Transformation hidden in the sand; developing a theoretical framework using a sand-tray intervention with adult clients.

Aim: Sand-tray is an addition to talking therapy, which enables the client to focus on the central issue in the ‘here and now’, helping them ‘stay with’ and explore their pain. The aim of this research was to produce a theoretical model and address the gap in the literature when using this intervention with adults in therapy. Design: The dual-role of counsellor-researcher is adopted in a multiple case study, incorporating grounded theory (Strauss & Corbin, 1990). Six participants each had six hours of sand-tray therapy. The dual role was managed in the study by evaluating the ethical implications of researching own clients, including issues of informed consent, role-fluency, boundaries, level of self-disclosure, avoiding harm and benefits for the participants, research and clinical supervision. In addition, the pragmatics of the therapeutic approach taken when using sand-tray was considered. Findings: The theoretical framework established from the grounded theory process indicated that a pluralistic approach was adopted. This included establishing the participants’ goals for therapy and working in collaboration with them to decide the tasks and methods in therapy, in order to meet their goals. Throughout the therapy process, every opportunity was taken to facilitate purposeful dialogue with the participants to establish a two-way relationship. In line with the pluralistic frame, assessment and feedback was also an essential feature of the process. The sand-tray is described as a metaphorical experiential theatre, where the sand-tray served as a stage where participants presented their intra-psychic, inter-relational and cultural/spiritual issues. The dynamic phenomenological field aspect of the framework consists of various elements of phenomenological shift, including intra, inter and intera-phenomenological shift, phenomenological flux and phenomenological distortion/denial. These concepts originate from the model’s foundation: sand-tray, pluralistic component and metaphor/symbolism. The sand-tray specific concepts of phenomenological anchor and phenomenological hook facilitated edge of awareness for all participants and unconscious processing for some. The sand-tray therapy resulted in a reduction in the participants’ psychological and emotional distress, related to their issues explored. Implications: This study has relevance for the counselling profession; therapists, who are open to working pluralistically, may draw upon the ideas presented when developing their practice of using sand-tray with adult clients.