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Combining the ETC and DCT in Therapeutic Treatment with a Depressed and Anxious Teen

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Recorded on Friday, November 18, 2022

Presented by Dr. Katherine Jackson, ATR-BC & Dr. Megan Seaman, LPC, NCC

When attended in full, offers 1.5 CEs for Psychologists, 1.5 IL CEUs for Social Workers, or 1.5 BBS CEUs for Counselors and Social Workers.

Workshop Description:

The Expressive Therapies Continuum (ETC) and Developmental Counseling and Therapy (DCT) are two methods of understanding cognitive and emotional styles of clients. Clarification of cognitive and emotional styles can foster positive relationships with clients, and promote transformation (Graves-Alcorn & Kagin, 2017; Ivey, Ivey, Myers, & Sweeney, 2005). The ETC is a theoretical framework composed of four continuum levels, representing the modes of interaction with media (Graves-Alcorn & Kagin, 2017; Kagin & Lusebrink, 1978). Three of the ETC levels reflect established systems of human development, including Kinesthetic/Sensory, Perceptual/Affective, and Cognitive/Symbolic. Clients can use various mind states and developmental sequences that correlate to art materials in order to work on trauma, depression, anxiety and a host of other disorders (Hinz, 2015). The level or continuum of the ETC is creativity, which is seen as a synthesizing agent (Kagin & Lusebrink, 1978). Like the ETC, the DCT offers four cognitive-emotional developmental styles, which are defined as Sensorimotor/Elemental, Concrete/Situational, Formal-Operational, and Dialectic/Systemic styles (Ivey, 2006; Ivey et al., 2005). 

Each of the four styles of DCT is a unique way of processing information. The therapist supports the client by matching her/his/their DCT style, and then helps the client expand her/his/their cognitive/emotional experience through horizontal movement in a particular style, or by facilitating challenge with vertical movement to a DCT style where there may be a block or underuse (Daniels, 1993; Ivey et al., 2005). A person can function in one style most of the time or in multiple styles. Both the ETC and DCT offer opportunities for growth and transformation based on increased insight of the individual. Additionally, both ETC and DCT allow the therapist to meet the client in the developmental mode that she/he/they are in, so that the necessary trust and relationship can be built to foster eventual client-directed transformation (Ivey et al., 2005). Researchers have found that the integration of DCT with creative strategies has been a promising approach to working with disorders such as trauma, depression, terminal illness, eating disorders, substance use problems, and anxiety disorders (Ivey et al., 2005; Myers, 1998). Combining talk therapy through the DCT with art therapy utilizing the ETC may foster holistic awareness and intentional action in clients suffering from anxiety and depression. Additionally, using ETC and DCT with children and adolescents who face some of the biggest transitions of development may offer a unique and holistic approach for youth who are facing developmental changes and mental health concerns (Crespi & Generali, 1995; Fernandez, Serrano, & Tongson, 2014; Myers, Shaffner, & Briggs, 2002). In this presentation 4 case studies will be presented using both approaches to decrease depression and anxiety, specifically in teens. Art work and therapeutic skills will be shown and highlighted.

Learning Objectives:

After completing this intermediate level program, participants will be able to

  1. Identify and describe the 3 modes of ECT and how to transition between them,
  2.  Identify and describe the 4 styles of DCT and how to transition between them,
  3. Describe the 5-Step Process of ECT-DCT Integration and Assessment and apply it a case study of an adolescent with depressive and anxious symptoms.

Program Standards and Goals:

This program meets APA’s continuing education Standard 1.1: Program content focuses on application of psychological assessment and/or intervention methods that have overall consistent and credible empirical support in the contemporary peer reviewed scientific literature beyond those publications and other types of communications devoted primarily to the promotion of the approach

This program meets APA’s continuing education Goal 2: Program will enable psychologists to keep pace with the most current scientific evidence regarding assessment, prevention, intervention, and/or education, as well as important relevant legal, statutory, leadership, or regulatory issues. 

Presenter Biographies:

Katherine Jackson, Ph.D., ATR-BC: Katherine Jackson is an Associate Professor in the Masters of counseling and art therapy department at Ursuline College. She is also in private practice at Beachwood Counseling Center.

Megan Seaman, Ph.D., LPC, NCC: Megan Seaman is an Assistant Professor in the Masters of counseling and art therapy department at Ursuline College. She is also in private practice at Beachwood Counseling Center.


Crespi, T. D., & Generali, M. M. (1995). Constructivist developmental theory and therapy: Implications for counseling adolescents. Adolescence, 30(119), 735 -743. 

Daniels, T. G. (1993). Ivey’s developmental therapy. Guidance & Counseling, 8(4), 21-29. 

Fernandez, K. T., Serrano, K. C. M., & Tongson, M. C. C. (2014). An intervention in treating selective mutism using the expressive therapies continuum framework. Journal of Creativity in Mental Health, 9(1), 19-32.

Graves-Alcorn, S., & Kagin, C. (2017). Implementing the expressive therapies continuum: A guide for clinical practice. New York, NY: Routledge. 

Ivey, A., Ivey, M., Myers, J., & Sweeney, T. (2005). Developmental counseling and therapy: Promoting wellness over the lifespan. Boston, MA: Houghton Mifflin.

Hinz, L. D. (2015). Expressive therapies continuum: Use and value demonstrated with case study. Canadian Art Therapy Association Journal, 28(1-2), 43-50.

Kagin, S. L. & Lusebrink, V. B. (1978). The expressive therapies continuum. Art Psychotherapy, 5(4), 171-180. 

Myers, J. E. (1998). Bibliotherapy and DCT: Co-constructing the therapeutic metaphor. Journal of Counseling & Development, 76(3), 243-250. 

Myers, J. E., Shaffner, M. F., & Briggs, M. K. (2002). Developmental counseling and therapy: An effective approach to understanding and counseling children. Professional School Counseling, 5(3), 194-202.

Workshop Pricing:

General Admission: $30

Continuing Education:

Target Audience: All mental health disciplines.

Psychologists. This program, when attended in its entirety, is available for 1.5 continuing education credits. The Chicago School of Professional Psychology is committed to accessibility and non-discrimination in its continuing education activities. The Chicago School of Professional Psychology is also committed to conducting all activities in conformity with the American Psychological Association’s Ethical Principles for Psychologists. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If program content becomes stressful, participants are encouraged to process these feelings during discussion periods. If participants have special needs, we will attempt to accommodate them. Please address questions, concerns and any complaints to [email protected] There is no commercial support for this program nor are there any relationships between the CE Sponsor, presenting organization, presenter, program content, research, grants, or other funding that could reasonably be construed as conflicts of interest.

Social Workers. This program, when attended in its entirety, is available for 1.5 hours of continuing education. The Chicago School of Professional Psychology is licensed by the Illinois Department of Financial and Professional Regulation (IDFPR) to provide continuing education programming for social workers. License Number: 159.001036

MFTs, LPCCs, and LCSWs. Course meets the qualifications for 1.5 hour of continuing education credit for MFTs, LPCCs, and/or LCSWs as required by the California Board of Behavioral Sciences. If you are licensed outside of California please check with your local licensing agency to to determine if they will accept these CEUs. The Chicago School of Professional Psychology is approved by the California Board of Behavioral Sciences (BBS) to offer continuing education programming for MFTs, LPCCs, LEPs, and/or LCSWs. The Chicago School of Professional Psychology is an accredited or approved postsecondary institution that meets the requirements set forth in Sections 4980.54(f)(1), 4989.34, 4996.22(d)(1), or 4999.76(d) of the Code.

Participation Certificate. The Chicago School of Professional Psychology is able to provide students and other participants who simply wish to have documentation of their attendance at the program a participation certificate.

Non Psychologists. Most licensing boards accept Continuing Education Credits sponsored by the American Psychological Association but non-psychologists are recommended to consult with their specific state-licensing board to ensure that APA-sponsored CE is acceptable.

*Participants must attend 100% of the program in order to obtain a Certificate of Attendance.

The Chicago School of Professional Psychology is approved by the American Psychological Association to sponsor continuing education for psychologists. The Chicago School of Professional Psychology maintains responsibility for this program and its content.