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Running head: ADLERIAN ASSESSMENT OF THE DEVELOPING LIFESTYLE 1

Adlerian Assessment of the Developing Lifestyle of Children Using Art and Play

A Master's Project

Presented to

The Faculty of the Adler Graduate School

_______________

In Partial Fulfillment of the Requirements for

the Degree of Master of Arts in

Adlerian Counseling and Psychotherapy

_______________

By:

April Bergstrom

_______________

Chair: Erin Rafferty-Bugher

Reader: Susan Dannen

_______________

December 2017

ADLERIAN ASSESSMENT OF THE DEVELOPING LIFESTYLE 2

Abstract

The purpose of this paper is to present a new Adlerian assessment of the developing lifestyle of

children. The assessment consists of a set of art and play directives that art therapists and play

therapists can use to gather lifestyle information. A review of the literature on how children

communicate demonstrates children prefer to communicate in holistic ways, using art and play.

Art therapy and play therapy are presented as developmentally appropriate therapies for children.

Adlerian play therapy is discussed as a well-designed, empirically-validated model for working

with children. Using techniques from Adlerian play therapy, art therapy, and questions from

formal Adlerian Lifestyle Interview templates, an Adlerian lifestyle assessment was created to be

developmentally appropriate for children and is intended for use by art therapists and play

therapists. This assessment can assist therapists in identifying maladaptive aspects of a child’s

developing lifestyle.

Keywords: art therapy, play therapy, Adlerian, lifestyle, assessment, children


Table of Contents

Abstract ........................................................................................................................................... 2

Adlerian Assessment of the Developing Lifestyle of Children Using Art and Play ...................... 4

How Children Communicate .......................................................................................................... 5

Therapy with Young Children ........................................................................................................ 7

Brain Development ..................................................................................................................... 7

Art Therapy with Young Children .............................................................................................. 8

Play Therapy Techniques ............................................................................................................ 9

Tracking ................................................................................................................................ 10

Restating content ................................................................................................................... 10

Setting limits ......................................................................................................................... 11

Returning responsibility ........................................................................................................ 11

Using metaphors ................................................................................................................... 12

Blending Art Therapy and Play Therapy .................................................................................. 12

Adlerian Play Therapy .............................................................................................................. 13

Adlerian Lifestyle Interview ......................................................................................................... 15

Eckstein ..................................................................................................................................... 15

Bartholow, Willhite, Brokaw, and Wolf ................................................................................... 16

Discovering the Child’s Lifestyle ................................................................................................. 16

The Garden................................................................................................................................ 17

Kinetic Family Drawing ........................................................................................................... 19

Kinetic School Drawing ............................................................................................................ 20

Family-Centered Circle Drawing .............................................................................................. 21

Self-Ideal/ Fictive Goal ............................................................................................................. 22

Early Recollections ................................................................................................................... 23

Conclusion .................................................................................................................................... 25

References ..................................................................................................................................... 26

Adlerian Assessment of the Developing Lifestyle of Children .................................................... 32


Adlerian Assessment of the Developing Lifestyle of Children Using Art and Play

The Adlerian Lifestyle Interview is used by Adlerian therapists to gather lifestyle

information from their clients which can be used to re-orient their lifestyles to be more functional

and socially useful (Carlson, Watts, & Maniacci, 2012). The Adlerian Lifestyle Interview is

typically used with adults, but by incorporating art therapy and play therapy into the interview, it

can be tailored to the needs and abilities of children.

Finella, Hampton, and Poulsen (2011) identified a need for more mental health services

tailored to the expressive abilities and needs of young children. One barrier to mental health

services, found by Finella, Hampton, and Poulsen, is the ability to identify young children who

need therapy services. Another identified problem to consider is that most traditional therapies

depend on the verbal expression of ideas and emotions and are not appropriate for young

children. This poses a problem in the accurate assessment of a child’s mental health needs.

Assessments that depend on the linguistic ability of the child may be invalid (Finello, Hampton,

& Poulsen, 2011). Art therapy offers a unique solution to the problem of assessment in that it is

based on non-verbal therapeutic experiences (Lusebrink, 2010). Play therapy also offers children

the opportunity to communicate in a way that comes naturally to them, through play (Willis,

Walters, & Crane, 2014). Both art therapy and play therapy support the non-verbal process for

expression and are necessary to consider for accurate assessment in child mental health.

Neuro-biological researchers Ryan, Lane, and Powers (2017) concluded interventions

that integrate sensory experiences, such as art making and play, are developmentally appropriate

for young children. However, many art therapists feel they lack the specific skills and

techniques needed to work with young children (Metzl, 2015). In contrast to art therapy, play

therapy utilizes specific models, skills, and techniques appropriate for young children (Kottman


& Meany-Walen, 2016). Many art therapists working with children integrate play therapy

techniques into their practice (Mezl, 2015).

Adlerian play therapy is recognized by the Substance Abuse and Mental Health Services

Administration as an evidenced-based practice for working with children (Kottman, 2016).

Adlerian play therapy uses art and play directives to assess and re-orient the child’s lifestyle

(Kottman & Meany-Walen, 2016). Traditional Adlerian therapists typically ask direct questions

about the client’s childhood experiences, familial relationships, and early memories (Carlson,

Watts, & Maniacci, 2012). Adlerian therapists may also utilize a formal Adlerian Lifestyle

Interview template to gather lifestyle information because it offers a standard, comprehensive set

of questions. The Adlerian Lifestyle Interview takes about two to three 45-minute sessions to

complete (Carlson, Watts, & Maniacci, 2012). An alternative version of the Adlerian Lifestyle

Interview template, utilizing children’s preferred methods of communication, would allow art

and play therapists to gather lifestyle information in a more comprehensive way.

How Children Communicate

Zubrick, Taylor, and Christensen (2015) found the linguistic abilities of young children to

vary widely and change quickly. They assessed the language ability of children at age 4, 6, 8,

and 10 years. Low language ability at age 4 was not an accurate predictor of language ability at

age 10 (Zubrick et al., 2015). This study highlights the crucial consideration of language

abilities of young children. The verbal expression of children is unpredictable at these ages and

should not be looked at as an accurate predictor of a child’s trajectory for language development,

nor used as a clinical indicator of delay for the purpose of mental health assessments (Zubrick et

al., 2015).


Children often prefer to communicate in nonverbal ways. Rice and Hoffman (2015)

found nonverbal intelligence in early childhood (3 to 5 years old) to be an accurate predictor of

future vocabulary growth and language ability. Nonverbal intelligence was measured using the

Columbia Mental Maturity Scale, which asks the child to look at several pictures and point to the

picture that is different. The child must formulate a rule for organizing the pictures based on

color, theme, and subtle relations between pictures to select which picture is different. Rice and

Hoffman suggested this nonverbal assessment may be a more accurate indicator of executive

functioning in young children than intelligence tests requiring language ability (Rice & Hoffman

2015).

Young children naturally use visual representations of their ideas to supplement verbal

expression (Guo & Mackenzie, 2015). Children use their drawings as a visual symbol or

“created sign” (p.82) to express ideas before they have mastered written language (Guo &

Mackenzie, 2015). Similarly, play is a symbolic activity that allows children to freely express

themselves by acting “as if” they are something or someone else (Šagud & Sočo, 2014).

Creative expression has been incorporated into early childhood education for years. The

Reggio Emilia approach, developed in Italy in the 1950’s, incorporates art and play into early

childhood education to encourage more meaningful expression of the unique ideas of children

(Santin & Torruella, 2017). Researchers continue to encourage early childhood educators to use

the Reggio Emilia approach (Edwards & Willis, 2000; Santín & Torruella, 2017). Similarly,

Chang (2012) demonstrated how creative expression can enhance learning in a science class.

Children were better able to express their ideas and demonstrate their understanding of science

concepts by using drawings to communicate (Chang, 2012). Researchers are finding that


children prefer to communicate in a holistic way, utilizing their art and play abilities. Tailoring

mental health services to children requires incorporating art and play expression.

Therapy with Young Children

According to Ryan, Lane, and Powers (2017) there is a need for more mental health

services tailored to young children. They stress the importance of early intervention of mental

health issues. Art therapy and play therapy are developmentally appropriate for young children

because they integrate sensory experiences, targeting the lower areas of the brain, and utilize the

natural abilities of children to express themselves through art and play (Ryan, Lane, & Powers,

2017).

Brain Development

Gaskill and Perry (2014) explained the brain develops from the bottom up and all areas of

the brain are connected by neurological pathways which originate at the bottom of the brain.

The development of the lower areas of the brain, such as the brainstem and diencephalon, effect

the development of the higher areas of the brain, such as the limbic and cortical areas which are

responsible for social, emotional, and cognitive functioning. Trauma in early childhood can

cause structural changes to lower areas of the brain, effecting the development of higher areas of

the brain. Children who have experienced trauma or attachment issues early in life may display

problematic behaviors, develop a dysregulated stress response system, have difficulty regulating

emotions, and lack appropriate social skills. To effectively treat these problems, the lower areas

of the brain need to be targeted first. These areas are activated through sensory stimuli such as

touch, vision, and sound (Gaskill & Perry, 2014). Early intervention, using therapies that

integrate sensory experiences, such as art, music, and play, can reorganize neurological pathways


and regulate stress response systems thereby creating an integrated and optimally functioning

system. (Ryan, Lane, and Powers, 2017).

Art Therapy with Young Children

Hinz (2009) described how art therapists can target lower areas of the brain and stress

response systems through kinesthetic and sensory experiences, such as pounding clay or finger

painting. Hinz also suggested incorporating rhythmic music during the art making to add the

sensory dimension of sound. The Expressive Therapies Continuum, developed by Hinz, can be

used by art therapists as a framework for targeting the lower areas of the brain with sensory and

kinesthetic experiences and then moving up to the higher areas of the brain with perceptual and

affective experiences and finally cognitive and symbolic experiences (Hinz, 2009). The

therapeutic properties of art making are supported by research (Gaskill & Perry, 2014; Ryan,

Lane, and Powers, 2017; Hinz, 2009). However, Metzl (2017) pointed out that art therapists lack

specific models, skills, and techniques needed to work with young children.

There are several well-designed research studies showing the effectiveness of specific art

therapy models with adults. Monti et al. (2013) found a mindfulness-based model of art therapy

to significantly improve the mental health of adult breast cancer survivors. Montag et al. (2014)

found open studio art therapy followed by group processing to significantly improve the mental

health of adults with schizophrenia. Kongkasuwan et al. (2016) studied the effects of art therapy

on adult stroke patients, using specific art therapy directives designed to benefit cognition,

physical state, emotion, communication, social relations, or spirituality. The art therapy

intervention improved the stroke patients’ mental health significantly. These studies all included

a specific model of implementing art therapy and provide evidence for the effectiveness of art


therapy with adults. When reviewing the literature, there are very few studies that examine the

effects of art therapy on young children.

Ziff, Ivers, and Shaw (2016) studied how creative art making effected stress levels in

elementary school children. Researchers studied 149 children ranging in age from kindergarten

to 6th grade over a time span of two years. Children participated in an open studio art group for

40 minutes once per week. Children were free to make what they wanted with the materials

provided. Researchers concluded the children showed a decrease in stress levels, measured via

body temperatures before and after the art activity (Ziff et al., 2016). This study suggested

making art lowers the stress levels of children. However, there were no art therapy directives or

processing of imagery and stress was assessed only via the child’s body temperature.

Art therapists surveyed by Metzl (2015) reported frustration over the lack of research on

using art therapy with young children. They identified a need for more clarity and understanding

about the different skills and techniques needed for working with young children in contrast to

working with adult populations. In contrast, play therapy models do specify basic skills and

techniques that are effective when working with children. Metzl found that art therapists

working with young children are incorporating play therapy techniques into their art therapy

practice to provide more age appropriate services.

Play Therapy Techniques

Play therapists are trained in basic skills and techniques that are effective and

developmentally appropriate for young children specifically. Kottman (2011) presented a

comprehensive description of the necessary basic skills for working with young children

including tracking, restating content, reflecting feelings, setting limits, returning responsibility,

and working with metaphors. This is only a short summary of basic play therapy skills.


Tracking. Kottman (2011) described tracking as a technique in which the therapist

verbally narrates what is happening by either describing what the child is doing or what the play

object is doing in a matter of fact way, without labeling the object. An example would be “You

picked that up,” or “It is moving up and down” (p.113). This shows the child that you are paying

attention to their actions (Kottman, 2011). Malchiodi (1998) described a similar technique used

in art therapy in which the therapist makes statements about what is happening in a child’s

drawing such as “I see a person looking out of the window…” (p. 50).

Restating content. Kottman (2011) described restating content as paraphrasing what the

child says and repeating this back to the child. This shows the child the therapist is listening to

and understanding their words. It can also give the child a chance to correct the therapist’s

understanding of the child’s meaning (Kottman, 2011). Tracking and restating content are

similar to the basic counseling technique of reflective listening, or mirroring, often used to

ensure the therapist clearly understands what the client is expressing (Arnold, 2014). In art

therapy, mirroring can manifest in non-verbal ways. Moon (2009) described creating artwork

alongside the client, mirroring the client’s behaviors by using similar materials, movements, and

techniques as the client. This gives the therapist a deeper understanding of the client’s physical

and mental state and also shows the client that he or she is not alone in the process (Moon,

2009).

Reflecting feelings. Kottman (2011) explained children may have a difficult time

finding the words to express their feelings. Rather, they may express their feelings through their

facial expressions, posture, behavior, and play. The therapist can reflect on feelings expressed

by the characters in the play, or the feelings expressed directly by the child. The therapist can

make a tentative statement such as “You seem really sad right now,” (p.129) or by describing a


pattern of feelings such as “I have noticed you seem sad whenever you talk about…” and then

observe how the child reacts. By reflecting feelings, the therapist can help children identify

their feelings. Therapists can also teach children new words to describe their emotions by

incorporating a wider variety of feeling words such as “depressed” or “ashamed” instead of

always using “sad.” It is especially important when working with young children to avoid asking

why they feel a certain way because they typically will not have an answer (Kottman 2011). The

technique of reflecting feelings is used by many therapists to help clients become more aware of

their feelings and attitudes (Arnold 2014).

Setting limits. Although there is a wide range of how strict or permissive play therapists

are with limits, Kottman (2011) suggested therapy with children requires some basic limits to

ensure safety. The most common limits set in the play room include not allowing any behavior

that could cause physical injury to anyone, not allowing the child to damage the play room or

toys, not allowing the child to leave the therapy room during the session without permission, and

not allowing the child to take toys out of the playroom. Additional limits and rules can be set at

the therapist’s discretion. Kottman suggested creating limits with the child as a team to share

power and responsibility and encourage learning (Kottman, 2011). Limit setting is a basic

technique used by parents and teachers when working with children. A study by Lengua et al.

(2014) concluded limit setting to be extremely important for a child’s development of self-

regulation abilities. The researchers suggested incorporating limit setting into prevention

programs for young children (Lengua et al., 2014).

Returning responsibility. Kottman (2011) described how therapists may feel drawn to

take care of young children and help them whenever they are struggling, even if the child is

capable of doing the task alone. It is important to return responsibility to the child by


encouraging children to solve problems on their own. When children are successful in

completing a task, they will feel more capable and confident. If the problem is too difficult for a

child to complete on his or her own, solve the problem as a team instead of taking over

completely (Kottman, 2011). This technique is derived from an Adlerian concept to never do for

children what they can do for themselves (Dreikurs, 1964). This type of encouragement is used

throughout Adlerian therapy to instill in the client a “Yes, I can” attitude (Carlson, Watts, &

Maniacci 2012).

Using metaphors. Both play therapists and art therapists use metaphors in therapy.

Kottman (2011) described how using metaphors in play therapy allows for a safe emotional

distance from the subject matter behind the metaphor. Using metaphors makes it easier for

children to communicate difficult experiences and feelings (Kottman, 2011). Similarly, Moon

(2009) discussed how talking about the aesthetics of the artwork, such as describing a drawing as

“ragged around the edges” (p.193) can facilitate a deep, meaningful connection without forcing

the client to translate the creative metaphor into reality. Art therapists might ask a client what it

would feel like to be inside the artwork or how a character in the artwork is feeling (Malchiodi,

1998). Similarly, play therapists often communicate with a child through the child’s play

metaphor, by commenting on what a toy is doing or how a toy might be feeling. A play therapist

may have a conversation with a toy, looking at and speaking directly to the toy and allowing the

child to answer through the toy (Kottman, 2011).

Blending Art Therapy and Play Therapy

As art therapists incorporate play therapy methods into their practice (Metzl, 2015), play

therapists are also incorporating art therapy methods into their practice. Kottman and Meany-

Walen (2016) discussed several art therapy directives to use with young children in a play


therapy setting. Some traditionally art therapy directives that play therapists are using in their

practice include the Kinetic Family Drawing, Draw-A-Person, House-Tree-Person drawing, and

Family-Centered Circle drawing (Kottman & Meany-Walen, 2016). This crossover between art

and play therapy leads to more informed and developmentally appropriate practice.

While there is much overlap between art therapy and play therapy, they are two separate

practices and are grounded in separate theories. It is important for therapists to not engage in

therapy practices or procedures that are beyond their competency and to seek supervision if there

is any doubt (American Psychological Association, 2017). At the same time, therapists are

expected to incorporate empirically-validated techniques into their practice (Carter & Goodheart,

2012). Since play therapy, such as Adlerian play therapy, is an empirically validated practice for

working with children, it is ethical to incorporate play therapy techniques that are within a

therapist’s scope of practice, or to pursue education and supervision in order to become

competent in play therapy skills and techniques.

Adlerian Play Therapy

Adlerian play therapy has been recognized by the Substance Abuse and Mental Health

Services Administration as evidenced-based practice (Kottman, 2016). Taylor and Bratton

(2014) argued that Adlerian play therapy is the most developmentally appropriate therapy for

preschool age children. Because of the strong evidence base and thoroughly developed

methodology of Adlerian play therapy, it is best practice when working with young children to

incorporate Adlerian play therapy.

Stutey, Dunn, Shelnut, and Ryan (2017) studied how Adlerian play therapy effected the

problematic behaviors of students in the classroom. At-risk children between the ages of 3 and

5, who were identified as exhibiting problematic behavior, participated in this study. The


children attended 7 individual Adlerian play therapy sessions followed by 7 group sessions

which incorporated techniques involving puppets, sand trays, and art materials. The model for

Adlerian play therapy includes (1) building an egalitarian relationship with the child using basic

play therapy skills such as tracking, reflecting feelings, restating content, and setting limits, (2)

exploring the child’s lifestyle using puppets, sand trays, and art materials to gather lifestyle

information, (3) gaining insight into the child’s lifestyle, and (4) re-orienting and re-educating.

After 14 weeks of Adlerian play therapy intervention, all the participants improved significantly.

The teachers of the participants rated the intervention as moderately to highly effective in

reducing problematic behaviors in the classroom (Stuey et al., 2017). Similar results were found

in a study by Meany-Walen and Teeling (2016). Meany-Walen and Teeling examined behaviors

of children in kindergarten to second grade. The children participated in 10-12 individual and

group Adlerian play therapy sessions. The therapy was effective for all participants in reducing

problematic behavior and improving social skills (Meany-Walen & Teeling, 2016).

An important aspect of Adlerian play therapy is exploring and gaining insights into the

child’s lifestyle (Kottman & Meany-Walen, 2016). When Adlerian therapists explore the

lifestyle of an adult client, they may utilize the Adlerian Lifestyle Interview, a set of questions

that assesses the client’s lifestyle in a standard, comprehensive way. However, the Adlerian

Lifestyle Interview is inappropriate to use with young children because of its length and

dependence on verbal expression. Instead, it is more appropriate to use art therapy and play

therapy techniques to gather the same information. Identifying a set of art and play directives

that gathers lifestyle information allows for a more standard and comprehensive assessment. To

identify art and play directives that gather similar lifestyle information, traditional Adlerian

Lifestyle Interview templates will be used as a reference.


Adlerian Lifestyle Interview

According to Carlson, Watts, and Maniacci (2012), the Adlerian life style interview

typically takes two to three 45-minute sessions to complete. The interview can be broken down

into two main sections: information related to the family constellation and the collection of early

recollections. The family constellation section includes questions about the sibling constellation,

family values, family atmosphere, parental behavior, and the role each child played in the family

(Carlson, Watts, & Maniacci, 2012, p.115).

Early recollections are collected as part of the lifestyle interview to get an idea of how the

individual’s lifestyle functions (Carlson, Watts, & Maniacci, 2012). Adler found that clients

unconsciously select certain memories that represent the client’s life story and pertain to the

client’s current life situation (Ansbacher & Ansbacher, 1956/1964, p. 351). Several lifestyle

interview templates have been created by Adlerian psychologists to offer clinicians a

standardized form for completing the interview.

Eckstein

Daniel Eckstein (2003), a student of Rudolf Dreikurs, created an in-depth interview

template that can be broken down into three main sections. The first section includes questions

about current situations, wellness, challenges, strengths, and how clients interact with the world.

Clients also rate their current satisfaction with five life tasks: work/school, friendship, love, self-

esteem, and spiritual/existential. Clients are then asked to identify specifically how their life

would be different if their problems were resolved.

The second section consists of questions about childhood, family, siblings, parents, and

community. They are asked to describe each sibling and how they compare to the client. They

are asked how the siblings interacted. Clients are asked to describe their childhood likes,


dislikes, fears, traumas, hopes, and dreams. Clients are asked to describe their parents, their

parents’ relationships to their children, and how they affected the client. They are also asked

about other role models who affected them. Questions about culture and identity are also asked

(Eckstein, 2003).

The third part involves collecting three early recollections from the client. From these

early recollections, the clinician and client together identify how the early recollections are

connected to the client’s current life and if there are any patterns. Clients are also encouraged to

talk about how they would change a recollection if they could (Eckstein, 2003).

Bartholow, Willhite, Brokaw, and Wolf

The lifestyle interview template originally created by Bob Bartholow and Bob Willhite,

and later revised by Sue Brokaw, and Jodi Wolf (2011), is similar to Eckstein’s interview,

although it delves further into early recollections and mistaken beliefs. It also included questions

specifically about how the child interacted at school and got along with peers to get an idea how

the child functions outside of the family. Bartholow et al. also include further analysis of the

early recollections such as discovering the client’s self-concept, self-ideal, environmental

evaluation, and ethical convictions. At the end of the interview, Bartholow et al. included a

section used to identify a universal goal, fictive goal, and mistaken beliefs.

Though there are variations of the lifestyle interview, the main concepts are always

included. Shulman and Mosak (1995) summarized the purpose of the lifestyle interview into

answering these five questions: 1. What is the client’s self-concept. 2. What is the client’s world

view? 3. What are the client’s ethical convictions? 4. What is the client’s self ideal/fictive goal?

And 5. What are the client’s methods for achieving this goal?

Discovering the Child’s Lifestyle


According to Adler (2012), the child’s lifestyle begins to form within the first year of life

as they receive feedback from their environment. Children learn which movements, sounds, and

emotional expressions are appropriate and begin to get an idea of what they need to do in order

to belong (Adler, 2012). The child’s developing lifestyle and world view typically becomes fully

established between the ages of 5 and 8 (Even & Armstrong, 2011). At the same time, the child

begins attending school and both families and teachers develop a fixed idea about who that child

is, reinforcing the child’s lifestyle (Kottman & Meany-Walen, 2016). Therapists working with

young children have the unique opportunity to discover maladaptive mistaken beliefs that are

affecting the child’s developing lifestyle and redirect them toward a more socially useful lifestyle

while they are still malleable (Even & Armstrong, 2011). The following set of art/play therapy

directives allows the art therapists and play therapist to gather information about the child’s

lifestyle similar to information gathered from the Adlerian Lifestyle Interview. The directives

included do not require administrator qualifications, but are intended to be used by therapists

who are familiar with creative metaphors. This set of directives is intended to be used by art

therapists and play therapists from their educated perspective. An assessment template utilizing

the following directives can assist art therapists and play therapists in identifying maladaptive

aspects of the developing lifestyle of children (see Appendix).

The Garden

The Rosebush technique has been used by school counselors and play therapists to gather

information about the child’s inner world (Ray, Perkins, & Oden, 2004). The Rosebush

technique asks children to imagine themselves as a rosebush. This metaphor allows children to

express their inner worlds and emotions without answering direct questions about their actual

situation, which can feel threatening (Ray et al., 2004). An alternative version adapted by


Kottman uses the imagery of a “plant” rather than a “rosebush” (Kottman & Meany-Walen,

2016). Using a plant instead of a rosebush allows for further individualization of the drawing

and is more sensitive to the child’s culture. Different cultures have different associations with

roses which may impact the child’s drawing. In Kottman’s adaptation of the Rosebush

technique, called The Garden, the therapist first engages the child in a short relaxation exercise.

Then, the child is instructed:

Close your eyes. Now I’d like you to imagine you are a plant in a garden. Become one

of the plants in the garden and find out what it’s like to be a plant. What kind of plant are

you? Are you very small? Are you large? Are you wide? Are you tall? Do you have

flowers? If so, what kind? They can be any kind you want them to be. Do you have

leaves? What kind? What are your stems and branches like? Do you have any thorns?

What are your roots like? Or maybe you don’t have any- you get to decide. If you do,

are they long and straight? Are they twisted? Are they deep? Look around you and see

if there are any other plants in the garden [pause]. If there are other plants, what do they

look like? Are there only a few of them or are there lots of them? Are the other plants

the same as you or are they different? Do the other plants have leaves… flowers…

stems… roots… thorns? How close are the other plants to where you are? Are they the

same size as you or bigger or smaller? Where is the garden? Is the garden in a pot or

growing in the ground? Or through cement? Or even inside somewhere? Look around

you… what else do you see? [pause] Are there statues in the garden? Animals? People?

Birds? Is there anything around you like a fence? If there is, what does it look like?

Does someone take care of you? Does that person also take care of the other plants?

What’s the weather like for you right now? What is your life like? How do you feel?


What happens to you as the seasons change? Be aware of yourself as a plant in a

garden… look carefully. Find out how you feel about your life in the garden. In a few

minutes, I’ll ask you to open your eyes and I want you to draw a picture [or make a

sculpture or do a sand tray] of yourself as the plant and the rest of the garden. Then, later

I’ll ask you a few questions, and will want you to talk about the picture as though you are

the plant in the garden [longer pause] … When you are ready, open your eyes and draw

[or make a sculpture or do a sand tray]. (Kottman & Meany-Walen, 2016, p.180-181)

These detailed questions allow the child to fully imagine the self as a plant before the

therapist asks the child to open his or her eyes and draw what was imagined. Because this

technique uses a metaphor instead of asking direct questions about the child’s life, this is a good

directive to start with. When processing this directive, it is important to stay in the metaphor

instead of asking the child direct questions about his or her family. Kottman and Meany-Walen

suggested re-asking many of the questions asked during the guided meditation to allow the child

to respond to these questions verbally. This technique gathers a wealth of information about the

child’s self-concept as well as the child’s family atmosphere (Kottman & Meany-Walen, 2016).

Kinetic Family Drawing

The Kinetic Family Drawing (KFD) directive developed by Burns and Kaufman (1972)

can be used to collect information about the client’s family constellation (Cook 1991; Kottman &

Meany-Walen, 2016). The KFD asks the client to “Draw a picture of everyone in your family,

including you, DOING something. Try to draw whole people, not cartoons or stick people.

Remember, make everyone DOING something- some kind of action” (Burns & Kaufman, 1972,

p.5). Kottman and Meany-Walen suggested modifying this directive to exclude the direction

“Try to draw whole people, not cartoons or stick people.” They suggested encouraging the child


to draw whole people, but not to prohibit stick people because this could discourage the child

from completing the drawing. Kottman and Meany-Walen also suggested an alternative to the

KDF using a sand tray and miniatures. In this alternative version, the child is given a wide

selection of miniatures to choose from and is asked to use the figures to represent each family

member engaged in an activity and to create a scene in the sand tray (Kottman & Meany-Walen,

2016).

When the kinetic family drawing (or sand tray) is completed, the therapist can reference

the creation when asking the child about his or her family. Cook (1991) suggested asking the

questions “Who are the people in your picture and how old are they?” “How would you feel if

you were to enter this picture?” and “What do you see in the picture?” (Cook, 1991, p. 523). The

answer to these questions give the therapist information about the client’s family atmosphere and

family constellation. Cook found that what her study participants expressed in the kinetic family

drawing was 90-94 percent similar to the participant’s answers to Adlerian Lifestyle Interview

questions (Cook, 1991). Additional questions from the Adlerian lifestyle interview can be asked

while referencing the KFD such as: Who is most like you? Who is the most different from you?

Who is most like each parent? Who gets in trouble the most? Who gets spoiled the most? Who

plays together? Who do you get mad at the most? These questions are similar to the questions

asked in the Adlerian lifestyle interview templates by Bartholow et al. (2011) and Eckstein

(2003).

Kinetic School Drawing

The Kinetic School Drawing is similar to the KFD. The child’s experiences and

behaviors at school form the child’s concept of self, others, and the world outside of his or her

family (Brooke, 2004). The therapist directs the child by saying “I’d like you to draw a school


picture. Put yourself, your teacher, and two or more students in the picture DOING

something…” (Knoff & Prout, 1985, p. 54). Again, a sand tray scene could be used in place of a

drawing. After the child is finished, the therapist can ask the child to describe what is happening

in the picture and what each figure is doing (Brooke, 2004). This picture can then be used as a

reference when asking the child further information about his or her life at school. The therapist

could incorporate some questions from the Adlerian Lifestyle Interview template by Bartholow

et al. (2011) such as: How do you feel about school? What is your favorite subject? What

subject do you like the least? What are you really good at? What are the boys in your class like?

What are the girls like? How do you feel about being a boy or a girl? Do either boys or girls

have an advantage over the other? What are your friends like? How do you feel about your

teacher?

Family-Centered Circle Drawing

The Family-Centered Circle drawing, developed by Burns, symbolizes the parent-child

relationship (Brooke, 2004). The Family-Centered Circle drawing begins by giving the client a

piece of paper with a large circle already drawn. The client is instructed to “Draw your mother

in the center of a circle. Visually free associate with symbols around the periphery of the circle.

Try to draw a whole person, not a stick or cartoon figure” (Brooke, 2004, p. 92). To make this

directive more appropriate for young children, the directive could be changed to “Draw your

mother in the center of the circle. Doodle whatever you want around the edge of the circle.”

The directive is then repeated for the father and then for the self. Other parental figures such as a

child’s step-parent, grandparent, or other primary caregiver can be used in place of a mother

and/or father in situations where using mother and/or father is not appropriate. Burns believed

the size of the drawn figure represents the amount of energy invested in that person. Burns


considered symbols repeated in both the self and parent drawings to be especially important.

Burns also suggested any symbol drawn directly above the drawn figure to be of great

importance (Brooke, 2004). When processing this drawing, the therapist can incorporate

questions from the Adlerian Lifestyle Interviews by Bartholow et al. (2011) and Eckstein (2003)

to get an idea of how the child relates to his or her parents: What is important to your parents?

What is important to you? What makes them happy? What makes you happy? What makes

them angry? What makes you angry? How are you like each parent? How are you different?

Do they ever fight? What do they fight about? What do you think it’s like to be a parent?

Self-Ideal/ Fictive Goal

A simple art directive that can be used to gather information about the child’s self-ideal

and fictive goal is to ask the child to “Draw yourself as you want others to see you” (Sutherland,

2008). This image may give the therapist a better idea of the child’s mistaken beliefs about what

they have to do in order to belong.

A similar directive suggested by Watts and Garza (2008) is to ask the child the miracle

question in the form of an art directive. The therapist could ask: “If you magically changed into

the person you want to be, what would be different? If I were watching a movie of your life,

what would be different?” The therapist could then ask the child to draw that person and ask

specific questions such as: “How would you be dressed? What would you be doing? What

would you see happening around you? If we could see inside your thoughts, what would they

look like?” The product of this drawing shows the child’s goals. Those goals may be

appropriate socially useful goals for therapy, or they may express additional mistaken beliefs and

socially useless goals (Watts & Garza, 2008).


Early Recollections

The collection of early recollections is an important part of the Adlerian Lifestyle

Interview. People unconsciously select memories that represent their life stories and present the

memories, often altering them, to fit with their fundamental view of life (Ansbacher &

Ansbacher, 1956/1964, p. 351). The early recollection is a distilled snapshot of how the client’s

lifestyle functions. It gives context to the information already gathered in the Adlerian Lifestyle

Interview. Kottman and Meany-Walen (2016) suggested having children use drawings, dolls,

puppets, or sand tray figures to express early recollections.

Even and Armstrong (2011) describe how to use a sand tray scene with children to collect

an early recollection. The scene begins with the prompt “Make a scene in the sand of something

you remember,” the child should be encouraged to use “as few or as many figures as needed to

complete the scene” (Even & Armstrong, 2011, p.396). The therapist should allow for as much

time and space as the child needs to complete their three-dimensional picture of their memory

without interruption. After the child is finished, the therapist can begin processing the child’s

creation by asking the child to “Tell me about your memory in the sand” (Even & Armstrong,

2011, p. 396).

When processing the sand tray scene, Even and Armstrong (2011) suggested “working

with the metaphor” (p. 398), a technique in which the therapist uses the child’s metaphor when

discussing the scene by talking about what the characters are doing, thinking, and feeling. It’s

important to pay attention to what the child calls each character and use those labels when

referencing a character in the scene. Talking about the scene metaphorically instead of asking

the child direct questions allows the child to keep a safe distance from the subject matter of the

memory (Even & Armstrong, 2011).


Even and Armstrong (2011) also suggest asking the child how the memory feels. To get

a more specific idea of the feeling, the therapist can ask the child to describe the color, and shape

of the feeling and where the child feels it in his or her body. Even and Armstrong suggested

staying in the “here and now” by asking questions like “Tell me what it’s like for you right

now,” (p. 398). After the scene has been processed, Even and Armstrong suggested closing the

activity by asking the child to give the scene a title. The title captures the essence of the scene in

a short description (Even & Armstrong, 2011). These play therapy techniques described by Even

and Armstrong can be applied to any metaphoric expression of an early recollection, such as a

drawing.

Rotter, Horak, and Heidt (1999) suggested asking the child to “Draw a picture of

something you remember,” they also suggested asking “What part do you remember most about

this memory?” and “What feelings do you remember having then?” (p. 319). The information

gathered from the early recollection gives the therapist an idea of how the child would answer

the questions: “I am… Others are… The world is... Therefore…” (Rotter et al., 1999, p. 324).

The child might instead want to act out a memory using puppets or other toys. Kottman

and Meany-Walen (2016) suggested asking the child to choose a doll or puppet to represent each

member of the family. Then ask the child to describe each character and how they selected each

character. The therapist can encourage the child to act out a memory or situation. The child can

use the puppets to express thoughts and feelings about typical family interactions. Again, the

therapist can work with the child’s metaphor to gather information about the child’s

interpretation of the scene by being curious about what each character might be feeling or

thinking (Kottman & Meany-Walen, 2016).


Conclusion

Ethical treatment of mental health issues includes incorporating current research and

evidence-based practices (Carter & Goodheart, 2012). Adlerian play therapy is supported by

current research and has been labeled “evidence-based practice” for working with children

(Kottman, 2016). Therefore, incorporating Adlerian play therapy into art therapy practice

provides a more ethical, developmentally appropriate treatment modality. This set of art and

play directives can be used to gather Adlerian lifestyle information from children. These

directives include The Garden, the Kinetic Family Drawing, the Kinetic School Drawing, the

Family-Centered Circle Drawing, the self-ideal and fictive goal drawings, and the collection of

early recollections. The authors of these directives did not set requirements for administrator

qualifications. They are intended to be used by therapists familiar with using creative metaphors,

such as art therapists and play therapists. This art and play based Adlerian assessment of the

developing lifestyle is intended to be as comprehensive as the formal Adlerian Lifestyle

Interview and is designed to be developmentally appropriate for use with children (see

Appendix).


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Appendix

Adlerian Assessment of the Developing Lifestyle of Children

Client name

Date

Therapist

The Garden:

Offer the child a variety of drawing materials or a selection of miniatures to use in a sand tray.

Directive: “Close your eyes. Now I’d like you to imagine you are a plant in a garden. Become

one of the plants in the garden and find out what it’s like to be a plant. What kind of plant are

you? Are you very small? Are you large? Are you wide? Are you tall? Do you have flowers?

If so, what kind? They can be any kind you want them to be. Do you have leaves? What kind?

What are your stems and branches like? Do you have any thorns? What are your roots like? Or

maybe you don’t have any- you get to decide. If you do, are they long and straight? Are they

twisted? Are they deep? Look around you and see if there are any other plants in the garden

[pause]. If there are other plants, what do they look like? Are there only a few of them or are

there lots of them? Are the other plants the same as you or are they different? Do the other

plants have leaves… flowers… stems… roots… thorns? How close are the other plants to where

you are? Are they the same size as you or bigger or smaller? Where is the garden? Is the

garden in a pot or growing in the ground? OR through cement? Or even inside somewhere?

Look around you… what else do you see? [pause] Are there statues in the garden? Animals?

People? Birds? Is there anything around you like a fence? If there is, what does it look like?

Does someone take care of you? Does that person also take care of the other plants? What’s the

weather like for you right now? What is your life like? How do you feel? What happens to you

as the seasons change? Be aware of yourself as a plant in a garden… look carefully. Find out

how you feel about your life in the garden. In a few minutes, I’ll ask you to open your eyes and I

want you to draw a picture [or make a sculpture or do a sand tray] of yourself as the plant and the

rest of the garden. Then, later I’ll ask you a few questions, and will want you to talk about the

picture as though you are the plant in the garden [longer pause] … When you are ready, open

your eyes and draw [or make a sculpture or do a sand tray]”

Description of

“self” plant

Description of

“other” plants

Description of

garden


Kinetic Family Drawing:

Offer the child a variety of drawing materials or a selection of miniatures and a sand tray.

Directive: “Make a picture [or sand tray scene] of everyone in your family, including you, doing

something. Try to draw whole people. Remember, make everyone doing something- some kind

of action.”

Record the names, ages, and description of each person depicted. (family constellation)

Name Brief Description

Father

Mother

Other parental

figures depicted

Siblings Brief Description

What would it feel like

to be in this picture?

Who is most like you?

In what ways?

Who is the most

different from you? In

what ways?

Who gets in trouble

the most? For what

reasons?

Who gets spoiled the

most?

Who do you play with

the most?

Who do you get mad at

the most?


Kinetic School Drawing:

Offer the child a variety of drawing materials or a selection of miniatures and a sand tray.

Directive: “I’d like you to draw a school picture [or make a sand tray scene]. Put yourself, your

teacher, and two or more students in the picture. Try to draw whole people. Remember, draw

yourself, your teacher, and two or more students doing something.”

Who is in the picture? What is each person doing?

Self

Teacher

Student

Student

Student

How do you like school?

What is your favorite

subject in school? How

did you pick that one?

How do you get along

with your teacher?

What are the boys in

your class like?

What are the girls in

your class like?

How do you feel about

being a boy/girl?

Do boys or girls have an

advantage over the

other?

How do you get along

with the other kids?


Family Centered Circle Drawing:

Offer the child three or more pieces of paper with large circles already drawn.

Directive: “Draw your mother in the center of the circle. Doodle whatever you want around the

edge of the circle.” (substitute another guardian or caregiver when appropriate)

After finishing first drawing: “On another piece of paper, draw your father in the center of the

circle. Doodle whatever you want around the edge of the circle” (substitute another guardian or

care giver when appropriate)

After finishing second drawing: “On the third piece of paper draw yourself in the center of the

circle. Doodle whatever you want around the edge of the circle.”

Reference all three images when asking the following questions:

What is important to your mom?

What is important to your dad?

How are you like your mom?

How are you like your dad?

How are you different from your

mom?

How are you different from your

dad?

What can you do that makes your

mom happy?


mom mad?


dad happy?


dad mad?

Who makes you feel better when

you are hurt or sad?

Do your parents ever fight?

What do they fight about?

How do they make up after a

fight?

What do you think it’s like to be

a parent?


Self-ideal/ Fictive Goal

Directive: “Draw yourself as you want others to see you”

Tell me about your

drawing?

How did you decided to

draw yourself in this way?

What does this drawing tell you about what he/she has to do in order to belong?

______________________________________________________________________________

Directive: “If you magically changed into the person you want to be, what would be different?

Draw yourself as that person.”

How are you dressed in

the picture?

What are you doing in the

picture?

What is happening around

you?

If you could look inside

your thoughts, what would

they look like?

What does this picture tell you about the child’s goals?

______________________________________________________________________________


Early Recollections

Offer a variety of drawing materials, a sand tray and miniatures, and/or puppets and dolls.

Directive: “Draw a picture of something you remember.”

Or “Make a scene in the sand of something you remember. Use as many figures as you need.”

Or “Choose a doll or puppet for each member of your family and use them to act out a memory.”

Tell me about

your memory.

[or act out the

memory]

Tell me about each person in the picture/scene. What is each person doing?

Name of person Description of person and what they are doing.

What part of the memory

do you remember the most?

Referring to the character that

represents the child in the

memory, ask: How does

he/she feel right now?

What color and shape is

that feeling?

What made him/her feel

that way?

How are the other

characters feeling?

Tell me what it’s like for

you right now.


Summary of the lifestyle

Use the information gathered from this assessment to fill in the following charts. Make note of

dysfunctional aspects of the developing lifestyle needing intervention.

Family Constellation

My role in the family..

I am the one who…

Oldest, middle,

youngest?

Family Atmosphere

The climate of the

household,

Interactions between

family members

Family Values

Family rules,

Cultural values,

What is important

(religion, school..)

Gender Guiding Lines

Beliefs about what it

means to be a man,

women, or other

Self-Concept

I am…

I like…

My self-image

Self-Ideal

I should be…

(or not be)

My ideal self

World View

Life is…

Men are…

Women are…

Ethical Convictions

Moral beliefs

What is proper

Right and wrong

In order to belong/ be significant, I must be ________________________________________ (fictive goal)

Therefor I must always/never/only ________________________________________________

______________________________________________________________________________ (mistaken beliefs)

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