spotlight

Therapeutic photography:
enhancing patient communication
Using photography with patients to help them express concerns, investigate coping strategies and
learn from their peers is known as therapeutic photography. The practice has benefits to both
professionals and participants, particularly with ‘hard to reach’ populations who may feel intimidated
or disempowered. Neil Gibson explains how this intervention can be structured in the health setting.

■ photography ■ communication ■ social identification ■ social work

I
s a picture truly worth a thousand words? It cases, a route to the unconscious (Weiser, 2004).
depends how it is used. The practice of using For any practice to be ‘therapeutic’ there has to
photography as therapy dates back to the 1850s be a benefit to the end user in terms of deepening
when Hugh Welch Diamond applied photographic understanding of the self, while enhancing coping
processes to document and highlight the different strategies and reducing inner conflict (Borden, 2000).
strains of mental illness he encountered among Therapeutic photography allows participants to enjoy
female patients, believing that capturing a person’s capturing images, but opens them up to question the
appearance in an image also revealed a window into image, discuss the content and discover more about
their character (Drinkwater, 2008). themselves as they do so. Because this might involve
After World War II, photography was used by outcomes, such as self-expression, rehabilitation,
recovering servicemen for recreation, but therapeutic healing and empowerment, Halkola (2013) suggested
benefits were also noted, leading to the adoption that sessions are best guided by professionals who
of the technique in some civilian hospitals to aid are able to assist in the emotions that may arise (e.g.
recovery from physical and psychiatric illnesses health, education and social work professionals).
(Perchick, 1992; Glover-Graf and Miller, 2006).
Since the early 21st century, the therapeutic use of ‘Aura of authenticity’
photographs has been divided into two categories: Academic research has recognised the benefits that
phototherapy and therapeutic photography. photography brings to the exploration of lived
Weiser (1984; 2001; 2004) offered a distinction experience because it has an ‘ability to render details,
between these two approaches, explaining that [and] has an aura of authenticity that gives it a unique
phototherapy refers to the structured use of power and fascination’ (Griebling et al, 2013: 17). By
photographs in a counselling or therapy session structuring this exploration against a socioecological
that, by definition, is led by a trained counsellor or model (Bronfenbrenner, 1986; 1992; 2009) and setting
therapist; whereas therapeutic photography is used tasks based around the themes at each level of this
to define photo-based activities that can be self- model, participants of therapeutic photographic
initiated, as well as group-based, but do not require interventions can be invited and encouraged to
the formal role of a counsellor or therapist. For consider their experiences.
many practitioners interested in using photographs Guided by a facilitator, participants can explore
in their practice to explore issues, but who do not their own photographs and discuss the importance
have a formal qualification, it is to the approach of and significance of images before capturing positive
therapeutic photography that they must look. aspects of their characteristics in a self-portrait. Family
In reality, there are grey areas into which these photographs can be shared and pictures can be
two approaches cross. In both practices, practitioners produced to represent significant relationships in the
cannot be taught how to decode photographs; the microsystem; days can be explored in visual format
image is a catalyst for communication and, in some to look at routines and challenges; and group projects
© 2017 MA Healthcare Ltd

can explore relevant issues to highlight the benefits

Neil Gibson and challenges faced by a minority group as they
Senior Lecturer, Robert Gordon University, Aberdeen pictorially examine the macrosystem.
Email: [email protected] When this is conducted between a facilitator
and a participant, the dynamics of the therapeutic

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 spotlight

relationship develops. Body language changes as the also underpins the application for associated health
participant invites the facilitator to lean in and see professionals, such as occupational therapists and
the image; eye contact is no longer focused on each physiotherapists, who need to work with patients to
other and becomes preoccupied with the photograph, put supports in place when someone is discharged
making it easier to talk freely. The participant from hospital, or coming to terms with a change
becomes the expert of their situation as they have in circumstance. The ability of a patient to visually
chosen what to photograph, what to show, and what document their own situation, highlighting areas
to say about the image, meaning they demonstrate where they incur difficulty, alongside areas where
greater control within the therapeutic milieu. With they can function with relative ease, provides the
control comes confidence and the ability to engage professional with valuable, personalised data to help
in a conversation with a facilitator, who is showing shape appropriate support.
a genuine interest in the photograph. These benefits So, is a picture worth a thousand words? With
increase again when a facilitator runs therapeutic therapeutic photography, it may well be a catalyst for
photography sessions with groups of participants as a patient to say a thousand words.
peer learning enhances the outcomes.
Social identity theory describes the process References
of individuals enhancing their identity through Borden W (2000) The relational paradigm in contemporary
psychoanalysis: toward a psychodynamically informed
perceived membership of social groups, where learning social work perspective. Social Service Review 74(3): 352–79
about the self becomes strengthened when listening Bronfenbrenner U (1986) Ecology of the family as a
context for human development: research perspectives.
to experiences of other group members (Tajfel and Developmental Psychology 22(6): 723–42
Turner, 1979). Identity theory deepens the process Bronfenbrenner U (1992) Ecological systems theory. In: Vasta
R, ed. Six Theories of Child Development: Revised Formulations
and recognises a reflexive element wherein individuals and Current Issues. Jessica Kingsley Publishers, London
begin to compare themselves against other group Bronfenbrenner U (2009) The Ecology of Human Development:
members and define roles within their lives (Stets Experiments by Nature and Design. Harvard University Press,
Cambridge: MA
and Burke, 2000; Stryker and Burke, 2000). Through Drinkwater M (2008) Photography and mental health: a
sharing images in a therapeutic milieu, by guiding one relationship kick-started by Hugh Welch Diamond. http://
tinyurl.com/gv59fvs (accessed 4 January 2017)
another on appropriate levels of disclosure, and by
Glover-Graf N, Miller E (2006) The use of phototherapy in
sharing a common interest in photography, the group group treatment for persons who are chemically dependent.
Rehabilitation Counseling Bulletin 49(3): 166–81
bonds and asserts identity and commonality.
Griebling S, Vaughn LM, Howell B, Ramstetter C, Dole D
(2013) From passive to active voice: using photography as a
‘Hard to reach’ patients catalyst for social action. International Journal of Humanities
and Social Science 3(2): 16–28
Because of the aspect of control that the participant Halkola U (2013) A photograph as a therapeutic experience.
experiences, therapeutic photography can be In: Loewenthal D, ed. Phototherapy and Therapeutic
Photography in a Digital Age. Routledge, London
particularly suitable for individuals who are ‘hard
Oliffe JL, Bottorff JL (2007) Further than the eye can
to reach’. When patients, clients and service users see? Photo elicitation and research with men.
Qual Health Res 17(6): 850–8. https://dx.doi.
come into contact with professionals, they are all too org/10.1177/1049732306298756
often asked to verbalise their issues; with therapeutic Perchick M (1992) Rehabilitation through photography: The
photography, a visual element is also provided which power of photography as physical and emotional therapy—
Contribution of Josephine U. Herrick’s volunteer service
is often a much needed support to enable the verbal photographers organization to teaching photography to
wounded World War II servicemen. PSA Journal 13–15
information to come out. Professionals dealing with
Sitvast JE, Abma TA (2012) The photo-instrument as a health
patients who have been through significant change care intervention. Health Care Anal 20(2): 177–95
may find this technique useful, particularly in the field Smith BK, Frost J, Albayrak M, Sudhakar R (2006) Facilitating
narrative medical discussions of type 1 diabetes with
of health and medicine where the power dynamic computer visualizations and photography. Patient Educ
is typically always in the hands of the professionals, Couns 64(1–3): 313–21
which can be intimidating. Stets JE, Burke PJ (2000) Identity theory and social identity
theory. Social Psychology Quarterly 63(3): 224–37
Oliffe and Bottorff (2007: 850) found that using Stryker S, Burke PJ (2000) The past, present, and future of an
photography to gain insights into the experience identity theory. Social Psychology Quarterly 63(4): 284–97
of men recovering from prostate cancer was Tajfel H, Turner JC (1979) An integrative theory of intergroup
conflict. In: Austin WG, Worchel S, eds. The Social
enlightening and empowering for the participants, Psychology of Intergroup Relations. Brooks-Cole, Monterey, CA
and described the information gleaned as ‘unique and Weiser J (1984) Phototherapy–becoming visually literate
about oneself, or, phototherapy?? What’s phototherapy??.
unanticipated’. Sitvast and Abma (2012) highlighted Phototherapy 4(2): 2–7
© 2017 MA Healthcare Ltd

the benefits when working within mental health Weiser J (2001) Phototherapy techniques: using clients’
personal snapshots and family photos as counseling and
nursing, while Smith et al (2006) recognised the therapy tools. Afterimage 29(3): 10–5
implications of using photography with patients Weiser J (2004) PhotoTherapy techniques in counseling and
who had type 1 diabetes so that narratives could therapy: Using ordinary snapshots and photo-interactions
to help clients heal their lives. Canadian Art Therapy
be better understood by medical professionals. This Association Journal 17(2): 23–53

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