Experiential play therapy (EPT) is a child-centered approach that uses play to help children process difficult emotions and past experiences. Through symbolic play, the child guides the therapy at their own pace while the therapist observes to gain insight into the child's perspective and needs. A case study demonstrates how EPT helped a 4-year old boy process his premature birth and medical trauma by allowing him to reenact the experience through play in a way that made him feel empowered.

1. Experiential Play
Therapy
Rachel Coleman

2. What is EPT?
• children experience the world experientially
• engages all the senses when working through
doubts, fears, anger and other unresolved
emotions
• Firm belief in the capacity of the child to heal

3. What is EPT? (cont.)
• Child is expert on his/her pain and knows how
best to approach it
• In therapy, therapist allows child the freedom
to work through struggles at his/her own pace
• child can reenact situations involving
behaviors not used in precipitating events

4. How does it work?
• Play is a child’s perspective on his/her experiences of
the world and relationships
 Child enters fantasy play as a defense mechanism to deal with anxiety
when sense of self has been disrupted/threatened.
• Dignity and empowerment are the primary processes
of EPT
o Child usually assumes power position; therapist to act/react as
child
•
gives therapist an insight on what it's like to be child
•
therapist to experience feelings of powerlessness,
ineffectiveness, apprehension, and insignificance

5. How does it work?
• Child becomes the creator of his/her experiences with
needs and fears expressed in a format he/she can control,
conquer, & change
• Child uses the symbolism and metaphorical expression of
play to communicate confusion, doubt, & pain
o EPT therapist responds to meaning of the metaphor rather than
reflecting the content

6. How does it work?
• Based on 3 major components:
1. The capacity of a child to use play, symbolism, and metaphorical
expressions to convey internal world & expressions
2. Therapists’ skill in understanding & relaying the child’s expressions
back to the child
3. Parental responsibility to learn and engage in the process of the child
• Consists of 5 stages:
 Exploratory Stage
 Testing for Protection Stage
 Dependency Stage
 Therapeutic Growth Stage
 Termination Stage

7. 5 stages of EPT
Exploratory Stage
• child gets acquainted with therapist, play room, and
time together
• therapist uses more observational statements ;
follows child’s lead
• child's behavior outside of playroom undergoes a
temporary, but dramatic, improvement
 indicator of child's potential for change

8. 5 Stages of EPT
Testing for Protection Stage
•goal: establishment of relationship
•child is testing counselor's trustworthiness & safety of
therapeutic alliance
 therapist to reflect & validate child's feelings
•Therapist should be aware of own limits of comfort
•Some disruption or regression in child behavior may
be evident at this stage; parents need to be informed

9. 5 Stages of EPT
Dependency Stage
• the emotionally intense, working stage; child is prepared
to face emotional turmoil
• 2 substages
• Child’s disclosure of experiences
• child engages in emotionally-themed fantasy play; feels safe
enough to invite therapist into his/her play
• Leveling of the fear object or perpetrator
• Trauma is a fear of death for the child, and the child must
conquer impending death fear in her play”
• The metaphorical equivalent of the pain & struggle of the past
being lifted off the child

10. 5 Stages of EPT
Dependency Stage
• child takes on aggressor/power stance
o Child must possess the power to accomplish through play what s/he
was unable to accomplish in reality (as long as child & therapist are safe
o Therapist assigned role of child; must respond as child would at that
age, using facial expressions, sounds, body movement
• 2o important processes occurring simultaneously:
Child develops an internal sense of empowerment & control
o Child gains a “spiritual victory” over fear object/trauma/challenge
• Dependency stage ends with annihilation or death of
aggressor

11. 5 Stages of EPT
Therapeutic Growth Stage
• Child briefly grieves the lost trauma persona
o Will display flattened affect
o Will seem to regress to exploratory stage
Use of Play for:
o skill mastery
o Re-experiencing lost developmental stages
o Eventually age-appropriate mastery, silliness, & laughter
Child no longer depends on therapist for sense of ID
Play becomes more interactive & cooperative

12. 5 Stages of EPT
Termination Stage
• Represents loss of a significant relationship
• With Introduce within therapist should:child time to react & say good
termination,
 firs 10-15 min to give
bye to play
 Communicate to child the importance of their relationship to
therapist
 Follow up with encouragement for the child’s ability to move forward
without therapist
• Ideally, child has gained the ability to interact
appropriately with others & can allow self to trust in caring
relationships

13. Parental Involvement in EPT
• Parent involvement critical to outcome of therapy; parent-
therapist relationship viewed as a key supportive
component of the play therapy process
• Parents need to be oriented to the concepts of healing pain &
regression; they are key in providing security, support, and
regulation when a child experiences a regressive episode
 Children may need to exhibit behaviors representative of an earlier age
 Regression indicates the child is approaching the irreconcilable internal
experiences (trauma/disruption) that drives the attitude/behavior
disruptions at the developmental age at which event occurred.
 Each regressive episode assists the child in experiencing regulation after
emotionally re-experiencing aspects of the trauma

14. Parental Involvement in EPT
• Therapist meets with parents 10-15 min after every session
to discuss themes expressed and emotional and security
needs to be met in between sessions.
 Critically important to maintaining sense of security between
sessions
• Therapist provides compassionate support to parents
as parents learn to soothe, support, and nurture
regressive response

15. Clinical Applications for EPT
• A prerequisite for a child to participate in EPT is the
capability for symbolic play
• EPT is beneficial for children presenting with the following:
o Reactive disorders
o Oppositional Defiant Disorder
o AD/HD
o Separation Anxiety Disorder
o Phobic Disorders
o Attachment Disorders
o Obsessive Compulsive Disorder
o Dissociative Indentity Disorder
o Some psychotic features ( associated with long term, high intensity
trauma )

16. Clinical Applications of EPT
• When using diagnostic disorders, it is really important to
determine an accurate history as reactions to trauma
may present as constitutional in nature
• Allows children to approach memories of trauma in a
way that is not overwhelming to them
• Not as beneficial to children with pervasive
developmental disorders, such as Autism or Asperger’s
Syndrome

17. Evidence Basis for EPT
• Relatively new concept in EPT
• Stages developed by observing children create their own
process of healing
o Progression relatively consistent
o Allows therapist to track child in process; can ascribe more appropriate
expressions to match the child’s meaning
• Focused on relationship with child, but gives more direct
expression to what the child expresses in play
• Brain Active form of play therapy
o uses integrated Right-left & top-bottom processes in the brain

18. Evidence Basis for EPT
• “Trauma is in the nervous system of the child, not the
event”
o Play process must be active and repetitive to dissipate trauma effects on
the brain
o Implicit memories and sensations + explicit or factual memory process
considered during regression
o Therapist must consider the stage of brain development being conveyed
o Look at neurological dysfunctions fueling inappropriate behaviors

19. Challenges of EPT
• Therapist must undergo a paradigm shift to understand
the meaning of each expression from the child’s
perspective
• Can be frequently difficult to maintain credibility with
other professionals who serve children
• High risk of counter-transference
o Self examination and growth of the EPT therapist is an constant process
o Processing own experiential world
• Therapist must refrain from leading the child’s play
o May offer redirection to facilitate the process or to provide a safer
environment

20. Case Study - *Seth, age 4
• Born prematurely at 8 months
• Critical for Mom & baby
o Baby punctured unsuccessfully 40 times with IV
o “Mimicking death”
• Referred for therapy for:
o Considerable anger towards other
o Anger at preschool
o Difficulty relating to other children
o Asthma
o Awkward & coordinated; little body awareness
o Little empathy or compassion for others

21. Case Study - *Seth, age 4
• Mother requested being present in the play room
• Testing for protection Stage
o Initially refused the leave the play room
o Trust established & was able to separate from play & playroom
• Dependency Stage
o Depicted struggle in prenatal position
o Assigned therapist role of child; Seth role of doctors
o Switch roles, allow Seth to “defend himself”
• Therapeutic Stage
o Validated new positive sense of self