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You have learned that play is the foundation to how children learn. Did you also know that play can be used to help heal emotional scars? No lies told here! Play is often used as an emotions intervention for young children who have experienced upsetting or traumatizing events. We sometimes call those events, ACEs or adverse childhood experiences. Young children who encounter four or more ACEs are at an increased likelihood for later childhood and adult challenges (Ballard et al., 2015; Van et al., 2014). These challenges have been shown to include increased school failure and school pushout rates, re-victimization, increased health risks, decreased cognitive and social-emotional development, and increased significant mental health problems (Reuben et al., 2016). Quite often, these outcomes can be ameliorated or at least altered when play therapy is used. Play therapy can also be used for concerns related to anxiety, childhood depression, attention deficit/hyperactivity disorder (ADHD) and several other social-emotional concerns.
According to the Association for Play Therapy (APT, 2016), Play Therapy is “the systematic use of a theoretical model to establish an interpersonal process wherein trained Play Therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development.”
Oh dear, what exactly does that even mean? Let me break it down for you.
Play Therapy is a series of strategies that use children’s natural way of communicating their ideas, feelings, and experiences. In the field of Play Therapy, we often think of Play as the language of children and the toys to be the children’s words. Through play rehearsal, children retell their traumatic experiences in an environment that is psychologically and physically safe for them to explore what happened or what they witnessed.
Play Therapy should only be implemented by a credentialed Play Therapist, which is a person who is both a licensed or certified mental health professional (e.g., licensed psychologist, licensed counselor, certified school psychologist, certified school social worker, etc.) and has gone or is going through (with appropriate supervision) the certification process of becoming a Registered Play Therapist (RPT; APT, 2016). By using Play Therapy, children are able to retell their stories and experience firsthand what it is like to redesign their narrative. This leads them to feeling empowered in their situation and improves their external behaviors. Children become able to express what they were not able to show during the time of the trauma.
There are many different approaches or theoretical orientations under the Play Therapy umbrella, and some of them meet the standard of being identified as evidence-based practices, which means that they have enough supporting rigorous research to be shown as effective treatments (Bratton et al., 2005). However, when people talk about Play Therapy, they are most commonly referring to Child-Centered Play Therapy (CCPT). This approach is most popular with young children around the ages of two to eight or nine years old. Depending on several factors such as culture, cognitive and social development, some older children may effectively engage in this approach. Child-Centered Play Therapy is a non-directive approach, such that the child is the leader of the toys selection process and how the toys will be used to tell their story. In this approach, the Play Therapist is the watchful observer allowing the child a judgment-free space as their trauma experience is shared (Landreth, 2012). The Play Therapist comments on what the child does, but avoids telling the child what to do. When the child invites the Play Therapist into their play, the Play Therapist becomes an active ingredient in the child’s story, and the child directs the Play Therapist so that the full story can unfold. In this way, CCPT is meant to heal the child from the inside out.
Different Play Therapy approaches can also be used to help improve parent-child relationships, older children, and non-trauma based mental health difficulties. Some Play Therapy approaches have even been found to be useful for adults in individual psychotherapy as well as for families and romantic couples. More recently, play therapy has ventured into the world of telehealth. It looks a little different, but still has some of the same healing agents.
Takeaways
So, what’s the mini knowledge bomb here?
Play Therapy is more than "just play or leisure" even though it uses play as a vehicle for emotional and psychological change.
Play Therapy is not an approach that can be done by just anyone.
Only skilled and highly trained Play Therapists can appropriately use Play Therapy.
Regardless of what you brought to this post, I hope that you find a moment to play a little today.
PlayfulLeigh, Dr. Dowtin
This was a little information about play therapy as an child therapy intervention. Feel free to leave a comment. Share this with others.
Is your child struggling with emotional or behavior challenges? Are you overwhelmed with their behaviors? Did something happen in your family that your child may need support? Schedule an intake session for you and your child.
Are you a trainee (LGPC in Maryland) looking for supervision from a board approved LCPC? Contact Dr. Dowtin to learn more.
Links/References
Association for Play Therapy. (1982). Retrieved from https://www.a4pt.org/page/AboutAPT
Ballard, E. D., Van Eck, K., Musci, R. J., Hart, S. R., Storr, C. L., Breslau, N., & Wilcox, H. C. (2015). Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood. Psychological Medicine, 45(15), 3305-3316.
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
Landreth, G. (2012). Play therapy: The art of the relationship(3rd ed.). New York, NY: Reuben, A., Moffitt, T. E., Caspi, A., Belsky, D. W., Harrington, H., Schroeder, F.,… & Danese, A. (2016). Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health. Journal of Child Psychology and Psychiatry, 57(10), 1103-1112
Van Niel, C., Pachter, L. M., Wade Jr, R., Felitti, V. J., & Stein, M. T. (2014). Adverse events in children: predictors of adult physical and mental conditions. Journal of Developmental & Behavioral Pediatrics, 35(8), 549-551.
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