Individual counseling

ESB 4083 INDIVIDUAL COUNSELLING

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ESB 4083 INDIVIDUAL

COUNSELLING

Name : Nuril Ekma Bte Hj Abd Muda KJC0950313

Section : 2

Lecturer : Dr. Wan Marzuki Wan Jaafar

Date submit : 31th Disember 2011

Marks :


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Question 1

Study the intervention used in counseling session & write a report on the technique, the strength

and weakness of the intervention

1. SOLUTION FOCUSED THERAPHY

Often referred to as simply 'solution focused therapy' or 'brief therapy', is a type of talking

therapy that is based upon social constructionist philosophy. It focuses on what clients want to

achieve through therapy rather than on the problem that made them seek help. The approach does

not focus on the past but instead focuses on the present and future. The therapist/counselor uses

respectful curiosity to invite the client to envision their preferred future and then therapist and

client start attending to any moves towards it whether these are small increments or large

changes. To support this, questions are asked about the client’s story, strengths and resources,

and about exceptions to the problem.

Solution focused therapists believe that change is constant. By helping people identify the

things that they wish to have changed in their life and also to attend to those things that are

currently happening that they wish to continue to have happen, SFBT therapists help their clients

to construct a concrete vision of a preferred future for themselves. The SFBT therapist then helps

the client to identify times in their current life that are closer to this future, and examines what is

different on these occasions. By bringing these small successes to their awareness, and helping

them to repeat these successful things they do when the problem is not there or less severe, the

therapists helps the client move towards the preferred future they have identified.

Solution focused work can be seen as a way of working that focuses exclusively or

predominantly at two things.

Supporting people to explore their preferred futures.

Exploring when, where, with whom and how pieces of that preferred future are

already happening. While this is often done using a social constructionist perspective

the approach is practical and can be achieved with no specific theoretical framework

beyond the intention to keep as close as possible to these two things.


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The technique

1. The miracle question

Is a method of questioning that a coach, therapist, or counselor uses to aid the client to envision

how the future will be different when the problem is no longer present? Also, this may help to

establish goals.

A traditional version of the miracle question would go like this:

"Suppose our meeting is over, you go home, do whatever you planned to do for the rest

of the day. And then, sometime in the evening, you get tired and go to sleep. And in the

middle of the night, when you are fast asleep, a miracle happens and all the problems that

brought you here today are solved just like that. But since the miracle happened overnight

nobody is telling you that the miracle happened. When you wake up the next morning,

how are you going to start discovering that the miracle happened? ... What else are you

going to notice? What else?"

Whilst relatively easy to state the miracle question requires considerable skill to ask well. The

question must be asked slowly with close attention to the person's non-verbal communication to

ensure that the pace matches the person's ability to follow the question. Initial responses

frequently include a sense of "I don't know." To ask the question well this should be met with

respectful silence to give the person time to fully absorb the question.

Once the miracle day has been thoroughly explored the worker can follow this with

scales, on a scale where 0 = worst things have ever been and 10 = the miracle day where are you

now? Where would it need to be for you to know that you didn't need to see me any more? What

will be the first things that will let you know you are 1 point higher. In this way the miracle

question is not so much a question as a series of questions.

There are many different versions of the miracle question depending on the context and the

client. In a specific situation, the counselor may ask,

"If you woke up tomorrow, and a miracle happened so that you no longer easily lost your

temper, what would you see differently?" What would the first signs be that the miracle

occurred?"

The client (a child) may respond by saying,

"I would not get upset when somebody calls me names."


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The counselor wants the client to develop positive goals, or what they will do, rather than what

they will not do--to better ensure success. So, the counselor may ask the client, "What will you

be doing instead when someone calls you names?"

2. Scaling Questions Scaling

Are tools that are used to identify useful differences for the client and may help to

establish goals as well. The poles of a scale can be defined in a bespoke way each time the

question is asked, but typically range from "the worst the problem has ever been" (zero or one) to

"the best things could ever possibly be" (ten). The client is asked to rate their current position on

the scale, and questions are then used to help the client identify resources (e.g. "what's stopping

you from slipping one point lower down the scale?"), exceptions (e.g. "on a day when you are

one point higher on the scale, what would tell you that it was a 'one point higher' day?") and to

describe a preferred future (e.g. "where on the scale would be good enough? What would a day

at that point on the scale look like?")

3. Exception Seeking Questions Proponents

Exception Seeking Questions Proponents of SFBT insist that there are always times when the

problem is less severe or absent for the client. The counselor seeks to encourage the client to

describe what different circumstances exist in that case, or what the client did differently. The

goal is for the client to repeat what has worked in the past, and to help them gain confidence in

making improvements for the future.

4. Coping questions Coping questions

Even the most hopeless story has within it examples of coping that can be drawn out: "I can see

that things have been really difficult for you, yet I am struck by the fact that, even so, you

manage to get up each morning and do everything necessary to get the kids off to school. How

do you do that?" Genuine curiosity and admiration can help to highlight strengths without

appearing to contradict the clients view of reality. The initial summary "I can see that things have

been really difficult for you" is for them true and validates their story. The second part "you

manage to get up each morning etc.", is also a truism, but one that counters the problem focused

narrative.


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5. Problem-free talk In solution-focused therapy

Can be a useful technique for identifying resources to help the person relax, or be more assertive,

for example. Solution focused therapists will talk about seemingly irrelevant life experiences

such as leisure activities, meeting with friends, relaxing and managing conflict. The therapist can

also gather information on the client's values and beliefs and their strengths. From this discussion

the therapist can use these strengths and resources to move the therapy forward. For example; if

a client wants to be more assertive it may be that under certain life situations they are assertive.

This strength from one part of their life can then be transferred to the area with the current

problem. Or if a client is struggling with their child because the child gets aggressive and calls

the parent names and the parent continually retaliates and also gets angry, then perhaps they have

an area of their life where they remain calm even under pressure; or maybe they have trained a

dog successfully that now behaves and can identify that it was the way they spoke to the dog that

made the difference and if they put boundaries in place using the same firm tonality the child

might listen.

The strength

The benefits of solution-focused brief therapy include the finding of solutions to

problems that the client has been facing. For example, symptoms of stress, anxiety, and

depression may bereduced interpersonal relationships may be improved. Another benefit of

solution-focused brief therapy is that clear goals are identified early on. Because of this,both

client and counselor know what success will look like and can more easily identify when therapy

is no longer needed. As with all forms of therapy, solution-focused brief therapy may result in

major life changes, such as changing jobs, beginning or ending relationships, moving, etc. Such

life changes can be experienced as quite positive (a benefit) or as very difficult (a risk) by the

client and/or the client's significant others. Solution-focused brief therapy can be done in

conjunction with other forms of therapy.

The waeknessess

Since, by definition, solution-focused brief therapy is brief, it may be less expensive than other

forms of therapy that traditionally required more sessions over a longer period of time.


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2. REALITY THERAPY

Reality therapy is a relatively new form of therapy in the world of counseling. It was

founded by William Glasser who was a psychologist from California in 1965 as a result of

Glasser's theory, psychoanalytic disagreement.

Kottler and Brown () states that reality therapy is an approach to teaching that emphasizes

problem solving, personal responsibility and the need to address or eliminate the need for 'reality'

of an individual. He said the reality therapy is based on the assumsi or assumptions that

individuals need to build the identity of either succeed or fail. John J. Pietrofesa (1984), holds

that reality therapy is based on the assumption of a behavior either help or hinder to meet basic

human needs. Such a requirement is the need for love and caring for others and the need to feel

valued and appreciate others. Behavior that can be filled are held responsible and the failure is

the opposite. Irresponsible behavior will fail to build identity and then a failure. Then the

counselor is to build the individual's identity to the success.

Glading (1993), the opinion asserts the reality therapy baahawa individual changes made

by the action and thought. He suggested that the inner world of individuals is the most influential

in determining the behavior of the dipilihya. This action-oriented therapy (action oriented) that

are concrete, teaching, directing, and cognition.

As a whole, we have more reality theory emphasizes the need to meet the psychological

needs (a fulfilments of psychology needs). In reality therapy is largely available to provide

individuals in susasana that can help them develop the psychological strength to assess the

current behavior or values. This therapy can also be used in individual counseling, family

counseling, rehabilitation counseling, sexual counseling, education, social work, group therapy,

crisis intervention, management development institutions and the development of society.

Reality Therapy Techniques

To help people to achieve goals in their lives and explains how to achieve the reality therapy has

been using certain techniques in the form of behavior. Those are:

1. Become a model or example:

In this technique a counselor must be a good example or model that serves as an

educator. As an educator, counselor tried to resist the negative behaviors the client

without the client's expense. Counselors’ need to teach clients the most efficient way to

meet the client's needs based on reality. This action allows the client to face reality and

realize the behavior is not realistic.

2. Humor

Counselors will be funny and not too serious. This means that the counselor will look at a

situation from a funny angle in order to ease the burden faced pressure or clients.

3 confrontations:

Counselor will face or challenge the client without allowing the client to give specific

reasons. Counselors can also use ridicule, scorn and criticism that can surprise clients in


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an effort to challenge the unrealistic behavior. This situation can provide a response to

the client's realistic to think of him.

4 Role Play (Role play):

Counselor will use in playing the role of communication with the client. In the game the

counselor will try to give emphasis on the 'here' and the 'moment' and avoid focuses on

past events and feelings are not good.

5 Reaction:

Counselor will ask the client to see his behavior as a way for clients to receive a

responsibility. Counselor will ask the client whether the action is in accordance with the

client and is there a way beneficial to him. In this case the client should decide whether to

change his behavior or vice versa.

6 Involvements:

Counselor will engage directly with the use of words such as 'I am concerned about you, I

am responsible to you'. Behavior highlighted by the counselor should be in line with the

words that were uttered it. Counselor and client should participate in the search for life

direction or new ways to achieve the client's life more successful and meaningful.

The strength of Reality Therapy

This therapy is very suitable for implementation and applied in the form of counseling,

such as counseling children, adolescents, adults, parents, marriage, family, individual counseling

and counseling Muhd Mansur (1993). This statement is supported by the James C. Hansen

(1990) who said;

"... Although now used with a variety of clients in a number of different settings. Reality

Therapy originally used in the treatment of office patients, mental hospital patients, and adult and

juvenile lawbreakers. Much of Glacier's work with juvenile offenders this grew out of years of

work at the Ventura School for Girls of the California Youth Authority. "

Reality Therapy approaches and methods used in concrete, clear and realistic where it can show

the effectiveness, evaluated, especially when the contract is made and agreed upon by the

counselor and client.

Reality therapy also has a master plan designed in a systematic and realistic by the client

with the help of a counselor as a guide for solving problems.

Therapy has been given the freedom of clients to think rationally, evaluate, determine and make

their own decisions.

Therapy has been using the short term to help clients compared to other theories such as

psychoanalysis and human concentration. Many statements made by some authors who support

the advantages of this therapy. Among these are Panek (1993:461) states that reality therapy

approach as "... stimulates active mental processes.". Kottler (1996) holds that reality therapy as

a short-term therapy and appropriate in school settings and beyond "... reality therapy is a short-

term treatment that has been widely used in schools, Institutions and Correctional Settings. It is a

fairly simple therapeutic approach and can be mastered withaut length training and supervision. "


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According to Samuel T. Gladding (1996:283-289) argues that reality therapy "... applicable to

many different populations; effective with Certain disorders; concertinas; short-term; centralized

training center; promote freedom without responsibility and blaming; stresses here and now;

integrates control theory . "

The weakness

Reality therapy also has its drawbacks. These therapies tend to focus only on behavior,

but also a human being is unique and acts as a whole, including emotion, perception, cognitive,

sensation, and so on. Therefore clear that this therapy has a limited capacity.

This therapy also emphasizes the concept now and here 'or' here and now 'and the current

situation so without regard to the concepts of unconscious life of the client and history. Whereas,

every person is likely to collaborate with the problems caused by biological factors, fantasy,

belief systems and values, and others.

Reality therapy also depends upon the language. So the communication system client

sometimes is quiet and weak or no expressive is not appropriate in the selection of therapeutic

action of reality.

Reality therapy is less to provide learning situations because it is quite demanding, and

stifling. Thus the client is not creative in making decisions and ultimately depends on the

counselor.

Counselors’ are also considered immoral because of too free and open to often

demanding clients build something. This will cause a negative impact on the client. The client is

likely to do or change of mind to follow or abide by the advice and guidance given by the

counselor.

Paul E. Panek (1993:461) states that a lack of reality therapy has existed in the beginning

"... designed for used in early stages and for the treament disoriented; limited efficacy ..".

John A. Axelson (1993 :368-369) states that "... although the therapist MIGHT be seen as a

tough and controlling person, he or she is also uninterested and sensitive human being who

understands and accepts uncritically behavior, but who never agrees with the client's

irresponsibility. Being more concerned with behavior than with attitudes, the therapy is not

intended to make someone happy, but to make someone responsible ... "


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4. PERSON-CENTERED THERAPY

Taking the view that every individual has the internal resources they need for growth, person-

centered therapy aims to provide three ‘core conditions’ (unconditional positive regard, empathy

and congruence) which help that growth to occur.

Underlying Theory of Person-Centered therapy

The person-centered approach views the client as their own best authority on their own

experience, and it views the client as being fully capable of fulfilling their own potential for

growth. It recognizes, however, that achieving potential requires favorable conditions and that

under adverse conditions, individuals may well not grow and develop in the ways that they

otherwise could. In particular, when individuals are denied acceptance and positive regard from

others or when that positive regard is made conditional upon the individual behaving in

particular ways, they may begin to lose touch with what their own experience means for them,

and their innate tendency to grow in a direction consistent with that meaning may be stifled.

One reason this may occur is that individuals often cope with the conditional acceptance offered

to them by others by gradually coming to incorporate these conditions into their own views about

themselves. They may form a self-concept which includes views of them like, "I am the sort of

person who must never be late", or "I am the sort of person who always respects others", or "I am

the sort of person who always keeps the house clean". Because of a fundamental need for

positive regard from others, it is easier to ‘be’ this sort of person, and to receive positive regard

from others as a result, than it is to ‘be’ anything else and risk losing that positive regard. Over

time, their intrinsic sense of their own identity and their own evaluations of experience and

attributions of value may be replaced by creations partly or even entirely due to the pressures felt

from other people. That is, the individual displaces personal judgments and meanings with those

of others.

Psychological disturbance occurs when the individual’s ‘self-concept’ begins to clash with

immediate personal experience, example like when the evidence of the individual’s own senses

or the individual’s own judgement clashes with what the self-concept says ‘ought’ to be the case.

Unfortunately, disturbance is apt to continue as long as the individual depends on the

conditionally positive judgements of others for their sense of self-worth and as long as the

individual relies on a self-concept designed in part to earn those positive judgements.


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Experiences which challenge the self-concept are apt to be distorted or even denied altogether in

order to preserve it.

The technique

The person-centered approach maintains that three core conditions provide a climate

conducive to growth and therapeutic change. They contrast starkly with those conditions

believed to be responsible for psychological disturbance. The core conditions are Unconditional

positive regard, Empathic understanding and Congruence

The first is unconditional positive regard, its means that the counselor accepts the client

unconditionally and non-judgmental. The client is free to explore all thoughts and feelings,

positive or negative, without danger of rejection or condemnation. Crucially, the client is free to

explore and to express without having to do anything in particular or meet any particular

standards of behavior to ‘earn’ positive regard from the counselor.

The second is empathic understanding, its means that the counselor accurately

understands the client’s thoughts, feelings, and meanings from the client’s own perspective.

When the counselor perceives what the world is like from the client’s point of view, it

demonstrates not only that that view has value, but also that the client is being accepted.

The third is congruence and its means that the counselor is authentic and genuine. The

counselor does not present an aloof professional facade, but is present and transparent to the

client. There is no air of authority or hidden knowledge, and the client does not have to speculate

about what the counselor is ‘really like’.

Together, these three core conditions are believed to enable the client to develop and

grow in their own way, to strengthen and expand their own identity and to become the person

that they ‘really’ are independently of the pressures of others to act or think in particular ways.

As a result, person-centered theory takes these core conditions as both necessary and

sufficient for therapeutic movement to occur like that if these core conditions are provided, then

the client will experience therapeutic change. Notably, person-centered theory suggests that there

is nothing essentially unique about the counseling relationship and that in fact healthy

relationships with significant others may well manifest the core conditions and thus be

therapeutic, although normally in a transitory sort of way, rather than consistently and

continually.


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Finally, as noted at the outset, the person-centered approach takes clients as their own

best authorities. The focus of person-centered therapy is always on the client’s own feelings and

thoughts, not on those of the therapist and certainly not on diagnosis or categorization. The

person-centered therapist makes every attempt to foster an environment in which clients can

encounter themselves and become more intimate with their own thoughts, feelings and meanings.

The Strength

Person-centered approach is that delivering the core conditions is what all good therapists

do anyway, before they move on to applying their expertise and doing the real work of ‘making

clients better’. On the face of it, this criticism reflects a misunderstanding of the real challenges

of consistently manifesting unconditional positive regard, empathic understanding and

congruence.

This is especially true of congruence, to the extent that some therapeutic techniques

deployed in some other traditions depend on the counselor’s willingness to ‘hold back’, mentally

formulate hypotheses about the client, or conceal their own personal reactions behind a

consistent professional face, there is a real challenge in applying these techniques with the

openness and honesty which defines congruence.

It may also demonstrate something of a reluctance to take seriously the empirical

research on counseling effectiveness and the conclusion that the quality of the client and

counselor relationship is a leading predictor of therapeutic effectiveness, although this is

somewhat more controversial, since one might argue that providing the core conditions is not the

only way to achieve a quality relationship.

The weakness

At a deeper level, there is a more sophisticated point lurking, which many expositions of

person-centered theory seem to avoid addressing head-on. Namely, given that the self is the

single most important resource the person-centered counselor brings to the therapeutic

relationship, it makes sense to ask, what (if anything) is it important that this self has, apart from

the three core conditions, such as manifesting of the core conditions does not by itself tell us

what experiences or philosophies the counselor is bringing to the relationship. It tells us that the

client will have transparent access to that self, because the counselor is congruent but it doesn’t


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tell us anything else about that self. Whether or not that self should be developed in any

particular way or whether that self should acquire any particular background knowledge, seems

to me a question which is more often side-stepped than answered within the person-centered

tradition.

Clients who have a strong urge in the direction of exploring themselves and their feelings

and who value personal responsibility may be particularly attracted to the person-centered

approach. Those who would like a counselor to offer them extensive advice, to diagnose their

problems, or to analyze their psyches will probably find the person-centered approach less

helpful. Clients who would like to address specific psychological habits or patterns of thinking

may find some variation in the helpfulness of the person-centered approach, as the individual

therapeutic styles of person-centered counselors vary widely, and some will feel more able than

others to engage directly with these types of concerns.


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4. Art Therapy Art Therapy is a form of psychotherapy that uses art media as its primary mode of

communication. It is a form of counseling which uses art making as a way to express feelings,

emotions, and personal stories. Clients who are referred to an art therapist need not have

previous experience or skill in art, the art therapist is not primarily concerned with making an

aesthetic or diagnostic assessment of the client's image. The overall aim of its practitioners is to

enable a client to effect change and growth on a personal level through the use of art materials in

a safe and facilitating environment. The relationship between the therapist and the client is of

central importance, but art therapy differs from other psychological therapies in that it is a three

way process between the client, the therapist and the image or artifact. Thus it offers the

opportunity for expression and communication and can be particularly helpful to people who

find it hard to express their thoughts and feelings verbally.

Art therapists have a considerable understanding of art processes underpinned by a

sound knowledge of therapeutic practice, and work with both individuals and groups in a variety

of residential and community based settings, for example adult mental health, learning

disabilities, child and family centre, palliative care and the prison service. The diversity of these

areas of work is reflected in the number of special interest groups that have developed in

affiliation with the British Association of Art Therapists. More detailed information about these

specialist areas can be obtained on request from the Association. The art therapist's work is

sometimes challenging and calls for skill and sensitivity; it follows that those who wish to pursue

a career in art therapy should be mature, flexible people.

'The training course, which combines theoretical and experiential work, is a Masters

Degree to be completed over two years full time or three years part time. Applicants must have a

first degree in art, although other graduates are sometimes considered, and some proper

experience of working in an area of health, education or social care. Details of training and a list

of training institutions can be obtained from the address below - or complete the enquiry form.

Art therapy is a diverse profession and it is important to ensure that those who practice it are

maintaining the standards that we as a professional body uphold. Art Therapists, along with

Drama and Music Therapists need to register with the Health Professions Council.

.

The Technique

1. Common Threads: HIV/AIDS Quilt

Overview: namely two art therapists will facilitate a communal art project with three groups.

Individuals will create squares illustrating personal stories about how they have been

affected by HIV/AIDS. Facilitators will teach basic skills in textile art and sewing and

group members will be encouraged to share their talents and skills with others. The

intent of this project is to facilitate the growth of self-sustaining art groups and support

networks in these communities from the Lyantonde district. This quilt will be

displayed in both the U.S. and Uganda to raise awareness about the lives of those

affected by HIV/AIDS and to decrease HIV/AIDS stigma.


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Materials or Techniques used : Fabric, sewing materials, drawing materials, barkcloth, beads,

seeds, embroidery, banana leaves.

Population: 3 groups of 10-15 individuals infected or affected by HIV/AIDS. Two groups will be

conducted at two local villages and one group will be conducted at Lyantonde

Hospital.

2. Art Therapy at Prince Primary School

Overview: An art therapy program will be developed with children from Prince Primary School.

During the third term of this year the focus of the program will be recording and

preserving oral history and educating the community about local family traditions and

life lessons through symbolic stories. Group interaction may allow for increased

group cohesion and improved social skills, as residents develop their personal identity

within a positive peer community.

Materials or Techniques used: Barkcloth, sewing materials, printing inks, beads, seeds, drawing

materials, embroidery, collage.

Population: P5-P7 pupils from Prince Primary School.

The strengths and weaknesses art therapy

Development of the Strategic Aims

The strategic aims for the development of Arts Therapies services have been based on

discussion within the service and identifying the most pressing needs to ensure that the

profession is robust and able to meet it’s obligations to people who use our services and

to the Trust. They also identify the steps necessary to ensure that Arts Therapists play an

active role in the development and refinement of services in the move forward to

Foundation Trust status

The Benefits of Art Therapy in Mental Health

Although conventional psychotherapy has its benefits there are many alternative therapies

such as music therapy, hypnosis and even colour therapy that have had a measure of

success in treating various conditions and enhancing well-being. Art therapy is one such

form of treatment. Art therapy is a form of expression that strives to aid the emotional

state of those that have suffered mental trauma and emotional abuse. Art therapy is based

on a belief that the creative process is healing and life affirming. For many people

psychological trauma can be difficult to express in words. Art therapy provides a creative

outlet for pent up emotions and hurtful feelings that are too painful to express verbally.


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Strengths

Range of highly trained and experienced staff

Valued members of MD Teams

Established structure

Good support network

Strong links with Multi Professional

colleagues

Co-ordinate leadership

Culture of innovative practice based evidence

Commitment to user empowerment

Comprehensive skills portfolio due to broad

training with continued specialist training

and development.

People want access to Arts Therapies

Maintain engagement with long term

complex people who don’t stay with other

services * see related threat in context below

continuity of service provision for people as

they move through other Trust services

Weaknesses

Lack of dedicated time for R&D

Co-ordinate risk strategy

No consultant posts for Music and

Drama therapy

Lack of admin support

No co-ordinate approach to

Service User involvement


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5. PLAY THERAPHY

Play therapy is generally employed with children aged 3 through 11 and provides a way

for them to express their experiences and feelings through a natural, self-guided, self-healing

process. As children’s experiences and knowledge are often communicated through play, it

becomes an important vehicle for them to know and accept themselves and others.

Play Therapy is a form of counseling or psychotherapy that uses play to communicate

with and help people, especially children, to prevent or resolve psychosocial challenges. This is

thought to help them towards better social integration, growth and development.

Play Therapy can also be used as a tool of diagnosis. A play therapist observes a client

playing with toys (play-houses, pets, dolls, etc.) to determine the cause of the disturbed behavior.

The objects and patterns of play, as well as the willingness to interact with the therapist, can be

used to understand the underlying rationale for behavior both inside and outside the session..

According to the psychodynamic view, people (especially children) will engage in play

behavior in order to work through their interior obfuscations and anxieties. In this way, play

therapy can be used as a self-help mechanism, as long as children are allowed time for "free

play" or "unstructured play." Normal play is an essential component of healthy child

development.

One approach to treatment is for play therapists use a type of desensitization or relearning

therapy to change disturbing behavior, either systematically or in less formal social settings.

These processes are normally used with children, but are also applied with other pre-verbal, non-

verbal, or verbally-impaired persons, such as slow-learners, or brain-injured or drug-affected

persons.

The technique

This procedure is for a "non-directive" version of play therapy. There are many variations on the

practice, but the materials typically remain the same.

1. Identify a youngster who might benefit from play therapy.

2. Decide if you will have a separate session with this child or whether you will sit near

the student during your class play period or recess.

3. Obtain materials for the session. Recommended items include:

manipulatives (e.g., clay, crayons, painting supplies)

water and sand play containers

toy kitchen appliances, utensils, and pans

baby items (e.g., bottles, bibs, rattles, etc.)

dolls and figures of various sizes and ages

toy guns, rubber knives

4. Place the materials in specific places where they can be located for each session.

5. Meet the student and introduce him/her to the play area.

6. Inform the student of limitations and how long the session will last

http://en.wikipedia.org/wiki/Social_integration

http://en.wikipedia.org/wiki/Individuation

http://en.wikipedia.org/wiki/Psychodynamic

http://en.wikipedia.org/wiki/Anxiety

http://en.wikipedia.org/wiki/Desensitization_(psychology)


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7. Allow the student to choose the materials with which to play. Do not suggest

materials or activities. If the youngster wishes to leave before the session ends, that

is allowed. However, in most cases the student is not allowed to return that day. He

is informed of the time of the next scheduled session.

8. Use the "reflection" technique (see the filed named "Non-Directive Counseling) to

respond to the student's comments. If the student is not speaking or is non-verbal,

your role will change; you will be describing what the student is doing. Just make a

report on the actions. DO NOT offer interpretations or judgements of the actions.

("He's a nice boy." "It's wrong for children to hit.") Some supervising adults ask

probing questions to get the child to speak or investigate a situation further. ("I

wonder why the grown up is doing that.", "What do you think that the girl is thinking

right now?")

9. As the end of the session nears, inform the student of that fact, stating the number of

minutes left. This procedure helps with transition back to other activities.

10. Upon reaching the time limit, inform the student in a manner similar to the following:

"Our time is up for today. We'll have to stop now and put the toys back where we

found them." The student is not allowed to continue playing if you deem that s/he

must return to other activities.

11. Inform the student as to when the next session will be held.

The strength

Specifically, play therapy encourages the expression of a child's feelings, experiences,

and cognitive functioning. This knowledge is vital to the therapist in determining the direction of

the therapy process, as well as measuring the success of the intervention throughout a series of

play therapy sessions. This method of extracting and utilizing information through effective

interpersonal communication is theoretically in tune with any therapeutic approach, but play

therapy distinguishes itself by conducting its observations in a uniquely revealing environment.

One approach to treatment is for play therapists use a type of systematic desensitization

or relearning therapy to change disturbing behavior, either systematically or in less formal social

settings. These processes are normally used with children, but are also applied with other pre-

verbal, non-verbal, or verbally-impaired persons, such as slow-learners, or brain-injured or drug-

affected persons. Mature adults usually need much "group permission" before indulging in the

relaxed spontaneity of play therapy, so a very skilled group worker is needed to deal with such

guarded individuals.

The use of play therapy is based on a developmental understanding of children. Piaget's

(1962) theory of cognitive development recognizes the differences between the way that children

understand and process information and the way that adults function. Most children at the

elementary level function at two stages: the "Preoperational Stage" (2-7 years) and the "Concrete

Operations Stage" (8-11 years). These stages are approximately identified with chronological

ages but there are significant variations among children.


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At the Preoperational Stage, a child is acquiring the skill of language in which symbols

are used to mentally represent objects. Also, in this stage, a child's thinking is rigid and limited to

how things appear at the time. This is the stage of magical thinking in which children create

implausible explanations for things that they do not understand. Regarding play, a child's play

behaviors become increasingly imaginary and fantasy driven. The play, however, will increase in

complexity from make-believe play to encompassing emerging cognitive patterns. Internally, the

child is improving understanding and knowledge, but externally, the child lacks the ability to

communicate this enhanced way of processing within the world. Play is one of the primary ways

in which a child can communicate this internal awareness of self and others.

During the Concrete Operations Stage, the child grows in personal ability to reason

logically and organize thoughts coherently. Children are able to manipulate ideas and accept

logical societal rules. However, they can only think about actual physical objects. They are

limited in their ability to engage in abstract reasoning. In this stage, children are unable to

express certain complicated emotions, such as guilt or resentment, because of the need for

abstract thought to understand such emotions.

For those children operating in the Concrete Operations Stage, play helps to bridge the

gap between concrete experience and abstract thought.

Though the type of play therapy employed will vary depending on a child's situation, the most

basic play therapy technique used by play therapists is commonly referred to as "child-centered

play therapy." The crucial elements in this formula, as in all play therapy approaches, are

environment and the child-therapist relationship. Play therapy sessions are held in intently

designed spaces called "play rooms" which contain an array of toys and activities deliberately

chosen and carefully placed by the play therapy practitioner. Since the primary purpose of play

therapy is to elucidate the child's natural behavior, the play therapist must create an especially

accepting and non-punitive atmosphere.

Projective play takes place when a child discovers the world outside themselves through

toys. Story making is a part of projective play and the objects/toys involved tend to have

alternative meanings. This type of play assists with the externalization of trauma and helps to

expand a child's perspectives.

Role play is when the child pretends to be someone else, usually the adult(s) involved in

the abuse or trauma. This type of play allows the child to voice issues and clarify inappropriate

behaviors with the therapist.

Imaginative play within sessions enables the child to "replay complex environmental

issues" and cast them into a form, which is manageable. The therapist remains non-judgmental

and acts as a "container" for the feelings and issues stirred up by play. There are issues of risk

around this containment however, as although the therapist sets up boundaries, it is important

that they realize the potential effects of disclosure on their own internal working models. This

enables them to remain as an empathizing yet non-judgmental individual.


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The weakness

Play therapists often have difficulties in describing their work to other professionals, and

indeed clients, in language that is understood by everyone. If there is confusion about what

happens in the therapy process, and outcomes are difficult to describe because the language is

not shared, then the therapy can be undervalued.

Limit setting is a necessary and vital part of the play therapy therapeutic process.

Although the procedures for setting limits may vary, the setting of therapeutic limits is part of all

theoretical approaches to play therapy. The structure of therapeutic limits is what helps to make

the experience a real-life relationship. Limits in play therapy have both therapeutic and practical

benefits in that they preserve the therapeutic relationship, facilitate the child's opportunities to

learn self-responsibility and self-control, among many other dimensions, and provide the child

and the therapist with a feeling of emotional security and physical safety. This feeling of

emotional security enables a child to explore and express inner emotional dimensions that

perhaps have remained hidden in other relationships.

Play therapy is not a completely permissive relationship because children do no feel safe,

valued, or accepted in a relationship without boundaries. Boundaries provide predictability.

Therefore, children are not allowed to do anything they want to do. A prescribed structure

provides boundaries for the relationship that the play therapist has already determined are

necessary. The play therapy relationship has minimal limits. Messiness is accepted, exploration

is encouraged, neatness or doing something in a prescribed way is not required, and persistent

patience is the guiding principle. The child's desire to break the limit is always of greater

importance than actually breaking a limit.

Because play therapy is a learning experience for children, limits are not set until they are

needed. The child cannot learn self-control until an opportunity to exercise self-control arises.

Therefore, placing a limitation on a child pouring paint on the floor is unnecessary unless the

child attempts such an activity. Limits are worded in a way that allows the child to bring him or

herself under control. The objective is to respond in such a way that the child is allowed to say

"No" to self. "You would like to pour paint on the floor, but the floor is not for pouring paint on;

the pan on the table is for pouring paint into" recognizes the child's feeling, communicates what

the floor is not for, and provides an acceptable alternative. The child thereby is allowed to stop

him or herself.

Education

Individual counseling