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Introduction
Garry Landreth has been quoted as saying, “In play therapy toys are viewed as the child’s words and play as the child’s language – a language of activity. Play therapy, then, is to children what psychotherapy is to adults.” (Landreth & Bratton, 1999). This is the very basis of play therapy, describing a therapy modality in which kids can use play and toys to work through traumas and disruptions in functioning. Play therapy is especially crucial because oftentimes children cannot voice what is going on in their heads; they aren’t cognitively able. But to be able to play out their various thoughts and emotions using toys, art supplies, and various media, they can show us their world.
Modalities
Within the realm of play therapy, there are a few different ways to conduct a play therapy session. There are different fields of study dedicated to directive approaches, and nondirective approaches. Directive approaches, or structured approaches, consist of therapist-directed activities in the playroom (Landreth, 2012). This approach is used to have children face their anxieties and traumas more head on, but this can be harder for a child to work through. Landreth (2012) recommends letting the child play freely afterward in order to recover from any potential discomfort. This is much like a debriefing at the end of a research study. Directive play therapy is useful in certain cases. Some children crave more structure in their lives, particularly if they are used to a more rigid lifestyle. This could be due to authoritarian parenting. While a goal of play therapy could be to have the child work through their need for structure, at first it may be overwhelming for the child to have to go from their norm of pure structure, to suddenly a completely self-directed session. Working a child up to a non-directive session would be ideal in this case. Another instance where directive play is ideal is in sand tray therapy. While the children pick their own figures and assign meaning to them on their own, sand tray itself is a directed activity in which the therapist prompts the child to show them something through the figures and the sand tray.
On the other side of the play therapy coin lies nondirective approaches. This approach is more popular and allows children to play freely with the toys and work through their traumas at their own pace. Ahuja and Saha (2016) bring up an excellent point in their journal that children do not need to be taught how to play. They know how to play at birth, and their play develops along with them. That being said, it isn’t a surprise that children use play to voice what they cannot through words. Certain traumas are hard for a child to cognitively process, especially if they happen early on in the child’s development. Play helps the child work through what they cannot process cognitively and turn to words. Letting a child play freely in a playroom as the counselor reflects and tracks what they are doing can be very telling on how the child is dealing with their trauma, whatever it may be.
Separate from directive and nondirective play, there is group child play therapy. Group play therapy can be so developmentally nurturing for children. An article by Jones (2002) showed the effects of group therapy on children who had experienced sexual abuse. The children played through their traumas, and they also got to experience social interaction. This helped the children know that they weren’t isolated in their experience, and this can help with feelings of shame and blame (Jones, 2002). There’s something very powerful about knowing you aren’t alone in your experience completely. while the other person may not have experienced exactly what you have, they’ve experienced something of the same type and a relationship can form. In a study by Kwon and Lee (2018), refugee children from North Korea joined a play therapy group once they had fled to South Korea and sought asylum. Positive outcomes were reported from this study, as the refugee girls experienced more empathic behavior and play, as opposed to the aggressive play they had previously exhibited (Kwon & Lee, 2018).
Non-directive Play Therapy
While there is valid research for each side of the play therapy coin, I tend to lean more towards non-directive play therapy. Giving the child a safe environment free of judgement gives them an opportunity to truly grow and to do it at their own pace (Ahuja & Saha, 2016). Giving them a sense of independence can be so important to children. Garry Landreth (2012) has spoken at length about the benefit of giving children choices. For some children, this could be the first time they’re given a choice; when they enter the playroom and are told ‘you can play with all of the toys in here in many ways that you like’. This of course extends to our concept of limit setting, and the ACT model (Landreth, 2012).
Some who value other methods of child therapy consider non-directive play therapy as an easy modality (Lebo, 1953). Lebo (1953)’s study mentions the vast amount of research that had already been conducted regarding non-directive play therapy. The journal gives various examples of these studies and mentions the benefit to the world of non-directive play therapy. This journal was published more than 50 years ago, it’s gratifying to see the research has mostly stayed the same regarding non-directive play therapy. If there were a lot of journals and research published already by that time, then the amount we have now is surely considered vast and plentiful.
The article by Ahuja and Saha (2016) examined resilience in children through non-directive play therapy. They acknowledge that oftentimes, children are touted for having this affinity for resilience, and that they can so easily bounce back. This of course is not true for all children. They cite a study that had been done previously that focused on children who had lost a parent or close family member, and how beneficial play therapy was to them. The children were free to let out their emotions, deep anguish and anger, through the modality of play and it proved fruitful for the children (Ahuja & Saha, 2016).
Non-directive play therapy is also useful for issues outside of trauma and grief. A study by Cogher (1999) looked into children who were attending speech and language therapy. While play is the language for the child, there is another method of speaking going on in the play room; the therapist’s tracking. As the therapist tracks, they’re putting the words to the child’s play, and the child often is listening. This can help facilitate language development, as they are learning words to represent what they are playing out (Cogher, 1999). This goes hand in hand with reflecting feeling and content. When the child does speak in session, the therapist paraphrases it or puts a feeling to their words and tone, and this facilitates language development as well (Cogher, 1999). Cogher (1999) introduces a concept called linguistic mapping. Linguistic mapping is a sort of paraphrase, wherein the therapist uses more adult language and structure to reiterate what the child has said. Cogher (1999) points out that this is especially useful in cases where a child shows issues in language, as well as their pre-verbal skills. Danger and Landreth (2005) published a journal as well with a group of children who experienced speech difficulties. It reiterates how crucial play is to a child and their language development. Play will put words to what the child cannot communicate verbally (Danger & Landreth, 2005).
Parents and Play Therapy
Wilson and Ryan (2001) published a journal pertaining to how play therapy is for parents. They point out how distressing it can be to a parent to take their child to counseling. Feelings of disappointment, defeat, uselessness can plague a parent’s mind. The study goes into detail about each child’s case, and how the parents played into the role of why the child was there. Their results showed that 10 out of 11 cases they examined had an improvement on the parent’s behalf, in handling their children and relating to them. More than one of the children seemed to experience some sort of attachment issue, and there was improvement at the end of the sessions (Wilson & Ryan, 2001). The cases showed different ways the parents were empowered, some accepting that their child was ready to be more independent, while other parents showed less of those feelings of disappointment and guilt over their children. Finally, some parents merely gained the confidence to be successful parents, and that was what they needed (Wilson & Ryan, 2001).
High levels of stress in parents correlate to higher levels of stress in children (Ray, 2008). It’s no mystery why this occurs; even in our adult lives if we are around someone who is in a highly anxious state, we can easily find ourselves picking up on their anxiety and feeling some within ourselves. Children are often looked at as sponges; they are used to looking to their parents for guidance, so if their parent is anxious and stressed, the child will be aware of it. An article by Ray (2008) shows the results of their conducted study and shows that play therapy can not only reduce stress for child and parent, but also positively impact the parent/child relationship. By bringing the stress levels down for both parent and child, a clear benefit was shown, and it was done through non-directive play therapy.
Conclusion
While there are benefits to both directive and non-directive play therapy, I found far more articles and research that use non-directive play therapy. The effects of these studies were profound, and positive. While non-directive play therapy may prove to be a longer process, it certainly seems worth the wait. Giving the child the freedom to work through trauma and diagnoses is a precious gift in their development, and if we can give them that gift it can yield incredible results.
When looking for articles pertaining to directive play therapy, and structured play therapy, the results were very sparse, so much so that many of the results that popped up were for non-directive play therapy instead. To me this showed just how many play therapists and researchers value an unstructured session. This was exciting to me, as often I think of research as something very clinical, something to be studied, and when thinking of studies one usually thinks of structure. The versatility of a non-directive study was so apparent in the volume of research that I found.
Personal Statement
I chose this as my topic of choice because there was just such a volume of research dealing with so many different traumas and diagnoses. I was so interested in everything I read I wanted to incorporate it all. It truly is amazing to watch a child in the playroom, and I was so grateful for the micropracticum experiences. I have done micropracticum in the past when I took adolescent play therapy, and the experiences were so vastly different. It was remarkable to watch other sessions and then to be in my own and get to be hands on with the children.
When thinking about potential limitations to non-directive play therapy, there were only a few that I could come up with. One limitation I considered was that a non-directive approach may not work as well with a child who is very rigid and anxious. The lack of structure may be too much for them, at least in the initial few sessions. Working toward unstructured play could be a goal, but at first, they may need a more directive approach until they are more comfortable lowering boundaries. Another limitation could lie in the parent’s perception of play therapy. Non-directive play therapy may just sound like play time to laymen. It could be hard for a parent to understand the therapeutic benefits of unstructured play, and how things will play out in the play room. This is why it’s crucial to educate the parents in intake and give them resources to help them better understand play therapy. Given these limitations I still believe that in most cases, a nondirective stance is what I will employ when I am doing play therapy with future clients.
References
- Ahuja, S., & Saha, A. (2016). They lead, you follow: Role of Non-Directive Play Therapy in Building Resilience. Journal of Psychosocial Research, 11(1), 167–175.
- Cogher, L. (1999). The use of non-directive play in speech and language therapy. Child Language Teaching and Therapy, 15(1), 7–15. doi: 10.1177/026565909901500102
- Danger, S., & Landreth, G. (2005). Child-Centered Group Play Therapy with Children with Speech Difficulties. International Journal of Play Therapy, 14(1), 81–102. doi: 10.1037/h0088897
- Jones, K. D. (2002). Group Play Therapy With Sexually Abused Preschool Children: Group Behaviors and Interventions. The Journal for Specialists in Group Work, 27(4), 377–389. doi: 10.1080/714860200
- Kwon, Y. J., & Lee, K. (2018). Group child-centered play therapy for school-aged North Korean refugee children. International Journal of Play Therapy, 27(4), 256–271. doi: 10.1037/pla0000077
- Landreth, G. L. (2012). Play therapy: the art of the relationship. New York: Routledge.
- Landreth, G., & Bratton, S. (1999). Play Therapy. ERIC Digest.
- Lebo, D. (1953). The Present Status of Research on Non-Directive Play Therapy. Journal of Consulting Psychology, 17(3).
- Ray, D. C. (2008). Impact of play therapy on parent–child relationship stress at a mental health training setting. British Journal of Guidance & Counselling, 36(2), 165–187. doi: 10.1080/03069880801926434
- Wilson, K., & Ryan, V. (2001). Helping parents by working with their children in individual child therapy. Child Family Social Work, 6(3), 209–217. doi: 10.1046/j.1365-2206.2001.00206.x
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