© 2011 Brooks/Cole, A Division of Cengage Learning Chapter 17 Play Therapy You can discover more about a person in an hour of play than in a year of conversation

© 2011 Brooks/Cole, A Division of Cengage Learning

Chapter 17

Play Therapy

You can discover more about a person in an hour of play than in a year of conversation.

Plato


Chapter Objectives

After reading this chapter, you should be able to

•Outline the history of play therapy

•Define and explain the goals of play therapy

•List the advantages and diversity applications of play therapy

•Demonstrate the skills of play therapy

•Discuss some play therapy strategies


Early play therapists

• Hermine Hug-Hellmuth

• Anna Freud

• Melanie Klein, and

• Margaret Lowenfield


Defining Play Therapy

• Natural medium of child’s self-expression.• Pleasurable and intrinsically motivating.

• Play has a make-believe quality and is flexible. Freedom of choice.

• Evokes fantasies and unconscious feelings.

• Offers familiar tools.

• Safe place to act out feelings, to gain understanding, and to change.


Goals of play therapy

• Boost self-acceptance, self-confidence, and self-reliance

• Facilitate learning about self and others• Explore and express feelings• Encourage ability to make good decisions• Arrange opportunities to practice control and

responsibility• Explore alternative views of problems and

relationships• Learn and practice problem-solving and relationship

skills• Increase feeling vocabulary and emotional concepts


Advantages of Play

• Helps counselors establish rapport with children

• Understand children

• The way they interact and

• Their relationships;

• Also allows the teaching of social skills


Schaefer’s Therapeutic Powers of Play


Personal Qualities of Therapist

• Appreciation of children, treating them with a respectful, kind manner.

• A sense of humor and willingness to laugh at self.

• Playful and fun-loving attitude.• Self-confidence and self-reliance.• Openness and honesty.• Accepting.


Cross-Cultural Practices• Respect all aspects of child’s culture.• Investigate the role of play in diverse populations.• Be familiar with values, beliefs, customs, traditions,

and • Be familiar with language of child’s culture.• Recognize the ongoing process of becoming

multiculturally competent.• Match philosophical basis of the play therapy.• Be aware of personal cultural biases, values, beliefs,

and attitudes.• Interact with multicultural populations.


Guidelines

1. Ask only relevant questions.,

2. Outline the play therapy session and relevant information

3. Focus on specific problems and help develop short-term goals for counseling.

4. Take an active, directive play therapy role.

5. Find brief, concrete problem resolutions.


Children appropriate for play therapy have the following1. the ability to tolerate/build/use a relationship with an

adult

2. the ability to tolerate/accept a protective environment

3. the capacity to learn new ways of coping

4. the potential to gain new insight and the motivation to try

5. the attention span and cognitive organization to participate


Play Therapy Approaches

Ecosystemic Play Therapy • hybrid approach that integrates biology, several theories of

psychotherapy and developmental concepts. • child’s interactions and experiences in the world as well as the

internal, symbolic world of the child are emphasized • goal of the intervention is to help children have their needs met

without interfering with the ability of other people to get their needs met.

• strategies aimed at altering the problem, the child’s view of the problem, and the child’s response to the problem.

• ultimate goal is to help the child change beliefs that are causing difficulties



Group Play Therapy• Children ages 2 – 12• Encouragement, connection and reality-checking

functions present in groups• Experience helps them learn to function well, to

explore their actions, to develop tolerance and to find joy in working with others

• Beneficial for children with social skills deficits.• And for children with similar problems, issues,

experiences.



Prescriptive Play Therapy: Interventions tailored to each child.• Counselors responsibilities include:

o Know every approach to play therapy.o Have skill in applying constructs and

strategies.o Be capable of applying short- and long-term

needs of children.o Know the current outcome research for the

most effective treatment for the specific issue.


Play Therapy with Families

Filial Therapy• Introduce parents to methods for conducting

child-centered play therapy• Help them practice skills in play sessions• Model the behaviors• Reduce each task to small components and

practice• Role play without children• Parents conduct sessions• Increase length of sessions and have home visits


Play Therapy with Families

Parent-child Interaction Therapy (PCIT)

• Developed to treat children exhibiting externalizing behavioral problems such as resistance and aggression

• Coach parents on ways to use appropriate and advantageous interactions with their child


Empirical Support

• Meta-analysis of play therapy

• Reviews 94 studies from 1940 – 2000

• Support that play therapy is effective for a variety of problems, populations, in numerous settings, and with a multitude of clinical orientations

• Common elements of effective include parental involvement and between 35-45 sessions


Play Therapy with Specific Problems

• School Adjustmento PMHP focuses on identifying elementary

children before they have problems

• Children Witnessing Domestic Violence

• Children Facing Persistent Illness• Autistic Children• Children Experiencing PTSD


Personal Qualities of Therapist

• Willingness to use play and metaphors as communication tools.

• Flexibility and ability to deal with ambiguity.

• Comfort with children and experience interacting with them.

• Ability to set limits and maintain personal boundaries.

• Self-aware. (Kottman, 2001)


Considerations

Therapist

• Create safe environment in which child can express self freely.

• Trust and respect the child and attend to child’s feelings.

• Be interested in the child and be warm, caring, and accepting.


Considerations

Appropriate Clients• Ability to tolerate/build/use a relationship with

an adult.• Ability to tolerate/accept a protective

environment.• Capacity to learn new ways of coping.• Potential to gain new insight and the

motivation to try.• Attention span and cognitive organization to

participate.


Play Stages

• Relationship

• Release

• Recreation

• Re-experiencing

• Resolving


Criteria for Assessing Progress

• Child comes to session looking more hopeful and relaxed.

• Child appears to have increased confidence.• Child can summarize what has happened and

what has been learned.• Child’s interactions with parents appear more

relaxed.• Play patterns, interactions, and/or body

language has changed.• Child openly raises a problem or concern.


Play material choices based on:

• Facilitating the relationship• Encouraging child’s expression• Helping counselor gain insight into

child’s world• Providing child chance to test reality• Providing child acceptable way to

express unacceptable thoughts and feeling


Categories of Play Media

Play media are the materials and props used in a session:• Real-life toys: dolls, furniture, telephone, money,

animals, nurse kit, household items, etc. • Acting-out toys and aggressive-release toys:

handcuffs, balls, guns, toy soldiers, inflatable punching toy, etc.

• Creative-expression and emotional release toys: colored chalk, sand and sandbox, crayons, clay, pipe cleaners, hats, costumes, paint, puppets, etc.


Basic Skills of Play Therapy

• Tracking: describe what the child is doing

• Restating content: paraphrasing what the child has said

• Reflecting feelings: deepen the relationship and help child understand emotions, being with others and build an affective vocabulary


Basic Skills of Play Therapy • Returning responsibility to the child:

builds self-confidence and self-responsibility

• Using the child’s metaphor: maintain the child’s story without interpretation of meaning

• Setting limits: keeps the child safe, increases sense of self-control and enhances responsibility


Selected Strategies

• Arto Magic arto Color emotive braino Clay

• Puppets• Sand

o Make a world techniqueo Stages of chaos, struggle and resolution

Documents

© 2011 Brooks/Cole, A Division of Cengage Learning Chapter 17 Play Therapy You can discover more about a person in an hour of play than in a year of conversation