DSM at The Movies: Bringing Clients into the Classroom via Visual Media

Janice J. Caron, Ed.D.
Capella University
School of Human Service
caronj@earthlink.net

Janice J. Caron has provided learning experiences for students and clients utilizing films in the classroom as well as clinical setting. She has taught and developed many of the Counselor Education courses at Capella Univesrity. She has extensive career experience in outpatient, in-home, college counseling, and community mental health services. In addition, she maintains a private clinical practice on Sanibel Island, Florida.

Although films do not permit mutual interaction between counselors-in-training and clients, they do afford beginning counselors the opportunity to experience complex therapeutic situations. Capturing the Friedman, directed by Andrew Jarecki, will be presented as an educational tool for teaching family and couple counseling concepts in the instruction and development of perceptual, conceptual, and executive counseling skills. This teaching modality provides students the opportunity to reflect on inner struggles, dilemmas, and problem resolutions through use of visual media.

An innovative way to bring the client into the classroom is through the use of popular media to present clinical information and to expand on students' reactions and experiences to these complex clinical situations. Several authors have discussed the use of film in the classroom. Chambliss and Magakis (1996) explored the use of film to teach abnormal psychology, pointing out pedagogic advantages of student debate of ambiguous and vague diagnoses and complex ethical dilemmas. Fleming, Piedmont, and Hiam (1990) reported that films provide an opportunity for students to "see realistic manifestations of psychiatric disorders, apply models of psychopathology, and suggest modes of treatment" (p. 185). Demerath (1981) discussed the use of film to teach sociology and the cultural transmission process. Dermer and Hutching (2000) use popular films to educate, normalize, reframe, and expose students to new ideas. Consequently, films have the potential to invoke innovative thinking styles to work with challenging cases and to promote insight into understanding diverse ethnic and minority clinical cases.

An important step is for instructors to prepare students before introducing movies into the classroom. This preparation includes letting students know the rationale for choosing a particular film and providing stimulus questions prior to viewing. Further preparations might include highlighting alliances and coalitions in the family and social context. Also, the use of profanity could be offensive to some students, even though in many counseling settings, clients choose to express themselves using profanity. For students who have lived sheltered lives and have not been exposed to working with clients from different socio-economic backgrounds, films can serve as an opportunity for them to desensitize in a safe environment. Students should be informed about the violence and profanity prior to viewing the movie and if a movie proves to violate their religious values, they should be given the option to decline the movie experience and complete a substitute assignment.

Before inviting the client into the classroom, Capturing the Friedmans is summarized below to grasp how a seemingly normal, upper-middle class family responds to the impact of stress on family dysfunction.

Arnold Friedman, a Columbia University graduate and award-winning school teacher who holds computer classes and piano lessons for neighborhood kids three times a week in his basement. Elaine is the devoted house wife and the Friedman’s have three active sons David, Seth, & Jesse who are home movie buffs. The Friedman’s apparent normalcy comes to an end when the postal inspector intercepts an envelope from the Netherlands containing child pornography. The envelope is addressed to Arnold. When Elaine is shown one of the pornographic photos, she comments, "My eyes were in the right direction, but my brain saw nothing." David, the eldest son informs the audience that Arnold didn't enjoy spending much time with his wife and that he kept an office in the basement where the maid wasn't allowed to clean.

Two search warrants and a broken-down door later, Arnold and the youngest son Jesse, who assisted Arnold and was linked by the students in police interviews, are taken away in handcuffs while eldest son David throws a fit as he walks around wearing underwear on his head to avoid being filmed by television cameras. The charges are, in addition to possession of a large amount of pornography depicting men with underage boys, ninety-one counts of orally and anally sodomizing boys from the computer class. However, watching them in their own home movies, it becomes impossible to see them as anything other than human beings.

The Friedman’s are not supposed to be like us, are they? We're not supposed to have anything in common with them. The very thought is uncomfortable, yet unavoidable.

This film provides the student with a realistic view of how a family deals with high conflict and ambiguous family situations.

In using the film, Capturing the Friedmans as a teaching tool, students can be asked to identify each family member’s role in the family system and to address both strengths and weaknesses of each family member as well as strengths of the family as a unit. Viewing highly intense films can elicit strong emotional reactions in students, who may then project their personal reactions to clients and hence interfere with their ability to sustain an objective systems perspective (Higgins & Dermer, 2001). Cleghorn and Levin (1973) contended that a counselor working with a couple or family must have certain skills in order to work with individuals but must also have specific skills when working with more than one person in the room. They define three skills necessary for working with couples and families: perceptual, conceptual, and executive counseling skills.

Perceptual Counseling Skills include the ability to collect and gather information, observe the interrelationships of members in a system, and gather information about the connections among transgenerational systems. For example, when viewing Capturing the Friedmans, a counselor working with a family needs to pay attention to the content of what people say, observe their nonverbal communication, and observe how different people in the family affect each other and the family as a whole (interactional communication). When viewing the Friedman family, one can easily notice the emotional alignment and affiliation of the Friedman family members, who seem to have been split on gender lines.

The counselor also needs to collect information about how the family both influences and is influenced by meta-systems (e.g., extended family, police, community, school, and work). This is of particular importance when students view the family members right after the arrest of Arnold. For example, stimulus questions can include “What is the impact of a police investigation on family interaction, truth, and public disclosures”?

To further increase the use of perceptual skills, the genogram can be used as a valuable tool for collection of data and assessment as well as student self-exploration. Furthermore, genograms are widely used by family therapists, family physicians, chemical dependency counselors, and other clinicians. It serves as a clinical assessment of clients and functions as a graphic tool for organizing extensive information gathered during a family interview. It enables a clinician to explore cyclical and transgenerational patterns in a family system (McGoldrick & Green, 1986). The use of family history and genograms for the professional development of clinicians was first popularized in the 1950s and 1960s by Dr. Murray Bowen. Bowen felt that a family therapist "must have a thorough understanding of his own position in the family; otherwise, his unresolved conflicts would obscure his ability to identify and counsel clients who required his professional objectivity" (Curtis, 1984, p. 36).

An additional example for increasing perceptual skills includes students watching clips of Capturing the Friedmans from different perspective. A student could view it from the perspective of Elaine (the mother), Arnold (the father), or either of the sons David or Jesse. Viewing it from different angles enables students to integrate multiple perspectives, and hence increase empathy for different family members and also for the entire family system. Furthermore, the ability to identify various perspectives helps to strengthen one’s perceptual skills, and increases counselor's ability to integrate multiple perspectives into a working hypothesis. This then contributes to the mastery of one’s conceptualization skills.

Conceptual Counseling Skills include the ability to bring together observations in a coherent manner and to understand them as parts of an entire system. The counselor uses conceptual skills to generate hypotheses based on information gathered during the counseling session. A student may be asked about possible hypotheses when Arnold’s brother, Howard, states he had no recollection of any sexual contact with Arnold in childhood, despite Arnold’s reporting it in a letter? Alternately, when several groups of students view the same information and then report (either verbally or in written form) hypotheses, it helps the counselor-in-training focus on the process of developing working hypotheses. When students generate and explain hypotheses, the student practices using conceptual skills.

Executive Counseling Skills describe the ability to integrate the content (what one observes) with comprehension (how one understands what one observes) into a way of influencing clients. Mental health professionals need to transform observational and comprehension skills into a method of instituting change. The acquisition of executive skills is an essential though sometimes elusive goal (Cleghorn & Levin, 1973). Practicing treatment planning gives students the opportunity to apply theoretical knowledge, reinforces systemic thinking, and introduces students to paperwork they will have to complete when they begin their practicum and internship experience. Formulation of treatment plans enable students to demonstrate how content and comprehension can be integrated to influence the treatment of couples and families. This integration is a fundamental aspect of executive skills.

The intent of viewing the film, Capturing the Friedmans will be to stimulate thought and discussion in the education of future marriage and family counselors about couple and family counseling: the process, the therapeutic relationship, various skills and techniques, and ethical considerations. Such films represent one of many possible tools in teaching theories and as such should not become the central focus of the class. Films are an entertaining and a unique supplement to any classroom activity. They represent diverse populations, including underrepresented populations; allow for multiple viewing; and provide a safe distance for the beginning counselor. Finally, as educators we can improve the learning process by using films for teaching diagnosis, theories, and counseling procedures.

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