Play therapy Flashcards
What are the common presenting issues in children?
- truancy
- not paying attention in school
- grades slipped despite being good student
- suicidal ideation
- parents undergoing separation
- mental illness (e.g. phobia, GAD)
- discipline issues (e.g. delinquency, drugs, petty theft)
- grief and loss (but less, because parents may not be in the position to understand if emotionally unavailable)
Why use play therapy in children?
- Children usually express emotions through their body (behaviour, actions, bodily sensations) because their vocabulary/language to express is not fully developed or may not be able to communicate their needs and may not have the ability to cope with their emotions
- children make sense of their relationships by imagination, interaction with the peers and family members (e.g. different parent serve different caregiving needs), internalising what adults say about them, how adults respond to their desires
What are the benefits of play therapy?
- offer children the opportunity to release pent-up emotions through their language of play
- express themselves verbally and non-verbally and through the use of symbols
- find solutions to problems through pretend play, the form of movements and stories to symbolise or represent the child’s internal world
- practice myriad situations they encounter
What is the guiding framework in play therapy?
SYSTEMIC THINKING:
- child is related to another system, e.g. relationship between parents and school
- child is a system within themselves, connection between child’s thinking, feeling and doing
What are children’s needs?
- care - dependency: the trust and emotional need of being cared for, speaks to the child’s sense of safety and self-worth
- play - mastery: children re-enact their internal world through play
- attachment - socialisation: the need for others in their lives, to develop a sense of who they are in this world, try out what works and what does not, develop a sense of attachment for people and things
What are the systemically informed stories in play therapy?
-
systemic empathy: to believe that the problem is systemic but manifested in the child
- enquire about the behaviour, feelings and beliefs of other family members -
internalised perception of self/others: e.g. self-blame, not feeling good enough, conflictual, distant, secured
- reflect the child’s feelings and let them know they have mastery over their play - object of permanence: e.g. in trauma, children may not recall the significant incident in their memory but the body remembers the experience
What are the goals of play therapy?
- To create a context safe enough, ie. in a state of play, for change to occur
- A domain where alternative ideas and behaviours in relationship may be explored and experienced
- A platform that is distant from the harshness of the actual events, so children in a state of play may identify and express their feelings in healthier, non-symptomatic ways and more able to cope with and resolve conflicting emotions
What are some therapeutic techniques?
- using archetypes as objects of permanence (e.g. when you’re feeling anxious, is there an object or someone you can pick to help you calm down? then invite them to pick a toy to represent it and place near their heart)
- sand-play
- role-play
- puppets
- clay
- strengths/values cards
- metaphor/story-telling
What is therapeutic languaging?
keep it at the metaphorical level (e.g. “when daddy rabbit bites mummy rabbit’s tail, how does baby rabbit feel?”, “what makes this rabbit be alone?”)
* the whole point of externalisation is to create safety, so don’t associate the object directly with the child
What are the 5 ‘C’s in overarching counselling skills?
- Context
- Communication
- Connection
- Curiosity
- Co-evolving
What does context involve?
Provide a safe and friendly environment before and during the session
* placing objects that children can identify with
* photos/pictures/posters
* suitable furniture
* which ‘hat’ they see you wearing
What happens when the child’s system is too rigid? What shall counsellors do?
If the child’s system remains rigid, there’s a limit on how the child can exercise their autonomy
Prepare a way of introducing yourself to the child and parent in a simple and understanding way, e.g. “together with the child, we hope to make the problem smaller so that the child can be happier” “we talk about how we want to talk to the adults, we do it in a safe way” “i will discuss with you first before we talk to the adults, is that ok with you?
What do communication and connection involve? (1)
- Listen with respect to children’s actions and ask questions to elicit their relationship/link to their experience
- Describe play in relational terms and connect with theme in conversation
- Connecting with the ‘good and helpful bits’ of the children’s understanding - compliment them on something specific
What do communication and connection involve? (2)
- Use names, rather than pronouns with children
- Use children’s lingo and terms: If not sure of their lingo, seek clarification by asking different options (eg. Is it a,b,c, or something else?)
- Use words or questions that are concrete, unambiguous, action oriented and context dependent, easy to understand
- Acknowledge comments by repeating as closely as possible to comments made by child, focused on the child and reflect what the child is feeling and doing
- Contain our reactions towards children’s choices, and try to understand what is going on in that play; and how can that play be done in a different way to facilitate change?
What does communication and connection involve?
- Use open-ended questions or those that allow for choice (What, Where, Who can usually be managed by the age of 3)
- Avoid questions involving time sequence (up to age 7)
- Use indirect ‘play’ dialogue, eg. “What does tigger do when he is sad?”
- Use drawings and play as medium of communication
- Sequence: play –> questions –> play –> questions –> play
