• Theory-Based Play Therapy
Resources
• Theory-Based Play Therapy Scoring Guide.
• Capella Graduate Online Writing Center – APA Style and Formatting.
• iGuide: ePortfolio.
• Capella University Library.
• Capella Graduate Online Writing Center.
• PSY5246 Library Guide.
• Learner Guide APA Writing Rubric.
• APA Writing Feedback Rubric
• Reflection and Final Submission
Submit all project components in an integrated manner for final assessment. The components include:
• Play Therapy Theory (Unit 4 assignment).
• Introduction
• Plato (429-347 B.C.) recognized play as an essential tool of learning. He stated that one could express oneself through one hour of playing more than they could through talk in a year. During Plato’s time, people saw play as a vehicle of learning and understanding persons, especially children. According to Demanchick (2013), one can use play can as a symbol of understanding people. He adds that it exemplifies the highest level of development in children. Through play, a child can entirely express himself or herself. Therefore, play is full of meaning. Sigmund Freud is among the first authors who wrote about the therapeutic use of play. Freud observed a child suffering from simple phobia. He even told his father that play children needed some play to help them grow in good health. He was the first child play therapist. He worked on the first ever documented case of “Little Hans” where he linked the child’s anxiety and other emotions to the difficulties they experience.
• Play therapy process refers to the provision of play materials to children and emphasizing the use of play to help in analyzing the child. Most child therapists have used play as a technique to analyzing children behavior in the recent past. They find it easy to analyze a child’s unconscious through play since it is similar to adult’s way of free association. Some therapist use play as a way of facilitating positive relationship between the therapists and the children and hence help in gaining the needed access to the child’s inner life
• Release therapy advanced by David Levy in the 1930s is a technique that emphasizes on the use of a structured approach to therapy (Cattanach, 2008). Following his theory, therapists first introduced children thought to be undergoing stressful life to play. After that, they would use stress evoking materials that would allow the child to react and show emotions of the associated traumatic events.
• During the 1950s, Gove Hambidge developed Levy’s work. He emphasized on the structured relationship play therapy. This method emphasized on introducing situations and countering them with play. The aim of the method was to evoke bad situations that the victim was experiencing, and then introduce the victim to free play. After that the therapist would free the victim to enhance recovering. This technique also enhanced the relationship therapy developed in 1930s. Here, the main emphasis is on the emotional relationship between a therapist and a child. It focuses on children’s freedom and strength.
• Earlier on, in the 1940s, therapist Carl Rogers advanced the works of Levy further and came up with the non-directive therapy. It then became popularly known as client- or child-centered therapy. In the 1950s, Virginia Axline tried to give a summary of play therapy. She conducted research on the same and based on her findings, she derived that the play experience was therapeutic. Her reasons were that it provided a secured relationship between children and adults. She explained that the child had freedom and room to state himself or herself in his or her terms, exactly as he or she felt at that moment.
• In the 1960s, Bernard and Louise Guerney developed the filial therapy. This approach emphasized on structured training program for parents. It helped to enlighten parents on ways of using child-centered play sessions at home. It then led to the growth of educational based and school-based play therapies. The result was positive effects especially when dealing with children issues (Guerney, 2001).
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• Play Therapy
• There are two broad categories of play therapy. They are the directive and non-directive play therapies.
• Directive Play Therapies
• Directive play therapy hinges on the idea that therapist should use directives to guide a child through play. Therapists believe that by doing so, the child will experience faster change than otherwise as in non-directive play therapies. Here, therapists perform larger roles than in-directive play therapy. A therapist can suggest new topics for the child to tackle other than letting the child make a choice by himself or herself. Techniques used here are sand try therapy and cognitive behavioral therapy.
• Mostly, directed sand try therapy is applicable to victims of trauma. It involves engaging in much talk. For instance, therapists may ask victims questions about what they do to forget bad memories. They may also ask the victims to elaborate on the things that trouble them in order to establish the best way of helping them manage the impact of these troubling moments in their lives (Cattanach, 2008).
• Therapists use cognitive-behavioral play therapy with young children of between the ages of two and six. They may use a particular type of toys to model some cognitive strategies such as problem-solving skills. This theory tries to emphasize on actions done during play than verbalization or communication. Use of toys and dolls helps to change the maladaptive thinking in children.
• Non-Directive Play Therapies
• This class of therapies entails an effective and non-intrusive theory that works therapeutically with children bothered by certain issues. It involves voluntary professionals working with emotionally challenged children. Increased challenges like in adolescence have caused increased numbers of practitioners that help the children in tackling dilemma situations or other emotional challenges. In this approach, practitioners help the emotionally challenged children to let out their thoughts and emotions freely. The children or adolescents may communicate directly through words or implicit phrases or through behavior and play. Practitioners need to listen, respond and understand the children’s communications. Having done that, they should help the children to understand themselves. This understanding may enable the therapists to discover hidden feelings. Non-directive therapy is synonymous with client-centered and unstructured play therapy. It provides favorable therapeutic conditions including speaking freely and playing.
• Generally, the classification of play therapy theories depends on therapeutic conditions. These theories include the psychoanalytic play therapy, object relations theory, cognitive behavioral theory, release therapy and structured play theory. With regards to the preceding discussion of relationship therapy, this paper expounds on the psychoanalytic play theory.
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• Psychoanalytic Play Theory
• Freud worked with adults in the case of Little Hans (father as therapist) and made the observation that play was important to children as it determined their later development. In this case, there arises an intuition of significance to the contribution of this play thought. Evidently, play is the child’s most absorbing and loved occupation. During play, a child expresses creativity and imaginary skills. He or she does so by engaging in activities what pleases him best. The child never takes his or her talk seriously but, on the other hand, takes their play seriously. He or she tries to link the real world with what adults may consider a child’s “daydreaming. Therapists study children’s play and dream as they help in linking the child’s unconscious world to their consciousness through interpretation. This technique helps in the study of psychiatry. The study of children’s feelings, motives and thoughts help in the mastery of maturation and conflicts. The study helps to interpret and understand symbolic content of how children engage in play.
• Psychoanalysis of children requires high levels of specialization and extensive time. It also includes intensive self-analysis. This theory is also useful in children suffering from neurotic but is not suitable for therapies involving sexually traumatized children.
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• Usefulness of Play Therapy
• Play therapy facilitates child contact and helps to encourage catharsis, and this is easily understood by therapists. Young clients communicate with social workers through different forms of play. Training of these social workers is needed so as to enable good relations with young clients. This helps the workers to understand their young clients properly. Play therapy is a field of study that most social workers consider.
• Play therapy is successful in cultures where busy parents use video games. Use of educative movies and cartoon programs has led to the continued growth of play therapy. Children can play video games/ listen to children songs or watch children movies so as to keep them busy or try to learn their thoughts, feelings or emotions toward certain graphics, pictures or sounds from the media.
• It’s more advisable to engage children in natural play interactions than artificial play. Playtime is more fun doing. This also helps the adults to reach children at their level for a better understanding. Freud believed that one could understand children totally when you observe them play. Play is a free interaction of children, and it is a way of understanding how children can develop a sense of self.
• Play theory can help to relate with clients or persons who are unable to verbalize their feelings. Through play programs, you can get the emotional reactions and the general functioning of children. Emotions can be well expressed through play. Play process through trained personnel helps to prevent children from psychological difficulties and also help resolve the difficulties. It enhances the establishment of interpersonal processes that help to achieve optimal growth and development (Lytle, 2003).
• Communication gap that may exist between parents and children is put aside by filial play theories. This is where therapist trains parents to interact with their children especially during play. Parent-child relationship is bonded since there comes up a mutual relationship between these two parties. Some children may benefit more on play therapy than others, but the scientist argue that play therapy is equally important to any child. Play therapy can be used to obtain facts on children with behavioral issues, psychological issues or medical problems. If talking is hard play is an option. It can help to link the past and the future on issues such as stress or dilemmas.
• Play therapy has led to increased play related interventions. These interventions help the practitioners in communicating effectively with their clients. These interventions help in planning and decision making. Symbolic meanings have been put forth to help in the assessment of children emotions. Materials such as dolls, puppets and toys help in play therapy. Children may have less anxiety when communicating to play instruments than talking to adults.
• In educational experiments and elementary learning play therapy is highly utilized. But increased use of screens, televisions and computers has led to deteriorating quality of play. This explains how children play today. The movement of parents and children to work and to school respectively highly affect the way children interact to play in recent time (Hirsh, 2004).
• There is an increase in need of becoming a trained play therapist. Those interested in becoming registered play therapists need to learn how to understand what play is. It can be a career progression for those who are passionate about interacting with the young ones. Therapists should undergo proper training so as to fit appropriately in this field.
• Diagnosis and Assessment
• Play diagnosis can be said to be a technique that help a young one to realize internal fantasies, perceptions of the earth and conflicts. Play materials are used in assessment and focus on significant events in children. They help to assess the impact on personalities and continued growth. In use of diagnostic assessment play in children may act out the true emotions and feelings with the assistance of certain ego defense ways. The methods could be a projection, displacement or symbolization. Anxieties, anger and frightening situations can help to determine the degree of emotional action through plays. This involves the use of symbolization/ mental defense system and projections (VanFleet, Sywulak, & Sniscak, 2010).
• According to scientist child play, is preoccupied with psychic reality (with s child’s perception of events) rather than objective reality. Practitioners should, therefore, interpret children’s play, understand its symbolic meaning and try to ascertain the children perception of events through objectivity.
• Play sessions are used to assessing child therapeutic needs. It helps primarily to identify children psychic reality and their perception to important life events. Play diagnosis helps practitioners to describe play related interventions. Through play limitations that are obligatory to younger children, disabled children and adults are outlined.
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• References
• Cattanach, A. (2008). Play therapy with abused children. London: Jessica Kingsley.
• Demanchick, S. (2013). International Journal of Play Therapy: Editor’s introduction. International Journal of Play Therapy, 22(1), 1-1. doi:10.1037/a0031414
• Guerney, L. (2001). Child-centered play therapy. The International Journal of Play Therapy, 10(2), 13-31.
• Hirsh, R. (2004). Early childhood curriculum. Boston: Pearson A and B.
• Lytle, D. (2003). Play and educational theory and practice. Westport, Conn.: Praeger.
• VanFleet, R., Sywulak, A., & Sniscak, C. (2010). Child-centered play therapy. New York: Guilford Press.
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• Play Therapy Practice (Unit 7 assignment).
Play Therapy Practice
Play Therapy Practice
Introduction
According to Bratton, Ray, Rhine & Jones (2005), play therapy is one of the widely used methods by psychologists to treat behavioral and emotional problems among children. This is because of the responsiveness of the therapy to the unique developmental needs of the children. The therapy uses play as a vehicle of communication between the therapist and the patient (Bratton et al., 2005). The therapy has been demonstrated to be very effective for various emotional and behavioral problems of both adults and children. For instance, Lawver & Blankenship (2008) successfully applies play therapy to the treatment of a six-year-old patient with oppositional defiant disorder. Ray (2008) also investigates the impact of play therapy on parent-child relationship and finds that play therapy significantly altered the parenting stress index. Therefore, play therapy is an effective method of treating various psychological disorders among patients.
However, play therapy only focuses on the non-stimulated and natural problem-solving skills in order to communicate the experience of the patients and to develop the healing process. Therefore, there is a need for the application of psychoanalytic theory of play by evaluating the therapeutic value on patient satisfaction (Waldron, Scharf, Hurst, Firestein & Burton, 2004). In other words, psychoanalytic theory provides the knowledge, the strengths and the weakness of a given play therapy. Based on play therapy and psychoanalytic theory of play, this paper will apply the later to a play therapy session for a child with a debilitating anxiety and persistent school absenteeism. The paper develops a play therapy session for the patient and applies various intervention mechanisms as per the theory of psychoanalytic play therapy. In addition, this article provides the legal, ethical and multicultural issues that might arise during the play therapy session for the child
Psychoanalytic Therapy Session and Interventions
A child name Patricia was referred to a psychotherapist. The child aged seven years old had a debilitating anxiety and persistent school absenteeism. Patricia was reported to have been staying at home frequently instead of going to school. When staying home, the child suffers from nausea, fever and vomiting. In caes, Patricia went to school; a child could leave school very early due to stomach-ache. Despite these symptoms, family doctor and paediatrician have found the girl to be of good health. Further medical history from Patricia’s parents indicates that the girl shows other signs such as alienation from other children, withdrawn, easily irritated and always taking the defensive side. Patricia’s teachers reported that the child was always mood, less jovial and had a low academic performance.
From the descriptions by the teachers and Patricia’s parents, it is evident that the child is very unhappy, alienated and lives an increasingly inhibited life. The traits of the child are also easily manifested during the psychoanalytic therapy session with a therapist. The child’s sitting position was suggestive of the psychological problems that the girl went through. For instance, Patricia sat stiffly without any form of expression, and when there was any smile, it was a nervous one. Further, the girl could not allow her mother to leave the therapist’s office. This was clearly demonstrated when the girl panicked whenever her mother moved towards the door of the therapist’s office. Upon asking, Patricia acknowledged that she often feel pain in her stomach and therefore did not want to go school. However, the child refused to give ears to the therapist who gave suggestions of the methods that could help her situations
Based on the problems that Patricia faces, the first intervention will be to create a safe and an accepting environment for the child. Patricia feels that her problem cannot be solved by the therapist and declines to hear any suggestions during the first therapy session. One of the ways of doing this is by telling the child that although the therapy would be painful and hard, it will be of great help to her situation. As argued by Porter, Hernandez‐Reif & Jessee (2009), the creation of an accepting and safe environment ensures that the child feels ‘at home’ and cared for. This initial step also ensures that the child develops a sense of belonging and appreciates the importance of the therapy. Creating a safe and accepting environment also ensures that the therapist upholds the child in a similar manner that the mother would have done. In doing so, the psychoanalytic therapist strives to hold the child therapeutically and absorbs the distress and excitement that mind and body of a child could not bear. Being the initial intervention, creating a safe and accepting therapy environment ensures that the child comes for the other therapy sessions and that the needs of the child are met. In this case, the therapist can start by allowing Patricia’s mother stay in the next room or at the door to ensure that Patricia is safe and that her needs are met.
Following the successful initiation of the first intervention, the therapist can then move to the second intervention which involves the creation of an empathic atmosphere. In this case, the therapist is expected to empathise with Patricia by ensuring that he empathically listens to the child and responding promptly to her questions. This ensures that the child is deeply understood and that her perspectives are hard. As highlighted by Cooper & Alfillé (2011), this ensures that the child is the one who drives the therapy session and not a therapy. Therefore, the child feels encoursaged and enjoys the remaining sessions of the therapy. In addition, empathy is reparative and facilitates the clinical interventions meant to accurately meet the patients at the point where the patient is neither falling fat or overwhelming emotionally. Showing empathy and not sympathy to Patricia will ensure that she takes control of the session and therefore feel part of the interventions proposed by the therapist. One of the major problems with Patricia at the start of the session was the blatant refusal to hear the proposals of the therapist. Another problem was the possible refusal to attend the therapy itself, creating an empathic atmosphere not only solves these problems but also motivates Patricia into appreciating the role of the therapist in changing her psychological state.
The creation of a safe, accepting and empathic atmosphere lays the foundation for the next intervention which involves solving the psychological problem of unhappiness. As was indicated in the medical history, Patricia often seemed unhappy with little joy if any. Developing a play mechanism that will alleviate this problem is, therefore, critical to the success of the psychoanalytic therapy. One of the ways of achieving this is by having Patricia draw pictures of happy-go-lucky children on the beaches, colourful fields of trees, butterflies and flowers. Drawing this will be very easy for Patricia because the initial interventions had adequately prepared her for this. Patricia now feels in charge and in control of the therapy and will, therefore, use the pride to draw this pictures. The pictures are very critical to the psychological development of the child in realizing the happier and friendly side of life. Children who play at the beach, flowers on plants and butterflies are symbols of happiness that can trigger Patricia into accepting the happiness that comes from life.
In addition, drawing the ‘happy pictures’ as a form of play therapy provides the child with an opportunity to express her thoughts. It is expected that the initial drawings that Patricia will make will not be ‘happily coloured, but continuous drawings will be more colourful painted. This will be an indicator of the psychological development of the child in terms of happiness. The drawings will also ensure that the child express her difficulties. Considering the psychological conditions of the child, drawing problems will be associated with the difficulties the child undergoes. Some of these difficulties can be identified by the therapist and therefore respond to them promptly. Having Patricia draw other children playing in the beach will also make her appreciate that other children are happy, and her being a child should also be happy. In general, this intervention is very important to the modification of the child’s perception about happiness and to modifying her behaviors, clarity of her own concepts of happiness and in building healthy relationships.
The next intervention will be dealing with the pains that the child often feel. The theory of psychoanalytic play therapy requires the therapist to deal with the pains that the children undergo along with helping them discover themselves. This principle of psychoanalytic theory of play will guide the interventions meant to relieve Patricia of her stomach-ache, nausea, fever and vomiting in school and at home. One of the ways of doing this is by asking the child about the stomach-aches. One of the expected outcomes is nervousness characterised by shaking, helplessness and teary. This will guide the therapist into understanding that the pain might not be physiological but rather psychological.
One of the reasons why the child should be asked about the pains and not doing laboratory diagnosis of the condition is that reports from the family doctors and paediatricians had found nothing wrong with Patricia. In order to alleviate the pain, the therapist can continuously ask the child to point where it hurts hour after hour. This should be done gently to avoid evoking emotions in the child. In Patricia’s case, the child can be asked to show where it hurts and explain the uncomfortable pains that she suffers. A continuous questioning of the pains and an explanation of the same is should provide the patients with relief and bring her back to ‘life.’ As explained by Giordano, Landreth & Jones (2005) asking a child such questions evokes good cheer, energy and a break-through from the fear and tensions that torment a child.
Finally, the last intervention for Patricia focuses on the overall psychological outcome of the therapy meant to improve Patricia’s school attendance, alleviates the pains and promotes happiness and social interactions. The theory of psychoanalytic play therapy requires the outcome of the session to reflect the patient satisfaction with the therapy outcome. In this session, the satisfaction of the patient can only be reflected in terms of school attendance by Patricia. One of the issues expected to arise during the therapy sessions is that Patricia may be reluctant to talk about her school absentee. As the therapy continues in the next two months or so, Patricia is expected to start talking about her school attendance more easily without any reservations. This can be an indicator of the success of the therapy. In summary, these interventions are meant to allow the child to put her pains, conflicts and problems to a symbolic arena without fear of being reprimanded. The expressions of these feelings free the child and therefore permits the child with a forum where she can face herself, her conflict and other people in a psychologically safer distance.
Legal, Ethical and Multicultural Issues
As highlighted by Carmichael (2006), play therapists provide their services to minor children and are, therefore, faced with circumstantial legal, ethical and multicultural issues. The application of the professional code of ethics, culture and the laws that applies to a certain population of people might affect the decisions made during a therapy session. Similarly, there are certain issues that can arise from the psychoanalytic therapy session for Patricia. For instance, the code of ethics in play therapy requires therapist to be competent, provide safety and make therapeutic agreements between him and the patient (Carmichael, 2006b). However, in this session it was difficult to make a formal agreement regarding the therapeutic sessions because Patricia was reluctant to undergo the therapy at first. The paly therapist can, however, make agreements with the child’s parents regarding the revisions to be made during the session. Carmichael (2006) also explains that some cultural issues might interfere with the therapy session as well as the outcome of the session. In this therapy session, for instance, some cultures might not believe the success of play therapy to the management of Patricia’s anxiety and school absentee problems.
References
Bratton, S. C., Ray, D., Rhine, T., & Jones, L. (2005). The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes. Professional Psychology: Research and Practice, 36(4), 376–390. doi:10.1037/0735-7028.36.4.376
Carmichael, K. D. (2006a). Cultural Issues in Play Therapy,. British Journal of Social Work, 36(5), 876–878. doi:10.1093/bjsw/bcl076
Carmichael, K. D. (2006b). Legal and ethical issues in play therapy. International Journal of Play Therapy, 15(2), 83–99. doi:10.1037/h0088916
Cooper, J., & Alfillé, H. (2011). A guide to assessment for psychoanalytic psychotherapists. London: Karnac Books.
Giordano, M., Landreth, G., & Jones, L. (2005). A practical handbook for building the play therapy relationship. Lanham: Jason Aronson.
Lawver, T., & Blankenship, K. (2008). Play therapy: a case-based example of a nondirective approach. Psychiatry (Edgmont (Pa. : Township)), 5(10), 24–8. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2695756&tool=pmcentrez&rendertype=abstract
Porter, M. L., Hernandez‐Reif, M., & Jessee, P. (2009). Play therapy: a review. Early Child Development and Care, 179(8), 1025–1040. doi:10.1080/03004430701731613
Ray, D. C. (2008). Impact of play therapy on parent–child relationship stress at a mental health training setting. British Journal of Guidance & Counselling, 36(2), 165–187. doi:10.1080/03069880801926434
Waldron, S., Scharf, R. D., Hurst, D., Firestein, S. K., & Burton, A. (2004). What happens in a psychoanalysis? A view through the lens of the analytic process scales (APS). International Journal of Psychoanalysis, 85(2), 443–466. doi:10.1516/5PPV-Q9WL-JKA9-DRCK
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• Reflection: As you reflect over the last 10 weeks, write a reflection that includes the following elements:
o How the project and knowledge garnered throughout the process may inform your work as a play therapist.
o Integrate a statement explaining how this project contributes to your personal philosophy and approach to play therapy.
o Revised professional development plan. Explain what activities you have engaged in since completing PSY5244. If you are taking PSY5244 and PSY5246 simultaneously, you are allowed to submit the same plan. Use the second discussion Unit 10 as a foundation for this section.
This assignment is a synthesis of previous assignments and new knowledge gained from the time of original submission. This is not meant to be a copy and paste of previous assignments into a new document. Synthesize the feedback you received from previous assignments to improve your work and add new insights and evidence of knowledge to make it a cohesive document.
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Submit all project components in an integrated manner for final assessment. Refer to the Theory-Based Play Therapy course project description for a complete description of what is expected for the final project.
Note: Your instructor may also use the APA Writing Feedback Rubric to provide additional feedback on your academic writing. The writing feedback rubric does not affect your assignment grade, but its feedback may factor into the grading criteria, if professional communication and writing is a course competency. Evaluate your own work using this rubric. Refer to the Learner Guide for instructions on viewing instructor feedback.
Portfolio Prompt: You are required to save this learning activity to your ePortfolio.
Project Requirements
To achieve a successful project experience and outcome, you are expected to meet the following requirements.
• Written communication: Written communication is free of errors that detract from the overall message.
• APA formatting: Resources and citations are formatted according to APA (6th Edition) style and formatting.
• Number of resources: Minimum of eight resources.
• Length of paper: 16–20 typed double-spaced pages referencing the original works of the historical figure as much as possible.
• Font and font size: Times New Roman, 12 point.
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