So often when I meet with parents before starting to work with their child, the parents are uncertain what play therapy is and how it actually works. This post will explain it all.
An overview
Primarily done with children ages 3-12, play therapy uses the child’s natural desire to play to support the child in expressing, experiencing, and working through emotions.
Play therapy uses certain types of toys (including games and art) that not only encourage a child to play imaginatively but to express emotions through the play.
The therapy is based on the idea that when children feel they are in a safe space to express themselves, they will naturally express emotions that are related to the issues they are struggling with. Because the therapist is often part of the play, the relationship dynamics between the child and therapist are part of the work itself, and often directly relate to the child’s issues, as you’ll see in an example below.
Therapists who do play therapy should have extensive knowledge of child development and be specifically trained to work with kids, especially in all their wacky creativity.
Play therapy is often non-directive
In non-directive therapy, the therapist is a participant in the play, letting the child lead, dictate, and develop the play according to the child’s whims. This helps the child feel safe because the play and the subject matter is within the child’s control. This means the play can veer into some pretty strange places—and the more strange and spontaneous, the better from a therapeutic point of view.
Some parents initially think the non-directive approach seems more like play and less like therapy, but regardless of how kids play, their emotions and struggles always seep into and drive the play. When kids feel safe and supported, they let out the tough emotions they are struggling with. And that’s what we want so that we can work through those emotions.
Sometimes when there is a specific issue the child is grappling with, I may suggest a type of play. For example, if a child has had medical trauma and seems ready to explore it, I might ask if he’s curious to play with my toy doctor’s kit. However, I would then let the child lead from there.
A major way kids and adults differ in therapy
Adults are very good at identifying and expressing emotions, yet they’re also excellent at pushing away and disguising emotions they’d rather not deal with. They can be very good at fooling themselves and therapists when wanting to avoid specific feelings or subjects.
Kids, on the other hand, are terrible at hiding their feelings: has a young child ever weighed the two options and decided, On second thought, I’ll pass on having a meltdown right now? And when he does have the meltdown, he certainly can’t label the emotions for us. A good amount of the time, we, too, may not be clear what’s going on in that head of his.
Once, when a five-year-old client knocked over my trashcan then quickly hid behind a chair, was he feeling scared, ashamed, guilty, angry, or even sad? He had feelings, that much was clear, but unlike an adult, he couldn’t name them.
The trick with kids is figuring out exactly what they are feeling so that we can help them recognize those feelings. They will tell us, but not in the ways that we’re used to.
Deciphering the child’s feelings
In the example above when the child knocks over my trashcan, it’s not clear what’s really going on. Does he want me to feel angry, sad, or helpless? Does he want me to clean up his literal and metaphoric mess? Is he hiding behind the chair because he’s ashamed? Or is scared I’ll get angry or that I won’t like him? Is he trying to control his anger by sending himself into a self-imposed timeout?
This not-knowing is a common experience for child therapists, and the one thing that helps us is to have context—that is, we need to know what’s been going on in the child’s life outside of our office. Clearly, this boy is showing me something he’s struggling with, and his parent will be able to give me examples of the child’s past behavior that will likely help clarify what the child is now feeling.
Frequently, children try to give the therapist their own, unwanted feelings. (For more on this, see the post, “A Key Technique Therapists Use to Figure Out Kids.”) For example, upon meeting me for the first time—I had already met with the parents the previous week—a four-year-old enters my office and immediately kicks over one of my small, kid-sized chairs. He looks around the room for something else to break, and I feel scared of him. This is his goal, I realize, for he is likely very scared of me, an adult he doesn’t know. He was giving me his fear, and in doing so, didn’t have to be scared because he imagined I was now scared. In those first few moments, he told me so much about himself which would help our work in the coming sessions.
How healing happens
Kids heal emotionally when they’re able to get the emotions out of themselves so that they can see and let go of those feelings. Initially, with the child who kicked my chair, we played with my toy dinosaurs, and each session, his dinosaur dominated mine, relentlessly attacking and biting my dinosaur. There was nothing my dinosaur could do to stop the attacks or defend himself. Because this was the kind of play the boy needed to create, I went along with it, taking my cues from him, while voicing my dinosaur’s feelings: “Oh, help, I’m being bitten again, and every time I try to fight back, I can’t, and I get hurt more, and there’s nothing I can do to stop it. Oh no, he’s coming back. I wish I could get away, he’s so scary!”
I was drawing out my dinosaur’s helplessness and fear, the exact feelings this boy was struggling with. I wasn’t pointing out to him that these were actually his feelings because he wasn’t ready to hear this. In this way, therapy and healing are all about timing and knowing when a child has the capacity to handle the emotions.
Healing is often done through the play itself, and sometimes labelling the feelings can be more direct. For example, with the child who kicked over my chair, a few months later when he was no longer afraid of me but rather trusted me, I reminded him of that first session which he remembered well.
“You didn’t know me,” I told him, “and you were scared of me. So you kicked the chair to make me scared. I think you’re often scared people will hurt you.” In this way, I was helping him recognize the fear that he carries. In time, I would also help him recognize that the fear was irrational and based on early experiences when he wasn’t safe.
The rules in the therapy space
I tell parents and kids that my office is very different than the outside world because I have only one rule: I’m safe, you’re safe, and my things are safe.
And I don’t take chances around safety.
A child can’t jump off my couch because it’s not safe for the child or my furniture. Nor can she throw a Lego piece at my head. If she does, I won’t be mad, but the session will end immediately and we’ll try again next week.
That’s it, those are the rules. Nothing more. A kid can say or do anything as long as everyone feels safe. Many parents are a bit surprised or even skeptical.
And sometimes, kids let loose on me.
I’ve had a child tell me his death ray was killing me and that he hoped I’d die in real life. A child once told me she hoped my dog would get kidnapped. Another child once remarked that I must be the worst father ever. Another kid said, “I bet you had no friends growing up because you’re so stupid.”
These types of comments don’t hurt me. I don’t take them personally because they’re rarely about me. Instead, they tell me a lot about the child and her big feelings, her struggles and conflicts. They also frequently mean that a child feels comfortable enough with me to let out her real stuff. And that’s the goal of therapy: when kids have support letting out, recognizing, and wrestling with their feelings, their behavior and mood will change.
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