An Orientation to Play Therapy Stephanie Pratola, Ph.D. January 11, 2012 KidS Group

Characteristics of play Action oriented (real or imagined) 2 Stephanie Pratola, Ph.D :15

Characteristics of play Spontaneous, self generated – intrinsically motivated 3 Stephanie Pratola, Ph.D

Characteristics of play Not too serious: Not goal oriented 4 Stephanie Pratola, Ph.D

Characteristics of play Not good or bad: it just is 5 Stephanie Pratola, Ph.D

Characteristics of play No rules - flexible 6 Stephanie Pratola, Ph.D

Characteristics of play Non-literal: uses fantasy or imagination Use of symbolic objects 7 Stephanie Pratola, Ph.D

Characteristics of play Don’t have to be “good” at it 8 Stephanie Pratola, Ph.D

Characteristics of play Fun 9 Stephanie Pratola, Ph.D

Characteristics of play Involves loss of self consciousness ( induces the state of “flow”) 10 Stephanie Pratola, Ph.D

Characteristics of play Play is the “medium” of children 11 Stephanie Pratola, Ph.D

Characteristics of play Play is intrinsically therapeutic 12 Stephanie Pratola, Ph.D

Characteristics of play Functions of play beyond to have fun are unconscious 13 Stephanie Pratola, Ph.D

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. 14 Stephanie Pratola, Ph.D

Association for Play Therapy APT promotes the value of play, play therapy, and credentialed play therapists by advancing the psychosocial development and mental health of all people and sponsoring and supporting those programs, services, and related activities that promote the: 15 Stephanie Pratola, Ph.D

Association for Play Therapy Public understanding and appreciation of play and play therapy Effective practice of play therapy through research, education and training, and support 16 Stephanie Pratola, Ph.D

Association for Play Therapy Recognition, incorporation, and preservation of diversity in play and play therapy Development and maintenance of a strong professional organization that satisfies this mission 17 Stephanie Pratola, Ph.D

Rationale for Play therapy- 18 Stephanie Pratola, Ph.D :30

Children naturally use play to Develop basic kinesthetic skills 19 Stephanie Pratola, Ph.D

Children naturally use play to: Learn to relax and release energy 20 Stephanie Pratola, Ph.D

Children naturally use play to: Explore their environment 21 Stephanie Pratola, Ph.D

Children naturally use play to: Master unfamiliar situations 22 Stephanie Pratola, Ph.D

Children naturally use play to: Develop an understanding of their world 23 Stephanie Pratola, Ph.D

Children naturally use play to: Master Conflicts 24 Stephanie Pratola, Ph.D

Children naturally use play to: Soothe and Distract Themselves 25 Stephanie Pratola, Ph.D

Children naturally use play to: Develop a sense of self separate from others 26 Stephanie Pratola, Ph.D

Children naturally use play to: Understand societal roles 27 Stephanie Pratola, Ph.D

Children naturally use play to: Learn to cooperate with others 28 Stephanie Pratola, Ph.D

Play Therapy There is no one school of play therapy 29 Stephanie Pratola, Ph.D

All play therapy has in common Emphasis on a relationship that honors play 30 Stephanie Pratola, Ph.D

All play therapy has in common: Use of techniques designed to harness the natural therapeutic power of play 31 Stephanie Pratola, Ph.D

Other “Common features” of Play Therapy: Use of “play” interactions and activities Characterized by Action- real or imagined Imagination Use of symbolic objects Creative productions Value on process rather than content 32 Stephanie Pratola, Ph.D

Other “Common features” of Play Therapy: Communication in the play interaction that is Developmentally appropriate Metaphorical/symbolic 33 Stephanie Pratola, Ph.D

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 34 Stephanie Pratola, Ph.D

History of Play Therapy There is no one school of play therapy Analytic: Anna Freud Jungian: Sand tray therapy Rogerian: Axline – non-directive Gureney – Filial Cognitive Behavioral – Integrative/Prescriptive/Multimodal 35 Stephanie Pratola, Ph.D :40

Schools of Play Therapy differ on several dimensions Directive vs. Non-Directive Structured vs. Unstructured Level of verbalization Choice and use of toys and materials Who is present in the session: parents, family, peers, individual 36 Stephanie Pratola, Ph.D

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. 37 Stephanie Pratola, Ph.D

Structured vs. Non Structured A dimension of Non-directive therapy Therapists 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 Stephanie Pratola, Ph.D

Level of Verbalization And ….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 39 Stephanie Pratola, Ph.D

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. 40 Stephanie Pratola, Ph.D

School of Play Therapy Associated with…..Therapist stanceUse of Interpretation?Toys (Client Centered) Axline Axline,Non-directive/ Unstructured NoA wide variety Psychoanalytic Freud, JamesNon-directive/ Unstructured YesA limited number Existential MoustakisNon-directive/ Unstructured YesA wide variety Theraplay JernbergDirective/StructuredNoSelected by therapist Adlerian Adler, KottmanDirective/StructuredYesSelected by therapist Cognitive-BehavioralSchaeferDirective/StructuredNoGames/ therapeutic activities Eco-systemicO’ConnorDirective/StructuredYesSelected by the therapist GestaltOaklanderDirective/UnstructuredNoSelected by the therapist JungianLowenfieldNon- Directive/Structured YesSandtray and objects provided 41 Stephanie Pratola, Ph.D

Clinically Play can be used to: 1. form a relationship 2. assess child’s thoughts, feelings, beliefs, expectations, skills, reactions 3. communicate important ideas: 4. challenge and teach new skills 5. provide opportunity for something different to happen in an interaction 6. help child make connections, understand self and motivations of others. 7. dissipate energy and cope with overwhelming feelings. 42 Stephanie Pratola, Ph.D

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. 43 Stephanie Pratola, Ph.D

Beginning a Play Therapy Relationship 44 Stephanie Pratola, Ph.D pm

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 Stephanie Pratola, Ph.D

Talking “ to a child in play 1. Avoid direct, intrusive questions 2. Child takes the lead, directs the action. 3. Describe what you see out loud (explained below) 4. Accept creations without judgment 5. Use “I wonder” statements 6. Be animated, energetic, dramatic – show PIZZAZZ 7. 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” 46 Stephanie Pratola, Ph.D

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.” 47 Stephanie Pratola, Ph.D

Role Play Practice Activity Divide into threes: child, RPT and RPT-S Stephanie Pratola, Ph.D

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

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 months Stephanie Pratola, Ph.D