As longevity continues to increase, late adulthood could easily be described as one of the fastest growing clinical populations for therapists. The aging population, defined as 65 years and older, is projected to double over the next 45 years, while the number of individuals aged 85 years and older is expected to triple (U.S. Census Bureau, 2012). While biological and societal influences certainly affect seniors, Kroger (2007) emphasized that unique psychological concerns emerge as well. In the integrity versus despair developmental stage, individuals begin to reflect on and evaluate the fulfillment of their life goals (Erikson, 1985). According to Flemming (2004), integrity entails “acceptance of a life that was well-lived” while despair implies a “lack of hope” for personal redemption. Self-perceived health, independence, and mortality can significantly impact older adults’ mental health (Lee, 2000) as they face numerous life changes associated with loss: family, friends, home, and cognitive and physical abilities (Stephenson, 2006). Since loss is generally a permanent phenomenon and prominent in the lives of older adults, counseling with the goal of trying to fix or change circumstances of an event would be presumably ineffective (Stephenson, 2006) and, in some cases, may even present a concern of re-traumatizing the individual. Counseling approaches that emphasize the individual’s strengths and successes and allow for self- expression and emotional growth are beneficial. Sandtray therapy can provide a creative avenue for self-expression and a visual tool with which to explore life changes and experience sensory stimulation. For those in late adulthood, the opportunity to engage in and create novel experiences can be sparse, depending on social support, physical health, mental health, and resources. With sandtray, seniors are free to be the authors of their own novel experiences and stories. Like children, adults benefit from opportunities to engage the right brain, gain mastery over uncontrollable events, and express painful or difficult material through nonverbal means.

in recent years leading to his admittance into the nursing home. Upon moving to the nursing home, Marvin lost his driver’s license and needed oxygen regularly. Although Marvin spoke openly about his hostility toward the nursing home and fears of losing his independence, he rarely discussed details of these past events that troubled him. Instead, he told elaborate metaphorical stories. For example, he expressed frustration when telling stories of being an FBI agent and being unable to drive to a local university for “special missions.” Marvin’s stories about his FBI work sometimes resulted in people questioning his cognitive state, although he currently does not suffer from dementia. As Marvin shared his stories about

With sandtray, seniors are free to be the authors of their own novel experiences and stories.

Marvin’s Sandtray Marvin* is an 89-year-old resident at a local nursing home. Marvin’s young wife and 9-year-old son died in a traumatic car accident nearly 50 years prior. As he spoke about the accident, Marvin expressed feelings of anger, guilt, and sadness related to their deaths, compounded by the fact that he was driving. In addition to the emotional distress Marvin had experienced for years, he currently suffered from several medical complications that caused him physical pain as a result of the tragic accident. As a veteran of the armed forces, Marvin shared stories of serving and flying airplanes during the war. Although Marvin’s cognitive abilities were intact, his physical health has declined

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working as an FBI agent, I was curious about what being an FBI agent meant for him. He was the hero in all of his FBI stories, a character that brings healing and negates wrongdoings. Based on Marvin’s military involvement and trauma history, it was reasonable and salient that he would envision being a hero, rather than the character “at fault.” Being an FBI agent also spoke to a desire to be in control and have purposeful work to do. The accuracy of his accounts did not seem as important to Marvin as the meaning behind the stories, especially because, to Marvin, the stories were real. Therefore, sandtray appeared to be a viable intervention, as it does not require direct verbalization of life events. During our session, sandtray offered Marvin a new medium

to tell his story and express himself. This was my first time using sandtray with an adult and Marvin’s first time doing sandtray; I was encouraged by his openness to the new experience and meaningful metaphors that manifested in his

September 2014 | PLAYTHERAPY 21

Photo by David Helber. Used with permission from Taylor Sophia Skaar