Integrating Play Therapy in the Home-Based Setting Module

Module Sections:

Four Dimensions of Theraplay

The following information is taken directly from Theraplay Activities by Dimension, The Theraplay Institute, www.theraplay.org.

Structure:

Children with attachment/trauma issues often engage in power struggles with caregivers in an effort to maintain control over the interactions and relationship. In Theraplay, the goal of structure is to relieve the child of the burden of that control. "The adult sets limits, defines body boundaries, keeps the child safe, and helps to complete sequences of activities" (p.1). Some examples of structure activities are:

  1. Peanut Butter and Jelly: Say "peanut butter" and have the child say "jelly" in just the same way. Repeat five to ten times varying loudness and intonation.
  2. Pop the Bubble: Blow a bubble and catch it on the wand. Have the child pop the bubble with a particular body part, for example, finger, toe, elbow, shoulder or ear. This is a structured way of playing with bubbles. Bubbles readily capture the interest of young children and can be used as an engaging activity either in this structured form or in a manner that invites more spontaneity (for example, by having the child pop all the bubbles as quickly as she can.)
  3. Mother May I?: parent gives instructions to the child to do something, for example, "Take three giant steps toward me." Child must say "Mother May I?" before responding to the command. If the child forgets, she must return to the starting line. The goal is to have the child come to her parent and get a hug on arrival
  4. Hide Something on Child and Find It: One adult hides and the other finds, for example, notes directing the finder to do something with the child ("Pop Sara's cheeks"); or find a cotton ball and give a soft touch, or find food and feed it to the child

Engagement:

Children with attachment/trauma issues often find it difficult to stay connected with a caregiver in positive ways. The goal of engagement is to "establish and maintain a connection with the child, to focus on the child in an intense way and to surprise and entice the child into enjoying new experiences" (p.3).

  1. Check up: Check body part, such as nose, chin, ears, cheeks, fingers, toes, knees to see if they are warm/cold, hard/soft, wiggly/quiet, and so on. Count freckles, toes, fingers and knuckles.
  2. Blowing Over: Sit facing the child and holding hands (or cradle the child in your lap), have the child "blow you over." Fall back as the child blows. Once the child understands the game, you can blow her over.
  3. Mirroring: Face the child, move your arms, face, or other body parts and ask child to move in the same way. For a very active child you can use slow motion or vary the tempo. Take turns as the leader.
  4. Hide and Seek: Hide the child under a blanket or under pillows and ask the parent or other adult to find the child. Parents should be coached to make appreciative comments about their child as they look for him and to find him quickly if he is young and impatient. A big hug is in order once the child is found.

Nurture:

Children with attachment/trauma issues often feel that they are unloved. The goal of nurture is to "reinforce the message that the child is worthy of care and that adults will provide care without the child having to ask" (p.4).

  1. Caring for Hurts: Check hands, feet, face and so forth, for scratches, bruises, hurts or "boo-boos." Put lotion on or around the hurt with cotton ball, or blow a kiss. Check for healing in the next session. (Note, for children sexually abused powder is a substitute for the lotion).
  2. Feeding: Have a small snack and drink available for all sessions. Take a child on lap or face seated child. Feed the child, listen for crunches, noticing if the child likes the snack and when the child is ready for more. Encourage eye contact.
  3. Twinkle Song: Adapt the words of "Twinkle, twinkle little star" to the special characteristics of the child. "What a special boy you are/Dark brown hair, and soft, soft cheeks/Bright brown eyes from which you peek/Twinkle, twinkle, little star/What a special boy you are." Hold the child in your arms and touch the parts you refer to as you sing.
  4. Blanket Swing: Spread a blanket on the floor and have the child lie down in the middle. The adults gather up the corners and give a gentle swing while singing a song. At the end bring him down for a "soft landing." Position parents so they can see the child's face. If the child is fearful of being lifted off the floor, rock him gently back and forth while he remains in contact with the floor.

Challenge:

Children with attachment/trauma issues often have security issues and are afraid to take risks. The goal of the challenge is "to help the child feel more competent and confident by encouraging the child to take a slight risk and to accomplish an activity with adult help" (p. 6).

  1. Balloon Between Two Bodies: Hold a balloon between you and the child (such as between foreheads shoulders, elbows) and move across the mat without dropping or popping the balloon. See if you can do this without using your hands.
  2. Cooperative Cotton Ball Race: You and the child get on hands and knees at one end of the room. Take turns blowing a cotton ball (or ping pong ball) to the other side of the room. You can try to better your time on repeated trials. A competitive version would be for each to have his own cotton ball and see who can get it across the room first.
  3. Pillow Push: Place a large pillow between you and the child. Have the child push against the pillow trying to push you over.
  4. Tangle: Standing in a circle, all cross their arms in front of themselves and take the hands of the two others in the circle, deliberately creating a tangle of hands. Participants then untangle without breaking the handholds. It is okay to slide hands around in the grip or to face different ways when untangled. It adds fun to put lotion on everyone's hands first.

The activities in each dimension are done in a very positive, warm, spontaneous, upbeat and fun manner. The last activity in each dimension listed above is one easily completed with a parent or caregiver present. It is advised that two therapists are involved in the treatment process with one therapist working with the child and the other therapist observing and interpreting with the parents. There are hundreds of Theraplay activities for each dimension and therapists often create their own activities! Theraplay activities are easily adapted to the home environment. The "equipment" is often the child himself or things that are easily transportable so Theraplay works well in the home environment. For more information on Theraplay and certification see the Theraplay Institute at www.theraplay.org

Audio Companion: Integrating Play Therapy