Play therapy is method developed for helping troubled children with their distress. According to Ann Cattanach (2003),the therapy makes use of play as the medium of communication and understanding between the child and therapist. The underlying principle in the play therapy is that play is a child’s first recognition of the outside world and a medium through which it makes contact with the environment. The play world for children is a world where their imagination mixes with the reality.The importance of living in an imaginary world for children is that they feel empowered to take decision, feel superior and are able to manipulate their world according to their own wishes. The imaginary world is a predictable entity for children, where they can move without fear and it mitigates their sense of isolation and insecurity (Cattanach, 2003).
Children make sense of and derive meaning of their environment from the context of their life. When children are engrossed in playing, they create their own context, which makes play as the most meaningful situation for children (Bruce, 1993).It is widely recognized among psychoanalysts and behavioral therapists that play starts very early in a child’s life, most likely within first few weeks after the birth (Mcmahon, 1992). Play helps babies to assimilate with their world, form bonding with people around them, especially the mother, experience their physical reality and slowly develop emotions and feelings. In view of psychoanalyst Melanie Klein (Klein, in Mitchell 1986) the initial psychological merger of mother and child helps the baby develop good feelings about self and gets rid of the bad feelings by projecting them on the mother.
This early phase in infant development plays a very important in defining everyone’s personality and is the main cause of the common tendency to blame or hurt others when in stress (Mcmahon, 1992). The play therapy works by revoking the same sentiments of attachment and containment in children that appeals to their sense of security and belonging they experienced with their parents (Bowlby, 1969 and 1982). Play Therapy Approach Play therapy focuses on four broad functions of play in creating a therapeutic model (Russ, 2004).The first is that play is a natural form of expression among children, referred to as the language of play (Chethik, 1989). Chethik described play as representation of child’s inner world that expresses their fantasies and conflict laden feelings and sometimes even the expression of the feeling works as a therapy (Axline, 1947). As a medium of expression , play helps children to deal with problems of their lives, and bring an overall sense of order, that works in preventing and relieving part of their distress (Mcmahon, 1992).
The second function of play is its role as a medium of communication between therapist and the child. The empathy that children develops with therapist as a result of interpersonal functional changes brought about play is considered vital by both psychodynamics and person-centered approaches (Russ, 2004). Russ (2004) states the third importance of play is facilitating the occurrence of insight and working through. According to Erickson (1963), who presented the concept of mastery, play helps a child a gain mastery over traumatic events, everyday conflicts, and anything unpleasant or remotely disturbing.
The play process in itself is considered as a vital expressive method for resolution of conflict in the child. It is a process where a child repeats an unpleasant experience repeatedly until the experience becomes a manageable one. The fourth importance of play is that it provides chances to experiment with a variety of ideas, behaviors, interpersonal behavior and verbal expressions (Russ, 2004). The reason is that play occurs in a secured environment, in an imaginary realm, and with a friendly adult in presence of whom, the child tries out with a combination of expressions without botheration with consequences of those attempts.These four major functions forms the core of multiple model of play therapies by helping the therapists to create a safe environment for play to occur and thoughts to be expressed.
Models of Play Therapy Cattanach (2003) describes three main models of play therapy that are 1. Non directive play therapy. 2 Focused play therapy and 3. Collaborative play therapy.
Non Directive Play Therapy It is based on child’s basic drive towards improvement and betterment by utilization of faculties and gifts they already possess, although under guidance of a friendly observer.Requirements on the part of therapists are that they should inspire the children by their genuiness and authenticity (Cattanach, 2003). They are also required to have a warmth and attitude of caring but without the tendency of getting too much emotionally involved with the children. The non directive play therapy works with therapist’s understanding and recognition of children’s ability to solve their own problems and take responsibilities to execute choices and options. This approach is very useful with children who have undergone some emotional trauma and as such may have distorted perception of the self and other individuals around them.
Such children have a need to protect themselves and as such a symbolic play is considered a highly assimilative activity for them (Cattanach, 2003). Non directive play therapy model has a drawback that it fails to adequately emphasize the ecology where the child lives. It alienates the child, and does not recognizes the community of the child as an essential component in therapy. Instead it focuses entirely on child’s ability to make self decision. It may force some children into inhibitions when they tart to view the therapist only as a passive and reflexive observant.As pointed by Cattanach (2003), under this model, it may become difficult for a child to find out about abuse without appropriate input of information by the adult.
Focused Therapy (Cognitive Behavioral Play Therapy) Focused therapy is described as combining cognitive and behavioral interventions with play therapy models (Knell, 1995). This model works on the principle of interplay of child’s awareness, response, emotions, behavior and physiology. This model interprets a disturbed as signature of irrational thinking on part of the child.The special stress of this model is on helping a child think and act like a child, by drawing their thoughts in interpretation of their own situation. The six special properties of cognitive behavioral play therapy (CBPT) are (Cattanach, 2003)1.
Through active play it involves child in the treatment process. The child is an active participant in the entire therapy 2. Child’s thoughts, feelings, fantasies and environment are given special attention in CBPT, making it possible to address a long range of child behavioral issues. 3. The child learn adaptive or new strategies through CBPT that helps in managing difficult situations and feelings.
4. CBPT is a goal oriented therapy where therapist works with the child and the family to draw goals and encourage the child to work towards these goals. 5. It involves use of puppets and dolls by therapist that rivet child’s attention 6.
The techniques used in CBPT are open for evaluation and empirical observation. Collaborative Play Therapy This model, developed by Ann Cattanach (Cattanach, 2003) focuses on collaboration between child and the therapist.The model inherently assumes that a developing child is part of a complex environment, far from being an isolated individual. The therapy includes three models of play that are embodied play, progressive or projected play and role-plays. Some Other Models of Play Therapy Structured Group Play Therapy This model describes a structured group ecosystem play therapy with components that address cognitive, behavioral, emotional, physical and social dimensions of a child’s difficulties (O’Connor, 1999).
The group activities proceed in a room with separate areas for activities, discussion and snacks.Another area contains table-chair arrangement used for table games that promote sharing, co-operation and mutual interaction through art work (Cattanach, 2003). Cooperation is emphasized in every area of the project. Therapist make extensive uses of toy, art and creative material including storytelling cards and board games. The group schedule includes directed relaxation exercise, eating snacks together, and conversation among themselves.
The session culminates with 15 minutes of free play where children are left free to choose their own play course.Filial Therapy Filial therapy combines play therapy and family therapy where the therapist trains and supervises parent-child interaction and help to conduct child-centered play therapy. The venue of these therapies is usually the home of children, where children are more comfortable and at ease. Filial therapy aims to create a congenial and safe environment where children are encouraged to fully express their feelings, achieve understanding of their world, develop capacity to solve problems and form a closer bonding of confidence and trust with their parents.
Filial play therapy helps to construct families with better communication skills, problem solving approach and closer family relationship (Cattanach, 2003). Teaching Children to Play Distressed and traumatized children are often required to be instructed in play therapy approach, to develop skills and evolve real life functioning and behavior (Russ, 2004). Training has been specially found effective with mentally retarded children.In an important research study conducted by Kim, Lombardino, Rothman, and Vinson (1989), on imaginative play therapy with children of mental age of three years, it was found that with regular thematic play interventions children showed marked improvement over the time. However normal children need little encouragement to participate in dramatic play, due to their previous experience on which they model their playing behavior ( Jessee ,Morgan, Wilson, 2004). The role of teacher with normal children rests with providing positive opportunities to gain experience and release of negative feelings.
In the play setting stuffed animals or dolls can be used as objects of child’s emotive expression and subsequent learning. Training and Professional Issues in Becoming a Play Therapist Role of a Play Therapist Cattanach (2003) describes the role of a play therapist, in both public and private domains as a professional who offers therapy to children, to help in supporting families with disturbed children, training other professionals on the use of play and to train the caretakers of children about various issues and approaches involved with play and child care.These multiple duties can be best handled only by a qualified play therapist The professional learning program to become a play therapist is all postgraduate programs that demand considerable experience on part of the candidate in working with children. To enroll in the professional degree course, the criteria is relevant professional experience in teaching, psychology, pediatric therapy, social work and degree in psychology or related subject (Cattanach, 2003). All the professional programs are validated by Universities and focus on the central role of play as a therapeutic process.Candidates can earn M.
Sc and Ph. D degrees in play therapy. The programs in play therapy cover modules that are related to observation of children with their parents, play methods, supervised practices and personal therapy and theoretical and clinical issues related to children’s problems and development (Cattanach, 2003). Stress is given on every aspect of training and therapist are encouraged to related their own experience of childhood while working with children, along with their knowledge and understanding of play therapy.
Social workers can also make successful transition as play therapists. It requires their perception to children’s needs, their exposure to the problems faced by children, realization of the significance of play therapy in helping the stressed children, and the personal empathy they are able to invoke in the clients. A therapist, who tries to take a child in deep exploration of some painful experience, or interpret what the child is unable to articulate, may trigger release of strong feelings of anger and fear, that may be traumatic for child and frightening for the worker (Mcmahon, 1992).This requires preparedness on part of the therapist to effectively negotiate the feeling of child.
A good play therapist is not expected to interpret all the play activities of children, but rather to stay with them as they unfold and discover the meaning themselves. An essential skill required is the art of reflexive listening to prevent child from getting overwhelmed by feelings that it is unable to play. A good play therapist should be able to intervene at appropriate moment so that child can continue with the play (Mcmahon, 1992).As a play therapist and intervener it is of prime importance for a worker to understand their role in context with emotional environment of the child and family. At delicate stages of play therapy, where the child may be required to contain, the therapist also needs containment; needing management support, and structure and facilities to effectively carry out the program. Child psychotherapists, in dealing with disturbed children, may focus entirely with the therapy session, and avoid recognizing child’s setting in a larger and complex world (Mcmahon, 1992).
In contrast, a social play therapist embarks on the role of acting as the bridge between the outside world and the child’s feelings. Moore (1985) listed the following qualities that are necessary for play therapists to execute themselves efficiently and beneficially to mental and psychological needs of the child. Learning to observe: It is foremost skill, required to gain an understanding of children’s emotions and the broader issue of understanding psychodynamic approach and the process of containment.Reflexive Listening: It is the most difficult and most essential skill required in play therapy. Reflexive listening is the ability to reflect the child’s play. The difficulty in reflexive listening lies with the fact that it is in complete contrast to normal adult behavior.
The adult observing the child is required to give a running commentary on the activities of child, without passing any value based judgment. This involves a high degree of observation with appropriate impassivity that leaves child comfortable and unperturbed in the play activities.Reflexive listening demands a level of discipline in observing and commenting on child activities that comes only with long practice and understanding of children’s reaction to even minor display of objection in adult’s approach. With increasing recognition of the psychoanalytic methods such as play therapy in meeting the emotive and cognitive requirements of children under stress and/or children with physical/mental disability, play therapy has emerged as a viable professional opportunity (Cattanach, 2003).
Current and Future Trends in Play TherapyPlay therapy is increasingly moving towards use of sophisticated and specialized research and practices. The prevailing major trends in play therapy, as identified by Ollendick and Russ (1999) are 1. Use of a developmental framework in play therapy; 2. Call for empirically validated treatment 3. Focus on particular problems and population; 4. Integration of treatment approaches; 5 Importance of situational and contextual interventions related to planning and implementation activities.
Russ (2004) also identifies guidelines for future research in play therapy.The suggestions include 1. Investigating particular mechanism and processes that define the link between play and creativity; 2. Increasing the focus on affect expression in play and creativity.
3. Carrying out studies that determine the time based development of creative processes and possibilities of early play predicting the real life creativity over one’s life. Conclusion Play therapy has staked its claim in making valuable contribution in psychoanalytic based treatment plans for stressed and challenged children.It crucially helps children to express their feelings and frustration and fears in safe and unbiased environment (Carmichael, 1994). Play therapist need to include parents at some stage of treatment to ensure the long term effectiveness of the play therapy.
Play therapist should also focus in transferring some of the teaching methods to the parents, so that they are enabled to understand and respond to child’s emotional needs. Communication through play is stressed at each stage of the play therapy, to keep the child active and responsive in the whole process.