Using Sand Tray Therapy with Individuals Diagnosed with Alzheimer's Disease

Abstract

It has been reported that the mental health needs of the aging U.S. population are historically underserved by the counseling profession. In response, this qualitative research investigated the impact of sandtray therapy on individuals diagnosed with Alzheimer's disease. Participants successfully completed the creation of sandtrays while the researcher observed, interviewed, and documented the individual sandtray creations. The researcher, also the sandtray therapist providing the intervention, had nearly seven years of experience working in a private practice setting using sandtray therapy. The sand tray therapist has completed multiple trainings in the modality, including multiple week-long experiences in Adlerian sandtray therapy with Dr. Terry Kottman. Dr. Kottman also consulted on this research and assisted in evaluating the clients' sandtrays. The intervention established that using the sand tray allows the dementia patient to kinesthetically connect to their inner cognitions through the intentional symbolic expression offered by this unique therapeutic medium. Using a series of eight sand trays of varying thematic concepts, the participants were offered a modality to facilitate a synthesization of their continued individuation, presenting a possible neural pathway to connect and express thoughts, feelings, emotions, concerns, challenges, and fears. The findings of this study include the fact that all trays were classified as "empty" and that the majority of the participants placed objects almost exclusively on the right side of the tray, which is commonly associated with the concrete or conscious side. The use of sandtray allowed each individual the opportunity to create autobiographies in the sand and literally navigate through time – past, present, and future, confronting fears, expressing hope and possibilities. The research study results offer insight into the psychotherapeutic effects of using sandtray therapy with dementia patients, as well as a better understanding of the cognitive and expressive abilities and limitations of an individual with impaired memory. The results also offer insight into this population's difficulties with short-term memory and possibly indicate a potential means for monitoring cognitive decline.