Integrating Play Therapy in the Home-Based Setting Module

Module Sections:

Why Play Therapy is Important

Play therapy provides children with a safe and secure atmosphere where they can work through their issues. The therapist provides the child with the means to work through issues while working alongside them without interpretation; it is a medium of expression solely based on the language of the child – play. Play therapy allows the child to work through issues in a manner that is congruent with the developmental level and through resources with which the child is most familiar.

The play therapy process, whether directive or nondirective, sandtray, or Theraplay, with the therapist only, or with the family, allows the child to interact with toys and other participants in a manner that is both cathartic and interventive. The child is able to engage with toys that are familiar (doll house, kitchen, games, art work, clay), or are fantasy based (puppets, imagery), or through storytelling (sandtray, puppets), or other activities of the child's creation. The child is able to act out the conflicts and create resolution to those conflicts. The child engages in activities that support the child's developmental age while the therapist gently encourages the movement that is controlled by the child's desired pace.

The Importance of Child Development

Children's play is impacted by their experiences and understanding how children play can assist you in understanding what a child is working through or in improving your interactions with them. Landreth (1991) explains that developmentally, children lack the cognitive and verbal ability to express their feelings and are emotionally unable to handle the intensity of these feelings or adequately express them in a verbal exchange.

Further, according to Piaget, children are not developmentally able to engage fully in abstract reasoning or thinking until approximately age eleven (Craig & Kermis, 1995). This puts the child at a disadvantage for the regular "talk therapy" because their thinking is concrete. Play is a developmental process and the mechanism for developing problem solving and competence skills.

Children's cognitive abilities differ between intellectual stages according to Piaget. It is important to understand Piaget's cognitive developmental stages when using play therapy. Practitioners must set reasonable expectations in order for the client to achieve realistic goals. According to Piaget, it is important to remember that mentally healthy children cannot digress through his cognitive developmental stages. Below is a table of Piaget's Cognitive Developmental Stages. It is important to remember that the ages listed below are guidelines and may not clearly define each individual.

STAGE

AGE

CHARACTERISTICS

1. SENSORIMOTOR

Birth- 2 years

  • Learn through environment 
  • Motor development and reflexes are main focus
  • Can modify child's behavior with senses: frown, tone of voice

2. PREOPERATIONAL

Age 2-Age7

  • Child uses symbols to represent objects
  • Egocentric
  • Language development is main focus

3. CONCRETE OPERATIONS

Age 7-Age 11

  • Abstract thinking 
  • Ability to classify objects
  • Capable of problem-solving

4. FORMAL OPERATIONS

Age 11- Age 15

  • Can perform hypothetical and deductive reasoning
  • Thought is more abstract

Erickson (1963) refers to play as the emotional laboratory where a child learns to cope with his/her environment and deal with concerns. Play therapy allows allows a child to repeat past events and gain mastery.

According to Erik Erikson, man a person experiences eight stages of psychosocial development over the duration of the lifetime. Erikson's research is most notable for the "psychosocial crisis" that appears in each stage and must be resolved before one can successfully continuing on e to the following next stage. Taking into account Erikson's developmental stages is essential for successful play therapy. In comparison to Piaget's cognitive developmental theory, practitioners must set reasonable expectations in order for the client to achieve realistic goals.

Below is a summary of Erikson's psychosocial stages and the tasks within each stage.

 

STAGE

AGE

CHARACTERISTICS

1. TRUST VERSUS MISTRUST

Infancy-Age 2

  • Develop trust with consistent and nurturing care 
  • Child develops hope and confidence
  • Mistrust occurs with inconsistent care giving
  • Child develops depression, withdrawal

AUTONOMY VERSUS SHAME & DOUBT

Age 2- Age 3

  • Guidance is key from care givers
  • Children will develop autonomy and a sense of will 
  • Permissive, authoritarian, or rejecting care giving can result in shame & doubt

INITIATIVE VERSUS GUILT

Age 3- Age 5

  • Children model adult's
  • Child will develop a sense of purpose
  • Children will develop guilt if attempts at initiative are punished

INDUSTRY VERSUS INFERIORITY

Age 5- Age 12

  • School age children must tame impulses and attempt to work with others
  • Sense of competence occurs when adults support effort of industry
  • Lack of support will lead to sense of inferiority and helplessness may occur

IDENTITY VERSUS ROLE CONFUSION

Age 12- Age 19

  • Young adult creates a sense of self-identity by trying on different roles
  • Achieving identity leads to fidelity-the ability to sustain loyalties
  • Identity diffusion occurs if identity crisis is not resolved

Play itself will not ordinarily produce changes. The therapist's interventions and utilizations of the play are critical. The therapist is a participant-observer, not a playmate. Play is an intervention which is based on theoretical premises, and is used to facilitate change. Play therapy is defined as, "an interpersonal process wherein a trained therapist systematically applies the curative powers of play to help clients resolve their psychological difficulties" (Schaefer 1993, p. 3). "Play in itself will not ordinarily produce changes, therefore, the therapist's interventions and utilizations of play are critical" (Chethik 1989 as cited in Gil, 1994, p.4).

Audio Companion: Integrating Play Therapy