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PROGRAM HIGHLIGHT: Playing and Doing Play Therapy

10/1/2019

1 Comment

 
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There is an age-old question clinicians hear all the time – “What do you DO with the kids in your office?”  A clinician typically takes a gulp and wonders…what AM I doing?  PLAYING?!?!?
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Over the years, I have decidedly used play therapy as the primary model of working with kids in therapy.  Play therapy is tricky to explain, since it can look a lot like simple play.  A client and a therapist can be deep in the throes of a storyline that involves different races of dinosaurs battling each other to the death, spies who turn out to be counterspies (who turn out to be counterspies), and babies who require care but are also very annoying.  Or a client can play Uno for several weeks, always changing the rules so that they win at the very end after a long, drawn out game.  Or a client tells lie after lie, spills toys carelessly, and asks to open every drawer in the therapy office, saying they will never come back for therapy.  Some of this looks like fun, boisterous play and some can be more coy and mischievous acts.

In play therapy, it doesn’t matter so much what the actions may be.  We are playing.  What makes it a therapeutic intervention is how the clinician responds to the client and how the space and time is held intentionally.  I found a straightforward infograph that highlights what the difference is between play therapy and play.  I use this often, in supervisions and as a reminder to myself.
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The use of play therapy is based on the belief that the child is processing things through  play.  The idea is that play is never without important meaning, nor is any play by chance or without aim.  Children use play to communicate, think through things, experience new situations, and inform their internal working models – the way they understand the world around them and their place in that world.  The second important aspect of play therapy is the adult relationship.  The experience of having an adult who has suspended judgement, is not moralizing or trying to formally teach, while remaining curious to allow the child to figure things out, control the story, or try different personas is a special interaction in therapy.  If both pieces- free play and a holding adult relationship- are present, play therapy presents limitless ways for kids to experience disconfirming stances.  “Disconfirming stances” are ways that we can support someone to have a new experience of themselves and the world, a chance to shift their internal working model if it’s become stuck or has resulted in unhealthy beliefs and behaviors. These disconfirming stances can be broad – like one client who witnessed severe violence in his family and arrived at the conclusion through play that love does not require you to destroy yourself to prove your love- or it can be very specific like the client who wanted to see different ways of playing games to make and keep friends.
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Play therapy is a fantasy place, where adults don’t have to push an overt agenda, hold to a list of action steps, or make sure to check for understanding from the child. It takes a lot of intention to not take the invitation to focus on how to correct or change a child’s behavior especially with the emphasis on teaching more observable behaviors like classic coping skills.  But the processing of the underlying needs of problematic behaviors is an important aspect of treatment that needs to be addressed for lasting health and strength.  Play therapy offers a space where these underlying needs (questions about what happened to them, what their self-identity is, what the rules of relationships are) can be addressed to support shifts in internal working models that inform our behaviors over time. This is, in essence, the process of changing from within.

In our school partnerships we have an opportunity to use multi-tiered supports as well as multi-leveled clinical interventions to address entrenched problematic behaviors.  In a world that values the effectiveness of CBT and skills based programs, please don’t forget to consider play therapy as an effective intervention that can give a new avenue for our students and clients to play with the prospect of change amidst limitless possibilities.
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Blog Post Written By: Julie Kim, Clinical Supervisor
1 Comment
Lihi Rosenthal
10/1/2019 06:21:48 pm

I love this so much!!! What’s wrong with the therapist’s office being seen as the most “playful” place on campus? Thanks Julie!

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