Integrating Play Therapy in the Home-Based Setting Module

Module Sections:

Directive Play Therapy

One approach to play therapy involves more active structuring by the therapist. The Directive play therapy approach assumes the therapist is responsible for the structure and direction of the therapy process. "Directive therapists structure and create the play situation, attempting to elicit, stimulate, and intrude upon the child's unconscious, hidden processes or overt behavior by challenging the child's defensive mechanisms and encouraging or leading the child in directions that are seen as beneficial." (Gil, Eliana. 1991. The Healing Power of Play. New York: Guilford Publications). The therapist will select activities and through these, challenge the child to work through the issues identified. The therapist has an active role in determining the direction and focus of therapy. Directive play therapy often involves a combination of cognitive and behavioral responses based on the activities that invite the child to engage with the toys and the therapist.

Directive therapy processes are often more short term in nature and may be more symptom-focused. For example, a child presenting with anger issues may be guided through the resolution of process through activities that identify and assist in controlling the angry reactions (Angry Kleenix Game, Boxing Balloons, etc.). A child with self-regulation issues may become involved in a series of activities that seek to escalate and deescalate behavior with the therapist assisting the child in learning to self-regulate (Red Light-Green Light followed by Mirroring, etc.). The resource section of this module contains several handouts that describe a variety of activities/interventions to coincide with a number of presenting issues.

There are a number of situations that make directive play therapy more appropriate than non-directive play therapy. When children struggle with engaging in play, more directive work may assist the child in becoming freer to engage in the future. When a therapist wants to address a particular issue and the child is not progressing through free play, then directive play therapy may be more appropriate. Family therapy and home-based therapy processes are more easily adapted to including play therapy. Play therapy allows young children to engage in the therapy process when the more traditional talk therapy may be too intimidating or difficult to keep children engaged. Finally, some issues such as attachment issues are more appropriately dealt with through directive therapy processes such as Theraplay described later in this module. Therapists may also use a combination of directive and non-directive play therapy approaches. The child may engage in free play and the therapist gradually introduces the stresses into the play situation. The child may then engage in free play again to help them recover from that stress.

Family therapy and specifically home-based therapy are specifically amenable to a more directive therapy approach. The therapist must determine ahead of time what the session should address and decide on the appropriate activities to draw the parents and children into interactions around the issues of concern. There are a number of family activities that are easily transportable to the home. The toolbox described in the resource section can assist the therapist in creating a portable play therapy process!

Audio Companion: Integrating Play Therapy