A Content Analysis of Person-Centered

Expressive Therapy Outcomes

Charles Merrill
Department of Psychology
Sonoma State University, Rohnert Park, CA 94928
Svend Andersen
Psychological Laboratory
Copenhagen University, Copenhagen, Denmark

(Originally published in The Humanistic Psychologist, Volume 22, Number
3, Autumn 1994)

Introduction

This study was based on the work of Natalie Rogers, the founder and director of the

Institute for Person-Centered Expressive Therapy. The institute offers a two year program

consisting of four levels and offers training for professionals who want to include

expressive arts in their therapeutic and/or educational work.

The program combines visual art, movement, dance, music, drama, writing, guided

imagery and meditation along with more traditional forms of individual and group

processes. The philosophical and pragmatic approach of Carl Rogers is integrated with the

expressive art modes, placing the person at the center of his/her learning. Qualities such as

empathic understanding, acceptance, and congruence are emphasized.

By combining different expressive modes, a process may evolve for releasing

more of a person's creative potential. Natalie Rogers' (1985b) theorizes that writing

improves our thinking, painting changes our feelings, movement integrates our body,mind,

spirit, and sound opens us to channels of energy.

Creativity is fostered when the facilitator permits the individual complete freedom to

express feelings in symbolic form. She calls the process the " creative connection", and

has a forthcoming book which will explore more fully the principles involved.

We, the researchers, found it important to give voice to participants who have

frequented the programfrom 1985 through 1991. We met while participating in the first

level of training during the summer of 1987. Although we were concerned about being

influenced by the "halo effect" we did not begin this study until 1990, and used each other

as informal reliability checks while analyzing the collectedresponses of participants.

Description of Participants

Participants were comprised of educators, therapists, health professionals, and

graduate students from the United States, Europe, South America, and Japan. The unusual

and varied backgrounds of persons in the training workshops was one of the reasons we

were interested in conducting thisoutcome study.

The age ranges of therespondents were from twenty-two to sixty-six. Twenty of

the thirty-tworespondents (66%) ranged between thirty-six and fifty.

Methodology

Workshop participants were asked to describe, in their own words, their experience of the

expressive therapy training. The plan of the study was to invite participants to describe on

an open ended questionnaire which was mailed to their home address, a situation in one of

their workshop sessions that stood out as especially meaningful to them. They were

specifically asked to reflect on hoe the remembered situation was meaningful to them. We

wanted to know if a remembered workshop incidentencouraged former participants to

have a reflective inner dialog with themselves. What we meant by inner dialoguewas the

possibility that critical incidents happening for participants may have given new meaning to

their personal lives. We were also interested in knowing whether participants' behavior

changed from their reported workshop experience.

A second question asked respondents to reflect how their "way -of-being" may be

related to their personal learnings. With such a question, we were hoping for an indication

of deeper level personal change. One additional question asked for feedback on how

writing about their experiences made them feel. The thirty two respondents were enough to

give a range of significant workshop situation.

Limitations of the Study

The questionnaire was mailed to two hundred former participants who had completed at

lease one of the four levels of training. No attempt was made to analyze the responses

based on levels. I was our opinion that a significant incident might happen at any one of

the levels, and the reported meaning of that particularly situation was what we were hopeful

of obtaining.

Level one was six days in length and was intense. Level two was a continuation

for an additional week. Respondents had completed at least Level one between 1985 and

1990. We wanted to limit our study to those participants who had completed their

expressive therapy training for at least one year so as to minimize any "halo effect."

We limited our analysis to the inherent structure imbedded in each written response.

Our approach was based on thematic content analysis following the phenomenological

research method of Amedeo Giorgi summarized by Donald Polkinghorne (1989). We

have been very careful not to read more into the responses and following Giorgi's

recommendation to use the words of the participants where

possible. One otherlimitation of ourstudywas that we were dealing with the

respondents memoryabout a specific situation which happened from one to several years

in the past.

Results and Discussion

We have drawn themes from the meaning units that is psychological and which

stays close to what we think the respondents meant. We began our analysis by reviewing

the activities which respondents emphasized in their written report. Exactly one half(16)

wrote about their creation of a significant drawing, painting, sculpture or collage. An

excellent example was given by one person who approacheda drawing from a process

perspective:

"When we were directed to translate our feelings into some art form I stormed
outside and started making a big angry painting. As I worked on it I felt sort of
detached and began watching myself acting on my anger to create something.
It was almost like the painting was creating me."(respondent # 17)

This excerpt suggests that a participant may express some unexplored aspect of

themselves through the art form without using words. Participants came to trust other

modes of expression and

exploration of feelings, images and possibilities. There was a valuing of whatever form a

participant chose to use as long as it did not impinge upon another person. The above cited

response to anger was expressed through the drawing and representing a more positive

relationship to this often suppressed emotion.

The next most frequent activity involved various forms of movement including

dancing alone and/or with others. The dancing might be to music, acting out a drawing, or

moving to a poem being read aloud. Seven respondents reflected upon some form of

personal experience with movement. Apowerful example of how dance can touch one at

some depth is given in the following example:

"I danced what for me was my emotional life story to that point. It was a painful
dance and one that drew me down, down, down, into profound feeling. I dared
myself....to feel the truth in its time and intensity. It was the riskiest work I have
ever done."(respondent #3)

The beauty of person-centered work through expressive therapy , is that the person

is central and has free choice what moralities well be used for self-exploration. Self-

exploration is the central principle here. Going back to Carl Rogers core conditions, the

individual will feel free to more fully express his/her own unique way of being in the

world.

We found it interesting that writing was not only narrative but included free writing,

poetry, and personal journaling. Sixparticipants referred to writing as meaningful

towards improving their self-esteem and inner strength. Below is a rich example of how

the writing process affected one person's life:

"We were....writing about a spirit guide we had met in an earlier meditation.
(After writing about her spirit guide)....They conducted a ceremony for me
in which the lesson was 'even darkness can be welcomed because I always
have myself'. This experience empowered me to take the center of my own
life in a unique way."(respondent # 10)

Sometimes the experience of writing was felt as complete in itself, and at other

times participants combined writing with another activity such as movement or some

dramatic enactment as the above example illustrates.

Sixindividuals wrote about a dramatic event such as role playing, improvisation,

gestures, masks, mime or some form of guided imagery. These modes helped them to

connect with an "inner wisdom."

An unusual example by an older participant follows:

"When Natalie led us in a drama of The Village, I became the wise old woman.
Others came to me for comfort and closeness. I liked this role; I think the process
helped me accept the fact of my ageing. I began to see myself as one who has
garnered a lot of wisdom which might be shared."(# 14)

The expressive therapy process seemed to help this woman to accept not only her

ageing but to value her life experience and she saw herself as having attained some degree

of wisdom.

Two people wrote about how music and making sounds on a rhythm and

percussion instrument was significant, andone person remembered meditation as

important. Following is an example of how one person was affected by sound and rhythm:

"playing the musical instruments, particularly the percussion ones, and creating
rhythms that fed upon each other, was energizing and satisfying. It strengthened
by belief in spontaneity and risk taking, that I could try the unfamiliar and create
something with myself and others."(#7)

The narratives show that choosing to participate in a form of creative activity helped

participants feel better about themselves. The process of creating something, participating

with others in a group or working on some solitary project gave inspiration and

encouragement to individuals to express themselves more openly and with less fear of

being judged. Expressive therapytraining provided participants with a wide range of

learning activities, and each person was encouraged to find his/her own areas of

exploration and expression and to allow the creative process to affect him/her in ways that

felt congruent with the chosen media.

In our content analysis of responses,we emphasized the self exploration aspect and

judgements were not made on the participants artistic abilities or products. We were being

consistent with the principles of expressive therapy which also emphasizes self-exploration

and following one's own direction.

Significant learnings

Carl Rogers' (1967) view of significant learning is an appropriate one in our analysis of the

meaning units

into psychological language. Rogers specifically states:

"significant learning is more than accumulation of facts. It is learning which
makes a difference in the individual's behavior, in the course of action he
chooses in the future, in his attitude and in his personality" (1967, p 167-175).

Significant learning is based on Rogers' core conditions and the person more fully accepts

his/her feelings and feels more self-confident and self-directing.

Responses analyzed on this dimension found seventeen respondents' referred to

feeling more self-accepting. One respondent reported:

"I am a different person than I might have been....This work encouraged me
to believe in myself! It gave me the courage to start my own business. It gave
me tools to fight the fears that were holding me back. (#2)

Not only were respondents more self-accepting, but six also reported they were

more accepting of others. It seems that when a person is willing to value him/her self in a

non-judgmental way, others are valued for the way they are, rather than how one expects

them to be. A telling example of accepting another follows:

"My personal life is different now, I have learned to related to other, including
my children, in a more realistic way, which of course helps me to have less
expectations towards me and others, and therefore, judge less and accept more of
what comes..." (# 30)

Another aspect of significant learning, according to Rogers, is to view oneself in a

completely new way. The person may return to his/her regular social environment, and

complete many of the same tasks, but with a major shift in perspective. We found nine

respondents who indicated they felt and saw themselves in a new way. One person put it

his way:

"When I returned home I felt really transformed. I felt much more....grounded
in this world, more sexual. My voice was deeper. I felt my center lower in my
body, around my solar plexus. I was greatly empowered...."(# 1)

Yet another respondent reported a very poignant shift in consciousness:

"As a result of a one-day workshop I got an inner image, and experience of the
part of me that is unaffected by life, the part of me complete in its 'being'.
It greatly reduced my fearwhen I felt it."(# 6)

The idea of experiencing an inner shift and seeing oneself differently after an

intense emotional experience is commonand the person will usually return to their regular

emotional state fairly quickly. In the case of these nine respondents their perspective was

maintained for a considerable time after the workshop experience. One factor involved

here is that expressive therapy work can be continued at home and through professional

associations. Since most to the participants were therapists and educators, they would be

in a good position to renew their perspective of themselves as part of theirpersonal lives.

The Creative Connection

Personal growth has been written about by many humanistic writers including

Natalie Rogers herself. In her book Emerging Woman (1980), she discloses her own inner

journey from being a dutiful wife and mother towards greater autonomy and personhood.

Natalie has been a model for many women as well as an educator and innovator of person-

centered learning.

Her writing and explorations on a process she calls the "creative connection"

(1985b) has been described by her as:

"...the connection between movement, art, writing and sound. We I movewith
awareness it opens me to profound feelings which can then be expressed incolor, line or
form. When I write immediately after movement or art work there is a free flow--
sometimes poetry--which emerges."(1985b, p. 7).

The "creative connection" involves personal development as a central tenet of the creative

process and is theoretically compatible with Carl Rogers' significant learning dimension

discussed earlier.

Several respondents reflected aspects of their learning which indirectly refer to

Natalie's construct of the "creative connection."The experience of feeling more integrated

with one's inner self was mentioned many times. Below is a powerful respondent example

which summarizes the over-arching integrative aspect of the "creative connection."

"I recall a process in which the group was led in a guided visualization. We went
within and found a door behind which were our sub-personalities. We opened
the door and let them out, encountering several and asking each who they were,
what they have to give us, and what they wanted. This process was very
integrating for me....helping me to acknowledge, hear and love these parts of
myself....(#9)

Another related dimension we found was that almost one-half (14) respondents

reported feeling self-empowered. Two participants expressed howthey were affected by

the expressive therapy experience:
"As a result of these workshops, I am much more interested in finding
my own expression and honoring it. I respect my uniqueness, even when
that uniqueness is so different from anything encouraged by the culture I live in."
(#11)

"the training opened me to the path to become a facilitator using art and
movement. I learned when we express things truly in us, we can make a deep
connection with ourselves...I think it helped me to become a more effective
facilitator..." (# 15)

Critical Feedback

A few respondents reported mixed feelings about their expressive therapy

experience. One person was bothered by some questionable ethics by the institute staff.

The person's own works are as follows:

"...in a general way, I feel I have benefitted from the experience. I also had
one unpleasant experience at the end of the workshop. However, it did
color my overall impression of the professionalism and ethics of the staff." (# 7)

Another respondent gave a less than enthusiastic response to her workshop experience.

She learned more about herself from the training, but was already well versed in personal

development moralities. She expresses it this way:

it is impossible for me to attribute a great 'AHA' to the workshop. The

workshop certainly reinforced how important is is to allow time and space
to simply 'be'."(# 5)

Although there were a few mixed statements, almost all the thirty two respondents felt

some significantchange. We do not know what the former participants who did not

respond to our questionnaire might have said.

Summary and Conclusion

The questionnaire instrument was open ended to allow for the fullest possible

response, and in a qualitative study such as this one our results were thematic based on

analyzing meaning units from the written responses. The data shows that almost all

individuals who responded to the questionnaire had apositive experience with expressive

therapy. Some of our respondents preferred drawing over movement or group activities.

Others liked more dramatic and musical activities along with dance.

Our content analysis shows that all but a few experienced some form of integration

and improved self-awareness. The accepting climate and non-intrusive facilitation enabled

participants to feel safe and yet be challenged to explore their feelings and established ways

of seeing themselves. The group experience was significant to most participants because

they felt encouraged and supported to share with othersthrough their artistic and creative

expression.

The most reported learnings ranged from greater self-confidence to less fearfulness

and more willing to risk. Finding a new inner strength and courage to create was reported

by almost all of the respondents. Although many reported feeling self-empowered to

change some external situation, the primary goal of expressive therapy is to provide a

facilitative learning climate where attitudes and beliefs can be reflected upon and examined.

A point frequently mentioned by respondents was the need for continuing

expressive therapy work after the workshop training had long ended. Several respondents

were able to continue on their own with no follow-up workshops. The Person-Centered

Expressive Therapy Institute does regularly offer follow-up workshops ranging from one

day to one week.

We support additional studies of expressive therapy work and would recommend

including in-depth personal interviews along with written responses. Based on the

interesting results of the data we had to work with, our conclusion is that expressive

therapy modes were significant in furthering transformative personal learning.

References

Brazier, David, Ed. (1993) Beyond Carl Rogers:Towards a Psychotherapy for the 21st

Century, London: Constable Publishing Company. (A more complete version of

this study is published in this book.)

Khanna, M. (1989)A Phenomenological investigation of creativity in person

centered expressive therapy. Unpublished doctoral dissertation.

University of Tennessee, knoxville.

Polkinghorne, D. E. (1989)Phenomenological Research Methods. In R.S. Valle and

Steen Halling (Eds), Existential-phenomenological perspectives in psychology.

New York:Plenum Press.

Rogers, C.R. (1969)Freedom to Learn. Columbus, Ohio:Charles E. Merrill.

Rogers, C.R. (1967)On Becoming A Person. Boston, Houghton Mifflin Company.

Rogers, N. (1988)Theory Notes. (Unpublished),Person-Centered Expressive

Therapy Institute, Santa Rosa, California 95404.

Rogers, N. (1985a)Express Yourself. Association of Humanistic Psychology,

Perspective, April.

Rogers, N. (1985b)The creative connection:A person-centered approach to expressive

therapy. (Available from Person Centered Expressive Therapy Institute, 1515

Riebli Rd., Santa Rosa, California 95404).

Rogers, N. (1980)Emerging Woman:A Decade of Midlife Transition. Point Reyes,

California:Personal Press. (Available from Person Centered Expressive Therapy

Institute, 1515 Riebli Rd., Santa Rosa, California 95404).