Play Therapy

Play Therapy Techniques & Guide

Everybody likes to play especially children. If this play is utilized for therapeutic use, what will be its effect?

Hi, I am Mohanadas presenting an article on “Play Therapy”.

Definition
Play therapy refers to a method of psychotherapy with children in which a therapist uses a child's fantasies and the symbolic meanings of his or her play as a medium for understanding and communication with the child.

Principle of Play therapy
The main principle behind play therapy is to cure the problems related to mind in children in a natural manner. It works on the fact that a child expresses its best when it is able to play.

How it works?
Play therapy is not just using of toys for treatment, it is a methodology to understand the problem areas in self esteem, anger control, courage, strength of ego and confidence. Each child is unique. A perceptive and intuitive approach is necessary to understand and facilitate the therapeutic process. As children’s experiences and knowledge are often communicated through play, it becomes an important vehicle for them to know and accept themselves and others. Play reveals the strength or lacuna in their coping skills and enhances their ability to define and master their problems. Play therapy training scientifically prepares therapists to understand and speak the language of play that patients relate to easily.

Historical background
Since the time of Plato (429-347 B.C.) the importance of play was recognized. Plato reported “you can discover more about a person in an hour of play than in a year of conversation.”
The first documented case, describing the therapeutic use of play, was in 1909 when Sigmund Freud published his work with “Little Hans.”

Hermine Hug-Hellmuth (1921) emphasize the use of the play to analyze the child.
In 1919, Melanie Klein (1955) began to implement the technique of using play as a means of analyzing.

Anna Freud (1946, 1965) utilized play as a means to facilitate positive attachment to the therapist and gain access to the child’s inner life.

A technique called release therapy was developed by David Levy in the 1930’s. In this therapy the child is allowed to engage in free play to release the stress.

In 1955, Gove Hambidge expanded on Levy’s work emphasizing a “Structured Play Therapy” model.
Jesse Taft (1933) and Frederick Allen (1934) developed relationship therapy. Here special emphasis was laid on relationship between the therapist and the child and the child was given full freedom and strength to choose.

Carl Rogers (1951)developed client-centered therapy.

Virginia Axline (1950) in an article summarized her concept of play therapy which provides a secular relationship between the child and the adult.

Bernard and Louise Guerney developed filial therapy in 1960’s. Filial approach emphasizes a structured training for parents as well as school counselors how to employ child-centered play sessions.

Alexander (1964); Landreth (1969, 1972); Muro (1968); Myrick and Holdin (1971); Nelson (1966); and Waterland (1970) also contributed significantly in the field of play therapy.

Dogra and Veeraraghavan (1994) conducted a study and found significant positive change in adjustment after different sessions of non directive play therapy.

Burroughs, Wagoner & Johnson (1997) studied twenty-one participants (ages 7–17) whose parents were either divorced or divorcing and found that their depression and anxiety were decreased after participation in play therapy.

Play therapy has also been studied with sexual abused victims by Reams and Friedrich(1994) found that they engaged in less isolated play than the control group.

Kaudson and Finnerty(1995) conducted a study with 63 children having ADHD and found significant improvement in sociability and attention after peer play therapy.

Over the past two decades the studies of Le Blanc & Ritchie, Ray, Bratton, Rhine and Jones were significant and they found a positive result regarding play therapy.

Father of Play therapy:
Charles E Schaefer Ph. D., Professor of Psychology at Fairleigh Dickinson University in Teaneck, New Jersey, is an expert in the field of play therapy is considered as the father of Play Therapy. He is the co-founder of the Association for Play therapy and the founder and co-director of the Play therapy Training Institute in New Jersey.

For whom play therapy works?
Play therapy is useful to all those in need of it regardless of age and sex. It is mainly helpful for the following categories of children.

  1. Having phobias of darkness, loud noises, etc.
  2. Traumatized (sexual, physical or emotional abuse).
  3. Adopted children.
  4. Children with parental conflict, separation or divorce.
  5. Children with illness or death of a loved.
  6. Hospitalized children.
  7. Children who have witnessed domestic violence.
  8. Experienced serious accidents or disasters.
  9. Children having Attention deficit Disorder.


In addition to the above list, play therapy is very instrumental for verbally impaired people. Recently this type of therapy is used for all age group depending on the type of disease.

Problems of the children who need play therapy -

  1. Excessive shyness.
  2. Difficulty adjusting to family changes.
  3. Aggressive behaviour (hurting others or self).
  4. Excessive anger, worry, sadness or fear.
  5. Preoccupation with sexual behaviour.
  6. Separation anxiety.
  7. Behavioural regression.
  8. Low self esteem.
  9. Learning or other school problems.
  10. Sleep, eating or elimination problems.


Benefits of Play Therapy for kids:

  1. It helps children to disclose their problems and seek remedies.
  2. Reduces anxiety about traumatic events in the child's life.
  3. Facilitates a child's expression of feelings.
  4. Promotes self-confidence and a sense of competence.
  5. Develops a sense of trust in self and others.
  6. Defines healthy boundaries.
  7. Creates or enhances healthy bonding in relationships.
  8. Enhances creativity and playfulness.
  9. Promotes appropriate behaviour.


Who needs to know Play Therapy?
Play therapy must be practiced by Counselors, Parents, Physicians , Family Lawyers, Marriage and Family Therapists, Teachers , Social Workers , Psychotherapists and Child Care Workers.

How to Use Play Therapy
Play therapy for the children must be taken away from the child’s house in a safe and natural environment. Once the child becomes comfortable in the place and the therapist then proceed the therapy.

We may follow these steps:
1. Select the student who needs play therapy.

2. Decide when you will do therapy: a separate session with this child or whether you will sit near the student during your class play period or recess.

3. Obtain materials for the session. Recommended items include:
- toy kitchen appliances, utensils, and pans.
-manipulatives (e.g., clay, crayons, painting supplies)
-water and sand play containers.
- toy cars, boats, soldiers, and animals.
- baby items (e.g., bottles, bibs, rattles, etc.).
- dolls and figures of various sizes and ages.
- toy guns, rubber knives.
- stuffed animals.
- blocks, erector sets.

4. Place the materials in specific places where they can be located for each session.

5. Meet the student and introduce him/her to the play area.

6. Inform the student of limitations and how long the session will last (usually 30-60 minutes).

7. Allow the student to choose materials. Do not suggest materials or activities. If the student wishes to leave before the session ends, that is allowed. However, the student is not allowed to return that day. He is informed of the time of the next scheduled session.

8. Use the "reflection" technique (see the filed named "Non-Directive Counseling) to respond to the student's comments. If the student is non-verbal, your role will change. You will be describing what the student is doing.

9. As the end of the session nears, inform the student of that fact, stating the number of minutes left.

10.Upon reaching the time limit, inform the student in a manner similar to the following: "Our time is over. We'll have to stop now and put the toys back from where you have taken." The student is not allowed to continue playing.

11.Inform the student regarding the next session.

Importance of Toys and Materials in Play Therapy:
Toys and other play materials are very important tools to attract the child and get involved in the therapy. It is difficult to ask a child to sit and talk about her problems unlike adults. The success of therapy partially depends on the toys and materials used. Children should love to play with those toys and materials provided. Only then they will have an interest to go ahead. Play therapy toys are used in play therapy rooms.

Different Techniques of Play therapy:
1. Sandtray Therapy
Sandtray, sandbox or sandplay therapy is a form of experiential workshop which allows greater exploration of deep emotional issues. Sandtray therapy is suitable for children and adults. It allows them to reach a deeper insight into and resolution of a range of issues such as grief, depression, anger or abuse. Through this play they realize that achieving success is not easy but it can be done by facing lot of obstacles.

2. Filial Play Therapy
Filial play therapy is entirely child-centered. Parents of children are engaged in this throughout the course. Very important thing in this method is that it helps parents to understand their children, their needs and how they respond etc. Children develop self confidence, deal with their emotions like anger differently and learn communication skills through parents and therapists.

3. Theraplay
This is applicable for children with attachment related problems. In this method also parents are actively involved. This is a short term for the over all play therapy techniques usable by therapists. It is designed to raise self-esteem, improve trust in others, enhance attachment and create joyful engagement. Theraplay sessions create an active and empathic connection between the child and the parents, resulting in a changed view of the self as worthy and lovable and of relationships as positive and rewarding.

4. Group Play Therapy
Children who are developmentally impaired and as a result can't verbally express their inner thoughts, feelings etc get to express things like these through play. Gradually they begin to develop group interactive ability and importance of group dynamics.

5. Storytelling play Therapy
Story telling in the play therapy technique assumes a high degree of importance as it compels application of brain and mind completely testing the mental integration. The storytelling awareness is built in the children in steps through sand tray therapy etc. The signs of improvements are ability to tell stories although in bits and pieces to begin with.

6. Puppetry
Puppetry lets children explore hard their creative side. The puppets, the control strings and finally the puppetry stage complete with scenery on all sides, hiding scenes, scene changing screens, marquee give them opportunity to develop story board and design new titles afresh with each session.

Play therapy techniques, when employed along with parent involvement have shown improvements in 6-10 weeks' periods. But what one should not forget is the safety aspect while using paid or free play therapy techniques, which is the essence of the whole game.

7. Systematic Model
In this technique the therapist's office will schedule an appointment with several children. In one session there can be as many as 2-5 children interacting. This organic interaction allows the therapist to properly evaluate the child’s emotions and feelings. This form of therapy allows the child to unknowingly reveal his emotion while playing with other children.
Along with children interacting with other children, the therapist will have the child play with certain toys in order to determine his concentration and source of any stress. Each toy and each style of enjoying them represents a different emotion and feeling.
It is believed that as people interact with others, they may work through their internal anxieties. In this idea, children should be encouraged to play, in order to develop as a healthy child.
The therapist will engage in desensitization exercises, in order to eliminate stress for children. These exercises include teaching the child how to relearn certain behavior through a formal system of tests.

8. Video Games Therapy
Video game therapy is the latest development in the field of therapy. In this video games are using for the purpose of therapy. It is very useful to cure problems like poor concentration and memory disorder by stimulating the brain cells repeatedly with the help of electromagnetic waves.
Video games are very effective in treating sick children because (1) Children are interested in video games. Therefore the therapist need not spend lot of time and energy in convincing them to play video games. (2)This type of treatment is easy for the children and the therapist.

Does Video Game help in gaining a Perception on Memory Disorder?
Video game therapy does help to rectify memory disorder. Most of the video games demand that you have a strong memory so that you can efficiently maneuver, manage tricks and win the game. If you are not having sufficient memory or concentration you are unlikely to win a game or even handle tough situations.

Due to interests in the game you will voluntarily memorize the rules , regulations and other important matters connected with the game like the different procedures to be followed in different level of the game. In a video game you have to cross several stages to be finally declared as a winner. In most of them you will not be able to proceed to the subsequent stage without going to the earlier one. Therefore you will learn to focus, remember and recollect lots of things. Videogame therapy not only helps in solving your memory problems but also it will help you to overcome barriers to concentration. Sports puzzles, war and other games can be categorized as brain memory games are very healthy for the children as it will help in their overall development.

Child Parent Relationship Therapy (CPRT)
To support the emotional, psychosocial and developmental growth of the child and to help strengthen & nurture the parent-child relationship, this therapy is useful. Individual or Group sessions teaching parents or carers how to have special play sessions based on the Child Centered Play Therapy model with the child.

Group Play Therapy for Adolescents, Elderly People and Individuals Affected By Dementia

It is essential that we should understand that dementia or mental deterioration can affect anyone of any age group.
Expert professionals have design play therapy customized for adolescents, elderly people and anyone affected by dementia.

Organizations
In 1982, the Association for Play Therapy (APT) was established marking not only the desire to promote the advancement of play therapy, but to acknowledge the extensive growth of play therapy. Currently, the APT has almost 5,000 members in twenty-six countries (2006). Play therapy training is provided, according to a survey conducted by the Center for Play Therapy at the University of North Texas (2000), by 102 universities and colleges throughout the United States.

In 1985, the work of two key Canadians in the field of child psychology and play therapy, Mark Barnes and Cynthia Taylor, resulted in the establishment of Certification Standards through the non-profit Canadian child psychotherapy and play therapy association.

During 1995/1996, a whole new horizon opened up for the profession of play therapy as a result of the Canadian Play Therapy Institute's pioneering efforts on an International basis. Play Therapy International was founded from the Canadian Play Therapy Institute and there now existed a mutually supportive recognition between Play Therapy International/The International Board of Examiners of Certified Play Therapists, The Canadian Play Therapy Institute, as well as a number of other professional bodies throughout the world.

In the UK, The United Kingdom Society for Play and Creative Arts Therapies Limited (known in short as PTUK) was originally set up in October 2000 as Play Therapy UK with the encouragement of Play Therapy International. Meanwhile the British Association of Play Therapists was distinguished from its American counterpart in 1996 and was granted charity status within the UK in 2006 by the UK Charities Commission.

By 2010 Play Therapy International has partnered sister organisations in Ireland, Canada, Australasia, France, Spain, Wales, Malaysia, Romania, Russia, United Kingdom, Slovenia, Germany, New Zealand, Hong Kong, Korea and Ethiopia.

Future Trends of Play Therapy
Numerous researches in the past and present confirm that play therapy helps in curing children. Some of the dreadful problems have been reported to be cured with the help of play therapy. After a child is cured from play therapy she /she will be able to exhibit normal behavior. Play therapy has successfully cured problems like depression.

Play therapy assessments under the umbrella play therapy research should lead the way for the future of the science. The trend for the future of play therapy puts emphasis on significance of larger play areas and toys, need for setting limitations for process and rationale etc. Though play therapy has come a long way in the last three decades, it still has a long distance to cover before it can replace the medication therapy.

If your child is facing an emotional or psychological problem and you are not able to confront him/her then it is a high time that you think of a play therapist.

Author Brief Bio - Mr. Mohanadas is an administrator, teacher, environmentalist and a social worker. He has established a few educational institutions. Presently working as the Head of a Middle School. Side-by-side he is pursuing “Advanced Diploma Course in Counseling and Guidance”. He is interested to work for the upliftment of the poor and the downtrodden. His main hobbies are reading and gardening.

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