Parents and Play Therapy

Parent Profiles

Resistant ParentOpposed to therapyReflecting helps reduce opportunities

for power strugglesConfused technique- “Can you help

me understand?”Show genuine interest

Parenting as a careerParent feels like a failure.Needs a lot of reassurance

Two Career ParentsMay feel guilty and blame selfMay have trouble making time for

therapyUse “small change” technique

Single parentFeels overwhelmed and inadequateMay have high anxietyAvoid overwhelming the parentImplore parent to take care of selfHelp develop quality time

Recently divorcedHigh anxietyLife may be chaoticEnormous loss and changeParent may feel shock, pain,

depression, anxiety, etc.Help parent see that life will get better.Child needs to safely express

emotions

Parents who are not seeking counselingCourt ordered, recommended by

school, etc. May be resistant and irritatedEasy to establish countertransference

issuesUse encouragement and compliments“Small changes”

GrandparentOften a big adjustmentInconsistent with dreams that people

have for themselvesExpensiveNeed reassurance and

encouragement.

Special Issues

Children are dependent on parents’ willingness to make arrangement for play therapy.

To what extent will parent be involved?

How do parents’ issues impact child and therapy (ex. Parents are going through divorce)

Initial Interview

Have to educate and “sell” parent by developing relationship with parent, too.

Landreth feels that background information is helpful, but not essential because it doesn’t change the way therapy is done. But, it does help to assess growth.

Ideally, Landreth recommends that another therapist interview and counsel the parent so that the child does not worry about parents being in “cahoots” with therapist.

Next best situation is for parents to meet at different times than child.

Least desirable is to have parents meet for a portion of the time, but separate from child.

Be sensitive to parents because it is difficult to admit that the child needs help.

Sometimes the problem has been brewing for a long time, but parents have hoped it would get better and put off getting help.

Parent may be feeling guilty, frustrated, inadequate, angry or sad. Attend to those feelings.

Permissions

Obtain permission from legal guardian. If parents are divorced, make sure the appropriate guardian is giving permission.

Also get permission for audio or video taping.

Get a signed release if you would like to talk to the child’s teacher, physician, etc.

Explain play therapy

Very critical See pp. 133-135 for example of

explanation Give a tour Encourage questions

Separating from child

Give explanation to parent that covers how the child might feel, what would be helpful, and how the parent should interact with child if the parent goes to the playroom.

Warn them that they may hear crying, yelling, etc. at times

Ask them not to talk to therapist about issues in the waiting room.

How should parents be involved? Encourage parents to be in own

therapy, if appropriate Or, use parent education or filial

therapy, if necessary Play therapy can be effective even if

parents do not participate When child begins behaving

differently as a result of play therapy, the family will change accordingly.

Working with Angry, Resistant Parents

Can be direct or indirect resistance Reflect feelings Goal is to win them over Acknowledgment of parent’s agenda Listen for parents’ goals Target areas for change Appeal to least resistant parent

Recommend individual or marital therapy Gentle confrontation-invite parents to

inspect their attitudes and thoughts; point out inconsistencies

Reframing-change perception Look for windows- look for unique ways to

reach difficult parent Prioritize. Keep it simple.

Take care of self

Keep sense of humor Establish boundaries Seek advice

Filial Therapy

Parents may feel alienated from child, be unaware of child’s emotional needs, or not know how to respond in facilitative ways

How the parents feel about themselves significantly impacts their interaction with their children.

Parents are susceptible to self-blame and doubt about their adequacy as parents.

When parents have high internal locus of control and high interpersonal support, they positively influence child’s development.

Therapist needs to convey faith in parent’s ability to learn the skills and develop a more positive relationship with the child.

History

Conceptualized by Bernard Guerney as a structured treatment program for children with emotional problems.

Louise Guerney worked with her husband to develop it.

Philosophy

Parent has more emotional significance to the child than does the therapist, so this approach is to help the parent become the therapeutic agent

Allows children to express themselves and work through issues and also builds the relationship between the parent and child.

Benefits

Therapy process closely resembles reality. Child is able to experience acceptance

directly from the parent. Parent feels less excluded and views the

therapist as an ally. Parent feels less defensive and resistant. Process uses the existing parent-child

relationship to facilitate therapy.

Structure Parents are taught play therapy

principles and skills in a small group of parents.

Parents work with their child in special play sessions at home, and receive supervision by the filial group.

Can be used with children aged 2-10, or even with older children if activities are substituted for play materials.

Process

Focus is on the importance of the relationship between the parent and the child.

Relationship is the vehicle for change Objective is to help parent relate to

child in ways that will allow the child’s inner directional, self healing power to develop.

Goals are to help parents: Understand and accept the child Develop sensitivity to child’s feelings Learn how to encourage child’s self

direction, self responsibility and self-reliance. Gain insight into self in relation to child Change perception of children Learn child centered play therapy principles

and skills.

Setting

30 minutes special play time Parent follows child’s lead, reflects feelings,

sets limits, etc. Objectives:

• Allow child, through play, to express thoughts, needs, and feelings

• Facilitate the child’s development of self esteem.• Help child develop an internal locus of control• Help child change negative perceptions of parent• Reduce or eliminate problematic, self-defeating

behaviors.

Parents are expected to use the skills only during the once a week play session, so are less overwhelmed.

Parents feel more successful because they are trained on specific skills rather than having to understand causes, develop new discipline routines, etc.

10 session model is most common

Selection

Good for all parents- even those with well adjusted children

Grandparent who have custody find it helpful Nannys For children who need to bond (long parental absence) Appropriate for most cultures Not appropriate for severely traumatized children,

children with severe mental health disorders, children who have been sexually abused and children whose parents are unable to give what it takes to complete the training.

Group format

Helps parents learn from one another Supportive place to share feelings Balance training with therapy Structured to cover all components of the

training Works best for groups of 6-8 Closed group Meet 2 hours a week for at least 10 weeks Homework to practice skills

Individuals or couples

May use training modules for an individual or couple, but the group process is preferred.

Session 1

Introductions Goals and objectives Videotape of skills Practice empathic responding Homework

Session 2

Tour of playroom Role play making tracking statement

and empathic responding Discussion of limit setting Parents have list of toys to use Homework- put toy kit together and

set up time and place.

Session 3

Play therapy skills reviewed Role play limit setting Parent is asked to observe child’s play Live demonstration, if possible Prepare parents for first session

Session 4

Review principles Provide support and encouragement Trouble shoot Video or live demonstration of a

parent play session with feedback Correction is kept to minimum Practice ACT limit setting

Sessions 5-9

Show “Choices, Cookies, and Kids” View parent video of session Continue to develop skills

Session 10

Share experiences Evaluate progress

Weekly 15 minute parent meetings

Meet before or after therapy sessions. Let child give input as to when.

Child must trust that confidentiality is protected.

Have child wait in waiting room. Do not let child play in playroom.

Format

Share weekly highlights (including homework)

Share session themes Make new homework assignments If there is a crisis, or if the parent is

very emotional, it may be best to set up a separate appointment.

Homework

Assess themes in child’s play. Assign homework to enlarge the

family’s behavioral repertoire. Provide means for learning and

practicing positive skills.

“Specific Date” with child

Parent and child plan a day (about 15 minutes) for a “date”. Write it on a parent or calendar to build the importance.

Key is being consistent and not letting child down.

Should be 1 on 1 time Allow no interruptions Allow child to share feelings But, shouldn’t be coaxed or pressured.

Sandwich Hug

Multiple members in a big hug while pretending to be parts of a sandwich.

30 Second Attention Burst

Parent stops whatever they are doing, and gives the child full attention for 30 seconds.

Notes, Cards, and Phone Calls

Let children know that they are being though about.

Concrete message to child that they are important

Structured Play Activities

Therapist teaches parent how to set up a scenario that the child can work on.

Good for issues such as separation anxiety, death of a pet, birth of a sibling, new school, etc.

Fantasy

Grant to children in fantasy what they cannot be granted in reality.

Helps child know that parent cares about the feelings.

Mutual Story Telling

therapist takes the theme of a therapy issues and creates a new story for the parents. The therapist asks that parent and child to go home and add to the story with new helpful solutions to the conflict of the story.

Family Meeting

Family establishes rules for family meeting such as when, where, how long, agenda items, and who will chair the meeting

Rotate chair Work towards consensus Give compliments and appreciations