Orientation to play thearpy shared version


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Selected modified slides from a presentation to KIDS Group, Roanoke, VA January 2012

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  • Example: A client that refuses to talk about feelings with adults….will express feelings in their play. Various levels of therapist response are: reflect on the play, respond in the play moment, talk about the play with the child, interpret the meaning of the play to the child.
  • Orientation to play thearpy shared version

    1. 1. An Orientation to Play Therapy Stephanie Pratola, Ph.D. January 11, 2012 KidS Group
    2. 2. Characteristics of play Action oriented (real or imagined) Stephanie Pratola, Ph.D.. 2012 12:15 2
    3. 3. Characteristics of play Spontaneous, self generated – intrinsically motivated Stephanie Pratola, Ph.D... 2012 3
    4. 4. Characteristics of play Not too serious: Not goal oriented Stephanie Pratola, Ph.D... 2012 4
    5. 5. Characteristics of play Not good or bad: it just is Stephanie Pratola, Ph.D... 2012 5
    6. 6. Characteristics of play No rules - flexible Stephanie Pratola, Ph.D... 2012 6
    7. 7. Characteristics of play Non-literal: uses fantasy or imagination Use of symbolic objects Stephanie Pratola, Ph.D... 2012 7
    8. 8. Characteristics of play Don’t have to be “good” at it Stephanie Pratola, Ph.D... 2012 8
    9. 9. Characteristics of play Fun Stephanie Pratola, Ph.D... 2012 9
    10. 10. Characteristics of play Involves loss of self consciousness(induces the state of “flow”) Stephanie Pratola, Ph.D... 2012 10
    11. 11. Characteristics of play Play is the “medium” of children Stephanie Pratola, Ph.D... 2012 11
    12. 12. Characteristics of play Play is intrinsically therapeutic Stephanie Pratola, Ph.D... 2012 12
    13. 13. Characteristics of play Functions of play beyond to have fun are unconscious Stephanie Pratola, Ph.D... 2012 13
    14. 14. Association For Play Therapy Multidisciplinary professional organization Promotes play therapy Has developed a credentialing system Promotes and sponsors training , now including university level Promotes research of treatment efficacy and development Pratola, Ph.D... practices. Stephanie of best 2012 14
    15. 15. Rationale for Play therapy- Stephanie Pratola, Ph.D.. 2012 12:30 18
    16. 16. Children naturally use play to Develop basic kinesthetic skills Stephanie Pratola, Ph.D... 2012 19
    17. 17. Children naturally use play to: Learn to relax and release energy Stephanie Pratola, Ph.D... 2012 20
    18. 18. Children naturally use play to: Explore their environment Stephanie Pratola, Ph.D... 2012 21
    19. 19. Children naturally use play to: Master unfamiliar situations Stephanie Pratola, Ph.D... 2012 22
    20. 20. Children naturally use play to: Develop an understanding of their world Stephanie Pratola, Ph.D... 2012 23
    21. 21. Children naturally use play to: Master Conflicts Stephanie Pratola, Ph.D... 2012 24
    22. 22. Children naturally use play to: Soothe and Distract Themselves Stephanie Pratola, Ph.D... 2012 25
    23. 23. Children naturally use play to: Develop a sense of self separate from others Stephanie Pratola, Ph.D... 2012 26
    24. 24. Children naturally use play to: Understand societal roles Stephanie Pratola, Ph.D... 2012 27
    25. 25. Children naturally use play to: Learn to cooperate with others Stephanie Pratola, Ph.D... 2012 28
    26. 26. Play Therapy There is no one school of play therapy Stephanie Pratola, Ph.D... 2012 29
    27. 27. All play therapy has in common Emphasis on a relationship that honors play Stephanie Pratola, Ph.D... 2012 30
    28. 28. All play therapy has incommon:Use of techniques designed to harness the natural therapeutic power of play Stephanie Pratola, Ph.D... 2012 31
    29. 29. Other “Common features” ofPlay Therapy: Use of “play” interactions and activities Characterized by  Action- real or imagined  Imagination  Use of symbolic objects  Creative productions  Value on process rather than content Stephanie Pratola, Ph.D... 2012 32
    30. 30. Other “Common features” ofPlay Therapy: Communication in the play interaction that is  Developmentally appropriate  Metaphorical/symbolic Stephanie Pratola, Ph.D... 2012 33
    31. 31. Developmentalconsiderations: (for example) 3 year olds begin symbolic play; 4 year olds can draw representational pictures Importance of how trauma is encoded Capacity for fantasy Defensive vulnerability as related to cognitive development Stephanie Pratola, Ph.D... 2012 34
    32. 32. History of Play Therapy There is no one school of play therapyAnalytic: Anna FreudJungian: Sand tray therapyRogerian: Axline – non-directive Gureney – FilialCognitive Behavioral –Integrative/Prescriptive/Multimodal Stephanie Pratola, Ph.D.. 2012 12:40 35
    33. 33. Schools of Play Therapy differon several dimensionsDirective vs. Non-DirectiveStructured vs. UnstructuredLevel of verbalizationChoice and use of toys and materialsWho is present in the session: parents,family, peers, individual Stephanie Pratola, Ph.D... 2012 36
    34. 34. Directive vs. Non-DirectiveHow active is the therapist in directingthe play in the session.Non-Directive play therapists typicallydeal with individual children or teach filialtherapy to parents. Stephanie Pratola, Ph.D... 2012 37
    35. 35. Structured vs. Non StructuredA dimension of Non-directive therapyTherapists from a cognitive behavioralorientation, for example, are highlystructured.Theraplay is another highly structuredtype of play therapy intervention wherethe therapist plans the session followingan assessment of the client needs. Stephanie Pratola, Ph.D... 2012 38
    36. 36. Level of VerbalizationAnd ….interpretation…..Non-directive play therapists will usewords to reflect what they observe in theplay.Most play therapists deal with conflicts,etc. in the play relationship Stephanie Pratola, Ph.D... 2012 39
    37. 37. Choice and use of toys Psychoanalytic play therapy: each child has a small collection of toys kept for their entire course of therapy Non-directive therapy: a variety of items consistently available Sandtray therapy: a large collection of objects and sand trays Cognitive behavioral/PCIT/ Eco- systemic/Integrative/Prescriptive: Therapist choses games and toys specifically brought in for each session. Stephanie Pratola, Ph.D... 2012 40
    38. 38. School of Play Associated with….. Therapist stance Use of Interpretation? ToysTherapy(Client Centered) Axline, Non-directive/ No A wide varietyAxline UnstructuredPsychoanalytic Freud, James Non-directive/ Yes A limited number UnstructuredExistential Moustakis Non-directive/ Yes A wide variety UnstructuredTheraplay Jernberg Directive/Structured No Selected by therapistAdlerian Adler, Kottman Directive/Structured Yes Selected by therapistCognitive-Behavioral Schaefer Directive/Structured No Games/ therapeutic activitiesEco-systemic O’Connor Directive/Structured Yes Selected by the therapistGestalt Oaklander Directive/Unstructured No Selected by the therapist Stephanie Pratola, Ph.D...Jungian Lowenfield Non- Yes Sandtray and objects 2012 Directive/Structured provided 41
    39. 39. Clinically Play can be used to:1. form a relationship2. assess child’s thoughts, feelings, beliefs, expectations, skills, reactions3. communicate important ideas:4. challenge and teach new skills5. provide opportunity for something different to happen in an interaction6. help child make connections, understand self and motivations of others.7. dissipate energy and cope with overwhelming feelings. Stephanie Pratola, Ph.D... 2012 42
    40. 40. A word about PiZZaZz Pizzazz is a dramatic, energetic and playful response to your child. Pizzazz is an attitude that clearly communicates “we are playing now” …it is sort of an induction into the playful mode. Pizzazz energizes both the pizzazzer and the pizzazzee. Stephanie Pratola, Ph.D... 2012 43
    41. 41. Beginning a Play Therapy Relationship Stephanie Pratola, Ph.D.. 2012 1pm 44
    42. 42. What the therapist does: The goal of the therapist is to create a trusting relationship by giving close attention to the child’s sharing of his thoughts and feelings through play. The attitude of the therapist is intensely interested, open ad accepting of the child. In child centered play interactions the therapist relates to child in a way that is different from how people usually relate to children. Here the child determines the direction of the interaction. The therapist follows and reflects the actions, thoughts and Stephanie Pratola, Ph.D... feelings that the child shares. 2012 45
    43. 43. Talking “ to a child in play1. Avoid direct, intrusive questions2. Child takes the lead, directs the action.3. Describe what you see out loud (explained below)4. Accept creations without judgment5. Use “I wonder” statements6. Be animated, energetic, dramatic – show PIZZAZZ7. Don’t take play personally or literally.8. Communicate “in role”9. React to the child’s feeling level: a. “That monster sure is scary” b. “I’m so sorry your dolly is sick” Stephanie Pratola, Ph.D... 2012 46
    44. 44. Description Involves following the child’s actions with descriptive statements. This is particularly useful when a child is non-verbal and/or very tentative in their play. Example:  “You’re getting all the dolls together”  “You’re being very careful with all those toys.” Avoid judgmental comments: “What a good job.” Stephanie Pratola, Ph.D... 2012 47
    45. 45. Role Play Practice Activity Divide into threes: child, RPT and RPT-S Stephanie Pratola, Ph.D... 2012 48
    46. 46. Registered Play Therapist Must be a licensed Mental Health Practitioner Master’s degree or Higher APT designated core graduate coursework 2 years and 2,000 hours of supervised clinical experience 150 hours of play therapy specific instructions 500 hours of play therapy experience ; 50 hours of play therapy supervision Renewal: 18 hours CEU every 36 months. Stephanie Pratola, Ph.D... 2012 49
    47. 47. Registered Play Therapist-Supervisor RPT requirements plus” Additional 3 years and 3,000 hours of supervised clinical experience 3 years of post licensure practice Additional 500 hours of play therapy experience 24 additional hours of supervision training or be a state approved supervisor 18 hours of CEUs every 36 months Stephanie Pratola, Ph.D... 2012 50