an orientation to play therapy

An Orientation to Play Therapy

Stephanie Pratola, Ph.D.January 11, 2012

KidS Group

Characteristics of play Action

oriented (real or imagined)

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2012 12:15

Characteristics of play Spontaneou

s, self generated – intrinsically motivated

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Characteristics of play Not too serious: Not goal oriented

Characteristics of play Not good or bad: it just is

Characteristics of play No rules - flexible

Characteristics of play Non-literal:

uses fantasy or imagination

Use of symbolic objects

Characteristics of play Don’t have to be “good” at it

Characteristics of play Fun

Characteristics of play Involves loss

of self consciousness

(induces the state of “flow”)

Characteristics of play Play is the “medium” of children

Characteristics of play Play is intrinsically therapeutic

Characteristics of play Functions of play beyond to have fun are unconscious 13

Stephanie Pratola, Ph.D... 2012

Association For Play Therapy Multidisciplinary professional

organization Promotes play therapy Has developed a credentialing

system Promotes and sponsors training ,

now including university level Promotes research of treatment

efficacy and development of best practices.

Rationale for Play therapy-

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Children naturally use play to Develop basic kinesthetic skills

Children naturally use play to: Learn to relax and release energy

Children naturally use play to: Explore their environment

Children naturally use play to: Master unfamiliar situations

Children naturally use play to: Develop an

understanding of their world

Children naturally use play to: Master Conflicts

Children naturally use play to: Soothe and Distract Themselves

Children naturally use play to: Develop a sense of self separate from others

Children naturally use play to: Understand societal roles

Children naturally use play to: Learn to cooperate with others

Play Therapy There is no one school of play

therapy

All play therapy has in common Emphasis on

a relationship that honors play

All play therapy has in common:Use of

techniques designed to harness the natural therapeutic power of play

Other “Common features” of Play Therapy: Use of “play” interactions and

activitiesCharacterized by

Action- real or imagined Imagination Use of symbolic objects Creative productions Value on process rather than content

Other “Common features” of Play Therapy: Communication in the play

interaction that is Developmentally appropriate Metaphorical/symbolic

Developmental considerations: (for example)

3 year olds begin symbolic play; 4 year olds can draw representational

pictures Importance of how trauma is encoded Capacity for fantasy Defensive vulnerability as related to

cognitive development

History of Play Therapy There is no one school of play

therapyAnalytic: Anna FreudJungian: Sand tray therapyRogerian: Axline – non-directive

Gureney – FilialCognitive Behavioral – Integrative/Prescriptive/Multimodal

2012 12:40

Schools of Play Therapy differ on several dimensionsDirective vs. Non-DirectiveStructured vs. UnstructuredLevel of verbalizationChoice and use of toys and materialsWho is present in the session: parents, family, peers, individual

Directive vs. Non-Directive

How active is the therapist in directing the play in the session.

Non-Directive play therapists typically deal with individual children or teach filial therapy to parents.

Structured vs. Non StructuredA dimension of Non-directive therapyTherapists from a cognitive behavioral orientation, for example, are highly structured.Theraplay is another highly structured type of play therapy intervention where the therapist plans the session following an assessment of the client needs. 38

Level of VerbalizationAnd ….interpretation…..Non-directive play therapists will use words to reflect what they observe in the play.

Most play therapists deal with conflicts, etc. in the play relationship

Choice and use of toys Psychoanalytic play therapy: each child has a

small collection of toys kept for their entire course of therapy

Non-directive therapy: a variety of items consistently available

Sandtray therapy: a large collection of objects and sand trays

Cognitive behavioral/PCIT/ Eco-systemic/Integrative/Prescriptive: Therapist choses games and toys specifically brought in for each session.

School of Play Therapy

Associated with….. Therapist stance Use of Interpretation? Toys

(Client Centered)Axline

Axline, Non-directive/Unstructured

No A wide variety

Psychoanalytic

Freud, James Non-directive/Unstructured

Yes A limited number

Existential Moustakis Non-directive/Unstructured

Yes A wide variety

Theraplay Jernberg Directive/Structured No Selected by therapist

Adlerian Adler, Kottman Directive/Structured Yes Selected by therapist

Cognitive-Behavioral Schaefer Directive/Structured No Games/ therapeutic activities

Eco-systemic O’Connor Directive/Structured Yes Selected by the therapist

Gestalt Oaklander Directive/Unstructured No Selected by the therapist

Jungian Lowenfield Non-Directive/Structured

Yes Sandtray and objects provided 41

Clinically Play can be used to:

1. form a relationship2. assess child’s thoughts, feelings, beliefs,

expectations, skills, reactions3. communicate important ideas: 4. challenge and teach new skills5. provide opportunity for something different to happen

in an interaction6. help child make connections, understand self and

motivations of others. 7. dissipate energy and cope with overwhelming

feelings.

A word about PiZZaZz Pizzazz is a dramatic, energetic and

playful response to your child.

Pizzazz is an attitude that clearly communicates “we are playing now” …it is sort of an induction into the playful mode.

Pizzazz energizes both the pizzazzer and the pizzazzee.

Beginning a Play Therapy

Relationship

2012 1pm

What the therapist does: The goal of the therapist is to create a

trusting relationship by giving close attention to the child’s sharing of his thoughts and feelings through play. The attitude of the therapist is intensely interested, open ad accepting of the child. In child centered play interactions the therapist relates to child in a way that is different from how people usually relate to children. Here the child determines the direction of the interaction. The therapist follows and reflects the actions, thoughts and feelings that the child shares. 45

Talking “ to a child in play1. Avoid direct, intrusive questions2. Child takes the lead, directs the action.3. Describe what you see out loud (explained below)4. Accept creations without judgment5. Use “I wonder” statements6. Be animated, energetic, dramatic – show PIZZAZZ7. Don’t take play personally or literally.8. Communicate “in role”9. React to the child’s feeling level:

a. “That monster sure is scary”

b. “I’m so sorry your dolly is sick”

Description Involves following the child’s actions with

descriptive statements. This is particularly useful when a child is non-verbal and/or very tentative in their play.

Example: “You’re getting all the dolls together” “You’re being very careful with all those toys.”

Avoid judgmental comments: “What a good job.”

Role Play Practice Activity Divide into threes: child, RPT and RPT-S

Stephanie Pratola, Ph.D... 2012 48

Registered Play Therapist Must be a licensed Mental Health Practitioner Master’s degree or Higher APT designated core graduate coursework 2 years and 2,000 hours of supervised clinical

experience 150 hours of play therapy specific instructions 500 hours of play therapy experience ; 50

hours of play therapy supervision Renewal: 18 hours CEU every 36 months.

Stephanie Pratola, Ph.D... 2012 49

Registered Play Therapist-Supervisor RPT requirements plus” Additional 3 years and 3,000 hours of

supervised clinical experience 3 years of post licensure practice Additional 500 hours of play therapy

experience 24 additional hours of supervision

training or be a state approved supervisor

18 hours of CEUs every 36 monthsStephanie Pratola, Ph.D... 2012 50

an orientation to play therapy

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