Many therapists that work with children, and sometimes adolescents, use play therapy or play therapy techniques in their practice. To those outside of the mental health community the thought of playing games with a child as part of therapy may seem simplistic or of little therapeutic value. Public perception of therapy is narrow: a person meets with the therapist, talking ensues, and the issue is eventually resolved. This is simply not reality, especially when working with children. To work effectively with someone a therapist must meet a client where they are at and speak their language. For children their language is play.
Children, particularly younger children, do not have the ability to verbalize their feelings. This can cause children mounting frustration, which can lead to acting out and tantrums. Children are able to use the medium of play to express their thoughts and feelings in a way that they are not able to do verbally. For example a three year old girl is playing a set of family dolls. The child places a mom doll in bed, a little girl doll in their room, and a dad doll outside the house. The therapist can ask exploratory questions to gather further information. After further exploration (more play and clarifying questions) the therapist is able to determine that the little girl is illustrating a typical day where her mother isolates and sleeps all day (possible depressive symptoms), the little girl is left alone and the father leaves for work. The girl does not have the ability to verbally explain that situation in its totality. However, through play and further exploration the child is able to communicate the family situation.
Play also allows the therapist and child to build rapport. Rapport is one of the most important aspects of any therapeutic relationship. During the rapport building stage I have the child choose any activities they wish. Allowing the child to pick the activity and following through with that choice allows trust to begin to be built. The activity that the child chooses is not as important as the child being allowed the autonomy to do so, and the therapist following through on what they said. This is very significant to a child, because in their world adults create the rules, adults decide when and where the child goes. The child’s choices are limited. In addition to allowing choice, the very act of playing with the child in session is a great way to align with the child and begin establishing rapport. Children respond well to a therapist who is willing to sit on the floor and play legos or build a small town out of figures. Society as a whole often watches a children play, whether or alone or with others but its not as common for an adult to play with children. By using play as a component of therapy, therapists are able to start building a rapport with children.
Play can also be used to teach skills. A child who has a difficult time losing or taking turns can be taught coping skills in real time when playing a board game such as Candyland or Chutes and Ladders as there are often moments of frustration. For example a child playing chutes and ladders lands on a chute that sends them back to the beginning of the board. The child becomes upset that they are not winning and throws the board game across the room. This is an opportunity for the therapist to explore the child feelings, assist the child in naming the emotion, recognize the physical sensations of that emotion, and develop coping skills that could be utilized in the future. The therapist does not correct or admonish the child but rather utilizes the opportunity to further the child’s treatment. This is just one such example. Play can present many therapeutic skill building opportunities.
Play is much more than a simple act that children engage in; it is their language. By understanding and utilizing children’s language therapists are able to better engage children in treatment.
