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Using films as an adjunctive treatment in psychotherapy: EA professionals may find it useful to supplement bibliotherapy with films, especially with clients who are nonverbal or unlikely to complete assigned readings.

There are numerous approaches to therapy and counseling (see Corsini and Wedding 2008), and many employee assistance professionals identify with one of more of these schools of psychotherapy. Although differing in theory and strategy, many of these approaches include bibliotherapy as a part of treatment. There is strong justification for this practice: At least a dozen controlled clinical trials document that self-help books and/or computer-based treatments are effective adjuncts to therapy (Norcross 2006). Examples of extremely popular books used to facilitate therapy include David Burns' Feeling Good and a classic book by Albert Ellis and Robert Harper, A New Guide to Rational Living.

However, bibliotherapy may not be appropriate for clients with little education or for those individuals who simply do not like to read books. While there are no randomized controlled trials documenting the efficacy of films in psychotherapy, there is ample anecdotal evidence that many clients benefit when films are included as a part of the therapy process (Sharp, Smith, and Cole 2002; Wedding and Niemiec 2003).

Watching films is a pleasurable activity for most people, and watching a movie usually requires less time than reading a book. It is less expensive to rent a film than buy a book, and most EAP clients have easy access to a large number of films through neighborhood video stores or via commercial outlets such as Netflix.

RECOMMENDED FILMS FOR THERAPY

You may be able to integrate cinematherapy (Berg-Cross, Jennings, and Baruch 1990) into your EAP practice. A few simple examples will help you generate your own ideas about how popular films can be used in treatment.

1. Iris, a biographical film illustrating the life of Iris Murdoch, Away Fro m Her, a love story about a woman with dementia (played by Julie Christie), or On Golden Pond, with Henry Fonda as an aging college professor, could be used as a springboard for discussion with someone coping with a spouse with Alzheimers disease.

2. Ordinary People, a somewhat dated but still powerful film, illustrates the effects of grief and how change can occur in psychotherapy

3. Days of Wine and Roses and The Lost Weekend are two powerful films illustrating the devastating effects of alcoholism; a more recent example of the ways in which alcohol abuse can affect a family is found in When a Man Loves a Woman.

4. Mr. Jones might be used to show a client how one behaves during the manic phase of bipolar disorder (though this film is flawed by the fact that the therapist, a psychiatrist, has an affair with her bipolar patient).

5. Once We Were Warriors is a powerful film about suicide and domestic violence, and it could serve as a stimulus for a meaningful discussion about either of these issues.

6. Boys Don't Cry could serve as a prelude to a thoughtful examination of gender identity issues.

Lampropoulos, Kazantis, and Dean (2004) surveyed 827 licensed practicing psychologists and found that 67 percent of respondents used films as an adjunct therapy technique. The majority of these practitioners (88 percent) felt the use of films in therapy facilitated outcomes; only 1 percent felt that the use of films could be potentially harmful. Therapists who identified as eclectic-integrative, cognitive-behavioral, or humanistic were the most likely to include movies as a part of therapy

These psychologists ranked 27 specific motion pictures on the basis of their therapeutic quality The 10 top-rated films were as follows:

1. Ordinary People (1980)

2. Philadelphia (1993)

3. The Great Santini (1979)

4. On Golden Pond (1981)

5. Trip to Bountiful (1985)

6. My Life (1993)

7. Kramer vs. Kramer (1979)

8. Dad (1989)

9. Dead Poets Society (1989)

10. When a Man Loves a Woman (1994)

Several books are devoted to the use of films in therapy, and these books may be worthwhile for EA professionals interested in exploring the use of films in their practice. Hesley and Hesley (1998) maintain that films can aid treatment planning by (1) offering hope and encouragement, (2) reframing problems, (3) providing role models, (4) identifying and reinforcing internal strengths, (5) potentiating emotion, (6) improving communication, and (7) helping clients prioritize values.

SUCCESS FACTORS FOR CINEMATHERAPY

Berg-Cross et al. (1990) write about the ways in which films can enhance the therapeutic alliance by creating what they call "a common bridge of understanding between the client's angst and the therapist's empathy" They report that films give clients deeper insights into their personal dilemmas, help them better understand their personalities, and create meaningful therapeutic metaphors capturing the essence of their presenting problems. According to these authors, cinematherapy is likely to be successful when four conditions are met:

1. The client must be actively and consciously working on a specific issue:

2. The therapist must want to deepen the level or broaden the issues on which the client is working;

3. The therapist must be able to adequately prepare the client for the film; and

4. The therapist must process the video with the client soon after it has been viewed (cited in Wedding and Niemiec 2003).

Solomon (1995 and 2000) offers practical suggestions for helping professionals interested in extending their practice by prescribing films likely to be therapeutic or useful in facilitating counseling or psychotherapy Wedding and Niemiec (2003) provide a detailed example of how Ingmar Bergman's Wild Strawberries was used to facilitate therapy with a Swedish client; other Bergman films discussed in therapy included Fanny and Alexander, Persona, and Smiles of a Summer Night.

Wedding, Boyd, and Niemiec (2005) have written a book, Movies and Mental Illness: Using Films to Understand Psychopathology, that classifies films by diagnostic categories. Each film is rated using a five-point scale. In a subsequent book, Positive Psychology at the Movies: Using Films to Build Virtues and Character Strengths, Niemiec and Wedding (2008) identify and discuss those films that best illustrate the six virtues and 24 character strengths identified by Chris Peterson and Martin Seligman in their book, Character Strengths and Virtues: A Handbook and Classification (2004).

The virtues listed by Peterson and Seligman include overarching categories such as wisdom and knowledge, courage, humanity, transcendence, temperance, and justice. Character strengths are more specific attributes such as creativity, integrity, gratitude, and humor. Both books contain detailed appendices that categorize, classify, and rate thousands of psychologically relevant films.

Cinematherapy is far from being an evidence-supported treatment; however, extensive clinical experience suggests this approach to treatment may be useful in selected cases. It provides a vehicle to support substantive discussion of important therapeutic issues during the therapy hour. Clients are more likely to comply with a request that they see a film than a request that they read a book. Finally, the practice provides the EA professional with a pleasurable way to engage clients and a potential springboard for the kind of intense, in-depth discussion and dialogue that is the hallmark of good therapy

References

Berg-Cross, L., P Jennings, and R. Baruch. 1990. Cinematherapy: Theory and application. Psychotherapy in Private Practice, 8, 135-156.

Burns, D. 1999. Feeling good: The new mood therapy. New York: Avon.

Corsini, R.J., and D. Wedding (Eds.). 2008. Current psychotherapies (8th ed.). Belmont, CA: Thompson Brooks/Cole.

Ellis, A., and R.A. Harper. 1975. A new guide to rational living. Oxford, England: Prentice-Hall.

Hesley, J.W, and J.G. Hesley 1998. Rent two films and let's talk in the morning: Using popular movies in psychotherapy. New York: Wiley

Lampropoulos, G. K., N. Kazantzis, and F.P. Dearie. 2004. Psychologists' Use of Motion Pictures in Clinical Practice. Professional Psychology: Research and Practice, 35, 535-541.

Niemiec, R., and D. Wedding. 2008. Positive psychology at the movies. Gottingen, Germany: Hogrefe & Huber.

Norcross, J.C. 2006. Integrating Self-Help into Psychotherapy: 16 Practical Suggestions. Professional Psychology: Research and Practice, 37, 683-693.

Peterson, C. and M. Seligman. 2004. Character strengths and virtues: A handbook and classification. New York: Oxford University Press.

Sharp, C., J.V. Smith,, and A. Cole. 2002. Cinematherapy: Metaphorically promoting therapeutic change. Counselling Psychology Quarterly, 15, 269-276.

Solomon, G. 1995. The motion picture prescription: Watch this movie and call me in the morning. Santa Rosa, Calif.: Asian Publishing.

Solomon, G. 2000. Reel therapy: How movies inspire you to overcome life's problems. New York: Lebhar-Friedman Books.

Wedding, D., M.A. Boyd, and R.M. Niemiec. 2005. Movies and mental illness: Using films to understand psychopathology. Gottingen, Germany: Hogrefe & Huber.

Wedding, D., and R.M. Niemiec. 2003. The clinical use of films in psychotherapy Journal of Clinical Psychology, 59, 207-215.

by Danny Wedding, Ph.D., M.P.H.

Danny Wedding is a clinical psychologist who directs the Missouri Institute of Mental Health, a policy and research center associated with the University of MissouriColumbia. He is a former J congressional fellow who has served in both the U.S. Senate and House of Representatives. He lectures widely on the ways in which popular films stigmatize people with mental illness and the professionals who treat them. He can be reached at danny.wedding@mimh.edu.
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Title Annotation:employee assistance professionals
Author:Wedding, Danny
Publication:The Journal of Employee Assistance
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Date:Oct 1, 2008
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