Holiday Writing Exercises

Developed by: Amanda Dixon

Goal: To facilitate and promote discussion through the use of metaphor.
Materials:
v

Construction paper

Markers (all colors)

Scissors

Tape

Glue

Preparation:
v

Depending on the time of year (Halloween, Christmas,

Hanukah, Thanksgiving, etc) cut out symbols related to those
holidays

Example: for Halloween out of construction paper cut out a

bat, pumpkin, and ghost

Description of activity:
v

At the beginning of the session show the individual the cut

outs, preface the session with realizing its getting close to
certain holiday and utilize the holiday as a means to get at that
child/teenagers feelings about that time of year

Ask the child/teenager to decorate the symbol and explain

that we will then work on writing a story surrounding the symbol

Example: the child/teenager selects the bat cut out and

continues to write a story about the bat, the bat being the main
character in the story.

If the child/teenager feels comfortable have them write the

story on their own. Give them time and space to do so. If they
need assistance provide it to them.

Following the completion of their story writing, either you

read the story or if the child/teenager is comfortable have the
story read aloud.

Once you or the child/teenager has read the story continue

the activity by asking the child/teenager questions pertaining to
the story. Take this a step further by asking them questions
about things they did not write about in the story, but ask them
things such as, What do you think would happen if.

Continue to work in the metaphor. If the child/teenager

takes to this type of activity, continue it in following activities
suggesting maybe that the child/teenager develops more of the
characters from the original story.

Heart Symbol Strategies

By David A. Crenshaw, Ph.D., ABPP
Readers who have followed my writing know that I use the heart symbol frequently
in my work because it has been a potent symbol in cultures around the world
throughout the ages. For many the heart symbolizes love, for others passion, or the
emotional center of the person. Among the strategies previously described are the
Heartfelt Feelings Strategies (Goodyear-Brown, 2002; Riviere, 2005; Crenshaw,
2008) and the Heartfelt Feelings Coloring Card Strategies (Crenshaw, 2008). The
strategies below build on the previous ones by using the heart shape in symbol
therapy work.
Materials: I collect hearts of a wide variety of shape and colors and materials at
novelty shops. My collection consists of plastic, felt, and various glass and gem
stone materials. I find that children are fascinated by the beauty and variety of the
hearts in the collection. I keep the hearts in a leather-bound and velvet lined jewelry
box that adds further mystique and value to the collection as perceived by the
children.
The Velvet-Lined Box of Hearts
Purpose: To create and expand on a potentially healing therapeutic dialogue about
important losses and disappointments in the childs life.
Materials: A collection of hearts in a leather bound and velvet-lined jewelry box.
Directions: The child is asked to pick from a collection of hearts in a leather bound
and velvet-lined jewelry box a heart that symbolizes someone important whom they
misssomeone they dont see at all (a person who died or someone who moved
away) or someone they dont see as often as they wish. They can pick more than
one heart to represent each of the persons they are missing.
On inquiry, the child is asked to tell why they picked that particular heart for each of
the persons they are missing, and to talk about that important person who is
presently missing from their life.
The Circle of Hearts
Purpose: To identify and create dialogue about the family and interpersonal
resources the child can draw on in times of crisis or emotional vulnerability.
Materials: Same as above.
Directions: The child is instructed to pick a heart from the velvet-lined box of hearts
to represent the self. Then the children are asked to pick a heart for every person
that loves them. These hearts are arranged in a circle around the heart they have
picked for self. If children are unable to make a full circle of people who love them,

they then should be directed to place also in the surrounding circle a heart
representing friends, peers or adults who care about them or support them. If they
are still unable to complete the circle the children can be asked to pick a heart to
represent people who they would like to be able to turn to for love and support.
Clinical Considerations:
As with all of my strategies that are evocative of emotion, sometimes quite powerful
emotions, only the clinician working with the child or family or group of children (in
group therapy or art therapy) can decide if such a strategy would be appropriate for
a given client(s) at a particular time. Obviously, timing and pacing are critical factors
in clinical decision making, as well as a thorough understanding of the childs level
of functioning at any one point in time, including the ability to tolerate anxiety and
emotional distress. The level of external stress in the childs life at the given point of
time also needs to be considered. It is impossible to overemphasize the factor that
repeatedly has been demonstrated empirically to have the most bearing on
psychotherapy outcome, the quality and strength of the therapeutic alliance. It is
important to realize that the tools I have introduced to child and family therapy are
just what the name impliesthey are tools but not the therapy itself. They are
techniques that can be used by child and family therapists who adhere to a wide
range of theoretical orientations, including but not limited to cognitive-behavioral
therapy, psychoanalytic and psychodynamic approaches, Jungian, play therapy,
gestalt therapy, narrative therapy, solution-focused therapy, family systems therapy,
and art therapy. The ultimate goal is to expand emotionally meaningful and heartcentered dialogue with the child, family, or group that I believe contributes to the
healing process.
References:
Brown Goodyear, P. (2002). Digging for buried treasure. Antioch, TN: Paris Goodyear
Brown.
Crenshaw, D. A. (2008). Therapeutic Engagement of Children and Adolescents:
Play, Symbol, Drawing, and Storytelling Strategies. Lanham, MD: Jason
Aronson/An Imprint of Rowman & Littlefield Publishers.
Riviere, S. (2005). Play therapy to engage adolescents. In L. Gallo-Lopez and C. E.
Schaefer, eds., Play therapy with adolescents, 2nd ed. (pp.121-142). Lanham, MD:
Jason Aronson/Rowman & Littlefield.
Copyright 2008 by David A. Crenshaw, Ph.D., ABPP. All rights reserved.

Heartfelt Feelings Coloring Card Strategies Kit

For the convenience of those familiar with the Kit, new ordering information is first.
Detailed information about the Heartfelt Feelings Coloring Card Strategies Kit is
below it.

Tools to Pursue the Heart of Therapy

The Kit consists of a printed and bound Clinical Manual and a set of 20 Expressive
Cards and a set of 20 Relational Cards. We are very excited about to make the
Heartfelt Feelings Coloring Card Strategies readily available to clinicians with the
Clinical Manual and Card Sets combined in one ready to use package.
The Heartfelt Feelings Coloring Card Strategies (HFCCS) are a series of strategies
that can be used in play therapy, child therapy, family therapy, group therapy, and
art therapy to facilitate the expression and sharing of heartfelt emotions. Many
clinicians have used some variation of the heart shape in child, play, art therapy and
other creative arts therapies. A comprehensive review of these creative
contributions can be found in the HFCCS Clinical Manual. The Manual contained in
the HFCCS Kit describes, gives directions, and offers clinical examples for both the

HFS and the HFCCS. Perhaps the part of the Heartfelt Feelings Strategies (HFS)
and the HFCCS that most distinguishes it from all the similar strategies using the
heart shape in art, child and family therapy is that in both the HFS and HFCC, Dr.
Crenshaw focuses on two core domains: Expressive and Relational. The
Expressive component offers structured therapeutic practice in identifying, labeling,
and expressing feelings. These are key skills in affect regulation and for developing
social competence. Allan Schore (2003a; 2003b) at UCLA, in his groundbreaking
work on affect regulation has demonstrated that affect dysregulation is central to
almost all forms of psychopathology so therapeutic interventions that address this
crucial deficit will have wide application across the psychodiagnostic spectrum.
The Relational component consists of systematic exploration of the heartfelt
feelings in connection with key attachment figures and with important persons in
the childs interpersonal world. Obviously our most heartfelt emotions do not
develop in a vacuum. They develop in an interpersonal context. Our most strongly
experienced emotions tend to be elicited in relation to the key attachment figures in
our lives. Witness the outpouring of some of the most intense emotions human
beings are capable of when an attachment bond is broken. In the HFS Strategy, the
relational is accomplished in two ways. Typically, Dr. Crenshaw asks the children to
color the heart in relation to a very specific relational issue, such as, Color in the
heart according to how you felt, when Daddy got mad and left the house last night.
The second way the Relational component is emphasized in the HFS is in the list of
follow-up questions. Some of the questions are related to the Expressive (E)
component such as, Which feeling was the strongest? or What feeling is the
hardest for you to express? Another group of follow-up questions however are
specifically focused on Relational (R) issues such as, Who in the family would
agree with your choice of the emotion that is expressed the least in the family? or
What emotion is most uncomfortable for you to express and who else in the family
is uncomfortable expressing that same emotion?
The social context is critical. Some children get angry at school but not at home,
others get angry at home but rarely at school. In the HFCCS the cards are also
divided into two succinct sets, the Expressive and the Relational, to once again
emphasize these two key components. In the HFS, thirty-five sample follow-up
questions are offered in the Clinical Manual to address both the Expressive and the
Relational domains of the HFS. In the HFCCS, the Expressive component takes the
form of practice in expressing in context over forty emotions arranged in sequential
fashion to cover the developmental landscape from preschool to adolescence. The
Relational component consists of forty specific directives to the child in using the
HFCCS cards, such as, Draw in the heart on the front of the card, a person who
once was in your heart but no longer is. The Clinical Manual also contains a
number of variations of both the HFS and HFCCS for use in bereavement work,
supervision, examining countertransference feelings, highlighting strengths, and
focusing on resources within the community.
REFERENCES
Schore, A. N. (2003a). Affect dysregulation and disorders of the self. New York: Norton.
Schore, A. N. (2003b). Affect regulation and the repair of the self. New York: Norton.

"The Volcano Speaks"

A Three Step Anger Modulation Strategy

Many children seen in clinical settings are not having trouble expressing their
feelings but rather they have major difficulty controlling their feelings. The child
therapy and play therapy literature is saturated with techniques to enable children
to be more expressive of their feelings and this is helpful to an internalizing,
anxious, depressed, or inhibited child. Children, who act-out or externalize their
feelings, however, dont need help in being more expressive, they need help in
being expressive in an appropriate way. This three-step drawing strategy was
developed by Dr. Crenshaw to teach the crucial skill of modulating anger for
externalizing kids whose presenting problem is reactive-impulsive anger and
aggression. Dr. Janine Shelby, a trauma specialist, at UCLA points out that
Cognitive-Behavioral Therapy (CBT), although of proven efficacy, tends not to
be "child friendly," (cerebral and dry). The new "Volcano Speaks"
strategy is designed to be "child friendly."
Step One (Scaling through artistic expression): Using metaphors from nature, ask
the child to make a picture of a volcano, or a storm (thunderstorm, tornado,
hurricane)that would show just how angry the child was on a particular occasion
(such as when he/she was thrown out of the baseball game). Alternatively, they can
draw an angry monster or a fire-breathing dragon if they prefer that would depict
just how angry they felt in the given situation (e.g., when they hit their teacher). This
step involves the child scaling his experience. If the picture shows a passing
thunderstorm it is relatively low on the anger thermometer scale; if on the other
hand the tornado or hurricane blasts through and levels the town or the volcano
erupts and spews hot lava and engulfs neighboring villages, the anger thermometer
is maxed out. By emphasizing that there are degrees of anger this step can teach
children with anger control problems that it need not be an all or none proposition.
The artistic expression of their anger also offers practice in a safe and socially
acceptable way of expressing anger. Dr. Crenshaw has not known of anyone who
has gotten into trouble for making pictures of volcanos or storms or even angry
monsters/dragons.
Step Two (Verbalization): The most crucial skill in developing the ability to modulate
anger is learning the use of verbal mediation. When children are able to express
anger through words instead of biting, kicking, and hitting they have taken a big
step toward expressing their anger constructively. The child can be instructed:
Pretend that the volcano (or storm or angry monster) can talk and give words to
the anger it feels, what would it be saying? The child can write directly on his
picture the words the volcano, storm, or angry monster would use to express its
feelings. If they prefer that the therapist or parent or other adult do the writing that
is no problem. It is important, however, to allow them to use their natural language
for expressing raw emotion. This is no time to insist on use of the Kings English.
Remember we are trying to move from biting, kicking, punching to verbalization so
that is a major accomplishment. We can work on finding more appropriate use of
language at a later time. A child may be sent to the principals office for using foul
language but they won't be in nearly as much trouble as they would if they belted a

child in the mouth. It is also important to try to get them to verbalize as many ways
of expressing the anger of the chosen metaphor (volcano, storm, angry monster) as
possible. What else would the storm say about how angry it is? By pushing the
child for additional ways of expressing the anger into language they are getting vital
practice in verbal mediation.
Step Three (Problem-Solving): This is a crucial step in which the therapist, parent,
or teacher engages the child in problem-solving and finding other alternatives to
exploding, erupting, destroying everything in the path etc. The therapist or other
adult can say to the child, Suppose the volcano noticed it was starting to get angry
at this early point (point to a lower point within the volcano far from the erupting
point at the top) or suppose the storm before it became a category two storm was
able to find a way to calm itself, what do you think are some ways it could do that?
It is important to use language that teaches children a vocabulary for these lower
level angers so that they once again are taught there are many degrees on the scale.
You can say, Lets pretend that the volcano was only irritated or annoyed at that
point, not really that angry, what do you think it could do to calm itself? Children
are being asked at this step to problem solve and generate alternatives. As they
propose an option, such as Talk to someone, or Think about something else, or
Take a deep breath, it is crucial to follow-up and ask them how they think that
would have worked out? Could all that destruction have been avoided? If a child
blocks and is unable to think of alternatives the therapist or other adult should offer
a menu of coping strategies for the child to pick from: Could it get more
information, clarification? Could it turn to a friend for support? Could it take a
time-out to think the situation over? Could it take three deep breaths and try to
just relax and stay calm? Could it just say to itself, This will pass, everything will
be okay, I will get through this? The therapist or adult is modeling for the child
some important CBT coping strategies. The prime deficit for an impulsive-reactive
aggressive child is the inability to stop and reflect on their impulses and feelings.
This is an important way that the child can be given practice in developing these
crucial problem-solving skills.
Copyright 2004 by David A. Crenshaw, Ph.D. All rights reserved.

The Ship Prepares for Voyage

This projective storytelling technique invokes the powerful metaphor of piloting or
organizing a voyage across the ocean (life journey) with all the adventure,
challenge, crisis, which facing the often-treacherous seas can entail (life is full of
challenge and setbacks). The story also elicits the childrens perception of their
resources both internally and within their interpersonal support system to prepare
for the anticipated adversities. The internal or external locus of control of children is
likely to be revealed by whether they choose to captain the ship themselves or rely
on someone else to pilot the ship. Their choice of guests to accompany them on the
voyage may be revealing of whom they regard as significant attachments and
supports in their lives. The degree of hope or hopelessness and their optimistic or
pessimistic explanatory style will be suggested by the outcome of the trip and how
the crises are handled. Water has often been viewed as a symbol of life and a
boat/ship as a vessel of life and a crossing as the bridge between life and death,
sometimes between good and evil, from life to after-life and so the story basics
contain rich symbolism that offers an unique opportunity to gain access to the

childs inner world of thought, feelings and fantasy. The ship leaving its home port
to face unknown dangers and uncertainties on the high seas is also powerfully
evocative of themes of loss, desertion, and abandonment for those left behind, fear
of never returning to ones home base and being separated forever from loved ones
for those leaving on their journey.
The Ship Prepares for Voyage
The Story: Now, I want you to pretend that you have your own ship and you are
preparing for a voyage across the ocean. Think about what preparations, what
supplies will be needed. How big a crew will you need? How experienced willyour
crew be? Will you be the captain of the ship or will you hire someone to pilot the
ship. How will you prepare for storms and rough seas? Who else will you invite to
go on this voyage with you? Now I want you to reflect and pause for a moment and
fully relax. I want you to think about your voyage across the ocean and what kind of
adventure it is going to be for you, your invited guestsand the crew. Think about
some of the challenges that you will face as you make your way across the ocean
and how you will manage those crises that arise. Make up a story about your
voyage, your adventure across the ocean; be sure to give your story a beginning, a
middle part, and an ending. Be sure to include some action, drama, and suspense in
the story, in other words make it a good story. Children are good at making up
interesting stories and I am sure you will be able to come up with an exciting story
of your own.
Among the follow-up questions to the childs story, consider the following:
1. What title would you give your story?
2. How did it all turn out in the end?
3. What would you do differently on your next voyage?
4. How did you feel about your voyage? How did your guests feel? How did your
crew feel about the voyage?
5. What can we learn from your story? Is there a moral or a lesson from your story?
6. If you could give advice to other people starting out on a voyage, what advice
would you give after your voyage across the sea?
Copyright 2004 by David A. Crenshaw, Ph.D. All rights reserved.

The Magic Key

One of the Projective Drawing Strategies developed by Dr Crenshaw is The Magic Key
(Crenshaw, 2004, Crenshaw & Mordock, 2005).
The therapist gives the following instructions to the child:
Imagine that you have been given a magic key that opens one room in a huge castle. There are
four floors in the castle and since the castle is huge there are many rooms on each floor, but
your magic key only opens one of the many, many rooms in the castle. So pretend you go from
room to room, and from floor to floor, trying your magic key in each door until you finally
come to the door that your key opens. You turn the key and the lock opens. Because this is a
magic key that only opens this door, what you see is the one thing that has always been

missing from your lifethe one thing you always believed would make you happy. Pretend
that you are looking into the room. What is it that you see? What is that one thing that has
been missing that you always believed would make you happy? When you have a clear
picture, please draw it as best you can.
Not surprising in this highly consumer oriented culture, is that children often draw a big
screen or flat panel TV. Some children, however, draw the missing or deceased parent, a safe
home they never experienced, or a family where the parents dont argue so often. They draw a
home they always longed for, one which is sadly missing in their lives. This projective drawing
strategy can be very useful with children whose lives are replete with loss. Many severely
aggressive children have suffered profound, multiple losses. When we dare to see what there is
to see, when we are receptive to hear what there is to be heard, underneath the gorilla suit
(aggressive acting-out) we will often findnot simply a bad kid but a vulnerable, in many
cases, traumatized child (Crenshaw & Hardy, in press).
Copyright 2004 by David A. Crenshaw, Ph.D. All rights reserved.

The Fair Trial-Counteracting Shame

One of the Projective Drawing Strategies developed by Dr Crenshaw is The Fair Trial
(Crenshaw, 2004, Crenshaw & Mordock, 2005).
This intervention is designed to challenge shame-based beliefs so prevalent in
aggressive children and impulsive kids who frequently get into trouble. Often these
kids view themselves as simply bad kids. I subscribe to the philosophy
expressed by a valued colleague, Charles Applestein, that there is no such thing as
a bad kid.[1] The negative messages these children receive, often from an early
age, due to their problems with affect and impulse regulation, are often encoded
with strong emotional intensity. As a result, calm, logical, reasoning with the child
does little to dislodge such beliefs. The goal as Beverly James[2] states is to match
the emotional intensity of the negative message that you are attempting to
counteract. This requires some creativity and ingenuity on the part of the child
therapist. It should also be noted that longitudinal research has concluded that
guilt, defined as condemnation of a specific act, is a healthy and constructive
emotion, while shame, defined as condemnation of self is a destructive emotion
associated with a wide range of psychopathology including aggression and
violence.[3] Thus, it is crucial for child therapists to find effective ways to challenge
and dispute shame-based beliefs.
One of my favorite interventions with shame-based beliefs in youngsters with
impulse-disorders is The Fair Trial.[4] I wait for harsh condemnation to arise in the
symbolic play scenarios of these children. Invariably, one of the play characters
does something to get into trouble and often is given a harsh sentence: He is
going to jail for the rest of his life, with no visitors, and no chance to ever come
out! Or, even more severe, is the death sentence; He is to die in the electric chair
tonight at midnight! At that point I intervene, Whoa, hold on here. Your honor, I
am the attorney for the defense and I think there is a rush to judgment here. I would
like to request the opportunity to present my case. If the judge permits, (if not I file
an appeal) I present my case identifying some of the redeeming qualities of this
fellow who seems always to get into trouble. An example follows: Your honor, I
have known this young fellow, Tommy, for some time now, and I am here to say that

by no means, no way, is he simply a bad kid. Lots of people think he is a bad kid
and he believes he is a bad kid. But let me tell you what I know about him. I know
that he stands up for little kids who are being bullied by bigger kids. There are a lot
of younger kids in the school he goes to who look to him for protection. I also know
he is very kind to animals. Just last week he found a stray kitten, took it home, and
took care of it until his mother was able to find the kitten a good home. Does that
sound like a bad kid to you Judge? I know he sometimes gets excited and he does
not always control his temper, and sometimes he goes overboard in the things he
does. He sometimes doesnt listen to his parents or teachers, but who ever heard of
putting a kid away for life or sending them to an electric chair? This is a terrible
mistake, Judge. When people take the time to get to know Tommy they find out that
he is a kid with a good heart, a big heart, and he deserves our support, not our
harsh punishments. I appeal to you, Judge, with all my heart, Tommy is not a bad
kid, in fact, he is a good kid. He just doesnt know it. I rest my case.
If the judge denies my argument, I ask for adjournment so I can present new facts
and work on making my case even stronger. Eventually, after modeling my
advocating for the so-called bad kid, I suggest that we switch roles and have the
child be the defense attorney and make the case for the redeeming, good qualities
in the bad kid. When the child is able to make the case with some emotion and
conviction behind it, I know that we have made progress in modifying the harsh
self-condemnation of self portrayed in the handing out of harsh and unforgiving
punishments of the play characters who, like him or her, are frequently in trouble.
[1] Appelstein, C. (1998). No such thing as a bad kid: Understanding and responding to
the behavior of troubled children and youth. Weston: MA: The Gifford School.
[2] James, B. (1989). Treating traumatized children: New Insights and Creative
Interventions. Lexington, MA: Lexington Books.
[3] Tangney, J. P. & Dearing, R. L. (2002). Shame and Guilt. New York: Guildford Press.
[4] Crenshaw, D. A. & Mordock, J. B. (2005). Handbook of Play Therapy with Aggressive
Children. Lanham, MD: Jason Aronson.

The Tree at the Top of the Hill

This projective drawing and storytelling strategy from Engaging Resistant Children
in Therapy involves a tall and proud oak tree that has lived long and weathered
many challenges, harsh winters, and challenges. The tree has seen wars, famines,
and droughts and has weathered them all. The tree has many stories to tell and one
night the people of the village gather under the tall and dignified oak tree to hear
one of the many stories it could tell. The story pulls for tales related to the harsh
circumstances that some kids have endured such as abuse or domestic or
community violence.
Drawing Directives
Now, if you are comfortable doing so, close your eyes for a moment and try to

picture that tree standing tall and proud on top of the hill. Try to get a clear picture
in your mind of the tree, and when you are ready gently open your eyes and draw as
best you can that tree on top of the hill that has survived and weathered so many
hard times, but still stands tall and proud.
Follow-Up to the Drawing
Include in you inquiry questions about others included in the picture.
1.

What title could you give to your drawing?

2.

If the tree could feel what would it be feeling in your picture?

3.

What is the relationship of any others in the picture to the tree?

4.

Is the tree in your picture healthy or sick?

5.

Is it strong or weak?

6.

Is it dying or will it live for at least another hundred years?

7.

Who cares about the tree?

Storytelling Directives
Every person who has been on a long journey has many interesting stories to tell.
This tree has had a long journey and has lived through many changes. If the tree
could talk what stories would it tell? The tree has seen and survived so many
challenges. The people of the village knew it had many stories it could tell. Pretend
that the people who live in the village climbed the steep hill and are gathered
around to hear the story of the tree.
Follow-Up to the Story
Therapists can look for central and emotionally significant themes that capture
key feelings or conflicts with which the child is struggling and then cross-validate
these themes by examining the childs other stories. The therapist can then employ
metaphors in communications that will capture, in a powerful way, these central
themes, feelings, and conflicts. The themes can also be used in interpretative
activity and in reflections upon subsequent artistic creations. Some additional
questions that might be asked of the child follow:
1.

What made the tree decide to tell its story?

2.

Why did he pick this time to do it?

3.

What would be a good title for the trees story?

4.

What did the village people learn from the trees story?

5.

Does that tall, strong, proud tree that has survived so much
anyone?

Falling Leaves: Past, Present, & Future

Developed by: Amanda Dixon
Affiliation: The Childrens Home of Poughkeepsie

remind you of

Goal: To facilitate and promote healthy discussion amongst family members.

Materials:
v

One large sheet of white paper

One large sheet of brown construction paper

One sheet of average-sized green construction paper

One sheet of brown average-sized construction paper

Markers (all colors)

Scissors

Tape

Glue

Preparation:
v

Cut the average-sized brown and green construction paper

into the shape of leaves, this should yield about six leaves for
each sheet of paper (you will need more paper and leaves if there
are more than two people in the family session)

Cut the large piece of brown construction paper into the

shape of a tree
Tape or glue the tree to the large sheet of white paper

v
Description of activity:

v
Pass out brown and green leaves to the family
members (each member should have two brown and
two green leaves)
v

Have the family members write something they like about

their relationship with their family or specific family member on
the green leaves.

Have the family members write something they would like to

see change in their relationship with their family or specific
family member on the brown leaves.

Have the family members take turns placing the green leaves
on the brown tree with glue.

Have the family members take turns placing the brown

leaves on the tree with tape.

Once a leaf has been placed on the tree the therapist should
try to facilitate discussion surrounding what the individual just
placed on the tree.

The tree should be accessible during most sessions

following the one that it is created as it is a valuable tool to
demonstrate how much the family has changed or stayed the
same throughout the therapy. Over time the brown leaves
should be taken off the tree as the family feels that they have
accomplished changing that part of their relationship.