Individual counseling


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Individual counseling

  1. 1. ESB 4083 INDIVIDUAL COUNSELLING ESB 4083 INDIVIDUAL COUNSELLINGName : Nuril Ekma Bte Hj Abd Muda KJC0950313Section :2Lecturer : Dr. Wan Marzuki Wan JaafarDate submit : 31th Disember 2011Marks : 1
  2. 2. ESB 4083 INDIVIDUAL COUNSELLINGQuestion 1Study the intervention used in counseling session & write a report on the technique, the strengthand weakness of the intervention1. SOLUTION FOCUSED THERAPHY Often referred to as simply solution focused therapy or brief therapy, is a type of talkingtherapy that is based upon social constructionist philosophy. It focuses on what clients want toachieve through therapy rather than on the problem that made them seek help. The approach doesnot focus on the past but instead focuses on the present and future. The therapist/counselor usesrespectful curiosity to invite the client to envision their preferred future and then therapist andclient start attending to any moves towards it whether these are small increments or largechanges. To support this, questions are asked about the client’s story, strengths and resources,and about exceptions to the problem. Solution focused therapists believe that change is constant. By helping people identify thethings that they wish to have changed in their life and also to attend to those things that arecurrently happening that they wish to continue to have happen, SFBT therapists help their clientsto construct a concrete vision of a preferred future for themselves. The SFBT therapist then helpsthe client to identify times in their current life that are closer to this future, and examines what isdifferent on these occasions. By bringing these small successes to their awareness, and helpingthem to repeat these successful things they do when the problem is not there or less severe, thetherapists helps the client move towards the preferred future they have identified. Solution focused work can be seen as a way of working that focuses exclusively orpredominantly at two things.  Supporting people to explore their preferred futures.  Exploring when, where, with whom and how pieces of that preferred future are already happening. While this is often done using a social constructionist perspective the approach is practical and can be achieved with no specific theoretical framework beyond the intention to keep as close as possible to these two things. 2
  3. 3. ESB 4083 INDIVIDUAL COUNSELLINGThe technique1. The miracle questionIs a method of questioning that a coach, therapist, or counselor uses to aid the client to envisionhow the future will be different when the problem is no longer present? Also, this may help toestablish goals.A traditional version of the miracle question would go like this: "Suppose our meeting is over, you go home, do whatever you planned to do for the rest of the day. And then, sometime in the evening, you get tired and go to sleep. And in the middle of the night, when you are fast asleep, a miracle happens and all the problems that brought you here today are solved just like that. But since the miracle happened overnight nobody is telling you that the miracle happened. When you wake up the next morning, how are you going to start discovering that the miracle happened? ... What else are you going to notice? What else?"Whilst relatively easy to state the miracle question requires considerable skill to ask well. Thequestion must be asked slowly with close attention to the persons non-verbal communication toensure that the pace matches the persons ability to follow the question. Initial responsesfrequently include a sense of "I dont know." To ask the question well this should be met withrespectful silence to give the person time to fully absorb the question. Once the miracle day has been thoroughly explored the worker can follow this withscales, on a scale where 0 = worst things have ever been and 10 = the miracle day where are younow? Where would it need to be for you to know that you didnt need to see me any more? Whatwill be the first things that will let you know you are 1 point higher. In this way the miraclequestion is not so much a question as a series of questions.There are many different versions of the miracle question depending on the context and theclient. In a specific situation, the counselor may ask, "If you woke up tomorrow, and a miracle happened so that you no longer easily lost your temper, what would you see differently?" What would the first signs be that the miracle occurred?"The client (a child) may respond by saying, "I would not get upset when somebody calls me names." 3
  4. 4. ESB 4083 INDIVIDUAL COUNSELLINGThe counselor wants the client to develop positive goals, or what they will do, rather than whatthey will not do--to better ensure success. So, the counselor may ask the client, "What will yoube doing instead when someone calls you names?"2. Scaling Questions Scaling Are tools that are used to identify useful differences for the client and may help toestablish goals as well. The poles of a scale can be defined in a bespoke way each time thequestion is asked, but typically range from "the worst the problem has ever been" (zero or one) to"the best things could ever possibly be" (ten). The client is asked to rate their current position onthe scale, and questions are then used to help the client identify resources (e.g. "whats stoppingyou from slipping one point lower down the scale?"), exceptions (e.g. "on a day when you areone point higher on the scale, what would tell you that it was a one point higher day?") and todescribe a preferred future (e.g. "where on the scale would be good enough? What would a dayat that point on the scale look like?")3. Exception Seeking Questions ProponentsException Seeking Questions Proponents of SFBT insist that there are always times when theproblem is less severe or absent for the client. The counselor seeks to encourage the client todescribe what different circumstances exist in that case, or what the client did differently. Thegoal is for the client to repeat what has worked in the past, and to help them gain confidence inmaking improvements for the future.4. Coping questions Coping questionsEven the most hopeless story has within it examples of coping that can be drawn out: "I can seethat things have been really difficult for you, yet I am struck by the fact that, even so, youmanage to get up each morning and do everything necessary to get the kids off to school. Howdo you do that?" Genuine curiosity and admiration can help to highlight strengths withoutappearing to contradict the clients view of reality. The initial summary "I can see that things havebeen really difficult for you" is for them true and validates their story. The second part "youmanage to get up each morning etc.", is also a truism, but one that counters the problem focusednarrative. 4
  5. 5. ESB 4083 INDIVIDUAL COUNSELLING5. Problem-free talk In solution-focused therapyCan be a useful technique for identifying resources to help the person relax, or be more assertive,for example. Solution focused therapists will talk about seemingly irrelevant life experiencessuch as leisure activities, meeting with friends, relaxing and managing conflict. The therapist canalso gather information on the clients values and beliefs and their strengths. From this discussionthe therapist can use these strengths and resources to move the therapy forward. For example; ifa client wants to be more assertive it may be that under certain life situations they are assertive.This strength from one part of their life can then be transferred to the area with the currentproblem. Or if a client is struggling with their child because the child gets aggressive and callsthe parent names and the parent continually retaliates and also gets angry, then perhaps they havean area of their life where they remain calm even under pressure; or maybe they have trained adog successfully that now behaves and can identify that it was the way they spoke to the dog thatmade the difference and if they put boundaries in place using the same firm tonality the childmight listen.The strength The benefits of solution-focused brief therapy include the finding of solutions toproblems that the client has been facing. For example, symptoms of stress, anxiety, anddepression may bereduced interpersonal relationships may be improved. Another benefit ofsolution-focused brief therapy is that clear goals are identified early on. Because of this,bothclient and counselor know what success will look like and can more easily identify when therapyis no longer needed. As with all forms of therapy, solution-focused brief therapy may result inmajor life changes, such as changing jobs, beginning or ending relationships, moving, etc. Suchlife changes can be experienced as quite positive (a benefit) or as very difficult (a risk) by theclient and/or the clients significant others. Solution-focused brief therapy can be done inconjunction with other forms of therapy.The waeknessessSince, by definition, solution-focused brief therapy is brief, it may be less expensive than otherforms of therapy that traditionally required more sessions over a longer period of time. 5
  6. 6. ESB 4083 INDIVIDUAL COUNSELLING2. REALITY THERAPY Reality therapy is a relatively new form of therapy in the world of counseling. It wasfounded by William Glasser who was a psychologist from California in 1965 as a result ofGlassers theory, psychoanalytic disagreement. Kottler and Brown () states that reality therapy is an approach to teaching that emphasizesproblem solving, personal responsibility and the need to address or eliminate the need for realityof an individual. He said the reality therapy is based on the assumsi or assumptions thatindividuals need to build the identity of either succeed or fail. John J. Pietrofesa (1984), holdsthat reality therapy is based on the assumption of a behavior either help or hinder to meet basichuman needs. Such a requirement is the need for love and caring for others and the need to feelvalued and appreciate others. Behavior that can be filled are held responsible and the failure isthe opposite. Irresponsible behavior will fail to build identity and then a failure. Then thecounselor is to build the individuals identity to the success. Glading (1993), the opinion asserts the reality therapy baahawa individual changes madeby the action and thought. He suggested that the inner world of individuals is the most influentialin determining the behavior of the dipilihya. This action-oriented therapy (action oriented) thatare concrete, teaching, directing, and cognition. As a whole, we have more reality theory emphasizes the need to meet the psychologicalneeds (a fulfilments of psychology needs). In reality therapy is largely available to provideindividuals in susasana that can help them develop the psychological strength to assess thecurrent behavior or values. This therapy can also be used in individual counseling, familycounseling, rehabilitation counseling, sexual counseling, education, social work, group therapy,crisis intervention, management development institutions and the development of society.Reality Therapy TechniquesTo help people to achieve goals in their lives and explains how to achieve the reality therapy hasbeen using certain techniques in the form of behavior. Those are:1. Become a model or example: In this technique a counselor must be a good example or model that serves as an educator. As an educator, counselor tried to resist the negative behaviors the client without the clients expense. Counselors’ need to teach clients the most efficient way to meet the clients needs based on reality. This action allows the client to face reality and realize the behavior is not realistic.2. Humor Counselors will be funny and not too serious. This means that the counselor will look at a situation from a funny angle in order to ease the burden faced pressure or clients.3 confrontations: Counselor will face or challenge the client without allowing the client to give specific reasons. Counselors can also use ridicule, scorn and criticism that can surprise clients in 6
  7. 7. ESB 4083 INDIVIDUAL COUNSELLING an effort to challenge the unrealistic behavior. This situation can provide a response to the clients realistic to think of him.4 Role Play (Role play): Counselor will use in playing the role of communication with the client. In the game the counselor will try to give emphasis on the here and the moment and avoid focuses on past events and feelings are not good.5 Reaction: Counselor will ask the client to see his behavior as a way for clients to receive a responsibility. Counselor will ask the client whether the action is in accordance with the client and is there a way beneficial to him. In this case the client should decide whether to change his behavior or vice versa.6 Involvements: Counselor will engage directly with the use of words such as I am concerned about you, I am responsible to you. Behavior highlighted by the counselor should be in line with the words that were uttered it. Counselor and client should participate in the search for life direction or new ways to achieve the clients life more successful and meaningful.The strength of Reality Therapy This therapy is very suitable for implementation and applied in the form of counseling,such as counseling children, adolescents, adults, parents, marriage, family, individual counselingand counseling Muhd Mansur (1993). This statement is supported by the James C. Hansen(1990) who said;"... Although now used with a variety of clients in a number of different settings. RealityTherapy originally used in the treatment of office patients, mental hospital patients, and adult andjuvenile lawbreakers. Much of Glaciers work with juvenile offenders this grew out of years ofwork at the Ventura School for Girls of the California Youth Authority. "Reality Therapy approaches and methods used in concrete, clear and realistic where it can showthe effectiveness, evaluated, especially when the contract is made and agreed upon by thecounselor and client. Reality therapy also has a master plan designed in a systematic and realistic by the clientwith the help of a counselor as a guide for solving problems.Therapy has been given the freedom of clients to think rationally, evaluate, determine and maketheir own decisions. Therapy has been using the short term to help clients compared to other theories such aspsychoanalysis and human concentration. Many statements made by some authors who supportthe advantages of this therapy. Among these are Panek (1993:461) states that reality therapyapproach as "... stimulates active mental processes.". Kottler (1996) holds that reality therapy asa short-term therapy and appropriate in school settings and beyond "... reality therapy is a short-term treatment that has been widely used in schools, Institutions and Correctional Settings. It is afairly simple therapeutic approach and can be mastered withaut length training and supervision. " 7
  8. 8. ESB 4083 INDIVIDUAL COUNSELLINGAccording to Samuel T. Gladding (1996:283-289) argues that reality therapy "... applicable tomany different populations; effective with Certain disorders; concertinas; short-term; centralizedtraining center; promote freedom without responsibility and blaming; stresses here and now;integrates control theory . "The weakness Reality therapy also has its drawbacks. These therapies tend to focus only on behavior,but also a human being is unique and acts as a whole, including emotion, perception, cognitive,sensation, and so on. Therefore clear that this therapy has a limited capacity. This therapy also emphasizes the concept now and here or here and now and the currentsituation so without regard to the concepts of unconscious life of the client and history. Whereas,every person is likely to collaborate with the problems caused by biological factors, fantasy,belief systems and values, and others. Reality therapy also depends upon the language. So the communication system clientsometimes is quiet and weak or no expressive is not appropriate in the selection of therapeuticaction of reality. Reality therapy is less to provide learning situations because it is quite demanding, andstifling. Thus the client is not creative in making decisions and ultimately depends on thecounselor. Counselors’ are also considered immoral because of too free and open to oftendemanding clients build something. This will cause a negative impact on the client. The client islikely to do or change of mind to follow or abide by the advice and guidance given by thecounselor. Paul E. Panek (1993:461) states that a lack of reality therapy has existed in the beginning"... designed for used in early stages and for the treament disoriented; limited efficacy ..".John A. Axelson (1993 :368-369) states that "... although the therapist MIGHT be seen as atough and controlling person, he or she is also uninterested and sensitive human being whounderstands and accepts uncritically behavior, but who never agrees with the clientsirresponsibility. Being more concerned with behavior than with attitudes, the therapy is notintended to make someone happy, but to make someone responsible ... " 8
  9. 9. ESB 4083 INDIVIDUAL COUNSELLING4. PERSON-CENTERED THERAPYTaking the view that every individual has the internal resources they need for growth, person-centered therapy aims to provide three ‘core conditions’ (unconditional positive regard, empathyand congruence) which help that growth to occur.Underlying Theory of Person-Centered therapyThe person-centered approach views the client as their own best authority on their ownexperience, and it views the client as being fully capable of fulfilling their own potential forgrowth. It recognizes, however, that achieving potential requires favorable conditions and thatunder adverse conditions, individuals may well not grow and develop in the ways that theyotherwise could. In particular, when individuals are denied acceptance and positive regard fromothers or when that positive regard is made conditional upon the individual behaving inparticular ways, they may begin to lose touch with what their own experience means for them,and their innate tendency to grow in a direction consistent with that meaning may be stifled.One reason this may occur is that individuals often cope with the conditional acceptance offeredto them by others by gradually coming to incorporate these conditions into their own views aboutthemselves. They may form a self-concept which includes views of them like, "I am the sort ofperson who must never be late", or "I am the sort of person who always respects others", or "I amthe sort of person who always keeps the house clean". Because of a fundamental need forpositive regard from others, it is easier to ‘be’ this sort of person, and to receive positive regardfrom others as a result, than it is to ‘be’ anything else and risk losing that positive regard. Overtime, their intrinsic sense of their own identity and their own evaluations of experience andattributions of value may be replaced by creations partly or even entirely due to the pressures feltfrom other people. That is, the individual displaces personal judgments and meanings with thoseof others.Psychological disturbance occurs when the individual’s ‘self-concept’ begins to clash withimmediate personal experience, example like when the evidence of the individual’s own sensesor the individual’s own judgement clashes with what the self-concept says ‘ought’ to be the case.Unfortunately, disturbance is apt to continue as long as the individual depends on theconditionally positive judgements of others for their sense of self-worth and as long as theindividual relies on a self-concept designed in part to earn those positive judgements. 9
  10. 10. ESB 4083 INDIVIDUAL COUNSELLINGExperiences which challenge the self-concept are apt to be distorted or even denied altogether inorder to preserve it.The technique The person-centered approach maintains that three core conditions provide a climateconducive to growth and therapeutic change. They contrast starkly with those conditionsbelieved to be responsible for psychological disturbance. The core conditions are Unconditionalpositive regard, Empathic understanding and Congruence The first is unconditional positive regard, its means that the counselor accepts the clientunconditionally and non-judgmental. The client is free to explore all thoughts and feelings,positive or negative, without danger of rejection or condemnation. Crucially, the client is free toexplore and to express without having to do anything in particular or meet any particularstandards of behavior to ‘earn’ positive regard from the counselor. The second is empathic understanding, its means that the counselor accuratelyunderstands the client’s thoughts, feelings, and meanings from the client’s own perspective.When the counselor perceives what the world is like from the client’s point of view, itdemonstrates not only that that view has value, but also that the client is being accepted. The third is congruence and its means that the counselor is authentic and genuine. Thecounselor does not present an aloof professional facade, but is present and transparent to theclient. There is no air of authority or hidden knowledge, and the client does not have to speculateabout what the counselor is ‘really like’. Together, these three core conditions are believed to enable the client to develop andgrow in their own way, to strengthen and expand their own identity and to become the personthat they ‘really’ are independently of the pressures of others to act or think in particular ways. As a result, person-centered theory takes these core conditions as both necessary andsufficient for therapeutic movement to occur like that if these core conditions are provided, thenthe client will experience therapeutic change. Notably, person-centered theory suggests that thereis nothing essentially unique about the counseling relationship and that in fact healthyrelationships with significant others may well manifest the core conditions and thus betherapeutic, although normally in a transitory sort of way, rather than consistently andcontinually. 10
  11. 11. ESB 4083 INDIVIDUAL COUNSELLING Finally, as noted at the outset, the person-centered approach takes clients as their ownbest authorities. The focus of person-centered therapy is always on the client’s own feelings andthoughts, not on those of the therapist and certainly not on diagnosis or categorization. Theperson-centered therapist makes every attempt to foster an environment in which clients canencounter themselves and become more intimate with their own thoughts, feelings and meanings.The Strength Person-centered approach is that delivering the core conditions is what all good therapistsdo anyway, before they move on to applying their expertise and doing the real work of ‘makingclients better’. On the face of it, this criticism reflects a misunderstanding of the real challengesof consistently manifesting unconditional positive regard, empathic understanding andcongruence. This is especially true of congruence, to the extent that some therapeutic techniquesdeployed in some other traditions depend on the counselor’s willingness to ‘hold back’, mentallyformulate hypotheses about the client, or conceal their own personal reactions behind aconsistent professional face, there is a real challenge in applying these techniques with theopenness and honesty which defines congruence. It may also demonstrate something of a reluctance to take seriously the empiricalresearch on counseling effectiveness and the conclusion that the quality of the client andcounselor relationship is a leading predictor of therapeutic effectiveness, although this issomewhat more controversial, since one might argue that providing the core conditions is not theonly way to achieve a quality relationship.The weakness At a deeper level, there is a more sophisticated point lurking, which many expositions ofperson-centered theory seem to avoid addressing head-on. Namely, given that the self is thesingle most important resource the person-centered counselor brings to the therapeuticrelationship, it makes sense to ask, what (if anything) is it important that this self has, apart fromthe three core conditions, such as manifesting of the core conditions does not by itself tell uswhat experiences or philosophies the counselor is bringing to the relationship. It tells us that theclient will have transparent access to that self, because the counselor is congruent but it doesn’t 11
  12. 12. ESB 4083 INDIVIDUAL COUNSELLINGtell us anything else about that self. Whether or not that self should be developed in anyparticular way or whether that self should acquire any particular background knowledge, seemsto me a question which is more often side-stepped than answered within the person-centeredtradition. Clients who have a strong urge in the direction of exploring themselves and their feelingsand who value personal responsibility may be particularly attracted to the person-centeredapproach. Those who would like a counselor to offer them extensive advice, to diagnose theirproblems, or to analyze their psyches will probably find the person-centered approach lesshelpful. Clients who would like to address specific psychological habits or patterns of thinkingmay find some variation in the helpfulness of the person-centered approach, as the individualtherapeutic styles of person-centered counselors vary widely, and some will feel more able thanothers to engage directly with these types of concerns. 12
  13. 13. ESB 4083 INDIVIDUAL COUNSELLING4. Art Therapy Art Therapy is a form of psychotherapy that uses art media as its primary mode ofcommunication. It is a form of counseling which uses art making as a way to express feelings,emotions, and personal stories. Clients who are referred to an art therapist need not haveprevious experience or skill in art, the art therapist is not primarily concerned with making anaesthetic or diagnostic assessment of the clients image. The overall aim of its practitioners is toenable a client to effect change and growth on a personal level through the use of art materials ina safe and facilitating environment. The relationship between the therapist and the client is ofcentral importance, but art therapy differs from other psychological therapies in that it is a threeway process between the client, the therapist and the image or artifact. Thus it offers theopportunity for expression and communication and can be particularly helpful to people whofind it hard to express their thoughts and feelings verbally. Art therapists have a considerable understanding of art processes underpinned by asound knowledge of therapeutic practice, and work with both individuals and groups in a varietyof residential and community based settings, for example adult mental health, learningdisabilities, child and family centre, palliative care and the prison service. The diversity of theseareas of work is reflected in the number of special interest groups that have developed inaffiliation with the British Association of Art Therapists. More detailed information about thesespecialist areas can be obtained on request from the Association. The art therapists work issometimes challenging and calls for skill and sensitivity; it follows that those who wish to pursuea career in art therapy should be mature, flexible people. The training course, which combines theoretical and experiential work, is a MastersDegree to be completed over two years full time or three years part time. Applicants must have afirst degree in art, although other graduates are sometimes considered, and some properexperience of working in an area of health, education or social care. Details of training and a listof training institutions can be obtained from the address below - or complete the enquiry form.Art therapy is a diverse profession and it is important to ensure that those who practice it aremaintaining the standards that we as a professional body uphold. Art Therapists, along withDrama and Music Therapists need to register with the Health Professions Council..The Technique1. Common Threads: HIV/AIDS QuiltOverview: namely two art therapists will facilitate a communal art project with three groups. Individuals will create squares illustrating personal stories about how they have been affected by HIV/AIDS. Facilitators will teach basic skills in textile art and sewing and group members will be encouraged to share their talents and skills with others. The intent of this project is to facilitate the growth of self-sustaining art groups and support networks in these communities from the Lyantonde district. This quilt will be displayed in both the U.S. and Uganda to raise awareness about the lives of those affected by HIV/AIDS and to decrease HIV/AIDS stigma. 13
  14. 14. ESB 4083 INDIVIDUAL COUNSELLINGMaterials or Techniques used : Fabric, sewing materials, drawing materials, barkcloth, beads, seeds, embroidery, banana leaves.Population: 3 groups of 10-15 individuals infected or affected by HIV/AIDS. Two groups will be conducted at two local villages and one group will be conducted at Lyantonde Hospital.2. Art Therapy at Prince Primary SchoolOverview: An art therapy program will be developed with children from Prince Primary School. During the third term of this year the focus of the program will be recording and preserving oral history and educating the community about local family traditions and life lessons through symbolic stories. Group interaction may allow for increased group cohesion and improved social skills, as residents develop their personal identity within a positive peer community.Materials or Techniques used: Barkcloth, sewing materials, printing inks, beads, seeds, drawing materials, embroidery, collage.Population: P5-P7 pupils from Prince Primary School.The strengths and weaknesses art therapyDevelopment of the Strategic Aims The strategic aims for the development of Arts Therapies services have been based on discussion within the service and identifying the most pressing needs to ensure that the profession is robust and able to meet it’s obligations to people who use our services and to the Trust. They also identify the steps necessary to ensure that Arts Therapists play an active role in the development and refinement of services in the move forward to Foundation Trust statusThe Benefits of Art Therapy in Mental Health Although conventional psychotherapy has its benefits there are many alternative therapies such as music therapy, hypnosis and even colour therapy that have had a measure of success in treating various conditions and enhancing well-being. Art therapy is one such form of treatment. Art therapy is a form of expression that strives to aid the emotional state of those that have suffered mental trauma and emotional abuse. Art therapy is based on a belief that the creative process is healing and life affirming. For many people psychological trauma can be difficult to express in words. Art therapy provides a creative outlet for pent up emotions and hurtful feelings that are too painful to express verbally. 14
  15. 15. ESB 4083 INDIVIDUAL COUNSELLING Strengths Weaknesses  Range of highly trained and experienced staff  Lack of dedicated time for R&D  Valued members of MD Teams  Co-ordinate risk strategy  Established structure  No consultant posts for Music and  Good support network Drama therapy  Strong links with Multi Professional  Lack of admin support colleagues  No co-ordinate approach to  Co-ordinate leadership Service User involvement  Culture of innovative practice based evidence  Commitment to user empowerment  Comprehensive skills portfolio due to broad training with continued specialist training and development.  People want access to Arts Therapies  Maintain engagement with long term complex people who don’t stay with other services * see related threat in context below  continuity of service provision for people as they move through other Trust services 15
  16. 16. ESB 4083 INDIVIDUAL COUNSELLING5. PLAY THERAPHY Play therapy is generally employed with children aged 3 through 11 and provides a wayfor them to express their experiences and feelings through a natural, self-guided, self-healingprocess. As children’s experiences and knowledge are often communicated through play, itbecomes an important vehicle for them to know and accept themselves and others. Play Therapy is a form of counseling or psychotherapy that uses play to communicatewith and help people, especially children, to prevent or resolve psychosocial challenges. This isthought to help them towards better social integration, growth and development. Play Therapy can also be used as a tool of diagnosis. A play therapist observes a clientplaying with toys (play-houses, pets, dolls, etc.) to determine the cause of the disturbed behavior.The objects and patterns of play, as well as the willingness to interact with the therapist, can beused to understand the underlying rationale for behavior both inside and outside the session.. According to the psychodynamic view, people (especially children) will engage in playbehavior in order to work through their interior obfuscations and anxieties. In this way, playtherapy can be used as a self-help mechanism, as long as children are allowed time for "freeplay" or "unstructured play." Normal play is an essential component of healthy childdevelopment. One approach to treatment is for play therapists use a type of desensitization or relearningtherapy to change disturbing behavior, either systematically or in less formal social settings.These processes are normally used with children, but are also applied with other pre-verbal, non-verbal, or verbally-impaired persons, such as slow-learners, or brain-injured or drug-affectedpersons.The techniqueThis procedure is for a "non-directive" version of play therapy. There are many variations on thepractice, but the materials typically remain the same. 1. Identify a youngster who might benefit from play therapy. 2. Decide if you will have a separate session with this child or whether you will sit near the student during your class play period or recess. 3. Obtain materials for the session. Recommended items include:  manipulatives (e.g., clay, crayons, painting supplies)  water and sand play containers  toy kitchen appliances, utensils, and pans  baby items (e.g., bottles, bibs, rattles, etc.)  dolls and figures of various sizes and ages  toy guns, rubber knives 4. Place the materials in specific places where they can be located for each session. 5. Meet the student and introduce him/her to the play area. 6. Inform the student of limitations and how long the session will last 16
  17. 17. ESB 4083 INDIVIDUAL COUNSELLING 7. Allow the student to choose the materials with which to play. Do not suggest materials or activities. If the youngster wishes to leave before the session ends, that is allowed. However, in most cases the student is not allowed to return that day. He is informed of the time of the next scheduled session. 8. Use the "reflection" technique (see the filed named "Non-Directive Counseling) to respond to the students comments. If the student is not speaking or is non-verbal, your role will change; you will be describing what the student is doing. Just make a report on the actions. DO NOT offer interpretations or judgements of the actions. ("Hes a nice boy." "Its wrong for children to hit.") Some supervising adults ask probing questions to get the child to speak or investigate a situation further. ("I wonder why the grown up is doing that.", "What do you think that the girl is thinking right now?") 9. As the end of the session nears, inform the student of that fact, stating the number of minutes left. This procedure helps with transition back to other activities. 10. Upon reaching the time limit, inform the student in a manner similar to the following: "Our time is up for today. Well have to stop now and put the toys back where we found them." The student is not allowed to continue playing if you deem that s/he must return to other activities. 11. Inform the student as to when the next session will be held.The strength Specifically, play therapy encourages the expression of a childs feelings, experiences,and cognitive functioning. This knowledge is vital to the therapist in determining the direction ofthe therapy process, as well as measuring the success of the intervention throughout a series ofplay therapy sessions. This method of extracting and utilizing information through effectiveinterpersonal communication is theoretically in tune with any therapeutic approach, but playtherapy distinguishes itself by conducting its observations in a uniquely revealing environment. One approach to treatment is for play therapists use a type of systematic desensitizationor relearning therapy to change disturbing behavior, either systematically or in less formal socialsettings. These processes are normally used with children, but are also applied with other pre-verbal, non-verbal, or verbally-impaired persons, such as slow-learners, or brain-injured or drug-affected persons. Mature adults usually need much "group permission" before indulging in therelaxed spontaneity of play therapy, so a very skilled group worker is needed to deal with suchguarded individuals. The use of play therapy is based on a developmental understanding of children. Piagets(1962) theory of cognitive development recognizes the differences between the way that childrenunderstand and process information and the way that adults function. Most children at theelementary level function at two stages: the "Preoperational Stage" (2-7 years) and the "ConcreteOperations Stage" (8-11 years). These stages are approximately identified with chronologicalages but there are significant variations among children. 17
  18. 18. ESB 4083 INDIVIDUAL COUNSELLING At the Preoperational Stage, a child is acquiring the skill of language in which symbolsare used to mentally represent objects. Also, in this stage, a childs thinking is rigid and limited tohow things appear at the time. This is the stage of magical thinking in which children createimplausible explanations for things that they do not understand. Regarding play, a childs playbehaviors become increasingly imaginary and fantasy driven. The play, however, will increase incomplexity from make-believe play to encompassing emerging cognitive patterns. Internally, thechild is improving understanding and knowledge, but externally, the child lacks the ability tocommunicate this enhanced way of processing within the world. Play is one of the primary waysin which a child can communicate this internal awareness of self and others. During the Concrete Operations Stage, the child grows in personal ability to reasonlogically and organize thoughts coherently. Children are able to manipulate ideas and acceptlogical societal rules. However, they can only think about actual physical objects. They arelimited in their ability to engage in abstract reasoning. In this stage, children are unable toexpress certain complicated emotions, such as guilt or resentment, because of the need forabstract thought to understand such emotions. For those children operating in the Concrete Operations Stage, play helps to bridge thegap between concrete experience and abstract thought.Though the type of play therapy employed will vary depending on a childs situation, the mostbasic play therapy technique used by play therapists is commonly referred to as "child-centeredplay therapy." The crucial elements in this formula, as in all play therapy approaches, areenvironment and the child-therapist relationship. Play therapy sessions are held in intentlydesigned spaces called "play rooms" which contain an array of toys and activities deliberatelychosen and carefully placed by the play therapy practitioner. Since the primary purpose of playtherapy is to elucidate the childs natural behavior, the play therapist must create an especiallyaccepting and non-punitive atmosphere. Projective play takes place when a child discovers the world outside themselves throughtoys. Story making is a part of projective play and the objects/toys involved tend to havealternative meanings. This type of play assists with the externalization of trauma and helps toexpand a childs perspectives. Role play is when the child pretends to be someone else, usually the adult(s) involved inthe abuse or trauma. This type of play allows the child to voice issues and clarify inappropriatebehaviors with the therapist. Imaginative play within sessions enables the child to "replay complex environmentalissues" and cast them into a form, which is manageable. The therapist remains non-judgmentaland acts as a "container" for the feelings and issues stirred up by play. There are issues of riskaround this containment however, as although the therapist sets up boundaries, it is importantthat they realize the potential effects of disclosure on their own internal working models. Thisenables them to remain as an empathizing yet non-judgmental individual. 18
  19. 19. ESB 4083 INDIVIDUAL COUNSELLINGThe weakness Play therapists often have difficulties in describing their work to other professionals, andindeed clients, in language that is understood by everyone. If there is confusion about whathappens in the therapy process, and outcomes are difficult to describe because the language isnot shared, then the therapy can be undervalued. Limit setting is a necessary and vital part of the play therapy therapeutic process.Although the procedures for setting limits may vary, the setting of therapeutic limits is part of alltheoretical approaches to play therapy. The structure of therapeutic limits is what helps to makethe experience a real-life relationship. Limits in play therapy have both therapeutic and practicalbenefits in that they preserve the therapeutic relationship, facilitate the childs opportunities tolearn self-responsibility and self-control, among many other dimensions, and provide the childand the therapist with a feeling of emotional security and physical safety. This feeling ofemotional security enables a child to explore and express inner emotional dimensions thatperhaps have remained hidden in other relationships. Play therapy is not a completely permissive relationship because children do no feel safe,valued, or accepted in a relationship without boundaries. Boundaries provide predictability.Therefore, children are not allowed to do anything they want to do. A prescribed structureprovides boundaries for the relationship that the play therapist has already determined arenecessary. The play therapy relationship has minimal limits. Messiness is accepted, explorationis encouraged, neatness or doing something in a prescribed way is not required, and persistentpatience is the guiding principle. The childs desire to break the limit is always of greaterimportance than actually breaking a limit. Because play therapy is a learning experience for children, limits are not set until they areneeded. The child cannot learn self-control until an opportunity to exercise self-control arises.Therefore, placing a limitation on a child pouring paint on the floor is unnecessary unless thechild attempts such an activity. Limits are worded in a way that allows the child to bring him orherself under control. The objective is to respond in such a way that the child is allowed to say"No" to self. "You would like to pour paint on the floor, but the floor is not for pouring paint on;the pan on the table is for pouring paint into" recognizes the childs feeling, communicates whatthe floor is not for, and provides an acceptable alternative. The child thereby is allowed to stophim or herself. 19