5 Ways to Incorporate Photovoice in Counselling

A picture is worth a thousand words . . .

If someone had asked me what place photographs held in counselling 15 years ago, I would have responded with “On the wall.” Thankfully, my eyes were finally opened to the creative possibilities photography can offer both clients and clinicians in revealing information beyond typical talk therapy.

Credit must be given to my doctoral supervisor, who showed me the power of using images in counselling through an assignment. This was by far one of the most difficult yet life-changing assignments I have ever received, and I have utilized every opportunity to incorporate photovoice as part of my counselling work with clients ever since.

I have found that images often reveal interesting information both for myself and the client.

Why photovoice?

If you were to run a quick online search for “phototherapy,” you would find research on the use of light in various medical therapies. However, people who incorporate photography in therapy understand the term differently.

Judy Weiser, a British Columbian psychologist and pioneer in the field of phototherapy, creates a distinction between therapeutic photography and phototherapy. She notes that the latter requires a trained counsellor to process the photos, whereas the former does not. Weiser would argue that therapeutic photography is used for personal catharsis and is more about the photographs than the meaning. Phototherapy, on the other hand, focuses more on the meaning of the images.

I am choosing to use photovoice instead because I have found an intersection of Weiser’s definitions and believe clients can receive multiple benefits both through the enjoyment of taking photographs as therapy, as well as processing the image with a counsellor. To me, photovoice is simply the dialogue that occurs because of an image being used in counselling. It helps us avoid the confusion of how phototherapy has been traditionally understood in the medical field.

How can the use of photos help both you and your clients?

While the possibilities are endless, here are five practical examples of where I have found photos to be incredibly informative in counselling:

• A Family Genogram

Have clients bring in pictures of family members so you can co-create their family genogram. The visual reminder of family members evokes an interesting discussion as clients visualize the family member.

I have found the image often reveals interesting information both for myself and the client. We have used the images to fully explore likenesses, differences, and the emotional connections among family members. One client brought in images of family members at the family dinner table. It showed how people maintained a specific seat over the years, highlighting some of the conflict that occurred with certain members, and how the seat at the dinner table served to continue this conflict.

• Check-In/Checkout

This involves having a series of photographs/images of many different examples on hand. I have over 80-100 photographs with any number of people/scenes/animals/expressions of emotions. You can easily find a wide array of free downloadable images, or you can purchase them through various online sources by doing searches related to reflective photography.

To start a session, I often have clients choose up to three images they would use to describe their week. You can also do a “checkout,” where the client chooses an image that describes how they are feeling after the counselling session. This can be a particularly helpful way to bookend sessions and assist in emotional regulation.

• Metaphoric Representation of Issues/Concerns

One of the more powerful ways I have used photography with clients is having them take photos in-between sessions with various directives to discuss at our next meeting. This is where I initially began my photovoice work, and the speed in which I have found images target specific themes is remarkable.

One of the more powerful ways I have used photography with clients is having them take photos in-between sessions with various directives to discuss at our next meeting.

For example, I gave one client a two-week homework assignment. I asked them to take photos that were representative of “the problem” and how they felt about it. I added directives related to specific theoretical modalities such as, “If you were to wake up tomorrow and this problem was no longer with you . . .” I asked them to take a series of photos that represent what their day would look like from start to finish and attempt to capture how they would feel.

• Perspective Taking and Seeing “Unseen” Details

Images have the unique ability to give people a lens into “unseen details.”

One example of this was an image a 16-year-old client took of their bedroom as part of their “story.” The photograph was taken for an entirely different purpose, but I observed that the bedroom was completely barren with blank walls, devoid of any identity, and extremely orderly. It resembled a bland hotel room, and not what I might characterize as a “typical” adolescent room.

The client described the need for their room to look a certain way (to maintain peace with their mom), and that they weren’t allowed to make any changes. This detail revealed an interesting dynamic that had not been discussed prior to this, and the client was largely unaware that this control was creating problems in their own sense of self, and the unwitting compliance they continued to maintain in every relationship.

Images have the unique ability to give people a lens into “unseen details.”

• Self-Portraits

I have found the use of self-portraits to be especially potent in my work with individuals struggling with body image issues, although I would add some caution here around working gently to maintain the client’s comfort level. There are a multitude of ways I have incorporated images in this area, including clients bringing in ideal images of others, and deconstructions of photos of themselves.

Clients with body image issues are often hyperfocused on areas they see as problematic. They often fail to see other parts of themselves with strength and self-compassion. Together we can use the images to reframe more realistic viewpoints, in addition to discussing what can and cannot be changed. Sometimes, we have gone back to our genogram photographs and discussed characteristics that have been passed down and how this has impacted their sense of self.

Photovoice has the power to expose areas that will surprise you, offer alternative perspectives, and more efficiently deepen the counselling relationship. I have been so thoroughly impressed with the use of photovoice in my work with clients, I could not imagine counselling without it. I trust that you will enjoy exploring the many ways this modality can enhance your counselling practice.

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