1. Why attachment matters in play Roberta Manners, Associate Theraplay ® therapist Sheila Lavery, Theraplay ® trained facilitator 2014

2. Objectives for the day  Learn the principles of Theraplay ®  Explore the role of play in building trust  Demonstrate and practise Theraplay ® activities  Consider how to employ Theraplay ® in your own practice. 2014 Why attachment matters in play

3. What is Theraplay ® ? Theraplay ® is adult-child play therapy, based on the natural patterns of healthy interaction between parent and baby. It is used to establish or re-establish connection between parents and children following loss, trauma or separation. 2014 Why attachment matters in play

4. Theraplay ® and child development  Early interactions between parent and child, create the foundation of the child’s being – their sense of self and how they relate to others and the world.  Fostered and adopted children have experienced a range of negative interpersonal interactions.  Foster and adoptive parents generally have more positive experiences of relationships. 2014 Why attachment matters in play

5. “… Because it focuses on attachment and relationship development Theraplay ® has been used successfully for many years with foster and adoptive families”. (Introductory Theraplay and MIM training) 2014 Why attachment matters in play

6. What difficulties respond to Theraplay ® ?  Withdrawn, depressed, fearful, shy children  Acting out, angry, non-compliant children  Attachment/relationship problems  Trauma history  Regulatory problems/ADHD  Autistic Spectrum Disorders  Developmental delays 2014 Why attachment matters in play

7. What makes it Theraplay ® ?  Responsive, attuned, interactive play  Modelled on “good enough” parenting  Focus on here and now  It is fun!  Adults direct the play  Focus is the relationship  Nurturing touch is integral  Geared to child’s emotional (not chronological) age. 2014 Why attachment matters in play

8. Benefits for the child  Feels safe and comforted  Experiences good touch  Learns to trust  Learns regulation  Improves self-image  Experiences fun with parents. 2014 Why attachment matters in play

9. Putting back the missing pieces Theraplay ® provides an opportunity for foster and adoptive parents to create positive inter- subjective experiences which their children missed or didn’t get enough of. soothing physical contact dyadic preverbal right brain to right brain intensive 2014 Why attachment matters in play

10. These developmental building blocks challenge the child’s negative internal working model of themselves and others, so they can accept what foster and adoptive parents have to offer. 2014 Why attachment matters in play

11. All children with an insecure attachment history need heaps of nurture. Yet parenting is often less intimate and playful with older children. Theraplay ® enables child and parent to accept the need for regression. Why attachment matters in play

12. Theraplay with traumatised children  Relational trauma with attachment figure is more traumatic than external threats.  Trauma is non verbal – adaptive responses  Traumatised children may resist conventional therapy  They see the world as threatening and overwhelming  Problems with relationships  Primed for stress – fight, flight or freeze 2014 Why attachment matters in play

13. Key concepts for trauma  Work at a slower pace  Respect and work with the child’s coping mechanisms  Combines with other trauma work such as life story work  Avoid working with dangerous, acting out or actively psychotic children or recently traumatised children 2014 Why attachment matters in play

14. Apply Theraplay ® to the everyday 2014 Why attachment matters in play

15. The 4 dimensions of Theraplay ® Scottish Attachment in Action 2014

16. The purpose of engagement “To establish and maintain a connection with the child, to focus on the child in an intense way and to surprise and entice the child into enjoying new experiences.” Let’s try Peekaboo Scottish Attachment in Action 2014

17. The purpose of nurture “To re-enforce the message that the child is worthy of care and that adults will provide care without the child having to ask.” Let’s try caring for hurts Scottish Attachment in Action 2014

18. The purpose of structure “To relieve the child of the burden of maintaining control of interactions. The adult sets limits, defines body boundaries, keeps the child safe and helps complete the sequence of activities” Let’s try hand stacking Scottish Attachment in Action 2014

19. The purpose of challenge “To help the child feel more competent and confident by encouraging the child to take a slight risk and accomplish an activity with adult help” Let’s try thumb wrestling Scottish Attachment in Action 2014

20. The three rules of Theraplay 1. No hurts 2. The adult is in charge 3. We have Scottish Attachment in Action 2014

21. The PLACE attitude Playful Liking Acceptance Curiosity Empathy Dan and Colwyn demonstrate shared meaning Scottish Attachment in Action 2014

22. Theraplay programme  Full history/presenting difficulties  Marschak Interaction Model (MIM) assessment  Parent preparation  Sessions are planned - possibly up to 20 weekly/fortnightly 45-minute sessions with regular reviews  Sessions are usually filmed. Scottish Attachment in Action 2014

23. Final things to think about  Find a safe, comfortable space  Adult sets structure (e.g. ready, steady, go!)  Flow of activities  Stay calm and focused on the child  Don’t say “don’t” (except with hurts)  Attunement and empathy  “We’re going to...” not, “ Would you like to...”  Be aware of resistance and trauma triggers  Stay playful and engaged. Scottish Attachment in Action 2014

24. Further reading  Theraplay – Helping parents and Children Build Better Relationships Through Attachment- Based Play by A Jernberg and P Booth (Jossey-Bass)  I Love You Rituals by Becky A Bailey (HarperCollins)  Fun to Grow On by Virginia Morin (Magnolia Street Pub.) Scottish Attachment in Action 2014