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Journal of Creativity in Mental Health

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Creating Relationship Trees With Grieving Clients:An Experiential Approach to Grief Counseling

N. Lynn Peterson & Rebecca M. Goldberg

To cite this article: N. Lynn Peterson & Rebecca M. Goldberg (2016) Creating RelationshipTrees With Grieving Clients: An Experiential Approach to Grief Counseling, Journal of Creativityin Mental Health, 11:2, 198-212, DOI: 10.1080/15401383.2016.1181597

To link to this article: http://dx.doi.org/10.1080/15401383.2016.1181597

Published online: 13 Jun 2016.

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Creating Relationship Trees With Grieving Clients:An Experiential Approach to Grief CounselingN. Lynn Petersona and Rebecca M. Goldbergb

aCrossroads Counseling, Columbus, Mississippi, USA; bMississippi State University, Starkville, Mississippi,USA

ABSTRACTThe Relationship Tree is an experiential approach to griefcounseling combining narrative theory and art therapy,whereby clients create trees representing memories of theirrelationships with deceased loved ones. The exercise isdesigned for grieving clients to facilitate processing the painassociated with their losses. Making the tree in a visual, artisticformat and then discussing it with a counselor enhances clientinsight into bereavement. A series of narrative questions posedby counselors helps clients reinterpret experiences withemphases on growth from the past and hopes for the future.The process fosters acceptance of mixed feelings about lossesand creates opportunities for bereaved clients to tell new,more empowering stories about lost relationships and theirmeanings.

KEYWORDSArt therapy; creativecounseling approaches;creativity in counseling;experiential activities;experiential intervention;grief counseling; loss andbereavement; narrativetherapy

As human beings are subjected to loss again and again throughout theirlifetimes, grief is intricately woven into the fabric of human experience.Because losses are so universal, it is crucial for counselors to have interven-tions available to help clients process them and move through grief inhealthy, life affirming ways. The death of loved ones, divorce, the destructionof a home by natural disaster, or loss of employment are just a few of thesituations that may result in the need for grief counseling. In this article, wepropose creating Relationship Trees, an experiential intervention for use bycounselors in their practices with clients experiencing grief and bereavement.The Relationship Tree is a novel, creative way for therapists to work withclients to process feelings and deepen self-awareness in times of death andloss. The term Relationship Tree may at first bring to mind the idea of afamily tree or genogram (see McGoldrick, Gerson, & Petry, 2008). In thiscase, however, the Relationship Tree represents a client’s relationship to oneparticular individual. Clients create tree trunks and then decorate thebranches with different colored leaves to represent their different kinds of

CONTACT Rebecca M. Goldberg Rebecca.goldberg@ssrc.msstate.edu Department of Counseling,Educational Psychology & Foundations, 175 President’s Circle, POB 9727, Mississippi State University, Starkville, MS39762, USA.

JOURNAL OF CREATIVITY IN MENTAL HEALTH2016, VOL. 11, NO. 2, 198–212http://dx.doi.org/10.1080/15401383.2016.1181597

© 2016 Taylor & Francis

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associations to the deceased loved ones. The colors help to graphically displaythe full spectrum of clients’ feelings about the relationships (see Figure 1).

The Relationship Tree intervention powerfully combines the benefits oftwo different counseling modalities: narrative theory and art therapy.Through the process of creating the trees, reflecting on them, and sharingthem with counselors, grieving clients have opportunities to identify emo-tions, connect with memories, and establish holistic views of losses. A holisticview of loss is one in which the griever is able to present a portrait of thewhole personality of the lost loved one without exaggerating or downplayingthe significance of the loss, and to understand and accept the wide range ofthoughts and feelings that are part of the grieving process. Working withtheir counselors, clients are able to incorporate the stories of their grief intolarger stories of meaning in their lives and hopes for the future. In thisarticle, we discuss the Relationship Tree in the context of individual counsel-ing and focus primarily on bereavement, however, the exercise can readily be

Figure 1. Computer-generated sample of a Relationship Tree (as described in the case study).

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used in group or family therapy and modified for grieving nondeath losses aswe present in the section on adaptations. The exercise works well with bothadults and adolescents, but it is not recommended for use with children whomay not be developmentally ready to deal with the kinds of complexities thatit addresses.

Rationale

The process of creating and sharing Relationship Trees provides grievers withopportunities to tell the stories of their relationships and explore the feelingsaccompanying their losses. Clients are invited to grapple with what Worden(2009) defined as the second task of mourning: processing the pain of grief.Making the Relationship Tree requires clients to reflect on their relationshipsfrom holistic perspectives, including positive, mixed, and difficult aspects,thus providing opportunities for thoughts and feelings to surface and beprocessed. Often it is difficult for grievers to maintain balanced views of theirlosses, especially in the early stages of adaptation to loss—a period ofadjustment both to life without the deceased and to the changes in self-concept that accompany loss (Worden, 2009).

For example, a widow whose romantic partner experienced numeroushealth problems may define herself in terms of her role as a caregiver.After the death of the romantic partner, her view of her loss may becomeunbalanced if she focuses solely on the pain of loss and her identity as acaretaker. Through creating a Relationship Tree, she might see thatalthough she enjoyed certain aspects of the caretaking, it had also beena limitation to her freedom. Once this more balanced view is established,she may begin to think of other aspects of her personality and other rolesshe might play as she adapts to life without her partner.

The visual representations of their relationships may also help clientsand their therapists to see more clearly the types of attachments to lostloved ones. Worden (2009) pointed out the significance of attachment as amediator of mourning. He explained that the strength and security of anattachment, any ambivalence in the relationship, conflicts with thedeceased, and issues of dependency have important impacts on the inten-sity and nature of the grieving process (Worden, 2009). As clients makeand talk about their trees, counselors have many opportunities to shedlight on the ways these different kinds of attachments may impact thegrieving process.

For example, clients whose alcoholic or abusive spouses die may feelrelief which often causes guilt. The same may be true for clients whocared for loved ones during prolonged illnesses. Sons and daughters mayhave unresolved issues with parents that surface as confusion and painupon those parents’ deaths. The Relationship Tree is purposely designed

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to help recognize and reconcile these mixed feelings which, if unacknow-ledged, can interfere with the grieving process (Humphrey, 2009; Worden,2009). Using the Relationship Tree as a tool for understanding theseaspects of grievers’ attachments to their lost loved ones helps to guidetherapists in their choice of interventions for grief counseling.

Use of narrative therapy in treating grief

Narrative therapy is a postmodern counseling approach developed byMichael White and David Epston based on the idea that individuals arecontinually in the process of telling themselves stories about their lives(White & Epston, 1990). How individuals choose to tell these stories canhave profound impact on their experiences. Based simply on interpretation,an event can become a positive and empowering part of an individual’shistory, or a debilitating and demoralizing memory that causes ongoingpain. As clients tell their stories, therapists may help them identify proble-matic aspects of their stories–events they have interpreted in disempoweringways (White & Epston, 1990). Once these have been identified, it is possibleto deconstruct the disempowering assumptions and beliefs that keep clientsstuck (White, 2007). Therapists engage clients in what White (2007) calls “re-authoring conversations” (p. 61) which enable them to see old events in newways. With new perspectives, clients can craft narratives of success and hope,which serve as positive frameworks from which to move forward with theirlives (White & Epston, 1990).

The Relationship Tree exercise sets the stage for these kinds of reinterpre-tations of life stories. First, by examining their trees, clients are able toidentify problematic aspects of their stories. Then, they can begin to decon-struct false assumptions and beliefs about their relationships and their losses(White, 2007). After these steps, clients are ready to develop uplifting perso-nal narratives that serve to bridge life as it was before the loss and lifeafterward, without the deceased (Neimeyer, 1999). For an excellent overviewof using narrative therapy specifically for grief counseling, see Humphrey(2009) for review. In the next sections, we address art therapy’s beginnings,as well as application thereof in counseling grieving clients.

History of art therapy in the United States

The history of art therapy in the United States dates back to the late 1800sand early 1900s, coinciding with the advent of psychiatry. Interested inpatients’ artwork, psychiatrists realized that art could serve as an adjunct tomedical treatment (American Art Therapy Association; AATA, 2014).Psychiatrists began to consider art to be a powerful tool to enable nonverbalself-expression for patients with severe mental illness through painting and

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sculpture (e.g., Malchiodi, 2006). Art therapy steadily grew in recognitionand in the 1940s became its own distinct profession (AATA, 2014; Malchiodi,2006). Since this time, art therapy has been used increasingly in differentsettings (e.g., hospitals, clinics, rehabilitation centers) as a supplement fortraditional talk therapy; the creative processes involved with making art hasbecome well-known for enhancing recovery, mental health, and overall well-ness for patients receiving treatment (AATA, 2014). The populations andpresenting complaints with which art therapy can be used are extensive,including individual and family counseling, substance and behavioral addic-tions, anxiety reduction and stress management, and disordered eating(AATA, 2014). For an in-depth review, see Maxine Junge’s (2010) TheModern History of Art Therapy in the United States. In the next section, wewill explain how art therapy holds particular usefulness for grief counselorsworking with clients who have experienced loss and bereavement.

Use of art therapy in treating grief

Art offers a direct way for clients to clarify and communicate their ideas,feelings, and interpretations without the constraints of language(Malchiodi, 2007). Creative expression can be one of the most helpfulmeans for processing grief, allowing clients to feel and communicatetheir emotions, experience continued connection with lost loved ones,and prepare for life beyond their losses (Buser, Buser, & Gladding,2005). Loss often engenders feelings of powerlessness. The act of crea-tion can restore feelings of power and acceptance (Edgar-Bailey & Kress,2010; Buser et al., 2005). Artistic renderings of personal experience allowroom for objectivity, promoting self-knowledge and externalization ofemotions (Bradley, Whiting, Hendricks, Parr, & Jones, 2008). Art mak-ing can also appeal to clients as a safe way to express difficult thoughtsand feelings that might seem unacceptable when put into language(Malchiodi, 2007).

Individuals may feel inhibited by cultural and social admonishmentssuch as “don’t speak ill of the dead.” The Relationship Tree exercise isdesigned to reduce censorship of clients’ thoughts, allowing them to freelyexpress ideas and feelings. In the case of difficult relationships, such as theone between a client and her mother outlined in the case study below,clients may focus solely on negative characteristics and memories, therebyrendering the relationship one-dimensional. Through the RelationshipTree exercise, clients are encouraged to experience and visually representthe whole spectrum of their feelings and memories to more holisticallyview relationships with their lost loved ones.

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Creation of the Relationship Tree exercise

Originally, the Relationship Tree exercise was created by N. LynnPeterson and a classmate to fulfill an assignment for a graduate coursein grief counseling for loss and bereavement taught by R. M. Goldberg.The development of the exercise grew out of a desire to help clientsprocess the deaths of loved ones with whom there existed complicatedrelationships in life. The Relationship Tree was first presented as a groupcounseling exercise for the class members, who responded with greatenthusiasm for the intervention. We then piloted the exercise at twouniversities in the Southeastern United States creating four case studieswith college students who voluntarily came to counseling, and we foundthat clients had powerful breakthroughs with the help of making andprocessing the Relationship Tree. After piloting the exercise with indi-vidual clients, we decided to adapt it for a large group presentation atthe State counseling association conference (Peterson, Goldberg, &Moore, 2013).

To simplify the process of creating the tree due to time constraints,we adapted the original exercise by giving the conference participantsprinted copies of trees that were already drawn, complete with trunksand leaves. Workshop participants wrote on the leaves and then coloredthem with crayons according to the color key provided. Colors werechosen to reflect the meanings of the leaves: green for the positive,vibrant aspects of the relationships, like healthy leaves in nature; yellowfor the mixture of positive and negative aspects, like a leaf that is partlyliving and partly dying; and brown for the negative aspects that do notnourish relationships, like dead leaves. Although using the predrawn treelacked the self-expressive aspect which is a part of traditional art ther-apy, it made the intervention possible in a short period of time with alarge group of people. Feedback from participants indicated that theyhad powerful experiences with the exercise, as had those in the smallergroup and individual settings where there were increased opportunitiesfor individualization of trees. Several conference workshop participantsreported going on to use the exercise successfully in their agencies withtheir own clients. Peterson has subsequently used the exercise withseveral clients in her private practice.

Comments from individuals after they took part in the exercise con-sistently centered on several themes: deeper releases of grief than pre-viously experienced, greater acknowledgment and acceptance ofambivalent feelings toward their loved ones, better understanding oftheir bereavement and the reasons for having had difficulty grieving,and increased ability to let go of the pain associated with their lossesthat resulted in newfound peace. One of the case study participants, who

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had never been able to process her brother’s death, allowed herself togrieve deeply for the first time and gained new insight into the dynamicof denial in her family following his fatal accident. Another felt she wasable to let go of resentments toward her alcoholic father for the firsttime, 15 years after his death. One participant in the large group pre-sentation setting used the tree to think about a possible divorce andreported gaining new clarity regarding the decision she was makingabout whether to leave her husband.

For the purposes of this article, we present a method for creating thetree that provides some freedom of expression (the client draws and cutsout the trunk) and some use of prepared materials (the leaves fordecorating are pre-cut) to balance time constraints with the value ofexpressive art. If time allows, the exercise can be a much more openprocess with clients using more fluid media such as drawing, painting,or making collages from torn paper. The one constant that must bemaintained for the exercise to be most effective is the use of threedifferent colors of leaves. Simplifying the tree to three colors is impor-tant for creating greater manageability of the complex mix of thoughtsand feelings about the deceased, though clients can choose any threecolors that they feel best represent the positive, mixed or neutral, andnegative memories associated with deceased family members.

Assumptions

The Relationship Tree exercise is based on the following assumptions:

(1) The Relationship Tree offers a unique contribution to the field ofcreative therapeutic techniques by drawing on the power of twoproven methods for addressing grief: art therapy and narrative theory.

(2) The Relationship Tree clarifies the nature of clients’ attachments to lostloved ones by conveying the complexity of their relationships in a simple,visual form.

(3) The Relationship Tree exercise is an experiential, cost-effective methodfor processing the pain of grief and can be adapted based on clientneeds and available resources.

Objectives

The objectives of the Relationship Tree are:

(1) To facilitate the processing of pain associated with loss,

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(2) To encourage clients to tell stories of their relationships with lost lovedones and bring associated feelings to the surface, enhancing insightinto their own bereavement,

(3) To help clients normalize mixed feelings about lost loved ones andcreate balanced views of their losses, and

(4) To facilitate clients’ recognition and deconstruction of problematicthinking about lost relationships and empower them to constructnew stories based on strengths and hopes.

The process of creating Relationship Trees

The process to prepare Relationship Trees is the following:

(1) Prepare the materials you will need ahead of time (see Table 1). Cutout leaves from the three colors of construction paper. Make thembig enough to write on, but small enough to fit on tree branches.Cut out enough so that your client has access to many leaves ofeach color. Create a sample Relationship Tree or copy the treeincluded in this article (see Figure 1) to show to your client as anexample. Copy the page that tells the meaning of the leaf colors forclient reference (see Table 2).

(2) In the session with your client, show the example of theRelationship Tree and give your rationale for suggesting the exer-cise. Explain that the Relationship Tree is designed to represent the

Table 1. Materials needed for making Relationship Trees.Materials list

Sturdy white paper for background (8½” × 11” or 11” × 14”)Brown, green, and yellow construction paper for leavesBrown construction paper or cardstock for trunksScissorsGlue stickPen

Table 2. Meanings of leaves on Relationship Tree.Leaf colors

Green Yellow Brown

Positive aspects of person orrelationship

Neutral but defining aspects of person orrelationship

Negative or difficult aspects ofperson or relationship

Loved one’s likeable traits Loved one’s traits that fall on acontinuum from positive to negative

Loved one’s less desirablequalities

Happy events shared withloved one

Shared events that evoke mixed feelings Unpleasant shared events

Ways in which loved one wassupportive or caring

Ways loved one was both supportive andburdensome

Burdens imposed by loved one

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full spectrum of positive, negative, and mixed aspects of the rela-tionship with a lost loved one, as represented by the different leafcolors. Give the client Table 2, which shows the meanings of theleaf colors, for continued reference throughout the process.

(3) Give the client the supplies for making a tree. Ask the client todraw and cut out a trunk from the brown construction paper andglue it to the white background, then write the lost loved one’sname on the trunk. Have the client choose leaves and write associa-tions on them according to the meanings for each color and gluethe leaves to the trunk.

(4) When the client is finished making the tree, use the prompt ques-tions to generate a discussion about it (see Table 3). Encourageyour client to say whatever comes to mind and to not censoranything. (More introverted clients may benefit from the optionto answer the questions in writing.)

(5) Note mixed feelings and contradictory memories that may causecognitive dissonance, or a conflict between what clients feel andwhat they think they ought to feel. Facilitate your client workingthrough and accepting these incongruities. Help client to identifyproblematic, disempowering interpretations of feelings andmemories.

(6) Empower your client to re-author difficult aspects of the relationshipand the loved one’s death that have emerged during discussion. Look

Table 3. Prompt questions.Sample questions to ask after client completes making tree

What do you see as you look at your tree?What did you feel as you wrote on the leaves?Did anything surprise you as you made the tree?If you could change one leaf on the tree, which one would it be?

Note. These questions serve as a starting point for processing feelings and insights gained from the exercise.They may be expanded upon and adapted as appropriate for your client.

Table 4. Questions that facilitate re-authoring conversations.Memories of events with lost loved one

What conclusions do you draw from this event? Could you interpret it in a different way and drawdifferent conclusions?

What would your lost loved one tell me about this memory if he/she was here?What strengths are revealed in you by the way that you dealt with this event at the time or how you dealwith the memory of it now?

What does the way you handled this reveal about what you value? What do these values suggest aboutfuture directions for you?

What is it about this memory that prevents you from moving forward? What would enable you to workthrough this memory?

How does this memory empower you to move forward? How would you like to incorporate this memoryinto your life?

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for examples of resilience and the client’s learning from difficultsituations, and utilize these to develop positive directions for theclient’s future.

Some examples of re-authoring questions are provided below (see Tables4, 5, and 6).

Case example

The following case example is hypothetical and based on a composite ofseveral clients from the authors’ experiences while using the RelationshipTree in counseling. Angela is a 35 years old, single Caucasian woman whosealcoholic mother has recently passed away. She says she just does not feel likeherself lately. She has lost all motivation in life; she is listless and unable toconcentrate at work or to do the daily chores necessary to maintain herapartment. After a medical check-up reveals no underlying physical cause forher symptoms, her general physician recommends that she seek therapy fordepression.

When she first enters counseling, Angela is very bitter and angry towardher mother. She has nothing positive to say about her and insists that she is

Table 5. Questions that facilitate re-authoring conversations.Personality traits of lost loved one

What is an asset you gained from dealing with this difficult quality in your loved one? How does this helpyou in life?

You are really missing this quality in your loved one. How could you bring this quality into your lifethrough another avenue?

What is it about this quality in your loved one that is important to you? What does this say about you andwhat you want for your life?

How does having mixed feelings about this trait in your loved one impact your grief experience?What could help you accept the range of feelings that you have toward your loved one?What is something you have learned from dealing with your mixed feelings toward this characteristic inyour loved one?

What have you learned from this relationship that will enable you to improve your relationships in thefuture?

Table 6. Questions that facilitate re-authoring conversations.Relationship with lost loved one

If your lost loved one was here, what would he or she tell me about you? About your relationship to oneanother?

What have you learned from this relationship that will enable you to have improved relationships in thefuture?

What could help you accept the range of feelings you have toward your lost loved one?What could you do now that would enable you to feel that you are honoring your lost loved one’smemory?

What have you learned from your loved one’s life and/or death that will impact your life choices?

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glad her mother is dead. Except for a few tears at the funeral, Angela says shehas not grieved at all. Although Angela insists that her depression is unre-lated to her mother’s death, her mother comes up repeatedly in her initialtherapy sessions. The counselor identifies bereavement as a key factor inAngela’s depression and seeks a creative way to help Angela gain insight intothe true impact of her mother’s death. The Relationship Tree offers just suchan avenue.

At first, Angela is skeptical of working with issues related to her mother,but the hands on project appeals to her and she agrees to try it. After drawingand cutting out the trunk for the tree and writing “Mom” on it, she sitsquietly for a long time looking at the leaves. Then she chooses several of eachcolor and writes on them, sometimes wiping away tears as she does so.

After Angela finishes making the tree, her counselor engages her in adiscussion of the art she has created using the process questions listed inTable 3. In response to the counselor’s question about what she sees whenshe looks at the tree, Angela explains that she chose to place a brown leafwith the word alcoholism at the center because she feels that their wholerelationship was colored and controlled by her mother’s addiction. Otherbrown leaves deal with some of the most difficult aspects of their relationshipas Angela grew up. She says she could have added many more leaves, but itwould have felt too overwhelming, so she chose just a few main ones torepresent everything. She likes being able to choose the yellow leaf thatmeans something was mixed with both positive and negative aspects becauseher mother’s sense of humor was like that: At times it was fun, but othertimes it was cruel and cutting.

The counselor purposefully waits until after Angela completes herRelationship Tree to process it with her so that Angela is able to create hertree freely, without being interrupted by questions and probes while sheworks. To access the emotions that Angela experienced as she was creatingthe tree, the counselor asks how she felt as she was writing on the leaves.Angela responds immediately, “Angry!” After a pause she adds, “And sad.But I feel like if I let myself really feel sad about everything, I could just cryfor the rest of my life.” As she speaks, Angela realizes that she would ratherfeel angry instead, because she can keep in control with the anger and keepmoving, but if she feels the sadness, “it seems like I will just lie down andnever get up again.”

Her counselor asks whether Angela’s trouble being productive at workand doing daily household chores might be a form of expressing hersadness. Her lack of motivation might stem from this impulse to “liedown and never get up again.” Angela stops to consider this. The moreshe thinks about it, the more she realizes that her mother’s death is playinga role in her listlessness that she has not previously recognized. Thecounselor then explores whether any other realizations occurred to her

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during the artistic process by asking whether anything surprised Angela asshe was working on her tree. She laughs, “That I had any positivememories at all!”

Angela talks about a song she and her mother used to sing together at thetop of their lungs whenever her mother broke up with a boyfriend. She alsorecalls a fun trip they took to the beach when she was eight. This was the onlytime she could remember that her mother had been truly caring and attentiveto her. Through that experience she says she got a little glimpse of what itmight have been like to have a “normal mom.” She points to her artwork andexplains that she pasted some of the green leaves falling to the groundbecause she lost what was positive about her mom as the alcoholismprogressed.

Angela says that, normally, when she thinks of her mom, all her thoughts arenegative, but making the tree helps her see that her mother was a lot of differentthings, not all one way or the other. She begins to understand that a lot of whatshe saw as her mom was actually the symptoms of her addiction. Seeing thishelps her shift some of her anger away from her mother and onto the addictionitself. She explains, “I feel more sympathetic toward her. It doesn’t feel good tocarry around so much bitterness; it is relief to let some of it go.”

This leads to the counselor’s next question: If Angela could change oneleaf on the tree, which one would it be? “Alcoholism. No doubt.” After apause, Angela adds, “But I can’t change it, no matter how angry or sad I feel.”This insight leads to an important realization for Angela—that she never gotwhat she needed or wanted from her mother. Her mother’s death makes thisfinal. As she talks, she realizes that this may be playing a role in her loss ofmotivation. Angela tells her counselor that she has always tried to work hardand be good, hoping one day her mom would finally love her. Now, Angelasees no point in working hard because it can never win her mother’s love.

Here the counselor identifies one of the problematic narratives that hasarisen for Angela due to her mother’s drinking—that she has to work harderand be “good” to be worthy of love. This leads to a discussion of Angela’sfeelings of low self-worth and her perception of herself as never good enough tobe lovable. The counselor will follow up on these beliefs in subsequent sessions.

At this point, the counselor takes the opportunity to look at the leaves onthe tree for some clues as to how Angela might begin to “re-author” (White,2007, p. 61) her story by finding positive aspects of her negative experiences.They discuss one leaf on Angela’s tree that says, “left home alone a lot” (seeFigure 1). Angela says that although this was very hard at the time, she canalso see that she learned to take responsibility for herself and gained a lot ofindependence. These qualities are a part of what has made her successful inher work.

In the coming weeks, the counselor will talk with Angela about what ispossible for her now that she understands more about the impact that her

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mother’s life and death have upon her. Since Angela has identified takingresponsibility for herself as a strength she developed in her childhood, thecounselor will draw upon this strength. Angela can now take responsibilityfor changing the negative beliefs about life and about herself that she devel-oped as a child based on her mother’s behavior. Through this process, Angelamay find new motivations and aspirations which will shape a positive direc-tion for her future.

Adaptations of the process

Creative applications of the Relationship Tree exercise can render it useful ina wide variety of therapeutic interventions. The Relationship Tree can easilybe adapted for clients who are grieving nondeath losses, such as divorce,being fired from or quitting a job, losing one’s home, acquired disability,natural disaster, surviving sexual assault, or those experiencing life transi-tions such as empty nesters and new retirees. The Relationship Tree exerciseis particularly well suited for use in a grief therapy group. Sharing their treesgives group members the opportunity to deepen their emotional bonds.When group members see that other individuals have multiple colors ontheir trees (i.e., mixed feelings about their relationships), it normalizes thewide range of feelings toward lost loved ones, something that may causegrievers guilt if gone unaddressed (Worden, 2009).

Requirements and limitations

There are two requirements for creating a Relationship Tree—access tosupplies for making the tree and a sighted client with color vision.Adaptations are available to prevent these from becoming limitations forthe exercise. In the case of a situation where art supplies are unavailable, theexercise can be done with paper and pen or on a dry erase board. The clientcan draw the tree and leaves and use dashes, polka dots, or other markings todelineate the different colors of the leaves. The counselor can take a pictureof the dry erase board to capture the image before it is erased. For a visionimpaired client, different textured fabrics or papers can be used to representthe different colors. Adaptive software technologies may be available for useas well. See Figure 1 for an example of a computer generated version of theRelationship Tree.

Conclusion

The Relationship Tree is a creative intervention for use in grief counselingthat uses both art therapy and narrative theory to facilitate the processing ofgrief. As bereaved clients create and share their Relationship Trees with their

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counselors, they tell the stories of their losses and consciously examineambivalent feelings about their relationships. They process painful feelingsand become more comfortable with the idea that their relationships were notall one way or another—that there were positive, mixed, and negative aspectsto their loved ones and their relationships with them. Through re-authoringconversations with their counselors, clients reinterpret problematic aspects oftheir histories with loved ones and find examples of strength and resilience.Clients are empowered to come to terms with their losses in healthy, holisticways and to incorporate new interpretations of their life stories into hopefulnarratives for their futures. Our society is increasingly recognizing that griefemerges in many situations in addition to bereavement related to death;future research could include adapting the Relationship Tree exercise toprocess other kinds of losses. Anecdotal evidence from our case studiessuggests that the combination of art and narrative therapies offers a promis-ing pathway to heal many kinds of grief related to different types of losses.

Acknowledgment

The authors gratefully acknowledge Alicia Moore for assistance with creating theRelationship Tree exercise.

Notes on contributors

N. Lynn Peterson is a counselor with Crossroads Counseling, Columbus, Mississippi.

Rebecca M. Goldberg works for the Department of Counseling, Educational Psychology &Foundations at Mississippi State University, Starkville, Mississippi.

References

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Buser, T. J., Buser, J. K., & Gladding, S. T. (2005). Good grief: The part of arts in healing lossand grief. Journal of Creativity in Mental Health, 1(3/4), 173–183. doi:10.1300/J456v01n03_11

Edgar-Bailey, M., & Kress, V. E. (2010). Resolving child and adolescent traumatic grief:Creative techniques and interventions. Journal of Creativity in Mental Health, 5(2), 158–176. doi:10.1080/15401383.2010.485090

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