This article is based upon material presented
at the 2001 Kingston Summer Play Therapy Institute by Dr Mark Barnes
IBECPT CPT-P. Now retired, Mark has done more than anyone else in
recent years to promote the cause of play therapy throughout the world
and to raise the standards of training and education in play therapy. PTA
is privileged to be associated with his work. His views on the Directive
v Non-Directive approaches are especially thought provoking.
Keep the Bigger Picture In Mind.
Play therapy is one piece of a total picture. It is an important piece, but
still, just one part of a larger process. There are other areas and people
to be dealt with, either by the therapist or by colleagues. As work
proceeds with the child, it is also important for someone to be involved
with other people in the child’s environment. We have seen a play therapy
service in a school in the UK run by well trained, very experienced, well
intentioned therapists founder because of a break down in communications
with the teachers.
Children of All Ages 0 - 100.
Play therapy techniques can just as easily be adapted for adults and their
inner children. We have , for example, observed the dramatic changes
effected upon adults who have completed a sand tray. Positive results were
obtained in a far shorter time than the use of talking therapy could have
achieved. Obviously there are certain adaptations that have to be made for
different age groups but, in general there are few limitations in tapping
playful or creative impulses in the healing processes. Until now 3 years
has been assumed to be the youngest age at which a child could benefit.
However the exciting developments in filial play and the latest research
into how young children learn and think suggests otherwise.
Avoid Dogma.
Remember that the entire mental health field is brand new. It is hardly a
century old and therapy with children is really so new that there is no
excuse for getting locked into dogmatic beliefs about there being “one
wonderful model that works”. Take everything you hear in the field
with a grain of salt. There are mountains of theories and philosophies
of working with children but relatively few facts. Models are based on
theories. Unfortunately when much of a theory has been disproved, we
are sometimes still left with the models. A critiquing mind is vital
for a therapist.
The Toolset.
The techniques and methods are the tools in the tool chest of a healer. The
more skills or tools one has the better one can adapt to new situations.,
difficulties or problems. These tools are also resources. The more
resources, inner and outer, that we have access to the less likely that we
will “burn out”. However it is no use knowing the theory of a tool without
the practical experience of using it, initially under safe conditions.
Healing Comes From the Heart.
Do not feel that you have to have all the “right” tools before beginning. You will
never have all the resources you could hope to have but you will always have
access to your own inner voice. Professionals in the most wonderfully
equipped play therapy settings can still do a poor job. Toys do not make
the therapy. A truly skilled therapist could work with only the air and
emptiness.
There are many people that we are in contact with in connection with our work:
parents, teachers, social workers, care workers, doctors etc. Some may not
have heard of play therapy. Many will not be convinced of its value. We
therefore need to undertake an educational job. Part of this process is
showing that play therapy is not some new fangled technique but one that has
strong historical roots.
In giving a background on play therapy, it does not necessarily mean that all or any of
the methods mentioned are still in use or that they necessarily work. What
we are looking at here are our “roots”, the beginnings of therapy with
children. Some of the methods would definitely not be used today. They are
given to indicate the growing process of our understanding of work with
children.
|
H Hug-Helmuth (1919)
|
First used play directly in the therapy of children.
Murdered by a client, who was her nephew and living with Hug Helmuth as
an adopted son. |
|
Melanie Klein (1932) |
Incorporated play into her sessions with children as a
‘lure’ into therapy |
|
Structured Play Therapies (late 1930s)
|
Used play therapy as a direct substitute for words.
Common factors:
-
A
psychoanalytic framework
-
At
least a partial belief in the cathartic value of play
-
The
active role of the therapist in determining the course and focus of
therapy
(Not connected to the Minuchin systemic family therapy
model known as “structural family |
|
Otto Rank (1936 |
Stressed the importance of the so-called “birth trauma”
in human development. |
|
Jessie Taft (1933)
Frederick Allen (1942)
Clark Moustakas (1959)
|
Adaptations of Rank’s thinking to work with children in
play therapy,
Through therapy the child is given the opportunity to
establish a safe, consistent relationship with a therapist in a safe
setting. This approach tended to emphasise the child-therapist
relationship and de-emphasise the significance of past events. Still
maintained a strong tie to psychoanalytic theory. |
|
Levy (1938)
|
Developed “release therapy” to deal with children with
specific trauma – made materials available to re-enact the trauma. |
|
Soloman (1938)
|
Developed a technique called “active play therapy” which
was used with impulsive/acting out children. It was thought that
expressing rage and fears through play would lead to more socially
accepted play. |
|
Hambridge (1955)
|
Set up play much like Levy, but was much more directive.
Directly recreated the event in play to aid the child’s “release”.
|
|
Client Centred Approach |
|
Carl Rogers
|
Developed this approach for therapy with adults. |
|
Virginia Axline
|
Modified the client centred approach into a play therapy technique for
children. Client centred play therapy aims at resolving the
imbalance between the child and his/her environment so as to facilitate
natural self-improving growth.
Keep in mind that, contrary to the beliefs of adherents, this approach
is anything but “non-directive” when it comes to interpretations and
analysis of a child’s play. |
|
Limits |
|
Bixler (1949) |
Wrote an article “Limits Are Therapy” which began a
movement where the development and enforcement of limits was considered
the primary vehicle of change in therapy sessions. Therapist sets the
limits with which she or he is comfortable. For example, the child
should not be allowed to:
-
Destroy any property in the playroom other than play equipment
-
Physically attack the therapist
-
Stay
beyond the time limit of the session
-
Remove
toys from the playroom
-
Throw toys or other material out of the room
|
|
Ginott (1959, 1961)
|
Felt
that the therapist, by properly enforcing limits, can re-establish the
child’s view of her/himself as a child who is protected by adults. |
Today we know that setting and enforcing limits is an important part of both
parenting and therapy. A child without limits is an abused child. Without
limits there is no sense of safety, boundaries or protection in the world.
Children without limits cannot trust adults to behave in a consistent
manner. We owe children limits. This is not to imply rigidity or
inflexibility. Limits should stem from loving concern for a child not for a
desire for power over the child.
A child should have as few limits as possible but as many as necessary.
One of the consequences of testing the limits should, under no circumstances, ever
involve physical punishment, spanking etc. Physical punishment only
represents inability to properly establish and enforce reasonable limits
earlier. It is a message in the clearest possible manner to the developing
child that physical abuse is legitimate and that hitting someone is
something that mum and dad both condone and practice.
However, therapy does not mean “anything goes”. Therapy should be a
lovingly and carefully guided process. There is a time for many different
pieces to the process. It must not deteriorate into “cupcakism” where the
therapist does only what pleases the child and does nothing that would make
the child dislike him/her.
|
Recent Influences |
| 1960s, 70s, 80s, 90s |
Creative arts – art, music, dance, movement
Dreamwork, sandplay
Nature, spirituality, pet-facilitated therapy, relaxation, social
skills, impulse control
Groupwork
Family involvement, family play therapy |
Since much of current play therapy practice is based upon Virginia Axline’s work it is worth quoting her basic rules.
The therapist:
Must develop a warm and friendly relationship with the child.
Accepts the child as she or he is.
Establishes a feeling of permission in the relationship so that the child feels free to express his or her feelings completely.
Is alert to recognise the feelings the child is expressing and reflects these feelings back in such a manner that the child gains insight into his/her behaviour.
Maintains a deep respect for the child’s ability to solve his/her problems and gives the child the opportunity to do so. The responsibility to make choices and to institute change is the child’s.
Does not attempt to direct the child’s actions or conversations in any manner. The child leads the way, the therapist follows.
Does not hurry the therapy along. It is a gradual process and must be recognised as such by the therapist.
Only establishes those limitations necessary to anchor the therapy to the world of reality and to make the child aware of his/her responsibility in the
relationship.
There is an ongoing debate in the play therapy field over which approach is “better” –
non-directive or directive. There are two issues of concern. First, there
is not one right way to proceed in our work with children. Contrary to the
dogmatic views of some theorists in the field, many approaches work with
children. Second, it is highly questionable that there is really any such
thing as non-directive therapy. The term “non-directive” is a misnomer.
A therapist should be fairly non-directive in the therapeutic process, often quite
directive with regard to the methods used in a session, and as non directive
as possible with regard to the interpretation of the material which arises
during a session, and quite directive in the issues of safety and best
interests of the child.
Therapists who call themselves non-directive or client-centred are often only non-directive
in terms of what they do in a session. They suddenly become very
directive in interpreting and analysing the client’s inner world and
reflecting back to the child.
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