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Chapter 17 Play Therapy
You can discover more about a person in an hour of play than in a year of conversation.
Plato
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Chapter Objectives
After reading this chapter, you should be able to:       
Outline the history of play therapy
Define and explain the goals of play therapy
List the advantages and diversity applications of play therapy
Demonstrate the skills of play therapy
Discuss some play therapy strategies
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Early play therapists
Hermine Hug-Hellmuth
Anna Freud
Melanie Klein, and 
Margaret Lowenfield
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Defining Play Therapy
Natural medium of child’s self-expression.
Pleasurable and intrinsically motivating.
Play has a make-believe quality and is flexible. Freedom of choice.
Evokes fantasies and unconscious feelings.
Offers familiar tools.
Safe place to act out feelings, to gain understanding, and to change.
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Goals of play therapy
Boost self-acceptance, self-confidence, and self-reliance
Facilitate learning about self and others
Explore and express feelings
Encourage ability to make good decisions
Arrange opportunities to practice control and responsibility
Explore alternative views of problems and relationships
Learn and practice problem-solving and relationship skills
Increase feeling vocabulary and emotional concepts 
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Advantages of Play
Helps counselors establish rapport with children
Understand children
The way they interact and
Their relationships;
Also allows the teaching of social skills
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7. Schaefer’s Therapeutic Powers of Play
Overcoming Resistance
Attachment Formation
Relationship Enhancement
Communication
Competence
Positive Emotion
Creative Thinking
Mastering Developmental Fears
Catharsis
Abreaction
Game Play
Role Play
Fantasy
Metaphoric Teaching
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8. Personal Qualities of Therapist
Appreciation of children, treating them with a respectful, kind manner.
A sense of humor and willingness to laugh at self.
Playful and fun-loving attitude.
Self-confidence and self-reliance.
Openness and honesty.
Accepting.
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9. Cross-Cultural Practices
Respect all aspects of child’s culture.
Investigate the role of play in diverse populations.
Be familiar with values, beliefs, customs, traditions, and
Be familiar with language of child’s culture.
Recognize the ongoing process of becoming multiculturally competent.
Match philosophical basis of the play therapy.
Be aware of personal cultural biases, values, beliefs, and attitudes.
Interact with multicultural populations.
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Guidelines
Ask only relevant questions.,
Outline the play therapy session and relevant information
Focus on specific problems and help develop short- term goals for counseling.
Take an active, directive play therapy role.
Find brief, concrete problem resolutions.
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11. Children appropriate for play therapy have the following
the ability to tolerate/build/use a relationship with an adult
the ability to tolerate/accept a protective environment
the capacity to learn new ways of coping
the potential to gain new insight and the motivation to try
the attention span and cognitive organization to participate
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12. Play Therapy Approaches
Ecosystemic Play Therapy  
hybrid approach that integrates biology, several theories of psychotherapy  and developmental concepts.  
 child’s interactions and experiences in the world as well as the internal, symbolic world of the child are emphasized
goal of the intervention is to help children have their needs met without interfering with the ability of other people to get their needs met.  
strategies aimed at altering the problem, the child’s view of the problem, and the child’s response to the problem. 
ultimate goal is to help the child change beliefs that are causing difficulties
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13. Play Therapy Approaches
Group Play Therapy
Children ages 2 – 12
Encouragement, connection and reality-checking functions present in groups
Experience helps them learn to function well, to explore their actions, to develop tolerance and to find joy in working with others
Beneficial for children with social skills deficits.
And for children with similar problems, issues, experiences.
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14. Play Therapy Approaches
Prescriptive Play Therapy: Interventions tailored to each child.
Counselors responsibilities include:
Know every approach to play therapy.
Have skill in applying constructs and strategies.
Be capable of applying short- and long-term needs of children.
Know the current outcome research for the most effective treatment for the specific issue.
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15. Play Therapy with Families
Filial Therapy
Introduce parents to methods for conducting child-centered play therapy
Help them practice skills in play sessions
Model the behaviors
Reduce each task to small components and practice
Role play without children
Parents conduct sessions
Increase length of sessions and have home visits
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16. Play Therapy with Families
Parent-child Interaction Therapy (PCIT)
Developed to treat children exhibiting externalizing behavioral problems such as resistance and aggression
Coach parents on ways to use appropriate and advantageous interactions with their child
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Empirical Support
Meta-analysis of play therapy
Reviews 94 studies from 1940 – 2000
Support that play therapy is effective for a variety of problems, populations, in numerous settings, and with a multitude of clinical orientations
Common elements of effective include parental involvement and between sessions
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18. Play Therapy with Specific Problems
School Adjustment
PMHP focuses on identifying elementary children before they have problems
Children Witnessing Domestic Violence
Children Facing Persistent Illness
Autistic Children
Children Experiencing PTSD
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19. Personal Qualities of Therapist
Willingness to use play and metaphors as communication tools.
Flexibility and ability to deal with ambiguity.
Comfort with children and experience interacting with them.
Ability to set limits and maintain personal boundaries.
Self-aware. (Kottman, 2001)
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Considerations
Therapist
Create safe environment in which child can express self freely.
Trust and respect the child and attend to child’s feelings.
Be interested in the child and be warm, caring, and accepting.
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Considerations
Appropriate Clients
Ability to tolerate/build/use a relationship with an adult.
Ability to tolerate/accept a protective environment.
Capacity to learn new ways of coping.
Potential to gain new insight and the motivation to try.
Attention span and cognitive organization to participate.
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Play Stages
Relationship
Release
Recreation
Re-experiencing
Resolving
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23. Criteria for Assessing Progress
Child comes to session looking more hopeful and relaxed.
Child appears to have increased confidence.
Child can summarize what has happened and what has been learned.
Child’s interactions with parents appear more relaxed.
Play patterns, interactions, and/or body language has changed.
Child openly raises a problem or concern.
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24. Play material choices based on:
Facilitating the relationship
Encouraging child’s expression
Helping counselor gain insight into child’s world
Providing child chance to test reality
Providing child acceptable way to express unacceptable thoughts and feeling
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25. Categories of Play Media
Play media are the materials and props used in a session:
Real-life toys: dolls, furniture, telephone, money, animals, nurse kit, household items, etc.
Acting-out toys and aggressive-release toys: handcuffs, balls, guns, toy soldiers, inflatable punching toy, etc.
Creative-expression and emotional release toys: colored chalk, sand and sandbox, crayons, clay, pipe cleaners, hats, costumes, paint, puppets, etc.
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26. Basic Skills of Play Therapy
Tracking: describe what the child is doing
Restating content: paraphrasing what the child has said
Reflecting feelings: deepen the relationship and help child understand emotions, being with others and build an affective vocabulary
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27. Basic Skills of Play Therapy
Returning responsibility to the child: builds self-confidence and self- responsibility
Using the child’s metaphor: maintain the child’s story without interpretation of meaning
Setting limits: keeps the child safe, increases sense of self-control and enhances responsibility
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Selected Strategies
Art
Magic art
Color emotive brain
Clay
Puppets
Sand
Make a world technique
Stages of chaos, struggle and resolution
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