Play is the natural language for children. It’s how children learn to communicate, gain social skills, express decision making and explore how to adapt to an environment. So, it makes sense that play could be incorporated into child therapy. In fact, it’s a practice that goes back decades to Freud and his contemporaries.
“Play Therapy for children is like Talk Therapy for adults. It’s how children express themselves,” says JF&CS Clinician Sherri Cauthen. Sherri is a Licensed Clinical Social Worker and a Registered Play Therapist Supervisor. She specializes in treating children and adolescents who experience difficulties with emotional regulation, impulse-control, complex trauma, grief, loss, anxiety, and mood disorders. “Play Therapy provides a safe space for children to be able to form a trusting relationship with adults and express what’s troubling them.”
Play Therapy is traditionally used with younger children, but studies have shown it has a positive effect on all ages. It can help people let down their guard. Play also helps therapists gain insights on how to help a client. Some people feel more comfortable when another part of their mind is occupied, whether that’s while fidgeting with a pen or playing with sand.
What happens during Play Therapy?
“In my office I have a doll house, toy cars, miniatures, games, and other different items that can initiate play. I can use these to address different themes like family, injustice, aggression, etc. I have items that help kids express themselves creatively through arts and crafts, like a sand tray, crayons, pencils, paper, and items for dress-up,” explains Sherri.
As an example of how this works, with sand tray therapy, a person constructs their own microcosm using miniature toys and colored sand. The scene created acts as a reflection of the person’s own life and allows them the opportunity to resolve conflicts, remove obstacles, and gain acceptance of self.
“When a child first comes in, they’re usually a little apprehensive. They don’t really know what to do. So, I usually start the first session explaining the playroom, setting some ground rules, and getting them comfortable. They get to choose what to play with as they navigate the playroom. I’m also assessing the child. Is the child jumping right into things, confident that they know what to do? Is the child timid, looking to me or their parents for permission? It helps me see what the child may be struggling with.”
Sherri explains that in order to maximize the benefits of play therapy, caregiver consultations are strongly recommended. Collaboration with caregivers help improve outcomes and are beneficial to the therapy process. The goals of the parental consultation is to establish a collaborative approach and educate parents about child development, caregiver parenting strategies, or additional resources. Collaborative sessions can occur anytime throughout treatment, with specific parent sessions occurring every 4-6 weeks.
"Caregiver sessions help with establishing goals, and provides an opportunity for the therapist to provide themes observed in the playroom and how they relate to addressing broader concerns at home, school or other environments," says Sherri. Caregiver sessions also provide an opportunity for parents to express their concerns, and address any other needs that child may have that are not currently being met.
Using different kinds of play for therapy
There are different theories within Play Therapy. Some therapists are more child centered, letting the child lead the play and assessing their actions. Other therapists may be more directive, deliberately providing specific toys to see how the child reacts and offering more suggestions. Many counselors, like Sherri, use a mix of the two depending on the child.
“For me, non-directive play therapy is the foundation. It allows for relationship building and offers time for the child to feel safe and secure. It shows them that there’s a caring, trustworthy adult with them. It allows me to track their behavior. I am also reflecting on what they are doing and providing them with insights on why they may be interacting with the items in a certain way. That way the child and the parents gain more insight into their behavior.”
A therapist like Sherri will work with the child and parents to set up goals for the therapy. Then they can use the different toys, games and puzzles to work toward those goals.
“When I’m more directive, I make use of intentionally-selected play therapy items to foster specific reactions from the child that align with their goals. We can then explore reactions through play, further enhancing insight and cementing desired skills. The toys are a tool I use to help guide the child.”
Therapeutic values of play
There are therapeutic values with any kind of play. Play therapy facilitates communication. It fosters emotional wellness, enhances social relationships, and increases personal strengths. It also allows the child to exercise their creativity. These factors alone can help the child. The therapist also uses play as a springboard for important conversations.
“If I am with a child that exhibits low self-esteem, I’m going to engage in games and make comments that build self-esteem. I might see them trying hard to do a puzzle and I can say ‘even though that’s hard, you’re still doing it.’ When they are accomplishing a task they failed at before, I can remind them that they are being courageous and brave. I’m try to highlight things they struggle with and address them.”
Often the way that the child deals with situations in the playroom is how they will deal with issues in the outside world. “Themes present themselves in their play, around some of the challenges they experience, whether it’s with friends and peers or with adult,” says Sherri. “Right now, we’re in a child mental health crisis. With everything going on with COVID-19, social unrest, all the problems worldwide, kids are just struggling with how to express themselves. They don’t know how to cope. Play Therapy has been shown to be helpful. It gives them an outlet for confronting the world around them.”
Studies have shown that social anxiety has been on the rise. “Kids have really started to internalize wanting to be safe; wanting to keep their family safe. After spending so much time away from others and only staying with their parents, it can be hard to get them out of their shell.” Play Therapy allows an avenue to re-learn some aspects of socialization that they haven’t had in a long time.
Play Therapy for adults
Just as with kids, adults can benefit from the therapeutic powers of Play Therapy. These tactics have been used to help almost every area of mental health, from soldiers with PTSD, to elderly adults who have lost their ability to express themselves.
“What I’ve found is that some adults don’t know how to play or don’t remember what it was like to play. Some don’t have a sense of fun or can’t naturally relax and so play itself is very therapeutic. With the sand tray, individuals get out of their head. Just the joy of play can be such a relief.”
If an adult has a hard time expressing themselves with words, something like a sand tray or crayon drawings can allow them to visibly represent something they haven’t been able to express before. Expressive therapy, such as Play Therapy, can give adults a way to heal from some of the trauma that they may be having in their life.
If you’re interested in learning about Play Therapy or any of the different styles of therapy offered at JF&CS you can contact the Frances Bunzl Clinical Services at therapy@jfcsatl.org or 770-677-9474.