Play Therapy
I want to provide helpful information for parents who are considering Play Therapy for their child. The following will answer common questions and concerns of parents, but this is merely a beginning point for our communication. As I become involved with your child’s therapy, I trust that we can have regular, open communication about your concerns and your child’s progress.
What is Play Therapy?
I am very excited about Play Therapy as a counseling approach for working with children.
Dr. Garry Landreth defines Play Therapy as:
“. . . a dynamic interpersonal relationship between a child and a therapist trained in Play Therapy procedures who provides selected play materials and facilitates the development of a safe relationship for the child to fully express and explore self (feelings, thoughts, experiences, and behaviors) through the child’s natural medium of communication, play.”
A child’s world is very different from our grown-up world. Play is the natural expression of children. They learn to understand their world through their play. It is a kind of “hands-on” thing, this world of a child—an experiential thing. Words are too abstract—too adult-world for communicating with children. Just talking about problems doesn’t work. But Play Therapy facilitates a child discovering and exploring concerns—and provide a safe, natural medium for resolving difficulties.
Allowing children to “play out” feelings and experiences is the most natural, dynamic, self-healing process in which children can engage. I think they do it automatically and resolve many of their little difficulties on their own on a daily basis. Play Therapy does that intentionally for the bigger emotional and behavioral challenges. So, if play is the language of children, then we must begin to recognize toys as the words of their unique language. Toys are wonderful! I’ve gathered a variety of toys and interesting objects to delight and engage my young clients.
Play Therapy is designed for children 4 – 11 years old. I have worked with a few 3 year olds. Teenagers consider themselves too mature for little kid stuff, but many of them enjoy Sandtray and art and having some fun. I think we all need playfulness in our lives. In my experience, play and a sense of humor returns for people of all ages as they heal.
When I first meet a child client, I instinctively look for the “wonderful” in him or her. Children are a wonderful delight to me! I look for each one’s unique strengths and personality. I prefer using a non-directive approach, at least to begin with, in working with children. This allows them freedom of exploration and expression. I learn many things about a child as I observe, and gentle descriptive or reflective responses let the child know
I am attuned to her. The first session, I say, “This is your special time and you can say anything you want to say and do almost anything you want to do. If there is anything you can’t do, I’ll let you know. So, you don’t have to worry about it.” I explain confidentiality in terms a child can understand and let them know the limits of confidentiality. (Self-harm or someone hurting them.)
Kids like it when I tell them my rule about not picking up toys! I explain that things are different here than at home. My reason is that what the child has done, whether messy or creative, is their communication of thoughts and feelings. I’d never tell my adult clients to take back the things they’ve said or to pick up the Kleenex after a good cry! I’m more concerned about a child being too neat and tidy or too perfectionist. Clean-up is my job. I’d rather have a mess and know the child was opening up and letting it all out.
The Sandtray and creating worlds in the sand with miniatures usually has the most draw for kids. When appropriate, we use therapeutic games, costumes, puppets, art work, collage, clay, various stress and relaxation techniques, and Cognitive Behavioral Therapy (CBT) used in playful ways. Some children could benefit from EMDR (Eye Movement Desensitization and Reprocessing) for trauma recovery. This option is fully explained to parents and only used with special consent. I do EMDR with children in a playful way and I have a wonderful child’s book to explain it. We call it Eyes Moving to Digest and Recover (thanks to Ana M. Gomez, MC LPC) I frequently use the Roberts Apperception Test for Children to get a clearer sense of a child’s level of anxiety or depression, as well as their adaptive strengths. The scored Profile is shared with parents when we meet to discuss treatment.
How important is it to bring my child regularly to Play Therapy sessions?
Can I stress, IT IS VERY IMPORTANT TO BRING YOUR CHILD REGULARLY TO THERAPY. Consistency is important for children. I wish we could meet oftener than just once a week because a week between sessions is a very long time, especially for young children. It takes time for your child and me to get to know each other. It takes time for trust to develop, for your child to know I will be here, that rules and limits will be consistent, that I don’t change, and that the Play Room is a special place just for them. It takes trust, safety, and consistency for a child to decide to do therapy work.
If a child does not come regularly, trust cannot develop and our relationship suffers. Frequent absence makes therapy lose its momentum. Toward the end of a child’s therapy, I sometimes taper to meeting every other week before the final “Goodbye Session.” But I’ve found that before then, if we schedule every other week, it’s like starting anew each time. We lose the continuity and progress slows. Remember, a young child’s sense of time isn’t developed, and frankly, a lot of “life” can transpire in one week.
Should a child miss school to come to therapy?
I try very hard to schedule older children so that they do not have to miss school, but my available session times are limited. If you have brought your child for counseling because of problems you know they have, your child is probably having trouble in school also. Involving the child in therapy may help the child cope better with school work and school relationships. I am interested in us working together as a team—home, school, and therapy—to help your child.
What can I expect as my child is in therapy?
Each child responds to things in his or her own unique way and Play Therapy is no different. Behaviorally, when going through tough times, some children act-out and other children withdraw. You know your child best. Your observations and concerns for your child are what brought you to consider getting therapy for them. Generally, I connect with children quickly and they like to come see me. They sense I care and like them. Some children instinctively “know how to do therapy.” They quickly involve themselves in active play and I see them play out themes consistent with issues in their lives.
However, I like to inform parents that it isn’t always that easy. Sometimes, when a child has serious issues, things may appear to get worse before they get better. I want to let you know about it now, and then when “it” happens, we can remind each other that we knew it was going to happen! Not frequently in my experience, but in some cases there will be a kind of “honeymoon” phase and then a “crash” phase. At first, the child “gets better” and whatever the problem was, you might think everything is fine now. But it isn’t. The child is just reacting to something new and positive in his or her life.
The honeymoon can be followed by “the crash” or a kind of monster stage. It will be a testing time for both you and me. You may begin to think, “Why am I putting all this effort into taking my child. He’s getting worse than ever!” That’s when I’ll remind you about “the crash.” And I’ll try to be supportive of you because I know that’s a hard time for parents. Really, it will be a sign that therapy is beginning to work and your child is getting in touch with significant feelings and issues that are troubling. That’s when we will pull together as a team for your child.
Think of it like with medical problems. The doctor often makes a person feel worse before they get better. Sore spots are sometimes cut open before healing happens. In Play Therapy, painful feelings come to awareness. And children, like adults, often lash out or act out when they hurt inside. Sometimes, they get pretty ugly when they have trouble identifying and working through their pain. Rarely, but sometimes, a kid will say they don’t want to come anymore. Or they might say therapy isn’t helping and deny they have any problems. That’s when we need to be especially understanding and supportive. As painful feelings are worked out, the “crash” slowly goes away. Your child is fortunate to have a parent concerned enough to get help. Believe me, therapy now is far better than 20-30 years from now when beliefs about self are “hard wired” and behaviors have negatively affected their life and relationships.
How much do you involve the family when it is one child who has the problem?
Families are like teams. Everyone on the team is important. Each family member has a special role they play. Imagine a baseball game if the first baseman decided to leave and just go for a walk during the game. The whole team would be affected by his behavior. It is the same with families. If one family member changes, other family members feel the impact. The family dynamics change. The family needs help adjusting to those changes. I want to offer emotional support and growth opportunities for the whole family, but sometimes it’s hard to schedule everyone getting together. When possible, we’ll do our best. I have a number of excellent parenting resources to recommend.
Your child will be helped just by understanding his parents care enough to be involved in trying to help him feel better. Usually, treatment time is shortened with parents involved as much as possible. I know your schedule and my schedule get extremely busy, but I want you to know I’ll be available as much as possible. Sometimes
I have parents keep me informed of recent things happening for the child by phone messages or notes. I communicate with teachers or doctors as needed with parental consent. After about the fourth session, we typically schedule to meet with parents alone to go over my assessment and inform them about their child’s therapy. There, I’ll give feedback on how their child is progressing, but I like to maintain confidentiality for children about their sessions. I don’t tell everything the child says or does. I feel that confidentiality is important for a therapeutic relationship with children as well as adults. When something comes up in session that is important for a parent to know, I talk with the child about how we should do that. Sometimes kids need me to speak for them.
How long will my child’s therapy take?
I wish I could give you an idea, but it is difficult to say. Some depends upon how long the problem has been going on. Some depends upon the age and development of your child. Change does not happen overnight. There are no “quick fixes.” Habits take time to change. It typically takes a month of sessions for a child to feel at home with me and the Play Room. It takes a while to feel safe enough to reveal feelings and problems. And each child is unique in how they process things. When there are behavioral problems, you as a parent will likely be helping work on it at home.
Deciding when therapy is through will be a joint decision between us. Why was the child brought for therapy? Are these problems solved? What has changed? How is the child? How are the parents feeling? How is the family doing? Many families are dealing with on-going issues, so we must keep that in mind as we consider the child.
I usually encourage parents to plan for 12 sessions. Many children get the benefit they need within that time. If more time is needed, we can extend things. Sometimes, children come back months—even years later for a “tune up.” I’m always glad to see them again. And I love it when parents let me know how their children are doing by sending a notes or a graduation announcement!
What will happen if we just decide to stop bringing our child?
I encourage you to talk with me before making that decision. I am concerned about the possible affects on your child. If the child has begun opening up and looking at feelings and thoughts, he or she could be at a very vulnerable spot. Leaving therapy could make the child less able to cope in a healthy manner. It could create problems. If you chose to begin therapy, please make a commitment to it. You will be involved for a while, but in the end, I think you will be glad you made the investment.
How can I help in the Play Therapy process?
Parental involvement will vary. Sometimes there may be specific behavioral interventions for which I will need your help at home during the week. For some cases I might recommend Filial Therapy, training a parent in basic Play Therapy skills for working with their own child in Special Time sessions at home. I’ve had some children who need to have their parent in session for a while. Sometimes a parent or sibling is invited to join us for a session. Many older children come by themselves after school. So involvement will vary depending upon individual needs.
If you have further questions or need more information, please call me.
(360) 281-5200