What's in a play therapy session?

No, I am not just playing Legos for fun with your child (although, I must admit, Legos are pretty cool). There's actually a lot that goes into a play therapy session. Children don't have the same language and communication skills as grown-ups. Play is the language of children. When treating kids, we have to use their language!

Here's a brief overview of what happens behind the scenes in a play therapy session:

1. Observation. I'm constantly observing how a child interacts with me, the toys, the office, and their parents. You can learn a lot by noticing if a child walks right in, dumps toys on the floor, and starts playing or if they are shy, careful, or seek permission. I look for themes and repetition. A single story highlighting a power struggle may not be significant, but if it happens over and over again, it's probably important. Another aspect of observation is assessing development and considering if this child is on par with most other children in their age range. I also look for strengths that parents with burn-out may not be able to see anymore and try to use them to the child's advantage.

2. Sandtray and metaphors. Sandtray helps children externalize. There's a big difference between directly asking a child "What's going on in your world? How are you feeling?" and allowing them the freedom of demonstrating their world through symbols or metaphor in a play setting. The sandtray provides a contained and external space in which to place internal experiences, struggles, and problem-solve. Some children also enjoy the sensory experience of sand and find it to be calming. You can read more about sand tray here. At times, I may go "beyond the box" and use sand tray theory in more active ways like using drama or movement.

3. Structured games and activities. I sometimes use card games designed especially for children with anger. I also have games that target emotion identification and expression (things like modified Jenga, CandyLand and Bingo). Another example is using bubbles as a way to teach deep breathing for relaxation.

4. Social skills. Games help with social skills like taking turns, but one of the most powerful therapy tools is using the therapeutic relationship to provide interpersonal feedback. Once I have rapport with a child, they can grow by hearing my experience of what it is like to play with them. It can be as simple as "I feel left out when you don't say Hi to me on your way in. Can we practice that?".

...and I didn't even get into art, storytelling, and drama! (maybe next time)

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