The following information is provided to parents whose children are receiving Play Therapy services within Oak City Counseling We have found it helpful for answering common questions about the Play Therapy process.
What is play therapy?
Play Therapy is the use of specific and varied toys to help children to communicate, express feelings, heal and ‘release’ pent up emotions such as anger, anxiety, sadness, fear, worry, stress, etc.
Toys are to children what words are to adults. Adults can make meaning out of words, thus talking and processing thoughts on a cognitive level. This can achieve a ‘release’ for adults and help to process feelings and resolve problems. THIS IS NOT THE CASE FOR CHILDREN. Research has shown that children (typically under age 12) who have not yet developed the higher executive brain functioning that adults or even older adolescents have, cannot achieve this release through talking, identifying feelings or being ‘taught’ how to do things-relax, breath, reframe irrational thoughts, etc.
In fact, research demonstrates that Cognitive Behavioral Therapy with children can be ineffective and even harmful if a child is forced to ‘talk’ or to participate in activities that they do not want to do. Not only does this make therapy an unpleasant experience for a child, it also ruins and prohibits the therapist from creating a bond with the child. The therapeutic bond between child and therapist is the MOST essential part of therapy as it allows the child to feel safe and to be open enough to respond to therapeutic interventions. Without this bond, almost any therapeutic technique will be ineffective.
Because of this, children are best helped in an environment that accommodates their needs, is relaxed, playful and can allow them to communicate in the ways that they feel comfortable. Most of the time this is achieved through playing with various toys, artistic/creative expression-with the use of paint, markers, crayons, clay, etc.-or sensory expression-using sand or water to express feelings.
Various themes that children present through playing with toys: Violence/anger/aggression, worry/fear, nurturing/love, sadness/grief, joy/happiness.
Can’t my child get the same benefits as Play Therapy from playing with their toys at home?
The answer to this question is most emphatically NO! While children do communicate and express themselves during their individual/solitary play at home it is far different than Play Therapy. In the Play Therapy session, the therapist is trained to elicit feelings and themes by using certain language and prompts. The Play Therapist helps the child to identify their feelings in a non verbal way and also helps them to promote independence throughout play and build self esteem through various tasks and language. The Play Therapist is also trained to remain completely neutral and accepting no matter what the child demonstrates or acts out in play, this way the child feels accepted and validated throughout the session, despite possibly communicating private thoughts/feelings or things which they normally are unable to communicate for various reasons. I can often find out a tremendous amount of information about how a child feels, thinks and acts by interacting with them during Play Therapy.
Can you tell me what my child is thinking and feeling or figure out why my child is acting in a particular manner?
This is a difficult question. The goal of Play Therapy is not to necessarily reveal all of the child’s private thoughts and feelings to the parents. This defeats the privacy and security of the child/therapist relationship and can often create a barrier to progress. While the Play Therapist will explain general themes, observations, thoughts and recommendations to parents during parent sessions, the Play Therapist will not go through a detailed account of each session, activities or statements made by children as this may be a breach of confidentiality for children and may not be easily translated into helpful information for parents. What the therapist will do is interpret and explain what the themes and behavior may represent and from this make suggestions and recommendations for parenting support, treatment techniques and future/ongoing treatment.
Will children talk about their problems during play? How will you know what they are working on or if the therapy is ‘working’?
Occasionally children will discuss problems during play, often it is in relationship to a character or theme within the play and is not necessarily identified as their own. Typically problems or issues that are weighing on a child will be acted out in various ways during Play Therapy. For example, this may be releasing anger by punching the punching bag, acting out a sad scene with family figurines, fighting armies against each other, hiding within the room, doing tasks independently as prompted by the Play Therapist.
How we can determine if Play Therapy is effective:
- What is the child’s response to the therapist and the interventions? Are they feeling safe? Do they appear open? Are they able to engage with the therapist and participate in interventions? If the answers to most of these are yes, this is a good indication that Play Therapy is effective for the child
- What is the child’s demeanor following Play Therapy? Do they appear more relaxed? More agitated? Occasionally children will appear energized or ‘hyper’ following a Play Therapy session, this can occur for various reasons, sometimes bringing up intense emotional issues can provoke this type of response from children, sometimes children feel so positive after a session that they may appear excited.
- What is the behavioral response at home and at school? Is the child improving in the symptoms and issues that they presented to therapy with? I typically like to look at the presenting problems/issues that were discussed at the first appointment. Are those issues improving? Staying the same? Or worsening? In my experience, MOST of the time the issues are improving within the first 3 months of treatment, sometimes they are staying the same and very very rarely have I had these issues/problems worsen. It’s important to look at the whole picture when assessing progress-if positive change is not occurring why is this? Are there environmental factors-such as new or ongoing life stressors-which are impacting this? Or are the therapeutic techniques not effective for this child? It is important to look at all areas of a child’s life to determine if anything is getting in the way of treatment or progress.
What can you as a parent do to help the therapy process and encourage your child to succeed in therapy:
- Be open minded to Play Therapy and the methods that are used in the process. If parents are judgmental or critical of Play Therapy it is very likely that the child will be resistant to engage and little progress will be made.
- Do not question the child or inquire about their session. Play Therapy sessions are private, often very sacred for children, where they feel safe to express themselves in very unique environment. While they may tell you portions of what they experienced, it is important not to question them or to criticize what they report. Statements such as ‘why did you do x, y, z’ or inquiring about what the child ‘talked’ about are not helpful as they may make the child feel as though what they accomplished in therapy was not enough or was not ‘correct’. It is important for children to feel as though even minor accomplishments or things that they view as important in therapy are valid and positive, this promotes growth and progress rather than detracting from the therapeutic value.
- Follow the recommendations made by the Play Therapist. I often get asked how long the duration of therapy might be. This of course depends on the severity of the issues presented, environmental factors and parent response to therapy. When a parent is willing to follow the suggestions and recommendations for home discipline, parenting, etc. the time frame will be much shorter than if parents are resistant or ‘too busy’ to take these actions at home. In order to see progress in Play Therapy, the recommended initial time frame would be 8-10 WEEKLY sessions, interspersed with parent sessions every 4 weeks-or sooner depending on the situation. It would not be realistic to expect to see significant progress in shorter timeframe (although it does sometimes happen) and without attending weekly sessions. When a child attends weekly sessions-especially in the beginning of therapy-it will maintain momentum and be much more effective than if therapy occurs sporadically or is inconsistent. Change is more likely to occur with consistent weekly sessions, especially in the beginning of therapy so that the child and therapist can bond and create a positive and effective working relationship.