Monday 22 December 2014

Play therapy: Playing attention

If your children are acting up and you can't figure out why, don't send them to the corner, try sending them to play therapy. It's a good way to help them work through issues

Lisa Jewell

Published 29/06/2009 | 00:00

Play therapist Sarah Rush at the Owen Connolly Counselling Centre

PLAY therapy isn't as well known or widely used in Ireland as it is in the UK and the States but it is a useful tool in helping children deal with emotional problems. Sarah Rush, who is a play therapist at the Owen Connolly Counselling Centre in Dublin, says there would be a huge benefit in having more play therapists in this country.

"Play therapy is a therapeutic intervention that's really designed to help children be as happy and well adjusted as possible," she says. "If the child is a little bit stuck in their development because of something that's happened, then play therapy can help them get back on the developmental track.

"Most parents who opt for play therapy for their child notice that the child has more confidence and self-esteem after a few sessions. It's giving them the emotional support so they can look at a difficult life experience that they've gone through."

Play therapy is often used for children dealing with parental separation or divorce, bereavement, attachment problems, family illness, anxiety or abuse. It is generally used for children aged three to 12 years.

Expression

At the best of times, children can find it difficult to articulate what they're feeling and that's only accentuated when they find themselves dealing with bigger life issues.

But play can be a way for a child to express their feelings about what's going on and they can open up to someone who is not directly involved in the situation.

"We use an enhanced play environment and the child has an opportunity to come in and choose what toys or materials they want to use," says Sarah, who worked in a Barnardos Family Support Centre for seven years and has a degree in psychology and an MA in Non-Directive Play Therapy.

"It's child-centred and it's non-directive, which means I don't use structured exercises but let the child lead the play. For instance, there's a doll's house in the corner of the room and that might be an opportunity to play around issues about home.

"There are dolls, nappies and bottles, which give opportunities to play around issues to do with nurturing, attachment and that sort of thing. There's a huge collection of dress up and children often use role-play as a way to express issues they're going through. Often the child will give me a role -- they might want to be a powerful king fighting the witch.

"I try not to push the therapy in any direction. If a little girl were coming to me because her mum and dad have split up, I wouldn't be asking direct questions about how she feels about that. I'd be very much focusing on developing this trusting relationship and making her feel safe.

"I'd be paying very close attention to this little girl and how she might be feeling. She might express that through non-verbal behaviour or she might express it through her play. So if she wanted to play a powerful king and I'm the witch, there might be certain feelings that she's expressing through that role.

"I'm trying to help her understand her feelings by making verbal reflections, like 'Oh you're the powerful king and you want to get rid of this witch'. The child will often say, 'Yes' so you know you're on the right track with it and you're helping them understand how they feel."

Play therapy can provide breakthroughs with children who are having emotional difficulties.

In one such case, Barbara* from Wicklow couldn't work out why her daughter Laura* got hysterical about going to school.

Attachment

"She started school in September 2007 and for the first two weeks, she loved it," she says. "Then towards the end of the month my father was diagnosed with cancer. Laura was very close to him and she took it very badly."

Over the next year, Laura would cry every morning about going to school.

"Everyone in the house was on tenterhooks because of it," says Barbara. "Nothing that we tried with her seemed to work. My father passed away in the April and Laura went back to school in September and the problem was still there."

Barbara's GP mentioned play therapy to her and she decided to give it a try.

"We thought Laura had been acting that way because my father had died but it was only through the feedback from the play therapy that we realised the problems had started back when he got sick. Laura associated going to school with being sick and she told the play therapist that when she went to school, she was afraid she wouldn't see me again.

"She was obsessed with people dying and she had this thing about people going into hospitals and not coming back out. It was a lot for a five-year-old to be dealing with.

"But since she's had the play therapy sessions, she's like a different child. She looks forward to going to school and it's like all those feelings she had have lifted.

"I'm glad she did the play therapy because it's like my GP said, if we didn't find out what was causing her anxiety about going to school, she might have ended up with more problems because of it."

Play therapy usually takes place over the course of six to eight sessions and it first begins with a home visit.

"That's particularly important for younger children so they know what the play therapist looks like," says Sarah Rush. "I usually bring a photo of the play room so that it seems a bit familiar to them. It's so that everyone is feeling a bit more comfortable with it. You could imagine that a four- or five-year-old might feel a little bit anxious about coming to this new place.

Feedback

"Another important thing is that mum or dad is sitting in the waiting area during the play therapy session. That lends a huge amount of emotional safety for the child so that if half way through the session they're working on some difficult feelings, they know they can go out to check on mum or dad and say hello before coming back into the play session."

While children can talk freely about what goes on during the play session, parents are asked not to quiz their child about it.

"I would meet with mum or dad every three to four sessions and give them general feedback on what I see the child is communicating in the play-therapy session," says Sarah. "We look together at what things could happen at home to better meet the child's needs.

"I always focus on the fact that the parent is here, they really care about their child and they want to make things better for them. They've taken a really important step in coming here and it's a collaborative process between the parents and me.

"I'm finding myself using filial play therapy more and more. Filial means the parent-child relationship and this type of play therapy involves supporting and training parents to do special play times at home with their child. They're not play-therapy sessions and the parent is clear that they're not a therapist at the end of the training.

"It's about supporting the parent to learn relationship-enhancing skills that they're going to be able to use to do child-centred play sessions at home with their child."

One area where filial play therapy is of particular help is in dealing with attachment problems that some adopted or fostered children experience.

Michelle*, from Dublin, is using filial play therapy with her daughter Ruth*, who was adopted from overseas when she was 14 months old.

"She was in an orphanage and then in foster care for several months," says Michelle. "The handover to me was quite fast so she didn't get the chance to get to know me over a period of time. I can imagine the stress of that for a young child -- to be taken from a culture she'd known and people she'd known and then she was living in another country.

"She was developmentally doing well but when she went to school I started to see some problems arising. She didn't develop relationships with the other kids and she had issues around control. Her need for control was a big challenge.

"It was suggested that play therapy might be a good idea. With any form of therapy, you can see some disimprovement at the beginning when some issues come up but my relationship with my daughter has gotten an awful lot better and I understand her more. Her play is a lot less intense and she's more chilled out.

"I felt there were skills that I could use in my relationship with Ruth so I decided to go down the filial play-therapy route. It gives us an allocated time slot when we can focus on play and on each other.

"If my daughter is explaining play therapy to someone else, she'll say, 'it's about getting mummies and daddies to talk to children better and know what they're thinking'. I think that's a great way of summing it up."

For more information on play therapy visit the Irish Play Therapy Association's website:

www.ipta.ie

or check out the British Association of Play Therapists' site at: www.bapt.info.

* Names have been changed

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