The Generative Process of Professional and Personal Development of Cognitive-Behavioural Clinical Psychologists in Training through the Inclusion of Strategies of Expressive Arts : A Qualitative Analysis and Comparison

Starting out from the perspective that art is in fact a process and not simply the creation of objects neither the creation’s final products, the present article reports a qualitative analysis, examination and comparison of the subjective nature of the generative process experienced with the inclusion of strategies of expressive arts, described and interpreted by two cognitive-behavioural clinical psychologists in training, both knowledgeable of the principles of cognitive-behavioural model of learning. Does the nature of the psychologists in training subjective experiences with the inclusion of strategies of expressive arts, as reported during their training of professional and personal development, share features and effects? Results revealed similar generative processes guiding towards the development of abilities to focus on the identification and contemplation of automatic thoughts. Such abilities facilitated the grasping of the mechanics of the cognitive-behavioural intervention and also triggered a beneficial sense of well-being during the course of training.


Introduction
The aim of this qualitative analysis and comparison is to argue for the efficaciousness of a professional and personal development of cognitive-behavioural clinical psychologists trained through the inclusion of strategies of expressive arts.In this sense, this article begins with a brief presentation of Complexism, Evolutionary Art, Complex Systems, Effective Complexity, and Generative Processes, followed by a brief presentation of the Cognitive-Behavioural Model of Learning and of some of its psychoeducational strategies for the training at a graduate level of development.Finally, the research question is properly formulated.

1.1
Arts and expressive arts Galanter (2008) introduced a new approach called Complexism, that is, an application of scientific knowledge on Complex Systems to the Arts and Humanities issues.Complexism's iconography is a dynamic one and it is called Evolutionary Art, that means that art is in fact a process and not simply the creation of objects neither the creation's final results.Complex Systems make reference to all the systems that possess a large number of small parts or components which interact with other parts and other components present in the system, make reference to multiple systems, to composite systems where interactions among parts and components lead to the system's selforganisation.Such self-organised systems are dynamic, adaptive, constantly changing and continuously in reorganisation, repairing, in permanent emergence or growth (Park & Reuter-Lorenz, 2009).
Human beings, being biological systems, are Complex Systems in permanent change and emergence of responses that are adaptive (Burke, 2014;Skinner, 1984).Thus, human beings are emergent phenomena.Complexity science tries to abstract an understanding of systems across all the disciplines and the study of complexity is the study of integration, the act of combining into an integral whole.The efficient complex adaptive systems, Effective Complexity, illustrate how the Effective Complexity generates a context for the understanding of the effects of expressive arts in the process of professional and personal development.
Evolutionary Art, which according to Galanter (2008) is a kind of generative art, makes reference to how the art is made and to the fact that the process of making it is determined by a precise rule or set of rules that specify a procedure, an algorithm.The generative art systems themselves are the focus of attention.Galanter (2008) proposes Complexism as something that will come after postmodernism and that will provide a more elaborate synthesis comprising the worries, attitudes and activities of both modernism and postmodernism.Complexism widens the horizons and creates a new point of view where Generative Processes (the subjective nature of the individual's experiences) are considered valuable as sources of information on the effects of the experienced phenomena.

1.2
The cognitive-behavioural model of learning The brain, as a physical system that was sculpted to generate behaviour, supplies extreme sensitivity to relevant information from the environmental context and coordinates behaviours that have adaptive consequences (Skinner, 1984;Burke, 2014) and the cognitive-behavioural model of learning estimates that specific environmental contexts, that is, a given event, circumstance or phenomenon, trigger flows of thoughts that occur simultaneously at three differing levels of thinking (refer to "Explanation" column on Table 1).Two of those levels of thinking occur below the level where the conscious thinking happens, exert a controlling influence over emotional reactions and over the behaviours that are emitted in specific environmental contexts (Zheng, Paterson, & Yap, 2013).As Complex Systems in perpetual growth, human beings experience with certain phenomena triggers flows of thoughts that trigger emotions/feelings that produce certain behaviours associated to that particular phenomenon and vice-versa, that is, behaviours emitted in certain situations trigger emotions that trigger flows of thoughts.

Professional and personal development of clinical psychologists
The psychoeducational strategies adopted during the training at a graduate level of professional and personal development of cognitive-behavioural clinical psychologists include the "Register of Automatic Thoughts", "Exercises of Mental Imagery", and "Activities of Expressive Arts" (Hogan, 2016;Keller-Dupree & Perryman, 2013).The present article examines and compares the subjective nature of the generative process experienced with strategies of expressive arts, described and interpreted by two cognitive-behavioural clinical psychologists in training, both knowledgeable of the principles of cognitive-behavioural learning.
Does the nature of the psychologists in training subjective experiences with the inclusion of strategies of expressive arts, as reported during their training of professional and personal development, share features and effects?

Method 2.1 Participants
Written reports produced by a graduate level 44-year-old female and by a graduate level 36year-old male in training of professional and personal development of cognitive-behavioural clinical psychologists, both knowledgeable of the cognitive-behavioural model of learning's central principles, main elements, basic concepts, and main characteristics, were randomly picked out, drawn among the group of the 26 trainees attending a public university.

Materials and procedure
Written reports during each of the training sessions, weekly written reflection reports on each of the sessions, and the final chapter of the weekly written reflection reports made independently by both trainees were analysed in order to answer the question "Does the nature of the psychologists in training subjective experiences with the inclusion of strategies of expressive arts, as reported during their training of professional and personal development, share features and effects?"

Training sessions
Session 1 -Introduction and phenomenon 1 As usually happens in any introductory training session, group rules, confidentiality, and the purpose of the process were discussed.All the trainees talked a little bit about their professional interests and about their feelings associated to this training of professional and personal development.After that, each member of the group was presented with a sheet of lined paper, asked to consider the question "If you were a fruit or a tree, which kind of fruit or tree would you be?" (Phenomenon 1), and to report in the lined sheet of paper her/his personal consideration (written report during the training session).When the group had finished reporting in writing, the group was invited to voluntarily share with the group their subjective experience with phenomenon 1.
The group was also asked to prepare a weekly written reflection report where they would retrospectively report their reflections on their subjective experiences with each of the circumstances (Phenomena) and their perceived effects of those circumstances.Every week a new chapter (report) was electronically submitted relative to the circumstance previously experienced.
Session 2 -phenomenon 2 Members of the group were asked to choose one among a set of colouring images, to choose some among a set of colouring pencils, and to take one sheet of lined paper, which were all displayed on the top of a table.Then they were asked to colouring the image (Phenomenon 2).When the group had finished colouring their chosen colouring image, they were asked to report in the lined sheet of paper her/his personal reflections on phenomenon 2 (written report during the training session).When the group had finished the written report, members were invited to voluntarily share with the group their subjective experience with phenomenon 2. Session 3 -phenomenon 3 By the end of Session 2, the group was asked to bring to the next Session (Session 3) photography to be personally taken during the following days depicting something in the nature of the University Campus that truly called their attention during their daily routine inside the Campus.At the beginning of Session 3 the group was asked to voluntarily present to the group the photography they took and brought to the Session and to talk a little bit about the choice made.Then, they were presented with a blank sheet of paper, a lined sheet of paper, colouring pencils, crayons, and were asked to consider the question "If you decided to design a frame for this photography, which kind of frame would it be?" (Phenomenon 3).When the group had finished, they were asked to report in the lined sheet of paper her/his personal reflections on phenomenon 3 (written report during the training session).After that, members were invited to voluntarily share with the group their subjective experience with phenomenon 3. Session 4 -phenomenon 4 Each member of the group was provided with one blank sheet of paper and one lined sheet of paper.The group had available colouring pencils and crayons.The group then was presented with two short La Fontaine fables and asked to draw in the blank sheet of paper an image that would represent one of the fables (Phenomenon 4).Then they were asked to report on the lined sheet of paper their personal reflection on phenomenon 4 (written report during the training session).After that they were invited to voluntarily share with the group their subjective experience with phenomenon 4.
Those above were the four sessions or four activities of expressive arts, Phenomena, included among the strategies of written registers and mental imagery during the training of professional and personal development of cognitive-behavioural clinical psychologists.

Two weeks after experiencing phenomenon 4
By the end of Session 4, the group was asked to, after having electronically submitted the weekly written reflection report on phenomenon 4, put aside during two weeks, written reports and expressive arts objects they created along four sessions.Then, after those two weeks, to revisit everything they had produced on those sessions, retrospectively reflect on their subjective experiences with each of the phenomena and on the effects of those circumstances and then to elaborate a final chapter for the weekly written reflection reports.

Results
Sources of data considered were a) Written reports during each of the training sessions; b) Weekly written reflection reports on each of the sessions; c) Final chapter of the weekly written reflection reports.Table 1 presents a comparison of the subjective nature of the generative processes experienced with the inclusion of strategies of expressive arts, described and interpreted by two cognitive-behavioural clinical psychologists in training, both knowledgeable of the principles of cognitive-behavioural learning.The fourth column (Explanation) explicit relevant substance for the understanding of several of the trainees reported aspects of their subjective experiences.The Mental Imagery Exercise is one of the strategies adopted for the identification of thoughts, associated feelings in a particular circumstance.The procedure involves relive, live over, a given circumstance, phenomenon, in order to reconnect with thoughts and feelings that occurred in that event, occasion.and had a productive insight, a breakthrough -becoming fully aware that she had a happy childhood and that she had never ever understood that before; -reported that during the week, kept remembering Phenomenon 2, its effects and then began pondering, at the level of consciousness, that life make or leave a mark on us and about the persons that stay inside of us.
-reported that her subjective experience with Phenomenon 2 triggered a feeling of happiness and a sense of inner change underway.
regaining relaxation over and over again; -reported that at the level of consciousness he came to a decision -introducing colouring images and colouring pencils in his interacting activities with his son.PHENOMENON 3 a) Written report during the session -reported that she brought to the session a photography of a very special place in her life; -reported that sharing such a secret with the group triggered a feeling of wellbeing and tranquillity.b) Weekly written report on the session -reported that learnt a lot during Session 3, that Phenomenon 3 was a very emotional one and that allowed for a lot to be brought to the consciousness level.a) Written report during the session reported that phenomenon 3 took him to a breakthrough -that he indeed loves nature and feels the best when in the countryside; -reported that session 3 triggered happiness, calm, tranquillity, and longing to be a child.b) Weekly written report on the session -reported that along the week, when exercising mental imagery, remembered the sensation of well-being during the session exactly at the moment of a breakthrough, when he realised that life in the countryside is what he really needs; -reported that reached a decision of trying hard to educate his child in the countryside; -reported that kept spontaneously remembering Session 3 Breakthroughs and Decisions -the aim of the cognitivebehavioural strategies is, in a first instance, the identification of adaptive and of dysfunctional schemata that, in a second instance, will be developed or modified, respectively.that triggered a flow of forgotten memories of happy childhood events with his grandfather.PHENOMENON 4 a) Written report during the session -reported a sense of deep involvement in the activity, the spontaneous recovery of memories long forgotten, the enormous astonishment when realising that she had those memories consolidated somewhere followed by a huge satisfaction.one's self and self-esteem.

Discussion
Does the nature of the psychologists in training subjective experiences with the inclusion of strategies of expressive arts, as registered during their training of professional and personal development, share features and effects?Analysis and comparison of the generative processes through the analysis and comparison of the subjective experiences, as reported along the process, and not the simple creation of objects or the artistic final result, disclosed, revealed that the nature, that is, the characteristics or the essential qualities, of the subjective experiences reported by both trainees with the inclusion of expressive arts do share features and effects.
Both trainees reported that in the first session of professional and personal development of cognitive-behavioural clinical psychologists, in their first contact with phenomenon 1, they began experiencing a whole lot of cognitions associated to the phenomenon and the controlling influence of those cognitions over their emotions in that situation.
Table 1 presents the generative process for each trainee and demonstrates the velocity with which in just four sessions both graduate level trainees in cognitive-behavioural clinical psychology learnt to identify their automatic thoughts flowing in association with the experienced circumstances of expressive arts.Such flows of automatic thoughts and the consequent feelings, according to the trainees' reports, continued to be examined between training sessions.These analyses or contemplation carried out between sessions contributed to individual insights on the central principles that orient cognitive-behavioural interventions and also to individual insights on personal issues and behavioural change.Both trainees realised that breakthroughs prompted them to design plans for behavioural change.
The "Explanation" column on Table 1, by describing the relevant elements (phenomenon, flow of thoughts, emotions, and behaviours) of the cognitive-behavioural model of learning, makes transparent the generative processes experienced by each of the trainees and also the efficaciousness of a professional and personal development of cognitive-behavioural clinical psychologists trained through the inclusion of strategies of expressive arts.Furthermore, the 36-year-old male in training of professional and personal development of cognitive-behavioural clinical psychologists reported that he had been examining, analysing, contemplating his thoughts, feelings, behaviours, and breakthroughs in order to identify nuclear schemata, which means that during the training he became fully aware of the possibility of bringing nuclear schemata to consciousness.

3.1
The shaping of a schema Human babies have a biological need, present at the moment they are born, of keeping close contact (proximity) with their mothers (or some other main caregiver), a normal connection that develops within the first six months of life through the mother's readiness to react to this particular need.During this critical period of development the first schemata begin to be shaped and these are exactly the schemata related to the child's basic emotional needs, and are extremely resistant to change (Bowlby, 1985).All the schemata shaped along the whole childhood form the base, the foundation, the structure for the child's flows of thoughts and are the product of a complex interaction between biological factors and the results of the child's initial experiences with the circumstances or phenomena around her/him.The overwhelming majority of schemata are the result of those interactions (Ginsburg & Opper, 1988).Schemata thus make reference to the child's underlying basic structures of her/his public actions or operant behaviours and, being resistant to extinction, exert a controlling influence over the thoughts, feelings, and behaviours of an individual for the whole length of her/his life (Beck, 1976).

Conclusion
The present article reported a qualitative analysis of the nature of the subjective experiences with strategies of expressive arts introduced as phenomena (refer to "Explanation" column on Table 1) during the training of cognitive-behavioural clinical psychologists.These subjective experiences were reported in written by the two trainees, one male and one female, both knowledgeable of the principles of the cognitive-behavioural model of learning.Does the nature of their subjective experiences with the inclusion of strategies of expressive arts share features and effects?The qualitative analysis evidenced that the reported experiences shared features and effects and culminated in similar generative processes, in the development of abilities to focus on the identification of automatic thoughts, in the contemplating of the automatic thoughts identified, in an improved understanding of the mechanics of the cognitive-behavioural model of learning, in a beneficial sense of well-being during their graduate studies.

Policy implications
The present analysis certified the efficaciousness of the inclusion of expressive arts for the purposes of training at a graduate level of cognitive-behavioural clinical psychologists.As for policy implications, the inclusion of expressive arts for the purposes of psychotherapeutic interventions should require the presence and the expertise of a properly trained psychologist.

Table 1 :
A comparison of generative processes experienced with the inclusion of expressive arts during the training of professional and personal development of cognitive-behavioural clinical psychologists