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Counsellors’ experiences of using creativity in counselling clients with concurrent disorders : what helps and hinders Smith, Barbara


This study investigated the experience of concurrent disorders counsellors using creativity in practice. In any given year, one in five individuals in Canada experiences a mental health illness that can include a substance use disorder. Lifetime prevalence estimates of individuals with substance use disorders and severe mental illness(es) varies from approximately 40% to 60% depending on the sample. Individuals with concurrent disorders often also face additional physical health, financial, education, relational, housing, and criminal justice challenges. Ultimately these issues cost the economy more than $50 billion per year. In an era of limited resources, the need for creativity in assisting individuals with concurrent disorders seems extreme. However, there is little research investigating how concurrent disorders counsellors use creativity with their clients, particularly with regard to what nourishes and impedes their creativity. The results of this study provide insight into the factors that help and hinder concurrent disorders counsellors’ creativity in practice. Eleven participants were interviewed using the Enhanced Critical Incident Technique. The study generated 298 incidents, including 167 incidents described as helpful to creativity in practice, 88 incidents perceived as hindering creativity and 43 wish list items. These incidents were grouped into 34 categories. The 12 helping categories were: personal factors, colleagues and collaboration, resources, education and training, client factors, autonomy, supportive management, client feedback, experience, personal or professional practice, meditation/mindfulness, and personal therapy. The 10 hindering categories were: client factors, personal factors, bureaucracy, imposed models, unsupportive management, time pressure, lack of resources, colleagues, physical environment, and lack of special topics education and training. The 12 wish list categories were: special topics education and training, resources, alternative therapies, therapeutic space, integrated co-occurring disorders centre, services integration, supportive management, time, time with creative people, client factors, autonomy, and preventative work. The findings show that personal and client factors along with colleagues, education and training, and management all play significant roles in helping and hindering concurrent disorders counsellors’ creativity. Unique findings included meditation and personal therapy enhanced creativity, imposed models hindered creativity, and desires for increased services integration, and the creation of concurrent disorders centres with integrated services to enhance counsellors’ creativity.

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