Therapeutic videography

1. Introduction

Version followed: therapeutic filmmaking as set out in Cohen, Johnson & Orr (eds., 2015, Video and Filmmaking as Psychotherapy: Research and Practice, Routledge), using J. Lauren Johnson's five production stages (development, pre-production, production, post-production, exhibition/distribution) as summarised by Tuval-Mashiach, Patton & Drebing (2018). Two named delivery formats are described alongside it: the four-day group "I Was There" film workshop for veterans (Patton) and the 24-session group Video Therapy model at the Ma'aleh School of Television, Film and the Arts, Jerusalem (Yarden Kerem). [source: Routledge book page; Tuval-Mashiach et al. 2018; Israel MFA 2014]

What it is. "Therapeutic videography" is not a single manualised therapy with a founder. It is an umbrella for using video cameras and filmmaking in therapy. Its main current form is therapeutic filmmaking: clients plan, shoot, edit and screen their own short films, alone or in groups, with a clinician. The literature also uses "video-based therapy", "videotherapy", "video art therapy" and "digital storytelling", and Tuval-Mashiach et al. note that the field has no agreed definitions. Related but separate methods are cinematherapy (watching and discussing existing films), video-confrontation or video feedback (showing clients footage of themselves), and video modelling / video self-modelling (imitation-based behavioural methods). This guide covers client filmmaking in full and the viewing-based variants only as far as the sources describe them. [source: Tuval-Mashiach et al. 2018; Saladino et al. 2020]

How change is thought to happen. The authors draw mainly on narrative therapy and art therapy, plus depth psychology in Cohen & Orr's chapter. The proposed mechanisms are:

Externalisation and distance. The story sits outside the person on a screen, where they can watch it, revise it and "work with it tangibly" (Johnson, quoted in Edify 2016).
Witnessing. Johnson: "Part of what's therapeutic is just telling the story and having it witnessed."
Agency. The client controls what is shown and how much.
Narrative reconstruction. Selecting, editing and choosing an ending mirrors the work of fitting a traumatic or difficult experience into a life story.
Multisensory processing. Image, sound, voice and body may reach sensory memories that are hard to put into words.
A durable product. Unlike a drama enactment, the film can be watched again and again.
Affiliation. In groups, people build a shared purpose with peers.

These mechanisms are proposed, not confirmed. [source: Tuval-Mashiach et al. 2018; Edify Edmonton 2016; Gagliano et al. 2023] [uncertain: Cohen & Orr's depth-psychological account of editing (book ch. 3) was known only from its chapter title]

2. Framework

Johnson's five stages are the backbone; every programme described follows some version of them. [source: Tuval-Mashiach et al. 2018, citing Johnson 2015]

Stage	Clinical goal	What happens
0. Screening and consent (precedes stage 1)	Judge readiness and the risk of reactivating trauma; set the consent frame	Screening interview; layered consent for filming, storage and later use; assent for minors [source: Tuval-Mashiach et al. 2018; Saladino et al. 2020; Gagliano et al. 2023]
1. Development	Find the story and the theme; build safety and group trust	Camera familiarisation, trust-building, story sharing, choosing a theme
2. Pre-production	Give the material shape; give the client authorship	Script, storyboard, roles, locations, schedule
3. Production	Embodied, enacted expression, with exposure the client controls	Shooting, acting, directing, reviewing footage, reshooting
4. Post-production	Make meaning and integrate; the client takes the "editor" position on their own story	Selecting scenes, ordering, titles, music and sound, choosing the ending
5. Exhibition/distribution	Witnessing, recognition, a considered decision about the public	Private or group screening and discussion; the client decides whether to share more widely

Typical formats in the sources:

I Was There (veterans, US). Four consecutive half-days, up to 15 participants per workshop, split into small groups of 3–4 that each make one film. Day 1: camera skills and filming exercises. Day 2: topic sharing, group discussion, forming groups and choosing a theme. Day 3: writing, acting and shooting. Day 4: editing, effects and sound, then a screening for participants and invited guests, followed by discussion. Professional filmmakers handle the technical side, and a mental-health provider is on site throughout. [source: Tuval-Mashiach et al. 2018; army.mil 2014]
Ma'aleh Video Therapy (Israel). Closed groups of 24 weekly sessions, co-led by a therapist and a filmmaker. Each participant writes and makes a short personal documentary (an "I movie"), or the group makes a short fiction film. Screenings and therapeutic discussion are woven through. [source: Israel MFA 2014]
Children with autism (Italy). One family assessment, 6 filmmaking sessions for pairs of children, 2 viewing sessions and follow-up at 1 and 3 months. Session 1: rules, getting used to the camera, storyboard. Sessions 2–4: shooting. Sessions 5–6: editing. Session length was not reported. [source: Saladino et al. 2020]
Intensive adolescent course (Italy). Daily sessions of 5–6 hours. The paper gives the length as both three and six weeks. Days 1–2: filmmaking theory and trust-building. Middle phase: pre-production and shooting. Last two days: post-production. Small groups made films of about 15 minutes. [source: Gagliano et al. 2023]
Individual work. Johnson's own work included single-person films (for example, hope-focused films by women about unplanned pregnancies). The session structure is not described. [source: Edify Edmonton 2016] [uncertain]

Criteria for moving between phases. None of the sources gives formal criteria. Practical markers [synthesis]:

Into development: screening is complete, consent is signed, and the client can stay within their window of tolerance when naming the topic.
Into pre-production: a theme the client (or group) has chosen freely, plus a decision on how directly to show it (literal, re-enacted by others, or metaphorical).
Into production: a script or storyboard the client endorses, roles agreed, and grounding strategies in place.
Into post-production: enough footage, no unresolved acute distress from the shoot, and the client willing to watch their own footage.
Into exhibition: the client has watched the cut privately, approves the audience, and has given separate consent for any wider distribution.

Professional frame. No regulated profession or protected title exists for therapeutic filmmaking or videography, and no single credentialing body was found. [uncertain]

Training. Ma'aleh runs a one-year certification with separate tracks for filmmakers and for certified therapists. Johnson founded the Therapeutic Filmmaking Institute in Alberta, Canada; its training content was not found. [source: Israel MFA 2014; Routledge book page]
Who should deliver it. The method should be delivered within an existing clinical licence: for example, a UK HCPC-registered art therapist (BAAT) or drama therapist (BADth), an AATA/ATCB-credentialed art therapist, a licensed psychologist, or a counsellor. When the work involves trauma narratives it should not be run by filmmakers alone. Every programme described paired film professionals with an on-site clinician. [synthesis, based on the staffing in Tuval-Mashiach et al. 2018, Gagliano et al. 2023 and Israel MFA 2014]
Not therapy on its own. Patton describes I Was There as not therapy in the sense of a one-to-one session. Treat such workshops as an adjunct you refer into or co-run. [source: army.mil 2014]

3. Guiding principles

Process over product (Patton). Judge the session by what the client experiences, not by film quality. Cut technical ambition when it crowds out reflection. [source: army.mil 2014]
Listen. Collaborate. Empower. These are the three stated working words of I Was There. Facilitators think alongside participants rather than directing them. [source: army.mil 2014; Tuval-Mashiach et al. 2018]
The client controls exposure. Participants decide what to disclose and how much. One veteran chose a different group rather than join a re-enactment of a traumatic event, and the programme allowed it. Always offer the symbolic or someone-else-plays-it route. [source: Tuval-Mashiach et al. 2018]
Partial, self-chosen exposure. The authors argue that graduated, chosen exposure may suit this format better than full exposure. Do not push for literal re-enactment. [source: Tuval-Mashiach et al. 2018]
Voluntary participation, free to leave. Say this at the start and repeat it before each shoot. [source: Tuval-Mashiach et al. 2018; Saladino et al. 2020]
Listen fully and empathetically, without interpreting. Ma'aleh trains filmmakers to do this. Keep interpretations out of script and editing decisions unless the client invites them. [source: Israel MFA 2014]
The camera as non-judgemental witness. Kerem: "The camera absorbs everything and is never critical." Introduce the camera as a safe receiver, not an evaluator. [source: Israel MFA 2014]
Rebuilding control through authorship. Kerem: "Film allows a sense of control over one's life." Give the client real creative decisions at every stage. [source: Israel MFA 2014]
Story told and witnessed (Johnson). Plan who will see the film as carefully as what goes into it. [source: Edify Edmonton 2016]
Clinician and filmmaker as a team. Divide roles explicitly: the clinician holds safety and meaning, the filmmaker holds craft. [source: Israel MFA 2014; Tuval-Mashiach et al. 2018; Gagliano et al. 2023]
The client owns the film and the distribution decision. Participants receive their films and decide about public sharing. Never screen or post without fresh, specific consent. [source: Tuval-Mashiach et al. 2018]
Layered, revocable consent, and honesty about permanence. Get separate consent for therapy use, research, teaching and any public channel. Warn that published material is hard to withdraw. [source: Saladino et al. 2020]
Secure storage. Footage is clinical material: use password-protected devices and locked storage, and share only within the team. [source: Saladino et al. 2020]
Ethics first. The editors open the book with an ethics chapter. Treat consent, confidentiality, dual roles and distribution as clinical questions, not admin. [source: Routledge TOC, ch. 2] [uncertain: chapter content]
Strengths-based framing for young people. The 2025 systematic review describes filmmaking as "a strengths-based intervention that promotes youth development". [source: Zhang et al. 2025/2026]
Cultural grounding. Johnson's chapter treats therapeutic filmmaking with First Nations communities under the heading "Vision, Story, Medicine". Work with community protocols and community ownership of stories. [source: Routledge TOC, ch. 5] [uncertain: chapter; the practical meaning is synthesis]

4. Intervention inventory

The inventory runs in stage order. Each entry names its source. Where a source names a component but gives no procedure, the steps are my operationalisation and are tagged [synthesis]. All example wording is illustrative unless it appears in quotation marks with a citation.

Materials and physical safety (applies to every entry) [synthesis unless tagged]

Equipment. Tablets or phones are enough. Have a tripod, an external microphone and simple editing software ready.
Room hazards. Tape cables down to prevent trips. Keep hot lights away from fabric and skin, and do not let anyone touch lamps until they have cooled.
Location shoots (participants in Gagliano et al. 2023 chose sports grounds and squares). Check traffic, weather, permissions and bystanders. Never film members of the public without their consent.
Stunts and acted violence. Keep action scenes slow and choreographed. No real weapons and no props that look like real weapons in public.
Data. Each clip is identifiable health information. Use encrypted, password-protected storage, keep a log of who holds copies, and agree in writing what happens to raw footage after therapy ends. [source for storage: Saladino et al. 2020]

4.1 Screening interview and readiness assessment

Purpose / when: Before enrolment. Assesses the risk that the work will reactivate trauma, and the client's suitability for a group. [source: Tuval-Mashiach et al. 2018]. Family version for children: a 60-minute parent interview and a 30-minute child interview. [source: Saladino et al. 2020]
Steps:
1. Take a history: trauma exposure, current symptoms, recent self-harm or suicidality, substance use, and current treatment.
2. Ask what story the client imagines telling, and how directly.
3. Check how they react to being filmed, to seeing themselves on screen, and to an audience.
4. Agree a personal distress signal and a stop plan.
5. Decide on group or individual work. Defer if the client is in acute crisis.
- Steps 1 and 3–5 are [synthesis]. The sources report that screening happened, not its content.
Example language (illustrative): "You decide what goes in the film and what stays out. Some people tell their story directly, some use a symbol, some have someone else play them. Which feels possible right now?"
Watch for: Pressure to disclose for the sake of the film. Discomfort with being photographed, which can be linked to shame, body image, surveillance trauma or paranoid ideation. Unrealistic expectations of fame or of reaching a public audience.

4.2 Layered consent and ownership agreement

Purpose / when: Before any filming. Keep it live throughout.
Steps:
1. Explain the method, and say where it is experimental. [source: Saladino et al. 2020]
2. Take separate consents for: filming in session; storage; viewing by the team; research; teaching; and each public channel (journals, TV, websites, social media). [source: Saladino et al. 2020]
3. Warn that material, once published, is hard to remove even if consent is later withdrawn. [source: Saladino et al. 2020]
4. Agree that the client receives the film and decides about public sharing. [source: Tuval-Mashiach et al. 2018]
5. For minors: written parental consent, plus child assent given in a separate meeting. [source: Gagliano et al. 2023]
6. Get consent from everyone who appears on camera, not just the client. [synthesis]
7. Revisit consent before the screening and again before any distribution. [synthesis]
Example language (illustrative): "Agreeing to film today is not agreeing to show anyone. We'll ask again before each step."
Watch for: Consent given to please you or the group. A carer consenting to something the young person later objects to. Clients who appear in each other's films, which creates cross-consent issues.

4.3 Group agreement (communication-rules poster)

Purpose / when: First session of group work. Builds cooperation and a shared frame. [source: Saladino et al. 2020]
Steps:
1. Ask the group to suggest rules. Saladino et al. report rules along the lines of listening, working together and using the camera to tell a story.
2. Write them on a poster that stays on the wall.
3. Add rules on confidentiality, on filming no one without their consent, and on leaving the room [synthesis].
4. Point back to the poster when conflicts arise.
Example language (illustrative): "What do we need from each other so everyone feels OK being in front of and behind the camera?"
Watch for: Rules imposed by the leader rather than owned by the group. Members who stay silent during rule-making. They may need individual check-ins.

4.4 Camera familiarisation and filming exercises

Purpose / when: Development stage (I Was There Day 1; session 1 in Saladino et al.; days 1–2 in Gagliano et al.). Lowers anxiety about the camera, teaches basic directing skills and builds trust. [source: Tuval-Mashiach et al. 2018; Saladino et al. 2020; Gagliano et al. 2023]
Steps:
1. Hand cameras round. Each person films objects, then hands or the room, before filming faces.
2. Teach a few basics: framing, close-up versus wide shot, steady shots, sound.
3. Run short paired exercises: one person films, the other speaks or moves, then they swap.
4. Play the clips back together, commenting only on technique at first.
- The specific exercises are [synthesis]. The sources say only that "filming exercises" and basic directing skills were taught.
Example language (illustrative): "Start by filming something in the room that you like the look of. No faces yet."
Watch for: Freezing or dissociation when the lens points at the client. Excessive self-criticism on playback. A sign it is working: clients start choosing shots on their own and joking about technique.

4.5 Film-language group exercises

Purpose / when: Early group sessions at Ma'aleh. Through exploring concepts such as what an image is and how conflict is expressed on screen, the group develops a shared voice and chooses a topic. [source: Israel MFA 2014]
Steps:
1. Show or make single images and discuss what each one conveys.
2. Explore how conflict can be shown visually: framing, distance, light, sound.
3. Connect these to the group's own concerns and draw out a common topic.
- The steps are [synthesis]; the source gives only the concepts.
Example language (illustrative): "If this conflict were a single shot, where would the camera be?"
Watch for: Intellectualising as a way to avoid personal material. That is fine early on, but move gradually toward the group's own lives.

4.6 Story sharing (story circle)

Purpose / when: Development stage (I Was There Day 2). Each person names a topic that is important or hard in their coping, and the group discusses it. [source: Tuval-Mashiach et al. 2018]. In digital storytelling, the story circle is a structured, non-judgemental round for sharing and shaping stories. [source: Roberts, Story Circles handout]
Steps (story-circle format, Roberts):
1. Prepare the room in advance: a circle of chairs, drinks, tissues and paper.
2. Explain the time limit (up to about 5 minutes each) and the theme. Remind people the telling need not be perfect.
3. Each person shares. The facilitator keeps time, thanks each speaker and makes no comment on individual stories during the round.
4. Watch participants' reactions and offer breaks.
5. Feedback comes only after everyone has spoken, and covers how the story is told as well as its content.
6. Thank the group and move into scripting or storyboarding.
- Clinical additions [synthesis]: stress the right to pass; tell participants they can share the theme without graphic detail; use grounding before and after the round.
Example language (illustrative): "You can tell us the topic without the details. 'Coming home' is enough."
Watch for: Graphic trauma disclosure that floods the teller or the listeners. Competitive comparison between stories. A sign it is working: members recognise themselves in others' stories, which participants describe as feeling understood. [source: Tuval-Mashiach et al. 2018]

4.7 Theme selection and forming small groups

Purpose / when: End of development. Members split into groups of 3–4 with shared concerns, and each group chooses a common theme for one film. [source: Tuval-Mashiach et al. 2018]
Steps:
1. List the themes raised in the story round.
2. Let members choose groups by the themes they share.
3. Each group agrees a single theme and a working title.
4. Check every member is comfortable with the level of directness chosen. If not, allow them to move to another group. [source for allowing a move: Tuval-Mashiach et al. 2018]
Example language (illustrative): "Which of these themes do you want to spend three days with?"
Watch for: A dominant member steering the theme toward their own trauma. Isolates left without a group.

4.8 Script writing

Purpose / when: Pre-production. Turns experience into a structured narrative the client authors. Used in I Was There (Day 2–3, written by the group), at Ma'aleh (each participant writes their own script) and in the adolescent course (group screenplays after brainstorming). [source: Tuval-Mashiach et al. 2018; Israel MFA 2014; Gagliano et al. 2023]
Steps:
1. Brainstorm scenes around the theme.
2. Choose a form: documentary, fiction or metaphor.
3. Draft a short beginning–middle–end. Give particular attention to the ending, since the authors link choosing an ending to integration. [source: Tuval-Mashiach et al. 2018]
4. Read the draft aloud.
5. The clinician asks what each scene means to its author, not what it "really" means. Follow Ma'aleh's non-interpretive listening.
Example language (illustrative): "What do you want the audience to feel in the last ten seconds?"
Watch for: Scripts that dwell on scenes of injury, self-harm or suicide. Adolescents in Gagliano et al. chose such themes. Check whether this is processing or rehearsal, and assess risk. See 5.6. Also watch for endings that are hopeless by default, and for a client who cannot imagine any ending, which is clinically informative. [synthesis]

4.9 Storyboarding (characters, actions, desires, fears)

Purpose / when: Pre-production. Especially useful for children and for clients with limited verbal expression. In Saladino et al., children built their plot around four categories: characters, actions, desires and fears. They used coloured markers, keywords, or photos of themselves acting out emotions. The authors link this to art-therapy expression and narrative psychotherapy. [source: Saladino et al. 2020]
Steps:
1. Give out a panel grid and four headings.
2. The client fills in who is in the story, what they do, what they want and what they fear.
3. Order the panels into shots.
4. Note the camera position for each panel.
Example language (illustrative): "What does this character want most? And what are they afraid of?"
Watch for: Fears that the client places on characters but could not say about themselves. Use these gently, as externalised material, and do not interpret them to the client. The psychotherapist in Saladino et al. also used storyboard notes in evaluation. [source: Saladino et al. 2020]

4.10 Emotion-mimicry photo game ("magical polaroid")

Purpose / when: Within storyboarding, for children with autism. Trains recognising and producing facial emotions. [source: Saladino et al. 2020]
Steps:
1. A child mimics a named emotion and a partner recognises it.
2. Only when both the mimicry and the recognition are correct is an instant photo printed.
3. The photo is added to the storyboard.
Example language (illustrative): "Show me 'surprised'. Can your partner guess it? Then the camera will take it."
Watch for: Frustration when no photo prints. Keep the task within reach. Also note whether the skill generalises outside the game.

4.11 Role allocation and role-switching

Purpose / when: Pre-production and production.
- Roles. Roles are self-selected (I Was There) or assigned by interest. In the adolescent course they covered script, direction, photography, sound, costume, make-up, production organisation and editing.
- Switching. In Saladino et al., pairs alternated between actor and director, and between interviewer and interviewee. One child interviewed the director on camera.
- Why. Switching builds perspective-taking and reciprocity. A behind-camera role offers a lower-exposure way to take part. [source: Tuval-Mashiach et al. 2018; Gagliano et al. 2023; Saladino et al. 2020]
Steps:
1. List the roles.
2. Members choose, with each person trying both an on-camera and an off-camera role where possible.
3. Switch roles at set points.
4. After each switch, debrief briefly on what each position felt like. [steps 3–4 partly synthesis]
Example language (illustrative): "You've been directing. Now step in front of the camera for this scene. What changes?"
Watch for: Someone always hiding behind the camera. That can be a valid way to regulate, but invite them to move gradually. Also watch for directors who control others harshly.

4.12 Distanced and symbolic depiction (someone else plays you; metaphor)

Purpose / when: Production, whenever direct depiction is too exposing. Participants told their experience literally, transformed it, or expressed it symbolically. Having another person play one's part let them see the experience from outside. The films often showed service, trauma and reintegration through metaphor. [source: Tuval-Mashiach et al. 2018]
Steps:
1. Offer three levels: literal, re-enacted by others, or metaphorical (an object, a landscape, a sound).
2. The client chooses the level for each scene.
3. If another person plays the client, the client directs them.
4. Afterwards, ask what it was like to watch "yourself" from the director's chair.
Example language (illustrative): "Would you rather show this, have someone else play it, or find an image that stands for it?"
Watch for: Over-distancing, where the story disappears entirely. Under-distancing, where the client is reliving the event during the shoot. Re-enactment of traumatic events is the highest-risk choice. Participation must be optional and the clinician must be present (see 5.3).

4.13 Shooting, with footage review and reshoots

Purpose / when: Production. This is the embodied, enacted stage of the work. Participants act, operate cameras and direct. They review footage for continuity and reshoot when needed. [source: army.mil 2014; Tuval-Mashiach et al. 2018]
Steps:
1. Brief the scene and the roles.
2. Do a grounding check before any emotionally loaded take [synthesis].
3. Shoot.
4. Review the take on the camera screen.
5. Decide together whether to reshoot.
6. Close the day with de-roling for actors: they step out of the character, say their own name and something about their real present [synthesis, drawn from drama-therapy practice; not described in the sources].
Example language (illustrative): "Before we roll: where are you, 0 to 10? If you need to stop mid-take, just say 'cut'."
Watch for: Repeated takes of a distressing scene, which become uncontrolled exposure. Cap the number of takes and offer cutaways [synthesis]. A sign it is working: clients start to make the material their own by changing angles and lines.

4.14 Personal documentary ("I movie")

Purpose / when: At Ma'aleh, over 24 weekly group sessions, each participant writes and makes a short personal documentary about their own life story, with screenings and therapeutic discussion. [source: Israel MFA 2014]. Johnson's films on unplanned pregnancy are an individual example of a film about one's own life. [source: Edify Edmonton 2016]
Steps:
1. Choose one strand of the life story.
2. Gather material: interviews with oneself or family (with their consent), places, objects, photos.
3. Script a voice-over.
4. Shoot and edit across the sessions.
5. Bring work-in-progress to group screenings for discussion.
- The steps are [synthesis]; the source gives only the overall format.
Example language (illustrative): "If this film had one sentence it wanted the audience to leave with, what would it be?"
Watch for: Family members filmed without real consent. Revelations that harm third parties. Advise the client to keep it private if in doubt. [synthesis]

4.15 Editing as a therapeutic process

Purpose / when: Post-production. Selecting, cutting and ordering footage lets clients organise chaotic experience and take a more objective view. [source: Tuval-Mashiach et al. 2018]. Saladino et al. call editing "a fundamental part" of the work: children selected scenes, chose titles and reviewed footage together. Cohen & Orr give a depth-psychological account of editing (book ch. 3). [source: Saladino et al. 2020; Routledge TOC] [uncertain: content of ch. 3]
Steps:
1. Watch all the footage once without judging it.
2. The client selects keepers and discards, saying why.
3. Order the shots and try at least two sequences.
4. Choose music and sound.
5. Choose the title and the ending.
6. Reflect: what was left out, and why.
- In the adolescent course, editors made a rough cut and then added effects, music and sound with the director. [source: Gagliano et al. 2023]
Example language (illustrative): "What happens to this memory if it comes after that scene instead of before it?"
Watch for: Perfectionism and endless re-cutting, which can be avoidance of finishing. Distress at seeing one's own face or body. Clients who start reshaping the ending of their own life story, which is the intended shift; note it and reflect it back.

4.16 Screening and discussion (exhibition)

Purpose / when: Final stage. The film is witnessed and recognised, and the group or family reflects on it.
- I Was There: a screening for participants and invited guests, followed by discussion. [source: Tuval-Mashiach et al. 2018]
- Ma'aleh: screenings, followed by work on the feelings the films bring up. [source: Israel MFA 2014]
- Saladino et al.: the finished film was shown in a cinema with families present, then discussed. The authors call this "cinematherapy", meaning a recreation of the cinema setting. [source: Saladino et al. 2020]
Steps:
1. Each client confirms the audience list before the screening.
2. Each filmmaker introduces their film briefly.
3. Screen it.
4. Discuss the filmmakers' experience first, then audience responses, framed as what moved them rather than critique.
5. Close with grounding.
- Steps 1 and 4–5 are [synthesis].
Example language (illustrative): "Before comments: how was it to watch it with everyone here?"
Watch for: Shame spikes, and family reactions that wound. Prepare family guests beforehand. A sign it is working: relatives say they understand the person better, as one spouse reported in the veterans study. [source: Tuval-Mashiach et al. 2018]

4.17 Individual video-confrontation viewing

Purpose / when: After the group screening. In Saladino et al., each child watched the film individually in the therapist's office, followed by discussion to bring out new thoughts and feelings. The paper also cites video-confrontation work with adolescents at clinical high risk for psychosis (Brazzale et al. 2018) and describes "videotherapy" as showing patients images of themselves. [source: Saladino et al. 2020] [uncertain: Brazzale protocol]
Steps:
1. Watch the film together, or selected clips of the client.
2. Pause at moments the client chooses.
3. Ask open questions about what they see and feel.
4. Note new self-perceptions.
Example language (illustrative): "Stop it wherever something catches you. What do you notice about the person on screen?"
Watch for: Harsh self-evaluation, depersonalisation, and body-image distress. With clients at risk of psychosis, avoid anything that could be experienced as surveillance. [synthesis]

4.18 Handover and distribution decision

Purpose / when: After exhibition. Participants receive their films and decide whether to share them publicly. [source: Tuval-Mashiach et al. 2018]. Distribution is Johnson's fifth stage. [source: Tuval-Mashiach et al. 2018]
Steps:
1. Give the client a copy (Saladino et al. gave a DVD).
2. Review the consent layers again.
3. Discuss likely reactions from the public and from people the client knows.
4. Recommend a waiting period before any posting [synthesis].
5. Agree what happens to the raw footage.
Example language (illustrative): "Let's imagine it's online in a year. Who do you hope sees it, and who would you rather didn't?"
Watch for: Impulsive posting. Online comments that re-traumatise. Employers or ex-partners finding the film.

4.19 Viewing existing films with therapeutic discussion

Purpose / when: Interleaved with filmmaking at Ma'aleh, which combines watching films with therapeutic discussion after each screening. [source: Israel MFA 2014]. Saladino et al. distinguish "filmtherapy", where the film's plot and characters are used for identification, from cinematherapy, where the cinema setting is recreated. [source: Saladino et al. 2020, after Casetti 2015]
Steps:
1. Choose a short film related to the group's theme.
2. Watch it.
3. Discuss identification with the characters and what the film's choices show.
4. Link this to the group's own film [synthesis].
Example language (illustrative): "Which character would you cast yourself as, and why?"
Watch for: Disturbing content in the chosen film. Preview everything first.

4.20 Named variants whose procedures are not drawn on

The edited volume names these applications. Their procedures are not drawn on here, so they are listed without steps. Get the chapters before using them. [source: Routledge TOC] [uncertain]

Green-screen technology in psychotherapy: Ehinger, ch. 4; Kavitski, ch. 14.
Digital storytelling as a trauma-narrative intervention for children exposed to domestic violence: Anderson & Wallace, ch. 8.
A technology intervention in a grief and loss programme for children and adolescents: McGurl et al., ch. 7.
Digital storytelling for social wellness: Otanez & Lakota, ch. 10.
Video art and activism in art therapy: Mosinski, ch. 11.
Video art therapy: Kerem, ch. 13.
Computer animation with an adolescent in foster care: Austin, ch. 15.
Digital video with special populations: Orr, ch. 9.
Client video media experience: Carlton, ch. 6.

Video modelling and video self-modelling are distinct behavioural methods. Saladino et al. note them only as background, and their procedures are not covered here. [uncertain]

5. Handling problems

The sources say little about problems. Apart from the items tagged with a source, this section is my own synthesis. [synthesis unless tagged]

5.1 Stuck: no story, blank page, "nothing to film"

Drop down to smaller units: one image, one sound, one object (see 4.5 and 4.9).
Offer the four storyboard headings (characters, actions, desires, fears) as scaffolding. [source for headings: Saladino et al. 2020]
Give a behind-camera role first.
Allow a fiction or metaphor frame (4.12). People can often say more as a character than as themselves.

5.2 Camera aversion and resistance to being seen

Never insist on the client's face appearing.
Offer alternatives:
- Hands, shadows, silhouettes or the back of the head.
- Voice-over only.
- Someone else plays them (distancing is a source-described route). [source: Tuval-Mashiach et al. 2018]
Explore what being seen means to the client, for example shame, surveillance, or past filming used for abuse.
If the client has a history of non-consensual filming or image-based abuse, discuss whether this method fits at all.

5.3 Overwhelm, flashback or dissociation during a shoot or screening

Have a mental-health professional present throughout. This is standard in I Was There. [source: Tuval-Mashiach et al. 2018]
Any participant can call "cut", and the take stops at once.
Use grounding: orient to the room, use the senses, slow the breath, give a present-day name.
Move the person out of the scene and offer a lower-exposure role.
Do not restart the same scene that day.
Follow up individually within 24–48 hours.
Re-enacting traumatic events is optional, and members may move to a different group. [source: Tuval-Mashiach et al. 2018]
Contraindications to trauma-content filmmaking:
- Acute PTSD with no stabilisation.
- Active psychosis.
- Current suicidal crisis.
- Ongoing unsafe circumstances, such as current domestic violence where a film could be discovered.
- Heavy substance use.
Clients with any of these can still do skill-focused or non-personal filmmaking.

5.4 Group conflict, friction, dominance and creative disagreement

Return to the communication-rules poster. [source: Saladino et al. 2020]
Separate creative disagreement, which is acceptable, from personal attack.
Rotate roles (4.11) so control is shared.
If one member's trauma story is taking over the group film, help the group find a theme they genuinely share, as in I Was There, where groups formed around shared concerns. [source: Tuval-Mashiach et al. 2018]

5.5 Non-adherence: missed sessions, unfinished films, dropout

In weekly formats such as Ma'aleh's 24 sessions, plan buffer sessions and an "unfinished cut" option, so a rough film can still be screened.
In intensive formats, keep each person's contribution modular so the film survives an absence.
Treat a wish to abandon the film close to the end as possible avoidance of being witnessed. Explore it rather than push.
Note that only completers were interviewed in the veterans study. Dropouts' experience is unknown, so ask people who leave why. [source for limitation: Tuval-Mashiach et al. 2018]

5.6 Self-harm, suicide or violence in scripts

Gagliano et al. report adolescents choosing injury, violence, self-harm, suicide and substance use as themes. An I Was There film depicted a suicide attempt. [source: Gagliano et al. 2023; army.mil 2014]
Ask whether the theme is current or past. Carry out a standard risk assessment, covering ideation, plans, intent, protective factors and a safety plan, and follow local policy.
Never film a realistic depiction of a method. Show these themes by implication, aftermath or symbol.
Follow safe-messaging principles for anything that may be shown publicly: no method detail, and include help-seeking and recovery.
Do not let footage that could act as a contagion leave the therapy space.

5.7 Ruptures: the client feels exploited, misrepresented or "edited"

Editing power is relational power. If the clinician or a filmmaker cuts something the client valued, or adds music that changes the meaning, repair openly: name it, restore the client's version, and ask what they need.
Never use footage in teaching or research without the specific consent layer. [source: Saladino et al. 2020]
Raise any conflict of interest (the clinician as researcher or film-festival submitter) at the start.

5.8 Regret after screening or distribution

Saladino et al. warn that material, once published, is hard to remove. [source: Saladino et al. 2020]
Prevent regret: private screening first, a waiting period, and audience lists confirmed one at a time.
If the film has already been posted, help the client with takedown requests and work through the shame or exposure in individual sessions.

5.9 Children and young people

Consent and assent. Take parental written consent and the child's assent separately. [source: Gagliano et al. 2023; Saladino et al. 2020]
Parental presence. Parents did not attend filmmaking sessions in Saladino et al. They attended assessment and screenings. [source: Saladino et al. 2020]
Safeguarding. A disclosure of abuse in a story circle, script or footage triggers your usual reporting duties. The footage itself becomes sensitive evidence: secure it, do not edit it, and follow local safeguarding procedure on retention.
Not diagnostic. Never treat a child's film, storyboard or enacted scene as evidence of abuse or disorder. None of the sources presents any validated diagnostic use. Saladino et al.'s observational ratings were a study measure, and the authors state that results cannot be generalised. [source: Saladino et al. 2020]
Online risk. Assume a film of a minor shown online can be copied. The default is no public distribution for under-18s.

5.10 Touch, staged contact and acted violence

Acted scenes may involve physical contact.
Agree all contact in advance, choreograph it, rehearse it slowly, and give anyone an opt-out.
Use stand-ins or camera angles instead of real contact where possible.
Never include sexual or genital touch, and never stage it.
Be aware of cultural norms about physical contact between genders and with strangers.

5.11 Cultural and community work

Johnson's chapter on First Nations communities suggests that stories can carry community, not just individual, ownership. [source: Routledge TOC, ch. 5] [uncertain: chapter]
Agree community protocols, community review and community ownership rights before filming.
Do not film ceremonies or sacred material unless the community's recognised authorities agree.

5.12 Technology getting in the way

If technical problems dominate, simplify: one phone, in-camera editing, or a still-image slideshow with voice-over.
Professional filmmakers handle the technical side in the programmes described, which frees the clinician to watch the process. [source: Tuval-Mashiach et al. 2018; Gagliano et al. 2023]

Sources

Sources

Books cited (not drawn on beyond the publisher's table of contents)

Cohen, J. L., Johnson, J. L., & Orr, P. P. (Eds.) (2015). Video and Filmmaking as Psychotherapy: Research and Practice. Routledge. This includes Johnson (2015) on the therapeutic filmmaking stages and Cohen & Orr (2015) on editing from a depth-psychological perspective.
Casetti, F. (2015). The Lumière Galaxy (cited via Saladino et al. 2020 for the filmtherapy/cinematherapy distinction). [uncertain: title inferred, not checked]

Further reading (not drawn on): Brazzale et al. 2018 (video-confrontation); the I Was There website (iwastherefilms.org); the Therapeutic Filmmaking Institute's training materials; the Ma'aleh certification syllabus.

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