EXPERTS IN PLAY: EXPLORING THE DEVELOPMENT AND USE OF PLAY-BASED EVALUATION METHODS IN FACILITATING CHILDREN’S VIEWS OF NON-DIRECTIVE PLAY THERAPY VOLUME ONE Jessica Jäger PhD University of York Department of Social Policy and Social Work February 2010 ↑ ↑The interested reader is directed to Gilroy’s (2006) discussion on the symbolism of Bambi and psychotherapy. On a more personal note the emblem is an adaptation of my family motto and crest. ii ABSTRACT Aims This study investigates the use of play-based evaluation methods, developed by the author, in non-directive play therapy practice. A review of the child therapy literature demonstrates that there has been limited development of child-centred methods to ascertain children’s views. Whilst there has been development of appropriate methods for gathering children’s views in other settings, these do not fully translate to the complex setting of therapeutic interactions. The study aims to record children’s views of play therapy as expressed through play-based evaluations; explore their use as a new method and, finally, explore what conditions are needed to fully facilitate children’s exploration and sharing of their views when using play-based evaluations. Methods The study employs a qualitative methodology utilising video observation as a less intrusive method for data collection of the children’s views that are expressed during play-based evaluation. The videos are analysed in two main ways: to record the children’s views and to explore the process between therapist and child during the interaction. Pre- and post- questionnaires are used to gain information regarding the children in the study and the therapists’ perceptions. Utilisation of computer-assisted software, visual methods of analysis and in-depth micro-analysis of video observation are combined to create an innovative and thorough methodological approach. Exciting new methods of visual representation are employed to present the findings in a way that respects the need for participant anonymity whilst allowing the reader greater access to the non-verbal processes described. Conclusions The study shows that play-based evaluation techniques are important and flexible methods for facilitating children’s views of child therapy. The study shows how therapists take different approaches to delivering the sessions. It is argued that those therapists who incorporate their therapeutic skills effectively, maintain flexibility and sensitively attune to the child during the session, enable the child to explore their views more fully. iii VOLUME ONE CONTENTS CHAPTER ONE: INTRODUCTION ...................................................................... 1 Background and Rationale........................................................................................ 1 Development of Play-Based Techniques .................................................................. 3 Aims of the Study ....................................................................................................... 4 Design of the Study .................................................................................................... 4 Influences on the study design ..................................................................................... 4 Structure of the Thesis............................................................................................... 5 PART ONE: LITERATURE REVIEW CHAPTER TWO: PLAY THERAPY: AN OVERVIEW OF THEORY AND PRACTICE BASED RESEARCH ........................................................................... 9 Introduction................................................................................................................ 9 Play Therapy: A Definition ....................................................................................... 9 The Use of Play in Child Therapy ............................................................................ 9 Play Therapy: A Brief History................................................................................ 11 Description of Non-Directive Play Therapy .......................................................... 12 Development of NDPT .............................................................................................. 13 The Research Base ................................................................................................... 15 Outcome Studies ........................................................................................................ 15 Process Studies........................................................................................................... 18 The Child’s Perspective ........................................................................................... 21 Conclusion................................................................................................................. 23 CHAPTER THREE: RESEARCHING CHILDREN’S PERSPECTIVES........ 24 Introduction.............................................................................................................. 24 Seeking Children’s Views........................................................................................ 24 Children’s Rights: An Overview ............................................................................ 26 Children’s Rights in Play Therapy............................................................................. 27 Children’s Rights in the Research Arena .................................................................. 30 Current Research Methods with Young Children ..................................................... 32 Children’s Memories and Use of Language........................................................... 35 Verbal Recall and Language Development................................................................ 35 Co-construction of Events.......................................................................................... 36 Emotion-laden Memories........................................................................................... 37 Children’s Testimony: Enhancing Children’s Accounts............................................ 38 Children’s Views of Child Therapy ...................................................................... 40 Group Therapy ........................................................................................................... 41 Family Therapy .......................................................................................................... 42 Mental Health Treatment and Assessment Interventions........................................... 42 Children’s Views of Play Therapy.......................................................................... 44 An Historic Study....................................................................................................... 44 A Filial Play Therapy Study....................................................................................... 47 A Study on Individual Play Therapy.......................................................................... 48 iv A Study on Trainee Play Therapists........................................................................... 52 A Study Incorporating the ‘Draw and Write’ Technique........................................... 53 Summary................................................................................................................... 58 Conclusion................................................................................................................. 59 CHAPTER FOUR: THERAPEUTIC RELATIONSHIPS .................................. 61 Introduction.............................................................................................................. 61 Facilitative and Inhibitive Factors in Psychotherapy........................................... 62 Attachment Theory .................................................................................................. 65 ‘Affect Attunement’................................................................................................... 67 ‘Narrative Regulation’ ............................................................................................... 69 Non-Directive Play Sessions: An Optimal Environment ..................................... 73 Extended Attachment Theory: ‘Dynamics of Attachment and Interest Sharing’ Model ........................................................................................................................ 75 Application of the Dynamics of Attachment to Interactions in Adult Psychotherapy77 Application of the Dynamics of Attachment to Interactions in Play Therapy........... 80 Conclusion................................................................................................................. 81 PART TWO: METHODOLOGY CHAPTER FIVE: THE DEVELOPMENT OF PLAY-BASED EVALUATION TECHNIQUES: THE PILOT RESEARCH ............................. 84 Introduction.............................................................................................................. 84 Initial Purpose .......................................................................................................... 84 Research Questions .................................................................................................... 84 Play-based Evaluation Methods ............................................................................. 85 ‘The Expert Show’ – a Role-Playing Technique ....................................................... 87 Background ...............................................................................................................