Orientation to play thearpy shared version

An Orientation to Play Therapy

Stephanie Pratola, Ph.D.
January 11, 2012
KidS Group

Characteristics of play
 Action
oriented (real
or imagined)

Stephanie Pratola, Ph.D..
2012 12:15 2

 Spontaneous,
self generated
– intrinsically
motivated

Stephanie Pratola, Ph.D...
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 Not too serious:
 Not goal oriented

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 Not good or
bad: it just
is

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 No rules -
flexible

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 Non-literal: uses
fantasy or
imagination
 Use of symbolic
objects

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 Don’t have
to be “good”
at it

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 Fun

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 Involves loss
of self
consciousness
(induces the state
of “flow”)

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 Play is the
“medium” of
children

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 Play is
intrinsically
therapeutic

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 Functions of
play beyond
to have fun
are
unconscious

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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 Pratola, Ph.D... practices.
Stephanie
of best
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Rationale for Play therapy-

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Children naturally use play to
 Develop
basic
kinesthetic
skills

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Children naturally use play to:
 Learn to
relax and
release
energy

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 Explore their
environment

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 Master
unfamiliar
situations

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 Develop an
understanding
of their world

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 Master
Conflicts

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 Soothe and
Distract
Themselves

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 Develop a
sense of self
separate
from others

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 Understand
societal roles

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 Learn to
cooperate
with others

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Play Therapy
 There is no one school of play therapy

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All play therapy has in common
 Emphasis on a
relationship that
honors play

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All play therapy has in
common:
Use of techniques
designed to
harness the
natural
therapeutic
power of play

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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

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Other “Common features” of
Play Therapy:
 Communication in the play interaction
that is
 Developmentally appropriate
 Metaphorical/symbolic

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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
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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
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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

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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.

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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.
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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
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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.
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School of Play Associated with….. Therapist stance Use of Interpretation? Toys
Therapy

(Client Centered) Axline, Non-directive/ No A wide variety
Axline Unstructured

Psychoanalytic Freud, James Non-directive/ Yes A limited number
Unstructured

Existential Moustakis Non-directive/ Yes A wide variety
Unstructured

Theraplay Jernberg Directive/Structured No Selected by therapist

Adlerian Adler, Kottman Directive/Structured Yes Selected by therapist

Cognitive-Behavioral Schaefer Directive/Structured No Games/ therapeutic
activities

Eco-systemic O’Connor Directive/Structured Yes Selected by the
therapist

Gestalt Oaklander Directive/Unstructured No Selected by the
therapist

Jungian Lowenfield Non- Yes Sandtray and objects
2012
Directive/Structured provided
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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.
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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.
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Beginning a Play Therapy

Relationship

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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.
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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”
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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.”

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Role Play Practice Activity
 Divide into threes:
 child, RPT and RPT-S

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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.

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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
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