Play Therapy Overview

1. Play TherapyOverview Vivian Mann, LLC LCSW, RPT-S, IMH-E® (III) vmann@vcu.edu (804) 334-4253

2. Participants will be able to: • collaborate with play therapists and utilize play techniques to foster growth and change in children • recognize the impact of trauma and support children experiencing traumatic stress reactions Learning objective

3. Introductionsopening activity

4. Play a Natural phenomena

5. What is Play Therapy

6. "Play Therapy is the dynamic process between child and Play Therapist in which the child explores at his or her own pace and with his or her own agenda those issues, past and current, conscious and unconscious, that are affecting the child's life in the present. The child's inner resources are enabled by the therapeutic alliance to bring about growth and change. Play Therapy is child-centered, in which play is the primary medium and speech is the secondary medium." What is Play Therapy British Association of Play Therapy

7. Virginia Axeline – 1947 • Non-directive Play Therapy (Also called Child-Centered Play Therapy) • Student of Carl Rogers • Maintains that play therapy can be most effective when child is allowed to take responsibility for direction of the therapy. Historical Perspective

8. Counselor: • develops a warm, friendly relationship with the child • accepts the child exactly as he/she is. • establishes a feeling of permissiveness in the relationship. Virginia Axiline’s (1969) Eight Principles of CCPT

9. is alert to recognize the feelings the child is expressing and reflects those feelings back to him so he gains insight into his behaviors. • maintains a deep respect for the child’s ability to solve his own problems. The responsibility to make choices and to institute the change is the child’s life. Virginia Axiline’s (1969) Eight Principles of CCPT

10. Virginia Axiline’s (1969) Eight Principles of CCPT • does not attempt to direct the child’s actions or conversation in any manner. The child leads the way; we follow. • does not attempt to hurry the process. It is a gradual process.

11. establishes only those limitations that are necessary to anchor the counseling to the world or reality and to make the child aware of his or her responsibility in the relationship Virginia Axiline’s (1969) Eight Principles of CCPT

12. We focus on the relationship, this is the most important factor. • We accept the child exactly as they are and DON’T ask that they change anything. • We do not investigate • We assess but don’t evaluate How Child Centered Play Therapy (CCPT) is different from other therapies.

13. We create an environment where the child can heal. • This can be frustrating to others because they are looking for a fast fix. How Child Centered Play Therapy (CCPT) is different from other therapies.

14. Structuring • Empathic tracking/responding • Imaginary Play • Limit setting 4 Basic Skills

15. Directivevs. Non-Directive • Non-Directive alone may work for some • When to add directive interventions • Child is dysregulated • Child becomes stuck in traumatic play or reactions • Child is overwhelmed by the play • Child needs to learn a skill

16. happen in the context of the relationship • arebased on children’s play being recognized as functional and symbolic • provides the opportunity to re-work traumatic events • Provide corrective emotional experiences which occur in the context of the relationship and the play All Play Therapy Models

17. Child Traumatic Stress

18. Child traumatic stress refers to the physical and emotional responses of a child to events that threaten the life or physical integrity of the child or of someone critically important to the child (such as a parent or sibling). • Traumatic events overwhelm a child’s capacity to cope and elicit feelings of terror, powerlessness, and out-of-control physiological arousal. • The National Child Traumatic Stress Network Child Traumatic Stress

19. A child’s response to a traumatic event may have a profound effect on his or her perception of self, the world, and the future. • Traumatic events may affect a child’s: • Ability to trust others • Sense of personal safety • Effectiveness in navigating life changes Child Traumatic Stress

20. Disrupts all aspects of normal development including: • Brain Development • Cognitive Growth and Learning • Emotional Self-regulation • Attachment to Caregivers and Social Emotional Development • Trauma predisposes children to subsequent psychiatric difficulties Child Traumatic Stress Lieberman et al., 2003

21. Types of Traumatic Stress • Acute • Chronic • Complex

22. Neurological Functions Neurological Hierarchy Psychological Phenomenon Abstract Thought Concrete thought Affiliation/Reward Attachment Sexual Behavior Emotional Reactivity Motor Regulation Arousal Appetite Sleep Blood Pressure Heat Rate Body Temperature Guilt/ Shame CORTEX Alcohol- Substance Abuse LIMBIC Depressive and Affective Sx. DIENCEPHALON Trauma Core Sx. BRAINSTEM (Dr. Bruce Perry, 2010

23. 4 R’s of Interventions • Relevant • Relational • Repetitive • Rewarding (Dr. Bruce Perry, 2010

24. Cook, A., Blaustein, M., Spinazzola, J., & van der Kolk, B. (Eds.) (2003). Complex trauma in children and Adolescents.White Paper from the National Child Traumatic Stress Network Complex Trauma Task Force Perry, Bruce M.D., (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children, the Neurosequential model of therapeutics. In Webb, N.B. (ed), Working with traumatized youth in child welfare (pp. 26-53). New York, NY: The Guilford Press. Ford, J., Curtois, C., Steele, K., van der Hart, O., Nijenhuis, E. (2005). In Journal of Traumatic Stress, vol 18, October, pp. 437-447. International society for traumatic stress studies Gil, E. (2011). Helping Abused and Traumatized Children: Integrating Directive and Nondirective Approaches. New York, NY: The Gilford Press. Landreth, Garry L. (2012). Play Therapy: the Art of the Relationship (3rd Edition). New York, NY: Taylor & Francis Group. Schaefer, Charles E.. (2011). Foundations of Play Therapy (2th Edition). Hoboken, NJ: Wiley and Son, Inc. van der Kolk, B.A., (2006) Clinical Implications of neuroscience research in PTSD. New York Academy of Sciences. van der Kolk B.A. (2005). Developmental trauma disorder: Towards a rational diagnosis for children with complex trauma histories. Psychiatric Annals, pp. 401-408. References