Sesame approach (Lindkvist)

1. Introduction

Version followed: Sesame drama and movement therapy as taught on the HCPC-approved MA Drama and Movement Therapy at the Royal Central School of Speech and Drama (London) and set out in the Sesame Institute texts edited by Jenny Pearson (1996) and by Watts, Pearson and Smail (2013). These books are not drawn on in full: only their catalogue entries, publisher descriptions and contents lists are. Session-level detail therefore comes from programme documents, a peer-reviewed paper (Hougham, 2012), a doctoral thesis (Batzoglou, 2012) and a practice report (TES). Gaps are marked.

What it is. Sesame is a named British school of dramatherapy, not a single manualised protocol. Marian "Billy" Lindkvist founded it. Sources spell her surname both Lindkvist and Lindqvist. Lindkvist was an actress. Her touring company, the "Sesame Kats", took drama and movement into hospitals and institutions. She began workshops with in-patients at Guy's Hospital in 1964 [source: CSSD programme specification; Batzoglou 2012, p. 11; Psychotherapy.net]. The name refers to "Open Sesame" in the Ali Baba story, a password that opens a door to inner riches [source: Psychotherapy.net].

The approach draws on four main influences [source: CSSD programme specification; CSSD blog]:

• Carl Jung's analytical psychology.
• Rudolf Laban's movement analysis.
• Peter Slade's child drama.
• Lindkvist's own "Movement with Touch and Sound".

Its main media are myth and fairy-tale enactment, movement, voice, ritual and play [source: Karnac description of Pearson 1996].

How change happens (in the school's own theory). Sesame works obliquely. It uses allegory, symbolic image, dramatic distance and play rather than the client's literal life story [source: CSSD programme specification].

The following are Jungian ideas the school adopts. They are theoretical claims, not established fact:

• The unconscious finds expression through symbols that emerge in drama and movement.
• The psyche is self-regulating and has self-healing capacities.
• Embodying a story's images allows the person to meet a problem from a changed angle. This can free them from adopted, introjected and limiting ways of being.

[source: CSSD programme specification; CSSD blog]

The Cork validation document describes Sesame as an "indirect, non-confronting, right-brain responsive" therapy. It aims to turn attention toward the healthy, creative part of the person rather than the diagnosis [source: CIT validation report]. The "right-brain" wording is the document's own and is not an established neuroscientific finding [synthesis].

2. Framework

Professional frame. In the UK, Sesame is practised as dramatherapy. "Dramatherapist" is a title protected by the HCPC. The recognised route is the two-year full-time MA Drama and Movement Therapy at Royal Central, which leads to HCPC registration [source: CSSD programme specification]. Requirements during that training include:

• At least 72 sessions of personal therapy, with Jungian analysis recommended for the individual part.
• At least 30 sessions of group dramatherapy.
• A weekly process group run along group-analytic lines.
• About 100 sessions of supervised client contact.
• An enhanced DBS check.

[source: CSSD programme specification]

The UK professional association for dramatherapists is BADTh [source: BADTh website]. In Ireland, IACAT recognises the approach [source: CIT validation report].

Short courses do not qualify you to practise as a therapist. These include Royal Central's introductory course, the Irish certificate and a CPD course for HCPC-registered professionals. The Irish validation document says the certificate "does not alone qualify" graduates to practise professionally [source: CIT validation report; CSSD blog].

If you are a psychotherapist without dramatherapy registration, you may use Sesame-informed story and movement elements within your existing scope. Do not present yourself as a Sesame or drama and movement therapist. Do not use the touch-based Movement with Touch and Sound work without Sesame training [synthesis].

Format. Sesame is delivered in groups and one-to-one [source: CSSD programme specification]. Recorded settings include:

• Long-stay psychiatric wards.
• Services for people with learning and/or physical disabilities.
• Autistic children and adults.
• Residential homes for severely disturbed children.
• Mainstream schools.
• Prisons, including Wormwood Scrubs.
• Secure psychiatric care.
• End-of-life care.
• Refugee women's community work.

[source: TES; Karnac; Wellcome contents list; UBC Press description; Dramatherapy 39(2) abstracts]

No source gives a standard number of sessions or a fixed set of treatment phases. [uncertain] Training placements, for example, run as weekly sessions over a term or a year [source: CSSD programme specification].

Session sequence. The structure most consistently described has these stages [source: Watts, Pearson & Smail 2013 contents; Hougham 2012; TES]:

1. Warm-up, usually physical.
2. Bridging in: focusing the group toward the theme.
3. Entering the world of the story.
4. Leaving the place of myth.
5. Reflection, which the 2013 book calls "soul talk".
6. Often a closing ritual.

The detailed content of each stage in the 2013 book is [uncertain].

Course-level framework [synthesis]. A typical course has three broad periods:

• Early sessions. Build safety, group rituals and a shared movement vocabulary. Use short, light stories and more structure.
• Middle sessions. Work with longer myths that carry themes the group has already shown. Choose stories that resonate with what has emerged [source for theme-led story choice: Hougham 2012].
• Ending sessions. Return to familiar rituals, review images the group has made, and say goodbye.

Move from early to middle work when members can enter and leave play reliably, accept the rituals, and tolerate touch or close contact at the level they have chosen. Pull back toward structure whenever enactments repeatedly tip into the literal and personal, or into overwhelm [synthesis].

3. Guiding principles

• Work obliquely. Approach difficulties through story, image and metaphor, not direct confrontation. In practice, do not steer clients toward their own biography. Let the story carry the material [source: CSSD programme specification; TES; CIT].
• Safety comes before imagination. Metaphor emerges once a person feels "sufficiently safe" [source: CIT]. In practice, build structure and ritual first and deepen later [synthesis on sequencing].
• The body comes first. Movement and embodiment run through every part of the work [source: CSSD blog; Pearson 1996 contents, "Beginning with the Body"]. In practice, start every session in the body.
• Do not interpret. Expressed creativity is "not judged, analysed or interpreted verbally" [source: Batzoglou 2012, p. 11]. In practice, avoid telling clients what their images mean. Reflection stays close to the story.
• Process, not product. There is no artistic product to perfect [source: Batzoglou 2012]. In practice, never rehearse for polish or correct someone's performance.
• Spontaneity. Create conditions that support spontaneous action [source: CSSD programme specification]. In practice, give a clear frame and open content within it.
• Trust the self-regulating psyche. This is Jung's idea as adopted by Sesame [source: CSSD blog]. In practice, follow emerging images rather than imposing goals.
• Hold opposites. Symbolic images bring opposites in the psyche into relation (Jungian theory) [source: Hougham 2012; Pearson 1996 contents, Tuby]. In practice, offer embodied polarities, such as heavy and light, monster and hero, and let both be played.
• The story carries collective wisdom, not morals. Myths are not used as morality tales [source: Hougham 2012]. In practice, never draw a lesson for the client.
• Ritual as container. Opening and closing rituals frame the work [source: Pearson 1996 contents, Deane; TES]. In practice, keep openings and closings the same from week to week.
• The therapist as attuned movement partner. Movement with Touch and Sound emphasises non-verbal attunement and sensitivity to space [source: CSSD programme specification]. In practice, match the client's rhythm and level before leading.
• Containment of behaviour. Hold impatience and attention-seeking, and set expectations for waiting and turn-taking [source: TES, Newman]. In practice, the frame protects the play.
• Reflexivity and supervision. Personal therapy, a process group and weekly supervision are built into training [source: CSSD programme specification]. In practice, take your own reactions to images to supervision.
• Cultural resonance. Choose stories for their resonance with the group's culture [source: Hougham 2012]. In practice, ask about clients' own stories, songs and rhythms. Lindkvist's South African work reconnected patients with songs of planting and harvest.

4. Intervention inventory

The published Sesame texts are not drawn on in full. Each item below names the source that records it. Step-by-step detail is mostly my operationalisation, tagged [synthesis]. Do not attribute these steps to Lindkvist or the Sesame Institute.

Before starting any group: screening and consent [synthesis].

• Assess each referral. Check current risk, recent trauma, dissociation, psychosis or mania, and seizure history. Check physical limits on movement and floor work, and what each person's history means for touch, such as abuse, sensory sensitivity or cultural norms.
• Get informed consent covering the main elements. These are movement, close contact, optional touch, voice, and enacting stories. Batzoglou's thesis included an informed-consent template, which indicates written consent is used in research practice [source: Batzoglou 2012, contents].
• Children and young people. Obtain parental or carer consent and the child's own assent. Explain the limits of confidentiality and safeguarding duties in age-appropriate words, and follow local safeguarding and mandatory-reporting procedures. An open after-school group may not be able to offer closed membership or assured confidentiality, so tell members this [source for the open-group limit: TES].
• Physical safety. Use a clear, warm space with a non-slip floor and no sharp edges. Agree a stop signal. Keep loud percussion moderate, and give ear protection or a quieter role to sensory-sensitive or autistic members. Check props for hazards.

Warm-up: beginning with the body

• Purpose / when. Opens every session. It arrives people in their bodies, sets the group's energy and gives the therapist movement information [source: Pearson 1996 contents, Cooper, "Beginning with the Body"; CSSD blog].
• Steps [synthesis; TES records children shaping their bodies to show emotions].
  1. Begin with the same opening ritual each week, for example a circle and a name-and-gesture greeting.
  2. Lead whole-body mobilising, from small to large movement, at a pace matched to the slowest member.
  3. Move into expressive shaping, for example "make a shape that is tired... now one that is bursting with energy".
  4. Add travelling through the space, changes of level, and simple partner mirroring.
• Example language (illustrative). "Let's wake up our feet first... now let that wake-up travel up to your knees." "Find a shape for how the weather feels inside you today. No right shape."
• Watch for. Who avoids eye contact or space. Breath held or rapid. Collapse or hyperactivity. These are working observations, not diagnoses [synthesis]. It is working when people loosen, breathe and begin to respond to one another.

Movement with Touch and Sound (Lindkvist)

• Purpose / when. Lindkvist's core contribution [source: CSSD programme specification]. It builds non-verbal relationship, attunement and sensitivity to space through the therapeutic use of touch. It is especially used with people whose disability has limited early or current movement experience. Published uses include end-of-life care and work with refugee women [source: CSSD programme specification; Pearson 1996 contents, ch. 7; Dramatherapy 39(2) abstracts: Russo, Portokaloglou]. TES describes it as emotion-laden physical interaction that has much in common with Laban dance technique.
• Training requirement. The detailed forms are taught experientially on Sesame trainings and are not described in the sources [uncertain]. Use only if you hold Sesame training.
• Consent steps for any touch-based work [synthesis].
  1. Explain beforehand what kind of touch may be offered (for example hands, back of shoulders, feet) and that it is always optional.
  2. Ask before each new form of contact and accept a non-verbal no: pulling back, stiffening, turning away.
  3. Offer non-touch alternatives of equal value, such as mirroring at a distance or a shared object like a scarf, ball or drum.
  4. Never use sexual, genital, chest or buttock contact, or restraint presented as play.
  5. Give extra care with trauma histories, cultural and gender norms, and people who cannot give verbal consent. With non-verbal clients, rely on clear body signals, carers' knowledge and the care plan.
  6. Record consent and any change in it.
• Steps (general shape only) [synthesis]. Begin with sound or rhythm at a distance. Then attune: match the client's breathing, rocking or vocal rhythm. Offer contact only where it has been accepted. Let the client lead the pace. Withdraw gently, using voice to keep the connection.
• Example language (illustrative). "I'm going to hum along with your rocking." "Would it be OK if our palms met? You can say no or just move your hand away."
• Watch for. Startle, freezing, dissociation or sexualised response: stop and return to distance. It is working when the client initiates contact or sound, reciprocity increases, and the client settles.

Feet, rhythm and drum

• Purpose / when. Butler's paper describes Lindkvist's work with feet and rhythm. It supports connection, sense of self and grounding [source: Dramatherapy 39(2), Butler 2018, abstract only].
• Steps [synthesis]. Stand or sit with feet on the floor. Find a shared pulse with feet, a hand drum or claps. Vary the tempo and volume, then return to a steady beat. Use it to open, to re-ground after intensity, or to close.
• Example language (illustrative). "Feel the floor under you. Let's find one beat together."
• Watch for. Volume getting too loud for sensory-sensitive members, and escalation into chaos. Lowering the volume and slowing the beat should calm the group.

Games and imaginative play

• Purpose / when. Builds group cohesion and spontaneity and practises turn-taking. Mainly used with children [source: TES, which records Hug Tag, imaginary dancing, and "shadowing" between dancers and musicians].
• Steps [synthesis around the named games].
  1. Choose a game with simple rules.
  2. Demonstrate it.
  3. Play briefly, then vary it.
  4. For shadowing, pair a mover with a percussionist: one leads and the other follows. Then swap.
  5. Any hugging game is opt-in only. Offer a non-touch variant, such as "freeze in a statue".
• Example language (illustrative). "The drum leads, the dancer follows. When I say swap, the dancer leads."
• Watch for. Over-arousal, exclusion and unwanted contact. It is working when children wait, respond to each other and laugh.

Projective and personal play (Slade)

• Purpose / when. Slade's two kinds of play, used on the course [source: CSSD blog; Pearson 1996 contents, ch. 11]. Projective play puts the imagination into objects and space, which keeps distance. Personal play puts it into one's own body. The definitions here are a brief gloss; the original text is not drawn on [uncertain].
• Steps [synthesis]. For anxious or defended clients, begin projectively with objects, puppets, cloth or toys arranged on the floor. Move to personal play, embodying a character, when the client shows readiness.
• Example language (illustrative). "Choose a few objects to be the people in this village." Later: "Would you like to step in and be the old woman yourself?"
• Watch for. Readiness shows as fluency and pleasure in object play, and spontaneous movement toward embodying. If embodiment produces panic, step back to objects.

Finding and embodying opposites

• Purpose / when. Gives bodily form to polarities. The Jungian rationale is that symbols bring conflicting opposites into relation [source: CSSD blog; Pearson 1996 contents, Tuby, "Resolution of Conflicting Opposites"; Hougham 2012].
• Steps [synthesis].
  1. Offer a pair, such as heavy/light, closed/open, giant/tiny, or a story figure and its opposite.
  2. Each person explores one pole, then the other.
  3. Find a movement that travels between them.
  4. Optionally, pairs meet as opposites.
• Example language (illustrative). "Be as heavy as stone... now as light as a feather... now find the path from one to the other."
• Watch for. Clients stuck in one pole. Be cautious with persecutor/victim pairs for trauma survivors. It is working when movement becomes more flexible and someone finds a third, in-between quality.

Bridging in: scene-setting before the story

• Purpose / when. Moves the group from warm-up into the story world. The 2013 book has a chapter on warming up and bridging in, and offers scene-setting suggestions [source: UBC Press contents]. The specific bridges it gives are [uncertain].
• Steps [synthesis]. Mark the threshold, for example with lowered lights, a cloth laid down or a sound. Build the setting together in movement and sound, such as the forest, the sea or the village. Introduce the story's atmosphere before its plot.
• Example language (illustrative). "When we cross this cloth we are in the forest. What sounds live here?"
• Watch for. Members who cannot cross the threshold: offer an observer or musician role.

Telling and choosing the story

• Purpose / when. The story is the vessel for the main work. Lindkvist began by telling and performing myth with long-stay psychiatric patients [source: Hougham 2012]. The therapist chooses a story for its cultural resonance and its link to themes the group has already shown [source: Hougham 2012]. The 2013 book offers 56 myths and fairytales found useful in Sesame work, with the authors' own versions [source: UBC Press description].
• Steps [synthesis].
  1. Choose between sessions, guided by emerging group themes, the group's developmental level and its cultures.
  2. Learn the story well enough to tell it rather than read it.
  3. Tell it simply, with sound and gesture, leaving room for images.
  4. Avoid stories that reproduce a member's known trauma too literally.
• Example language (illustrative). "Today's story comes from Russia. It's about a girl called Vasalisa who has to go into the forest..."
• Watch for. Restlessness can mean the story is wrong for the group or too long. Stillness and absorption suggest resonance. Hougham uses the tale of Vasalisa to show possible focal points, but gives no session account of it [source: Hougham 2012].

Group montage: choosing a resonant image

• Purpose / when. After the telling, the group shows which parts of the story are alive for it. The result becomes a template for further work [source: Hougham 2012].
• Steps (Hougham 2012, paraphrased).
  1. After the story, each member chooses an image, role, landscape or atmosphere that resonates with them. This can be framed as a small personal ritual.
  2. Each member places themselves in the space as that image, so together they form a montage.
  3. The therapist observes the pattern: the rhythm of choices, pairings (two people choosing the same figure), convergence on one image, and images nobody chose. In Jungian terms, Hougham suggests the unchosen images may point to the group's shadow.
  4. Use the montage as the basis for the enactment.
• Example language (illustrative). "Which part of the story stays with you: a person, a creature, a place, a feeling in the air? Go and become it somewhere in the room."
• Watch for. Everyone avoiding a frightening figure is information. Do not force anyone into it. Treat any reading of the group's shadow as a hypothesis for supervision, not a statement to the group [synthesis].

Movement into enactment: myth enactment

• Purpose / when. The main event. The group moves the story's images through body and voice. Hougham calls the aim "spontaneous communitas" [source: Hougham 2012].
• Steps (Hougham 2012, paraphrased, with [synthesis] where noted).
  1. Using the montage, divide into pairs, small groups or individuals as the material needs.
  2. Use action methods to develop images. Hougham names sculpting, repetitive actions, repetitive gestures, vocal or physical "scores", and embodying single images.
  3. Direct attention to the textures of the story and its images, not to realistic role play.
  4. Let improvisation, not discussion, carry the meaning, and let the choreography emerge.
  5. Notice "chimes": moments of charged energy, or quiet sustained moments. Hougham links these to the Jungian idea of the numinous, where personal and group material meet.
  6. [synthesis] Keep an eye on time so that at least a third of the session remains for leaving the story and reflecting.
• Example language (illustrative). "Find one gesture for the river. Repeat it. Let it change only when it wants to." "Those of you who are Baba Yaga's hut, give us its sound."
• Watch for. Sliding into literal personal drama, such as a client re-enacting a real event. Respond by gently returning to the story's images. Watch for overwhelm, covered in section 5. It is working when members are absorbed, respond to each other, and images transform.

Story enactment with swapped and shared roles (children)

• Purpose / when. Allows children to take on and set aside difficult feelings safely inside a role [source: TES, Newman's school group]. In the recorded example, children in a jungle-village story negotiated with monsters using a drumbeat.
• Steps [synthesis around the TES example].
  1. Tell a short story.
  2. Cast roles by choice, and let several children share one role.
  3. Play a scene, then swap roles so no child stays only the monster or only the victim.
  4. Use percussion to cue entrances and endings.
• Example language (illustrative). "Now the monsters become villagers and the villagers become monsters."
• Watch for. A child stuck in an aggressor role or real aggression: freeze the scene and swap. Newman summarised her frame as "the three Rs: reparation, recognition and reflection" [source: TES].

Voice work

• Purpose / when. Voice is a core Sesame medium [source: Karnac; Pearson 1996 contents, Armstrong, "The Unique Voice That Lives Inside Us All"; Hougham 2012, expressive voice work]. Use it to embody images, to build shared rhythm and to reach clients who move little.
• Steps [synthesis]. Begin with breath and humming. Give sounds to images, such as wind, animals or calls. Build group soundscapes. Invite each voice without pushing anyone to perform.
• Example language (illustrative). "What sound does the dark forest make? Let it come out quietly first."
• Watch for. Shame about one's voice. Keep sounds collective so no one is exposed. Keep loud shouting brief.

Laban movement observation

• Purpose / when. The course teaches Laban movement analysis and the psyche–soma link [source: CSSD programme specification; Pearson 1996 contents, Sam Thornton, "Laban and the Language of Movement"]. The therapist uses it to observe and to widen clients' movement range.
• Steps [synthesis]. Note each client's habitual qualities, such as tempo, use of space, force and flow. Offer movement tasks that invite the qualities they lack, framed through story images. The framing of Laban's categories here is a gloss, not checked against a primary Laban text [uncertain].
• Example language (illustrative). "The giant moves slowly and strongly. The mouse is quick and light. Try both."
• Watch for. Use observations to guide your choice of tasks. Do not use them as diagnostic labels.

Ritual: openings, closings and ritual enactment

• Purpose / when. Gives a container and continuity. Ritual is also a medium of its own [source: Pearson 1996 contents, Roose-Evans and Deane chapters; Karnac]. Hougham describes Sesame work as ritual process and notes Jung's view that ritual can counter regression in groups [source: Hougham 2012].
• Steps [synthesis; the closing example is from TES]. Keep a fixed opening, such as a circle, greeting or sound. Keep a fixed closing. Newman's children's group ended with a loud shout followed by a quiet whisper [source: TES]. Introduce ritual moments for transitions within a story, such as a procession or an offering of an imagined object.
• Example language (illustrative). "Let's make our closing circle. One big shout... and now the smallest whisper."
• Watch for. Religious or cultural rituals belong to their communities. Draw on general ritual forms, not borrowed sacred ceremonies [synthesis].

Leaving the place of myth (de-roling)

• Purpose / when. A deliberate exit from the story so clients do not carry roles or images out of the room. The 2013 book has a chapter titled "Entering and Leaving the Place of Myth" [source: UBC Press contents]. Its specific procedures are [uncertain].
• Steps [synthesis].
  1. Signal that the story is ending, for example with a sound or by returning the cloth.
  2. Each person physically steps out of the role: shake it off, or put it down in a chosen place.
  3. They say their own name and something true about the room or the day.
  4. Re-ground with feet, rhythm or breath.
  5. Dismantle the set together.
• Example language (illustrative). "Put the wolf down here by the wall. Shake your hands. Tell us your name and one colour you can see in this room."
• Watch for. A member who is still "in" the role, flat, or dissociated. Spend more time on grounding and check in individually before they leave.

Reflection ("soul talk")

• Purpose / when. A brief verbal or creative sharing at the end. The 2013 book calls the reflective space "soul talk" [source: UBC Press contents]. Sesame does not interpret expressed creativity verbally [source: Batzoglou 2012].
• Steps [synthesis]. Sit in a circle. Invite a word, image or moment from the story that stayed with each person. Speak in story language. Do not link it to personal history unless the client does so, and then receive it briefly without exploring it. A drawing or a gesture can replace words.
• Example language (illustrative). "What moment in the story is still with you?" "So the bridge felt shaky. Thank you."
• Watch for. Pressure to explain, or the group interpreting each other: redirect to the images. It is working when people share freely and leave calm.

Other strands named in the Sesame literature

These are named in the 1996 contents but no technique detail is given [uncertain]. Do not use them without training material:

• "Dance As You've Never Danced Before!" (Susi Thornton).
• "Circus Skills and Commedia" (Mitch Mitchelson).
• Drama with prisoners at Wormwood Scrubs (chapter 15).

5. Handling problems

The Sesame sources say little about problem management. Apart from the three source-based points directly below, everything in this section is my synthesis [synthesis]. The sources do support three points:

• Safety precedes imaginative expression [source: CIT].
• Containment of impatience and attention-seeking is part of the therapist's role [source: TES].
• The oblique approach exists precisely to avoid confronting clients [source: CSSD; CIT].

Overwhelm, flooding and retraumatisation during enactment.

• Signs. Freezing, shaking, crying that escalates rather than settles, glazed eyes, hyperventilation, or speaking as if a real past event is happening now.
• Response.
  1. Pause the whole scene with a pre-agreed signal.
  2. Lower the stimulation: drum quieter or stopped, lights up.
  3. Approach at the client's eye level without touching unless touch has been explicitly agreed.
  4. Orient the client to the present: their name, the room, their feet on the floor, the date.
  5. Offer a role change or an observer seat.
  6. Do not resume the same image that day.
  7. Before the client leaves, check how they are, agree a plan for the next 24 hours, and follow up before the next session.
  8. Review the client's suitability and the choice of story in supervision.
• Risk. If the episode reveals current risk to self or others, follow standard risk-assessment and safeguarding procedures.

Screening out or postponing. Defer group enactment for people with:

• Acute psychosis or mania.
• Severe uncontained dissociation.
• Very recent trauma.
• Active suicidality without a safety plan.
• Medical limits that make vigorous movement or floor work unsafe.

For some of these, adapted one-to-one, projective or seated work may be possible. Decide with the client's care team.

Pacing. Increase depth step by step: projective before personal play, group images before solo ones, short stories before long myths. Keep enough time for de-roling and reflection however rich the enactment.

Touch refused, or touch going wrong.

• Treat refusal as valid and offer equal non-touch roles.
• Stop immediately if touch provokes startle, freezing or a sexualised response, and return to distance.
• Never insist that touch is "therapeutic".
• Discuss any incident in supervision, record it and inform the client's team as needed.
• With children, follow safeguarding procedures if touch or play brings a disclosure.

Disclosures in play. Do not treat images, enactments or movement as evidence of abuse. If a child or adult discloses harm in words, follow safeguarding procedures.

Stuck or flat group. Low energy, no one choosing images, mocking. Possible responses:

• Go back to simpler games, rhythm and object play.
• Shorten the story.
• Offer more structure, such as fixed roles.
• Ask in story terms what the group's story would need.

Persistent flatness can be a group theme. Hougham's discussion of unchosen images suggests noticing what the group avoids, and taking that to supervision rather than naming it to the group [source for the idea: Hougham 2012].

Resistance to the oblique approach. Some clients say "this is childish" or "what has this to do with my problems?".

• Explain the rationale briefly: stories let people approach hard things at a safe distance.
• Offer adult-respectful stories, such as epic myths rather than nursery tales.
• Allow observer or musician roles.
• If a client consistently needs direct verbal work, refer them or combine Sesame with it.

Literalising. A client keeps turning the story into their own biography. Gently return to the story's images, for example: "In the story, what does the girl do next?" Offer individual sessions for the personal material.

Over-arousal and chaos (especially children).

• Use fixed rituals and a stop signal.
• Lower the drum volume and slow the rhythm.
• Swap roles to break aggressor positions.
• Use short turn-taking structures [the turn-taking point has source support: TES].

Non-attendance and dropout. Contact absent members. Keep the opening ritual stable so returners can re-enter. In open groups, explain the limits of continuity and confidentiality [source for open-group limits: TES].

Ruptures with the therapist. A client may feel exposed, pushed into a role, or touched without wanting it. Acknowledge this plainly, apologise where you misjudged, and agree changes, such as more choice, less touch or an observer option. Repair before resuming enactment.

Jungian frame misused. Do not tell clients what their archetypes or shadows are. These are concepts from Jung's psychology that Sesame adopts as a working frame. They are not facts about the client and not diagnostic categories.

Working beyond your training. If you are not a registered dramatherapist with Sesame training, keep to low-intensity story and movement elements within your own scope. Refer clients on for Movement with Touch and Sound or deep myth enactment.

Sources

Sources:

• Royal Central School of Speech and Drama – MA Drama and Movement Therapy programme specification (PDF)
• Royal Central – Exploring the Sesame approach to drama and movement therapy (blog)
• Hougham, R. – The Matrix, Group Processes and Psychotherapy (repository PDF) and repository record
• Batzoglou, A. – Towards a theatre of psychagogia (PhD thesis PDF, partly readable)
• [Cork Institute of Technology – Validation report, Principles of Sesame Drama-Movement Therapy (2017)](https://www.cit.ie/contentfiles/0-validation-reports/2016-2017/Non-Major Awards/FINAL_Validation Report_Princip. of Sesame Drama-Movement Ther. 15_5_17.pdf)
• TES – Once more with feeling
• Psychotherapy.net – Sesame Drama & Movement Therapy (video description)
• Karnac – Discovering the Self Through Drama and Movement (description)
• Wellcome Collection catalogue – Discovering the self through drama and movement (contents)
• UBC Press – Dramatherapy with Myth and Fairytale (description and contents)
• Dramatherapy vol. 39 issue 2 (2018) – contents and abstracts
• BADTh website

Further reading (full texts not drawn on unless stated):

• Pearson, J. (ed.) (1996). Discovering the Self through Drama and Movement: The Sesame Approach. London: Jessica Kingsley. Contents list and description only.
• Watts, P., Pearson, J. & Smail, M. (2013). Dramatherapy with Myth and Fairytale: The Golden Stories of Sesame. London: Jessica Kingsley. Contents list and description only.
• Hougham, R. (2012). The matrix, group processes and psychotherapy. The Arts in Psychotherapy, 39(1), 60–65.
• Batzoglou, A. (2012). Towards a theatre of psychagogia: an experimental application of the Sesame approach into psychophysical actor training. PhD thesis, Central School of Speech and Drama.
• Butler, C. (2018). Billy's drum: feet and rhythm in Sesame therapeutic practice. Dramatherapy, 39(2), 63–75. Abstract only.
• Jones, P. (2018). Lindkvist in the Sesame Institute archive: an autoethnographic study. Dramatherapy, 39(2), 84–101. Abstract only.
• Portokaloglou, T. (2018). Transplanting the soul-tree. Dramatherapy, 39(2), 102–112. Abstract only.
• Russo, S. (2018). Meeting through touch. Dramatherapy, 39(2), 113–122. Abstract only.
• Johnson, D. R. (2018). Learning from experience: the legacy of Billy Lindkvist. Dramatherapy, 39(2), 76–83. Title only.