play therapy is more than child's play

“You can discover more about a person in an hour of play than in a year of conversation.” – Plato

Some issues that clients bring to the counseling office can be addressed via talk therapy, while others respond more adroitly to non-verbal interactions. For those in the younger set, being able to express themselves beyond words is an essential aspect of healing. Play Therapy is best suited for those ranging in age from 3-16 years old.

The Association for Play Therapy (APT) defines play therapy as “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.”

There are many indications for the need to engage in this modality.

  • Acting out behaviors, including harm to self or others, withdrawal and isolation.
  • Depression and anxiety.
  • Defiant behaviors and overt and disruptive breaking of social, familial or educational systems’ rules such as Oppositional Defiant Disorder or Conduct Disorder.
  • The use of substances to self-medicate.
  • Suicidal ideation.
  • Non-verbal autism or Asperger’s Syndrome.
  • Selective mutism.
  • Reactive Attachment Disorder.
  • Eating Disorder such as Anorexia or Bulimia.

According to the British Association of Play Therapists, the modality was developed by Anna Freud, Margaret Lowenfeld and Melanie Klein, who witnessed the benefits of this alternative to psychoanalysis. These researcher/clinicians were able to enter a child’s rich inner world by observing their interactions with objects related to play. The methods are varied, but the intention is the same: to elicit healthy emotional responses in a safe environment, create a sense of positive regard from therapist to client and allow for healing and resolution of symptoms that may range from mildly distressing to devastatingly damaging.

In a play therapist’s office, one might find a dollhouse to simulate the home in which the child lives, figurines, dolls and puppets to represent the family system, games that evoke feelings, as well as art supplies with which the child may express where verbalization falls short. The goal isn’t specifically to get the client to use words, but rather for the therapist to glean meaning from the actions the child takes when engaging in the treatment. Structure is put into place if safety is involved, such as the therapist re-directing the child if he or she is attempting to break a toy or injure himself or herself, or the therapist with the object. It is also appropriate for the therapist to remind the client that the toys need to remain in the room, rather than come home with the child, so that it will be there for others to share and for the next time he or she comes back.

Various Forms of Play Therapy

David Levy, created a therapeutic approach called “release therapy” in 1938. This was a structured approach that encouraged a child who had experienced a trauma, such as witnessing abuse of losing a parent an early age to engage in free play. The therapist then gradually brought on board, materials related to the traumatic event, allowing the child to safely re-experience the event and release any unresolved feelings.

Joseph Soloman developed an approach called “active play” to assist children who displayed impulsive behaviors. The approach was based on his contention that expressing emotions such as fear and anger in play would result in more socially acceptable behavior in the child’s daily life.

Carl Rogers is renowned for person-centered therapy during the 1940s and 1950s. This type of therapy emphasizes the importance of genuineness, trust, and acceptance in the therapeutic relationship that extends outward into the therapeutic playroom. Virginia Axline advanced nondirective play therapy by adapting Rogers’ approach into a play therapy technique that was better suited for children.

Roger Phillips suggested the idea to combine cognitive therapy and play therapy in the early 1980s. Cognitive behavioral play therapy has been used to treat children as young as two years old.

Filial Play Therapy involves parental involvement and assists in strengthening the relationship bond between them. Each session begins with the child having the freedom to play with whatever items are in the room in self-selected combinations and variations. The therapist uses observational statements, such as, “It seems like you are enjoying playing with the car more than anything else,” rather than suggesting adding on other toys. If a child is drawing or painting, the therapist might note that the client is using certain colors, rather than praising the imagery itself. “That’s a really big flower leaning over that tiny blade of grass.”

From the Therapist’s Files

A therapist, who was part of a team from a community mental health center wrap around (home and family based) program, was assigned to work with a 7 year-old boy living at home with his mother, who was raising him as a single parent. His diagnosis placed him on the autism spectrum. He was quite verbal, but according to his mother and school, he would benefit from learning socialization skills. On their first meeting, he told the therapist that he loved dinosaurs and could identify every species. He could draw them as well. He had a well-stocked toy chest containing the plastic creatures. Every time the therapist would visit, he would take his favorites with him when they ventured out to a hillside in his neighborhood. The therapist would observe the ways in which he would have them fight initially and then resolve their conflicts.

Another skill this child had was the total recall of the plot of every movie he had ever seen and would recited the dialog aloud. He would ask the therapist to sing along with him when songs were part of the script. They worked together for a year or so, and the goals of the treatment plan were fulfilled. A few years ago, the therapist was at a community event and was approached by the mother, who had recognized her. She was accompanied by a tall and handsome young man, now in his early 20’s. She reported to the therapist that he was doing well, had completed school and had learned socialization skills. He had no active recollection of the specific activities in which he and the therapist had engaged, but smiled when she reminded him.

Finding a Well-Trained Play Therapist

Mental health professionals who seek specialized training and experience in play therapy may earn their credentials from the APT. The APT is a nationally recognized professional institution which aims to further the play therapy modality and advance the expertise and knowledge of mental health professionals involved in the clinical practice, instruction, and supervision of play therapy. The APT offers two standard credentials: The Registered Play Therapist™ (RPT) and the Registered Play Therapist-Supervisor™ (RPT-S).

Applicants desiring to become a Registered Play Therapist™ must:

  • Possess an active individual state license which allows him or her to independently provide clinical mental health services.
  • Have earned a master’s degree or higher in a mental health field, with special emphasis on areas such as child development, psychotherapy, theories of personality, ethics, or child and adolescent psychopathology.
  • Have two years of general clinical experience (as required for state licensure) and 2000 hours of general mental health clinical experience.
  • Complete 150 hours of play therapy instruction from APT-approved providers or tertiary level academic institutions.

Play family photo available from Shutterstock