Opportunities for Joy: A Mindful Path to Self-Compassion and Compassion for the Neurodiverse

This paper articulates the positive effects on the therapeutic relationship between an adult with neurodiversity, their family, and their counselor of a counseling career growth opportunity in expressive arts play therapy. In a larger sense, this articulation exemplifies the importance of career growth opportunities for mitigating counselor burnout by strengthening a counselor's ability to form deeper therapeutic relationships with their clients.

Career growth opportunities in counselling are an ethical foundation for our professional roles and are an essential component of our ethical commitment to working with families and family members (American Association for Marriage and Family Therapy [AAMFT], 2015; American Psychological Association [APA], 2017; International Association of Marriage and Family Counselors [IAMFC], 2017).Training and supervised experiences contribute to our "personal commitment and lifelong effort to act ethically…to ensure the competence of [our] work… [and] to protect clients…from harm" (APA, 2017).Supporting this sense of ethical purpose and commitment is vital to the practice of counselling and to our career and goal development regulation (Marttinen et al., 2018).When we intentionally and confidently engage in searching, selecting, and making decisions about which career growth opportunities will support our career goal pursuits (Marttinen et al., 2018), we are reflecting on how we can support our clients in a manner that is ethical and meaningful to them (American Psychological Association [APA], 2014).Career growth opportunities, when selected intentionally, also have the potential to support practitioners in a mindful path that nurtures compassion for our clients as well as self-compassion (Germer, 2009).Specifically, in this paper, I will define and consider the importance of play, play therapy, and expressive arts in helping us to work with clients who are neurodiverse.Then, I will introduce a fictional client named 'Joy,' an adult with neurodiversity, and explore a mindful path to self-compassion and compassion for the client and her family through the lens of a career growth opportunity I experienced in expressive arts play therapy (Dhaese, 2022).

Play, Play Therapy, the Expressive Arts, and People First
Play is a way for an individual to be present in their body to actively experience their world, process and organize physical, emotional, social, cognitive, and spiritual input, use their imaginations, and live joyously (Dhaese, 2022;Palagi, 2023).Play therapy creates a zone of proximal development where the individual behaves beyond their daily behaviors (Vygotsky, 1966(Vygotsky, / 1979) ) with the support of a mentor such as a counselor.The mentor guides and nurtures the individual as they transform their lived experiences freely, flexibly, and within a safe, contained environment.Play therapy experiences promote the individual's self-knowledge, knowledge of others, knowledge of how the self works with others, self-acceptance, and therapeutic healing.The expressive arts "include drawing, crafts, sewing, knitting, music, movement, dress-up, masks, dollhouse play, storytelling, going for nature walks, creating a garden, or playing in the outdoor sandbox…[with] objects [found] on nature outings, such as seashells, feathers, stones, acorns, chestnuts, and pine cones, [that] found their way into the sandbox" (Dhaese, 2011, p. 76).The expressive arts provide individuals with safe, nonpharmacological avenues of expression where they can drop their false self, transcend their lived experiences and circumstances, and choose who they are and who they want to be through their personal selection and interaction with objects in their environment (Dhaese, 2022;Luo et al., 2023).This therapeutic process, involving play using expressive arts, relies on counselors to see the abilities and potential of the individuals we serve while respectfully acknowledging the differentials in neurocognitive functioning across neurocognitive domains.These neurocognitive domains include: (a) complex attention (sustained attention, divided attention, selective attention, processing speed), (b) executive functions (planning, decision making, working memory, responding to feedback/error correction, overriding habits/inhibition, mental flexibility), (c) learning and memory (immediate memory, recent memory [including free recall, cued recall, and recognition memory], very long-term memory [semantic, autobiographical], implicit learning), (d) perceptual-motor (visual perception, visuoconstructional, perceptual-motor, praxis, and gnosis), and (e) social cognition (recognition of emotions, theory of mind).(Diagnostic and Statistical Manual of Mental Disorders; 5th ed.; DSM-5; American Psychiatric Association, 2013, pp. 593-595).
For a person whose neurocognitive function has changed, truly seeing that individual goes beyond what 'they were,' to mindfully and compassionately seeing who they are now and who they choose to be.The person-centric nature of play, play therapy, and the expressive arts are appropriate for considering the strengths, abilities, and preferences of people in general but particularly people whose neurocognitive function has changed.Creating a therapeutic alliance with individuals requires that we wholeheartedly engage in career-growth opportunities that light our mindful path to the practice of selfcompassion and compassion for our clients.

Case Example of Joy
Joy is an 88-year-old second-generation Canadian female of Eastern European ancestry and middle-class socioeconomic status.She earned a post-secondary education that furthered her professional career.Her husband of over 60 years is deceased.She has four children, three grandchildren, and one great grandchild.

Presenting Abilities and Strengths
In her youth, Joy was trained and accomplished in sketching, painting, singing, piano, ballet, and folk dancing.She continued to enjoy singing, reading, artistic expression, and storytelling during her professional career and in retirement.After her retirement, she continued to be an avid reader and also became an author of books for children and adolescents.She continued to play the piano and to paint and sketch using various mediums like charcoals, pastels, pencils, and acrylic paints.Her sketch books were filled with her work to perfect her presentation of faces, hands, and feet.She also loved nature and would go for long walks along the beach to collect stones, feathers, and driftwood that would wash ashore to use in or inspire her artistic expressions.As she walked, she would stop and take time to drink in the beauty, sketch, and make notes about her sketches.She loved cooking and was an excellent cook.While preparing meals, she could be heard singing operatic arias that she had been trained to sing in her adolescence and young adulthood.Music was always playing, and she would hum along and work.Joy was truly a renaissance woman.
Joy continued to demonstrate personal strength, selfknowledge, and awareness and came to her family to discuss her concerns about her declining abilities in the areas of memory and perceptual-motor skills.She discontinued driving and preparing meals.She was no longer able to walk for very long distances or without the aid of a walker.She began to have difficulty reading.Her life began changing.She would often reflect, "I am not the same person I was.Why is this happening to me?" The Sympathetic Interconnected Human Needs of the Client and Counselor These changes that Joy was experiencing required support and an attitude of mindful compassion and self-compassion on the part of the counselor who, in alliance with Joy and her family, witnessed the changes to Joy's attention, executive functioning, memory, motor skills, and emotion regulation.Joy's life was changing.The counselor was also witness to Joy's efforts and articulated personal need to find her own way along the path to mindful self-compassion and selfacceptance.Although "self-compassion and compassion entail the provision of care…the recipient of self-compassion is the self, whereas the recipient of compassion is another individual" (Dodson & Heng, 2022, p. 169).Compassion is a gentle and fluid tri-partite practice that entails physical, cognitive, and emotional awareness whereby (a) we are physically receptive and notice difficult emotions such as grief and loss; (b) we give ourselves permission and allow ourselves to empathically sit with the discomfort of the feelings, perceptions, and thoughts; and (c) we emotionally act with loving kindness to ease the discomfort (Germer & Neff, 2013).When experiencing the very human challenges of suffering or personal failure, selfcompassion involves three components: (a) self-kindness-extending kindness and understanding to oneself rather than harsh judgment and self-criticism, (b) common humanity-seeing one's experiences as part of the larger human experience rather than seeing them as separating and isolating, and (c) mindfulnessholding one's painful thoughts and feelings in balanced awareness rather than over-identifying with them.(Neff, 2003, p. 89) When we are self-compassionate as counselors, we model this way of caring for the self with the people with whom we interact.Career growth opportunities can be not only learning experiences but also chances to review, reinforce, and renew our care and commitment to ourselves as well as the people with whom we interact.

Reflecting on Compassion and Self-Compassion in Practice
A career growth opportunity with Dhaese (2022) included a review of the 8 "basic principles that guide the therapist in all non-directive professional therapeutic [relationships]" (Axline, 1969(Axline, /1993, pp. 73-74), pp. 73-74).These 8 basic principles have the potential to support our mindful reflections about who we are as counselors and what we believe about compassionate and self-compassionate thoughts, feelings, and actions.

Developing a Warm, Friendly Relationship
"The therapist must develop a warm, friendly relationship with the [client], in which good rapport is established as soon as possible" (Axline, 1969(Axline, /1993, p. 73), p. 73).A counselor's work begins with discovering with the individual what they love and what brings them joy and peace so that they will be able to use this love throughout their lives (Dhaese, 2022).We must attune to the beauty in the person we are working with and where they are in the moment.For example, Joy found value in the expressive arts including drawing, coloring, singing, dancing, selfcare, hair styling, free play with language and words (metaphors, similes, synonyms, antonyms, replacing words with others), making up and telling positive affirming jokes and stories, reading, and meal preparation with family members.We also explored ways to safely and pleasurably explore nature (Koltz & Koltz, 2022) in a way that Joy found meaningful.Joy, her family, and I would take time to go out in her front and back yards to sensorially enjoy and appreciate the natural environment.This included having Joy select something she found beautiful in nature, such as a fallen branch with a pine cone attached, sprigs of English and Spanish lavender, and varied rocks.Her family and I would ask her to decorate her home with these elements of nature, draw them, and talk about these natural objects, especially to have her try to remember where she found them, why she placed them in those special spots in her home, and why they were beautiful to her.As a part of her connection with nature, Joy created a rock garden that she worked on for two months choosing the space for the rock garden, analyzing the space, selecting rocks, taking note of the shapes of the rocks, and taking time to appropriately fit the rocks together, often saying, "I have to get them just right, just the way I like.My rock garden isn't ready just yet."When Joy felt that her rock garden was just right, she invited her family and me to come outside and admire her work as she described why she placed the rocks into their configuration and what the rock garden meant to her.There were other times when I compassionately needed to take notice of her grief and loss over the skills she once possessed in these expressive areas.I would slow down the process and, together with her family, adjust when and how long she spent doing expressive arts activities as well as their difficulty.These modifications made it possible for Joy to work within her capabilities and helped us set the limits for her success so that she did not hurt herself, others, or destroy the environment in anger and frustration.

Accepting Clients as They Are
"The therapist accepts the [client] exactly as [they are]" (Axline, 1969(Axline, /1993, p. 73), p. 73).As I began working with Joy and her family, I realized the importance of being filled with curiosity, wonder, and awe by Joy as an individual person apart from her neurodiversity and cognitive functioning.This meant putting aside my intellectual hypotheses and being even more tentative, gentle, and centered on her present capabilities.Because Joy loved art, she was rather hard on herself and her work and manifested perfectionistic responses.To mitigate these responses, we started coloring together so that she could still experience the creation of beauty.As Dhaese (2022) recommended, "Play, desensitize but don't push.Toe dipping over time can become comfortable for the individual."In adherence, I began where Joy wanted to start in a picture, and I asked permission to color with her and moved with her around the picture only as much as she wished to move.Joy became comfortable with this gentle interaction, and one day she stopped coloring and invited a family member to join in the coloring.She asked the family member what color they would choose and, upon seeing the choice, told them that their color choice was nice, so they could join in the coloring experience.Later, she confided to me that, "I didn't know he could color so well.He made good color choices and stayed in the lines."Over time, being gentle with Joy meant providing her with choices of coloring with crayons, pencils, or pastels, working with clay, or sometimes drawing a picture.It also meant respecting her personal will and agency when she did not want to engage with an activity, saying, "I am not feeling inspired today."Joy would wait to see her family's and my reaction, and we all agreed with her, indicating that her reflection and self-knowledge were important because creativity and engagement in the arts should not be forced.She was very appreciative of our analysis of the situation, saying, "Yes, you are correct.Tomorrow, I may be inspired.Thank you for understanding."At other times, Joy would become frustrated and angry with her level of present abilities.As Dhaese (2022) affirmed, "The self grows from the challenges in life.See the aggression a [client] may manifest and turn it towards the positive."Joy would manifest anger and would hit out, and I would respond by gently reminding her that this was not her true self talking.With her family, we reiterated that Joy's true self was kind, and her true self would use words to tell us what she needed.Joy would stop and think about our words and say, "You are right.I am a gentle person.You see that in me.Thank you for reminding me of who I am."This made it possible for Joy to rediscover and embrace her kind and loving self.

Freedom of Expression in the Relationship
"The therapist establishes a feeling of permissiveness in the relationship so that the [client] feels free to express [their] feelings completely" (Axline, 1969(Axline, /1993, p. 73), p. 73).If a client feels uncomfortable with an activity, the counselor must feel the client's discomfort, be sensitive to what the client may be experiencing, and honor their efforts (Dhaese, 2022).The counselor can then help the client, if they are willing, to find an alternative activity, task, or behavior that they feel is appropriate and engaging for them.This was an important point of learning for me and for Joy's family as we respectfully interacted with her.When I worked individually with Joy, I also introduced her to a special drawing board that could free people from perfectionism because the drawings with water would evaporate after a short while.She did not want to try this form of expression, even though her drawings would not be permanent.Her family and I sensed her anxiety with putting any marks on the drawing board and waited to see if she would talk about her feelings.She shared that she felt her work would "not be right," and she asked to color instead because she said, "there are lines I can follow."Joy felt safe to share her concerns with the knowledge that we would really hear these concerns and promptly respond in a way that was comforting and comfortable.

Recognizing and Reflecting the Client's Feelings
"The therapist is alert to recognize the feelings the [client] is expressing and reflects those feelings back to [them] in such a manner that [they gain] insights into [their] behavior" (Axline, 1969(Axline, /1993, p. 73), p. 73).A counselor must listen, try to understand, track, and then reflect on what the client is presenting in terms of their actions, thoughts, feelings, and behaviors (Dhaese, 2022;Paré, 2013).When Joy did decide to draw, she repeatedly drew her family members together and drew her image of herself off to the far left or right.With Joy's permission, we talked about this and identified when she felt closest to her family and less physically distant.Over time, her drawings of her family revealed less distance and a closer physical proximity and included activities where she was at the center of the family unit.In talking with family members before, during, and after drawing, Joy would display the art and talk about why she felt included in family activities and which activities she preferred and enjoyed the most.In the confluence of family life, each compassionate interaction with Joy required family members and the counselor to really see the whole person… with unlimited possibilities… by turning toward the experience of the moment to be with and in it [without expectation of] how it will be, for anyone… [because] it's not about trying to have a particular experience, but about being friendly toward the one you are having" (McCown, 2017, pp. 13-15).
Using her preferred expressive art form as a catalyst for Joy's conversations with her family members was a way to mindfully non-pathologize Joy, remove hierarchical power structures, and eliminate a must-fix-it deficit mindset (McCown, 2017).These mindful practices of compassionate interaction were not simply getting along "but rather [practicing] the know-how of 'going on' together" (McCown, 2017, p. 16).Together, Joy, her family, and I practiced friendliness "for [our] own sake i.e., in virtue of goodness" (Aristotle, ca 335-322 B.C.E./1999, p. 132).We did so by taking pleasure in seeing one another ("I am so happy to see you"); by being happy for others and practicing sympathetic joy ("This is a really great job you've done making it to the end of the street with your walker to see the pretty red flowers in the neighbor's front yard"); by being compassionate and wanting each other not to suffer ("I see that you really want to stay up later, but sleep is important for all of us and gives our brains and bodies the energy they need to better enjoy reading tomorrow"); and by practicing equanimity as a way to appreciate and be content about our time and experiences together ("We are so lucky to know each other and spend time each day together playing cards, telling jokes, drawing, singing, dancing, and doing gentle seated exercises").Tending to these practices of friendliness strengthened our respect, trust, and positive relationship as a community (McCown, 2017;Murray et al., 2021).

Belief in the Client's Agency
"The therapist maintains a deep respect for the [client's] ability to solve [their] own problems if given an opportunity to do so.The responsibility to make choices and to institute change is the [client's]" (Axline, 1969(Axline, /1993, p. 73), p. 73).A counselor must give the client space to develop their inner world and see the value in the resources they possess, thereby respecting their human dignity and ability to achieve self-determination (Baer & Nagy, 2017;Dhaese, 2022).There were times when Joy would put her head down in her lap, frustrated and angry with herself because she could not fix her hair the way she once was able.I would respectfully take note of how she combed her bangs that day and asked her how she did this.My intent was to be respectful of her efforts, support her persistence and exertion of life force to continue trying, and nurture her ability to soothe herself by seeing the good in what she had done.
The Client as Leader "The therapist does not attempt to direct the [client's] actions or conversation in any manner.The [client] leads the way; the therapist follows" (Axline, 1969(Axline, /1993, p. 73), p. 73).The counselor should be guided by the client (Dhaese, 2022).During our initial sessions, Joy would draw on her paper.Over time, Joy felt comfortable allowing family members and me to color and draw with her.She would typically direct us to choose certain colors and draw certain shapes.Over time, she allowed us to choose colors that were different from her choices.Following Joy's lead allowed her to control her environment during these activities when she functionally could not do so anymore in other aspects of her life, and her being able to lead the activities gave her the time she needed to develop trust and confidence in those around her to make choices with which she could be happy.

The Unhurried Process of Counseling
"The therapist does not attempt to hurry the therapy along.It is a gradual process and is recognized as such by the therapist" (Axline, 1969(Axline, /1993, pp. 73-74), pp. 73-74).The counselor must take the time with the client to discover with them their new world and new world view (Collins & Arthur, 2010;Dhaese, 2022).Joy was slow to warm to a small dog who lived with her family.Joy liked him, but at a distance.With family member consent, I gently invited Joy to offer the dog his dog food kibbles as treats, if she felt comfortable.At first, she declined, saying, "No, you do it, show me how it's done."Once she saw that the dog was reliably gentle over a few months, she then asked if she could give him the treats.She enjoyed reminding the dog to be gentle, and she took great joy at his pleasure and his gently taking the treats from her.This also reinforced the importance of gentleness and calmness for her in her own interactions.

Counseling in the Goldilocks Zone
"The therapist establishes only those limitations that are necessary to anchor the therapy to the world of reality and to make the [client] aware of [their] responsibility in the relationship" (Axline, 1969(Axline, /1993, p. 74), p. 74).Limit setting is a form of safe and respectful containment, yet the counselor must also create a container that is large enough to support the client and clientcounselor relationship.Playfulness and gentle welcoming to join in activities can help a client who feels reluctant to take a more active role in an activity (Dhaese, 2022).In order to encourage Joy to engage in gentle seated exercises with the family, I would gently invite her to lead her favorite exercises in the order she chose.Appealing to Joy in this way promoted calmness, reduced reluctance, and increased engagement in her own physical health and well-being.Over time, Joy began showing a willingness to initiate activities she had previously been reluctant to join, saying, "Come on, let's do our exercises." An 8-Fold Mindful Path These 8 guiding principles enable counselors to reflect on and find out about each client's identity, strengths, needs, and feelings so that the client experiences the relief and joy of being valued.Through this reflective and unhurried process, we begin to feel the spirit of our clients, and they in turn learn to trust our spirit of empathy and compassion.

Conclusion and Implications for Practice
Career growth opportunities provide counselors with dedicated occasions to be open to learning and growing the capability of expressing self-compassion and compassion for others.When we counselors reflect on our learning experiences, this helps us grow our own counseling skills and competencies (Dhaese, 2022).Reflecting on our learning experiences also encourages us to consider how best to meaningfully support an individual in our therapeutic care based on putting our empathy and vicarious experiencing of their feelings, perceptions, and thoughts into action (American Psychological Association, n.d.).
Empathy and compassion for our clients is foundational to experiencing a rich, deep, and complex therapeutic relationship that is mutually and collaboratively developed and nurtured.Relational depth is defined as the psychotherapeutic contact, immersive connection, interaction, investment, understanding, and valuing that is consistently expressed by the counselor and client for one another (Cooper, 2005;Kim et al., 2020;Knox, 2008;Knox, 2012;Zarzycka et al., 2021;Zarzycka et al., 2022).Relational depth is "the main predictor of [counselor] well-being and burnout, and its relationship with wellbeing and burnout is mediated by the quality of the therapeutic relationship" (Zarzycka et al., 2021, p. 256).As exemplified by the 8 effects of a career growth opportunity on the relationship between Joy, her family, and her counselor, career growth opportunities can strengthen our ability to form deeper therapeutic relationships with our clients as we gain and renew competence and confidence in thoughtful ways to care for our clients ethically and mindfully.

Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.