Use of Child Centered Play Therapy Responses in a Child Care Setting the Use of Child Center Play Therapy (CCPT) Techniques by Caregivers Joel H

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Use of Child Centered Play Therapy Responses in a Child Care Setting The use of Child Center Play Therapy (CCPT) techniques by caregivers Joel H. Muro, Lilia can be effective in encouraging emotional and social development in Lamar Muro, Katherine children. Kensinger Rose, Lindsey Webster & Cassie Allen The communication process between care providers suaging children’s emotional reactions that may surface and children can, at times, be complex. Young children in a childcare setting. Ideally, the use of the responses typically lack the verbal language necessary for complex would strengthen the connection between adult and emotional expression. In this work, the authors contend child, allowing the provider to enter the world of the that using some basic child centered play therapy (CCPT) child. When early childhood educators and therapists techniques would be beneficial in enhancing communi- combine their expertise in the child care setting, envi- cative patterns in a childcare setting. The use of CCPT ronments that once were deemed frightening to children responses by caregivers can be effective in encouraging may become welcoming and reassuring. emotional and social development in children. Because Play therapy offers a unique opportunity for children child care providers spend a great deal of time with chil- to explore their feelings and problems through play, the dren, this approach may lead to a more nurturing and medium with which they are most comfortable. Play stable relationship than parents are able to provide. therapy is commonly offered in a therapeutic setting, Research conducted by the authors has indicated that but is infrequently found in childcare facilities, as many CCPT in a preschool, primary school, and a variety do not employ a play therapist. The authors contend of other settings with children can be beneficial to the care providers can also apply some basic principles when child (Stickley, V. Muro, J, & Blanco, P., 2013). When interacting with children. care providers, therapists, and parents work collabora- tively, the use of CCPT responses holds a great deal of potential. The frustrations that seem to exist, especially in emotionally charged situations between the child and care provider, may disappear altogether with the applica- CCPT can be a tion of many basic play therapy techniques. tool in generating In order to understand CCPT, a definition is in order. "Child-centered play therapy is a developmentally ap- communication. propriate, humanistic, nondirective approach for children that includes the use of toys and play-based materials to facilitate a broad range of verbal and non-verbal expression" (Blanco & Sheely-Moore, 2012, p.66). In Children who experience a positive relationship with addition, Landreth (2012) suggested that responses to teachers typically are more adjusted to school in com- children in play therapy should be conducted, "in a parison to those who have not. According to Sepulveda, way that communicates sensitivity, understanding, and Garza, and Morrison (2011) programs such as Head acceptance and conveys freedom and responsibility and Start have been established for at risk children with the is for many beginning play therapists like learning a main focus of preparing them for school. Head Start foreign language" (p. 211). instructors spend copious amounts of time with those CCPT responses may assist childcare providers in as- children who are enrolled. This gives them the

Dimensions of Early Childhood Vol 45, No 2, 2017 13 Use of Child Centered Play Therapy Responses in a Child Care Setting Courtesy of Knollwood Preschool (Community Church), Burke, VA VA Burke, (Community Church), Courtesy of Knollwood Preschool Play equals work for young children. opportunity to provide a more noteworthy reduction in “internal- p. 53). As a child is able to use play consistent and nurturing relation- izing behavior problems” (p. 15). to act out his/her fear and anxiety ship than primary caretakers do Overall, research by Sepulveda et al. from abuse, he/she gains power over (Sepulveda et al., 2011). In work- (2011) suggested that teachers are repetitive behaviors that can be all ing with children from challenging more than able to learn therapeutic consuming. The child gains strength backgrounds, CCPT can be a tool in skills such as reflection of content, and confidence over a past history of generating communication. meaning and feeling(s) and that the hurt through the use of play. Most children do not have com- use of those skills results in a positive Children are given the opportunity plex verbal and reasoning skills change of behavior in children. to exhibit and overcome their fears (Wells, 1987; Bruner, 1981; Bloom, Research by Stubenbort, Don- through the use of play. Studies have 2002). It can be very difficult for a nelly and Cohen (2001) indicated repeatedly shown that play is the child to fully understand the range that when children can use play in preferred method of treatment with of emotions that accompanies dif- a structured environment such as a young children, and the outcome ficult life situations. According to classroom they are able to demon- is overwhelmingly rewarding for Sepulveda et al. (2011), “in such strate their concerns. A keen observ- both child and therapist. The use of cases, play therapy can be used in er may gain insight that he or she play therapy in the classroom can order to assist children in creating may not benefit as effectively other- be rewarding on many levels. Not responses to difficult experiences by wise. Furthermore, “play therapy is only does the child benefit through using a language that comes natural said to decrease internalizing behav- the use of play but also the teacher for them, play” (p. 13). They fur- iors, interrupt externalizing behav- and classmates do as well. Through thered that children with teachers iors, and address trauma-repetitive CCPT, a child is able to work trained in play therapy showed a behaviors” (Stubenbort et al, 2001 through maladaptive behaviors in a

14 Vol 45, No 2, 2017 Dimensions of Early Childhood Use of Child Centered Play Therapy Responses in a Child Care Setting safe environment, thereby increasing the child’s development. Childcare tives is easily accessible (Erikson, his or her social skills and adaptability. providers are among this group of 1950/1963; Piaget, 1962; Smilan- adults who are crucial to children. sky, 1990; Vygotsky, 2004). Most Industry vs. Inferiority Childcare providers are an impor- agree that the work of a child is tant component when considering play, and it is through hands-on how children learn, develop social manipulation of objects that they During the elementary years, Erik- interest, enhance goal setting, create master their environment. Piaget son (1950/1963) described the child a solid work ethic, form healthy rela- (1962) and Erikson (1950/1963) as one who “learns to win recogni- tionships, and build autonomy and both acknowledge the importance tion by producing things” (p. 259). self-esteem (Illig, 1998). of the child’s own body as the center According to Erikson, it is during of play. Piaget theorized about and this stage that children begin to The ability of caregivers to support investigated the importance of play evaluate themselves based on exter- children’s autonomy is an indicator to cognitive development. The idea nal standards set by others. Erikson of meeting the child’s psychologi- that a child’s behavior and thoughts stated, “The child’s danger, at this cal needs. This push for autonomy, are separate but connected through stage, lies in a sense of inadequacy while in a supportive environment, play is arguably his most important and inferiority” (p. 260). More sim- results in higher self-esteem and a hypothesis. Through meticulous ply stated, the developmental task of greater sense of identity (Coatsworth play observations, it is evident that the child during the elementary years & Conroy, 2009). play allows children to express their is to gain a feeling of productiveness inner desires, feelings, problems, and and acceptance for that produc- anxieties (Piaget, 1962). tiveness. Erikson stated, “We have pointed in the last section to the The work of a child danger threatening individual and Child-Centered society where the schoolchild begins is play. Play Therapy to feel that the color of his skin, the background of his parents, or the Child-centered therapy, derived fashion of his clothes rather than his from Carl Rogers’ (1951) theoretical wish and his will to learn will decide In an effort to help early childhood framework, is the approach many his worth…” (p. 260). Working educators foster positive develop- child centered counselors use with with children from an Eriksonian mental outcomes in children with children and adult clients. Virginia perspective requires that adults focus whom they work, we are advocat- Axline (1969/1982) utilized Rogers’ mostly on the “wish and the will” ing a new communicative model concepts to develop child-centered (p. 260) in providing children with for caregivers to accomplish goals play therapy (Axline, 1950; Ginott, feedback on their actions, behaviors, related to the fostering of emotional, 1961; Guerney, 1991; Landreth, and academic, creative, or athletic physical, and social development. By 2012; Moustakas, 1951; Ray, 2004; endeavors. This has important impli- integrating play therapy principles Rogers, 1951). cations for early childhood educators of unconditional positive regard and The relationship created in play who may be focused on outcomes or techniques such as reflection of feel- therapy gives children the autonomy behavior more so than the process ing into their teaching and behavior to express themselves in the precise of being. Allowing children to be, to interventions and using a develop- moment. In the therapeutic setting, feel and to connect to the self can be mental approach in understanding children are given the freedom to of benefit. children’s behaviors and needs, child act without the pressures of exter- care specialists/ early childhood edu- nal expectations, offering them the Childcare Providers and cators may be able to influence chil- therapeutic benefits of play proposed Developmental Influence dren positively in multiple domains. by Erikson (1950/1963) in his theory There are a variety of discussions of psychosocial development. Children As children begin to mature and and viewpoints of play by well-noted have the power to decide how they will separate from their parents, exter- scholars. A surfeit of information use play to express themselves through nal people become influential in analyzing play from diverse perspec- this non-directive style (Axline, 1950).

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premise that play is the child’s mode of self-expression (Schaefer, 1985). In order to truly understand the world of the child, the play therapist employs a variety of techniques, foremost being the presence of the caring therapist and the ability of the therapist to accurately track and communicate empathically to the child. While all facilitate growth and movement, the authors hypothesize that reflective listening, a standard technique used by all play therapists, is the procedure that may best assist caregivers in more effectively communicating with their players.

Reflective Listening Verbal tracking, reflection of content, and reflection of feeling are reflective listening techniques that may be employed by the caregiver who wishes to use CCPT. The authors concur with Bratton and Landreth (2006), regarding to how to most effectively use reflective listening. Verbally mirroring and validating children’s presence describes verbal tracking. For example, when a child runs down the field to catch a pass, Reflective listening can strengthen adult/child relationships. an appropriate tracking response Photo Courtesy of Pre-K 4, San Antonio, Texas Antonio, 4, San Courtesy of Pre-K Photo would be “You are jumping up and down about your catch.” A relationship develops between (Frost, Wortham, & Reifel 2005; Reflecting content is a technique children and therapists, centered Landreth, 2012). used to convey a sense of compre- hension as to what children are stat- on the play therapy materials. This In order to understand the child’s ing. Because of the frequent misun- coincides with the adult’s hope that conscious and unconscious world, derstanding of reflecting content as play can be therapeutic and heal- it is imperative to be a mindful and parroting, restructuring children’s ing (Frost, Wortham, & Reifel, active, but non-invasive and non- responses is strongly advised. For 2005). Consistent with Erikson’s directive, participant of the child’s example, “I drank my water without (1950/1963) ideas about the thera- play (Bettleheim, 1987). Adults spilling!” might prompt a reply of, peutic benefits of play, child-cen- use speech as their natural form of “You got it up to your mouth and tered play therapy posits that play is communication, but children are back down on the table!” Using often symbolic, offering insight into not as comfortable with using speech reflection of content is a basic form the struggles and terrors that might as their primary communication of connecting with children. be haunting the child. Play is consid- tool, seeing as verbal skills are not ered the child’s language, with toys as adroit as their older counterparts. In order to develop empathy and being the child’s worlds, which cata- Play therapy is supported by the communicate understanding of the lyze communication and expression

16 Vol 45, No 2, 2017 Dimensions of Early Childhood Use of Child Centered Play Therapy Responses in a Child Care Setting child’s world, using responses that likely to build a relationship with Reflective Responses reflect feelings are best suited. In re- adults founded on trust. This rap- and Caregiving sponse to the above example, an ap- port empowers children to express Feelings are the pathway for un- propriate reflection of feeling might their thoughts and feelings without derstanding and acceptance. Chil- be, “You are excited about your not feeling censored or judged. While dren learn to handle their emotions spilling!” This statement notes you she created these principles for play through the simple acknowledgment are attending to the child as well as therapists, they can be generalized to of the existence of their feelings. Play understanding the child’s emotional adults who come into contact with therapists use reflections of feeling to reaction to something that seems to children, specifically caregivers. facilitate an understanding with chil- be creating a degree of pride can be Children draw from their personal dren that their feelings are suitable. described as an empathic response. experience to converse with adults. The act of rescuing children from Empathy is the ability to under- It is vital to recognize that children their feelings or ignoring the feelings stand another person’s emotional have other experiences outside deprives them of the opportunity to perspective without being person- of the learning environment the learn how to handle them and can ally consumed by the feelings. This caregiver occupies from which they have consequences later in life, as is commonly known as reflection of will draw. Children will use nonver- they develop complex defenses to feeling. A person adept at reflection bal communication in addition to hide and contend with them. of feeling might offer an understand- actions and words to alert adults of Perhaps one of the more com- ing comment replete with feeling feelings and needs. mon experiences for adults to do is words. For example, a child might to discount children or attempt to say, “I said my ABC’s!” The caregiver change their negative perceptions employing reflective listening tech- because these feelings are difficult to niques might first praise the child Reflective listening manage. Adults often struggle with “Way to go!” and then follow with may best assist feelings themselves and having to the reflection of feeling, “You are contend with another who is not yet proud of yourself!” caregivers. developed fully and may have strong emotional reactions is a daunting Play & Caregiving task. Statements such as, “Stop be- Because of the developmental Likely, caregivers may not look for ing upset at nap time and sleep.” or, aspects of both play therapy and the same outcome as play therapists, “The other children will take turns: the setting of caregiving, integrating but they still have the opportunity to you do not need to worry.” can these techniques is feasible. Axline use the play therapy responses that adversely affect children’s feelings. (1969/ 1982) developed basic prin- mirror the interactions exercised in Statements like these force children ciples to use in a therapeutic setting a playroom. Understanding the feel- to accept what others want them to with children. One of her seminal ing the child has around the specific feel, while denying their own experi- points was her assertion that adults incident and communicating as such ence. As noted prior, the authors are need to accept the child with feelings with reflection of feeling may soothe not advocating for an acceptance of warmth and friendliness. This is the child and strengthen the bond. for all behaviors, merely that every sometimes called unconditional posi- A child who is upset might like hear- feeling evidenced by the behaviors is tive regard, a term created by Carl ing “You feel really mad (or sad).” valid and worthy. Rogers (1951). It is not accepting all The authors assert that the strong The reflection of feelings and the behaviors a child exhibits, but development of verbal and nonver- behaviors (tracking) are the most accepting the child because s/he ex- bal communication skills, providing vital techniques for relaying what ists. The caregiver communicates ac- positive feedback, giving attention, is happening in the moment, im- ceptance through entering the world listening, being clear and concise, and mediacy. Questions are considered of the child and using reflective building a trusting and caring relation- a hindrance to therapy because they statements, ensuring the child knows ship with the children will strengthen create defensiveness in children and s/he has been heard. By creating this not only the relationship but also the take them out of their present expe- open atmosphere, children are more child’s self esteem and self efficacy. rience. One might argue this would

Dimensions of Early Childhood Vol 45, No 2, 2017 17 Use of Child Centered Play Therapy Responses in a Child Care Setting Photo courtesy of Pre-K 4, San Antonio, Texas Antonio, 4, San courtesy of Pre-K Photo Play is often symbolic for young children. be the same in a childcare setting. learning this new style of commu- are really discouraged that we share.” The act of answering a question re- nicating, it is helpful to understand combined with a softer tone. quires children to remove themselves four primary feelings: happy, angry, To ensure that the reflection from what they are experiencing. sad, and surprised (Landreth, 2012). captures the emotion as opposed to When the early childhood educator Because feelings are often portrayed a cognitive statement about what addresses the child with a reflection in the face of a child, it is important the child thinks, begin reflections of of feeling, it is possible that the child to attend to facial expressions (Brat- feeling with “you feel” or “you are will be more open to the construc- ton & Landreth, 2006). feeling” instead of “you feel like.” tive criticism that may follow. For Feelings can be detected not only The reader can note that you can example, an early childhood educa- through facial expressions, but interchange “you think” for “you feel tor might say to a student, “You’re through body language as well. Once like” and see how cognition is being frustrated that you cannot draw a caregivers have determined that a addressed, but not feeling. Engaging circle. I understand why you might child is experiencing a feeling, the in this pattern of responses to players feel that way. Perhaps if you changed opportunity to reflect feeling should then allows the child to feel under- the way you have your arm, you’d be grasped to communicate that the stood by the early childhood educa- find this an easier process.” caregiver understands the child’s cur- tor, and will promote a deeper level Reflecting feeling is a basic level rent world. The authors recommend of trust between the two parties as of response that encourages a deeper that when using reflection of feeling, well as feeling connected and heard. understanding of children. By engag- caregivers should attempt to match Making the distinction between ing in this communication pattern, the intensity level of the feeling encouragement and praise is also the early childhood educator then is that the child is experiencing. For important. Focusing on the motiva- relating to the child the four basic example, if a child is disappointed tion, intent, and process involved in tenets of listening, “I am here, I about sharing a toy, an appropriate the child’s efforts (encouragement) is hear you, I understand, and I care.” reflection of feeling may be, “You are much more influential than offering While early childhood educators are sad the rules are we share.” or “You

18 Vol 45, No 2, 2017 Dimensions of Early Childhood Use of Child Centered Play Therapy Responses in a Child Care Setting a compliment on a final product Moustakas, C. (1951). Situational play therapy with References normal children. Journal of Consulting Psychology, (praise). For example, rather than 15, 225-230. stating, “Good picture.”, an early Axline, V. (1950). Entering the child’s world via Piaget, J. (1962). Play, dreams and imitation in child- childhood educator might instead play experiences. Progressive Education, 27, 68-75. hood. New York: Norton. Axline, V. (1969/1982). Play therapy. New York: Ray, D. (2004). Supervision of basic and advanced say, “I could see how hard you were Ballantine Books. skills in play therapy. Journal of Professional Coun- trying!” Focusing the child’s atten- Bettelheim, B. (1987). The importance of play. seling: Practice, Theory, & Research, 32(2), 28-41. tion on the effort rather than the end Atlantic Monthly, 3, 35-46. Rogers, C. (1951). Client-centered therapy. Boston, result helps them to understand the Blanco, P., & Sheely-Moore, A. (2012). Gift-giving MA: Houghton Mifflin. and receiving in play therapy, an ethical response. Schaefer, C. (1985). Play therapy. Early Child Devel- path to success and allows each child Journal of Humanistic Counseling, 51, 66-77. opment and Care, 19, 95-108. to feel successful (industrious). And, Bloom, P. (2002). Mindreading, communication, Sepulveda, C. , Garza, Y., & Morrison, M. (2011). and the learning of names for things. Mind & Child-teacher relationship training: A phenomeno- as the children begin to feel more suc- Language, 17, 37-54. logical study. International Journal of Play Therapy cessful, the early childhood educator Bratton, S., & Landreth, G. (2006). Child parent 20(1), 12-25. reaps benefits in that the child will relationship therapy (CPRT). NY: Taylor & Francis. Smilansky, S. (1990). Sociodramatic play: Its rel- Bruner, J. (1981). The pragmatics of acquisition. evance to behavior and achievement in school. In endeavor for greater personal success. In W. Deutsch (Ed.), The child’s construction of E. Klugman & S. Smilansky (Eds.), Children’s play language (pp. 39-55). New York: Academic Press. and learning: Perspectives and policy implications Conclusions Coatsworth, J. & Conroy, D. (2009). The effects of (pp. 18-42). New York: Teachers College Press. autonomy-supportive coaching, need satisfaction, Stickley, V., Muro, J., & Blanco, P.J. (2013). Col- and self-perceptions on initiative and identity in laborating university play therapy programs with It can be argued that caregivers are youth swimmers. Developmental Psychology, 45(2), elementary schools: Alleviating school counselor 320-328. stress. Open Journal of Education, 1(5), 143-147. significant figures as well as role mod- Erikson, E. (1950/1993). Childhood and society. Stubenbort, K. Donnelly, G. & Cohn, J. (2001). els. Therefore, a caregiver who enters New York: Norton. Cognitive-behavioral group therapy for bereaved the child’s world and attempts to un- Frost, J., Wortham, S. & Reifel, S. (2005). Play and adults and children following an air disaster. Group child development (2nd ed.). Upper Saddle River, Dynamics: Theory, Research, and Practice, 5(4), derstand and communicate effectively NJ: Pearson Merrill Prentice Hall. 261-276. offers an example of positive, healthy Ginott, H. (1961). Group psychotherapy with chil- Vygotsky, L. (2004). Imagination and creativity in relationships. Doing so might create a dren. New York: McGraw-Hill. childhood. Journal of Russian and East European Psychology, 42(1), 7-97. situation where a coach has an impact Guerney, L. (1991). Parents as partners in treating behavior problems in early childhood settings. Wells, G. (1987). The negotiation of meaning: that can last beyond childhood. By Topics in Early Childhood Education, 11(2), 74. Talking and learning at home and at school. In B. employing some of the methods of- Illig, D. (1998). A comprehensive review of the Fillon, C. C. Hedley, & E. C. DiMartino (Eds). literature and a series of policy options for early child- Home and school: Early language and reading (pp. fered in the work, the authors assert hood interventions in response to a request by Senator 3-25). Norwood, NJ: Ablex. that this communicative style can Dede Alper. Sacramento, CA: California Research enrich and enhance what is already a Bureau. Landreth, G. (2012). Play therapy: The art of the very meaningful relationship between relationship (2nd ed.). New York: Brunner-Rout- caregiver and child. ledge.

About the Authors focuses on developmental applications focusing on research, theory, and practice in counseling, empathy development, related to multiple aspects of child devel- counseling couples, and counseling opment. Her research focuses on parental Joel H. Muro, Ph.D., is a Professor of at-risk, underserved populations. She decision making about non-parental child Counseling at Texas Woman’s University. has published her work in academic and care arrangements and has published He is a Licensed Professional Counselor, a practitioner journals such as, The Ameri- her findings in a variety of professional Registered Play Therapist, and a Nation- can Journal of Family Therapy, Journal journals, including the Journal of Family ally Certified Counselor. His research of Couple and Relationship Therapy, The Issues, Community, Work and Family, interests and publications are in play Practitioner Scholar: Journal of Counsel- and Texas Child Care Quarterly. therapy and assisting adults in better com- ing and Professional Psychology, and NC Lindsay Webster, LPC, CSC, NCC municating with children, specifically in Perspectives. is an Instructor in the Department of the primary school setting. Katherine K. Rose, is professor in Teacher and Counselor Education at Lilia Lamar Muro, Ph.D., LPC, is an early child development and education Oregon State University, Cascades Bend, Associate Professor of Counseling and De- in the Department of Family Sciences at Oregon. velopment at Texas Woman’s University Texas Woman’s University. She has experience Cassie M. Allen is a student at Texas in Denton, Texas and a Licensed Profes- working in early childhood education as both Woman’s University sional Counselor in the state of Texas. Her a teacher and administrator and currently teaching, clinical experience, and research teaches graduate and undergraduate courses

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