Guidelines, transcripts, and case examples are provided for governing sensitive issues at every stage of the therapeutic process, from the first meeting to the end of the relationship. This new edition will incorporate the relevant research that has taken place since the publication of the previous, and includes new sections on supervision of play therapists, legal and ethical issues, and multicultural considerations in play therapy" Author : Garry L.
Play Therapy Author : Garry L. Keep reading to learn about free games and tools for your virtual counseling sessions. The following list of interactive games can be played live during your virtual counseling or TeleHealth sessions. Although the steps for each website vary, you can follow these general directions to get started:. Virtual Battleship Example. Interactive art tools can be used in virtual counseling sessions in a variety of ways. Explore the sites below to use art as a tool for expression, coping skills, and more.
Witeboard : Witeboard is a simple digital drawing tool that can enhance your virtual counseling sessions. Ideas to get you started:.
Quick Draw : Use this drawing tool from Google as a fun way to interact with your client during virtual counseling. Share your screen to introduce the tool. You get 20 seconds to draw the prompt that is on the screen. Best for ages 8 and up. Color Your Own Mandala : Share your screen to teach your client how to color a virtual mandala.
Introduce this site as a relaxation tool for your client. Inspirograph : Inspirograph is a digital version of the traditional Spirograph tool. Share your screen to teach your client how to use this relaxing tool.
Inspirograph Example. A sandtray is one of the best expressive tools to use when counseling children. Now, you can use a virtual sandtray to accomplish some of the same benefits as using sand in real life. Many of the game boards include interactive tick boxes for students to check off as they progress in the game. AND to make it even more fun, the included tutorial video shows you how to add movable game pieces! I have also included 2 free digital dice alternatives for those of you wanting to be fully digital.
For the themed PDF games: Each download includes 18 editable game boards plus 3 themed pages with blank centers for your creative use. There are a bunch of themes and for each theme, there are 6 different layouts. Each layout is designed with your caseload in mind. You may also like our editable book companion PDF. You will need adobe acrobat reader on your computer to use this download as intended. It is free and you can find it here. For best results open this in the notes writer app found here.
Parents may tease their children in an abuse of power. They may play with their children as if they were sibling rivals.
Where this cannot be offered by family or friends it may come from professional help. Containment may also be offered in less formal situations. Most children do not need extra help in dealing with the ups and downs in their lives.
Yet some children have too much happening in their lives, separations, losses, abuse, repeated disruptions, changes of family membership and abode, changes of caretakers and attachment figures. Such events can be too great to cope with unaided.
Some children, while anxious and angry, can cope adequately if they have an opportunity to share their feelings with an understanding adult who can help them to make sense of what has happened and clear up the frequent misapprehension that the child was to blame. Play techniques can be a good way of helping these conversations along. Other children, often those experiencing continual deprivation or abuse, or suffering from very profound loss, need more help in exploring and communicating their strong feelings, which have possibly been long repressed or expressed inappropriately.
Children who have suffered a profound but isolated upheaval in their lives may respond quickly to play therapy, speeding the process of recovery which might otherwise take a long time and interfere with other aspects of development. Where experience over a long period of time has been damaging, children are often too disturbed to be able initially to use spontaneous play therapeutically. For them a longer experience of play therapy may be helpful.
Other children who can benefit from play approaches and play therapy are young children with emotional problems whose language skills are not well developed, older children with difficulties in the use of language, and elective mute children those who choose not to speak.
Similarly, children with developmental delays and learning difficulties, even in adolescence, may be helped through play therapy. The least damaged children may play spontaneously at a developmental level appropriate to their age, Others may be playing at a much earlier stage of development or may have missed out on certain types of play experiences. It is often important to determine whether the child can use symbolic play.
From the intensity of the emotion expressed in play it becomes possible to identify areas of acute distress. For example, all children are likely to be jealous of a new baby and may show this by squeezing a doll baby; acutely hurt children may squeeze or hit the doll harder, more often, and with more display of anger.
Some children may play defensively, hiding rather than revealing their true feelings. Others may suffer from play disruption. The extent of disruption and the play events which lead up to it may give the worker some idea of areas of difficulty.
More severely damaged children may initially not be able to play at all. This discussion has focused on assessment of children.
The next chapter explores different approaches to using play in helping children and families. The adult, as uncomfortable as the child, resorts to questions. Clare Winnicott explains how to bridge the communication gap, She writes: We spend a good deal of time creating the conditions which make communication possible. We try to establish between ourselves and the children a neutral area in which communication is indirect. In other words we participate in shared experiences, about which both we and the children feel something about something else, a third thing, which unites us, but which at the same time keeps us safely apart because it does not involve direct exchange between us.
Clare Winnicott writes: We have to be able to reach them and respond to them at any given moment and be willing to follow them as best we can. Of course we shall not always understand what is going on or what they are trying to convey to us, and often this does not matter.
What matters most is that we respond in a way which conveys our willingness to try to understand. And it must be obvious that we really are trying all the time. Having reached the child we try to look at his world with him, and to help him sort out his feelings about it, to face the painful things and discover the good things. Then we try to consolidate the positive things in the child and in his world, and to help him make the most of his life.
It considers the range of focused or structured play techniques and their application. It examines developmental and behavioural play techniques. Finally it considers play methods in group work with children and in the growing area of family work.
She further describes her approach in Play Therapy , republished in Within this protected setting the child was free to choose what to do. She used the technique of reflective listening, based on the counselling principles of empathy, warmth, acceptance and genuineness, described in Truax and Carkhuff There is no attempt to direct play or to hurry the child.
Axline and sets out eight principles for non-directive play therapy. She does not suggest anything particular that the child might do. If the child sits in silence, the therapist accepts it and sits quietly too. Praise and encouragement are as inappropriate as criticism and disapproval, since both imply judgment. Axline illustrates her approach. She went into the playroom with Oscar who had reluctantly left his mother. The child leads the way; the therapist follows. It is a gradual process and recognized as such by the therapist.
He cries and tells his mother that he is afraid but she makes him go anyway. And see. He is sinking down and down and down into the quicksand. He tells his mother he is afraid, but she makes him go out anyway and he gets buried in the sand. Perhaps the interpretation is correct, but there is a danger of thrusting something at the child before he is ready for it. Axline b , in Haworth: —3. It underlies her expectation of the child taking the initiative and choosing how to use time in the playroom.
As in all play, freedom is possible only because of the safe limits of the situation. The boundaries consist of time, one hour, usually weekly, and space, the playroom and materials within it. The child is not permitted to hurt itself or the therapist and some limits may be placed on the destruction of materials. These limits are not laid down at the outset but explained to the child as the need arises.
The child is helped to understand that the playroom hour is only part of its life and that the real world imposes other constraints and limits to which it must adapt, whatever it feels. For example, Axline told Dibs he had only three minutes more before it was time to go home. Dibs suddenly stood up. Dibs no go home. Not never! But you and I only have one hour every week to spend together here in the playroom.
No want to go home. No feel like going home. However, as the example of doll play in the sand shows, the therapist does not make direct interpretations of play but stays within the symbolism expressed in play, until the child is ready to move on. Non-directive play therapy is particularly suitable for use by workers who do not have a psychodynamic training. Its drawback is that it can be a very slow process and there may be few workers who have time to offer it.
It offers, however, great hope of recovery to some deeply disturbed children. The child is also allowed to go out. The adult takes responsibility for limits.
You can do anything you like, and we can go outside if you want to. With one child who sat still for 50 minutes the adult copied his body movements and facial expressions; much later he recalled this session as helpful Very occasionally contact is made with a reluctant child by the taker starting to play itself hostessing ; the taker ceases to take the initiative as soon as the child joins in. If the child puts the taker into a role, such as prisoner or monster, the taker takes that role but is ready to drop it as the child indicates.
At all times the adult avoids making suggestions, interpretations or assessments. Students of Freudian psychoanalysis, such as Anna Freud, Melanie Klein, Donald Winnicott and Margaret Lowenfeld, each in their own very different ways, have developed the theory and practice of psychoanalytic work with children. Before starting therapy she aimed to create a loving and caring relationship with the child so that the child would like her and feel dependent on her.
Play was one of the main ways of achieving this. Unlike Melanie Klein who thought that all play was symbolic, Anna Freud believed that it could be a re- playing of real events or even pure exploration. Anna Freud saw playing in therapy as a means of permitting children to talk about conscious feelings and thoughts and to act out unconscious conflicts and phantasies. Interpretation to the child of the symbolism of its play might follow, but only if it was suggested by a good deal of material.
Freud The immature self of the child used the analyst as a model for identification. She did not think a quick, deep interpretation could be lastingly therapeutic. In sharp contrast to Anna Freud, Melanie Klein made profound interpretations to children of the unconscious meanings of their play from the outset. When a child accepted an interpretation its anxiety and guilt would lessen, enabling the symbolic exploration of feelings, free of the fear of damaging real people.
Her interpretations often involved sexual meanings which she did not hesitate 10 offer to the child. It is perhaps this which led many people to reject her ideas, although with the current concern about sexual abuse a re-appraisal may well be due.
She concluded that it was possible to work with very young children. Many of her patients were under five years old and some were as young as two. Klein was probably the first therapist to use a carefully planned playroom Her materials included a large number and variety of miniature toys with many human figures, drawing and painting materials, materials for cutting out, and water. Children directed their own play. If they gave the therapist a part in role play she would play the part allotted.
They might play shops, doctor and patient, schools, or mother and child. Klein comments, In such games the child frequently takes the part of the adult, thereby not only expressing his wish to reverse the roles but also demonstrating how he feels that his parents or other people in authority behave towards him—or should behave.
Sometimes he gives vent to his aggressiveness and resentment by being, in the role of parent, sadistic towards the child, represented by the analyst. Klein, in Mitchell The therapist neither encourages nor disapproves of expressions of aggression but interprets their meaning to the child. Klein set the model for much subsequent child psychotherapy and play therapy. Interpretation of play continues to form a major part of current therapy, although a more cautious approach is adopted in which the timing of the interpretation becomes important.
An understanding of the workings of the mechanisms of projection and introjection and the use of containment, and the recognition and use of the transference, are invaluable methods which can be learned and applied by workers who are not trained in child psychotherapy. The use of direct interpretation to the child needs to be used much more cautiously and only with skilled supervision.
Donald Winnicott and Erik Erikson—play as therapy Donald Winnicott has not only provided a theory of play but has also informed the practice of play therapy. He observed that the pre-occupation of a child playing is akin to adult concentration. In play, children use objects from the real world in service of some aspect of their inner world, and this precarious interplay makes play an exciting and even potentially frightening creative experience see Chapter 1.
Modern play therapy is based on the observation that a child made insecure by a secret hate or fear of the natural protectors of his play in family and neighbourhood seems able to use the protective sanction of an understanding adult to regain some play peace. Grandmothers and favourite aunts may have played that role in the past; its professional elaboration of today is the play therapist.
The most obvious condition is that the child has the toys and adult for himself, and that sibling rivalry, parental nagging, or any kind of sudden interruption does not disturb the unfolding of his play intentions.
Erikson Although Winnicott used interpretation, illustrated in case studies in Playing and Reality and The Piggle , he believed that fundamental psychotherapy could take place without it.
This was as true for adults, he felt, as for children. It could happen suddenly or it could slowly inhibit play. It occurs when painful repressed material is getting too near the surface. The therapist may interpret this to the child, trying to put its experience into words to increase its insight. Erikson used quite deep interpretations—for example, a child who built a rectangle of inward-facing dominoes was helped by the interpretation that it was his coffin. However, the level and timing of interpretation was crucial.
Winnicott saw that playing might reach its own saturation point at which the child could not contain any more experience. Erikson recognized that play therapy does not take place in a vacuum but that social context is crucial. Play therapy could only be successful where there were social and cultural reinforcements, both in the family and beyond.
This could be denied, for example, to a black child in a white culture. Items included figures of people, soldiers, wild, domestic and farm animals, houses, cars, boats, fences and trees. She would tell children to use pictures in their heads to construct their world.
When completed she asked the child to explain it to her. A child often built a volcano, representing internal turmoil, at the point where it had stopped getting rid of its bad feelings by projection.
The make-a-world technique has been borrowed and adapted for wider use. Sally Maxwell provided a sand tray with miniature toys, in a separate small room, in a Camden Family Centre. Children were offered regular opportunities to play there on their own with an attentive adult. The role of the adult was reflective listening, re-capping what the child was doing as it played Pinney The first two times the child makes a world it is left at that.
Children may use a symbol, such as a monkey or an elephant, to represent themselves. Newson suggests following a make-aworld session with drama play described later. It focuses on the creative processes of drawing, painting and three-dimensional work. Children may be exploring and playing with art materials as well as using them to create an image. Art therapist Susan Tumer finds that painting and play offer the child A way to objectify and express thoughts and feelings, to experiment with relationships, to find new approaches, or to absorb and grow through past experiences by making a symbolic form in which the experiences can be safely contained and re-experienced and in time healed.
Furthermore, strong statements can be made in an acceptable form, for example, aggressive, non-acceptable behaviour can be expressed in a painting where it can be worked through. It is also true to say that if the child needs to be destructive in his painting he also has the opportunity to take action and to restore in the art work what he needed to destroy for a time. This can be very helpful in enabling the child to overcome his fears of being overwhelmed by negative emotion.
Like many peripatetic workers she may not have the use of a room specifically designed for her work. She sets out art materials for the child at the edge of a large plastic sheet on the floor and sits herself on a low chair close by. In the session her intervention and active involvement will vary depending on the needs and circumstances of the child. In painting, the child takes the responsibility to make choices and to institute change. Gillespie continues: After she discovered I had conferred with her family, she drew a fortified castle, warning me to keep our special relationship defended from outsiders.
Twin-towered it stands, surrounded by its moat, door securely barred, alone in a large hilly countryside. Outside stand two riderless horses, one brown, one white like us , saddled and waiting until we are able to continue our journey. Jefferies and Gillespie Art therapy helped Sonia to cope with deep levels of emotional pain, freeing her to benefit from relationships offered by her foster parents and her social worker.
It can be helpful to children, and adults, of all ages, and is often acceptable to older children who feel too grown-up to play but may not be able to cope with talking therapies, It is used in work with children in a variety of contexts, including under-fives family centres, child psychiatry, black children, children in hospitals, assessment centres, residential special schools, described in Case and Dalley , and family placement Gillespie A more general introduction to art therapy is Dalley While it is a specialized field and art therapists expect to nurture and be fed by their own creative art process its basic approach can be used by others.
She describes how year-old Mark, about to return home from care, drew a picture of pointing fingers, illustrating his feeling that dad had always called him a thief and his fear that his step-mum did not want him, and an exploding bottle. The worker did not need to speak. The therapy of drawing had enabled the child to put his feelings into words where they could be thought about. Relevant play materials were offered at frequent intervals so that the children could overcome their fears by repeatedly playing out the situation provoking them.
For example, a child afraid of using the potty would be offered dolls and potties to play with. Today the use of focused play is more varied. Jewett suggests an open-mouthed dinosaur, a van with sliding doors that can take people and furniture, a hulk-like figure and a police car, to help children to play out angry feelings and re-play their experience of loss and separation. Alternatively the worker may be more active in directing play, either openly or more subtly. The worker may introduce play themes through participation in pretend play, or may ask children to talk to the figures or puppets they are playing with or drawing and ask them to speak as the figure, or write letters to them.
The theory behind them is that it is more useful to help children to deal with their present feelings than to go back to early traumatic experiences. Oaklander suggests many fantasy and projective techniques.
For example, children might be asked to draw their family as symbols or animals, to go on a fantasy journey, perhaps in a guided fantasy, and draw their room or the place they get to, to create their own world, or a particular feeling, on paper, just using shapes, lines, curves and colours, or to draw themselves as a rosebush or a boat in a storm. Older children might be asked to choose a toy in the room and then to imagine that they are it, describing how they are used, what they do and what they look like, and what they want to do.
In another projective technique a child might be asked to draw a house symbolizing the mother , a person the father and a tree the child Sluckin He would draw a random squiggle and ask the child to turn it into something, then in turn ask the child to draw a squiggle which he would then complete.
Ecomaps, picture genograms or illustrated family trees, picture flow charts and time drawings are widely used Figures 2.
Card and board Figure 2. A child may be encouraged to draw or paint its family or some aspect of its life. They deal with conscious or near-conscious feelings rather than deeply unconscious ones.
These focused play techniques will be discussed further in later chapters. Some focused approaches border on non-directive play. The worker sits on the floor and waits to be asked to join the game. Toy telephones are provided to ease communication. Otherwise the child is free to direct play and people within safe limits. Clare Winnicott warns against going ahead of children and verbalizing or interpreting feelings before children have shown that they are ready to think about them.
She reassures us that children work things out in their own way. With angry and hostile children, whether anger is expressed overtly or by passive indifference, adults must meet and survive their hostility, even when feeling out of their depth and not understanding.
Later the worker can help them to put their feelings into words. Such an approach can be effective, especially with younger children. The child with the fire engine replied that since his dad had been away his mother expected him to do everything! What does it say? Where they are ready for it children are helped to go beyond symbolization to conceptualization of their feelings, becoming able to reflect on them, developing a stronger self-awareness and self-esteem, and helping them to reach integration.
Sensory and regressive play Some focused methods work at profoundly unconscious levels. Chief among these are sensory and regressive play. These can help children who have suffered severe deprivation and loss, as well as children in hospital and children with learning difficulties. Children have often either withdrawn and isolated themselves from contact with their environment, or else, particularly in the case of abused children, submerged their self to accommodate adult expectations Thom They have blocked off the feeling part of them and hence do not have the means to know what they feel or the tools to express these feelings.
Simmonds, in Aldgate and Simmonds Children can re-learn to become aware of their bodies and their contact with the world around them. Violet Oaklander has been the source of inspiration for much recent sensory work, especially by social workers for children in care.
She gives the example of the girl who cannot tell hot from cold; on a hot day she sweats in heavy clothing and does not think of taking any off. Her senses are blunted, a sign of her low self-esteem.
Work might start by asking about the kinds of textures she likes and dislikes feeling. Each week she concentrates on one of the senses—touch, sight, sound, smell and taste. Day-to-day opportunities for sensory experiences are seized, and foster parents or carers are asked to follow up each session in an enjoyable way with similar experiences.
Her programme includes the following ideas: Touch—Relaxation and breathing exercises, paying attention to different sensations. Explain what we will be doing. Begin by exploring our own bodies, touching ears, toes, hair.
What can we feel? How do we feel? Touch a collection of objects made of wood, rubber, rock, sponge, fur, silk, tissue, cotton wool and face cream, talking about how they feel and using words such as bumpy, fluffy, sticky, warm, prickly, spongy, hairy, freezing, tingly. Use clay, sand and water trays, taking time, and touching with hands, feet or noses.
Use finger paints and talk about touching and feeling. From a bag of hidden objects, ask the child to find things that feel soft, hard, silky, etc. End the session by discussing what we have done. Ask carers to continue exploring touch during the week, in the house and outside, with grass, trees and earth.
Sight—Begin by looking around the room, then look at each other, and then look in the mirror, describing what we can see. Choose an object in the room to look at and draw from memory. Look at objects through a magnifying glass, Cellophane and water.
Dim the lights and then have bright light.
0コメント