Play therapy
by Hsiao-Shan Lin
1. The Definition of Play Therapy
“Play therapy is defined as a dynamic interpersonal relationship between a child and
a therapist trained in play therapy procedures who provides selected play materials and
facilitates the development of a safe relationship for the child to fully express and explore
self through play” (Landreth, 2002).
A. Play therapy as a dynamic interpersonal relationship
Even though play therapists are supposed to assume responsibilities for setting
up the stage of the children’s play, they are instructed to be active observers not direct
instructors. They have to be sensitive to children’s reactions to the settings and toys
in the play. The therapists are not expected to execute the purposeful play plan
precisely in a session.
Rather, a counselor has to modify any treatment plan
according to each child’s unique responses.
B. The therapist as a trained professional specializing in play therapy
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Not all therapists are qualified as specialists in the field of play therapy. Play
therapy is not just about sessions with casual plays.
“The clinician should always
proceed with caution, gingerly laying a foundation that advances a sense of security”
(Gil, 1991) to get the clients actively involved in sessions.
is often concerned with abused children.
In addition, play therapy
Working with an abused child sometimes
means dealing with difficult tasks with long durations and of various conditions.
For
instance, if a counselor works with a seriously abused child, he/she might even have
to testify in the court.
In essence, play therapy is quite different from common
counseling practices.
The practitioners have to undergo specific training and
practicum.
C. Play therapy is designed to express and explore inner children’s inner selves.
Most well-conducted plays are designed to carry out certain functional goals.
As for the play in play therapy, it is arranged to let the children have the opportunities
to become aware of and speak up with their own voices.
Intelligently challenged or
creativity-oriented games are not the ideal types of play during sessions.
2. History and Development of Play Therapy
In the first place, the concept of play therapy was not an independent entity. Play
therapy was once considered the complementary method to verbalized therapy drawn
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from psychoanalysis for adults. Psychotherapists found it challenging to have children
engaged in verbal expression actively.
Therefore, they tried to encorporate play into
sessions to understand the children’s world.
As the pioneer of psychotherapist, Sigmund Freud is also the first one who
“describes the therapeutic use of play and a psychological approach to working with a
child” (Gil, 1991).
(Freud 1909/1955).
In 1909, he publishes an article about a little boy, “Little Han”
In that case, he designs the little boy’s treatment plan according to
the notations of the kid’s play.
Following Freud’s footsteps, “Hermine Hug-Hellmuth
seems to have been one of the first therapists to emphasize play as essential in child
analysis and to provide children in therapy with play materials to express themselves”
(Gil, 1991). She asserts that it is more difficult to guide the children to explore
themselves by verbal communication than by play.
She believes that children can
express themselves thoroughly and freely during play.
Inspired by her work, “Melanie
Klein and Anna Freud formulate the theory and practice of psychoanalytic play therapy”
(Gil, 1991).
The theories they postulate are considered psychoanalytic play therapy.
A. Psychoanalytic play therapy
Melanie believes that “analysis is carried out by substituting play for verbalized
free association” (Landreth, 2002). She regards children’s play as the “windows to
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their unconsciousness.”
every session.
The symbolic meanings in children’s play are interpreted in
Then, she tells her clients her interpretation in simple words, letting
the children have insight into their emotions and inner worlds.
On the other hand,
Anna Freud focuses on the dynamic relationships between the therapist and the client.
She does not aggressively apply her interpretations of the children’s play at the
beginning sessions.
Instead, she might suggest her postulations after she has
gathered enough information and has aligned with the child.
Unlike her father,
whose treatment plans are mostly based on clients “free associations”, Anna Freud
invites her clients to “involve in a feeling lever experience” (Landreth, 2002).
She
encourages the children not only to talk about but also to experience their feelings.
However, both “Klein and Freud stress the importance of uncovering the past and
strengthening the ego” (Landreth, 2002), so they are categorized as psychoanalytic
play therapists.
B. Release play therapy
In the late 1930s, a structured therapy, release therapy, is formulated by David
Levy.
His goal was to “help the child assimilate the negative thoughts and feelings
associated with the trauma by reenacting it over and over again” (Gil, 1991). This
kind of method is designed to deal with a single traumatic event in the first place.
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For example, a child who is physically abused might be gradually introduced with the
play materials that symbolize the violent environment.
Levy believes that the
reenactments “facilitate the child’s abreaction” (Gil, 1991) and help the child release
pain and tension.
For Levy, the play in the clinical environment is meant to release
the pressure and negative feelings.
C. Relationship play therapy
The previous two approaches are considered goal-oriented. Comparatively,
there are also play therapists who advocate “client-centered play therapy” (Guerney,
1983), which is based on a personality theory that “assumes that an individual has
within himself not only the ability to solve his own problems but also a growth force”
(Schaefer, 1980) that modifies his previous unsophisticated responses to the
environment.
Axline, the author of “Play Therapy”, is considered the icon of
client-centered therapists.
She proposes that “the individual’s accumulated
experiences, attitudes, thoughts, and feelings” have the power “to bring about insight”
(Axline, 1969).
She formulates the “Non-directive Therapy” (Axline, 1969), which
guides the counselor to perceive the client as a temporarily confused soul that seeks
for different coping strategies.
for the sessions.
A counselor is not expected to set a therapeutic goal
Instead, he/she is advised to create a secure environment so that the
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individual is offered “the opportunity to be himself, to learn to know himself, to chart
his own courses openly (Axline, 1969).” Personally, I believe that a safe and
trustworthy relationship has its own healing power indeed.
With the discovery of the
inner voices and power, the client “may form a more satisfactory design for living”
(Axline, 1969).
Therefore, for a non-directive play therapist, his/her challenges are
not to interpret the meanings of symbolic play or to uncover the suppressed memories
of the past.
It is the “here and now” that has to be addressed. The way the kids
play with the toys and the stories the clients recreate are the main focuses in the
sessions. Therapists have to be aware of the true feelings of the child minute to
minute, but should not focus on analyzing their behaviors or words.
3. Main Subjects of Play Therapy: The Abused Child
Most of the time, children are brought to the clinical environment because of certain
abnormal behaviors. Sometimes, the acentric behaviors are the products of one single
stressful situation.
Under these circumstances, the mal-adaptive behaviors can be
modified during several sessions. However, some children who come in the clinic might
suffer from chorological abuse or neglect.
special therapeutic needs.
These traumatized children might need
Therefore, it is important for therapists to be able to identify
children who might undergo seriously disadvantageous surroundings.
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Some types of abuse have been identified: “sexual abuse, physical abuse, neglect and
emotional abuse” (Gil, 1991).
Children suffered from different kinds of abuse manifest
different syndromes. For example, physical abused children usually exhibit “some
psychiatric symptoms, low self-esteem, learning problems, hyper-vigilance, and
compulsivity” (Martin, 1976).
The children’s internal or external mal-adaptations might
come in different patterns and degrees.
Therefore, the counselor has to individualize
every case and progress the procedure discreetly based on the needs of their clients.
4. The Provisions of Play Therapy
A. Playroom
 Playroom location
Because a child can be noisy while he/she plays, it is optimal that “the
playroom can be located in an area of the agency least likely to distract or disturb
other clients and staff members” (Landreth, 2002).
recommended to be equipped with sound insulation.
In addition, the play room is
If a child can hear other
kid’s voices out of the room, he/she might feel uncomfortable of revealing their
thoughts and feelings for he/she is afraid of others’ eavesdropping. Sometimes, a
family member or a guardian may threaten the kid not to tell the “secrets” to the
counselor again if the conversations in the playroom are overheard.
Ideally, it
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would be wonderful to locate the playroom in a separate house “with complete
isolation” (Landreth, 2002).
 Playroom size
“A room approximately 12 feet by 15 feet seems to meet the purpose of play
therapy best” (Landreth, 2002).
constricted.
If the room is too small, the kid might feel being
If the room is too large, the kid may run around and the therapist has
to chase after the client, wasting time on “catch me if you can”, leaving limited
time for productive and therapeutic play time.
 Playroom Characteristics
(1) Windows
It is better not to have windows in the playroom because the windows are
leaks to privacy.
If there is a possibility to be peeped at, the kid would feel
insecure and uncomfortable.
(2) Floor Covering
It is common that when a kid plays, he/she creates a mess. Therefore,
“vinyl tile squares is the preferred floor covering” (Landreth, 2002) for play
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room. They are easy to clean up and convenient to be replaced if one piece of
them gets broken. A large carpet is not recommended because “it is difficult
to keep clean and almost impossible to sweep sand out of” (Landreth, 2002).
In addition, some kids might be allergic to the mildew under the carpet.
(3) Walls
“The walls of the playroom should be painted with washable enamel”
(Landreth, 2002). The tone of the wall color should not be too bright to over
stimulate the kid. A tender off-white is the best choice for the walls.
(4) A chalkboard
With a chalkboard on the wall, the kids can draw whatever they want to
and erase the unwanted pictures with ease.
If various colors of chalks are
offered, the children can pigment a visual world creatively.
(5) A Sink
“A sink with running water is recommended” (Landreth, 2002).
It is
almost impossible for a kid to keep his/her hands clean during play time.
It
would be convenient to have a sink right in the playroom so that clean water is
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available within seconds.
In addition, some kids might find running water
fascinating. For them, the faucet and the sink are also materials for play.
(6) A sand stray
Sand play is intrinsically fun for kids. The texture of sand and the flows
within hands are enjoyable for kids, even for adults.
play at the site of sand tray.
Kids can play dramatic
Additionally, the practitioners of “sandplay
therapy” (Boik, 2000) reply heavily on the symbolic sandplay for successful
counseling.
Accordingly, it would be exemplary to have a sand tray at the
playroom.
(7) Shelves
“The typical playroom will probably need shelves to provide enough
space for toys and materials” (Landreth, 2002) to be put away.
Sometimes, the
kids might also regard the empty spaces of the shelves as play areas.
For
example, when a child feels vulnerable, he/she might want to hind in the shelves
and calm himself/herself down within the mystical territory.
(8) Child-sized Furniture
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Since the kids are the main entities of play therapies, it is essential that a
playroom be equipped with child-sized furniture, such as low tables and little
chairs.
(9) One way Mirror
If there are enough funds for playroom, a one way mirror “for supervision
and training purposes (Landreth, 2002)” is recommended, because counseling
traumatic children might be an arduous task even for an experienced
professional.
However, therapists have to bear in mind that to protect the
client’s confidentiality, it is forbidden to invite the parents to watch the sessions
behind the mirror.
B. Materials
“All playthings should be simple in construction and easy to handle” (Axline,
1969).
If a kid has no ideas about what to do with the toys, he/she might feel
frustrated.
Items that elicit dramatic play are ideal play materials.
In the
groundbreaking book, Play Therapy, Axline makes a list of several play materials for
play therapists to refer to.
 A doll house
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 Playhouse materials: tables, chairs, cot, bed, stove, tin dishes, pans, spoons,
nursing bottles, doll cloths, clothesline, clothespins and clothes basket
 Various kinds of dolls: a doll family, a large rag doll, a didee doll, and paper dolls
 Puppet play: puppets and a puppet screen
 Aggressive symbols: toy soldiers, army equipment and toy guns
 Arts: crayons, clay, finger paints and an easel
 Models: peg-pounding sets, toy animals, little cars, small airplanes and a toy
telephone
 Cleaning Stuff: a small broom and mop
5. Common activities in Play Therapy
A. Paintings or Drawings
Paintings or drawings are the most powerful communicative tools for young
children. They might not be able to articulate their thoughts and feelings precisely,
but they do find it natural to express themselves through art creation. Personally, I
regard the clients’ words the driveways leading to the kid’s unconsciousness.
However, my opinion is that counselors should avoid understanding the kid by
interpreting the paintings or drawings solely.
Counselors are recommended to use
the art work as a tool to get children engaged in self-expression and self-explorations.
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B. Dramatic play
Dramatic play is one of the most common types of spontaneous child play.
With the concrete mental representatives at hand, such as dolls and models, they can
explore their inner world by acting it out.
It is a process of self-understanding and
pressure releasing as well.
C. Therapeutic stories
Therapeutic stories are commonly applied in play therapy.
“Because children’s
imagination and ability to identify is so powerful, they can easily enter a story, making
unconscious connections to heroes, conflicts, and resolutions” (Gil, 1991).
I deeply
believe that the stories really have the power to transform the thinking and feelings of
children and adults as well.
By introducing the therapeutic stories, the therapists can
redirect the children’s behaviors and cognition into an adaptive path.
D. Sand play
Playing with sand seems to one of the most common activities for children all
over the world.
The process of touching sand, gathering sand, adding water, creating
scenes and etc. is intrinsically fun for kids.
In addition, some therapists even apply
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sandplay therapy in their sessions, viewing the site of sandplay as a representative of
children’s psyches.
Sandplay therapy is proposed by Dora Kalff, Jungian Analyst in Zurich.
She
believes that “sandplay not only allowed for the expression of the fears and angers of
children, but also encouraged and provided for the processes of transcendence and
individuation (Kalff, 2004).” She suggests that sandplay therapy undergoes at least
two stages.
First, the kids create a scene on the sand tray. Then, the therapist asks
the kids to tell a story about the picture. By telling the story, the child reorganizes
his/her ideas and then he/she is able to express inner feelings verbally, too.
In a
sense, this method stimulates the children to speak up the symbolic meanings of their
own creation.
In addition, those therapists who practice psychoanalytic tradition can
also gain invaluable sight to the clients’ unconsciousness.
Since sand play serves multiple purposes, a play therapist is recommended to
apply this approach within sessions.
6. Implications
Honestly, before I started working on this project, I had no ideas what play therapy
is.
Now since I have dipped my toes in this ocean, I feel like reading more articles and
papers about this field.
It is obvious to me that play is such a powerful tool for
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counselors. As high school guidance, I believe that it would be wonderful if I can learn
how to reach my students by words and plays.
Knowing this brand new tradition of
therapy is really beneficial to my professional practices.
References
Axline, V. (1969). Play Therapy.
New York: Ballantine Books.
Boik, Barbara L. (2000). Sandplay Therapy: A Step-By-Step Manual for Psychotherapists of
Diverse Orientations.
New York: W. W. Norton & Company
Freud, S. (1909/1955). Analysis of a Phobia in a Five-Year-Old Boy in Collected Papers.
New York: Basic Books.
Gil, E. (1991). The Healing Power of Play: Working with Abused Children. New York: The
Guilford Press.
Guerney, Louise F. (1983). Client-Centered (Nondirective) Play Therapy in Handbook of
Play Therapy.
New York: Wiley-Interscience
Kalff, Dora M. (2004). Sandplay: A Psychotherapeutic Approach to the Psyche.
Cloverdale,
CA: Temenos Press
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Landreth, Garry L. (2002). Play Therapy: The Art of the Relationship, Second Edition.
New
York: Brunner Routledge.
Martin, H. P. (1976). The Abused Child.
Cambridge, MA: Ballinger.
Schaefer, C. E. (1980). Play Therapy in Emotional Disorders in Children and Adolescents.
New York: Spectrum.
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