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 Ask only relevant questions., Outline the play therapy session and relevant information Focus on specific problems and help develop short-term goals for counseling Take an active, directive play therapy role Find brief, concrete problem resolutions © 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 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 © 2011 Brooks/Cole, A Basic Skills of Play Therapy • Returning responsibility to the child: builds self-confidence and selfresponsibility • 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 © 2011 Brooks/Cole, A Selected Strategies • Art o Magic art o Color emotive brain o Clay • Puppets • Sand o Make a world technique o Stages of chaos, struggle and resolution © 2011 Brooks/Cole, A [...]... 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,... relationship and help child understand emotions, being with others and build an affective vocabulary © 2011 Brooks/Cole, A Basic Skills of Play Therapy • Returning responsibility to the child: builds self-confidence and selfresponsibility • 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... © 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,... 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 Basic Skills of Play Therapy • Tracking: describe what the child is doing • Restating content: paraphrasing what the child has... 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... 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... 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,... 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... 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... 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 ... 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,... 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... 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