child and adolescent counseling chapter 17

Chapter ObjectivesAfter 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 diversi

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

Early play therapists

• Hermine Hug-Hellmuth

• Anna Freud

• Melanie Klein, and

• Margaret Lowenfield

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.

Goals of play therapy

• Boost acceptance, confidence, and

self-reliance

• Facilitate learning about self and others

• Explore and express feelings

• Encourage ability to make good decisions

• Arrange opportunities to practice control and

Schaefer’s Therapeutic

Powers of Play

• Playful and fun-loving attitude.

• Self-confidence and self-reliance.

• Openness and honesty.

• Accepting.

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.

1 Ask only relevant questions.,

2 Outline the play therapy session and relevant information

3 Focus on specific problems and help develop short-term

goals for counseling.

4 Take an active, directive play therapy role.

5 Find brief, concrete problem resolutions

Children appropriate for play therapy have the following

1 the ability to tolerate/build/use a relationship with an

adult

2 the ability to tolerate/accept a protective environment

3 the capacity to learn new ways of coping

4 the potential to gain new insight and the motivation to

try

5 the attention span and cognitive organization to

participate

Play Therapy Approaches

Ecosystemic Play Therapy

• hybrid approach that integrates biology, several theories of

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 to the problem

• ultimate goal is to help the child change beliefs that are causing difficulties

Play Therapy Approaches

Group Play Therapy

• Beneficial for children with social skills deficits.

• And for children with similar problems, issues,

experiences.

Play Therapy Approaches

Prescriptive Play Therapy: Interventions

tailored to each child.

• Counselors responsibilities include:

o Know every approach to play therapy.

o Have skill in applying constructs and strategies.

o Be capable of applying short- and long-term needs of children.

o Know the current outcome research for the most effective treatment for the specific issue.

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

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

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

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

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)

• Be interested in the child and be

warm, caring, and accepting.

• Capacity to learn new ways of coping.

• Potential to gain new insight and the

motivation to try.

• Attention span and cognitive organization to

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.

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

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,

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

Basic Skills of Play Therapy

• Returning responsibility to the child: builds self-confidence and self-

responsibility

• 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

o Make a world technique

o Stages of chaos, struggle and resolution