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Child-Centered Play Therapy

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Child-Centered Play Therapy Child-Centered Play Therapy Risë VanFleet Andrea E. Sywulak Cynthia Caparosa Sniscak Foreword by Louise F. Guerney THE GUILFORD PRESS New York London Contents PART I. BACKGRouND AND RELEVANCE CHapTer 1. The Importance of Play 3 What Is Play? 3 Play and Child Development 6 Changing Trends in Children’s Play 7 Assumptions about the Therapeutic Use of Play 8 CHapTer 2. A Brief Overview of Play Therapy 11 Types of Play Therapy 13 Why Play Therapy? 18 CHapTer 3. History, Theory, Principles, and Variations 20 of Child- Centered Play Therapy Building the Relationship 21 Acceptance of the Child 23 Establishing a Sense of Permissiveness 25 Empathic Recognition and Reflection of Feelings 26 Respecting the Child’s Ability to Solve Problems 30 Letting the Child Lead the Way 32 xvii xviii Contents Treating Play Therapy as a Gradual Process That Cannot Be Hurried 37 The Importance of Limits 38 Variations of CCPT 41 PART II. LogISTIcs AND TECHNIQUES CHapTer 4. Playroom Set-Up and Logistics 45 Playroom Set-Up 47 Principles of Toy Selection 49 Toys for Older Children 52 Messy Materials 53 Controversy about Aggression Toys 54 Arrangement of Toys 55 Logistics 56 Explaining CCPT to Children 58 CHapTer 5. The Four Skills of Child- Centered Play Therapy 59 Structuring 59 Empathic Listening 65 Child- Centered Imaginary Play 75 Limit Setting 78 Are You Really Being Nondirective? 86 CHapTer 6. Recognition and Interpretation of Play Themes 88 Recognition of Play Themes 89 Critical Considerations in Understanding Play Themes 90 Thematic Stages in CCPT 90 Levels of Interpretation 92 Understanding Play Themes in Context 94 Common Play Themes 99 Suggestions about the Interpretation of Play Themes 99 Documentation of Themes and Progress 100 PART III. PARENT INVOLVEMENT CHapTer 7. Engaging Parents (and Teachers) in Child- Centered 105 Play Therapy Introducing Parents to CCPT: The Importance of Empathy 106 Establishing Treatment Goals 108 Handling Parental Resistance 109 Regular Meetings with Parents 112 Handling Behavior Issues 114 Preventing Behavior Problems 118 Contents xix Helping Children with Their Feelings 119 Handling of School Issues 121 Other School- Related Issues 123 Confidentiality and Consent to Treatment 124 Summary 126 CHapTer 8. Filial Therapy 127 The Value of FT to Children 128 The Value of FT to Parents 129 Conducting FT 132 The Importance of Training in FT 133 Where to Get Training in FT 134 Other Sources of Information about FT 135 PART IV. PRACTICAL AppLICATIONS AND IssuES CHapTer 9. Child- Centered Play Therapy with Different 139 Presenting Problems Anxiety 140 Divorce 143 Attention- Deficit/Hyperactivity Disorder 146 Developmental Disability 147 Attachment Problems 148 Posttraumatic Stress Disorder 151 Perfectionism/Obsessive– Compulsive Disorder 154 Medical Illness 157 Severe Trauma and Attachment Problems in Adolescents 159 Acute Trauma 162 Oppositional Defiant Disorder 163 Summary 166 CHapTer 10. Handling Select Child Behaviors 167 and Special Circumstances Bossiness 167 Bad Words 169 Cheating 172 Very Withdrawn Behaviors 173 Aggression 175 Does Acceptance in CCPT Open Pandora’s Box in Daily Life? 180 Therapist Discomfort 181 CHapTer 11. Touch in Child- Centered Play Therapy 182 The Role of Touch in CCPT 183 Risks of Touch in CCPT 186 xx Contents Special Considerations for Traumatized Children 188 Informing Parents and Documenting Touch in CCPT 191 CHapTer 12. Cultural and Systemic Considerations in the Practice 192 of Child- Centered Play Therapy Cultural Relevance 193 Misunderstanding of CCPT by Other Professionals 195 Pressures for Quick Results 196 CCPT with Children in Foster or Protective Care 199 Using CCPT in Conjunction with Directive Play Therapy Approaches 202 Using CCPT in School, Hospital, or Home-Based Settings 204 Adaptability 206 PART V. RESEARCH AND PRofEssIONAL IssuES CHapTer 13. Research on Child- Centered Play Therapy 209 and Filial Therapy Sources of Knowledge about Therapeutic Methods 209 Summary of Empirical Support for CCPT and FT 213 CHapTer 14. Developing Competence in Child- Centered 217 Play Therapy Training 217 Supervision 219 Resources Available 221 Credentials 222 Conclusion 223 References 225 Index 231 PART I BACKGROUND AND RELEVANCE CHAPTER 1 The Importance of Play Although most people seem to recognize play when they see it, an agreed-upon scientific definition of “play” has eluded professionals from many different fields. Play seems to be enjoyable for those engaging in it, and it often involves creativity, flexibility, risk taking, curiosity, adapt- ability, problem solving, and “flow.” Play also seems important because it occupies such a prominent place in the lives of the young. This chapter explores current and emerging knowledge about the importance of play in the lives of humans and other animals. What Is Play? Else (2009) has emphasized that play is a process chosen freely and directed by the players, and one that seems to be its own reward: “In summary, playing children choose the content and purpose of their actions, following their own instincts, ideas and interests, in their own way for their own reasons” (p. 11). Similarly, Clark and Miller (1998) have suggested four criteria for defining children’s play: (1) It is non- literal; (2) it is done for its own reasons and not directed toward an external goal; (3) it is associated with positive feelings and is enjoyable; 3 4 BACKGROUND AND RELEVANCE and (4) it involves flexibility in the use of play objects as well as in the process. While these conceptualizations of play may serve our immediate purposes, there is no universal acceptance of what play entails. The phenomenon of play has been of interest to child development experts, child mental health clinicians, biologists, comparative psychologists, his- torians, ethologists, anthropologists, and even dog trainers (e.g., Bekoff & Byers, 1998; Brown & Vaughan, 2009; Burghardt, 2005; Chudacoff, 2007; Elkind, 2007; Fagen, 1981; London & McConnell, 2008; Miller, 2008; Paley, 2004; Pellegrini & Smith, 2005; Sutton-Smith, 1997; Terr, 1990). Sutton-Smith (1997) identifies seven views that have been pro- posed through the years by professionals from several fields of study: Play is seen (1) as an adaptation that furthers development and learn- ing; (2) as an application of strategy and skill that establishes power or hierarchy; (3) as a mechanism of optimism that offsets the negative or pessimistic side of life; (4) as a transformation from the ordinary, with its exaggerations and pretenses; (5) as an expression of one’s self or iden- tity; (6) as a means for social bonding and community building; and (7) as fun, in contrast to the world of work. The proponents of these views do not necessarily agree with each other, and may even vehemently disagree. Burghardt (2005, pp. 45–82) provides an excellent exploration of the history, theory, and science of play, highlighting important research and proposing a five-part definition that shows promise for identifying play in human and nonhuman animals. His criteria for identifying play are as follows: 1. Limited immediate function. This means that the behavior is not completely focused on survival matters. Play is not serving some well- defined function that leads specifically to the player’s survival. The play may have a function, but it is not immediately evident what it is. For example, the play is not designed to result in food or money acquisition, or to produce some other specific result. 2. Endogenous component. This means that play comes from within. It can be described as having one or more of the following attributes: It is spontaneous, voluntary, intentional, pleasurable, rewarding, and/or done for its own sake. For example, when children play, they often smile or laugh. They are motivated to continue their play activities without any adult prompting. Players of many species seem immersed in the play and convey a joyful demeanor while engaged in it. The Importance of Play 5 3. Structural or temporal difference. This criterion posits that play behaviors differ from the “serious” forms of the behaviors in some way. Play is characterized by exaggerated expression, awkward movements, or a different sequence in the behavior pattern. Qualitative or quantitative differences distinguish it from more serious behavior. For example, in many species there are differences between play fighting and real fight- ing, such as different facial expressions or other signals, and the play fighting is not as rough or potentially harmful. Mouths meet more gently (dogs and other mammals inhibit their bite), and toy swords touch with at least a little more care (children inhibit the force of their blows). 4. Repeated performance. Play behaviors are typically repeated many times, but often with variations on the theme. For example, dogs who chase balls return for another throw over and over, often until they are exhausted. Hopscotch is a game with many repetitions of throwing the stone and hopping on the numbers on the sidewalk. Children’s imagi- nary tea parties can involve endless pouring of water into cups, but the water may represent tea, coffee, juice, or milk throughout the play. 5. Relaxed field. This suggests that an animal shows little moti- vation to perform other behaviors when playing. The animal is more relaxed, with lower levels of stress; also, its behavior is not being influ- enced heavily by some other drive, such as hunger, predation, or escap- ing danger. Bodies seem relaxed and loose in a safe environment. If a real threat appears, play usually
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