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    http://www.jstor.org

    Action Techniques for Therapy with Families with Young Children

    Author(s): Lawrence A. Wolfe and Judith A. Collins-Wolfe

    Source: Family Relations, Vol. 32, No. 1, (Jan., 1983), pp. 81-87

    Published by: National Council on Family Relations

    Stable URL: http://www.jstor.org/stable/583981

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    Action Techniques for TherapywithFamilies with Young Children

    Lawrence A. Wolfe and Judith A. Collins-Wolfe*Many therapists want to include family members of all ages in family therapy.

    However, they are at a loss to know how to keep young children in ongoing familytherapy. This paper presents some nonverbal activities in which all members of thefamily, including young children, can participate. It also suggests timing for the ac-tivities and ways of using them in the course of therapy.

    When doing therapy with families in whichthere are young children (3 to 11 years), it is im-portant to use approaches that will evoke inputfrom them. In cases where children are quitearticulate verbally, they can be involved intraditional verbal therapy. However, mostyoung children reveal themselves morethrough play. For this reason, activities thathave nonverbal as well as verbal componentsare essential for family therapy with young chil-dren. This paper describes activities and waysof processing the outcomes that are useful inspecific stages of family therapy.

    Before discussing specific activities, it is im-portant to mention the possible resistance ofadults to such activities. Often when a familyseeks therapy, the adults are feeling helpless,inadequate, and maybe even childish in dealingwith their problems. Sometimes autocraticparents expect children to be seen, not heard.The therapist must call on his/her authority totake charge of how therapy will be conducted.

    In a warm, caring, yet firm manner, the thera-pist says, Here in therapy, we do things in

    *LawrenceA.Wolfe is an Assistant Professor, UniversityofSanta Clara,Graduate Division Counseling Psychology andEducation, 226 BannanHall, Santa Clara,CA95053. Judith A.Collins-Wolfe, Marriage, Family, Child Therapist in privatepractice inSan Jose, California nd a part-time ecturer,Univer-sity of Santa Clara.

    Key Concepts: Family Therapy, modeling, nonverbaltheraputictechniques, childrenin therapy,theraputicchange.(Family Relations, 1983, 32, 81-87.)

    such a way that everyone can share becausewhat each person in your family thinks andfeels is important. If anyone feels silly, embar-rassed or nervous, notice if and when that feel-ing changes during our time together.Eliciting the Family System

    One of the first tasks for the therapist is toelicit the family's system of interaction, toassess what is functional and dysfunctional.The following four techniques require interac-tion and communication among the familymembers. The therapist gives directions whichinclude a reasonable time limit determined bythe size of the family, then steps back toobserve what happens. The directions are pur-posely vague so they will evoke the communi-cation skills, interactional patterns, rules andtone unique to a particular family.Activities to Elicit the System

    1. Doodle exercise. Give each member apiece of paper and felt pens. Ask each one tocreate a doodle. When each member has com-pleted a doodle, the family members are askedto share their drawings and then to select oneof the doodles as a base for a family doodle.(Rubin & Magnussen, 1974).

    2. Building blocks. Present the family with alarge box of building blocks. Ask them tocreate/make something using the blocks.

    3. Sand pictures. Present the family with awooden sandbox, 23 x 28 x 4 , andminiatures of all kinds. Ask them to make a pic-ture in the sand with the small toys. Kalff (1971)

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    originally developed this technique for usewith individuals.

    4. Clay. Give the family a large plastic dropcloth and a large chunk of terra cotta clay orplasticene. Ask them to create a world.Criteriato Assess the System

    How the family works on its project is thefocus of the therapist's observation rather thanwhat the family creates. While the therapist isobserving the family in action the followingcriteria can be used to make an assessment.

    1. Verbalcommunication skills.Each member:Speaks for self Speaks for othersIndicates mes- Ignores input from

    sages are heard from othersChecks out mes- Assumes or mindsages reads

    Specifies GeneralizesExpresses Withholds thoughts

    thoughts and and feelingsfeelings

    Sends congruent Sends incongruentmessages messages

    2. Emotional tone of communicationEngaging WithdrawingSpontaneous ControlledFriendly Remote, hostileExpressive Depressed, sup-

    pressed, repressedReasonable IrrationalControlled ExplosiveGenuine PretendingSupportive Discounting

    3. Non-verbalcommunicationEye contact Avoidance of eye con-

    staring tactdartingflirtingconnecting

    Touching Non-touchingclingingaggressiveseductivedistractivesupportive

    Physical close- Physical distanceness

    4. Interactional patterns.Who speaks for whom?Who leads whom, who follows whom?

    Who allies with whom, against whom?Who seeks approval or disapproval from

    whom?Who rescues whom, from what or whom?Who attacks whom?

    5. Family rules.Who can disagree with whom? agree with

    whom?Who protects whom?Who participates? Who withdraws?Who can express what feelings? How?Who can be independent? dependent?Who can be different or separate?How do they decide?What is most important-following direc-

    tions or enjoying the activity?Questions to Process the Activity

    When the activity is completed or the allot-ted time for the activity is over, the therapistcan facilitate sharing the experience by askingquestions about leadership and participation.

    Who was the leader (boss)?Who picked him/her?Why did you (the leader) take the job?What do you like about being the leader/what

    don't you like?What do you like about being a follower/what don't you like?What did you do in the activity that you

    liked?What did you do that you didn't like?What would have happened if you didn't do

    it?What did someone else do that you liked/

    that you didn't like?If you had your way, how would have the ac-

    tivity have gone?The therapist can use this interaction to furtherassess what does and doesn't work for thefamily.

    In addition to being an assessment device,these activities and the questions about thefamily process encourage communication.Families who have particular difficulty in shar-ing their thoughts and feelings will begin tofeel hopeful, even if scared or threatened, to befinally talking to each other.Feedback to the FamilyAt the end of each session or series ofassessment sessions, the therapist can use

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    the information gathered from observing theactivities and the sharing following them togive feedback to the family. This diagnosiscan pinpoint problem areas and pave the wayfor strategic changes. For example, thetherapist can say, I noticed as you werebuilding your world with clay, there was noleader. Everyone worked alone. You didn't talkabout what your plan was. So your clay worldlooks like separate towns with no roadsleading in or out of them. When you talkedabout how you would like to have done the ac-tivity, you children said you wanted help toknow what to do; John, you said you wantedthe four of you to make one world; and Mary,you said you wanted to play with the clay morelike you remember doing in school. It seemsthat what your family wants is leadership, away to talk about what you want from and witheach other, and to have some fun together.Maybe you can begin by planning how to usethe clay to connect those towns.Communicating Feelings

    After assessing the family system in the firstfew sessions, one of the more common goalsis to have family members express how theyfeel in their family. The following activitiesallow young children and adults to share theirfeelings about their family:Activities to Promote Awareness of Feelings

    1. Kinetic family drawing (Burns & Kaufman,1970). Give each family member a piece ofpaper and a pencil. Then ask him/her to drawhis/her family doing something. You mayselect a category to be used for the drawing,e.g., Draw your family as animals or astransportation vehicles or plants.2. Toy miniature projections. Present thefamily with toy miniatures of all categories.Ask them to select one miniature for eachmember of the family and then to arrange theminiatures on the floor or on a piece of paper ina way that expresses how their family relatesto each other. For example, all figures touch,forming a circle, or all figures are scattered indifferent directions.

    3. Construction paper family (Rubin andMagnusson, 1974). Supply the family with awide variety of colors of construction paper,scissors and glue. Ask them to pick a color and

    cut or tear a shape for each member of thefamily. Then on a separate sheet of paper askeach person to arrange their constructionpaper family in a way that expresses how theirfamily relates to each other.

    4. Magazine family. Supply the family withlots of magazines, paper, scissors and glue.Ask them to cut out one or more pictures thatremind them of each member of the family,e.g., a box of Kleenex for mother who is seenas soft. When they have pictures for eachmember, ask them to arrange the pictures inrelation to each other to express how the fami-ly relates.

    5. Sculpting (Simon, 1972). Explain to thefamily that each member will become a sculp-tor, using the family members to shape a livesculpture that will express how that personviews the family. All the other members are tobe like clay in the hand of the sculptor, takingthe exact position and posture and making thegesture the sculptor wants. The therapist tem-porarily stands in for the sculptor until thesculpture is set. Then the sculptor takes thetherapist's place.Interventions to Facilitate Sharing of Feelings

    1. Modeling. It's important that the therapiststructure the kind of verbal interchange follow-ing the activities that will encourage com-munication. The therapist models responses ina descriptive rather than interpretive orevaluative way. For example, comments onshapes, distance and size are made, e.g.,

    Mary, I notice you see yourself as a small redsquare between your big green circle fatherand your big orange triangle mother. How doesit feel to be between those big shapes? Thetherapist may also ask Mary's parents whatthey've learned about how Mary sees their rela-tionship and how they feel about it. If Mary'smother questions the accuracy of Mary's per-ception of herself, the therapist can ask themother to share her project with its view oftheir relationship with Mary. Or the therapistcan ask the mother to share with her familywhere she stood in relation to her parentswhen she was Mary's age. In this way, thetherapist deals subtly with the distinction be-tween facts, whose accuracy can be verified,and feelings, which originate from internal ex-periences.

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    2. Questioning. For families unskilled insharing feelings, the therapist may help by ask-ing leading questions about the activity.

    What family member was easiest/hardest todo?

    Who's at the center of your project?Who can see each other and who is touching

    in your project?With whom do you want to share your pro-

    ject?With whom don't you want to share your pro-

    ject?3. Challenging enmeshed or distant families.

    If the therapist is working with a family with anenmeshed parent-child subsystem (Minuchin,1974), each member of the family can be askedto do the Kinetic Family Drawing, the Con-struction Paper Family or the Magazine Familyin separate rooms. The therapist will also doone of these activities. The therapist's projectwill visually demonstrate some form of separa-tion or differentness in the family. For exam-ple, all the children are drawn playing a gamewith the father but the mother is not drawn inthe picture. Or all the family members but oneare represented as gentle, domestic animals.The one who is not gentle is represented as awild animal. The therapist collects the proj-ects, keeping them anonymous. When the fam-ily has reassembled, the therapist presentsone project at a time for the family to commenton, not knowing whose project is being shared.

    The experience of doing the projects sep-arately without the possibility of checking outeach other's work will be threatening to anenmeshed family. When the therapist's projectis presented, there will usually be a high levelof defensiveness, much denying and blaming.The therapist can use the family members' re-actions to explore their fears of separating andindividuating. What does it mean to each ofthem that one of their members may see thingsdifferently from the others? Since they are allupset right now at this project, what happensat home if someone wants to do things dif-ferently?

    The same technique can be used with disen-gaged families (Minuchin, 1974). With thesefamilies, the therapist's project would revealsome element of closeness. For example, allthe family members would be different shapesof the same color paper, arranged so they were

    almost touching. The therapist has to beprepared to deal with the anxiety evoked bythis amount of contact.

    What does it mean to this family that one ofits members may want to be closer than theothers? What would happen if each personcame closer?Setting Goals

    Activities that facilitate the sharing of feel-ings can also be used to help set goals. For ex-ample, the therapist can request the family todo one of the projects to reveal how they hopethe family will be. When a comparison projectis completed, the therapist asks questions toclarify short-term and long-term goals. If achild currently fights with his siblings butwould like to'be able to play with them, thetherapist asks what is happening in the firstproject that makes it possible to fight. Maybethe mother is present, acting as a referee. Whatis happening in the hopeful project that makesit possible for the child and siblings to getalong? The child may notice that mother andfather are doing something together in a dif-ferent room. The long-term goal for this childmay be enhancing the ability to play with sib-lings. Some of the short-term goals would be:learning to interact without mother's interven-tion; learning what starts or encourages fight-ing (not taking turns, hogging the show); and/orlearning how to negotiate with peers. As thischild is exploring the goals as expressed viathe project, the parents are learning how theycontribute to the problem when they don'tmake time to do things together, apart from thechildren. However, the child may also learnfrom the parents' project that they are afraid tobe close. And, the child will see that the needfor mother's refereeing has saved the parentsfrom doing what they are afraid of.Structuring Change

    Structuring change in how the family in-teracts is often another goal in therapy. Thetherapist chooses activities with the family'sgoal in mind.To Establish Generational Boundaries

    The therapist may want to establish cleargenerational boundaries in a family where theparents do not take responsibility for the chil-

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    dren. The therapist may ask the parents to doone task and the children to do another. For ex-ample, the parents may be asked to think of asong or a game from their childhood whichtogether they will teach their children. Thistask requires the parents to perform an activityessential to effective parenting, i.e., teaching.The children will be asked to make a collage ofthe parents using magazine pictures. This as-signment focuses the children's attention ontheir parents as a unit separate from them.

    As the therapist observes the process of theparents, intervention to teach them ways ofworking together more effectively or ways todeal with their fear of taking responsibility maybe undertaken. The children will be witnessingthe separation of their parents from them andalso the cohesion of their parents as a unit. Thetherapist will work with the parents as a teamuntil they together have the skills necessary toteach the song or game confidently to theirchildren. Meanwhile, the children will be ex-periencing a new way of relating without theirparent's involvement. Ideally, a co-therapistwill work with the children, helping them workcooperatively, deal with competition, jealousy,and other feelings evoked by being separatedfrom their parents. If there is no co-therapist,the therapist works alternately with the parentdyad and the children. When the children sharetheir collage with the parents, each of thechildren will be encouraged to speak for theirposition. The parents will experience how andwhat their children can do without their in-volvement. And the parents will receive feed-back about their children's perception of themindividually and their relationship.

    Many sessions of this nature-each sub-group doing separate activities-may be nec-essary to establish clear generational boun-daries. Activities should be chosen that:1) separate each group; and, 2) relate to the in-herent task of each group. For example, par-ents can be asked to do activities that requirethem to learn to make decisions, to lead, toteach, to encourage, etc. Some activities forthe parental subgroup are: planning an outingfor themselves; teaching each other somethingthat the other doesn't know-a magic trick, asentence in a foreign language, a danceroutine; moving to music while alternatingleading and following. Children can be asked to

    do activities that require them to learn to followdirections, to participate with social skills, toplay for fun. Some activities for the children'ssubgroups are: playing board games that re-quire taking turns; playing physical activitygames that require alternating taking and fol-lowing the lead; setting up a group projectwhere each child is requested to do an in-dividual task which is essential to complete thegroup project.To Establish New Coalitions

    In a family in which the father has beenperipherally involved with the children and themother has been negatively overly involvedwith a son, the therapist may want to establishnew coalitions. A mother-daughter team cancompete with a father-son team to completepuzzles or solve riddles or play table tennis. Orthe family may be asked to put on a puppetplay; the father-son dyad may be the helpers,such as firemen or policemen; the mother-daughter dyad may need their help to be savedfrom a fire or a robbery. To encourage thesenew relationships, homework assignmentsmay be given which require these new coali-tions to continue. Father and son will be askedto wash one family car, while mother anddaughter wash the other to see which team isfaster. Competition is used here to strengthenthe new relationships.To Establish Separation in Enmeshed Families

    In extremely enmeshed families whereeveryone does everything together, the thera-pist may structure serial dyad activity to en-courage separate activities. The family will bedivided into dyads. One person from each dyadwill lie down on a large piece of paper on thefloor. The other person will draw the outline ofthe partner using a felt pen. When the first per-son's body is outlined, the partners reverseroles. Now each person takes the outline of thebody to a new partner. This new partner ex-changes drawings. Each person, using feltpens or crayons, draws and colors in the faceof the partner. When the faces are completed,everyone rotates to a new partner who addsears, hair and shoes. This shifting continuesuntil the drawing is completed. To encouragethis kind of dyad interaction each person willbe asked to do something with each family

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    member are not good candidates for this ap-proach. Families in crisis condition (suicide,homicide, drug overdose) may first need tohave their current emergency tended to beforethis approach can be tried.Therapists who arevery rigid themselves and are unable to dealwith the anxiety elicited by play and metaphormay sabotage this method.

    At times this approach works when a thera-pist least expects it. The following case exam-ple typified the method's unexpected useful-ness. The Davis Familyhad been in therapy for8 months. The family was comprised of adaughter, age 14 and two parents. Usually, thefamily worked unsuccessfully to detriangulatethemselves using a verbal approach. One day,the therapist, ratherthan throw up her hands inresignation decided to try one last technique.She took the family into a play room where shegave them a big box of blocks and told them tomake something. They argued over who woulddo what. Finally,the father and daughter madeone structure while the mother made another.Everybody felt angry and irritatedwith every-one else. Then the therapist asked them to useall the blocks again to make something in oneminute. Somehow this short time limit sparkeda spirit of competition in all three. They forgottheir triangulating behaviorand gleefully threwall the blocks together to form a structure andbeat the clock. It had been months since thetherapist and the family had felt hopeful of

    breaking the deadlock. A clue to unlocking thesolid enmeshing coalition of two against onewas competition against an outside force, inthis case time. These three people operated asone for a brief period and felt happy. Now thetherapist and family had to translate this playexperience to reality.To summarize, activities generate the pro-cess a family uses to function together. It isthis process that is the focus of family therapy.However, to include all members of a family intherapy, it is helpful to be skilled in using ver-bal approaches as well as nonverbal ones infamilies with young children. The activitiesmentioned in this article, their use in differentstages of therapy and some methods of usingtheir outcomes are meant to generate manycreative new ideas for the family therapist.

    REFERENCESBurns, R., and Kaufman, S. Kinetic family drawings. New York:

    Brunner/Mazel, 1970.Kalff, D. Sandplay. San Francisco: The Browser Press, 1971.Minuchin, S. Families and family therapy. Cambridge: Harvard

    University Press, 1974.Rubin, J., & Magnusson, M. A family art evaluation. Family Pro-

    cess, 1974, 13, 185-200.Simon, R. Sculpting and family. Family Process, 1972, 11,

    49-59.

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