Issues in play therapy

Chapter 13

Confidentiality

• Say “in this is special time, what you say or do is private. I will not tell your parents or teacher or anyone unless it is necessary to keep you safe. It you want them to know what you do here, you can tell them. That will be fine. You can decide”

• Do not display art work or show to teachers or parents unless the child decides to do so.

• When you talk to parents, discuss general observations and avoid revealing specific behaviors.

Participation in Child’s Play

• Think about the child’s real motivation for wanting the therapist to play.

• Is the child wanting the therapist to be more involved because the therapist seems emotionally removed?

• The therapist, if choosing to participate, should keep the child in the lead, and maintain an adult-therapeutic role- not be a “playmate”. The therapist also must maintain appropriate boundaries through limit setting.

• Let the child lead. The child tells the therapist what he/she wants to therapist to do.

Accepting Gifts from Children

• The timing of the gift is important to consider. Is the child feeling guilty about previous behavior?

• Cost is a factor.

• Emotional gifts are more powerful and satisfying than tangible gifts. A gift of the child’s artwork or something like a picked flower is more emotional giving and is thus acceptable.

• If you turn it down, say “ You bought this just for me. That says you were thinking about me. I really appreciate that, but you don’t have to give a gift to say you like me. I would like you to have this.”

• Don’t display the gift.

Giving a reward or memento at end of session or termination

• Play experiences are intrinsically rewarding. They do not need a reward for playing.

Asking child to clean up

• Requiring child to pick up may be internalized that making a mess is not okay. Child may feel punished. It could also lead to power struggle.

• Don’t praise child who spontaneously picks up.

Informing children of why they are in play therapy

• Becomes problem based.

• Implies that something is “wrong” with them.

• If child asks, “Your parents are concerned because sometimes things don’t seem to go very well for you at home, and they thought you would like to have a special time in the playroom on Tuesdays just for you.”

Bringing a friend

• Axline says okay- child is choosing own group therapy.

• Traumatized children need all of therapist’s attention.

• Child might be jealous of attention shown the other child.

• Another person changes the dynamics

• Children stimulate each other requiring more limit setting

• In some situations, could be helpful

Inviting parents or siblings

• Presence of a parent or sibling can restrict development of relationship between therapist and child.

• In some cases, might be therapeutic for siblings to come together.