She’s only playing! How Play and Play Therapy can

Transform UsDr Maggie RobsonSenior LecturerKeele UniversityUK

Overview• explore the transformative effects of

play on our development and mental health

• Look at children playing• consider observations of the play of a

group of Kenyan children who took part in a research study

• explore how play therapy can help both children and adults therapeutically.

• invitation to engage in play

Importance of Play

’children’s …play has been hypothesised to contribute to the cognitive, motor and social development of children, including the development of perception, attention, memory, problem-solving skill, language, communication, creativity, logic operations, emotion regulation, self regulation, social skills, gender roles, social relationships, conflict resolution, coping with stress and so on.’(Power, 2000)

Children PlayingWatch short clip of children playing in

Nairobi, Kenya

What functions do you think it is fulfilling?

Why is it important to study play?

1. Play is a fundamental right of all children and recognised as such in Article 31 of the United Nations Convention on the Rights of the Child

(Office of the United Nations High Commissioner for Human Rights, 1989).

2.Play is important in child development

3. It is the theoretical base of play therapy & the theory of play rests on observations of European children

Source: http://kabiza.com/images/aochildren2.jpgAccessed 19th March 2009

Transformative Effects of PlayThe “natural language” of children is play. Play is more than recreation. It is an activity whereby children can process experience and assimilate that experience and make some sense of it. Children have little choice; they are compelled to play

“In the process we change ourselves and our view of the world. We dare to change because our autonomy is not challenged or threatened. On the contrary, the process of playing gives the glorious sensation of increased autonomy. Play can be deeply satisfying. As it is with adults so it is with children. Yet children’s needs to play are greater since their autonomy less” (McMahon, 1992, p.1.)

“Play under the control of the player gives the child his first and the most crucial opportunity to have the courage to think, to talk and perhaps even to be himself” (Bruner 1983)

“Play is a unique experience in our lives that has a reality of its own, an activity in which human beings explore their worlds and their identity in relation to other worlds and identities. Play is the place where children first recognise the separateness of the self from others and begin to develop a relationship with the world beyond the self” (Cattanach, 1995)

Nuffield Research Foundation Funded Research Project

Small grant to:1.Collect rich descriptions of children’s play2.Pilot an observation scheduleIt is hoped to use the data gathered here to conduct comparative studies in Europe, the US and other parts of Africa

Child (Aliases) Age LocationMary 8 years Outskirts of Nairobi –

between Kibera slums & modern Olympic Houses

Jed 8 years Kibera slums

Joseph 9 years Lavington District

Dotty 10 years Buru-Buru Estate

Shiro 8 years Nahashon

Mike 9 years Nyanza Province, Bondo District

Eunice 10 years Vihiga District

George 8 years South Nyanza Province

ObservationsEach child was observed by a pair of observers 4 times for approximately 45 minutes each time: 2 different times in school2 different times at home There were 4 urban children and 4 rural children – 16 observations in total

Kenyan Children & Piaget

All the children were between the ages of 8 & 10 so we would expect them to be playing make believe, symbolic play & games with rules. They did!

• Jed -They are playing a game called Kati. Two girls hold play. The have a ball and they try aiming and hitting the girls in the middle if you are hit by the ball then you are out of play and have to be rescued

• Dotty - Some children who have been brought to the line are saying we are the policemen and some are saying we are the robbers. Dotty’s turn reaches and she is brought to the line and she says, ‘am a robber.’ When everybody is on the line, they count, one, two, three…..ten. Then they all run scattering in different directions. The police are chasing the robbers. Dotty is a robber. She has been caught by a police but she breaks loose.

Differences in Play: Rural & Urban

Qualitative data does not aim to generalise but there did seem to be commonalties in some of the observations:When playing at home, rural children and children from the poorer urban homes tend to play more made up games and the urban children who came from more comfortably off homes seemed to have more technology based e.g. playing while watching TV

Differences in Play: Rural & Urban

Rural Home & Poorer Urban Home• Shiro has a few friends around her

at home, three boys. She has taken a stick and has a tin. She hits the tin and a boy comes, picks it up, and runs away with it. She is hitting the tin after the toys; however, it is holding the stick in the mouth. A fourth boy has come to join.

• Eunice gets in to skip and this time they sing along a song called Jimmy do You Love Eunice? She skips and skips and skips as the brother swings the rope (This game entails questioning and where the rope stops as you skip is what becomes the answer to the question. Some of the choices available were, Nyumba ya nyasi, mabati, simiti-Utafanyia wapi harusi? Where will you wed? Church, toilet, bafu, Utakuwa na watoto wangapi-10, 30, 40, 50,60etc)

Urban Comfortably off Home• . Joseph has put it (the car)

upside down indicating that the car has rolled and awaiting help, looking at it, he has stopped driving to watch Television, a cartoon program about spider man is running. He momentarily recovers the overturned car back on the road (table)

• Mary keeps looking at the Television and mouthing the remote control then she plays with it. She talks to her sister, telling her she has many things.

Taking on adult roles in RuralAreasEunice (10) has taken her lunch and also made sure she has given food to younger brother and sister. Her parents left in the morning.Eunice is called by the grandmother to attend on house chores. She is cleaning some basins. She carries the basin to go and wash. Carries the cloth for washing. She finally finishes washing George (8) comes out with a bucket of water. He then brings out a sack and pours its contents on the ground. They are sweet potatoes. All this is happening outside his uncles house. He picks a potato at a time and washes. He scrubs the potatoes very thoroughly and puts the clean one on a separate piece of rug….. He continues to wash the sweet potatoes. They are talking about the war between the Luos and the Maasai. They talked about how the attacks were scary. (George’s home is at the border of Maasai and Luos)

Mike (9) tells us that at this time they don’t play coz they have roles to play. They carry Jeri cans to go fetch the water. He goes for the first trip comes back and empties into the big drum in the next room. His bro joins him and the go the next trip together. They come back and empty again into the drum in the house again. Go for another trip together again and do the same routine. When they come back, he doesn’t go the next round but his brother goes to fetch the water. He sets his waters outside but his brother empties into the big drum in the house. He starts removing the utensils one after another. He places them where he had put the water. He moves from room to room looking for the dirty utensils. He locks the door and goes to the shop. He tells us he is going to the shop to buy soap to come and wash utensil. He says that they usually take turns in washing the utensils. He tells us his brother will cook food. Their mum has gone to the market to sell food stuffs for money. He has a very serious face at this time. He comes back and washes the dishes one after the other until they are all over then he takes them to the house.

Onto Play Therapy

Cattanach (2003) argues that:

‘When children play imaginatively, in whatever context, they create a fictional world, which can be a way of making sense of their real world’

Paul’s Story• Paul was 6 years old and was referred for play therapybecause his long

term foster placement had broken down and he seemed to be experiencing behaviour problems due to loss triggered by this experience.

• Paul was placed under a care order when he was a young baby. His mother physically neglected him and he and his elder brother were placed in care. His father was a drug addict and disappeared shortly after Paul's birth.

• Paul was placed in long term foster care but this placement broke down, allegedly because of Paul's unmanageable behaviour at home, shortly before Christmas 1997 and he was placed in another long term foster home. His brother remained in the original foster home and at the beginning of therapy, Paul visited him and his previous foster parents on a regular basis.

• Paul also has regular contact and visits with his birth mother but has not had any contact with his father since he was born. His father died in a drug related incident just before commencement of the therapy.

• Because of his contact with his birth mother, Paul knew his foster mother was not his real mother but the Social Worker thought he believed that his foster father was his real father.

Paul had 11 sessions of play therapy over a four month period.

Themes of the PlayThe major themes of Paul’s play have been the balance between destruction and nurture and being in and out of control. Much of his play centred around a wolf who was sometimes defeated by him and sometimes defeated him. In this play, sometimes the wolf was imaginary – we would both ‘hear’ him approaching – and sometimes one or other of us would take on the role of the wolf.

Second SessionThe themes in the second session seemed to be centredaround excess and containment. There was a sense of him grabbing as much of everything that he could, while he could –biscuits, paints, toys. The wolf appeared again, as did the 'mind your own business' photo game. Again, my role was of containment and holding the therapeutic space whilst accepting and reflecting on his play. These themes appeared consistently throughout our time together. Watch short excerpt

Process of TherapyThe fourth session seemed to be something

of a turning point. The previous session had felt quite wild and verging on being out of control. I had had to speak quite sharply to Paul when he tried to get out of a moving car on the way back to school, and had told him that if he couldn't keep the rules we would have to discontinue the therapy.

Process of Therapy• concerned that I had spoilt our relationship and that he no longer

trusted me. • was concerned that I had introduced an element of conditional

regard into the relationship. However, it was important to keep Paul physically safe as well as psychologically safe, and he could not be allowed to endanger himself.

• Perhaps because of congruence in explaining my behaviour was the result of concern for him

• Perhaps because he felt safer because the boundary was held,• he returned to the fourth session seemingly having worked

through something.

Process of Therapy• This session had a much different feel to it. It

was much more contained and protected. He played with the dolls for the first time and the themes of nurture and protection emerged again. He nursed the dolls and put them in the pram to take for a walk. He then ‘fed’ them from the bottle and had a tea party with the cups and plates. He both nurtured and protected me and the doll as well as being angry with it for crying. He gave me tea in the toy cups and made sure I was comfortable.

Process of Therapy• The theme of nurture persisted throughout all the following sessions and

he became more able to 'control' - his behaviour, the wolf and his emotional responses.

• Session 6: Paul seemed to be moving towards a resolution of his anger with his ex step father and become more self confident and less of a powerless victim.

• By the seventh session, Paul seemed less insatiable and the predominant theme was nurture. He seemed able to offer and receive nurture. He nurtured us both by making tea and looked after and fed the dolls. The wolf made an appearance but was shot by Paul or I - he could protect and be protected.

• The theme of power persisted over the next session. He seemed very pleased with his powerfulness and it felt positive rather than dangerous. He was very active in directing my roles in the play and enjoyed being ‘bossy’. This is something I have noticed with other children I have woked with which often seems to be a sign that they have achieved a degree of resolution to their difficulties. They feel powerful and enjoy exercising this power over an adult in a safe and contained situation. Paul continued the nurture theme by painting pictures to give to his teacher and foster mother.

Process of Therapy• The themes in session 9 were varied. He had just been told that he

would not be seeing his ex foster parents again as they let him down too often. He was unable to revive himself from the dead when killed in a game where we were both attacked by powerful foe and felt I couldn't help him either. The theme here seemed to be hopelessness, powerlessness and helplessness. He did, however, manage to nurture us both with drinks from the tea set. The themes this session seemed to oscillate between almost being out of control and being pleased with himself and nurturing. Perhaps this reflects his ambivalent feelings about loosing contact with his first foster family.

Process of Therapy• Session 10 again oscillated between nurture - of himself, me and

the baby doll - and loss - killing the wolf, killing me as the bus driver and himself being killed. He directed a very complicated game in which I was a bus driver and he was the passenger and the bus got faster and faster and the driving more reckless until it spun out of control and crashed, killing us both. He seemed very angry with me and at one point took off my watch when trying to revive me from the crash and flung it against the wall. This was, perhaps related to the fact that this was our penultimate session. I felt the need to come out of role at this point and remind him of the platy room rules. He seemed to accept this and was, perhaps, relieved that the boundaries were held. After this, he was , able to nurture. He feed from the baby's bottle and gave me biscuits and fed the doll with a bottle.

Process of Therapy• Our last session and took place after a three

week break while Paul was on holiday. This felt like a real ending session with no new material being worked on and the focus on finishing. We took (real) photos of each other and Paul was very concerned that we both ended up with an equal share. He has always seemed to need to leave the playroom (to go to the toilet, visit the kitchen) when things get too much for him and he visited it many times that day. This session was sad but the sadness was acknowledged and the ending planned and, as far as possible, in Paul's control.

And so to Play!

Winnicott’s Squiggle Game:In pairs:1 person draws a squiggle – a simple shape e.g. A loop or a curve.

2nd person makes a drawing out of it

Squiggling!1st person encourages the 2nd to create

a narrative around the drawing e.g. The person you’ve drawn looks exited, did you ever fly a balloon....

Swap over and 2nd person draws a squiggle and 1st person draws

Squiggling!Discuss in pairs:• how did you feel when completing

the drawing? • did it tell you anything about

yourself?• Anything else that occurred to you?

Quotes to play by!• G K Chesterton

The true object of all human life is play. Earth is a task garden; heaven is a playground.

• George Bernard ShawWe don't stop playing because we grow old; we grow old because we stop playing.

• Mark TwainWork and play are words used to describe the same thing under differing conditions.

• PlatoYou can discover more about a person in an hour of play than in a year of conversation.

• D. W. WinnicottIt is in playing, and only in playing, that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self.

(retrieved from http://quotations.about.com/cs/inspirationquotes/a/Play1.htm )

And finally!• Play is an integral part of our

development so keep playing!• It can be a place for us to make

sense of our experiences• It’s powerful and often fun!

Quotes to play by!• G K Chesterton

The true object of all human life is play. Earth is a task garden; heaven is a playground.

• George Bernard ShawWe don't stop playing because we grow old; we grow old because we stop playing.

• Mark TwainWork and play are words used to describe the same thing under differing conditions.

• PlatoYou can discover more about a person in an hour of play than in a year of conversation.

• D. W. WinnicottIt is in playing, and only in playing, that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self.

(retrieved from http://quotations.about.com/cs/inspirationquotes/a/Play1.htm )

Books and Articles that may be of Interest• Axline, V., (1989) Play Therapy London: Churchill Livingstone• Bruner, J. (1983). Child's talk: Learning to use language. New York: Norton • Cattanach, A., (1995), 'Drama and Play Therapy with Young Children' in The Arts in

Psychotherapy, Vol.22, No., 3., pp223-228• Cattanach, A., (1992) Play Therapy with Abused Children London: Jessica Kingsley• Cattanach, A., (1997) Children's Stories in Play Therapy London: Jessica Kingsley• Carroll, J., (1998) Introduction to Play Therapy Oxford: Blackwell Science• Daniels, D. & Jenkins, P. (2000) Therapy with Children, Children’s rights,

confidentiality and the law, London, Sage • Jennings, S., (Ed), (1995) Dramatherapy with Children and Adolescents London:

Routledge• Lane, D. & Miller, A., (1992) Child and Adolescent Therapy: A Handbook Buckingham,

Philadelphia: Open University Press• McMahon, L. (1992) The Handbook of Play Therapy, London: Tavistock and Routledge• Pennels, Sister Margaret, & Smith, S., (1995) The Forgotten Mourners London:

Jessica Kingsley• Power, T. (2000) Play and exploration in children and animals Mahwah, NJ: John Wiley

& Sons • West, J., (1990), 'Play work and play therapy: distinctions and definitions' in Adoption

and Fostering, Vol: 14, No. 4. Pp 30 - 37• West, J., (1992) Child Centred Play Therapy London: Arnold