Landscape montage technique and frame-drawing method (Nakai)

Domain VIII · Creative & expressive arts therapies · Nakai Hisao · 1969 · Japan

What it is

Psychiatrist Nakai Hisao devised LMT in Japan in 1969 after hearing Kawai Hayao lecture on sandplay (箱庭療法). It began as a preliminary paper test of whether patients with schizophrenia could tolerate sandplay, and as a stopgap until a sandplay set was available. Nakai then found it valuable in its…

Format

• LMT has no phased treatment course. The "framework" is (a) the fixed stages inside one administration and (b) how administrations are spaced across a therapy.
• Format. Individual, face to face, one sheet of drawing paper, a felt-tip pen (サインペン) for lines, crayons (or similar) for colour. Paper size and the exact wording of the instruction are not stated in the sources. Group administration exists and gives different results: stereotyped human figures are…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• You cannot watch each person closely, so use group LMT for activity or screening of engagement only, not for individual clinical reading.
• Remember that a change seen in the drawing is a subjective judgement, and that changes in the drawings do not always match changes in the client's life.
• Your own wish to find meaning. Write readings as questions ("river very narrow and vertical: does the task feel too difficult right now?"), not conclusions.
• Whether the scene is lived in (time, weather, activity) or remains a set of separate objects. PDI answers belong to the client's own account; record them verbatim next to the picture.
• Points of breakdown, such as an item that cannot be placed, a sudden change of viewpoint, or items scattered without relation. These mark where to slow down. They are not diagnostic signs.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.