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VLE 3: Rebuilding Attachments with Military
Children Utilizing Play Therapy
1

Connecting military family service providers
and Cooperative Extension professionals to research
and to each other through engaging online learning opportunities
www.extension.org/militaryfamilies
MFLN Intro
Sign up for webinar email notifications at www.extension.org/62831
2

3

James Corbin, MSW, LSW
•Doctoral candidate from the Clinical Social Work Institute in
Washington, DC
•Licensed Social Worker in Pennsylvania with a specialty in
childhood mental illness and individual and family therapy with
children, adolescents, and their families
•Since 2008, has served as full-time clinical faculty and
instructor in the Graduate School of Social Work at Temple
University and is the Clinical Director and Lead Developer of the
Family Center at Temple University Harrisburg
•Has written and presented extensively on the subject of
neuroscience, trauma, and attachment and the impact on clinical
practice and been a featured presenter for the National
Association of Social Workers at their Annual Conference.
•Received training in child-centered play therapy and practiced
as a child and family therapist for The Play Therapy Center and is
a former associate with D.K. Watkins Psychology Associates in
York, Pennsylvania.
Today’s Presenter
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Attachment, Play Therapy, and the
Military Child
Presented for the Military Families Learning Network
CC0 Public Domain
https://pixabay.com/en/soldier-daughter-child-looking-870387/
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 Hall describes the Family
Fortress and Characteristics:
 Secrecy
 Stoicism
 Denial
(Hall, L.K. (2008). Counseling military families: What mental
health professionals need to know. Routledge, New
York)
 They are characteristics that
are helpful to the warrior and
their mission, but often
complicate matters when
problems arise.
Military family and children
CC0 Public Domain
https://pixabay.com/en/soldier-america-independence-day-1385436/
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 Type I – trauma from a
discreet incident
 Type II – occurs (often) in
small increments and on
more than one occasion
 Domestic Violence
 Alcoholism
 Military Relocation
 Multiple Deployments
Types of trauma military children may
experience
CC0 Public Domain
https://pixabay.com/en/sad-child-boy-kid-crying-tears-214977/
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 Family Support Networks
– Family Readiness
Groups (FRG)
 Child and Family Services
(various branches and
National Guard)
 Family Readiness System
(the network of agencies, programs,
services, and individuals, and the
collaboration among them, that promotes
the readiness and quality of life of service
members and their families.) DoDI 1342.22
Military Family Readiness
Forms of support for children and families
CC0 Public Domain
https://pixabay.com/en/family-love-kids-romance-emotions-1404825/
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The Neurobiology of Attachment
Trauma and Healing
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Infant Research and
Attachment
 Bowlby (1960) in
describing the primacy
of early childhood
attachments suggested
that the biological
motive for attachment
was equal to that of the
instinctual drives.
Childhood development: Theoretical
constructs
10
Image by James Corbin used by permission

 Winnicott (1952) is
well-known for his
idea that “there is no
such thing as a
baby” in describing
the primacy of the
early mother-infant
relationship and its
role in the child’s
developing object-
relations.
Mother-infant attachment
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Image by James Corbin used by permission

 Indeed, animal research as well as infant studies have
confirmed that neuroanatomy, neurochemical events, and
observable behaviors are all subsequently modified by
early interactions with caregivers and that these internal
processes are concurrently organized and affect each
other (Schore, 1999; Beebe & Lachmann, 2002).
The critical role of attachment
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 In the absence of appropriate dyadic attachment
experiences during infancy, a child as they grow into
adulthood may exhibit difficulties in their ability to self-
soothe, self-organize, regulate affect, and engage in
healthy relationships (Bowlby, 1969; Winnicott, 1959;
Kradin, 2004).
Some problems associated with attachment
13

 It is generally agreed that attachment security protects
against psychopathology (Fonagy, 2001). Attachment
experiences include the complex physiological, biological,
genetic, and behavioral facets of the early caregiving
environment and concomitant interactive processes.
Therefore it is no surprise that there exists clear evidence
that neglect and attachment difficulties in early
development may be even more damaging than abuse
(Schore, 2003).
Problems with attachment, continued . . .
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Gross anatomy of the brain
CC0 Public Domain
https://pixabay.com/en/brain-biology-abstract-cerebrum-951874/
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Focus on the Brain
Its hemispheres and the effect of trauma on the brain, its
structures, and their basic functions.
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 The left hemisphere is largely
involved in language, logical
reasoning, the conscious,
sequential, mathematical,
storytelling, and verbal
processes (Simpson, 2005a).
 We know that this
hemisphere is generally more
pronounced in females than
in males (Simpson, 2005c).
The left hemisphere
CC0 Public Domain
https://pixabay.com/en/face-silhouette-brain-communication-535761/
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 Generally believed to involve the
processes of the unconscious, emotion,
spatial awareness, abstraction and is
concerned with holistic process and the
Gestalt (Simpson, 2005a).
 Matures faster and is larger than the left
hemisphere and is actually responsible
for inducing the growth and development
of the left hemisphere (Simpson, 2005a).
 Generally considered dominant and is
larger in males than females (Simpson,
2005c). We also know that similar
damage to a particular hemisphere in
male and female brains affects
functioning in different ways between the
genders (Ornstein, 1997).
The right hemisphere
CC0 Public Domain
https://pixabay.com/en/face-silhouette-brain-communication-535761/
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 The hemispheres are joined together by
a dense formation of connections called
the corpus collosum (which means “big
bundle”).
 The corpus collosum is the brain’s
“superhighway” and one of the main
avenues for the hemispheres of the
brain to communicate (Simpson,
2005a).
 It was discovered that certain processes
that are affected by trauma in one area
of a hemisphere of the brain can be (on
some level) taken over by a related
structure in the opposite hemisphere
(Gazzaniga, 1999).
The corpus collosum – the brain’s
superhighway
CC0 Public Domain
https://www.flickr.com/photos/brewbooks/7780990192
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 The amygdala is also a key
structure in memory in that it
creates the “emotional
content” of memory and the
feeling responses related to
memory (Teicher, 2002).
The amygdala
20
CCO Public Domain
https://commons.wikimedia.org/wiki/File:Amygdala.jpg

 This structure compares new
experience with old memories
and response; familiarity often
evokes a predictable response
comparable to novel
experiences (Simpson, 2005d).
 The hippocampus is an area of
the brain that is affected by
Alzheimer’s disease (Simpson,
2005a).
The hippocampus
CC0 via Public Domain
https://en.wikipedia.org/wiki/Hippocampus#/media/File:Gray739-emphasizing-
hippocampus.png
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 Liggan and Kay (1999) suggest that part of treatment for
children with attachment difficulties, for instance, is
focusing on the patterns and rules of implicit memory in an
effort to help the child to reveal and reflect on them more
fully.
 They felt that what may be mutative in psychotherapy was
that new patterns of relationships would be explicated,
repeated, and learned so that these newly learned habits
may be “engrained in the implicit memory system” (p. 105).
Role of therapy with children
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Play therapy and its benefits
Military children and application
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 Play therapy can be
defined in a general way
as “an interpersonal
process wherein a trained
therapist systematically
applies the curative
powers of play to help
clients resolve their
psychological difficulties.”
(Schaefer, 1993, p. 3)
Play therapy
CC0 Public Domain
https://pixabay.com/en/three-girls-female-kids-children-1325106/
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 As Landreth so pointedly
reminds us about children,
“toys are their words” and play
is their language (1993, p. 41).
 For the child, play is the
medium by which they can
express their feelings and gain
mastery over ideas, thoughts,
and conflicts that may be
reflected to the child as
unacceptable in the adult
world.
Play therapy
CC0 Public Domain
https://pixabay.com/en/lego-toys-boy-build-creative-286232/
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 Play therapy comes in
many forms and lies
along a continuum of
activities from those
techniques that are
more directive and
focused in scope to
those that are quite
ambiguous and non-
directive.
Forms of play in therapy
CC0 Public Domain
https://pixabay.com/en/sand-pit-toys-toy-bucket-sand-780855/
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 Play that facilitates
talking
 “Fishing therapy” case
 “Puppet introduction”
case
 “The Ungame”
 Cards for teenagers
 Other therapeutic
games
Direct forms
CCO Public Domain
https://en.wikipedia.org/wiki/Queen_(playing_card)#/media/File:Queen_playing_cards.jpg
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 The use of play as a
therapeutic technique is well-
established and has been
used by some of
psychotherapy’s most
prominent figures.
Play therapy – theoretical history
CC0 Public Domain
https://pixabay.com/en/boy-child-family-female-guardian-1300397/
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 Freud recognized the
importance of play and wrote:
“The opposite of play is not what
is serious but what is real. In
spite of all the emotion with
which he cathects his world of
play, the child distinguishes it
quite well from reality.”
(Freud, 1908, p. 143).
Sigmund Freud
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Papa Freud, conflicted, with cigar by Carla 216 CC via Flickr

 Freud and many psychoanalysts recognized the value
of play (1920) as did Erikson (Tyson, 1990) and
Piaget.
 Anna Freud and Burlingham used play in their work
with orphans and small children in the Hampstead
War Nurseries (A. Freud, 1942).
 Mahler recognized play in the “practicing phase” of
development as a means of solving problems and
understanding the world around them (Mahler, et al.,
1975).
Play therapy history
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 Winnicott believes that play
in of itself is “a therapy” and
that a child’s play has
“everything in it” (1971, p.
259)
 Winnicott (1953) and
Melanie Klein recognized its
usefulness in their work with
child and young adolescent
clients.
Donald Woods Winnicott
CC0 Public Domain
https://pixabay.com/en/sculpture-child-teenagers-bench-609838/
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 Winnicott (1971) describes the relationship of play
to psychotherapy:
 [I]t is play that is the universal, and that belongs to
health:
 playing facilitates growth and therefore health;
 playing leads into group relationships;
 playing can be a form of communication in
psychotherapy;
 and, lastly psychoanalysis has been developed as a
highly specialized form of playing in service of
communication with oneself and others . . . (p. 257).
D.W. Winnicott, continued
32

 It also plays a crucial role in
the integration of object-related
wishes and fantasies as a
means of problem-solving and
reality testing.
 Winnicott described how
babies and children
manipulate play objects in their
environment to gain mastery
over their growing object
relationships.
D.W. Winnicott, continued
CC0 Public Domain
https://pixabay.com/en/crayons-coloring-book-coloring-book-1445053/
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 Winnicott continues,
“If the patient cannot play,
then something needs to
be done to enable the
patient to become able to
play, after which
psychotherapy may begin”
(1971, p. 54).
D.W. Winnicott, continued
CC0 Public Domain
https://pixabay.com/en/kid-child-young-childhood-1350663/
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 The hopeful case of
“Lava Boy”
Child-centered play therapy
CCO Public Domain
https://pixabay.com/en/volcano-erupting-mountain-krakatoa-609104/
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 Carl Rogers (1951) first
coined the term “client-
centered therapy” and was
highly influential in the
development of the
theoretical base and
techniques of play therapy.
Carl Rogers
CC0 Public Domain
https://pixabay.com/en/learning-development-looking-people-164332/
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 One of Roger’s close
colleagues, Virginia Axline
(1947) collaborated with him
on a number of occasions
and is largely recognized as
one of the founders of
child-centered play therapy—
a very special derivative of
the client-centered approach
used previously by Rogers
with adult clients.
Virginia Axline
CC0 Public Domain
https://pixabay.com/en/child-play-kindergarten-kita-1439032/
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 Children communicate
through play
 Toys are children’s
words, and play is their
language ~G.Landreth
Child-centered play therapy
38
Image by James Corbin used by permission

Play therapy
 Axline (1950) summarized her concept of play
therapy, “A play experience is therapeutic
because it provides a secure relationship
between the child and the adult, so that the child
has the freedom and room to state himself in his
own terms, exactly as he is at that moment in
his own way and in his own time” (p. 68).
39
CC0 Public Domain
https://pixabay.com/en/boys-sitting-playing-toddlers-286784/

There are eight basic principles that guide the child-centered
play therapy as described by Axline (1947). They are:
1) The therapist must develop a warm, friendly relationship with
the child, in which good rapport is established as soon as
possible.
2) The therapist accepts the child exactly as he is.
3) The therapist establishes a feeling of permissiveness in the
relationship so that the child feels free to express his
feelings completely.
4) The therapist is alert to recognize the feelings the child is
expressing and reflects those feelings back to him in such a
manner that he gains insight into his behavior.
The “ax”ioms of child-centered play therapy
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5) The therapist maintains a deep respect for the child’s ability to
solve his own problems if given an opportunity to do so. The
responsibility to make choices and to institute change is the
child’s.
6) The therapist does not attempt to direct the child’s actions or
conversation in any manner. The child leads the way; the
therapist follows.
7) The therapist does not attempt to hurry the therapy along. It is
a gradual process and is recognized as such by the therapist.
8) The therapist establishes only those limitations that are
necessary to anchor the therapy to the world of reality and to
make the child aware of his responsibility in the relationship.
(pp. 73-74)
The “ax”ioms of child-centered play therapy, cont’d
41

Child-centered play therapy involves free play with three
types of equipment (Landreth, 1993).
1.Real-life toys include family dolls, doll houses, puppets, cars, trucks, a
cash register, money, and other nondescript figures.
2.Play equipment may also include items that facilitate aggressive
release such as bop bags, toy soldiers, animal figurines, guns, knives,
and swords.
3.Equipment would also include items
that facilitate creative and emotional
expression including such things as
crayons, paper, clay, sand and water,
building blocks, an easel for drawing,
and paint. (pp. 56-57).
Play therapy equipment
42
Image by James Corbin used by permission

 Hartley and his colleagues point to nine therapeutic benefits
of play therapy (1952). Play gives children a chance to:
1) imitate various adults
2) play out real life roles in an intense way
3) reflect numerous relationships and experiences
4) express immediate and pressing needs
5) release unacceptable impulses and feelings
6) reverse roles usually taken in real life
7) mirror growth
8) work out problems and conflict
9) experiment with various solutions in a safe setting
Therapeutic benefits of play therapy
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 Play therapy is well-documented
in its effectiveness for children
and early adolescents working
through a variety of loss and
grieving experiences including:
 Death
 Divorce
 Separation from care givers
 Trauma
 Neglect and abuse
Play therapy and grief work with children
CC0 Public Domain
https://pixabay.com/en/divorce-parents-child-people-156444/
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 The case of “Rocket Girl
and Interplanetary Mail
Delivery”
 The use of two playhouses
and the blended family
Grief work and separation
CC0 Public Domain
https://pixabay.com/en/heart-broken-patched-patch-symbol-48522/
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 Association for Play Therapy: http://www.a4pt.org/
 Temple University Certificate in Play Therapyhttp://www.temple.edu/harrisburg/Default.aspx?
PageID=29
Articles/Books
 V.M. Axline (1974). Play therapy. Ballantine Books: New York.
 Bratton, S.C., Ray, D., Rhine, T., Jones, L. (Aug.,2005). The Efficacy of Play Therapy With Children:
A Meta-Analytic Review of Treatment Outcomes. Professional Psychology: Research and Practice,
Vol 36(4), pp. 376-390.
 G.L. Landreth (2012). Play Therapy: The art of the relationship. Routledge: New York.
 R.VanFleet. (1994). Filial therapy: Strengthening parent–child relationships through play.
Practitioner's resource series. Sarasota, FL, US: Professional Resource Press/Professional
Resource Exchange. xvi 69
 C.E. Shaefer. (1994). Play therapy for psychic trauma in children (in Handbook of play therapy:
Advances and innovations. Eds. C.E. Shaeffer, K.J. O’Connor). Wiley: Canada
Play therapy resources
46

Neuroscience references and resources
47
 Amini, F., Lewis, T., Lannon, R., et. al. (1996). Affect, attachment, memory: Contributions toward psychobiological
integration. Psychiatry, 59, 213-239.
 Andreasen, N. (2001). Brave new brain: Conquering mental illness in the era of the genome. New York: Oxford
University Press.
 Baron-Cohen, S. (2003). The essential difference: The truth about the male and female brain. New York: Basic
Books.
 Beebe, B. & Lachmann, F. (2002). Infant research and adult treatment. London: Analytic Press.
 Clark, J. (1989) (Ed.) The human body. New York: Arch Cape Press.
 Damasio, A. (2003). Looking for Spinoza: Joy, sorrow, and the feeling brain. New York: Harcourt, Brace, and
Company.
 Damasio, A. (1999). The feeling of what happens: Body and emotions in the making of consciousness. New York:
Harcourt, Brace, and Company.
 Damasio, A. & Damasio, H. (1999). Brain and language. In the Scientific American: Book of the Brain (Editors of
Scientific American). New York: The Lyons Press, pp. 29-42).
 Edelman, G.M. (2004). Wider than the sky: The phenomenal gift of consciousness. New Haven: Yale University
Press.
 Fonagy, P. & Target, M. (1996). Playing with reality II: The development of psychic reality from a theoretical
perspective. The International Journal of Psychoanalysis, 77:
 Gabbard, G. (2000). A neurobiologically informed perspective on psychotherapy. British Journal of Psychiatry, 177,
117-122.
 Gazzaniga, M. (1999). The split brain revisited. In the Scientific American Book of the Brain from (Eds.) from
Scientific American, New York: The Lyons Press, pp. 129-138.

References and resources, continued
48
 Gruber, C. (2004, October 2). Cognition and Development. Lecture presented for The Clinical Social
Work Institute, Washington, DC.
 Hedaya, R. (1996). Understanding Biological Psychiatry. New York: W.W. Norton.
 Joseph, R. (1992). The limbic system: Emotion, laterality, and unconscious mind. Psychoanalytic
Review, 79: 3, 405-455.
 Kandel, E.R. (1998). A new intellectual framework for psychiatry. American Journal of Psychiatry,
155, 457-469.
 Liggan, D.Y., Kay, J. (1999). Some neurobiological aspects of psychotherapy: A review. Journal of
Psychotherapy Practice, 8(2), 103-114.
 McGuigan, F. (1994). Biological psychology: A cybernetic science. Englewood Cliffs, New Jersey:
Prentice Hall.
 Model, A. (2003). Imagination and meaningful brain. Cambridge, Massachusetts: A Bradford
Book/The MIT Press.
 Ornstein, R. (1997). The right mind: Making sense of the hemispheres. New York: Harcourt Brace
and Company.
 Ratey, J. (2001). A user’s guide to the brain: Perception, attention, and the four theaters of the brain.
New York: Pantheon Books.
 Schore, A. (1999). Affect regulation and the origin of the self. Mahwah: Lawrence Erlbaum.

 Schore, A. (2003). Affect regulation and disorders of the self. New York: Norton.
 Siegel, D.J. (1999). The developing mind: Toward a neurobiology of interpersonal
experience. New York: The Guilford Press.
 Simpson, G. (2005a, September 23). Neuroscience. Lecture presented for The Clinical
Social Work Institute, Washington, DC.
 Simpson, G. (2005b, October 6). Neurotransmitters and the neural communication
process. Lecture presented for The Clinical Social Work Institute, Washington, DC.
 Simpson, G. (2005c, October 21). Sex differences in the brain. Lecture presented for
The Clinical Social Work Institute, Washington, DC.
 Simpson, G. (2005d, December 2). Memory, image, and representation. Lecture
presented for The Clinical Social Work Institute, Washington, DC.
 Solms, M. & Turnbull, O. (2002). The brain and the inner world: An introduction to the
neuroscience of subjective experience. New York: Other Press.
 Spitz, R.A., & Wolf, K.M. (1946). Anaclitic depression: An inquiry into the genesis of
psychiatric conditions in early childhood, II. Psychoanalytic Study of the Child, 2, 313-
342.
 Stern, D. (1985). The interpersonal world of the infant: A view from psychoanalysis and
developmental psychology. New York: Basic Books.
 Stern, D. (2004). The present moment in psychotherapy and everyday life. New York:
W.W. Norton and Company.
References and resources, continued
49

 Stolorow, R.D. & Atwood, G.E. (1992). Context of being: The intersubjective foundation of
psychological life. Hillsdale, NJ: The Analytic Press.
 Teicher, M.H. (2002). Scars that won’t heal: The neurobiology of child abuse. Scientific
American, 286(3), 68-75.
 Thompson, R. F. (2005). Memory: The key to consciousness. Washington, DC: Joseph
Henry Press.
 Trevarthen, C. (1990). Brain circuits and functions of the mind. Cambridge: Cambridge
University Press.
 Trevarthen, C. (1998). The concept and foundations of infant intersubjectivity. In Braton,
S. et, al. (Eds.) Intersubjective Communication and Emotion in Early Ontogeny: Studies in
Emotion and Social Interaction. Cambridge: Cambridge University Press.
 Tyson, P.T. (2002). The challenges of psychoanalytic developmental theory. Journal of the
American Psychoanalytic Association, 50(1), 19-52.
 Van der Kolk, B. (2003). Posttraumatic Stress Disorder and the nature of trauma: In
Marion, Solomon, & Daniel Siegel (Eds.). Healing trauma: Attachment, mind, body, and
brain. pp. 168-195. New York: W.W. Norton and Company.
 Winnicott, D.W. (1959). The fate of the transitional object. In Psychoanalytic Explorations.
Cambridge, MA: Harvard University Press.
References and resources, continued
50

 http://www.neuroguide.com/ - ground zero for any search on the internet involving the
brain or neuroscience – should be one of your first stops
 http://msnbc.msn.com/id/14309026/from/ET/ - contained in this article about the placebo
effect is a terrific interactive demonstration about the brain
 http://www.msnbc.msn.com/id/15310599/wid/11915773?GT1=8717 – this interactive site
includes a interactive program that demonstrates the effect of various illegal drugs on
the brain and body
 http://www.brainconnection.com/ - a terrific interactive resource for education about the
brain and various conditions of the brain salient to clinicians and educators – includes
brain games and neuroscience in the news as well as links to numerous resources
 http://quest.arc.nasa.gov/neuron/ - this site and on-line neurolab discusses the latest
NASA mission and their project NeurOn that explores the effect of gravity on the nervous
system – a fun site for children and educators
 http://thalamus.wustl.edu/course/ - an on-line tutorial on brain and neuroscience basics
sponsored by the Washington University School of Medicine – a highly educational and
informative site for human service professionals
 http://www.sfn.org/ - official site for the Society for Neuroscience – includes information
about upcoming conferences in neuroscience, information about grants and news
related to professional development
On-line resources about the brain
51

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you learned today?
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CE Credit Information
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Family Development
Upcoming Event
VLE 4: Exploring the Impact of Moral
Injury on Military Families
• Date: Thursday September 22nd
• Time: 11:00am-12:30pm Eastern
• Location: https://learn.extension.org/events/2653
For more information on MFLN Family Development go to:
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