play therapy presentation

8/4/2019 Play Therapy Presentation

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PLAY

- any voluntary activity engaged in for the purpose ofenjoyment.

- play activities vary greatly from child to child and

among different age, cultural, and socioeconomic groups.

THERAPY

- in the broadest sense, is a term that can be applied

to any form of treatment for any illness or disorder

PLAY THERAPY

- is a psychoanalytic technique used by psychiatrists

to help children understand their feelings and thoughts andmotivations better.

- in play therapy, the psychiatrist attempts to interpret

the childs verbal and nonverbal cues.


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Sigmund Freuds

Psychosexual Development


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Stage Age Characteristics

Oral Stage

Birth to 1

year

Freud termed the infant period the oral phase becauseinfants are so interested in oral stimulation or pleasure during

this time. If this need is not met, the child may develop an oralfixation later in life, examples of which include thumb-sucking,smoking, fingernail biting and overeating.

Anal Stage1 to 3

years

Childrens interest focus on the anal region as they begin toilet

training. Elimination takes on new importance for them.

Children find pleasure in both the retention of feces and

defecation. Too much pressure can result in an excessive needfor order or cleanliness later in life, while too little pressure

from parents can lead to messy or destructive behavior later in

life.

PhallicStage

3 to 6years

Childrens pleasure zone appears to shift from the anal to the

genital area. Masturbation is common during this phase.Children may also show exhibitionism, suggesting they hope

this will lead to increased knowledge of the two sexes.

Latent

Stage

6 to 11

years

A time in which childrens libido appears to be diverted into

concrete thinking.


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Stage Age Characteristics

Genital

Stage

11 to 18

years

The onset of puberty causes the libido to become active once

again. During this stage, people develop a strong interest in the

opposite sex. If development has been successful to this point,the individual will continue to develop into a well-balanced

person.


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ErikEriksons Psychosexual Tasks


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Stage BasicConflict

Important

Events OutcomeInfancy

(birth to 18

months)

Trust vs.Mistrust

Feeding

Children develop a sense of trust when

caregivers provide reliabilty, care, andaffection. A lack of this will lead to

mistrust.

Toddler

(2 to 3 years)

Autonomy vs.

Shame and

Doubt

Toilet

Training

Children need to develop a sense of

ersonal control over physical skills and

a sense of independence. Success leads toeelings of autonomy, failure results in

eelings of shame and doubt.

Preschool (3

to 5 years)

Initiative vs.

GuiltExploration

Children need to begin asserting control

and power over the environment.

Success in this stage leads to a sense of

urpose. Children who try to exert too

much power experience disapproval,

resulting in a sense of guilt.

School Age (6

to 11 years)

Industry vs.

Inferiority School

Children need to cope with new social

and academic demands. Success leads to

a sense of competence, while failureresults in feelin s f inferi rit .


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Stage BasicConflict

Important

Events Outcome

School Age (6to 11 years) Industry vs.Inferiority

School

Children need to cope with new social

and academic demands. Success leads toa sense of competence, while failure

results in feelings of inferiority.

Adolescence

(12 to 18years)

Identity vs.

Role Confusion

Social

Relationships

eens need to develop a sense of self and

ersonal identity. Success leads to an

ability to stay true to yourself, whileailure leads to role confusion and a weak

sense of self.

Young

Adulthood

(19 to 40years)

Intimacy vs.

Isolation

Relationships

oung adults need to form intimate,

oving relationships with other people.

Success leads to strong relationships,

hile failure results in loneliness and

solation.

Middle

Adulthood

(40 to 65

Generativity vs.

Stagnation

Work and

Parenthood

dults need to create or nurture things

hat will outlast them, often by having

children or creating a positive change

hat benefits other people. Success leadsfeelin s f usefulness and


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Jean Piagets Cognitive

Developmental Stages


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STAGE OF

DEVELOPMENTAGE SPAN NURSING COMPLICATIONS

Sensorimotor

Neonatal

Reflex

1 mo y Stimuli are assimilated into

beginning mental images.

y Behavior entirely reflexive.

Primary

circular

reaction

1-4 mo o Hand -mouth and ear-eye

coordination develop.

o Infant spends much time lookingobjects and separating self from

them.

Secondary

circular

reaction

4-8 mo y Infant learns to initiate, recognize,

and repeat pleasurable experiences

from environment.

y Memory traces are present


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Coordination of

secondary

reactions

8-12 mo o Recognizes shapes and sizes of

familiar objects

o Because of increased sense of

separateness, infant experiences

separation anxiety when primary

caregiver leaves.

Tertiary circular

reaction

12-18 mo y Child is able to experiment to discover new

properties of objects and events

y Capable of space perception and time

perception as well as permanence

Invention of new

means throughmental

combinations

18-24 mo o Transitional phase to the preoperational

thought periodo Uses memory and imitation to act

o Can solve basic problems, foresee maneuvers

that will succeed or fail

o Good toys for this period: those with several

uses, such as blocks, colored plastic rings


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Preoperational

Thought

2-7 yr y Can arrive at answers mentally instead

of through physical attempt

y Comprehends simple abstractions but

thinking is basically concrete and

literal

y Child is egocentric(unable to see the

viewpoint of another)

y Centering or focusing on a single

aspect of an object causes distortedreasoning

Concrete

Operational

Thought

7-12 yr o Concrete operations include systematic

reasoning

o Uses memory to learn broad concepts(fruit)

and subgroups of concepts(apples andoranges)

o Child is aware of reversibility , an opposite

operation or continuation of reasoning back

to a starting point(follows a route through a

maze and then reverses steps)


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Formal

Operational

Thought

12 yr y Can solve hypothetical problems with

scientific reasoning

y Understands causality and can deal

with the past, present and future

y Adult or mature thought

y Good activity for this period: talk

time to sort through attitudes and

opinions


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Types of Play Age Type of Play Description Example

Infant Observation Child watches particular

play intently, although

not actively engaged in

it.

Watching a mobile

Toddler Parallel Two children play side

by side but seldom

attempt to interact with

each other

Playing separately with

similar push toy

Preschooler Associative Children play together in

a similar activity; there

is little organization of

responsibilities

Engaging in typical backyard

play

School-age Cooperative Children play with an

organized structure or

compete for desired goal

or outcome

Playing organized games

with rules


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Toys Appropriate for

Specific Age group


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Age Toy/Game Toy/Game

Infancy 1-3 months:Mobiles

Parents face

Rattles

Stuffed animals4-6 months:

Squeez toys

Boxes or blocks

Play pensPlastic boats

Rattles

7-9 months:

Cloth texture toysRubber duckies

Blocks and boxes

Large colorful balls

10-12 months

Building blocksRings of assorted sizes that

fit on a center post

Stacking toys

Play peek-a-boo

Putting things in and out of

a containerPulling toys


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Age Toy/Game Age Toy/Game

Toddler

Trucks

Squeaky frogs

Waddling

ducks

Rocking horses

Pegs to poundBlocks to stack

Toy telephone

Large balls

Imitate

parents (drive acar)

Pre-school

School Age

Trycycle, big

wheels

Backyard play

Imaginative and

dramatic play

Electronic games

Books

CraftsBoard and card

games

Team sports

Complex puzzles


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Purpose of PlayTherapy:

To decrease those behavioral and emotionaldifficulties that interfere significantly with achild's normal functioning

To improved communication and understandingbetween the child and his parents.

To improved verbal expression, ability for self-observation, improved impulse control, moreadaptive ways of coping with anxiety andfrustration, and improved capacity to trust and to

relate to others.To treat problems that are interfering with the

child's normal development


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Axline Principles of PlayTherapy: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 thechild feels free to express his or her feelings completely.

Is alert to recognize the feelings the child is expressing and reflectsthese feelings back in such a manner that the child gains insightinto his/her behavior.

Maintains a deep respect for the childs ability to solve his/herproblems and gives the child the opportunity to do so. Theresponsibility to make choices and to institute change is thechilds.

Does not attempt to direct the childs actions or conversations inany manner. The child leads the way, the therapist follows.

Does not hurry the therapy along. It is a gradual process and mustbe recognized as such by the therapist.

Only establishes those limitations necessary to anchor the therapyto the world of reality and to make the child aware of his/herresponsibility in the relationship


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Principles involved in PlayTherapy: Microbiology

Toys should be washable to prevent spreading ofdisease.

Safety and Security

Be sure to screen all toys for safety. They should haveno sharp edges and no small parts that can be swallowed or

aspirated. As a rule, if a toy can fit through the center of atoilet tissue tube, it is too small for safe play.

Sociology

As children talk with playmates during play, theydevelop both language and social skills.

PsychologyPlay may be used to help assess childrens level of

knowledge and feelings about their condition so that moreindividualized nursing care can be planned.


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GuidelinesBe certain that the toys offered will not lead

children into danger.Allow the children to choose the articles with

which they want to play.

Provide the specific materials that are needed for

the child and orient it to them.Reflect only on what the child expresses (verbal

expression)

Do not criticize play.

Use therapeutic responses and positivereinforcements to child.

Supervise therapeutic play. For example, childrenwho are playing modeling clay may eat it.


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Nursing Responsibilities:Before:

Prepare all the necessary materials needed for the activities

Introduce yourself to the patient Inform the parents/guardian the purpose of the therapy

During:

Create a friendly relation to the patient

Establish a feeling of permission

Ask the parents/guardian about the background information of thepatient

Stay close to the patient

After:

Communicate to the parents on the understanding of the childspsychological needs.

Evaluate the outcome of the activity

Do after care


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The End. . .

play therapy presentation

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