You can discover more about a person in an hour of play than in a year of conversation” – Plato
What is Play Therapy?
When an adult encounters a challenging situation, we often analyze it, think about it from different perspectives and talk to others we trust and get advice. But children are different. When they encounter a tough problem, they don’t always have the ability to problem solve, let alone, communicate what’s going on to someone else. That’s where play therapy comes in. Play therapy is a developmentally sensitive model that acknowledges that children naturally communicate through the language of play. Before the age of 11-12, the brain does not develop the capacity for abstract reasoning and thought, and therefore, it is difficult for children to express themselves in words (Paiget’s theory of child development). In play therapy, we create a safe atmosphere where children can express themselves through play, experientially “play” out new roles, learn social skills, and work through their problems. This gives children the opportunity to learn to solve problems, explore different ways of reacting and change maladaptive behaviors.
Does my child need Play Therapy?
Throughout their lives, most children experience a stressful event, trouble making friends, or adjusting to changes at school or home. Some children need more help than others to get through these times. If you or other adults in your child’s life are concerned about your child’s behavior, play therapy can help. It gives children an outlet to express themselves through a safe medium of play. In addition, by speaking with the play therapist in parent consultations, you will gain a better understanding of what your child is going through.
What type of child benefits from Play Therapy?
Play therapy can be a successful medium for many children. Children that benefit from this approach are children that struggle with trust or opening up to adults and/or other children or appear withdrawn or introverted. Play therapy can also be a successful medium for attention seeking and aggressive children. Play therapy is also a good fit for children with language challenges such as learning disabilities or selective mutism because a play therapist knows that children can communicate their feelings without talking about it, and instead by playing in a particular way.
What is it like in the playroom?
The playroom provides a child-friendly environment equipped with an extensive range of therapeutic toys and art supplies. These toys are carefully selected to allow your child to play out themes of real life, safely express their feelings and allow creative expression.
How do I prepare my child for their first Play Therapy session?
Tell your child that they are going to meet (insert therapist’s name) in a special playroom with lots of toys each week. You might also add, “when things are hard for you at home (and/or school), sometimes it helps to have a special place to play and feel good about you.”
As a parent, what should I expect from the Play Therapy process?
At our office, we believe you as the parent are an important part of your child’s healing journey. You may feel at a loss of how to best help your child. We like to invite you to your child’s sessions. As the therapist gains insight into why your child is struggling, you get to learn right along. You will also learn the tools to help your child process their emotions and help regulate your child, so you are equipped to help your child throughout the week, not just an hour a week in therapy.
Your therapist will meet with you for 5-10 minutes at the start of each session to learn your perspective on your child’s triggers from the week, so she/he can be intentional on what can be worked on during session that day. Following this, you and your child will meet with the therapist together. The play therapy will be focused on your child’s needs, and you will be invited throughout the session to engage in ways that will enhance your child’s healing process.
Research shows play therapy is more effective when the parents and therapist work collaboratively. We believe you are the expert on your child. We also ultimately would like you to be the one your child leans on emotionally and tells her secrets to, more than their therapist.
In cases of divorce or other unique circumstances, we do suggest the child see their therapist individually without their parents. Some children may not want their parents in their sessions and we are sensitive to cases where the child may need their own space.
What happens in a Play Therapy session?
We use a variety of Play Therapy techniques at our office.
Child-Centered Play Therapy One established method of play therapy that many of our therapists use is child-centered play therapy. Child-centered play therapy gives children an open play space to “play out” and express their feelings with a facilitative coach, the therapist. Just as adults want to direct how and what they talk about in counseling, children also need to express themselves naturally during sessions. This method is effective with young or resistant children or children who aren’t yet ready for “talk therapy,” and as an adjunct to other child therapies.
Prescriptive Play Therapy Another play therapy used in individual therapy and group counseling is structured play therapy. This involves setting up expressive activities and game play to help children work through particular issues and address developmental needs. With this treatment, the therapist chooses the most appropriate activities or games in order to facilitate targeted skill development. We use this approach with children of all ages, in groups especially, and in combination with other child counseling approaches.
Theraplay and Filial Play Therapy Two additional parent-child treatments we often use are Theraplay and filial play therapy. Theraplay promotes positive interactions through nurturing activities between parents and their child with the goal of strengthening the parent-child bond. Filial play therapy is an approach in which the therapist trains the parent in therapeutic play techniques and provides practice play therapy sessions with the parents and child together. This model is most effective for parents who want to enhance their relationship skills with their child and address emotional issues through a positive play therapy program in the home.
Both of these models are effective with children who are sensitive or anxious; dealing with transitions; or are having problems with their behavior, emotions, or social relationships.
Cognitive Behavioral Therapy for Children Cognitive behavioral therapy (CBT) for children is an evidence-based approach of “talk therapy,” where children participate in understanding their feelings, sharing their thoughts, and identifying their behaviors. We will integrate games, art, and play to help children develop a feeling vocabulary and to begin to understand that “feelings aren’t facts,” and “thoughts and feelings influence actions.”
This process helps children identify their emotional triggers, notice their thinking errors, and replace their negative thoughts with positive thoughts. Our goal is to help children cope with the impact of anxiety or depression, improve low self-esteem, manage a difficult temperament, and unlearn negative behaviors acquired from difficult life situations.
We practice these new skills during our counseling sessions with children, and often assign “practice sessions and activities,” for parents and caregivers to try at home with their children in order to help children apply newly learned skills to their home and school lives.
Cognitive behavioral therapy is also a primary treatment method used in our group therapies for children. We combine CBT with play therapies, including art and games, to help children practice new skills with peers. This helps children practice skills and take home what they’ve learned in group to use in their friendships and social situations.
Group therapy for children is often a way to add to a child’s individual therapy program so that they have another venue in which to practice; it can complement individual therapy or serve as a way to step-down a child’s treatment.
What’s the difference between Play Therapy and playing with my child at home?
Play therapy is not the same as playing. Play therapy uses your child’s natural tendency to “play out” their feelings, worries and life situations in the presence of a specially trained play therapist. The play therapist helps the child to feel accepted, understood and gain a sense of control or understanding about difficult feelings or situations.
How does Play Therapy work?
Recent brain research has told us that the brain has “neuro-plasticity” which means it continues to mold and grow based on experience. Of course, personality and temperament are somewhat determined by genes, but the primary agent of change within the brain is through experience.
That’s why play therapy works! It works at an experiential level, giving children the opportunity to play out real-life situations in the context (and safety) of the play in order to gain understanding about themselves and the world around them.
Check out articles that explain the research behind the efficacy of Play Therapy by clicking here.
How long does a child receive Play Therapy?
The length of time a child is seen in Play Therapy varies from child to child. The research shows that a minimum of 20 sessions is recommended, with most long term changes occurring at closer to 40 sessions. Though some children show significant changes and progress before 20 sessions. It depends upon the child’s personality, the intensity of the presenting problems and implementation of other environmental supports (for example, suggestions that parents receive in parent consultations to help support progress). The therapeutic progress will be discussed during parenting sessions, usually suggested every 4-6 weeks, or as clinically indicated.
EMDR Therapy for Children
EMDR should only be performed by a trained clinician who understands the complexities of trauma and who is prepared to manage any adverse reactions that might come up. It can be a great treatment option for adults and kids.
What is EMDR? EMDR is a type of mental health treatment that stands for Eye Movement Desensitization and Reprocessing. Whoa! That’s a mouthful and one of the reasons that the abbreviation is used so commonly. Also, because the name itself is kind of scary. Eye movement and reprocessing?!?
Common Concerns About EMDR So, when you tell kids what EMDR stands for, they immediately think that you are going to touch their eyes, or somehow mess with their vision, or make it difficult for them to see. Or, they think about reprocessing and are afraid that you are going to erase their memory or take away some part of their brain. Obviously none of this is true and the creator, Francine Shapiro, has stated that she wishes that she would have chosen another name for this therapy. Nonetheless, EMDR does not “mess with” your eyes or vision and it does not “erase your memories” or do any special magic tricks.
What is EMDR for? EMDR is usually associated with trauma-most frequently with combat veterans. But, it’s really for anyone that has been through a life threatening or severely frightening experience. For that reason, it is often associated with the diagnosis of Post Traumatic Stress Disorder. But, even more simply, it can be effective for any distressing or disturbing memory or life event.
So, the short answer is that EMDR is especially good at dealing with BIG trauma (abuse, rape, violence, war, major injuries, etc) but can also be extremely effective at dealing with LITTLE traumas (change in schools, divorce, bullying incident, something embarrassing).
Who is a good candidate for EMDR? Most anyone can be a good candidate for EMDR. There is a myth that EMDR can only be used on adults. That is simply untrue. EMDR can be used with children (even pre-verbal children in some cases). The only people who are not good candidates for traditional EMDR are people who score high on a screening tool for Dissociative Disorder. More than likely, your child does not have Dissociative Disorder. But, your clinician should do the screening anyway.
Dissociative Disorder is characterized by a breakdown in memory, awareness, identity, or perception that can sometimes develop as a defense mechanism for dealing with trauma. People who have this diagnosis require an even more specifically trained clinician in order to receive EMDR therapy.
More Details About EMDR Therapy: After the initial screening, there are follow up sessions to prepare the child to manage trauma symptoms. This is similar to other therapy models and includes mindfulness techniques, creation of safe/relaxing images, and other positive coping skills needed to manage stress.
The therapist then helps the child to select a target memory that causes them distress. Typically, this is a part of the traumatic event that feels “stuck” or “frozen.” The child identifies a negative thought that often comes up when that memory is accessed. Thoughts might be things like, “I am a bad person” or “It’s all my fault.”
Next, the therapists asks the child to think about that distressing memory while doing something else. That something else is called Dual Attention Stimulation (also known as Bilateral Stimulation).
The Key To EMDR: Dual Attention Stimulation Dual Attention Stimulation is where the Eye Movement stuff comes in. When this therapy was created, this meant moving your eyes back and forth (following the therapists finger) while thinking about the trauma.
In our office, we use a little device we therapists refer to as “the buzzies.” Want to see the buzzies in action?
Watch this Youtube Video
How the Buzzies Work: The child holds one in each hand and they gently vibrate back and forth (in the left hand and then in right hand). Most kids find these to be very relaxing. It is not a shock therapy and it is not painful at all.
Other forms of Dual Attention Stimulation: Headphones that alternate beeps in the right ear and then the left. Tapping your arms on the right and left side (aka: The Butterfly Hug). Alternating taps with each hand in the sandbox. Throwing a ball back and forth with each hand. Swimming (not in my office…but it has been done elsewhere). Throwing a ball back and forth while thinking about something distressing doesn’t sound nearly as scary as “eye movement desensitization and reprocessing.” But it works in the same way.
DISCLAIMER AGAIN: EMDR should only be performed by a trained clinician who understands the complexities of trauma and who is prepared to manage any adverse reactions that might come up. Remember, any feeling that was felt during the trauma might come up during this therapy. Don’t assume that just because this sounds simple enough that you can do this therapy on your own.
That being said – sometimes Dual Attention Stimulation by itself can help kids relax when they are angry, frustrated or scared. If a child is really mad about something, parents should recommend that their children go for a run, take a swim, or dribble a basketball. It can help reduce the intensity of the emotion. But it is not EMDR. Practicing using Dual Attention Stimulation during times of stress is often given as homework or practice between therapy sessions.
Other Parts of EMDR Another critical component of EMDR is pairing the distressing image with a more positive thought. Something like, “It’s not my fault” or “I’m OK now.” The memory is still there. The event still happened. But instead of thinking about it and feeling bad about yourself and having a negative reaction in your body, you feel neutral. People often say, “The memory is there. It happened. But it doesn’t bother me anymore.”
Final Thoughts: EMDR can be especially helpful for kids who have been through other treatment (like TF-CBT) and found it ineffective. It’s really good for kids that “don’t want to talk about it” because it does not require the detailed retelling of the trauma the way other therapies do. Not always, but often, it can be effective in just a few sessions (1-3 sessions and some children are feeling significantly better).