Talk To Me About Play Therapy

[beaners]

A developmental pediatrician recommended play therapy for my daughter for anxiety.  I'm finding therapists with the Association for Play Therapy about an hour away, but most of them seem to work in specialized settings like the cancer ward at the children's hospital or in shelters for women and children.

 

Assuming we have trouble finding someone, will other counselors or therapists know about and be able to use some of the same techniques if we ask? Or is it the kind of thing that is worth driving two hours each way for each session? Or is it not much more effective than any other counseling that would help all of us address anxiety?

[scrapbookbuzz]

Following.  Maybe I can glean ideas for my older daughter. Even though she is almost 15yo, the Aspergers puts her on a social level of about 12 or 13.

[Tap]

DD6 was in OT from 2-4yo and BT from 2-3 and again 4-current.  Her therapists have always used play therapy with her.  Now that she is getting older, a little more purposeful dialog is happening along with it, but her sessions are still 2/3 to 3/4 play based.

 

ETA OT-occupational therapist  BT-behavior therapist.

[MomatHWTK]

Our therapist uses games, toys, etc. to engage and work with her clients.  I know that some play therapy is more intensive and intended to help with autism. But for anxiety I think you could start with someone more local and see how it goes. 

[albeto.]

I should think the same skills will apply. What they do is play. The therapist will start by creating a comfortable, enjoyable atmosphere; a place an anxious child can feel safe, secure, and not have to worry as much about being on guard. Don't be surprised that this may take some time and may look to you like they're "just playing." They're not, they're establishing a relationship, they're establishing security. Little by little, the therapist will be highlighting some things your child says or does, seemingly shooting the breeze. In reality, the therapist will be looking for signs of the root of anxiety, what kinds of fears is the child trying to avoid. The play, and talk that accompanies it, will explore this a bit as well as explore possible alternative solutions to avoidance. Giving the child a sense of empowerment over her problems ideally will not only help her feel better, it will give her a more effective skill for dealing with stress. Stress and anxiety are an inescapable reality, and not everyone has effective means to address it. Play therapy functions to slowly, safely, help a child incorporate these skills in her natural learning style - play. If you don't mind my asking, about how old is your child?

[SpecialClassical]

I should think the same skills will apply. What they do is play. The therapist will start by creating a comfortable, enjoyable atmosphere; a place an anxious child can feel safe, secure, and not have to worry as much about being on guard. Don't be surprised that this may take some time and may look to you like they're "just playing." They're not, they're establishing a relationship, they're establishing security. Little by little, the therapist will be highlighting some things your child says or does, seemingly shooting the breeze. In reality, the therapist will be looking for signs of the root of anxiety, what kinds of fears is the child trying to avoid. The play, and talk that accompanies it, will explore this a bit as well as explore possible alternative solutions to avoidance. Giving the child a sense of empowerment over her problems ideally will not only help her feel better, it will give her a more effective skill for dealing with stress. Stress and anxiety are an inescapable reality, and not everyone has effective means to address it. Play therapy functions to slowly, safely, help a child incorporate these skills in her natural learning style - play. If you don't mind my asking, about how old is your child?

Yes, this is the way it should go. My daughter's therapist rushed into the questions and exploration of possible problems. I hope you find a wonderful therapist nearby. Maybe try a pediatric therapist instead of one specifically trained in play therapy.

[bolt.]

Play therapy requires a play room -- if a pediatric therapist works in a play room, it's likely that there is some overlap and play therapy will be happening. If a therapist works in an office with a few toys, it's likely that the therapy there is part of a different dynamic/school of thought.

[texasmama]

I did play therapy for many years as a psychotherapist.  I was never a "certified play therapist".  I never took the time to get this extra certification.

 

In your situation, I would search for a therapist who specializes in kids.  It is helpful to get a recommendation from a known source - friends, neighbors, pediatrician, etc.  Many therapists have websites, and you can glean a lot about them and their style from the site.  You can ask to do a short phone interview with a potential therapists - some will want you to set up an appointment but some will do a short phone interview.  It can be difficult to find a good fit, just as it is for an adult seeking therapy.  It is important that you and your child feel comfortable with the therapist.

 

I would add more, but my kids are going wild, and I need to get myself together to go out to dinner.  lol

[beaners]

Thanks everyone.  She is 4.

[albeto.]

Thanks everyone.  She is 4.

 

Aw. I love 4.

 

:001_wub:

 

 

So her play may look very innocent, very unproductive to you until you really learn how it works. I've had therapists that let me sit in quietly, some that let me play, some that wanted one-on-one time alone with my son. People have their preferred way of working, but ultimately it's a matter of who you trust and what you're comfortable with. There is no "right" way, although there are wrong ways. (We went to one therapist who borrowed a colleague's office in the city once a week, didn't have any toys, so asked my 7 year old to tell him what's up. I looked at him like he was bonkers. Did he really expect my 7 year old, anxious child to flop down on the couch like Woody Allen and rattle off all the thoughts bouncing around his head?  :huh: ) 

 

So look around, get recommendations, find out who to avoid, check on-line referrals, Yelp comments, Angie's list, and things like that. Ask what they do, what will it look like, what do they hope to accomplish, things like that. At four, she may play my little ponies or with finger puppets or play in a sand box with umpteen figurines and toys to choose from. She may draw or play cards or read books. My son's therapist read physiology books with him (Asperger's ;)). It takes time, but I liken it to loosing weight - you can try and accomplish a lot rapidly, but you won't likely change behaviors. Or you can slowly but surely replace ineffective, unwanted habits with new, more effected, satisfying habits. It takes time, so be patient. And don't be afraid to ask any and every time you wonder something. The more you know, the more you can support your daughter. Oh, also, don't be discouraged if the first therapist doesn't work out. This is a really personal thing, so finding the right personality may take some time. 

 

 

Good luck.

[Rosie_0801]

Anxiety can also be a symptom of retained primitive reflexes, so that is something else to explore.

[Guest submarines]

Not specific to play therapy, but trust your gut, no matter how highly recommended the therapist might be. We tried two therapists with DD for anxiety. Play therapy when she was 6, and cognitive-behavioral when she was 9. Both therapists were so highly recommended. Both were absolutely inept.

 

The play therapist kept awkwardly insisting that DD would draw, while DD didn't like drawing at all at that time. Three sessions later, and it was just a waste of money.

 

The second therapist was skeptical about homeschooling and kept quizzing DD about her school work. Five useless sessions.

 

In retrospect I shouldn't have continued with them for more than 1 session. Trust your gut.

 

FWIW, I kept teaching her coping skills and she is a bit anxious now, but she doesn't have severe anxiety or anything that would require medication or therapy at 11.

[Alexigail]

My son is also 4 and was diagnosed with ASD and anxiety yesterday.  Thanks for posting this thread.   I'm all ears. 

 

 

 

 

Anxiety can also be a symptom of retained primitive reflexes, so that is something else to explore.

 

 

What does this mean?  

[Rosie_0801]

Retained primitive reflexes means all those baby reflexes that ought to have gone away and didn't. They relate to, or cause, long lists of problems including sensory issues, some Aspie traits, learning difficulties of various sorts, some ADHD traits, anxiety and all sorts of things. The list reads like a government conspiracy theory!

They are tested on a scale from 0-4. When my kid was diagnosed, he had a whole lot at 4. Now most of them are down to 1 or 2. He was diagnosed by a paediatric chiropractor, but I assume there must be other professionals able to test for these things. I've been working on my son's for a year now. They aren't a quick fix, that's for sure, but I really do notice the difference in my boy.

 

There are a few that are easy to test for.

 

The palmar reflex must be completely eroded before most of the others can be. My son is most resistant to working on this one, so while I can keep the others down to minimal most of the time, they will sometimes creep up again because I can't get it to go away. Try tickling your child's palms with a paintbrush or something. If you can get to 40 strokes without a more severe reaction than "that's annoying" and a scowl, that reflex is absent. If you can't get that far, you need to keep practicing until you can. My boy won't put up with paintbrush tickling, but will sometimes allow me to tickle his palm with my finger if we play that "Round and round the garden, like a teddy bear" kiddie game and sometimes he'll let me rub or kiss his palms.
 

The plantar reflex can be tested by pressing or tickling the ball of the feet. If the toes curl up, there's a retained reflex and lots of foot rubs will eventually erode it.

 

The spinal galant is tested by running a finger down each side of the spine. If the kid twists away or shrugs at all, the reflex is present. There should be no reaction more severe than "Mum, what are you doing?" :p Lots of back rubs will eventually erode this.

If a kid is chewing, it will be either the rooting reflex or the tongue thrust. I'm not sure how to test whether they are completely gone, but stroking from their cheeks down to their chin will eventually erode it.

 

I don't know how to test for the Moro reflex with kids bigger than babies (that's the one where they throw their arms out if you startle them) but if your kid hates spinning and being turned upside down, this is a possible reason. Eroding this requires curling up and stretching out movements, so that kiddie game of "Row, Row your boat" works on this.

There are many, many more of them, but these are a few to get you started while you seek out someone to test more thoroughly.