Play Therapy Explained
As explained on the "Therapy for Children & Teens" page, sometimes talking is just not enough. When treating a child, it is important to think like a child. Play therapy helps the therapist join a child at his/her level. Children believe in magic and fairy tales. They believe that Santa comes down the chimney and that the Tooth Fairy really exists. Play is a child's language; this is how s/he communicates. We use this innocence and learn their language to make communicating about scary issues safe and doable. Below are the different types of "expressive therapy" that are utilized during sessions.
Non-Directive (Child Centered) Play Therapy
While at play, children develop & practice new skills all the while communicating their thoughts and ideas. Non-direct play therapy allows the child the freedom to express himself through self directed play. The therapist then uses learned techniques to assist the child to explore and process issues of concern. This style of therapy works especially well with younger children starting as young as 3 years of age, or children with processing disabilities. At times parents are taught play therapy techniques and are invited to participate in the treatment as well.
Two Examples from Gabrielle Anderson, Director:
I am a mom of 2 young children. My daughter has a severe allergy to dairy milk which has been really really scary for her (and us!). When she was 3 years old, her Grandma was visiting from out of town. The two of them were upstairs playing tea party in my daughter's room. Grandma came downstairs after playing with my daughter pretty disturbed. She was upset because my daughter had assigned her dolls and stuffed animals their own individual food allergies. In this particular play my daughter was the mom feeding all the dolls/animals and she herself could eat anything she wanted at the party. I was thrilled. I knew it seemed sad for Grandma to see her grandchild's play plagued by food allergies, but I knew it wasn't benign play...it was helpful, therapeutic play. My daughter put herself in the power position over the allergies. She was the mom and she dictated who had them and she had control over the food. Very empowering for a child. If she were a child in my office and she began that play, I would make sure she was in the power position and if she wasn't, if she was a victim in the play, I would help her get to the powerful role. Play therapy helps disruptive play turn into empowered play. When children begin to feel how freeing and calming this type of play can be, they begin to practice playing differently at home too.
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I had a 6 year old boy come to therapy after being chased and bitten by a dog. As a result he became very fearful of dogs and playing outside. When he started treatment, he was afraid to leave the house, even getting him to school was a struggle. We used non-directive play therapy. In the beginning of treatment, he liked to chase me around my office with a bumble bee puppet. As the therapist, my job is to help children balance their negative and troublesome feelings. He needed to feel empowered over the dogs and using a bumble bee instead of a dog provided enough distance for him to begin to approach the emotion safely.
Part of empowerment is gently pushing a child to resolve an issue by having him access the relevant emotions during the session and then helping him move through them safely. As the therapist, it is important for me to know what the child may have been thinking and feeling during and after the scary event so I can insert these feelings aloud into the play. In this example, I verbalized, "I'm so scared of this bee! I'm not sure how to get away". When the chase intensified, that was my cue that my (his projected emotion) scared feelings intensified too.
When play therapists really begin to get into that primary emotion, it is important to check in with the child to be sure it feels congruent and accurate. Sometimes children will cue us "Now cry and I'll pretend not to hear" therapists play out the intended emotion .."Am I doing it right?" I might whisper. "Cry louder!" Might be his response, or "that's just right".
This type of play organizes and purges the emotion, but also can provide empowerment over the emotion and event. This type of play continued for a few weeks until it was no longer necessary. By the end of this little guy's therapy, he was able to play outside, go to parks and easily tolerate dogs at the bus stop.
Because the solutions come from the child and because s/he is nudged to be the powerful one, feelings of victimization decrease until they no longer have an impact and are no longer relevant. Empowerment play coupled with the therapist's verbalizations during the play help a child to improve symptoms of disruptive or insecure behavior. When the child can be the aggressor in a safe therapeutic environment and is encouraged to move through the event or feelings, s/he no longer needs to be the aggressor with siblings or friends because the feelings now have an outlet and a direction
Non-Directive (Child Centered) Play Therapy
While at play, children develop & practice new skills all the while communicating their thoughts and ideas. Non-direct play therapy allows the child the freedom to express himself through self directed play. The therapist then uses learned techniques to assist the child to explore and process issues of concern. This style of therapy works especially well with younger children starting as young as 3 years of age, or children with processing disabilities. At times parents are taught play therapy techniques and are invited to participate in the treatment as well.
Two Examples from Gabrielle Anderson, Director:
I am a mom of 2 young children. My daughter has a severe allergy to dairy milk which has been really really scary for her (and us!). When she was 3 years old, her Grandma was visiting from out of town. The two of them were upstairs playing tea party in my daughter's room. Grandma came downstairs after playing with my daughter pretty disturbed. She was upset because my daughter had assigned her dolls and stuffed animals their own individual food allergies. In this particular play my daughter was the mom feeding all the dolls/animals and she herself could eat anything she wanted at the party. I was thrilled. I knew it seemed sad for Grandma to see her grandchild's play plagued by food allergies, but I knew it wasn't benign play...it was helpful, therapeutic play. My daughter put herself in the power position over the allergies. She was the mom and she dictated who had them and she had control over the food. Very empowering for a child. If she were a child in my office and she began that play, I would make sure she was in the power position and if she wasn't, if she was a victim in the play, I would help her get to the powerful role. Play therapy helps disruptive play turn into empowered play. When children begin to feel how freeing and calming this type of play can be, they begin to practice playing differently at home too.
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I had a 6 year old boy come to therapy after being chased and bitten by a dog. As a result he became very fearful of dogs and playing outside. When he started treatment, he was afraid to leave the house, even getting him to school was a struggle. We used non-directive play therapy. In the beginning of treatment, he liked to chase me around my office with a bumble bee puppet. As the therapist, my job is to help children balance their negative and troublesome feelings. He needed to feel empowered over the dogs and using a bumble bee instead of a dog provided enough distance for him to begin to approach the emotion safely.
Part of empowerment is gently pushing a child to resolve an issue by having him access the relevant emotions during the session and then helping him move through them safely. As the therapist, it is important for me to know what the child may have been thinking and feeling during and after the scary event so I can insert these feelings aloud into the play. In this example, I verbalized, "I'm so scared of this bee! I'm not sure how to get away". When the chase intensified, that was my cue that my (his projected emotion) scared feelings intensified too.
When play therapists really begin to get into that primary emotion, it is important to check in with the child to be sure it feels congruent and accurate. Sometimes children will cue us "Now cry and I'll pretend not to hear" therapists play out the intended emotion .."Am I doing it right?" I might whisper. "Cry louder!" Might be his response, or "that's just right".
This type of play organizes and purges the emotion, but also can provide empowerment over the emotion and event. This type of play continued for a few weeks until it was no longer necessary. By the end of this little guy's therapy, he was able to play outside, go to parks and easily tolerate dogs at the bus stop.
Because the solutions come from the child and because s/he is nudged to be the powerful one, feelings of victimization decrease until they no longer have an impact and are no longer relevant. Empowerment play coupled with the therapist's verbalizations during the play help a child to improve symptoms of disruptive or insecure behavior. When the child can be the aggressor in a safe therapeutic environment and is encouraged to move through the event or feelings, s/he no longer needs to be the aggressor with siblings or friends because the feelings now have an outlet and a direction
Directive (Activity Based) Play Therapy
Direct play therapy utilizes deliberate activities and toys during therapy sessions to create a safe, child-friendly environment for assessment and treatment to take place. The therapist plans the session by introducing therapeutic activities and by teaching new skills. Treatment is often made more efficient by the use of therapeutic "homework" whereby a child is asked to practice new skills in between sessions.
Sometimes a child is too old to play. In cases like these, we involve therapeutic activities in the session, much like a teacher would do at school, to make the lessons and sessions more fun and interactive. This may look like incorporating a fun therapeutic workbook, maybe it involves playing a therapeutic card game or utilizing the dart board to get conversations flowing. Age appropriate therapy is a MUST in order to engage children and help them feel safe and secure.
Example by Gabrielle Anderson, Director:
As stated previously, anxiety is one of the things I really enjoy treating. When a school-aged child or teen comes in to therapy for anxiety related issues, I tend to use a more directive approach. I believe in empowering a child to overcome and control their worry thoughts. I will teach them how to listen to their thoughts, and stop and replace the worries. We learn how to detect the way our bodies respond to stress and learn how to calm ourselves down with deep breathing, and relaxation techniques. I teach children how to trick their brains into calming down their nervous tummies, nail biting, etc. We do this by different (age appropriate) activities like, progressive muscle relaxation, where children are taught to tense up different muscle groups as a way to release tension in their muscles. We may also, for example, paint of picture of a stressful situation and color code it according to the different feelings they experienced at the time of the stress...yellow=happy, blue=sad, green=scared, etc. These examples of techniques show how children can learn more about their inner processings and how therapy gives them a great way to explore and communicate them.
Sometimes 1:1 Play Therapy is not Enough
When symptoms at home seem to effect the parent child relationship, or a trauma has directly impacted the family, individual play therapy sessions may not be enough. Theraplay is a modality that strengthens the parent child relationship in a structured play therapy environment. Theraplay is also wonderful for the child with special needs and developmental challenges and has been used with great success for those on the Autistic spectrum. Read about the family healing approach of Theraplay here.
Sometimes a child is too old to play. In cases like these, we involve therapeutic activities in the session, much like a teacher would do at school, to make the lessons and sessions more fun and interactive. This may look like incorporating a fun therapeutic workbook, maybe it involves playing a therapeutic card game or utilizing the dart board to get conversations flowing. Age appropriate therapy is a MUST in order to engage children and help them feel safe and secure.
Example by Gabrielle Anderson, Director:
As stated previously, anxiety is one of the things I really enjoy treating. When a school-aged child or teen comes in to therapy for anxiety related issues, I tend to use a more directive approach. I believe in empowering a child to overcome and control their worry thoughts. I will teach them how to listen to their thoughts, and stop and replace the worries. We learn how to detect the way our bodies respond to stress and learn how to calm ourselves down with deep breathing, and relaxation techniques. I teach children how to trick their brains into calming down their nervous tummies, nail biting, etc. We do this by different (age appropriate) activities like, progressive muscle relaxation, where children are taught to tense up different muscle groups as a way to release tension in their muscles. We may also, for example, paint of picture of a stressful situation and color code it according to the different feelings they experienced at the time of the stress...yellow=happy, blue=sad, green=scared, etc. These examples of techniques show how children can learn more about their inner processings and how therapy gives them a great way to explore and communicate them.
Sometimes 1:1 Play Therapy is not Enough
When symptoms at home seem to effect the parent child relationship, or a trauma has directly impacted the family, individual play therapy sessions may not be enough. Theraplay is a modality that strengthens the parent child relationship in a structured play therapy environment. Theraplay is also wonderful for the child with special needs and developmental challenges and has been used with great success for those on the Autistic spectrum. Read about the family healing approach of Theraplay here.