. t
Cohesion______6.1756 2.430______6.7059 2.340 1.67
Statistically significant p < .05
A t-test was used to determine whether there was a
significant difference between pretest and posttest scores
in the experimental groups. The mean for the pretest scores
was 7.38 and the mean for the posttest scores was 8.11. The
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obtained t-value was 1.36 which did not approach the
critical t-value of 1.69. There was no significant
difference between pretest and posttest scores on Cohesion
in groups using collaborative writing (see Table 6).
Since there was no significant difference between
pretest scores in the control and experimental groups, a t-
test was used to test the hypothesis that there would be a
significant difference between posttest scores on Cohesion
in poetry therapy groups with and without collaborative
writing (see Table 7). The mean of the posttest score in
the poetry therapy control groups without poetry therapy was
6.075 and the mean for the experimental poetry groups was
8.125. The t-value computed was 1.95, indicating a
significant difference on the posttest scores. Therefore,
the hypothesis that there would be a significant difference
between the posttest scores in Cohesion for the control
group and the experimental groups was accepted.
Discussion
This study was designed to determine whether the
difference would be significant (p > .05) between posttest
scores in Cohesion on the Group Environment Scale for poetry
therapy control groups without collaborative writing and
experimental groups with collaborative writing. It was
hypothesized that there would be a significant difference
between posttest scores in Cohesion for the control and
experimental groups. The hypothesis that there would be a
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difference between posttest scores in Cohesion on the Group
Environment Scale was accepted.
TABLE 6
Comparison of Mean Pretest and Posttest Scores in Cohesion on the GES for Poetry Therapy Groups With Collaborative ______Writing______
t1 (31) = 1.69
Pretest Posttest
Variable m s.d. m s.d. t
Cohesion 7.375 1.58 8.1250 1.50 1.36
Statistically significant p < .05
TABLE 7
Comparison of Mean Postttest Scores in Cohesion on the GES for Poetry Therapy Groups With and Without Collaborative Writing
Without Collaborative With Writing Collaborative Writing (n=16) (n-17)
t1 (31) = 1.69
Variable m s.d. m. s.d. t
Cohesion 6.7059 2.568 8.125 1.50 1.95*
* Statistically significant p < .05.
These findings are consistent with previous research on
poetry therapy and cohesion. The relationship between
poetry therapy and cohesion has been discussed in Goldstein
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. (1989) and Cohen (1992). In 1977, Ross compared poetry
therapy and group therapy on the Group Environment Scale
(Moos and Hanson, 1974) and determined that there was a
significant difference in Cohesion in poetry therapy groups.
In 1981, Mazza also compared poetry therapy groups and
psychodynamic groups on the Group Environment Scale. The
poetry groups in Mazza's study utilized collaborative
writing as a poetry therapy technique. Mazza's research
revealed that the difference between posttest scores in
Cohesion on the Group Environment Scale for poetry and non
poetry groups was significant. Narrative reports by
participants in his study suggested that the use of
collaborative poetry might have been one of the variables
that contributed to the higher scores in group cohesion. In
his recommendations for further study, Mazza suggested that
there was a need to research collaborative writing as a
therapy technique.
The present study isolated collaborative writing as a
variable in poetry therapy and compared it to poetry therapy
without collaborative writing by examining possttest scores
on Cohesion in the Group Environment Scale. Although
generalizations between these studies cannot be made, the
increased, but not significant, posttest scores on the GES
in this study for both control and experimental poetry
therapy groups, while not significant, support the findings
of both Ross (1977) and Mazza (1981) that poetry therapy,
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with or without collaborative writing, results in an
increase in cohesion among group members.
In addition, the significant difference between
posttest scores in poetry therapy groups with collaborative
writing and poetry therapy groups without collaborative
writing support the findings in Mazza's study, which
suggested that the use of collaborative writing may have a
significant effect on cohesion.
Other Findings
Although this study was done to determine if there was
a significant difference between posttest scores on Cohesion
for the GES, t-tests were done to compare differences
between pretest and posttest gains for the control and
experimental groups on the nine additional scales of the GES
(see Tables 8 and 9).
Conclusion
The examination of pretest and posttest scores on The
Group Environment Scale for control and experimental poetry
therapy groups indicate that, while the differences were not
significant (p > .05), poetry therapy increased scores on
cohesion. These findings are similar to those of Ross
(1977) and Mazza (1981).
In addition, this study supported findings by Mazza
(1981) which suggested that the use of collaborative writing
enhanced cohesion. There was a significant difference
(p > .05) between posttest scores in Cohesion on the GES
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TABLE 8
Comparison of Mean Pretest and Posttest Scores on the GES for Poetry Therapy Groups Without Collaborative Writing Pretest Posttest
Variable m s.d. m s.d. t Cohesion 6.18 2.43 6.71 2.57 .27 Leader Support 6.88 1.27 7.41 1.81 .17 Expressiveness 4.47 1.91 5.18 1.59 .13 Independence 6.35 1.77 7.18 1.67 .09 Task Orientation 6.18 1.59 6.59 2.15 .27 Self-Discovery 6.47 1.13 6.29 2.42 .39 Anger and 2.18 1.38 1.53 1.23 .08 Aggression Order and 7.06 1.64 7.76 2.02 .14 Organization Leader Control 5.82 1.33 5.59 1.37 .31 Innovation 5.18 2.46 4.82 2.04 .32
Statistically significant p < .05.
TABLE 9
Comparison of Mean Pretest and Posstest Scores on the GES for Poetry Therapy Groups With Collaborative Writing Pretest Posttest
Variable m s.d. m s.d. t Cohesion 7.38 1.58 8.13 1.5 .09 Leader Support 5.94 1.69 7.50 1.10 .00 Expressiveness 5.00 1.41 5.88 1.20 .04 Independence 6.78 1.18 7.00 1.36 .29 Task Orientation 6.13 1.78 7.50 1.37 .01 Self-Discovery 5.25 2.22 8.44 1.09 .02 Anger and 2.00 2.00 .88 1.20 .03 Aggression Order and 7.13 2.12 8.44 1.09 .02 Organization Leader Control 5.94 1.80 5.62 2.09 .33 Innovation 4.69 1.45 4.31 1.62 .25
* Statistically significant p < .05.
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for experimental poetry therapy groups with collaborative
writing (8.13) and control poetry therapy groups without
collaborative writing (6.08). Chapter Five will discuss the
significance of these findings.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER V
DISCUSSION
The purpose of this research was to determine whether
the use of collaborative writing in poetry therapy groups
enhanced group cohesion. This chapter will provide a
discussion of the results and the relationship of this
research to other studies. The limitations of this study
and the implications for research and practice will then be
described.
Discussion of Results
General Research Question
Does the use of collaborative writing make a
significant difference in group cohesion in a poetry therapy
group? This research question was explored by examining the
posttest results on the Cohesion subscale of the Group
Environment Scale (Moos and Hanson, 1974) for poetry therapy
groups with and without collaborative writing. The 33
subjects were 16 and 17 female students in an intact
graduate Group Counseling class at an urban university who
were randomly assigned to control and experimental groups.
The pretest posttest control group design was utilized and
the two group leaders were cross assigned to both control
and experimental groups.
102
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Cohesion
The scores on Cohesion for both the control and the
experimental groups increased from the pretest to the
posttest. The scores on Cohesion for the control groups
without collaborative writing were 6.18 for the pretest and
6.71 for the posttest. The scores on Cohesion for the
experimental groups with collaborative writing were 7.38 for
the pretest and 8.12 for the posttest. Even though the
increase in pretest and posttest scores was not significant
for either group (p > .05), the posttest gains suggest that
poetry therapy may increase cohesion, with or without
collaborative writing.
The Cohesion subscale on the Group Environment Scale
was examined based on the differences between posttest
scores on the Cohesion subscale of the Group Environment
Scale. The mean for the posttest scores of the experimental
groups utilizing collaborative writing (8.12) was higher
than the mean of the control groups without collaborative
writing (6.71). A t-test was conducted to determine whether
the scores were significant and the t-value of 1.95 was
significant (p > .05).
Collaborative Writing
The influence of collaborative writing on Cohesion was
examined by comparing posttest scores for the experimental
group using collaborative writing. Although the difference
between pretest and posttest scores was not significant for
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the experimental groups, the increase between pretest and
posttest scores in the experimental groups suggest that
collaborative writing may increase cohesion.
The use of collaborative writing in the experimental
group resulted in a difference on the posttest scores
between poetry groups with and without collaborative writing
which was significant (p > .05). These findings support
those of Mazza (1981; 1994) and are consistent with reports
by Hynes and Hynes-Berry (1986), Gorelick, (1989), and
Yochim (1994).
Summary
This research suggests that the use of collaborative
writing resulted in a significant difference in Cohesion on
the Group Environment Scale for poetry therapy groups.
Therefore, the use of collaborative writing appears to make
a significant difference in group cohesion for poetry
therapy groups. These results are consistent with previous
research on cohesion and poetry therapy (Ross, 1977; Mazza,
1981).
Descriptive Reports
Participants in this study were invited to keep a
journal of their experiences in with poetry therapy groups.
Most of the journals began with comments expressing
discomfort with poetry or unfamiliarity with the technique
of poetry therapy. This was also found in Mazza's
dissertation research.
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Later journal entries by participants expressed
enhanced comfort with the technique of poetry therapy. In
addition, participants expressed greater comfort with each
other and with poetry therapy sessions.
Many of the early journal entries reflected verbal
comments during initial sessions which expressed discomfort
with the writing process and the idea of writing poems.
Later entries suggested that participants became more
comfortable with both individual and collaborative writing.
By the end of the treatment groups, participants requested
copies of the poems written during the group, suggesting
greater comfort with their writing.
Preexisting Poems
The preexisting poems chosen for this study consisted
of 6 poems used in Mazza's dissertation research and 6 poems
chosen by the group leaders. Leaders therefore had access
to 12 poems for the 6 poetry therapy group sessions. The
leaders agreed to begin with the same poem and chose "If I
Should Take Off This Tattered Coat" (Crane in Dore, Ed.,
1970) because of its non-threatening subject matter and its
open endedness. Leaders then chose the poems for the
remaining 5 sessions based on their assessment of the
previous session and the mood of the group during the
current session. This type of flexibility in the literature
selection was used based on recommendations by Brown (1977)
and Mazza (1981) since the selection of appropriate
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literature is dependent on the facilitator's assessment of
group dynamics, group goals, and the moods of the group
members.
Collaborative Writing
The use of collaborative writing in the experimental
groups was the independent variable in this study.
Participants in the experimental control groups were handed
copies of a preexisting poem and were invited to discuss the
poem (see Table 2). A copy of one of these poems, "Warning"
(Joseph in Martz, Ed., 1987) has been included as a sample
(see Appendix D) with permission from her literary agent
(Elizabeth Fairbairn, personal communication, July 08,
1994). Participants were then handed copies of the
preexisting poem in which select nouns and verbs were
omitted, a variation on sentence completion writing
exercises (see Appendix E). The participants shared some of
their lines with the group and then the group leader
initiated a collaborative writing exercise in which
participants were invited to contribute lines from their
individual poems to create a collaborative poem. The group
leader used a blank copy of the preexisting poem with words
omitted which had been passed out for the individual writing
exercise (See Appendix E). The members took turns
contributing words or lines as they wished and the group
leader write down their contributions and then read the poem
aloud (See Appendix G).
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Copies of the group poem were distributed at the next
session and group members were invited to comment on the
poem before the leader passed out copies of the preexisting
poem for that session.
Both of the group leaders expressed initial difficulty
in getting the group members to engage in the writing of the
group poem. Group leaders reported that participants became
increasingly comfortable with the group poem with each
session.
Cohesion
Literature on the relationship between cohesion and
poetry therapy groups has been both research oriented and
anecdotal. In 1977, Ross conducted dissertation research in
which 33 patients from a psychiatric institute were divided
up into poetry and non-poetry groups. Both the posttest
scores on the Group Environment Scale (Moos and Hanson,
1974) for Cohesion and self-reports by group members
indicated that poetry therapy groups had greater cohesion
than non-poetry groups.
In 1981, Mazza conducted dissertation research on 32
undergraduates in an intact classroom. Participants were
divided into poetry and non-poetry groups and evaluated for
group process variables including cohesion. The poetry
groups used a combination of preexisting and collaborative
poems. The poetry groups reported higher cohesion scores on
the Group Environment Scale than non-poetry groups. In
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addition, feedback from participants cited the use of
collaborative writing as contributing to group cohesion.
In 1985, Mazza and Prescott utilized preexisting poems
and music in combination with collaborative writing in
therapy groups with students at a university counseling
center. The groups, consisting of six members, met for seven
one and a half hour sessions. The authors found a parallel
between themes expressed in the collaborative poems and
stages of the group process as defined by Garland, Jones,
and Kolodny (cited in Mazza and Prescott, 1985, p. 65).
They concluded that the writing of collaborative poems at
the end of each session and the distribution of typed copies
of collaborative poems from previous sessions at the
beginning of each session was useful in providing a sense of
continuity between sessions. The use of collaborative
writing seemed to enhance and reflect group process.
The relationship between poetry therapy and cohesion as
one of Yalom's curative factors has been discussed by
Goldstein (1989) and Cohen (1989). Mazza and Prescott
(1981) observed that the use of collaborative writing
resulted in group cohesion in clients at a university
counseling center. Gorelick (1989) reported an increase in
cohesion when collaborative writing was used with a group of
institutionalized men. Chase (1989) emphasized the
interreliance which developed between members of a group in
a mental hospital as a result of collaborative writing.
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Yochim (1994) used collaborative writing in her work with
patients at a psychiatric unit.
Cohesiveness, of course, is an important issue in any group, but most especially on a psychiatric unit where staff is working toward encouraging individuals to participate, initiate, and interact appropriately. The collaborative poem accomplishes much towards this goal and aids in the pleasure of group process and effectiveness, (p.146)
The value of collaborative writing as an aid to
cohesion is discussed by Hynes and Hynes-Berry (1986) and is
a technique often employed in poetry therapy groups. In an
article in the Journal of Poetry Therapy suggesting research
areas for research in poetry therapy, Mazza (1994) indicated
that collaborative poems increase cohesion and reflect group
development. Mazza emphasized the need for additional
research on collaborative writing.
In the present study, previous findings regarding a
positive relationship between cohesion and poetry therapy in
general and collaborative writing in particular were
supported. The posttest scores on the Group Environment
Scale (1974) were the main measures of group cohesion for
the poetry therapy groups. In addition to this instrument,
journals kept by participants suggested increases in group
cohesion, as evidenced by journal entries which expressed
increasing comfort with the poetry therapy groups and with
the leaders.
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The leaders also observed greater cohesion in the
groups from earlier to later sessions based on the increased
verbal participation of the group in discussing the
preexisting poem, sharing individual writing, and engagement
in the collaborative writing of a group poem.
Implications
Limitations
Although the sample size used in this study is
acceptable for experimental studies and is similar to that
of other empirical studies (Ross, 1977; Mazza, 1981), a
larger sample size might have allowed the results to be more
readily generalizable.
While the sample used in this study was not large and
therefore not generalizable to other populations, this study
represents the third empirical study which suggests that
poetry therapy has a significant effect on cohesion. The
previous studies (Ross, 1977; Mazza, 1981) compared poetry
therapy groups to group therapy and in each case poetry
therapy had a significant effect on group cohesion. Mazza
included collaborative writing in his poetry therapy groups
and, based on observation and narrative reports, suggested
that it may have increased collaborative writing.
This study builds on this previous research. The
increase in posttest scores on Cohesion on the Group
Environment Scale for poetry therapy groups with and without
collaborative writing, while not statistically significant,
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suggest that poetry therapy, with or without collaborative
writing, increases cohesion.
The significant difference between posttest scores in
poetry therapy groups with collaborative and poetry therapy
groups without collaborative writing suggests that
collaborative writing was able to increase cohesion.
A larger sample size would also have allowed the
researcher to determine whether gender or age differences
were significant. Other factors such as race or attitudes
toward poetry and writing might also have been explored.
Another limitation of this study is related to the
research design. Since the items on the Group Environment
Scale are constructed so that it must be used after
participation in a group, the instrument was administered
after the first poetry therapy session in both control and
experimental groups. This is consistent with the way the
instrument was employed in Mazza's dissertation study
(1981). As a result, the pretest scores acquired in this
study may have already reflected cohesion which was produced
by the use of treatment in that first session. The high
pretest mean on Cohesion for the experimental group (7.38)
may have reflected the impact of the use of collaborative
writing in that very first session. High pretest scores
make it difficult to find significant differences between
pretest and posttest means. Thus, the pretest scores may
have been higher than they would have been if the pretest
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had been administered in groups which had not received the
treatment of poetry therapy. The higher pretest scores
which occurred might have explained why there was no
significant difference in pretest and posttest scores for
both control and experimental groups.
Research
Further research on group cohesion and collaborative
writing in poetry therapy groups is needed. It would be
valuable to explore the role of collaborative writing in
relation to cohesion and the role of cohesion in relation to
the other curative factors outlined by Yalom (1975).
The use of collaborative writing in poetry therapy
groups includes a variety of collaborative writing
techniques such as the writing of acrostics, sentence
completions, completing modified versions of preexisting
poems, and freewriting. A study which examines the effects
of these different techniques would be beneficial. Studies
could be done with different populations and cohesion and
other group processes could be examined. It would be
interesting to know whether some techniques work better with
developmental populations or if some are more effective with
clinical populations.
Based on Leedy's isoprinciple (1969) and research done
by Brown (1977), research on the collaborative poem as an
expression of group mood would also be valuable. A study
which measures leader's perceptions of group mood
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independent of the use of collaborative poems and with the
use of collaborative poems could establish the efficacy of
using collaborative poems as a diagnostic technique. The
use of collaborative poems as an indicator of group mood and
therefore as an aid to appropriate poetry selection for
subsequent sessions could also be explored.
Another area which could use additional research is the
dynamics of reader response theory within the context of
group poetry therapy. The influence of the group's
perception of the leader's selection of the literature could
be examined as well as the influence of group members'
interpretations of the literature. Reader response theory
in poetry therapy groups could be explored in relation to
variables such as creativity, self-expression, and mood.
Reader response theory could also be used to increase
understanding of the works created as a result of
collaborative writing. A content analysis could be used to
evaluate recurring words, images, or themes in collaborative
writing.
Research on the effect of poetry therapy and
collaborative writing on behavior change also needs to be
done. Much of the literature on poetry therapy and behavior
change remains anecdotal (Mazza, 1994).
In addition, since the Group Environment Scale in this
study was administered after the first treatment session and
the scores may have reflected the impact of the poetry
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therapy treatment, future studies might be done in which the
pretest is administered after a group session introducing
the study, but before poetry therapy treatment sessions have
begun.
Practice
The results of this study support previous anecdotal
and experimental studies which suggest that the use of
poetry therapy seems to enhance group cohesion. Since
cohesion has been identified as a necessary condition for
therapeutic growth, the use of poetry therapy appears to be
an important modality in counseling both developmental and
clinical populations. The increase in cultural diversity
combined with scarce allocation of resources in many school
and institutional settings has resulted in more
heterogeneous counseling and therapy groups. Persons with
differing communication abilities and developmental and
clinical needs are often combined in heterogeneous groups.
The use of poetry therapy with or without collaborative
writing might be used as a modality to increase feelings of
cohesion among dissimilar group members.
In addition, the use of collaborative writing as a
poetry therapy technique appears to be beneficial to both
group participants and leaders. The act of writing a group
poem provides a common experience for the group and appears
to express group mood and theme as well as to enhance
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cohesion and other aspects of group process (Mazza, 1981;
Mazza and Prescott, 1985).
Summary and Conclusion
In summary, this study supports previous research which
indicated that poetry therapy has a positive effect on group
cohesion and the use of collaborative writing enhances this
effect. The increase in posttest scores on the Cohesion
subscale of the Group Environment Scale was significant for
poetry therapy groups using collaborative writing.
Observations by group leaders as well as journals by
participants supported the results of the quantitative
research. These results are consistent with previous
research which has been done in this area.
In conclusion, while further research is needed, it
appears that poetry therapy and collaborative writing hold
promise as therapeutic techniques.
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116
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Agreement to Participate in Research Study
This research study deals with how people relate to one
another in poetry therapy groups. The research study
consists of participation in six consecutive one-hour poetry
therapy sessions. The groups will be developmental in
nature, and poetry will be used to guide participants in
self-growth and self-exploration. Participation in a group
is considered a normal educational practice in a group
counseling class. According to The Ethical Guideleines for
Group Counselors and Professional Standards for Group
Practice. "Training for group leaders should include
practice, including observation and participation in a
group, whihc couuld include a classroom group."
In addition to participating in six group sessions,
participants should also attend a pretreatment session and a
posttreatment session. The research study will take place
within the structure of a Group Counseling class at the
University of the District of Columbia, but participation in
the study or the decision not to participate in the study
will in no way affect grades in the Group Counseling class.
Participants can choose to opt out of the study at any time.
In addition to attending the sessions, participants
must agree to take the Moos Group Environment Scale which
measures group interactions at the beginning and at the end
of the group sessions. The Group Environment Scale is a
paper and pencil instrument which can be completed in about
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ten minutes.
The names of participants will not be used in reporting
the findings and the identity of the participants in this
study will be kept confidential. Social security numbers
instead of names will be used on the Moos GES data sheet to
protect confidentiality and anonymity. Only the researcher
will have access to the date linked to social security
numbers and all data will be destroyed after a reasonable
amount of time. Participant involvement in this study will
assist in furthering knowledge of poetry therapy as a group
therapy modality.
I agree to participate in this study.
Signature of Participant
Signature of Researcher
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PRE-TREATMENT INTRODUCTION
TO POETRY THERAPY
119
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INTRODUCTION TO POETRY THERAPY
Definition
"Poetry therapy is a therapy modality employing poetry
and other forms of evocative literature to achieve
therapeutic goals and personal growth."
National Association for
Poetry Therapy
Modality
o Poetry therapy is a recognized therapeutic
technique
o Utilizes literature to provide a model for
alternative, healthy behavior
o Non-threatening intervention where clients
disclose at their own comfort level
o Uses literature as a springboard for creative
self-expression
o Encourages clients to develop empathy for others
o Counselor can use poetry therapy in conjunction
with his or her own counseling orientation
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GROUND RULES FOR POETRY THERAPY GROUP SESSIONS
1) Group participation is voluntary and participants
can stop the group at any time
2) Participation in the groups will in no way affect
academic course grades
3) Group members should agree to meet for six one-
hour sessions
4) Group members should try to attend all sessions
5) Group sessions are confidential, and all
participants agree to respect the privacy rights
of each member
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POST-TREATMENT DISCUSSION OF POETRY THERAPY
122
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APPROPRIATE SELECTION OF LITERATURE IN POETRY THERAPY
o Literature selected should be compatible with
group goals
o Conveys caring and support to the group
o Emphasizes feelings and therefore encourages
clients to share feelings
o Includes literature which offers hope and
alternative, healthy behaviors
o Does not emphasize feelings of hopelessness of
helplessness
Based on guidelines in Hynes, A. & Hynes-
Berry, M. (1986). Poetrv/bibliotherapv: The
Interactive Process. A handbook. New York:
Westview Press.
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SAMPLE POEM
124
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WARNING*
When I am an old woman I shall wear purple
With a hat which doesn't go, and doesn't suit me
And I shall spend my pension on brandy and summer gloves
And say we've no money for butter
I shall sit down on the pavement when I'm tired
And run my stick along the public railings
And make up for the sobriety of my youth.
I shall go out in the rain
And pick the flowers in other people's gardens
And learn to spit.
You can wear terrible shirts and grow more fat
And eat three pounds of sausages at a go
Or only bread and pickle for a week
And hoard pens and pencils and beermats and things in boxes.
But now we must have clothes that keep us dry
And pay our rent and not swear in the street
And set a good example for our children
We must have friends to dinner and read the papers.
But maybe I ought to practice a little now?
So people who know me are not too shocked and surprised
When suddenly I am old, and start to wear purple. -Jenny Joseph
* Printed with permission from Ms. Joseph's literary agent, Elizabeth Fairbairn 7/94
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MODIFIED VERSION OF SAMPLE POEM
126
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. WARNING
When I am I shall wear
With a which doesn't go, and doesn't suit me
And I shall spend my pension on and
And say we've no money for
I shall sit down on the when I'm tired
And run my along the
And make up for the of my youth.
I shall go out in the
And in other people's
And learn to
You can wear and grow more
And eat of at a go
Or only and for a week
And hoard and and and in boxes.
But now we must have that keep us
And pay our and not
And set a good example for
We must and
But maybe I ought to practice a little now?
So people who know me are not too shocked and surprised
When suddenly I am and start to
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SAMPLE OF INDIVIDUAL WRITING
128
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When I am an old woman I shall wear long Victorian „ flr.ass.gs> With a shawl which doesn't go, and doesn't suit me
And I shall spend my pension on chocolates and lace
And say we've no money for bread
I shall sit down on velvet cushions
And run my stick along the sidewalk
And make up for the sobriety of my youth.
I shall go out in the rain without an umbrella
And pick the flowers in public gardens
And learn to sing.
You can wear anything vou want
And eat three pounds of chocolate ice cream at a go
Or only scones and cream for a week
And hoard jewels and buttons and photographs and things in boxes.
But now we must be more serious
And pay our rent and not be late with our bills
And set a good example for our clients
We must be responsible and not get too carried awav.
But maybe I ought to practice a little now?
So people who know me are not too shocked and surprised
When suddenly I am old, and start to wear long Victorian dresses.
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SAMPLE OF COLLABORATIVE WRITING
130
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WARNING
When I am an old spirit I shall wear red
With a disposition which doesn't go, and doesn't suit me
And I shall spend my pension on unity and love
And say we've no money for war.
I shall sit down on life
And run my stick along the living
And make up for the sobriety of my youth.
I shall go out in the rain
And pick the flowers in the vallev
And learn to love again.
You can wear uniqueness
And eat thee pounds of disrespect at a go
Or only hate and misery for a week
And hoard shame and blame and ignorance and things in boxes.
But now we must live
And pay our rent and not pine
And set a good example for the universe
We must toil and carry the yoke of our children.
But maybe I ought to practice a little now?
So people who know me are not too shocked and surprised
When suddenly I am old and start to wear red.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. WORKS CITED
Adams, K. (1990). Journal to the self: Twentv-two paths to personal growth. New York: Vintage Books, Inc.
American Association for Counseling and Development (1988). Ethical standards. Alexandria: Author.
Association for Specialists in Group Work. (1989). Ethical guidelines for group counselors and professional standards for the training of group workers. Alexandria, Author.
Beach, R. (1993). Reader-response theories. Urbana: National Council of Teachers of English.
Bell, G. (1982). Poetry therapy. The arts in psychotherapy. 2, (l), pp. 25-30.
Berger, A. & Giovan, M. (1989). Poetic inteventions with forensic patients. Journal of poetry therapy. 4 (2), pp. 83-92.
Bergler, E. (1950). The writer and psychoanalysis. New York: Doubleday and Co.
Bleich, D. (1975) Readings and feelings: An introduction to subjective criticism. Urbana: National Council of Teachers of English.
Block, J., Mott, J.R., Swanson, J., and Wallace, C. (1992). The healing "1.11 Gainesville: The Write Solutions.
Borg, W. & Gall, M. (1983). Educational Research. New York: Longman Inc.
Bosweld, J. (1994). Topics for getting in touch: A ooetrv therapy sourcebook. Johnstown: Pudding House Publications.
Brand, A. G. (1979). The uses of poetry in psychotherapy. Journal of humanistic psychology. 19. (4), pp. 53-72.
Brier, Bob (1980). Ancient Egyptian magic. New York: William Morrow and Co., Inc.
Brown, D. H. (1977). Poetry as a counseling tool: The relationship between response to emotion oriented poetry and emotions, interests, and personal needs. Dissertation Abstracts International.
132
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 3 3
Butler, T. and A. Fuhriman. (1980). Patient perspectives on the curative process: A comparison of day treatment and oupatient psychoherapy groups. Small group behavior. 11 (4), Nov. 1980, pp. 371“ 388.
Campbell, D. in Buros, O., ed. (1978). T.h.e ei.gh.th .mental. measurements yearbook. Highland: The Gryphon Press.
Campbell, D.T. & Stanley, J. C. Experimental and quasi- experimental design for research. Chicago: Rand McNally, 1963.
Campbell, 0. J., Van Gundy, J. & Shrodes, C. (1940). Patterns for living. New York: Macmillan.
Cappachione, L. (1979). The creative journal. North Hollywood: New Castle Publishing Co., Inc.
Cappachione, L. (1989). The well-being journal. North Hollywood: Newcastle Publishing Co., Inc.
Chaliff, C. (1973) Emily Dickinson and poetry therapy: The art of peace, pp.24-29. In Poetry the healer. J. J. Leedy, (Ed.), Philadelphia: Lippincott.
Chase, K. (1989). About collaborative poetry writing. Journal of poetry therapy. 2, 97-105.
Chavis, G. (1985). The therapeutic power of poetry. Spotlight: The Minnesota Rehabilitation Association Newsletter, 5 (6), p .5.
Cohen, L. J. (1989). Reading as a group process phenomena. Jpu;nial__Q.f.jap.etpy..therapy - 2 (2), pp.73-83.
Cohen, L. J. (1992). Bibliotherapv: The experience of therapeutic reading from the perspective of the adult reader. Unpublished dissertation, New York University. Dissertaton Abstracts International.
Corey, M. & Corey, G. (1987). Groups. Process and practice. Pacific Grove: Brooks/Cole Publishing.
Crane, S. If I should cast off this tattered coat. (1970). In Dore, A. (ed.), The premier book of maior poets. Greenwich: Fawcett Publications.
Curtis, M. in (1985). Mitchell, J., ed., TJhg_.nilltlh-mejn.tal. measurements yearbook. Lincoln: The Buros Institute.
Denberg, Ken. (1990). Poetry in the prisons: Coming back up with light. jflHmal-Qf pp-airy therapy> A (i), 21-26.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 3 4
DeMaria, M. (1990). Poetry and the abused child: The forests and the tinted plexiglass. Journal of poetry therapy. 2, 79-93.
Drescher, S. and G. Burlingmae’,-and A. Fuhriman. (1985). Cohesion: An odyssey in empirical understanding. Small group behavior. l£, (1), pp.3-30.
Edgar, K. F., Hazley, R. & Levit, H.I. (1969). Poetry therapy with hospitalized schizophrenics. In J. J. Leedy (Ed.), Poetry therapy. (pp. 29-37). Philadelphia: J. B. Lippincott.
Edgar, K. F., Hazley, R. (1969). Validation of poetry therapy as a group technique. In J. J. Leedy (Ed.), Poetry therapy pp.111-123. Philadelphia: J. B. Lippincott.
Evans, N. and P. Jarvis. (1980). Group cohesion: A review and evaluation. Small group behavior. 11 (4), pp. 359-370.
Evans, N. And P. Jarvis. (1986). The group attitude scale: A measure of attraction to group. Small group behavior. 12 (2), May, pp. 203-216.
Felman, S. (1978). Writing and madness, (trans. by M.L. Evans and S. Felman) Ithaca: Ithaca University Press.
Festinger, L., S. Schecter, and K. Back (1950). Social pressur_e_s_J.n informal groups. New York: Harper and Row.
Fish, S. (1970). Literature in the reader: Affective stylistics. New literary history. 2, (1).
Frank, J. D. (1973). Persuasion and healing, (rev. ed.) New York: Shocken.
Freud, S. (1908). The relation of the poet to daydreaming. In J. Riviere (trans.) Collected papers of Sigmund Freud. (Vol. 4). New York: Basic Books.
Friebert, S. In Behn, R. and Twetchell, C. (1992). The practice of poetrv. New York: Harper Collins.
Fuhriman, A., S. Dresher, E. Hanson, R. Henrie, and W. Rybicki. (1986). Refining the measurement of cohesiveness: An empirical approach. Small group b eh a v i o r, 1Z (2), pp. 186-201.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 3 5
Gorelick, K. (1989). Poetry on the final common pathway of the psychotherapies: Private self, social self, self- in-the world. Journal of ooetrv therapy 3 (l) pp. 5-18.
Gladding, S. (1985). Counseling and the creative arts. Counseling and human dev.Qlppmgnt , 1 8 , p- 1-12. Gladding, S. (1992) Counseling as an art: The creative arts in counseling. Alexandria: American Counseling Association.
Goetzel, R., Shelov, S. & Croen, L. (1984). Evaluating self- help support groups for medical students. Journal of medical education. £9, 331-340.
Goldstein, M. (1989). Poetry and therapeutic factors in group therapy. Journal of poetry therapy. 2, 231-241.
Griefer, E. (1963). Principles of poetry therapy. New York: Poetry Therapy Center, 1963.
Gross and Martin in Evans, N. and P. Jarvis. (1980). Group cohesion: A review and evaluation. Small group behavior. H (4), pp. 359-370.
Harrower, M. (1972). The therapy of poetry. Springfield, IL: Charles C . Thomas.
Holland, N. (1968). The dynamcis of literary response. New York: Columbia University Press.
Holland, N. (1973). Poems in persons. New York: Columbia University.
Hynes, A. (1981). Some observations on process in biblio/poetry therapy. The arts in psychotherapy. &, pp. 237-241.
Hynes A. & Hynes-Berry, M. (1986). Bibliotherapy: The interactive process. A handbook. New York, Westview Press.
Jaskowski, H. (1980). Poetry, poetics, and the poetry therapist. The arts in psychotherapy. 2 (4), pp. 75-79.
Joseph, Jenny. (1987). Warning. In Martz, Sandra (Ed.). When I am an old woman I shall wear purple. Watsonville: Paper Mache Press.
Jung, C. G. (1966). On the relation of analytical psychology to poetry. In The spirit in man, art. and
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 3 6
literature, pp. 65-83. (Hull, R. F. C., Trans.). Princeton: Princeton University Press. (Original work published 1931)
Jung, C. G. (1966). Psychology and literature. In The spirit in man, art. and literature, pp. 84-105. (Hull, R. F. C., trans.) Princeton: Princeton University Press. (Original work published 1950)
Jung, C. G. (1966). Ullysses: A monologue. In The spirit in man, art. and literature, p. 128. (Hull, R. F. C., trans.) Princeton: Princeton University Press. (Original work published 1934)
Keister, D. J. (1977) In Ross, D. L. D. Poetry therapy versus traditional supportive therapy: A comparison of group process. Unpublished dissertation. Dissertation Abstracts International.
Koch, E. (1990). Rose, where did vou get that red? Teaching great poetry to children. New York: Vintage Books.
Koch, K. (1977). I never told anybody: Teaching poetry writing in a nursing home. New York: Random House.
Lack, C. R. (1082). Biblio-poetry therapy with acute patients. The arts in psychotherapy. 2, pp. 291-295.
Lauer, R. & Goldfield, M. (1970). Creative writing in group therapy. Psychotherapy; Theory, research, and practice. 2 (4), 248-252.
Lawler, J. (1972). Poetry therapy. Psychiatry. 35. 227-237.
Leedy, J. J. (Ed). (1969). Principles of poetry therapy. In J.J. Leedy, Poetry therapy. Philadelphia: J.B. Lippincott.
Leedy, J.J. (Ed). (1973). Poetry the healer. Philadelphia: J . B . Lippincott.
Leedy, J.J. (ed.) (1985). Poetry as healer: Mending the troubled mind. New Jersey: Vanguard.
Lerner, A. (1975). Poetry as therapy. APA Monitor. 9-10, 4.
Lerner, A. (1976). An Editorial: A look at poetry therapy. The arts in psychotherapy. 2, pp. i-ii.
Lerner, A., ed. (1978). Poetry in the therapeutic experience. New York: Pergamon Press.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 3 7
Lerner, A. in Lippin, R. Poetry and poetry therapy: A conversation with Art Lerner. The arts in psychotherapy, 2, pp. 167- 174. Lesser, S. 0. (1962). Fiction and the unconscious. New York: Vintage Books.
Lessner, J. W. (1974) The poem as catalyst in group counseling. Personnel and Guidance Journal. 53, (2), 33-38.
Libo, L. M. in Evans, N. and P. Jarvis. (1980). Group cohesion: A review and evaluation. Small group behavior. H (4), pp. 359-370.
Lieberman, H. A., I. D. Yalom, & H. B. Mules (1973). Encounter groups: First facts. New York: Basic Books.
Littlepage, G., L. Cowart, and B. Kerr. (1989). Relationships between group environment scales and group performance and cohesion. Small group behavior. 2 0 (1), pp.50-61.
Margolis, G. F. (1971). The use of poems in cousneling theory and practice. Unpublished dissertation. Dissertation Abstracts International.
McGrath, J. (1977). In Ross, D. L. D. Poetry therapy versus traditional supportive therapy; A comparison of group process. Unpublished dissertation. Dissertation Abstracts International.
Mazza, N. (1981). Poetry and Group Counseling: An Exploratory Study. Unpublished Doctoral Dissertation, Florida State University. Dissertation Abstracts international. 42, (6A) 2505 ISSN 04194209.
Mazza, N. (1988). Poetry and popular music as adjunctive psychotherapy techniques. In P.A. Keller & S.R. Heyman (Eds.). Innovations in clinical practice. 2, (pp. 485-494). Sarasota: Professional Resource Exchange.
Mazza, N. and Prescott, B. U. (1981). Poetry: An ancillary technique in couples group therapy. American journal of family therapy, £, pp. 53-57.
McGrath, J. (1977) In Ross, D. L. D. Poetry therapy versus traditional supportive therapy; A comparison of group process . Unpublished dissertation. Dissertation Abstracts International.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 3 8
McKinney, F. (1976). Free writing as therapy. Psychotherapy; Theory, research, and practice. 11 (2), pp. 183-187.
Moos, R. & Humphrey, B. (1974). Group Environment Scale Form E* Palo Alto: Consulting Psychologist Press.
Moos, R. (1986). Group environment scale manual. Palo Alto: Consulting Psychologist Press.
Nezu, M. in Corroley, J. & Karamer, J. (1989). The tenth mental measurements yearbook. Lincoln: University of Nebraska-Lincoln.
National Association for Poetry Therapy (1993a). Membership brochure. Port Washington: Author.
National Association for Poetry Therapy. (1993b). Training manual. Port Washington: Author.
Peris, F.S., Hefferline, R.F. & Goodman, P. (1971). Gestalt therapy; Excitement and growth in the human personality. New York: Julian Press.
Pies, R. (1987). Poetry therapy in the treatment of borderline personality disorder. Journal of poetry therapy. 1 (2), pp. 88-94.
Prescott, F. (1922). The poetic mind. New York: The Macmillan Co.
Prince, (1973). Introduction to the study of the narrattee. Poetique, 14.
Progoff, I. (1975). At a journal workshop. The basic text and guide for using the intensive journal. New York: Dialogue House.
Progoff, I. in Brand, A. G. (1979). The uses of poetry in psychotherapy. Journal of humanistic psychology. 19, (4), pp. 53-72.
Ranee, C., Price, A. (1973). Poetry as a group process. American journal of ocupational therapy. 27, pp. 252- 255.
Rank, 0. (1932). Art and artist. New York: W.W. Norton Co.
Rice, P. and Waugh, P, (Eds.) (1989). Modern literary theory; A reader. New York: Routledge, Chapman, and Hall.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 3 9
Rolfs, A. and S. Super. (1988). Guiding the unconscious: The process of poem selection for poetry therapy groups. The arts in psvchothrapv. 15., pp. 119-126.
Robins, A. & Sibley, L. (1976) in Talbott-Green M. (1988). A comparative study of feminist group psychotherapy and poetry therapy as an adjunctive treatment to increase self-actualization. Dissertation Abstracts International. 8820360.
Rogers, C. (1967). The process of the basic encounter group. In J.F.G. Bugetal (Ed.), Challenges of humanistic psychology. New York: McGraw Hill, 1967.
Ross, D. L. D. (1977). Poetry therapy versus traditional supportive therapy: A comparison of group process. Unpublished dissertation. Dissertation Abstracts International.
Rossiter, C., Brown, R., & Gladding, S. (1990). A new criterion for selecting poems for use in poetry therapy. Journal of poetry therapy. A (1), 5-11.
Rossiter, C. (1992). Commonalities among the creative arts therapies as a basis for research collaboration. Journal of Poetry therapy. 5 (4), pp. 227-235.
Rubin, R. J. (ed.) (1978). Bibliotherapv sourcebook. Phoenix: Oryx Press.
Schauffler, R. H. (1925). The poetry cure: A pocket medicine chest of verse. New York: Dodd, Mead, and Co.
Schloss, G. A. (1976). Psvchopoetrv: A new approach to self- awareness through literature. New York: Grossett and Dunlap.
Schloss and Grundy in Lerner, A. ed., (1978). Action techniques in psychotherapy. In Poetry and the therapeutic experience. pp. 81-96. New York: Pergammon.
Shelley, P. B. In Prescott, F. (1922). The poetic mind. New York: The Macmillan Co.: Prescott, (1922).
Shrodes, C. (1949). Bibliotherapv: a theoretical and clinical experimental study. Ph.D. diss., University of California, Berkeley.
Shrodes, Van Gundy, & Husband, (1943) Psychology through literature. An anthology. New York: Oxford University Press.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 4 0
Silverman, H. L. (1986). Poetry therapy. The arts in psychotherapy. 13, pp.343-345.
Slatoff, W. (1988) In Talbott-Green, M. A comparative study of feminist group psychotherapy and poetry therpay as an adjunctive treatment to increase self-actualization. Dissertation Abstracts International. 8820360.
Spotnitz, H. (1977). In Ross, D. L. D. Poetry therapy versus traditional supportive therapy: A comparison of group process. Unpublished dissertation. Dissertation Abstracts International.
Stokes, J. (1,83). Components of group cohesion. Small group behavior. 14. (2), May, pp. 163-173.
Talbott-Green, M. (1988). A comparative study of feminist group psychotherapy and poetry therpay as an adjunctive treatment to increase self-actualization. Dissertation Abstracts International. 8820360.
Toro, P. & Rappaport, J. (1985). Social climate comparison of mutual help and psychotherapy groups. Paper presented at the annual convention of the American Psychological Association, Los Angeles, Ca.
Wadeson, H. (1981). Self-exploration and integration through poetry. The arts in psychotherapy, a, pp. 225-236.
Wenz, K., and McWhirter, J.J. (1990). Enhancing the group experience: Creative writing exercises. Journal for specialists in group work. 15. 37-42.
Whitaker, J. F. (1987). The use of poetry in psychiatry. In Morrison, M. P. (Ed.), Poetry as therapy p p . 195-204. New York: Human Sciences Press.
Wilcox, M. R. (1980). Variables affecting group mental health consultation for teachers. Professional psychology. 11f pp. 728-732.
Williams, M.B. (1991). Verbalizing silent screams: The use of poetry to identify the value systems of adult survivors of childhood sexual abuse. Journal of poetry therapy, 5. (i), 5-20.
Wordsworth, W. W. (1962). Preface to lyrical ballads. In Norman, C. (Ed.), Poets on poetry, pp.136-158. New York: The Free Press. (Original work published in 1800).
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 4 1
Yalom, I. D. (1975a). The theory and practice of group psychotherapy (2nd ed.). New York: Basic Books, 1975.
Yalom, I. D. (1975b). The written summary as a group therapy technique. Archives of genral psychiatry, 32, 605-613.
Yochim, K. (1994). The collaborative poem and inpatient group therapy: A brief report. The journal of poetry therapy 2 (3), pp. 145-149.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.