Is Play Therapy Effective?
Play therapy allows children, and sometimes adolescents and adults, to express their inner feelings and emotions through play. It can be used to help people to deal with difficult situations that are taking place in their lives and to learn appropriate ways to behave and to respond to these.
Play Therapy: What is it?
Play therapy is a treatment process which can help children, and sometimes adults, to confront stressful situations and to learn to deal with them. It is particularly useful for children under the age of twelve who cannot express themselves in words. During play therapy children often act out, using the toys they choose to play with, the things that are causing them distress. Play therapy allows communication without relying on words, although verbally communication is also encouraged.
Play Therapy Theory
Play is not only a way in which children relax and amuse themselves, it is also vital for the healthy development of the mind. Children often do not have the ability to find the words to express their feelings and emotions. This can be because they simply have not learned enough vocabulary to express themselves. Or, because their brains have not developed the capacity to pass information stored in one part of the brain to the section of the brain responsible for communication. Or, because the memories are suppressed as they are too painful for the conscious mind to deal with.
In play therapy, the child uses toys and games to express their thoughts and emotions. By close observation, a trained therapist can discover unresolved traumas that may be negatively affecting the child’s development or behavior. Play can then be directed towards confronting these issues and learning appropriate ways to deal with them. This can help to relieve the stress and pressure that the child may be experiencing, and which may be reflected in their poor relationships, slow development, or aggressive or introvertive behavior.
In his book ‘Play Therapy: The Art of the Relationship’, G.L. Landreth states, “In play therapy, toys are like the child’s words and play is the child’s language”
How Does Play Therapy Suggest the Mind Works?
The brain grows most during the first five years of a child’s life, and play is important for the healthy development of a child’s brain. Although at birth, babies have millions of brain cells, these cannot communicate with each other. It is the process of developing the connections between the neurons which turns those thousands of non-communicative cells into the complex organ that is the adult human brain. Scientific studies show that play encourages the development of the connections between the neurons. The correct growth of these neural links is essential to the child’s emotional and social development, and his ability to learn and to develop his memory.
If the child has suffered a traumatic event or has been abused, these memories are stored in a part of the brain which does not have the ability to verbally communicate the problem. Play therapy does not depend on words to express these painful emotions and memories. It gives the child a way to confront and learn to adapt to these distressing situations without the need for language.
What Happens in a Play Therapy Session?
Play therapy is most commonly used in children between the ages of three and twelve, but it can be useful for people of all ages. Typically, a session of play therapy lasts about 30-45-minutes and the average course is for 20-sessions, with one session per week.
The therapist will normally meet with the parents or guardians of the child first to discover the reasons why the child is being brought for therapy. These can include traumatic events in the family such as a recent death, or an abusive situation. The child may be referred by their doctor or teacher if they are not developing mentally at a normal rate, if they have trouble relating to people, or if they exhibit behaviors such as aggressiveness or solitariness.
Sometimes the therapist will meet with the child before the actual play therapy session to evaluate what type of toys would be most appropriate to use for his age, condition, and stage of mental development.
During a play therapy session, the child is usually left alone with the therapist in a safe comfortable room where there are a variety of specially chosen toys to play with. Observing the child at play lets the therapist into the child’s inner world where they can discover what problems the child is facing. Play therapy sessions are usually just with one child, but they can also take place with small groups of related or unrelated children.
Toys are specially chosen by the therapist to allow the child the best options for expressing themselves. Commonly used toys include a sandpit with miniature figures, Lego or other types of building blocks, dolls and stuffed animals, a fully equipped dolls house, puppets, costumes and clothes for dressing up in. Therapists also sometimes use other tools and techniques. These can include, modeling clay, arts and crafts, music, dance, therapeutic storytelling, and role play.
Techniques Used in Play Therapy
Frequently, during the initial sessions of play therapy, the child is encouraged to play with whatever toys they wish, with few, or no restrictions. Observing the toys chosen and the way that they are used allows the therapist to discover areas where the child may have problems, stress, or trauma. As the sessions advance the therapist may limit the choice of toys to ones that they feel will help the child to better express their problems and conflicts. The way the child interacts with the toys will allow the therapist to discover hidden problems.
Play therapy can be directive or non-directive.
In non-directive play therapy, the child is allowed to heal himself by providing him with the conditions and implements to do so. The therapist observes rather than guides the sessions. Results from this kind of play therapy may take longer to be noted.
In directed play therapy the therapist is more actively involved and guides the sessions to get the most out of the time. This means that progress is often quicker as the therapist manipulates the sessions to have the maximum effect in a shorter time. Once the problems have been identified, the therapist can guide the play therapy sessions so that the child learns how to deal with the stressful situation. At this time, limits may be put on what the child can and cannot do during the sessions. This helps the child to learn what is acceptable and what is not acceptable behavior in real life.
How Does Play Therapy Cause Change?
Play therapy causes change first by allowing the therapist to identify the problems that the child is experiencing and then teaching them how to do deal with these problems.
Heath practitioners or teachers may recommend play therapy for children who have behavioral or emotional problems. Sometimes, the causes of these problems may be known, but often it is during play therapy that hidden causes can be discovered. Often, some kind of unknown emotional, physical, or sexual abuse is discovered during therapy.
Once the reason for the child’s problems has been found, the therapist can direct the play therapy so that the child can come to terms with what has happened to them and then they can learn new skills to deal with this. Play therapy allows children to act out situations in a detached way so that they are able to confront them. In their conscious mind, they may be unable, or unwilling, to think about a situation which causes them distress or pain. During play therapy, however, they can express these feelings and emotions through toys and games, and this allows them to be guided through a healing process.
Play therapy can also encourage creativity and the development of positive skills. It can introduce the child to new ways of thinking and behaving. Additionally, it can help the child to develop better social and problem-solving skills and to become more confident and surer of themselves.
The therapist often holds separate conjunctive sessions with the adults who are important in the child’s life, to orient them to the findings and the best way to deal with them. Sometimes the adults are included in the therapy session itself. The support of the family is vital to the child’s progress. Reports may also be sent to the child’s doctors or teachers so that they are informed and can support the healing and developmental process.
Does Play Therapy Work?
Depending on the problem which the child faces, and the skill of the therapist, play therapy definitely works. Not all kinds of emotional or behavioral problems in children are best treated by play therapy, but it is certainly a useful therapeutic tool which can offer effective relief if employed correctly.
In adults, play therapy can enhance a person’s cognitive and physical behaviors. It can improve relationships, enhance learning capacities and improve general health and well-being. It is frequently used to help people to confront health problems related to illness, accidents, or old age. Often, in the relaxed environment created by a play situation, adults may find themselves able to express their concerns about more serious issues that are worrying them.
What Kinds of Concerns is Play Therapy Best For?
Play therapy is indicated for conditions such as
- Slow emotional development
- Learning disabilities
- Behavioral problems, such as aggressiveness, extreme shyness, bullying, etc.
- Grief or loss, such as the death of a parent, or a divorce
- Attention deficit hyperactivity
- Depression and anxiety
- Dementia (in adults)
How Are Play Therapy Specialists Trained?
Play therapists are professionally formed by a nationally recognized institution called the Association for Play Therapy (APT).
All play therapists must hold a master’s degree in some realm of mental health, such as psychotherapy, child development, child psychopathology, or theories of personality. They must also have completed the requirements to hold a state license which allows them to offer clinical mental health services.
For people who meet these requirements, the APT offers two standard credential options.
To become a Registered Play Therapist™(RPT) the person must receive 18-hours of play therapy training every 36-months and must renew their credentials every year.
To become a Registered Play Therapist-Supervisor™ they must have completed 500-hours of play therapy and have 50-hours of field-specific supervision.
Concerns/Limitations of Play Therapy
Not all children, adolescents, and adults will respond to play therapy and in some cases, noticeable improvements can take a long time to show.
Sometimes, children develop a very strong bond with the therapist, and while this is beneficial for treatment, if, for some reason therapy is stopped or interrupted, this can cause distress and a feeling of abandonment in the child.
Important Practitioners in Play Therapy
Play Therapy has been evolving and developing since the early 20th century. Some of the most important practitioners were-
- Hermine Hug-Hellmuth. She was the first person to advocate the use of play as therapy for children in 1921.
- Melanie Klein. She formulated the idea that play gave an insight into a child’s unconscious mind.
- David Levy. He introduced a more structured approach called ‘release therapy’ in 1938.
- Joseph Soloman. He developed a technique called ‘active play’
- Anna Freud. She argued that using play to establish a trusting relationship between the therapist and child could aid access to the child’s inner emotions and thoughts.
- Carl Rogers. He developed ‘person-centered therapy’ in the 1940’s.
- Virginia Axline. She modified Carl Rogers therapy to make it more relevant for children.
- Roger Phillips. In the 1980’s, he combined play therapy with cognitive therapy which can help children as young as two years of age.
How to Find a Therapist
Your health care team will be able to give you a list of qualified Play Therapists who can help you.
What Should I be Looking for in an LMHP?
Make sure that the therapist you choose has a current state license and has completed the approved training to become certified as a Registered Play Therapist™(RPT) by the Association for Play Therapy (APT).
Questions to Ask a Potential Therapist
How does play therapy work?
How many play therapy sessions will be needed before results are seen?
Will the child be alone or with other children during the therapy sessions?
Will the parents or guardians be involved in the play therapy?
Play Therapy is an important psychotherapeutic tool that allows professionally trained therapists to discover hidden problems, traumas, and stresses, particularly in children. These hidden problems, or other recognizable problems, can be causing a variety of negative symptoms in the child. Play therapy can be used to modify undesirable or inappropriate behavior or emotions by acting out situations using toys and games. It can also provide a platform for positive learning and social development in both children and adults.