Friday, May 2, 2014

Play Therapy - How Can It Help My Child?

Many people look for therapy for their children and they have a narrow focus of what play therapy is. They may think that it is sitting down with the child and having long conversations with them to find out why they are acting the way they are acting. They may think the therapist needs to be firm and tell the client how to behave. This is not play therapy.

What is Play Therapy?

Virginia Axeline (author of Dibbs and In Search of Self) was one of the founders of play therapy. She believed that children expressed themselves through play and that is how they are healed. She would bring the client into the play therapy room, filled with a specific array of toys. She would take dubious notes and write down what the child said and did during the play therapy encounter and later interpret it.

Gary Landreth, founder of Child-Centered Play Therapy followed in her footsteps. When children at home can no longer use their own problem solving tools, they may misbehave or act out at home or school. He believes that, when provided with the right conditions, children can once again learn to cope with difficult emotions and find solutions to their own problems. Thus, he uses play therapy to assess and understand children's play. Part of this is done by allowing children to take ownership of their reactions and behaviors. He also believes that with play therapy, children can learn self-discipline and self-control in the play therapy room.

Instead of the elaborate note take of Virginia Axeline, Gary Landreth would jot down notes. However, he would also "track" what the child is doing. He might say, "You are pouring that into there." He would be careful not to label what the child was using before the child labeled it. The child may be using one object and pretending it was something else. Once the child labeled the item, then he would use their terminology. He would track what they were doing not all the time, but every 5 minutes or so depending on what they were doing. The child may correct him or may go on playing.For instance the child may pretend he is shutting a door and he acts as if he is slamming it, he might say, "You are really angry." The child may then correct him and say that he was just closing the door. If the child did a very positive thing, he may say something like, "Look what you did. You did that all by yourself." He may repeat it, if the child ignores him. He would be careful not to praise the child as he does not want the child trying to pleasing him with their behaviors. He wants the child to be able to take ownership of their own problem solving behaviors or their own feelings.

Usually children talk in their play. Gary Landreth would "reflect" or repeat back what the child would say. Sometimes it is a direct quote, but other times it is reworded so that it means the same thing. It is important for the child to know you are listening to them. Now he may not reflect every utterance. Again it may only be every so often. The child may say, "I don't know if I can do this." The reflection may be "You're wondering if you can really do this by yourself."

What is the Difference Between Directive and Non-Directive Play Therapy?

Virginia Axeline and Gary Landreth take a non-directive approach to play therapy. It is just one approach. Some play therapists are more directive in their approach to play therapy. They may take the stance of confronting problems in the clinical play therapy setting so the children can learn healthier solutions by challenging negative thinking, doing role play, modeling, and playing games that focus on skill development. Neither one is better than the other. What the professional therapist uses is based on the needs of the child.

Why Play Therapy?

Many parents question why play in therapy and not just talk therapy. Children communicate best through play. They do not have the advanced vocabulary as we adults do and their feelings come out naturally in their play. Gil, a pronounced play therapist in her own right, utilizes play therapy to help children express what is troubling them when verbal language to express their thoughts and feeling fails. Toys are the children's world and play is the child's language. However, that is only half of the equation. Children need to build a relationship with their therapist. This is crucial to treatment. Change occurs when all of these things are combined.

Emily was an eight year old girl placed in foster care because her guardian was diagnosed with advanced Alzheimer's disease and could no longer care for her. At the time this happened, Emily would take my toy animals and set up a stage, a play or musical so to speak. The animals were paired with their mothers and they would each sing different songs. During her play, it was inevitable; one of the singers would collapse and need resuscitation. This theme was played out several times. Then, one day during the singing, an ambulance was introduced and took the collapsed singer to the hospital and she was never to return. Emily told me that when she grew up she was going to find a cure for Alzheimer's and then her guardian wouldn't have to go away and die.

Emily had been working on grieving the loss of her guardian and coping with the illness. We can never second guess what the child's meaning of the play is. That is, we cannot interpret it. It is what the child says it is. A car is a car, if the child says it is a car. We don't read into it. We let the child tell their story through play.

Who is Play Therapy For?

Play therapy is typically used with children three through twelve. However, play therapy can also be used with adolescents. Play therapy is used to treat a variety of conditions including anger management, grief, loss, family dissolution, and trauma. It is also used to modify behavioral disorders including anxiety, depression, attention deficit hyperactivity (ADHD), autism, and pervasive developmental, academic, and social developmental, physical and learning disabilities, and conduct disorders. It is also used in treating children whose problems are related to life stressors including, but not limited to divorce, death, relocation, hospitalization, chronic illness, stressful experiences, physical and sexual abuse, domestic violence, and natural disasters.

What are the Benefits of Play Therapy?

Play therapy helps children in a variety of ways.

They become responsible for their behaviors

They develop creative solutions

They develop respect for others

They develop self-acceptance

They learn to experience and express emotions in socially appropriate ways.

They learn empathy for the thoughts and feelings of others

They develop healthier social skills with friends and family members

They develop self-efficacy and are more self-assured about their abilities.

How Long Does My Child Need to Be in Therapy?

Typically treatment on average takes 20 play therapy sessions to resolve a particular problem. However, a lot depends on the child. Serious or ongoing problems take longer to resolve. Sessions usually occur once a week for 45-50 minutes.

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