See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/353466473

I-Poetry as an Instructional Tool in Counselor Education

Article in Journal of Creativity in Mental Health · July 2021

DOI: 10.1080/15401383.2021.1950592

CITATION READS

1 843

2 authors:

Shannon McFarlin Teri Sartor

Lamar University St. Edwards University
18 PUBLICATIONS 4 CITATIONS 6 PUBLICATIONS 34 CITATIONS

SEE PROFILE SEE PROFILE

All content following this page was uploaded by Shannon McFarlin on 16 February 2022.

The user has requested enhancement of the downloaded file.

 Journal of Creativity in Mental Health

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/wcmh20

I-Poetry as an Instructional Tool in Counselor

Education

Shannon L. McFarlin & Teri A. Sartor

To cite this article: Shannon L. McFarlin & Teri A. Sartor (2021): I-Poetry as an
Instructional Tool in Counselor Education, Journal of Creativity in Mental Health, DOI:
10.1080/15401383.2021.1950592

To link to this article: https://doi.org/10.1080/15401383.2021.1950592

Published online: 20 Jul 2021.

Submit your article to this journal

Article views: 4

View related articles

View Crossmark data

Full Terms & Conditions of access and use can be found at

https://www.tandfonline.com/action/journalInformation?journalCode=wcmh20
JOURNAL OF CREATIVITY IN MENTAL HEALTH
https://doi.org/10.1080/15401383.2021.1950592

I-Poetry as an Instructional Tool in Counselor Education

a b
Shannon L. McFarlin and Teri A. Sartor
a
Lamar University, Beaumont, TX, United States; bOffice of Graduate and Professional Studies, St. Edward’s
University, Austin, TX, United States

ABSTRACT KEYWORDS
Originally intended for qualitative research, I-poetry is proffered here I-poetry; counselor
as a tool that counselor educators can use to help counselor trainees education; creativity in
develop case conceptualization and treatment planning skills. counseling; andragogy; case
conceptualization; treatment
Discussion includes a description of the I-poem Transcript and Case
planning
Conceptualization (ITCC) assignment, a teaching strategy that incor­
porates I-poetry with case conceptualization. With the discussion, we
present step-by-step instructions for constructing an I-poem transcript
from a recorded counseling session and using a client’s “I” statements
from the transcript to conceptualize elements of a client’s case utiliz­
ing the T/C Model for Case Conceptualization. We include reflective
questions that can help counselor trainees to devise treatment plans
based on their written conceptualizations and discuss additional appli­
cations of I-poem transcripts in counselor education and clinical
practice.

In 1982, Carol Gilligan presented her Listening Guide to the qualitative research commu­
nity, introducing the method of qualitative poetic inquiry that Debold (1990, April) later
termed I-poetry. In her Listening Guide (1982), Gilligan outlined a qualitative research
methodology involving multiple “listenings” (p. 258) of interview data in data analysis
processes. Each listening strategy functioned to assist the researcher in unearthing “distinct
aspects of a person’s expression of . . . experience within a particular relational context”
(Gilligan et al., 2003, p. 255). The I-poem was one of the listening tasks that Gilligan (1982)
included for the second phase of her methodology. During the past four decades, the
I-poem, which centers on an individual’s first-person voice expressed “physically with
breath and sound, psychologically with emotions, and culturally with ideas” (Zambo &
Zambo, 2013, p. 4), has risen as an efficacious means of seizing and unveiling “what people
know, [and what they don’t know that they know], about themselves” (Kiegelmann, 2009,
para. 35) and others in relational context.
Gilligan’s (1982) I-poem constitutes a form of research poetry, which Langer and Furman
(2004) defined as a poetic representation of qualitative research data that “utilize[s]
a participant’s exact words in a compressed form” (p. 1), excluding the researcher’s
interpretations of the data. When constructing an I-poem from a research participant’s
transcribed interview, the researcher maintains fidelity with the data, including only the
participant’s actual words in their spoken order. Because the data that constitute the lines of
an I-poem were not originally intended as poetry, the I-poem does not rhyme and does not
follow rules of formal poetic craft (Debold, 1990, April; Gilligan, 1982; Gilligan et al., 2003).

CONTACT Shannon L. McFarlin, [email protected] P.O. Box 10034, Beaumont, TX 77706

© 2021 Taylor & Francis Group, LLC
2 S. L. MCFARLIN AND T. A. SARTOR

Purpose Statement
Whereas Gilligan (1982) originally proffered the I-poem as a method of qualitative data
analysis, the I-poem is presented here as a tool that counselor educators and supervisors can
utilize to assist counselor trainees with the development of case conceptualization skills. As
Zubernis et al. (2017) explained, case conceptualization is the process whereby a counselor
develops an understanding of a client by eliciting and organizing information, developing “a
blueprint for how to interact with, listen to, and ultimately help the client” (p. 181; Betan &
Binder, 2010; Seligman, 2004). For counseling professionals, the American Counseling
Association ([ACA], Ratts et al., 2015) denotes case conceptualization as a core competency
for multicultural counseling.

Conceptual Framework
As Berman (2019) asserted, case conceptualization should proceed with a guiding organiza­
tional structure. In the professional literature, there are several existing models for case
conceptualization, many of which are theory-specific (e.g., Bach & Moran, 2008; Kuyken
et al., 2009; Luborsky & Crits-Christoph, 1998; Persons, 2008), that provide frameworks for
organizing and understanding information pertinent to sundry elements of a client’s case.
Whereas theory-specific models can help counselor trainees transfer theoretical knowledge
to clinical practice (Cashwell & Dooley, 2001), their exclusive use in counselor education
programs can delimit students’ learning and skills development, especially if students are
not exposed to alternative case conceptualization models that can accommodate other
theoretical perspectives (Strope, 2019).
Regarding counselor trainees and theoretical perspectives, Corey (2016) underscored
that, during the graduate training period, it is crucial that counselors-in-training (CITs)
explore a variety of counseling theories and assess each one for a personal fit. Corroborating
Corey’s point, some CITs have asserted that opportunities to engage in group discussions
about contrasting theories and to experiment with different theoretical modalities can help
to facilitate their processes of selecting a theoretical orientation to counseling (Strope, 2019;
Watson & Super, 2020), which many counseling programs encourage among students
throughout their training programs (e.g., Halbur & Halbur, 2015; Jackson, 2010;
Rønnestad & Skovholt, 1993; Strope, 2019).
Thus, here, we propose that the I-poem transcript be used in conjunction with an
atheoretical case conceptualization model that students can use to conceptualize client
cases from any theoretical perspective. From among available models of this type, we
recommend Zubernis and Snyder’s (2015) temporal/contextual (T/C) model for case con­
ceptualization (depicted in Figure 1), which is a comprehensive, atheoretical model that
uniquely includes attention to temporal (i.e., time-specific) influences in a client’s narrative.
Hereto forward, we refer to the conjoint use of the I-poem transcript and T/C model for
case conceptualization as the I-poem transcript and case conceptualization (ITCC)
assignment.
In Figure 1, the triangle represents the client’s thoughts, feelings, and behaviors
(Zubernis & Snyder, 2015; Zubernis et al., 2017). Thoughts, or cognitions, include the
client’s self- and other- perceptions and interpretations, beliefs system, and styles of relating
to others that the client formulates from experiences of interacting with the environment.
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 3

Figure 1. Temporal/Contextual Model for Case Conceptualization (Zubernis & Snyder, 2015; Zubernis et
al., 2017)

Feelings, or affect, encompass the client’s emotional expression, regulation, and awareness,
and behaviors are the client’s observed and reported actions. Each of these three elements of
the human experience mutually influences the others, characterizing interdependence
among the three. In addition to thoughts, feelings, and behaviors, the triangle encompasses
the client’s personality traits (i.e., internal personality characteristics, or IPCs) and both
biological and psychological experiences, which also are reciprocal in their influences on
each other (Zubernis & Snyder, 2015; Zubernis et al., 2017).
The inner circle of Figure 1 represents the client’s internal world, which includes
strengths, coping skills, life roles, symptom manifestation, and readiness for change
(Prochaska & DiClemente, 1983). The outer circle represents influences in the client’s
environment, such as cultural ideologies, socioeconomic status, stressors, and those with
whom the client has interpersonal relationships. Finally, the timeline captures the client’s
experiences and influences pertinent to three general time periods: past, present, and future
(Zubernis & Snyder, 2015; Zubernis et al., 2017).
As Zubernis et al. (2017) explained, application of the T/C model for case conceptualiza­
tion involves gathering information from the client to document the client’s experience or
condition for each of the elements listed in Table 1 below. Typically, the counselor collects
information from the client via an intake interview. After collecting the data, the counselor
documents information for the elements in Table 1, denoting aspects that require additional
4 S. L. MCFARLIN AND T. A. SARTOR

Table 1. Elements Comprising a Case

Conceptualization Per Zubernis et al.’s
(2017) T/C Model.
Element Evidence
Client’s Presenting Problem
Internal Personality Constructs
Self-efficacy
Self-esteem
Attitudes/Values/Beliefs
Attachment Style
Biology/Physiology/Heredity
Affect/Feelings
Cognitions/Thoughts
Behaviors
Symptomology
Coping Skills and Strengths
Readiness for Change
Life Roles
Environment
Relationships
Culture
Family Norms and Values
Religious or Spiritual Beliefs
Timeline
Past Influences
Present Influences
Future Goals

information with an asterisk (Zubernis et al., 2017), and subsequently gathering the missing
information to complete the chart. When adequate information is obtained from the client,
the counselor scrutinizes the documented information to identify areas for intervention and
to formulate a hypothesis of the client’s presenting problem, which, using the T/C model as
a guide, the counselor can accomplish using any theoretical lens (Zubernis & Snyder, 2015;
Zubernis et al., 2017).

Instructional Basis
For counselor training programs that are accredited by the Council for Accreditation of
Counseling and Related Educational Programs (CACREP), graduate students must com­
plete practicum and internship courses that require them to provide counseling services to
actual clients. Per CACREP Standards (2016), “Supervision of practicum and internship
students [should include] program-appropriate audio/video recordings and/or live super­
vision of students’ interactions with clients” (para.1, 3.B). Currently, there are several
existing training models (e.g., Microcounseling, Daniels et al., 1997; Helping Skills, Hill,
2004; Interpersonal Process Recall [IPR], Kagan & Kagan, 1997; Skilled Counselor Training
Model [SCTM], Smaby et al., 1999) that include methods for counselor educators and
students to review recordings of trainees’ counseling sessions. Whereas the models do
constitute significant contributions to the field of counselor education, most of them
share the same primary purpose: to assess the counselor trainee’s performance and experi­
ence in counseling sessions.
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 5

In contrast, the ITCC assignment focuses attention to the client’s first-person voice, not
to the CIT’s in-session performance. By focusing on the client, rather than on the self,
trainees can learn to conceptualize client cases at a deeper level and to develop treatment
plans that are meaningful for clients. Thus, the ITCC assignment is a unique training
method that we propose as a supplement to, not as a replacement for, teaching methods that
function to amplify students’ relational counseling skills.

Using I-Poems for Case Conceptualization

The process of completing the ITCC assignment proceeds in five distinct steps: (1)
recording a session with a client who has offered permission for recording, (2) construct­
ing an I-poem transcript of the recorded session, (3) extracting evidentiary excerpts from
the I-poem for each element listed on the T/C model for case conceptualization chart, (4)
scrutinizing the “I” statements documented in the chart to construct a written concep­
tualization for each element of the client’s experience, and (5) responding to reflective
questions to explain new understandings of the client and to devise a plan for the client’s
treatment. The sub-sections below include specific instructions for Steps 2–5 of the
process.

Step 2: Constructing an I-Poem Transcript

After recording a session with a client, the next step is to construct an I-poem transcript.
The first step in doing this involves listening to the recording of the counseling session
multiple times to get a feel for the client’s narrative. Then, using word processing software
or pencil and paper, the CIT returns to the beginning of the recording and listens again,
documenting only the client’s words and utterances in the order in which they were
vocalized in the session. Each sentence/phrase is documented on a new line, and, after
transcribing the client’s final words, the lines are numbered from top to bottom. Next, the
counselor trainee goes back to the first line of the transcript and reads it from beginning to
end while listening to the recording, scrutinizing the transcript for accuracy, and adding
words that were missed during the first round of transcribing. The latter step is repeated
until the trainee is satisfied that all the client’s words and utterances are accurately
documented in their original spoken order. Then, returning to Line 1, the transcript is re-
read, and all lines that do not contain an “I” pronoun (e.g., I, I’ve, I’m) are deleted or crossed
out, leaving only the client’s “I” statements intact in their original chronological order.
Whereas some trainees might be compelled to begin the Step 2 process by transcribing only
the client’s “I” statements, rather than all of the client’s statements, it is important that they
document all of the client’s words at the outset of the transcribing process, and then to omit
lines that are void of first-person references, to ensure that none of the client’s “I” state­
ments are overlooked.
With only the client’s lines with first-person references documented in the transcript, the
CIT re-reads it several times, “listening” for shifts in meaning, changes in voice and
cadence, and beginnings of new breath (Gilligan et al., 2003). When a sense of completeness
is obtained, the lines are creatively grouped into stanzas to delineate shifts in thought and
emotion and to highlight important aspects of the client’s narrative, maintaining the
original chronological order of the client’s spoken words. As Gilligan et al. (2003) explained,
6 S. L. MCFARLIN AND T. A. SARTOR

Table 2. Exemplar from an I-Poem Transcript.

Line Transcribed Statement
1 At first, I believed it was my fault, but it’s not.
2 Like, yeah, I broke up with him, but it was his choice to take the drugs.
3 I didn’t hand it to him.
4 I didn’t shove it up his throat.
5 I didn’t do nothing!
6 And I felt guilty.
7 I’ve been writing about it a lot.
8 And Blake [my boyfriend], every time I bring up Joe’s name [my ex-husband], he gets pissed.
9 I was with Joe for 10 years and that was my life!
10 I was with him for a really long time.
11 I was attached to him, so it was still hard for me to let go.
12 I was so hurt, but I wasn’t in love with him anymore.
13 But I cared about him, you know?
14 But I wasn’t in love with him.
15 I didn’t want to stay with him anymore.
16 Because I didn’t want to be miserable anymore.
17 I was so depressed.
18 I knew he was out there sleeping with other people.
19 It was just . . . he slept upstairs, and I slept downstairs.
20 I can’t do this anymore.
21 At that time, I was clean.
22 But then, when he died, I took it the wrong way.
23 I thought it was my fault.
24 I blamed myself, because I left him.
25 I used over it, and I didn’t think I’d ever use again.
26 It’s scary, like, thinking I can use at any time based on feelings and anger.
27 I never thought I’d be like I was that day, and . . .
28 But I didn’t reach out.
29 I didn’t know.
30 I just thought, “Good, at least someone talks to me.”
31 And I was just staring at her like, “OK, you gonna let me hit that?”

“Often the I-poem itself will seem to fall readily into stanzas” (p. 159), espying an “associate
stream of consciousness” (p. 159) that is revealed via the individual’s first-person voice. In
the end, the I-poem is all that remains of the counseling session transcript. With permission
from the trainee, Table 2 presents an exemplar from a CIT’s I-poem transcript that was
constructed from a recorded counseling session. All names in the I-poem transcript have
been converted to pseudonyms.

Step 3: Extracting Evidentiary Lines From the I-Poem Transcript

Step 3 involves scrutinizing the I-poem transcript for lines that evidence the client’s inner
world. For each element listed on the T/C model for case conceptualization chart, eviden­
tiary “I” statements are plucked from the I-poem transcript and documented on the chart.
Although the client might not have provided evidence for all the elements in the session that
was recorded, the chart is to be completed as thoroughly as possible.

Step 4: Constructing Written Conceptualizations

After extracting evidentiary “I” statements from the I-poem transcript, the next step is to
scrutinize the evidence documented for each element on the T/C model for case concep­
tualization chart. Considering developmental theories, counseling theories, information in
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 7

the Diagnostic and Statistical Manual ([DSM], 5th ed., American Psychiatric Association,
2013), and professional literature, a written conceptualization is documented on the chart
for each element, with quotes from the client interjected throughout the narratives to
substantiate the clinician’s impressions. For elements on the chart that the client did not
evince with first-person statements, the CIT simply can make note of such.

Step 5: Reflecting and Planning for Treatment

The last step requires the students to reflect over their written conceptualizations and to
document responses to a series of questions that can help them to bridge their case
conceptualizations with clinical practice. As Griffith and Frieden (2000) explained, in
counseling practice, thinking reflexively about theory and the beliefs and assumptions
that influence personal perspective-taking can aid counselors in developing greater under­
standings of their clients and identifying germane interventions for clients’ treatment plans.
Thus, for this step of the process, we developed a list of six reflective questions for students
to consider after constructing their I-poem transcripts and completing their case concep­
tualizations. With the questions, we included instructor directives for students’ responses,
which we integrated to ensure that responses were grounded in research and professional
literature. Before responding to the reflective questions, CITs should scrutinize the written
conceptualization documented for each section of the chart, compare information across
sections to identify relationships among the data, and holistically analyze all information
documented on the chart to obtain an overall feel for their clients’ existential experiences.

Table 3. Step 5: Reflective Questions, Instructor Directives for Responses, and Purposes of Questions.
No. Question Instructor Directive for Responses Purpose of Question
1 Based on your conceptualization of the Discuss at least three treatment foci in Identify and prioritize foci for
client’s case, what do you think should their order of priority and explain your client’s treatment
be primary foci for your client’s justification for each. Cite at least one
treatment? professional source to support your
response.
2 What theoretical approach do you think Cite at least one professional source to Choose and justify
would be effective for this client’s support the use of your chosen a theoretical approach for
treatment? theoretical approach for this client’s client’s treatment
treatment.
3 What are three treatment interventions All interventions must stem from the Select and substantiate
that might be helpful for this client? theory that you identified in your theory-driven treatment
response to Question 2. Cite at least interventions for the client
one professional source to
substantiate your response.
4 How do the interventions that you Cite at least one professional source to Evaluate the extent to which
described in your response to support your assertions. responses to Questions 1–3
Question 3 support the client’s support client’s treatment
treatment goals? goals
5 Based on what you know about the Cite at least two professional sources to Assess client characteristics
client’s presenting problem(s) and support your response. One of the that could influence her/his
readiness for change, how might you sources must be Prochaska and treatment outcomes
expect the client to respond to DiClemente’s (1983) stages of change
treatment, and how do you model.
conceptualize the client’s prognosis?
6 Before you completed the I-poem case Discuss at least one new understanding Reflect on learning and
conceptualization assignment, what of your client that you gained through identify new
had you been missing about your your engagement with the understandings of the
client? assignment. client
8 S. L. MCFARLIN AND T. A. SARTOR

When compiling the list of reflective questions, we purposefully ordered the first three to
facilitate backward, or deductive (Shin, 2019), thinking among trainees. As Shin (2019)
explained, deductive reasoning “sets up a desired goal first, then finds a supporting basis . . .
for the goal . . . therefore, it is regarded as a goal-driven approach [to problem-solving]”
(p. 302). questions presented for Step 5 accordingThus, Question 1 focuses on establishing
foci for treatment based on clients’ presenting concerns and treatment goals. Question 2
addresses theoretical orientation to the treatment process, requiring CITs to identify
theoretical approaches that can support their client’s goals and treatment foci, and
Question 3 requires identification of theory-specific treatment interventions that are sui­
table for addressing clients’ needs. Questions 4 and 5 are assessment-oriented, with one
aimed at evaluating the degree to which responses to Questions 1–3 support clients’
treatment goals, and the other geared at estimating potential treatment outcomes based
on clients’ presenting problem(s) and readiness for change (Prochaska & DiClemente,
1983). The final question, Question 6, directs attention to the learning process, prompting
CITs to consider new understandings of clients that resulted from engagement with the
ITCC assignment. Below, Table 3 presents the reflective questions that we constructed for
Step 5 of the process, the purposes of the questions, and the instructor directives that we
included for students’ responses.
Whereas Lazarus (1981) argued that counselors and therapists should be adept with
a variety of theoretical approaches that they can employ to suit clients’ needs, some scholars
(e.g., Halbur & Halbur, 2015; Rønnestad & Skovholt, 2003) have asserted that counselor
trainees typically lack the knowledge and experience necessary to sort through and shift
between treatment modalities. Therefore, instructors may opt to allow students to respond
to the theory-related questions presented for Step 5 according to their chosen theoretical
orientations, which can help CITs to gain confidence in their practice (Gerhardt, 2016), or
to approach those questions as Lazarus would: with a mind for the theoretical modality that
best fits the client’s needs.
Regarding client input in the treatment planning process, the Substance Abuse and
Mental Health Services Administration ([SAMHSA], 2011 has endorsed shared decision-
making (SDM), defined as a process by which clinicians and clients “work together to
identify treatment targets and decide on a course of action” (Langer et al., 2015, para. 2), as
an evidence-based practice for mental health clinicians. Therefore, for Step 5 of the ITCC
assignment, counselor educators may opt to incorporate SDM strategies that students can
utilize to practice collaborative treatment planning with clients. Here, Step 5 is presented so
that students may complete it in the absence of their clients to cultivate and strengthen their
case conceptualization and treatment planning skills.

Applications
With this paper, we present the ITCC assignment as an instructional strategy for counselor
educators that combines the utilization of I-poem transcripts with the T/C model for case
conceptualization (Zubernis & Snyder, 2015). However, the I-poem transcript can be used
in isolation or in conjunction with other case conceptualization models. Additionally, the
I-poem transcript can be assigned to a CIT who is struggling to understand or to empathize
with a client, as the I-poem is a way of engaging the reader’s emotions and of highlighting
the complexities of an individual’s narrative (Koelsch, 2015).
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 9

In clinical practice, the I-poem transcript can be used as an intervention with a client
who has reached an impasse in treatment. Used this way, the clinician constructs an
I-poem transcript from a recorded session with a client and subsequently presents the
I-poem to the client. Then, the clinician helps the client to process her/his emotional
responses to the content of the I-poem, which comprises nothing but the client’s spoken
words. When working with a couple, the clinician can utilize a similar strategy. However,
when transcribing the session, the clinician creates two separate I-poems: one for each
partner’s voice in the session. Then, the clinician presents each member of the dyad with
their partner’s I-poem transcript, which each partner reads (silently or aloud) and
processes to garner new understandings of their significant other.
Anecdotally, after we presented the ITCC assignment in a breakout session at a state-
level professional counseling conference, a colleague who had attended our session reached
out to us via e-mail to share an adaptation of the I-poem transcript that she had imple­
mented with a client in clinical practice after the conference. As the colleague explained, her
client had been one who had enjoyed journal writing, so she had invited her client to create
an I-poem with the “I” statements that she had documented in her journal “as a way to
identify values, conditions of worth, and ultimately, identity” (Anonymous, personal com­
munication, March 5, 2020). Per the colleague’s account, engaging in this task had helped
the client to find and assert her voice, and resultingly, the client had “made incredible
progress” in treatment. Thus, as a treatment intervention, the I-poem transcript can be
a client-created, rather than a clinician-created, product that functions to help clients think
introspectively about themselves and others.

Limitations
In some cases, language differences can be limitations in applications of the I-poem
transcript. As one counselor trainee noted in his response to a reflective question posed
for Step 5 of the ITCC assignment:
In the Hispanic culture, the ‘I’ statements are not as common as in the American culture. My
client is a Hispanic . . . woman, so getting the ‘I’ statements from the session . . . was not easy.
The essence of the content gets lost in translation, and . . . when a person is speaking in Spanish,
the ‘I’ in the sentence is [usually] implied.

Moreover, transcribing I-poems from recorded sessions with clients can be challenging for
students and supervisees who are hearing impaired. Thus, counselor educators who opt to
incorporate the ITCC assignment into coursework should anticipate these types of chal­
lenges for students and plan for appropriate accommodations in advance.

Authors’ Anecdotal Experiences

For my doctoral dissertation research, I, the primary author of this paper, conducted
a mixed-methods study that included I-poetry as a method of qualitative data analysis.
Two years after completing the research, I birthed the idea for the ITCC assignment when,
as a new counselor educator in search of instructional strategies to help counselor trainees
cultivate empathy for their clients, I recalled my earlier experience with research poetry and
the way that I-poetry had helped me to connect emotionally with my research participants’
10 S. L. MCFARLIN AND T. A. SARTOR

experiences. Then, with this recollection in mind, I asked myself the question: If creating
I-poems from research transcripts can ameliorate my empathy for research participants,
then can it do the same for counselors-in-training who create I-poems from counseling
transcripts?
After developing my conceptualization of the ITCC assignment, and at the first oppor­
tunity, I piloted it with CITs who were enrolled in one of my internship courses.
Subsequently, I shared the teaching strategy with a fellow counselor educator, the second
author of this paper, who helped me to refine and develop it further. Since then, the two of
us have facilitated the ITCC assignment for approximately 150 practicum and internship
students across seven academic semesters. Below, we share our experiences of facilitating
the assignment with students, and we include excerpts from students’ responses to the Step
5 reflective questions (with permission from the CITs who authored them) to present some
of their anecdotal experiences of completing it.
In our experiences of implementing the ITCC assignment with CITs, students have
expressed mixed reactions when first introduced to it. Whereas some of their initial
responses have been excitement, others have experienced hesitancy and anxiety, expressing
statements like: “I’m not creative. I can’t write poetry!” However, the majority of those who
initially had experienced apprehension ultimately embraced the challenge with an attitude
of: “OK, I’ll give it a try.” In the end, even the CITs who had been doubtful at the outset had
articulated appreciation for the assignment, and, overall, students’ conclusive feedback
about their experiences with it has been overwhelmingly positive. The following excerpt
from a CIT’s responses to reflective questions exemplifies a shift in thinking that CITs
commonly have experienced as they have undergone the ITCC assignment:
The I-Poem was so confusing to me at first, and it took me a while to really get the grasp for
what its purpose was and how it would help me working with the client, but once I got it, it
was so eye-opening to me . . . I feel like [the I-poem] is something that I should do for every
client to help me see what is at the heart of what [they] are saying to me.
Since our first implementations of the ITCC assignment, my coauthor and I have
requested that our students read their I-poem transcripts aloud as part of their final case
presentations to their university supervision groups. A phenomenon that we have noticed
among students is that, when conducting their I-poetry readings, some seemingly have
slipped inadvertently into their clients’ voices, speaking their clients’ words as the clients
would. For many audience members, recitations delivered in this way have evoked strong
emotions, sometimes catalyzing silent tears, and frequently spawning spontaneous discus­
sions about novel understandings of clients’ existential experiences. Thus, we have come to
see the I-poetry reading component of case presentations as valuable to the overall experi­
ence of the ITCC assignment, as, for our CITs, it seems to have facilitated even greater
degrees of empathy for clients among them.
In closing, we share poignant excerpts from students’ responses to reflective questions
that illustrate some of the new understandings that they gained of their clients, themselves,
and the counseling process via engagement with the ITCC assignment. Within the excerpts,
all names have been replaced with pronouns and pseudonyms to protect students’ and
clients’ identities.

● When [I] attempted to establish rapport [with my client, he] would immediately become
defensive. As I reviewed the I-poem transcript, [his defensiveness] made sense for
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 11

someone with his life experiences. He is screaming out for help . . . and is struggling
under the weight of the life stressors he is required to navigate at just 14 years old.
● The main thing I was missing about my client before creating the I-Poem transcript . . .
was the degree [to which she was] feeling like she had no safe space to express her
emotions, and this reinforced the importance for me to ensure our counseling relation­
ship created that for her.
● After reading [the I-poem transcript] I realized [that my client is] not ready. I’m going
to approach her differently . . . and shift the focus to recognizing [her] emotions. My
client isn’t ready to process what happened, and that’s okay.
We have no known conflict of interest to disclose.

ORCID
Shannon L. McFarlin http://orcid.org/0000-0003-2100-875X
Teri A. Sartor http://orcid.org/0000-0003-4469-3585

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th
ed.). https://doi.org/10.1176/appi.books.9780890425596
Bach, P. A., & Moran, D. J. (2008). ACT in practice: Case conceptualization in acceptance &
commitment therapy. New Harbinger Publications.
Berman, P. S. (2019). Case conceptualization and treatment planning: Integrating theory with clinical
practice (4th ed.). Sage. https://doi.org/10.1002/anzf.1396
Betan, E. J., & Binder, J. L. (2010). Clinical expertise in psychotherapy: How expert therapists use
theory in generating case conceptualizations and interventions. Journal of Contemporary
Psychotherapy, 40(3), 141–152. doi: 10.1007/s10879-010-9138-0
Cashwell, T. H., & Dooley, K. (2001). The impact of supervision on counselor self-efficacy. The
Clinical Supervisor, 20(1), 39–41. https://doi.org/10.1300/J001v20n01_03
Corey, G. (2016). Student manual for theory and practice of counseling and psychotherapy (10th ed.
ed.). Cengage Learning.
Council for Accreditation of Counseling and Related Educational Programs. (2016). Section 3:
Professional practice. Retrieved from https://www.cacrep.org/section-3professional-practice/
Daniels, T. G., Rigazio-Digilio, S. A., & Ivey, A. E. (1997). Microcounseling: A training and super­
vision paradigm for the helping professions. In C. E. Watkins Jr. (Ed.), Handbook of psychotherapy
supervision (pp. 277–295). John Wiley & Sons, Inc.
Debold, E. (1990, April). Learning in the first person: A passion to know. Paper presented at the Laurel-
Harvard conference on the psychology of women and the development of girls, Cleveland, OH.
Gerhardt, D. R. (2016). Theory and treatment planning in counseling and psychotherapy. Cengage
Learning.
Gilligan, C. (1982). Ina different voice: Psychological theory and women’s development. Harvard
University Press. https://doi.org/10.1111/j.1471-6402.1985.tb00902.x
Gilligan, C., Spencer, R., Weinberg, M. K., & Bertsch, T. (2003). On the listening guide: A voice-
centered relational method. In P. M. Camic, J. E. Rhodes, & L. Yardley (Eds.), Qualitative research
in psychology: Expanding perspectives in methodology and design (pp. 157–172). American
Psychological Association.
Griffith, B., & Frieden, G. (2000). Facilitating reflective thinking in counselor education. Counselor
Education and Supervision, 40(2), 82–89. doi: 10.1002/j.1556-6978.2000.tb01240.x
Halbur, D. A., & Halbur, K. V. (2015). Developing your theoretical orientation in counseling and
psychotherapy (3rd ed.). Pearson.
12 S. L. MCFARLIN AND T. A. SARTOR

Hill, C. E. (2004). Helping skills: Facilitating exploration, insight, and action (2nd ed.). American
Psychological Association.
Jackson, J. L., Jr. (2010). Theoretical counseling orientation: An initial aspect of professional orientation
and identity (Doctoral dissertation). Available from ProQuest Dissertations and Theses database.
(UMI No. 27603029)
Kagan, H., & Kagan, N. I. (1997). Interpersonal process recall: Influencing human interaction. In
C. E. Watkins Jr. (Ed.), Handbook of psychotherapy supervision (pp. 295–309). John Wiley & Sons.
Kiegelmann, M. (2009). Making oneself vulnerable to discovery: Carol Gilligan in conversation with
Mechthild Kiegelmann. Qualitative Social Research, 10(2). Retrieved from https://www.qualitative-
research.net/index.php/fqs/article/view/1178/2718
Koelsch, L. E. (2015). I poems: Evoking self. Qualitative Psychology, 2(1), 96–107. https://doi.org/10.
1037/qup0000021
Kuyken, W., Padesky, C. A., & Dudley, R. (2009). Collaborative case conceptualization. Guilford Press.
Langer, C. L., & Furman, R. (2004). Exploring identity and assimilation: Research and interpretive
poems. Qualitative Social Research, 5(2), 1–39, Art. 5. http://www.qualitative-research.net/index.
php/fqs/article/view/609/1319
Langer, D. A., Mooney, T. K., & Wills, C. E. (2015). Shared decision-making for treatment planning
in mental health care: Theory, evidence, and tools. Oxford Handbooks Online. Retrieved from
https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199935291.001.0001/oxfordhb-
9780199935291-e-7?print=pdf
Lazarus, A. A. (1981). The practice of multimodal therapy. McGraw-Hill.
Luborsky, L., & Crits-Christoph, P. (1998). Understanding transference: The core conflictual relation­
ship theme method (2nd ed.). American Psychological Association.
Persons, J. B. (2008). The case formulation approach to cognitive-behavior therapy. Guilford Press.
Prochaska, J., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an
integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395. https://
doi.org/10.1037/0022-006X.51.3.390
Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2015). Multicultural
and social justice counseling competencies. Association for Multicultural Counseling and
Development. Retrieved from https://www.counseling.org/docs/default-source/competencies/mul
ticultural-and-social-justice-counseling-competencies.pdf?sfvrsn=20
Rønnestad, M. H., & Skovholt, T. M. (1993). Supervision of beginning and advanced graduate
students of counseling and psychotherapy. Journal of Counseling & Development, 71(4),
396–405. https://doi.org/10.1002/j.1556-6676.1993.tb02655.x
Rønnestad, M. H., & Skovholt, T. M. (2003). The journey of the counselor and therapist: Research
finding and perspective on professional development. Journal of Career Development, 30(1), 5–44.
https://doi.org/10.1177/089484530303000102
Seligman, L. (2004). Diagnosis and treatment planning (3rd ed.). Plenum Press.
Shin, H. S. (2019). Reasoning processes in clinical reasoning: From the perspective of cognitive
psychology. Korean Journal of Medical Education, 31(4), 299–308. https://doi.org/10.3946/kjme.
2019.140
Smaby, M. H., Maddux, C. D., Torres-Rivera, E., & Zimmick, R. (1999). A study of the effects of a
skills-based versus a conventional group counseling training program. Journal for Specialists in
Group Work, 24 (2), 152–163. Retrieved from. https://www.tandfonline.com/doi/abs/10.1080/
01933929908411427?journalCode=usgw20 .
Strope, R. G. (2019). The lived experiences of counselors-in-training developing a theoretical orientation
(Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (UMI
No. 27603029) Retrieved from https://shsu-ir.tdl.org/handle/20.500.11875/2682
Substance Abuse and Mental Health Services Administration. (2011). Shared decision making in
mental health care: Practice, research, and future directions. Retrieved from https://store.samhsa.
gov/sites/default/files/d7/priv/sma09-4371.pdf
Watson, D. M., & Super, J. (2020). Selecting a theoretical orientation: A constructivist grounded
theory study with counselors-in-training. The Journal of Counselor Preparation and Supervision, 13
(2). Retrieved from https://repository.wcsu.edu/cgi/viewcontent.cgi?article=1339&context=jcps
 JOURNAL OF CREATIVITY IN MENTAL HEALTH 13

Zambo, R., & Zambo, D. (2013). Using I poems to hear the voices and understand the actions of EdD
students conducting action research. The Qualitative Report, 18 (84), 1–17. Retrieved from https://
nsuworks.nova.edu/tqr/vol18/iss42/2/
Zubernis, L., & Snyder, M. (2015). Case conceptualization and effective interventions: Assessing and
treating mental, emotional, and behavioral disorders. SAGE. https://doi.org/10.4135/
9781483399928
Zubernis, L., Snyder, M., & Neale-McFall, C. (2017). Case conceptualization: Improving under­
standing and treatment with the temporal/contextual model. Journal of Mental Health
Counseling, 39(3), 181–194. https://doi.org/10.17744/mehc.39.3.01

View publication stats