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Child-Centered Group Play Therapy Implementation Guide

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CHILD-CENTERED GROUP PLAY THERAPY IMPLEMENTATION GUIDE DEE C. RAY & YI-JU CHENG ADAPTED FROM RAY, D., & CHENG, Y. (2018). CHILD-CENTERED GROUP PLAY THERAPY: THERAPEUTIC POWER OF RELATIONSHIP. JOURNAL OF TAIWAN PLAY THERAPY, 7, 1-21. Copyright Ó 2018 by the University of North Texas Center for Play Therapy All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic means without permission in writing from the authors. Published by University of North Texas Center for Play Therapy Denton, TX USA 2 Child-centered group play therapy (CCGPT) is a journey of self-exploration and self- discovery not only for children but also for play therapists (Landreth & Sweeney, 1999). Within this therapeutic relationship—which can encompass a relationship between children, a relationship between a child and a therapist, or both—each child moves toward growth and develops a sense of self. CCGPT is unique in its integration of child-centered play therapy (CCPT) and group intervention, which increases the complexity of the philosophy and implementation of CCGPT. CCGPT also requires advanced knowledge and skills in both play and group therapies, and it demands acceptance and belief in children and their positive and negative interactions (Landreth & Sweeney, 1999; Ray, 2011). This level of commitment to children and the therapy process may challenge therapists’ comfort levels and sense of competence as they therapeutically facilitate CCGPT. In addition to discussing the tenets and process that underlie CCGPT, then, we seek to specifically introduce the nonverbal skills and verbal responses that are essential to facilitating CCGPT—a task that has been a void in the literature. Theoretical Approach CCGPT evolved from the individual child-centered play therapy (CCPT) approach grounded in Rogers’ (1951) person-centered theoretical orientation to counseling. CCPT was developed in the 1940s, distinguishing it as one of the longest-standing mental health interventions that has continued to thrive over decades of practice and research. Rogers (1957) proposed six conditions that must be present in order for persons to change, advancing toward more self-enhancing ways of being. All six conditions are based on the primacy of the relationship between therapist and client. They include 1) two persons are in psychological contact; 2) the first person (client) is in a state of incongruence; 3) the second person (therapist) 3 is congruent in the relationship; 4) therapist experiences unconditional positive regard for client; 5) therapist experiences an empathic understanding of the client’s internal frame of reference and attempts to communicate this experience to the client; and 6) communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved (Rogers, 1957). Based on Roger’s (1951) person-centered theory, Virginia Axline (1947) presented the first structure of CCPT by operationalizing the philosophy of person-centered therapy into a coherent working method for children. In CCPT, the therapist promotes the self-directed nature of the child by following the child’s lead and not guiding the client’s goals or therapeutic content (Ray, 2011). Axline (1947) offered eight principles that serve as guidelines to enact the philosophy of the child-centered approach, including: 1. The therapist develops a warm, friendly relationship with the child as soon as possible. 2. The therapist accepts the child exactly as is, not wishing the child were different in some way. 3. The therapist establishes a feeling of permissiveness in the relationship so that the child can fully express thoughts and feelings. 4. The therapist is attuned to the child’s feelings and reflects those back to the child to help gain insight into behavior. 5. The therapist respects the child’s ability to solve problems, leaving the responsibility to make choices to the child. 6. The therapist does not direct the child’s behavior or conversation. The therapist follows the child. 4 7. The therapist does not attempt to rush therapy, recognizing the gradual nature of the therapeutic process. 8. The therapist sets only those limits that anchor the child to reality or make the child aware of responsibilities in the relationship. (pp. 73-74). CCPT is characterized by a high level of relational interaction between therapist and child in which the therapist provides statements of reflection, encouragement, self-responsibility, and limits when necessary (Sweeney et al., 2014). CCPT is facilitated in a playroom stocked with toys and materials that encourage the expression of all feelings by a child. Materials for the playroom include toys, craft materials, paints, easel, puppet-theater, sandbox, and child furniture. CHILD-CENTERED GROUP PLAY THERAPY (CCGPT) CCGPT combines the advantages of CCPT and group process (Landreth & Sweeney, 1999). In CCGPT, children encounter opportunities to understand themselves; learn about themselves as perceiving regard from both the therapist and other group members; and explore the importance of individuality and uniqueness, cooperation and compliance, creativity, and originality (Sweeney et al., 2014). CCGPT not only helps children develop interpersonal and intrapersonal skills, but also assists children in processing emotional issues (Landreth, Homeyer, Glover, & Sweeney, 1996). The integration of play therapy and the framework of the group process are beneficial for facilitating a child’s sense of control, feelings of empowerment, and abilities to master overwhelming emotions (Landreth et al., 1996). Axline (1969) believed that “group experience injects into therapy a very realistic element because the child lives in the world with other children and must consider the reaction of others and must develop a consideration of other individuals’ feelings” (p. 25). Axline also suggested that children struggling with social adjustments may benefit more from group play 5 therapy than from individual therapy. Correspondingly, Landreth (2012) described group play therapy as “a psychological and social process in which children, in the natural course of interacting with one another in the playroom, learn not only about other children but also about themselves” (p. 42). Using a term first coined by Slavson and Schiffer (1975), Ginott (1961) referred to the power of social hunger as a therapeutic change agent in group play therapy expressing the belief that people desire to conform, to gain acceptance by others, and to maintain status in their groups. The group process extends the benefits of therapy with additional characteristics afforded by the presence of other group members (Ray, 2011). In CCGPT, children may be more comfortable than in individual therapy due the presence of another child. In addition to feeling more comfortable in the presence of another child, children may participate more freely as they experience the permissive environment with one another (Sweeney & Homeyer, 1999). In observing the play of another a child, a child may be emotionally stimulated to play out her own issues resulting in vicarious or induced catharsis (Ginott, 1961). As children play with one another, they also learn from one another, specifically learning how to meet their own personal needs while staying in relationship with others. Additionally, group play therapy allows the therapist the opportunity to observe a child’s interpersonal skills and ways of being with other, a process not readily observable in individual play therapy (Ginott, 1961). In a safe environment of therapy, children are able to experiment with reality testing and limit-setting as they develop coping skills for interpersonal interactions (Sweeney & Homeyer, 1999). Finally, with facilitation and reflections from a therapist, children experience an environment with “interactions coupled with awareness” that may increase “positive experiences with peers” (Ray, 2011, p. 185). 6 With these foundational concepts in mind, the primary objective of CCGPT is the facilitation of an environment in which children can increase their self-acceptance and self- reliance, learn coping skills, increase self-responsibility, improve self-control, and connect CCGPT experiences to reality (Ray, 2011; Sweeney & Homeyer, 1999). With a play therapist’s facilitation and reflections, children participating in a group can become more aware of their own and others’ feelings, thoughts, and needs; they can also learn to interact in accepting and supportive ways (Ray, 2011). One unique feature of CCGPT is that children serve as therapeutic agents for each other. Through relating and interacting with each other in the group setting, children may help each other consider personal responsibility in interpersonal relationships that they can accordingly extend to other relationships in the real world (Landreth, 2012). Research in CCGPT Researchers have indicated the beneficial effects of CCGPT on children’s anxiety (Shen, 2002), self-control (Trostle, 1988), self-concept (DeMaria & Cowden, 1992), behavioral problems (Tyndall-Lind, Landreth, & Giordano, 2001), and social and personal adjustment (Elliott & Pumfrey, 1972; Fleming & Synder, 1947). Over the last decade, CCGPT has received continuous attention from researchers in the play therapy field. For example, Baggerly (2004) explored the impact of CCGPT on self-concept, depression, and anxiety of children who were homeless. Data analysis results demonstrated that CCGPT was facilitative
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