Why Play Therapy for Children?
Play is children’s natural and most comfortable medium of communication. Children’s feelings are often inaccessible at a verbal level, and developmentally they lack the cognitive and verbal facility to express what they feel or the intensity of their feelings. Children live in the concrete world of the present, and are unable to engage fully in abstract and symbolic reasoning until age eleven at the earliest. Play is the concrete expression of the child and the child’s way of coping with the world. A therapeutic relationship is best established with children through play, in which the therapist’s responsibility is to communicate with children at the level at which they are most comfortable. The play therapist is the individual who is well adjusted, has developed coping skills, and possesses specialized developmental understanding of young children. The child is never placed at a disadvantage of having to accommodate the therapist and her developmental level. In this relationship, children play out their experiences and feelings, resolve conflicts, and engage in a dynamic self-healing process.
What is Play Therapy?
“Play therapy is the systematic use of a theoretical model to establish an interpersonal process wherein trained therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development.” – (The Association for Play Therapy, www.a4pt.org)
Play therapy is characterized by two broad approaches, relational therapies in which the therapist is primarily non-directive, and directive therapies including Gestalt, Adlerian, Narrative, Cognitive-Behavioral. While primarily child-centered, I utilize elements of both non-directive and directive approaches in my work with children.
The Play Therapy Room
Toys and materials in a play therapy room are deliberately selected to contribute to the process of play therapy. If play is the child’s language, toys are their words. Materials are intentionally chosen to be accessible to children up and down the developmental continuum, to facilitate a wide range of creative and emotional expression, to allow exploration of real-life experiences, and to facilitate self-understanding and self-control.
What Children Learn in Play Therapy
A play therapy session is as unique as the child in it. There are, however, some common learning experiences all children take away from play therapy:
- Children learn to respect themselves.
- Children learn that their feelings are acceptable.
- Children learn to express their feelings responsibly.
- Children learn to assume responsibility for themselves.
- Children learn to be creative and resourceful in confronting problems.
- Children learn self-control and self-direction.
- Children learn to accept themselves.
- Children learn to make choices and to be responsible for those choices.
Parent/Guardian Consultation
Parent/guardian consultation is an important piece of working effectively with children. The first parent consultation occurs after an initial phone consultation and completion of required paperwork. This meeting will cover parent concerns, a biopsychosocial history of the child, clarify treatment goals, cover termination, and answer any questions parents or guardians may have about the process of play therapy. From thereafter, regular check-ins occur at each session and ongoing consultations are typically held as needed. Ongoing consultation is an opportunity for parental feedback, and to discuss developmental, emotional, and behavioral progress/changes. Consultations may consist of learning and practicing specific Child Parent Relationship Therapy (CPRT) skills including circles of communication, reflecting, limit setting, self-esteem building, choice giving, returning responsibility, and special playtimes.
Research on the Efficacy of Play Therapy
A number of meta-analyses have been conducted examining the efficacy of play therapy in general (Bratton, Ray, Rhine, & Jones, 2005; LeBlanc and Ritchie, 1999; LeBlanc and Ritchie, 2001) and found play therapy to be effective regardless of the presenting problem of the child and equally effective across age and gender, as well as more robust findings for humanistic approaches. They additionally found support for the efficacy of play therapy in the treatment of poor self-concept, emotional maladjustment, social maladjustment, problematic school behavior, anxiety/fear, family functioning, and parent-child relationships. These analyses also found that including parents and caregivers in therapy leads to larger treatment effect sizes than when the child is in individual play therapy with a therapist.
References
- Bratton, S.C., Landreth, G.L., & Yin, Y.W. (2010). Child parent relationship therapy: A review of controlled-outcome research. In J. Baggerly, D. Ray, and S. Bratton (Eds.), Child-Centered Play Therapy Research: Evidence Base for Effective Practice (pp 267-293). Hoboken, NJ: Wiley,
- Bratton, S.C., Ray, D., Rhine, T., & Jones, L. (2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes. Professional Psychology Research and Practice, 36(4), 376-390.
- LeBlanc, M., & Ritchie, M. (1999). Predictors of play therapy outcomes. International Journal of Play Therapy, 8(2), 19-34.
- LeBlanc, M., & Ritchie, M. (2001). A meta-analysis of play therapy outcomes. Counseling Psychology Quarterly, 14(2), 149-163.