Brandon Ballantyne, 28, a licensed professional counselor at Reading Hospital in Reading, Pa., has found a way to use his passion for the arts to help his teenage clients. Ballantyne, a member of the American Counseling Association and the Pennsylvania Counseling Association, has been a drummer for more than 15 years. He incorporates music, along with other creative interventions such as art and journaling, to help his adolescent clients express sometimes difficult thoughts, feelings and experiences. The teens with which Ballantyne works are typically admitted into the hospital’s inpatient psychiatric unit after episodes of self-injury, psychosis, suicidal ideation, suicide attempts, aggression or homicidal ideation. Still, Ballantyne believes that utilizing creative interventions is important for every counselor to practice, regardless of the client population. 

Why did you first decide to work with adolescent patients? 

Many people have asked me this question, and I have given most people the same interesting, honest response. Originally, I wanted to become a tornado chaser. However, I took a psychology class in high school and really enjoyed the material and concepts. I decided that the tornado-chasing idea was a little too risky, so I chose to pursue a career in working with teenagers.

Yes, these two career pursuits are very different, but maybe not as different as one would think. While working with adolescents as a counselor, you can encounter various challenges and obstacles to the therapeutic process. The therapeutic process itself is something that has always been very rewarding for me to be a part of. In therapy, we should not “chase” the challenges. And we should not fear the challenges. We should embrace them and be open to them. We should accept them as an important part of the therapeutic process.

If you know what I am talking about, then you can understand why I chose to work with adolescents. I believe that adolescents have an incredible ability to utilize their resilience and potential. As a counselor, I feel that you have the option of working with many aspects of a teen’s individuality, which includes but is not limited to their sense of humor, skills, hobbies, talents, aspirations, family and creativity.

Why did you think that creative interventions would be helpful for them?

Creative interventions are helpful for adolescents because it provides them with a safe, less intimidating outlet to express their thoughts, feelings and self-concept. From my personal experience, creative interventions allow adolescents to access their strengths more effectively in the therapy session. With the combination of art, music, journaling and talk therapy, the adolescent is able to experience various styles of self-expression. They also experience the autonomy of working with a counselor who allows them as an individual to choose which therapeutic outlet is most beneficial.

How long have you been using creative interventions with these patients? What results have you seen?

I have been using a combination of art, music, journaling and talk therapy with adolescents for approximately six years. Most of my work has been done on an acute inpatient psychiatric unit. I have noticed that when art is combined with journaling and cognitive therapy, the adolescents appear more comfortable disclosing thoughts and feelings. It seems as if they perceive support from both the counselor and the protective platform that their artwork creates.

What is a typical session like with your patients?

Initially, I start the session by inviting the patient to complete a drawing. I typically ask my patients to use colored pencils because I feel it gives them more opportunity to add more detail to their picture. For example, I may ask the patient to draw a picture of a volcano. Now, we all know that sometimes a volcano is just a volcano. However, each volcano is different. And each volcano has different characteristics.

Next, I would ask the patient to create a story about [his or her] picture. I would be sure to communicate that the plot of the story is completely up to them. However, it must include their volcano in some way. I also invite them to include a description of their volcano in the story as well.

After the story is complete, we are about 20 to 30 minutes into the session. Next, I invite them to share their picture and story with me. I have found that the stories that adolescents create to go along with their pictures are usually either really creative and intricate, or very brief and concrete. However, as a counselor, I pay most attention to the themes they include in their story as well as the description of their volcano. They might describe their volcano as explosive, or simmering, or quiet, or maybe even violent. The theme of their story might represent similar dynamics. The goal is to invite them to compare the characteristics of their drawing and creative story to themes in their actual life. Maybe their preference to express emotions is similar to the way they imagine their volcano erupting.

I think that if the patient is able to connect their own interpersonal preferences to the characteristics in their creative work, insight can be grown. I believe that once the adolescent discovers insight, they are able to experience more awareness of how situations and relationships in life influence them. I find that, sometimes, this type of insight is hard to grow in a classic talk therapy session.

Adolescents are unique individuals with unique ideas and perceptions. Using a creative intervention such as the one [I] described can provide them with an opportunity to discover new insight into their self-concept. By the end of group, a volcano will not just simply seem like a volcano anymore. I imagine you could facilitate the same intervention using tornadoes.

The specific object that they choose to draw is just as important as the themes and characteristics brought out in the story. This creative intervention is a less intimidating, safe platform that can be used to assess interpersonal themes, coping skills, relationships, self-esteem and more. I think it is important to end the [session] by making connections between their drawing and their real-life situations. This is the point in the session where insight can occur.

I believe that it is also important to offer a homework assignment as well. Inviting the patient to complete homework assignments reinforces a sense of responsibility to themselves and their treatment. For example, I might ask my patients to write a paragraph about what they feel they learned during the session and invite them to share it with me the next day. This also increases the flow of therapy and creates continuity from session to session, thus providing the patient with a fluid, consistent therapeutic experience.

Have you found any interventions to be more effective than others?

I have used art as a single intervention, journaling as a single intervention, talk therapy as a single intervention and music as a single intervention. All of these provide a unique platform for the patient to express thoughts and feelings, as well as build insight. However, it seems that the most progress has been made by using a combination of art, journaling and talk therapy [as part of] one creative activity. I feel that music is a good complementary item to utilize either at the beginning or at the end of the session. I tend to use soft rock/acoustic music to help the patients ground their mood both at the beginning and the end of the session. This is something that can be applied to both group and individual therapy.

What kinds of counselors do you feel would benefit from using these types of interventions?

I believe that all counselors can benefit from creative interventions. My priority as a counselor is to create a safe environment for my patients to express their thoughts and feelings. I feel that music, art, journaling and talk therapy can provide a client-centered environment that reinforces the patient’s autonomy to invest in treatment. I believe that the best progress is made when the patient is able to access their personal strengths, talents and creativity. 

Is there anything else you would like to add?

I believe that at the very root of all adolescents, there is a sense of resiliency that patients can access with the help of creative outlets. I encourage all counselors to consider the use of creative interventions when working with patients who seem to gravitate toward that kind of platform. Creative interventions may not be helpful for all adolescents. However, it is our professional and ethical duty as counselors to take a flexible approach with patients. We have to be willing to explore various styles of counseling and work with the patient to determine which styles are most beneficial. Allow your adolescent to have autonomy and control in your session, while at the same time providing assignments to reinforce accountability. As a counselor, you should not feel like a tornado chaser. Instead, maybe more like a tornado embracer.