From Reel To Real: Use of Video As A Therapeutic Tool. (After Image).

Videowork is a therapeutic process in which clients and therapists discuss themes and characters in popular films that relate to core issues of ongoing therapy. In videowork, I use films to facilitate self understanding, to introduce options for action, plans and to precede future therapeutic interventions. We select films for both positive and negative associations. Some films dramatize possible solutions. Others show predictable outcomes if dysfunctional patterns remain unaltered.

I am not suggesting that merely watching a film is sufficient to bring about desired change. The ability of an inspirational film to effect change is short lived, much like a New Year's resolution. Though some counselors have suggested that films are useful as self-help, our approach emphasizes the partnership of conventional therapy and film homework; videowork is one more strategy in attaining therapeutic objectives. (1) It presupposes that competent therapists will make use of the insights their clients garner from films.

As with any intervention, there are risks. Films can influence behavior positively and negatively. (2) But by choosing from an anthology of therapeutically useful films, assigning them strategically and establishing boundaries for viewing, therapists can minimize the risks. My goal is to provide the information that clinicians need to use films safely and successfully in therapy or education.

Practitioners have long recommended books, plays, poetry and the visual and performance arts as a means of teaching concepts of mental health and providing corrective emotional experiences. (3) As early as 1840, Sir Walter Gait cataloged fictional and nonfictional literature recommended by psychiatrists for religious and moralistic education to hospitalized psychiatric patients. It was not until the 1930s that the casual practice of prescribing therapeutic readings to patients was formalized into a practice known as bibliotherapy. In the bulletin of the Menninger Clinic, William C. Menninger first described how selected literature might serve educational, recreational and social purposes in psychiatric hospitals. According to Menninger, literature provides immediate gratification for patients and serves as a source of information. It encourages patients to invest in an interest outside themselves and to thereby maintain contact with external reality. It leads to insight into their problems. And through discus sing books with others, literature helps patients to identify with a social group. (4)

Menninger also suggests guidelines for literary assignments. Clinicians should prescribe books to patients according to their needs, backgrounds and symptomatic pictures. He recommends older as well as newer works; the salient issue is how clearly artistic works serve as appropriate channels of expression for the ideas and emotions of patients. He cautions clients to exercise sound judgments in utilizing the rich source of ideas found in fiction and requires that therapeutic readings be ordered only by the attending physician.

Bibliotherapists who followed Menninger echoed his concern for undesired effects. Hazel Sample, in the first paper to treat bibliotherapy as a discrete field cautions that fiction often contains unstated counterproductive values. Sample recommends that bibliotherapists carefully weigh a story's conflicts and its resolution. She warns that authors express their own ideas and opinions through characters in a story and that those ideas and opinions should enlighten rather than confuse a patient. Her conclusion is that readings can be an effective aid to therapy but that clinicians should exercise good judgment in the works they choose and how they are used in treatment. (5)

Initially both fiction and nonfiction readings were assigned. But in the past 20 years, as clinicians themselves produced self-help literature for the general public, nonfiction has become the dominant genre in bibliotherapy. Clinicians who recommend books to their clients cite evidence that such readings are effective adjuncts to therapy in many areas. Self-help books enhance self perception, help clients cope with the traumas of divorce and abuse, effect attitude change and reduce depression. (6) By the time many clients enter therapy, they have already read a number of self-help books.

Therapists report that readings give clients tasks that focus their thinking as well as a sense that they are participating more fully in therapy. According to Menninger, readings help clients to understand themselves better, verbalize their concerns, discover their problems in the stories of others, dispel isolation and develop a better sense of context. (7) Readings also show how others have solved similar problems and clarify values, while also leading to honest self evaluation.

Videowork is an extension of bibliotherapy, sharing its aims, advantages and limitations. But it differs from current practices of bibliotherapy, most prominently in using fiction rather than nonfiction. Whereas nonfiction self-help materials offer guidelines for behavior illustrated by examples from ordinary life, films show ordinary life and let clients (in conversation with therapists) find guidelines that work for them. A film offers a wide range of interpretations determined by the specific needs of a client, by the directions a clinician gives for viewing and by the connections that a therapist helps a client draw.

Videowork also differs from bibliotherapy in terms of strategy. Films are occasionally assigned to reinforce an idea introduced in therapy sessions, but they are more often intended to encourage internal search and insight by the client. As clients watch films by themselves or with partners or family, they identify corresponding resources or limitations in their own repertoires that may not have emerged in therapeutic conversations.

Finally, in comparing videowork to traditional bibliotherapy, it is our impression that clients do film homework more readily than book assignments. Films are enjoyable to watch, require only a small investment of time, and are already part of many clients' usual routines. Some clients do not like to read, but they watch films regularly and have excellent recall of plots and characters. Additionally, clients who might read only a single book during treatment are willing to watch a series of films that address a number of clinical issues.

A close relationship exists between videowork and a clinical use of therapeutically constructed metaphors. Both involve surprise that disrupts habitual responses--both use rich messages that require a client to supply personal content in order to construct meanings that are relevant and both involve implied directives for change. Clinicians use metaphors to broach sensitive areas and to go beyond the conscious material that clients have identified in therapeutic conversations.

Narrative and metaphor afford individuals the opportunity to distance themselves from events in their own experiences and to become the protagonist in their own life narratives. Metaphor and narrative enable them to rehearse potential solutions until they achieve insight and new direction. Once material previously deemed intolerable is thought and rethought, it can gently knock on the door of consciousness and present itself. A metaphor is a story that allows people to bridge the gap between what is and what can be. (8)

Thus films are metaphors that can be utilized in therapy in a manner similar to stories, myths, jokes, fables and therapeutically constructed narratives. Films address the affective realm and add to the impact of cognitive insights. Because films galvanize feelings, they increase the probability that clients will carry out new and desired behaviors. Cognitive insights tell clients what they ought to do but affective insights give them the motivation to follow through.

In an era of managed care, therapists are challenged to make therapy more cost-conscious without sacrificing effectiveness. This challenge necessitates a departure from the traditional 50-minute, once-a-week session. Sessions are often scheduled farther apart and there is no guarantee that clinicians will have more than a few opportunities to influence positive change. The problem, therefore, is how to get the most out of the time that is available.

In maximizing their effectiveness, therapists increasingly rely on therapeutic homework--structured assignments introduced by a therapist during sessions and completed at home by clients. According to Alfred Bandura, the underlying assumption in assigning homework is that desired behaviors introduced in therapy sessions are practiced and mastered in a client's natural environment, leading to the development of effective self-regulatory functions. (9) Therapists introduce concepts, assign homework that will reinforce key therapeutic points and process the exercise in a follow-up session.

Several specific benefits of homework have been described by clinicians. First, therapeutic material may be more readily mastered. What is initially encountered in the therapy session is practiced and reinforced outside. (10) Therapists can also achieve a better continuity of care. By using daily and weekly report forms, they can monitor the details of a client's daily life, marking progress and change and modifying treatment approaches where needed. (11) Homework helps therapy be more relevant to daily life. Through practice outside sessions, the effects of therapy can be generalized throughout the client's environment. (12) Finally, homework can act as a hurdle or challenge that, once mastered by the client, advances therapeutic progress and leads to greater self reliance. (13) Hence, using homework assignments in which clients practice new skills or reintegrate old ones is a technique by which connections may be made between the special setting of therapy and the client's life. This practice enables client s to practice what they learn in therapy, (14) helps clinicians track progress and modify treatment plans to achieve better continuity of care, (15) maximizes the effects of therapy in the client's own environment, (16) advances therapeutic progress and leads to greater self reliance (17) and serves as a bridge between therapy and life.

In making that connection, therapists assign imaginative as well as realistic tasks. Bereaved clients visit cemeteries where deceased relatives have been buried. They conduct imaginary conversations and write letters to their loved ones, bringing closure not completed at the time of death. (18) Shy clients rank threatening social situations, then master the list item by item. (19) In assigning homework, therapists give rationales for assignments and thoroughly process exercises in subsequent sessions. Homework builds from one successful experience to another, as lessons from one assignment suggest new objectives for the next. Likewise, a film assignment that proves helpful to a client can be followed by another film that will facilitate additional insights.

Although not every client will watch each film assigned, most clients will give this new approach a chance. It takes them by surprise. They are accustomed to having their therapists suggest a self-help book, but they have rarely looked to films for help with their problems. If the first experience with a film yields positive results, clients will likely be enthusiastic about similar homework assignments in the future. Once they are convinced that the approach works for them, they will be on the lookout for relevant films, sharing therapeutic films with friends and families. Overall clients report that they enjoy discussing films, even when the material is emotionally charged and personally challenging.

Emotionally distraught clients may fare better with film assignments than with books; whereas reading assignments require an ability to focus that depressed or anxious clients find difficult, films require less concentrated attention. Clients with limited language skills can also benefit from films. Clients who are reluctant to venture out to a movie theater can watch films in their own homes. For couples in which one partner likes to read and the other doesn't, watching a movie is a task they both can agree on. I have found that adolescents in particular are almost always willing to watch a film.

Families can share movie watching even when some family members have not participated in therapy. This sharing facilitates productive conversations within the family. Clients borrow useful concepts from films to explain therapeutic issues to other family members or to share some of their concerns. One client whose husband had been unwilling to talk with her about their problems agreed to watch an assigned film. Afterward, she was able to tell him much of what was bothering her by talking about the characters and their interactions; he did not know that her feelings ran as deeply as was portrayed in the film. Once he understood what she felt, he was more willing to talk about the things that mattered to her.

Because therapists may also be sending messages to a client's family via the films they assign, they should think carefully about how a film will impact other family members as well as the client. I instruct my clients to explain to others in the family that the films they watch are part of therapy. When appropriate, I encourage them to invite others to watch. (It is not usually appropriate, for instance, in homes in which abuse is occurring.) I also issue an invitation for family members who have viewed films to attend a followup session if they wish. I always assume that others in the family might see assigned films, so I make selections with that in mind. If family members react negatively to a film we assign, I ask that they attend a therapy session so that we can address their concerns appropriately.

Because I explain my rationale for using films, videowork assignments seem logical to our clients. But the films I pick are sufficiently removed from the problem at hand to potentiate a client's curiosity. Clients know that I have reasons for recommending a particular film but they are not sure what those reasons are. They ask themselves which characters I see as similar to them and how the plot compares to their own situation. This questioning facilitates creative thought from the moment I mention a title. I have had many instances in which clients watched a film several times to make sure they "got" they thought I intended for them to take from the film. This aspect adds intensity to a videowork assignment; films are puzzles to be solved. And when clients return from watching a film with only part of the message I hoped they would hear, I frequently ask them to view it a second time.

Much of a client's life is outside the direct experience of the therapist. Films shared by clients and therapists deepen therapeutic affiance by providing an experience they have in common and by putting therapists and clients on more level ground. Undesirable authoritarian aspects of the therapeutic relationship are attenuated somewhat by film homework.

A therapist's training and experience, ironically, may convince a client that they have little in common and hence may limit the positive influence that a therapist can have. Talking about films, a more neutral subject, often brings therapists and clients closer together. Clients assume that a therapist is an expert at doing therapy, but they perceive equality when talking about films.

As is true in all homework, practice allows clients to become more comfortable using videowork. They will get that practice if they take film assignments seriously. For that to happen, therapists should view film homework as important to therapy and should provide dear rationales. The key factor in obtaining useful results in videowork is the confidence with which therapists introduce films into therapy, a confidence that begins by understanding the benefits of videowork.

A film can by itself reverse a negative worldview. Therapists can select films that begin in despair and end in triumph, thereby giving rise to hope. Clients who can identify with characters trapped by their circumstances and who can share the characters' disappointments as well as unsteady steps toward liberation may find reason for optimism in their own situations. Since the meaning that any event has depends upon the frame in which we perceive it, when the meaning changes, the person's responses and behaviors also change. (20) In practice, reframing occurs when a therapist draws different conclusions about an event than what clients had concluded. Reframes startle clients and cause them to reconsider earlier judgments. When therapists introduce respectful new perspectives, reframes serve to weaken the dominance of an unchallenged meaning. The reformulations do not have to be profound. Modest reframes can lead to large therapeutic advances.

Films, because they often reframe fictional crises, are ideal vehicles for refraining the problems of clients and for causing clients to entertain productive doubts about their own crises. What seems to be true at the beginning of a film is soon cast into doubt and by the end is refrained into an entirely different context.

Some clients describe their families as irreparably flawed and believe that their situation is hopeless. Therapists can use the film to demonstrate that even in the most trying circumstances, people still act forcibly to improve their lives. The film shows how one family refuses to accept stereotyped definitions of itself and can therefore find novel solutions. By extension, a client's troubled family can be reframed into a setting in which personal growth can take place.

Some clients, reared in emotionally impoverished circumstances, have few mentors or guides. They want a better life but have not met people who demonstrate qualities or behavior from which they can learn. Clinicians help such clients find mentors or may even serve that function themselves. But role models for the specific issues clients are facing may not be at hand. In those cases, film characters are useful substitutes.

Many contemporary therapists focus more on identifying and utilizing internal resources than on exploring clients psychopathology, building on strength rather than weakness. Viewed from this perspective, clients are not dysfunctional so much as they are unaware of their assets and the means by which they can access those assets. Therapy helps clients recall forgotten or discounted resources, then facilitates opportunities for those resources to be applied. Films assist in reaching that objective by portraying fictional characters who resolve difficult problems, often with no more personal skills than those possessed by the clients themselves.

Because films deal with stories of individuals rather than with abstract principles of human behavior, clients identify with the characters they encounter in films--people who also have their ups and downs. Film characters find resolutions to their problems through familiar and readily accessible skills. Clients recognize and appropriate resources from their own repertoires. Films trigger emotions and open doors that might otherwise be closed. It is one thing to talk about a problem, quite another to feel it. Particularly for clients who intellectualize, viewing a film that elicits emotion and connecting the film to personal situations enhances therapeutic conversations.

Clinicians attempt to help clients communicate unfamiliar concepts to their partners, but a film can introduce understanding through readily grasped images. One client was puzzled about what his wife meant when she called him "cold and indifferent." But after watching The Accidental Tourist (1988, by Lawrence Kasdan), a film about a repressed and inflexible man, he said to her: "Oh, that. I never knew that bothered you." I ask clients in relationships with strained communications to select a film with a message they want to convey to a partner. By watching the film together and explaining to the partner why they picked that particular film, they are able to enter into more productive conversations. Films thus serve as metaphors that more accurately represent the feelings clients cannot always put in words.

According to Friedman, when the culture has lost its traditional capacity to inspire, all we have now are our own stories and inventions to encompass the clash between chaos and control that seems central to life today. (21) We are not comparing Hollywood films to the great philosophies or religions, but social critics agree that popular films constitute one of the primary sources for the dissemination of cultural values in our time. (22)

Films do transmit values. They suggest norms, define the good life and offer opinions about which goals are worthy and which are not. There is, of course, a danger in the nuance of a film. When clients accept underlying messages without examination, they are vulnerable to the filmmaker's point of view. But when clients analyze films in the context of ongoing therapy, they find that films help them prioritize their values and aid in resolving ethical dilemmas.

At a time when traditional philosophies and religions have lost much of their authority, films represent a source of cultural identity through the adoption of attitudes, beliefs, behavior and even the language of film characters. The distinction between the fictional worlds that characters inhabit and the real world has become increasingly blurred as film characters and the celebrities who portray them assume lives of their own.

Life also imitates art in the therapeutic consulting room. Therapists sometimes refer to the soap operas they hear at work each day. Clients' lives can resemble recent films or television shows. Clients also compare themselves to characters in films they have recently seen. When they are having trouble explaining a point, they will say, "You know, it's a lot like what so and so did when she was going through a divorce," and they name a television or movie character rather than a friend.

Films are neither good nor bad in themselves, but they become so when viewers internalize the messages films contain. My approach to films in therapy is to encourage clients to examine films for what is life affirming and reject what is not. I know that they will continue to watch films on a regular basis with or without our encouragement. I want films to become part of their lifelong emotional journey of greater authenticity and healing. If film relationships provide significant emotional experiences for clients, and I believe that they do, how can therapists enlist films for therapeutic purposes? The first step is to consider the relationship that therapists have to films and to delineate the specific skills therapists need to link film viewing to therapy.

As therapists, clinicians attend to the nuances of their clients' narratives, they encourage self disclosure by accepting nonjudgmentally what clients offer and they ask open-ended questions to gain a better understanding of viable goals. These same skills are required to discuss films with clients. Clinicians should listen to what clients are actually saying about films instead of just hearing the interpretations that they are leading toward. Clinicians should work with the films that clients prefer without imposing their own aesthetic preferences, and their questions about films should be modeled on the news reporter who asks "who, what, when, where, and how," rather than being formulated to validate personally preferred psychotherapeutic theories.

But further skills are required. First, therapists should learn to watch films therapeutically so they can describe the process effectively to their clients. Next, they should assemble a list of therapeutic films. Finally, they should think of films as co-therapists in the process of encouraging and utilizing insights.

Videowork is not the same as entertainment. Viewers typically pay more attention to a film's plot and less to character development. Videowork, however, concentrates on characters and their relationships. What is most critical is the process of change in and between characters. I ask clients to pay attention to how characters appear at the beginning, how they react to the conflicts they face and how they are different by the end of the film. I ask that clients note how relationships improve or deteriorate as the story unfolds, what each character does to make things better or worse and how the character appears to feel in response to changes.

Another difference between viewing for entertainment and viewing for therapeutic benefit is the emphasis on conscious identification. Anyone who watches a movie identifies with a character to some extent. But in videowork, I encourage clients to articulate their identifications. Which characters elicit the most personal identity? Which elicit the least? What behaviors would clients like to adopt? What attitudes seem useful in relating to others? How are the issues that the characters are struggling with similar to clients' own issues? Is a character's approach to problem solving similar or dissimilar to their own? What feelings does a client associate with a character? Are those feelings familiar? If unfamiliar but positive, can the client access untapped feelings and utilize them?

A third difference between casual and therapeutic viewing has to do with articulating ideas for change derived from the film. I ask clients to consider the film's unique voice. How does that voice differ from the clients, from those of their families and friends, and what new perspectives do they hear? If the film were an encoded communication showing a new way of looking at their problems, what is the message? What new ideas for action emerge during the process of watching the film? How viable are the ideas it contains? If these ideas are potentially useful, how can a client put them into practice? If the ideas are impractical as they stand, can they be modified so they will work better?

Therapists should assemble a working list of therapeutically useful films that are available on videotape and should be aware of the films playing in theaters. It is important to identify several films that address each clinical issue because no film suffices for all clients and because clinicians work better with some films than with others. Once clinicians begin to employ films frequently, they will find favorites that fit their therapeutic approaches and their clients' needs.

A wealth of resources exists to help therapists select films that meet their clients' needs. The first resource is, as in our example, one's own clients, who will readily suggest films they have seen. Another resource is other therapists who use movies in therapy. Many of the films I use in practice were recommendations from other therapists. Shannon B. Dermer and Jennifer Hutchings, in a survey of marriage and family therapists, identified 100 films that therapists regularly use or deem useful for therapy in addressing marriage and family problems. (23) Family Therapy Networker contains monthly reviews of new films from a clinical viewpoint. For therapists with access to the Internet, numerous film sites list both current and older films. But therapists themselves are the best resource for useful films. When therapists watch films with an eye for how those films apply to a client's problems, their database grows rapidly. A whole world opens for inspection and evaluation.

Clients who are functioning moderately well in their home and work or school environments, and whose problems involve interpersonal components, are ideal candidates for videowork. I use films with individuals, couples and families, with adults, adolescents and some preadolescents. I do not assign films to clients who have recently had traumatic experiences similar to the characters in the film. Clinicians should make decisions about a client's readiness for a film by using the same criteria they use with any high impact homework. If they have doubts that a client's emotional strength is sufficient to deal with the feelings that a film may elicit, they should choose a less threatening film or not use videowork at all. Finally, if clients express a dislike of films in the intake interview, I do not use videowork. Plenty of people already enjoy films--there is no need to convince those who do not that they should. Clients who do already watch movies will interpret film assignments as busywork and will not comply with the assignment. In my experience, this group represents no more than about five percent of clients.

Therapeutic films should correspond to clients' narratives as closely as possible in terms of chronological age, socioeconomic background, education, values and subject matter. Close correspondence is more necessary for some than for others. Clients who abstract easily, who are imaginative and tolerant of other opinions and lifestyles, can benefit from a wider range of films than those who identify exclusively with films and characters that reflect familiar environments. Ordinarily, however, films should mirror the client in as many ways as possible.

Content can be matched to therapy issues analogically as well as concretely. Not all adolescent clients face problems similar to those of the young basketball players from an inner city neighborhood in Hoop Dreams (1994, by Steve James), but many adolescents can share those players' confusion over immediate versus delayed rewards, goals for the future and pressures from adults to succeed according to the adults' standards. Likewise, few couples are as literally combative as the caricatures Oliver and Barbara Rose in the film War of the Roses (1989, by Danny DeVito), but many divorcing couples do act as if they are in a vicious battle. Films can express the spirit of a client's problem while being very different in the particulars.

Clients often have strong preferences in the films they want to talk about and are not hesitant in asking me to see their choice of films. Eventually I realized that, in film assignments, I was not speaking a familiar language with clients, but was instead expecting them to learn a foreign tongue in my movie preferences. At that point, I began asking clients what films they enjoyed before I made suggestions of my own and then used the films they liked as often as possible. I found ways to caution against those aspects of films we thought might cause trouble (such as therapists falling in love with their clients), but we let the driving force of homework assignments be movies that they naturally enjoyed. And with that change, the hits start outnumbering the misses.

Films are ideal metaphors for problem solving because they involve thesis, antithesis and synthesis. A character experiences a crisis, tries out several unsuccessful responses and ultimately finds a resolution. Although films rarely provide exact solutions that clients can imitate in their own lives, they frequently act metaphorically to generate new approaches. Ideally, clients identify with the major characters, test out options considered by those characters and find points of agreement as well as disagreement with the resolution. In follow-up discussions, I reinforce the experience by making these impressions explicit, that is, by asking clients to describe which actions taken by the characters seemed to be the most helpful and how those same ideas might be utilized for the client's own problems.

Like other homework, videowork builds on previous assignments, addressing concerns as they arise in ongoing therapy. Clients who have a good experience with an initial film will be eager to receive new film assignments that correspond specifically to emerging issues. Therapists should assign follow-up films that target, through a character or theme, an issue that has become central in therapy. Therapists may find that eventually they are not assigning films as much as discussing films that clients have watched on their own initiative.

Once clients learn that films speak to therapy issues, they make more connections with any films they see, assigned or not. I find that client's look for films that address their problems and are delighted to present me with their discoveries, which, because of the ownership involved, can have more impact than films I suggest. Training in videowork changes mere entertainment into a productive therapeutic exercise.

Videowork is, of course, only one of many homework-based approaches available to the clinician who works from an outcomes perspective with a brief therapy orientation. Videowork should not be used exclusively; in fact, it does not work with every client. By itself, it offers few magic answers, but it spurs the client's imagination to be creative, to consider new ideas and modes of behavior, and to find novel solutions to wearisome problems.

ABBY CALISCH is a Clinical Psychologist and certified Art Therapist with over 25 years of clinical experience in the use of the arts in psychotherapy. She currently is an Associate Professor at the University of Louisville and serves as an Executive Board member of the American Art Therapy Association. She has published and presented extensively both nationally and internationally.

NOTES

(1.) Mary Ann Horenstein, B. Rigby, M. Flory and v. Gershwin, Reel Life/Real Life (Burlington. VT: Fourth write Press, 1994) and G. Solomon, The Motion Picture Prescription (Santa Rosa, CA: Asian Publishing, 1995).

(2.) Leon Eisenberg, "Does bad news about suicide beget bad news?," in New England Journal of Medicine vol. 315, no. 11, PP. 690-94 and B. Harry, "Movies and behavior among hospitalized, mentally disordered offenders." in Bulletin of the American Academy of Psychiatry and the Law Vol. 2, no.4, PP. 359-64.

(3.) John Pardeck, Using Bibliotherapy in Clinical Practice (London: Greenwood Press, 1993),

(4.) William C. Menninger, "Bibliotherapy." in Bulletin of the Menninger ClinicvoL. 1, no.8, pp. 263-74.

(5.) Hazel Sample, Pitfalls for Readers of Fiction (Chicago: National Council of Teachers, 1940).

(6.) Linda Berg-Cross, Pamela Jennings and Rhoda Baruch, "Cinematherapy: Theory and Application," in Psychotherapy in Private Praceice. Vol. 8, no. 1, pp. 135-57.

(7.) Menninger, ibid.

(8.) Geoffrey Hill, Illuminating Shadows: The Mythic Power of Film (Boston: Shambala, 1992).

(9.) Alfred Bandura, Principles of Behavior Modification (New York: Holt, Rinehart and Winston, 1969).

(10.) Berg-Cross, et. al., ibid.

(11.) Bernard D. Beitman, The Structure of Individual Psychotherapy (New York: Guilford Press, 1987).

(12.) Bandura, ibid.

(13.) Jay Haley, Uncommon Therapy (New York: W.W. Norton,1973).

(14.) Berg-Cross, et. al., ibid.

(15.) Beitman, ibid.

(16.) Bandura, ibid.

(17.) Haley, ibid.

(18.) Carol Staudacher, Beyond Grief (Oakland, CA: New Harbinger Publications, 1987).

(19.) Philip G. Zimbardo, Shyness: What it is, what to do about it (Reading, MA: Addison-Wesley, 1977).

(20.) Richard Bandler and John Grinder, Reframing (Moab, UT: Real People Press, 1982).

(21.) Steven Freidman, The New Language of Change (New York: Guilford Press, 1993).

(22.) Kenneth Gergen, Saturated Self(New York: Basic Books, 1991).

(23.) S. B. Dermer and J. B. Hutchins, Utilizing movies in family therapy: Applications for individuals, couples, and families. Manuscript in preparation.

Viewing for Entertainment  Therapeutic Viewing

Plot                       Characters
Action                     Relationships
Outcome                    Process
Excitement                 Insight
Suspense                   Analysis
Movie stars                Focus on oneself