An Orientation to Play Therapy

1. An Orientation to Play Therapy Stephanie Pratola, Ph.D. January 11, 2012 KidS Group

2. Characteristics of play • Action oriented (real or imagined) Stephanie Pratola, Ph.D.. 2012 12:15

3. Characteristics of play • Spontaneous, self generated – intrinsically motivated Stephanie Pratola, Ph.D... 2012

4. Characteristics of play • Not too serious: • Not goal oriented Stephanie Pratola, Ph.D... 2012

5. Characteristics of play • Not good or bad: it just is Stephanie Pratola, Ph.D... 2012

6. Characteristics of play • No rules - flexible Stephanie Pratola, Ph.D... 2012

7. Characteristics of play Non-literal: uses fantasy or imagination Use of symbolic objects Stephanie Pratola, Ph.D... 2012

8. Characteristics of play • Don’t have to be “good” at it Stephanie Pratola, Ph.D... 2012

9. Characteristics of play • Fun Stephanie Pratola, Ph.D... 2012

10. Characteristics of play • Involves loss of self consciousness (induces the state of “flow”) Stephanie Pratola, Ph.D... 2012

11. Characteristics of play • Play is the “medium” of children Stephanie Pratola, Ph.D... 2012

12. Characteristics of play • Play is intrinsically therapeutic Stephanie Pratola, Ph.D... 2012

13. Characteristics of play • Functions of play beyond to have fun are unconscious Stephanie Pratola, Ph.D... 2012

14. Association For Play Therapy • Multidisciplinary professional organization • Promotes play therapy • Has developed a credentialing system • Promotes and sponsors training , now including university level • Promotes research of treatment efficacy and development of best practices. Stephanie Pratola, Ph.D... 2012

15. Rationale for Play therapy- Stephanie Pratola, Ph.D.. 2012 12:30

16. Children naturally use play to • Develop basic kinesthetic skills Stephanie Pratola, Ph.D... 2012

17. Children naturally use play to: • Learn to relax and release energy Stephanie Pratola, Ph.D... 2012

18. Children naturally use play to: • Explore their environment Stephanie Pratola, Ph.D... 2012

19. Children naturally use play to: • Master unfamiliar situations Stephanie Pratola, Ph.D... 2012

20. Children naturally use play to: • Develop an understanding of their world Stephanie Pratola, Ph.D... 2012

21. Children naturally use play to: • Master Conflicts Stephanie Pratola, Ph.D... 2012

22. Children naturally use play to: • Soothe and Distract Themselves Stephanie Pratola, Ph.D... 2012

23. Children naturally use play to: • Develop a sense of self separate from others Stephanie Pratola, Ph.D... 2012

24. Children naturally use play to: • Understand societal roles Stephanie Pratola, Ph.D... 2012

25. Children naturally use play to: • Learn to cooperate with others Stephanie Pratola, Ph.D... 2012

26. Play Therapy • There is no one school of play therapy Stephanie Pratola, Ph.D... 2012

27. All play therapy has in common • Emphasis on a relationship that honors play Stephanie Pratola, Ph.D... 2012

28. All play therapy has in common: Use of techniques designed to harness the natural therapeutic power of play Stephanie Pratola, Ph.D... 2012

29. Other “Common features” of Play Therapy: • Use of “play” interactions and activities Characterized by • Action- real or imagined • Imagination • Use of symbolic objects • Creative productions • Value on process rather than content Stephanie Pratola, Ph.D... 2012

30. Other “Common features” of Play Therapy: • Communication in the play interaction that is • Developmentally appropriate • Metaphorical/symbolic Stephanie Pratola, Ph.D... 2012

31. Developmental considerations: (for example) • 3 year olds begin symbolic play; • 4 year olds can draw representational pictures • Importance of how trauma is encoded • Capacity for fantasy • Defensive vulnerability as related to cognitive development Stephanie Pratola, Ph.D... 2012

32. History of Play Therapy • There is no one school of play therapy Analytic: Anna Freud Jungian: Sand tray therapy Rogerian: Axline – non-directive Gureney – Filial Cognitive Behavioral – Integrative/Prescriptive/Multimodal Stephanie Pratola, Ph.D.. 2012 12:40

33. Schools of Play Therapy differ on several dimensions Directive vs. Non-Directive Structured vs. Unstructured Level of verbalization Choice and use of toys and materials Who is present in the session: parents, family, peers, individual Stephanie Pratola, Ph.D... 2012

34. Directive vs. Non-Directive How active is the therapist in directing the play in the session. Non-Directive play therapists typically deal with individual children or teach filial therapy to parents. Stephanie Pratola, Ph.D... 2012

35. Structured vs. Non Structured A dimension of Non-directive therapy Therapists from a cognitive behavioral orientation, for example, are highly structured. Theraplay is another highly structured type of play therapy intervention where the therapist plans the session following an assessment of the client needs. Stephanie Pratola, Ph.D... 2012

36. Level of Verbalization And ….interpretation….. Non-directive play therapists will use words to reflect what they observe in the play. Most play therapists deal with conflicts, etc. in the play relationship Stephanie Pratola, Ph.D... 2012

37. Choice and use of toys • Psychoanalytic play therapy: each child has a small collection of toys kept for their entire course of therapy • Non-directive therapy: a variety of items consistently available • Sandtray therapy: a large collection of objects and sand trays • Cognitive behavioral/PCIT/ Eco-systemic/Integrative/Prescriptive: Therapist choses games and toys specifically brought in for each session. Stephanie Pratola, Ph.D... 2012

38. School of Play Therapy Associated with….. Therapist stance Use of Interpretation? Toys (Client Centered) Axline Axline, Non-directive/ Unstructured No A wide variety Psychoanalytic Freud, James Non-directive/ Unstructured Yes A limited number Existential Moustakis Non-directive/ Unstructured Yes A wide variety Theraplay Jernberg Directive/Structured No Selected by therapist Adlerian Adler, Kottman Directive/Structured Yes Selected by therapist Cognitive-Behavioral Schaefer Directive/Structured No Games/ therapeutic activities Eco-systemic O’Connor Directive/Structured Yes Selected by the therapist Gestalt Oaklander Directive/Unstructured No Selected by the therapist Jungian Lowenfield Non-Directive/Structured Yes Sandtray and objects provided Stephanie Pratola, Ph.D... 2012

39. Clinically Play can be used to: • form a relationship • assess child’s thoughts, feelings, beliefs, expectations, skills, reactions • communicate important ideas: • challenge and teach new skills • provide opportunity for something different to happen in an interaction • help child make connections, understand self and motivations of others. • dissipate energy and cope with overwhelming feelings. Stephanie Pratola, Ph.D... 2012

40. A word about PiZZaZz • Pizzazz is a dramatic, energetic and playful response to your child. • Pizzazz is an attitude that clearly communicates “we are playing now” …it is sort of an induction into the playful mode. • Pizzazz energizes both the pizzazzer and the pizzazzee. Stephanie Pratola, Ph.D... 2012

41. Beginning a Play Therapy Relationship Stephanie Pratola, Ph.D.. 2012 1pm

42. What the therapist does: • The goal of the therapist is to create a trusting relationship by giving close attention to the child’s sharing of his thoughts and feelings through play. The attitude of the therapist is intensely interested, open ad accepting of the child. In child centered play interactions the therapist relates to child in a way that is different from how people usually relate to children. Here the child determines the direction of the interaction. The therapist follows and reflects the actions, thoughts and feelings that the child shares. Stephanie Pratola, Ph.D... 2012

43. Talking “ to a child in play • Avoid direct, intrusive questions • Child takes the lead, directs the action. • Describe what you see out loud (explained below) • Accept creations without judgment • Use “I wonder” statements • Be animated, energetic, dramatic – show PIZZAZZ • Don’t take play personally or literally. • Communicate “in role” • React to the child’s feeling level: • “That monster sure is scary” • “I’m so sorry your dolly is sick” Stephanie Pratola, Ph.D... 2012

44. Description • Involves following the child’s actions with descriptive statements. This is particularly useful when a child is non-verbal and/or very tentative in their play. • Example: • “You’re getting all the dolls together” • “You’re being very careful with all those toys.” • Avoid judgmental comments: “What a good job.”   Stephanie Pratola, Ph.D... 2012

45. Role Play Practice Activity • Divide into threes: • child, RPT and RPT-S Stephanie Pratola, Ph.D... 2012

46. Registered Play Therapist • Must be a licensed Mental Health Practitioner • Master’s degree or Higher • APT designated core graduate coursework • 2 years and 2,000 hours of supervised clinical experience • 150 hours of play therapy specific instructions • 500 hours of play therapy experience ; 50 hours of play therapy supervision • Renewal: 18 hours CEU every 36 months. Stephanie Pratola, Ph.D... 2012

47. Registered Play Therapist-Supervisor • RPT requirements plus” • Additional 3 years and 3,000 hours of supervised clinical experience • 3 years of post licensure practice • Additional 500 hours of play therapy experience • 24 additional hours of supervision training or be a state approved supervisor • 18 hours of CEUs every 36 months Stephanie Pratola, Ph.D... 2012