Play Therapy Final – Flashcards

You seem frustrated that... You look happy... You're angry that... You're confused... You look excited... You are really sad... You just felt like crying... You really like... You don't like... That one's really mad at that one. You are proud... You enjoyed that... Hmmm...wonder how that... You want me to.... You feel... You're curious about That's really funny to you. In empathetic listening, reflecting emotions is important because it demonstrates that you understand the speaker's emotions.

(NAME), A - acknowledge feelings (what's the desire) C - communicate limit T - target alternative (redirects the go...its gonna happen) BILLY, You're really angry at me. But I am not for shooting. You can pretend the Bobo is me and shoot the Bobo. WILLY, I know you really want to paint that But toys are not for painting. You can choose to play with that or paint over there (on the paper) LILLY, I know you miss your mom But this is our time to be in here (But we have 10 min left) You can choose to leave in ___ or ___ minutes. JILLY, I know your really feeling frustrated But toys are not for breaking. You can choose to play with that or use the (egg carton, playdough, bubble wrap, popsicle sticks, Bobo) to show your frustration

Use ACT 3-4 times If you choose to ______ again, you choose not to play with ____ anymore today. If you choose not to ______, you get to play with ____ for the rest of our time in the playroom today. ***USE WITH CAUTION

1. Physical and Emotional Security and Safety for Children 2. Protects physical well being of therapist - facilitating acceptance of child 3. Facilitates: Decision making (how do I fix this?/ small choices lead to bigger, informed choices) (how making choices feels) Self-control Self responsibility of child (how does responsibility feel?) 4. Anchors session to reality (time) 5. Emphasizes the here and now 6. Promotes consistency in playroom environment 7. Preserves professional, ethical, and socially acceptable relationship 8. Protects play therapy materials and room

1. You know how to make that work. 2. You know just how you want it to look. 3. You remembered where that was/how to open it.... 4. You built that this high. 5. There, you made it stay together. 6. Looks like you know how to..../ you know where,what... 7. There, you figured it out. You did it. 8. You worked hard on...

1. In here, that's something you can do. 2. In here, you get to decide..... 3. In here, you choose. 4. The important thing is the kind of picture you would like to draw. 5. Sometimes it is hard to decide. What you play with first is for you to decide. 6. In here, it can be anything that you want it to be. You can do/spell it any way you'd like in this room. 7. You can choose what it is. 8. Hmmm...seems like you can find out where that is. 9. You really want me to ____, but in here that's something you can do. 10. Show me what you want me to do.

Only when needed!! Learned only when opportunity to exercise self-control occurs Do not present "rules" ---red button

It is important when working with a non-verbal child to maintain an attitude of responsiveness that communicates verbally and non-verbally acceptance of the child's silence. -Be patient -Making reflections about the child's body language. -Tracking responses and reflections of feeling are also useful. You seem like.... (unsure, trying to decide, exhausted...) You're really focused

Accept the child who is being silent Communicate verbally & nonverbally acceptance of the child's silence Do not make acceptance contingent on the child's talking Maintain an attitude of responsiveness Listen carefully to the child, whether the child speaks or not Respond verbally to what the child is doing at the moment or to what is sensed within the child at the moment Realize that children can recreate scenes they have experienced & words are not necessary for communication Proceed at the child's pace Allowing the child to provide direction for the interaction Avoid responding to everything the child does Avoid applying any pressure for the child to talk

As a general rule if the item fits the criteria (what were they again?) for an acceptable toy in the playroom then the item is permitted. Why is it important? Remember to reflect the importance of the item. Avoid permitting books, electronic toys, and games. Set a limit using ACT Recognize & accept the child's desire to take a special toy to the playroom Imply permission Recognize the importance of the toy Show appreciation or prizing of the toy Prohibit toys that do not facilitate interaction with children Remote-control toys, Mechanical toys, MP3 with headphones, glass items, books "I know you'd like to bring... "Its fun to play with... but its time to go to the playroom" "Our time together is not for reading. You can..."

As a general rule, food should not be brought into the playroom. "I know you'd like to bring..." Have the child finish the food/drink in the waiting room. Take a sip of drink Tell child it will be waiting for them when session is over Help to remember the item is waiting for them in the waiting room. Be conscious of dinner time You never know what the child has in their pocket, if offered food how should you respond?

The objective of the therapist is to return responsibility to children and facilitate their self reliance Children must be allowed to struggle with doing things for themselves. The therapist responses should convey confidence in the child and return responsibility to the child. "You can get it." "You can take them off if you want it off." In here that is something that you can do." "You can decide." These should also be paired with the child's intent or feeling. You would like for me... You're curious if... You want me to...

"What is important is what you think/feel about what you have made." Is it pretty? - You painted...you put...you made this blue all the way up there...you added orange up in the corner too. I noticed that you... You may choose to make whatever you want.. You have decided... You worked hard on that. What is important is how you feel about it

"I sound different than other people." "I'm trying to let you know I'm interested in you and what you're doing." "I guess maybe what I say does sound different." Negative feeling "You dont like the way I talk." "Sounds like you want me to stop talking." -avoid parroting -avoid over tracking - avoid just reporting what is being done.....REFLECT

Guess.... "Sounds like you have a plan." "You have something in mind." "You can tell me." "You can show me." "I'd like to know..."

Looking for acceptance "You're wondering if that's okay to say." "You're really angry"

May be unsure where they stand in the relationship. "You are special to me and this is a special time together." DO NOT!!! - you're wondering if I like you.

What is the underlying motive? Examine own needs. Videotape. Do not initiate. Innocent/no underlying motive: permitted and facilitative for a few minutes. Hug - don't be rigid. Set limits if necessary. Inappropriate: I know that's fun for you, but I know that you like me without ________(action).

Concerned about feelings from action Belief in child, that he will return it Wait until the end of the session (may take out later) "I know you would like to take (object) with you, but the (object) in your pocket/hand stays here so it will be here for you to play with next time." "You would like to pretend you don't know where it is. But the (object) in that pocket stays in the playroom."

"I know you want to go see mommy. You can choose to see Mommy 1 time and can choose to see her for 1 or 2 minutes." *Allow for bathroom *Parents can take before session

Give a five minute warning. Give a one minute warning. When time is up. "Our time is up for today." (and stand up) Child continues playing (begin ACT) Child continues playing (continue with ACT but walk toward the door) Child continues playing (reach door and continue ACT) Child continues playing (turning handle of door, drop the T and continue with A&C) Child continues playing (door opened, begin choice giving along with the A) "Jessica, I know you want to stay in the playroom. But our time is up for today. You can choose to hold my hand/walk beside me/march like a soldier or race me down the hall." "You would like to stay longer. But its time to leave."

Preferably the therapist would inform the child at the beginning of the session prior to the anticipated absence, followed by a reminder at the end of the session. Make sure the child understands when the next time they will be back in the playroom. "Billy, I will not be able to meet next week because I will be out of time at a meeting, we will meet the week after that. If you are unable to cancel in person, speak to the child directly over the phone.

Understand & accept the child Reflect feelings & desires while firmly stating the established limit Avoid debates & lengthy explanations Exercise patience, calmness, & firmness Never threaten the child with what may happen if a limit is broken Do not use limits as a way to punish a child Do not extend a consequence to the next session ALWAYS BELIEVE: child is capable of bringing himself under control and deciding not to do something (even if they do). UNWAVERING BELIEF AND CENTRAL TO CCPT

Destruction of room or play materials Trying to leave the playroom Staying in the playroom when time is up. Limiting the amount of water in the sandbox "I know you want to put water in the sandbox, But the sandbox is not for filling up with water. You can choose to put 1 or 2 cups of water into the sand." Urinating in the playroom Taking toys from playrooms Socially Unacceptable behavior Inappropriate displays of affection.

"In this special time, what you say or do is private. I will not tell your parents or teacher or anyone unless it is necessary to keep you safe. If you want them to know what you do here, you can tell them. That will be fine. You can decide." "Is there something you want me to talk about/not talk about with your parents?"

Should NOT be displayed in the playroom or anyplace within a clinical setting. That is a breach of confidentiality as their paintings are part of their play hence their words. Having paintings displayed could also make the assumption that creating a drawing is what should be done in the playroom. Therefore limiting the child's freedom of expression and creativity. Influence and structure the session, based on what the child feels should happen. Create feelings of worth and competition. If a child requests that you keep a painting, have the painting dry in a secure place and place it in the child's file. If a child's painting appears to be specifically significant, take a picture of the painting and place it in the child's file.

Parents have legal right however, it is not as important to reveal specifics of what the child has said or done. -less specifics, more generalities Inform about observations and to speak in themes. Info dependent on the parent's ability to use the information appropriately. Consider: Content Emotional vulnerability of the child Physical safety of all parties involved Protect children from potential physical harm from themselves & others

Depends on: The child The situation The therapist Wait until invited. Take cues (whisper technique) Keep the child in the lead (follow nonverbals) Keep the child in view Maintain an adult-therapeutic role Maintain appropriate boundaries through limit setting -that's something you can do -you really want me to help with that Make sure it promotes and facilitates independence - not dependence. What does the child want me to do?

Think about the potential consequences of accepting a gift. What will accepting or rejecting the gift: -communicate? -do to the therapeutic relationship? -what does it do to our relationship? - will it enhance or damage it? Repair gift - "I'm just glad you're here." Emotional gifts are more powerful and more satisfying than tangible gifts. "You really wanted me to have that." "You knew I'd like that." Rules for gift: 1. time of year - celebration? 2. nature of the gift 3. implication of accepting or not accepting gift Gift over $50 -- not accept (code of ethics)

Cheats child out of experience Cheapens the relationship Who's needs are being met? "What a child carries away in his heart is indefinitely more important than anything the child can hold in his hand. What is held in the hand can be lost. What is held in the heart can never be lost." Intrinsically rewarding. Don't need a reward for playing

Depends on theory CCPT - frowned upon Limits creativity and freedom of expression Adult - clean up tissues? No. Set limits or shorten session by 5 minutes

"I'm doing this for my class. My teacher is making me do this for homework." "Your parents/teachers are concerned because sometimes things don't seem to go right for you at home/school, and they thought that you would like to have a special time in the playroom each Tuesday, just for you." ***Telling the reason: Place the therapist in the lead Focus on the problem, not child Is not necessary in CCPT Is not necessary for change and growth to occur Implies that something about the children is unacceptable

Group Therapy: group play therapy children are placed in group typically children struggling with peer interactions Bringing a friend to the playroom is discouraged for children who Need the therapist's total attention & acceptance Are sensitive to comparisons with other children May perpetrate sexual or aggressive behaviors on other children in the playroom Have been traumatized Use bringing a friend to distance from the therapist May compete for the therapist's attention Must be careful not to imply that one child is accomplishing more Can allow a friend to attend if it benefits the child

Parents are not allowed in sessions. PERMISSIBLE IF: child invites parent to see something in the playroom at the therapist's discretion. (Remember having a parent come into a messy playroom child be considered a breech of confidentiality.) Siblings the playroom. PERMISSIBLE, but show the sibling before the play session with the understanding that they will not be joining you in session.

PRAISE: -evaluative -directs behavior -restricts freedom -increases dependency - fosters external motivation - inhibits creativity - results in lower self-esteem - does not communicate acceptance - indicates therapist is not in touch with inner dynamics of the child and hinders therapeutic relationship ENCOURAGEMENT -communicates acceptance; non-evaluative -recognizes and responds to effort and energy - enhances self-esteem - allows child to experience themselves as capable - fosters internal motivation - fosters creativity - increases independence

Role is to listen first, and be empathetic second. Being sensitive to the parents' feelings to obtain therapy for their child. Need to believe that it is actually possible to improve the present situation. Help parents feel understood, cared about, and empowered. This is not time to give advice.

The primary objective of the first session are to gather data about the reason for the referral, the presenting problem, and changes related to the presenting problem. Winning the parent over to the play therapy process is vastly important. Trust and Rapport Building! Reflect feelings - REFLECT, REFLECT, REFLECT Clarify Expressions (frequency, duration, meanings of expressions) Gather Info - Question, Response, Reflect - Client Questionnaire Define Therapy Goals Support Efforts of Parents (positive aspects as possible of the parents' skill, efforts, and especially, their successes) Educate Parents (education and training, learn more about how and what their child is thinking and feeling, child's personality, specific parenting skills, developmental issues, appropriate and typical behaviors for their child) Explain PT (procedures, risks, prognosis, ideal-realistic outcomes) Principles of PT Define PT How to explain PT to child

Using play and toys allow children to express themselves within their natural medium of communication. Building rapport and an accepting and therapeutic relationship with children. Recognizing and respecting the developmental positions of children. Recognizing and acknowledging the actions, thoughts, and feelings of children to help them achieve a better understanding of their behaviors. Setting limits that promote respect for boundaries within the therapeutic relationship as well as other relationships. Using the therapeutic relationship to help children have more self-confidence, self-control, and respect for self and others.

A dynamic interpersonal relationship between a child and a therapist trained in play therapy procedures who provides selected play therapy materials and facilitates the development of a safe relationship for the child to fully express and explore self (feelings, thoughts, experiences, and behaviors) through the child's natural medium of communication, play.

Child may be sad, angry confused Do things you don't understand Children express fears and worries through play - play out their feelings Use toys and play to express self in natural form of communication Child will meet with PT each week (builds rapport/acceptance/trust) PT will -reflect feelings -recognize feelings to have better understanding of others -help develop positive self-direction -set limits for inappropriate behavior to build good coping skills and to respect boundaries -learn how to express feelings in acceptable ways that will benefit them - in time, behavior will change: more self-confidence, self-control, and respect for self and others.

Opposed to therapy, but not mandated. Therapy is useless feel dragged to therapy fears airing the family's dirty laundry. Reflecting, empathizing, and avoiding power struggles are helpful. Allowing this parent to have a point of view that is heard and not judged. Attempt to display genuine interest in their concerns and involve them in the process.

Parents who do not work outside of the home. Feel like failures if their child needs to attend therapy. Needs a lot of reassurance. Reflect feelings Show empathy May also need encouragement and compliments on what they are already doing. COMMUNICATE: being a parent is the most important, yet most difficult job anyone can have.

Both parents work full time. Can be irritated that they have to deal with problems their child is experiencing. View themselves as successful Should not be having these problems Feel guilty for not being more available for their child. When meeting with these parents it is important to honor their time, and not to threaten their already busy schedule. Give them small tasks, to keep them involved. HOMEWORK: - sandwich hug - 30 second attention burst - notes/cards/texts/call - 15 minute date

Feels overwhelmed and inadequate. Anxious behavior (being the primary caregiver and sole provider is an immense job) Anxiousness then is passed onto the child. The therapist must avoid overwhelming the parent. Allowing the parent to create some "me" time can help diminish some of the overwhelming feelings.

High levels of anxiety. Emphasize that the early period of separation or divorce is a very real crisis. Parent experiencing shock, pain, depression, anxiety, and other emotions associated with grief. WHICH SHOULD THEN be reflected. Discuss with the parent the importance of not blaming the child as a factor in the decision.

Reflect, reflect, reflect. Giving the parents compliments as a way of developing rapport can be useful.

Changes in dreams/plans. Changes in role, now caregiver. Guild/fear as being seen as initial failures with their own children. Highlight the positive parenting techniques that the grandparent has used in the past. Reflect the concerns the grandparent has compliment their ability to step up and take on additional responsibilities.

Increase the bond between the parent and the child Giving a parent something that they can do at home Keeps them invested in the play therapy process