David A. Crenshaw, Ph.D., ABPP, RPT-S
Clinical Director, Children’s Home of Poughkeepsie
Faculty Associate, Johns Hopkins University
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Wittgenstein: “You can’t enter any world for
which you don’t have a language.”
“You can’t build loving relationships without a
language for affection” (David Whyte, 2008,
The Three Marriages, New York: Riverhead)
You can’t build therapeutic relationships
without a language for healing. Distinction
between healing and treating.
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Self-Calming Rituals
Centering Stones
“Sandy Bottom” (Siegel, Kabat-Zinn)
Creating Safe Places
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Build with materials in the room
Create in fantasy
An internal space
With Clay
In Sand
Make a collage
Family Puppet Play
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Coping with Dissociation (Yvonne Dolan)
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Counting second hands on a watch
Counting fingers
Counting books with blue jackets
Rule of 2/3rds (Kevin O’Connor)
Timing and Pacing
◦ Metaphor of Family Photo Album (Joyce Mills)
◦ Box of “unmentionables”
◦ “Garbage bag” (Beverly James)
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Affect Regulation
◦ Volcano Drawings (Eliana Gil)
◦ Storm Drawings (Rage or Terror Expression and
Modulation)
◦ Angry Monster
◦ Fire-Breathing Dragon
◦ Raging Bull
◦ “Party Hats on Monsters” (Crenshaw, 2001)
◦ Projective Drawing and Storytelling: “Blow-Up
Bernie” (Crenshaw, 2008a)
◦ “Downshifting”
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Play Strategies
◦ “Alligator goes Ballistic”
◦ “Passport Protected Coping Club”
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Cognitive Strategies
◦ Problem solving and develop laminated “Menu of
Best Coping Strategies”
◦ Problems solving and develop laminated “Menu of
Best Coping Statements”
◦ Safety Plan
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Learning the Language of Feelings
◦ Feelings Map (Drewes)
◦ Heartfelt Feelings Strategies (HFS)
◦ Expressive Cards in the Heartfelt Feelings Coloring
Card Strategies
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Education about Specific Symptoms
◦ Flashbacks (voluntary vs. involuntary subjective
experience—Jay Haley)
◦ Dissociation (when it is helpful—when it is not)
◦ Teach about Defenses (Metaphor of “Fawn in Gorilla
Suit”)
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Role Playing
Behavioral Rehearsal
Social Skills Training Groups
Empathy Training Exercises
Recognizing Social Cues
Reading Facial Expressions
Starting and Maintaining Conversations (last 3
particularly valuable with Asperger’s and NonVerbal LD, but aggressive and traumatized child,
highly anxious children as well)
Importance of Humor
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Honoring Strengths and Validation
◦ Personal symbol of Unique Genius (David Whyte)
◦ Symbols representing Strengths or Redeeming
Qualities
◦ “Badge of Ability” (Hardy & Laszloffy, 2005)
◦ Projective Drawing and Storytelling: “The Ballistic
Stallion” and “The Wise Ole Owl” (Crenshaw, 2008a)
◦ “Mountain of Strengths” (Crenshaw, 2006)
◦ “Cumulative Strength List (Mordock)
◦ “Superheroes” (Larry Rubin)
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Reframing Suffering as Basis of Strength (Ben
Furman)
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“Courage Tapes”
Stories of Sports Heroes (Crenshaw & Barker, 2008)
“Three Doors” (Door #1, Crenshaw)
Shifting Identification from Aggressor to
Empowering Helper Role (Kevin O’Connor)
Developing Capacity for Gratitude
◦ “Coins in Fountain”-An exercise in appreciation
(Crenshaw)
◦ “Giving Thanks”
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Directed Drawings
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“Inside/Outside” (Beverly James, 1989)
“Color-Your-Life” (O’Connor, 1983)
“Boat in Storm” (Oaklander, 1988)
“Your Place” (Oaklander, 1988)
“The Cave” (Crenshaw)
“Serial Drawings” (John Allen, 1988)
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Projective Drawing and Storytelling
◦ “The Misunderstood Mouse” (Crenshaw, 2008a)
◦ “The Secret Life of Nicole” (Crenshaw, 2008a)
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Clinical Use of Symbols
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Child Directed Play
◦ Symbol Association Therapy Strategies (SATS-C)
(Crenshaw, 2008a)
◦ Directed Symbol Work
◦ HFCCS (Relational Strategies)
◦ A Case Example: “Stitches are Stronger than Glue”
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Spontaneous Drawings
◦ Clinical Example: “The Dragon in the Well for 150
Years”
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Creative Writing
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Poetry
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Music
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Journal Writing
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Loss and Grief
◦ “The Magic Key” (Crenshaw, 2008a)
◦ “The Puppy in the Animal Shelter” (Crenshaw,
2008a)
◦ “The Bunny seeking her Mother” (Crenshaw, 2008a)
◦ HFCCS Relational Strategy (“Person who will be in
your heart forever”)
◦ “Heart Symbol Strategies” (Crenshaw)
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“The Linking Object” (Crenshaw, 2008a)
◦ Based on psychoanalytic writing of Volkan (1983)
◦ Rationale: Traumatic grief that the child can’t
access, detached or cut-off from feeling. This
disconnection is causing problems in the child’s
functioning and other less evocative strategies
have been tried.
◦ This is an intervention (not a strategy) that
should only be used under supervision or in close
consultation with a colleague
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Projective Drawing and Storytelling Strategies
◦ “Fourteen going on Twenty” (Crenshaw, 2006)
◦ “Mike’s Version of Russian Roulette” (Crenshaw,
2008a)
◦ “Eli and Zuko in the Land of Endless Hope”
(Crenshaw, 2006)
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Project Approach with Adolescents (unsafe
sex, dangerous driving, alcohol and drug
abuse, eating disorders, self-mutilation, and
suicidal spectrum behaviors)
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Projective Drawing and Storytelling
◦ “Jake the Boy who sit alone in the Cafeteria”
(Crenshaw, 2008a)
◦ “The Pig who Didn’t Fit” (Crenshaw, 2008a)
◦ “Behind the Closed Door” (Crenshaw, 2008a)
◦ “The Fair Trial” (Crenshaw & Mordock, 2005b)
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Soliciting Prideful Stories with Child and
Family (Fiona True, Ackerman Institute for the
Family)
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HFCCS (“Relational--Person who was once in
your heart but no longer is”)
“The Three Doors” (Door #2, Crenshaw, in
press)
Child-Directed Symbolic Play
Clinical Use of Symbols (“The 140lb. Weight
on my Back”)
Projective Drawing and Storytelling
◦ “The Tree on the Hill” (Crenshaw, 2008a)
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“Hope can be Dangerous” (Walter Bonime,
M.D. Senior Training Psychoanalyst)
“Magic Stones” (Crenshaw, 2006)
“The Three Doors” (Door #3, Crenshaw, in
press)
Scaling Techniques (Solution-Focused)
“House of Hopes, Dreams, and Promises”
(Crenshaw, 2008a)
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“Story of Jose and Pete on the Mountain”
(Crenshaw, 2006)
Countdown
Album
Talk Show
Letter
“One Last Conversation”
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“Doing” is the easy part (Crenshaw, 2006,
2008a)
Conversations with Ken Hardy, Eliana Gil, and
Garry Landreth
“Being” is much harder. It takes a certain
maturity and ripening as a therapist to
appreciate the importance of “being” as well
as to realize just how difficult it is to be fully
present in the midst of a child or family’s raw
pain (Crenshaw (ed.) 2008b
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A Plethora of Projective Drawing, and Storytelling, Directed