child and adolescent counseling chapter 17

Chapter 17

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

© 2011 Brooks/Cole, A


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
© 2011 Brooks/Cole, A


Early play therapists
• Hermine Hug-Hellmuth
• Anna Freud
• Melanie Klein, and
• Margaret Lowenfield

© 2011 Brooks/Cole, A


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.
© 2011 Brooks/Cole, A


Goals of play therapy
• Boost self-acceptance, self-confidence, and selfreliance
• 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
© 2011 Brooks/Cole, A


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
© 2011 Brooks/Cole, A


Schaefer’s Therapeutic
Powers of Play

© 2011 Brooks/Cole, A


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.
© 2011 Brooks/Cole, A


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.
© 2011 Brooks/Cole, A


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.

© 2011 Brooks/Cole, A


Children appropriate for play
therapy have the following
1. 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

© 2011 Brooks/Cole, A


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
© 2011 Brooks/Cole, A


Play Therapy Approaches
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.
© 2011 Brooks/Cole, A


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

Know every approach to play therapy.
Have skill in applying constructs and
strategies.
Be capable of applying short- and long-term
needs of children.
Know the current outcome research for the
most effective treatment for the specific issue.
© 2011 Brooks/Cole, A


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
© 2011 Brooks/Cole, A


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
© 2011 Brooks/Cole, A


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
© 2011 Brooks/Cole, A


Play Therapy with Specific
Problems
• School Adjustment
o

PMHP focuses on identifying elementary
children before they have problems

• Children Witnessing Domestic
Violence
• Children Facing Persistent Illness
• Autistic Children
• Children Experiencing PTSD
© 2011 Brooks/Cole, A


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)
© 2011 Brooks/Cole, A


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.
© 2011 Brooks/Cole, A


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.
© 2011 Brooks/Cole, A


Play Stages
•
•
•
•
•

Relationship
Release
Recreation
Re-experiencing
Resolving

© 2011 Brooks/Cole, A


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.
© 2011 Brooks/Cole, A


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
© 2011 Brooks/Cole, A


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.
© 2011 Brooks/Cole, A