2. What is EPT?
• children experience the world experientially
• engages all the senses when working through
doubts, fears, anger and other unresolved
emotions
• Firm belief in the capacity of the child to heal
3. What is EPT? (cont.)
• Child is expert on his/her pain and knows how
best to approach it
• In therapy, therapist allows child the freedom
to work through struggles at his/her own pace
• child can reenact situations involving
behaviors not used in precipitating events
4. How does it work?
• Play is a child’s perspective on his/her experiences of
the world and relationships
Child enters fantasy play as a defense mechanism to deal with anxiety
when sense of self has been disrupted/threatened.
• Dignity and empowerment are the primary processes
of EPT
o Child usually assumes power position; therapist to act/react as
child
•
gives therapist an insight on what it's like to be child
•
therapist to experience feelings of powerlessness,
ineffectiveness, apprehension, and insignificance
5. How does it work?
• Child becomes the creator of his/her experiences with
needs and fears expressed in a format he/she can control,
conquer, & change
• Child uses the symbolism and metaphorical expression of
play to communicate confusion, doubt, & pain
o EPT therapist responds to meaning of the metaphor rather than
reflecting the content
6. How does it work?
• Based on 3 major components:
1. The capacity of a child to use play, symbolism, and metaphorical
expressions to convey internal world & expressions
2. Therapists’ skill in understanding & relaying the child’s expressions
back to the child
3. Parental responsibility to learn and engage in the process of the child
• Consists of 5 stages:
Exploratory Stage
Testing for Protection Stage
Dependency Stage
Therapeutic Growth Stage
Termination Stage
7. 5 stages of EPT
Exploratory Stage
• child gets acquainted with therapist, play room, and
time together
• therapist uses more observational statements ;
follows child’s lead
• child's behavior outside of playroom undergoes a
temporary, but dramatic, improvement
indicator of child's potential for change
8. 5 Stages of EPT
Testing for Protection Stage
•goal: establishment of relationship
•child is testing counselor's trustworthiness & safety of
therapeutic alliance
therapist to reflect & validate child's feelings
•Therapist should be aware of own limits of comfort
•Some disruption or regression in child behavior may
be evident at this stage; parents need to be informed
9. 5 Stages of EPT
Dependency Stage
• the emotionally intense, working stage; child is prepared
to face emotional turmoil
• 2 substages
• Child’s disclosure of experiences
• child engages in emotionally-themed fantasy play; feels safe
enough to invite therapist into his/her play
• Leveling of the fear object or perpetrator
• Trauma is a fear of death for the child, and the child must
conquer impending death fear in her play”
• The metaphorical equivalent of the pain & struggle of the past
being lifted off the child
10. 5 Stages of EPT
Dependency Stage
• child takes on aggressor/power stance
o Child must possess the power to accomplish through play what s/he
was unable to accomplish in reality (as long as child & therapist are safe
o Therapist assigned role of child; must respond as child would at that
age, using facial expressions, sounds, body movement
• 2o important processes occurring simultaneously:
Child develops an internal sense of empowerment & control
o Child gains a “spiritual victory” over fear object/trauma/challenge
• Dependency stage ends with annihilation or death of
aggressor
11. 5 Stages of EPT
Therapeutic Growth Stage
• Child briefly grieves the lost trauma persona
o Will display flattened affect
o Will seem to regress to exploratory stage
Use of Play for:
o skill mastery
o Re-experiencing lost developmental stages
o Eventually age-appropriate mastery, silliness, & laughter
Child no longer depends on therapist for sense of ID
Play becomes more interactive & cooperative
12. 5 Stages of EPT
Termination Stage
• Represents loss of a significant relationship
• With Introduce within therapist should:child time to react & say good
termination,
firs 10-15 min to give
bye to play
Communicate to child the importance of their relationship to
therapist
Follow up with encouragement for the child’s ability to move forward
without therapist
• Ideally, child has gained the ability to interact
appropriately with others & can allow self to trust in caring
relationships
13. Parental Involvement in EPT
• Parent involvement critical to outcome of therapy; parent-
therapist relationship viewed as a key supportive
component of the play therapy process
• Parents need to be oriented to the concepts of healing pain &
regression; they are key in providing security, support, and
regulation when a child experiences a regressive episode
Children may need to exhibit behaviors representative of an earlier age
Regression indicates the child is approaching the irreconcilable internal
experiences (trauma/disruption) that drives the attitude/behavior
disruptions at the developmental age at which event occurred.
Each regressive episode assists the child in experiencing regulation after
emotionally re-experiencing aspects of the trauma
14. Parental Involvement in EPT
• Therapist meets with parents 10-15 min after every session
to discuss themes expressed and emotional and security
needs to be met in between sessions.
Critically important to maintaining sense of security between
sessions
• Therapist provides compassionate support to parents
as parents learn to soothe, support, and nurture
regressive response
15. Clinical Applications for EPT
• A prerequisite for a child to participate in EPT is the
capability for symbolic play
• EPT is beneficial for children presenting with the following:
o Reactive disorders
o Oppositional Defiant Disorder
o AD/HD
o Separation Anxiety Disorder
o Phobic Disorders
o Attachment Disorders
o Obsessive Compulsive Disorder
o Dissociative Indentity Disorder
o Some psychotic features ( associated with long term, high intensity
trauma )
16. Clinical Applications of EPT
• When using diagnostic disorders, it is really important to
determine an accurate history as reactions to trauma
may present as constitutional in nature
• Allows children to approach memories of trauma in a
way that is not overwhelming to them
• Not as beneficial to children with pervasive
developmental disorders, such as Autism or Asperger’s
Syndrome
17. Evidence Basis for EPT
• Relatively new concept in EPT
• Stages developed by observing children create their own
process of healing
o Progression relatively consistent
o Allows therapist to track child in process; can ascribe more appropriate
expressions to match the child’s meaning
• Focused on relationship with child, but gives more direct
expression to what the child expresses in play
• Brain Active form of play therapy
o uses integrated Right-left & top-bottom processes in the brain
18. Evidence Basis for EPT
• “Trauma is in the nervous system of the child, not the
event”
o Play process must be active and repetitive to dissipate trauma effects on
the brain
o Implicit memories and sensations + explicit or factual memory process
considered during regression
o Therapist must consider the stage of brain development being conveyed
o Look at neurological dysfunctions fueling inappropriate behaviors
19. Challenges of EPT
• Therapist must undergo a paradigm shift to understand
the meaning of each expression from the child’s
perspective
• Can be frequently difficult to maintain credibility with
other professionals who serve children
• High risk of counter-transference
o Self examination and growth of the EPT therapist is an constant process
o Processing own experiential world
• Therapist must refrain from leading the child’s play
o May offer redirection to facilitate the process or to provide a safer
environment
20. Case Study - *Seth, age 4
• Born prematurely at 8 months
• Critical for Mom & baby
o Baby punctured unsuccessfully 40 times with IV
o “Mimicking death”
• Referred for therapy for:
o Considerable anger towards other
o Anger at preschool
o Difficulty relating to other children
o Asthma
o Awkward & coordinated; little body awareness
o Little empathy or compassion for others
21. Case Study - *Seth, age 4
• Mother requested being present in the play room
• Testing for protection Stage
o Initially refused the leave the play room
o Trust established & was able to separate from play & playroom
• Dependency Stage
o Depicted struggle in prenatal position
o Assigned therapist role of child; Seth role of doctors
o Switch roles, allow Seth to “defend himself”
• Therapeutic Stage
o Validated new positive sense of self
Notes de l'éditeur
Bullet point 1 - Experiential Play Therapy is based on the concept that children encounter their world in an experiential manner versus a cognitive one. Bullet Point 2. EPT children engage all of the senses to work through problems, concerns
T4P: at this stage, the child wants to know if the therapist can be trusted with his/her story. Testing comes in many forms, most commonly boundary testing.