I am currently working on a certification in Play Therapy. I have attended a Sandplay workshop before and now I am studying all the research and different theories on Play Therapy at Capella University online. I will write a series of blog posts on different types of Play Therapy. Anna Freud, Sigmund Freud’s daughter, was the first therapist to claim that toys and play could be used with children in psychotherapy. The clinic she founded is still serving children in London today.
I have studied and mostly used Child Centered Play Therapy, the theory developed by Virginia Axline from Carl Rogers work and later developed by Gary Landreth. Through this program I have begun to have a great respect for many other theories and techniques and to use them in therapy. I really like Adlerian Play Therapy, Jungian Play Therapy, and Filial Play Therapy with parents and kids. Today I will share some of what I wrote about Experiential Play Therapy. Some of the posts on this site are ‘Readers Digest’ and others are more academic.
Experiential Play Therapy focuses on allowing the child to express his or her feelings through the symbolism of play. Building trust with the child, validating, expressing respect and supporting their expression of feeling is the important role of the therapist in this theory. The child first will use fantasy and metaphors, which they communicate with as early as age 2, and as trust and confidence grows the child will begin to recreate unresolved difficult situations more closely resembling reality (Shaeffer, 2011, p.187). EPT also involves the parent or parents if possible. The parents can even act in the role of the therapist with a bug in their ear and while the therapist watches and prompts them through a double-sided mirror ( Shaeffer, 2011, 194-196).
There are five distinct phases of therapy in this model: exploratory, testing for protection, dependency, therapeutic growth, and termination. In the exploratory phase the child is just learning what toys are in the playroom and their uses, as well as that the therapist is there as a support and not to make them uncomfortable. The therapist in this phase focuses on reflecting behavior and not so much feelings yet so that the child is not intimidated by focus on vulnerable emotions (Shaeffer, 2011, 188-189). In the testing for protection stage the therapist must convey that he or she will allow the child to freely express their emotions and validate them by acting them out and reflecting them for the child rather than not allowing these expressions or ignoring them. The therapist must set limits while also validating the child’s feelings and needs. Once the child surrenders to the direction of the therapist in setting limits the child will begin to trust and confront their upsetting emotions. This may lead to regressions at home in their behavior (Shaeffer, 2011, p, 189-190). During the next stage, dependency, the child begins to act out the traumatic experience as the aggressor and the therapist must effectively express the meaning of what the child went through in their experience of trauma. Then the child will switch roles and act out their own experience and the therapist must allow the child to overcome the aggressor as the therapist acts out that role (Shaeffer, 2011, p. 190-191). In the last stage, the therapeutic growth stage, the child grieves the loss of their trauma persona and begins exploratory play again to gain a sense of mastery. The child may regress to earlier stages of development which they missed out on because of the trauma and pretend to be a baby asking for nurturing, for example. In the termination phase the therapist must introduce the idea early in the session and allow a few sessions for the child to process the significance of the therapy and gain a sense of closure. The therapist must allow the child to express the importance of the relationship with the therapist and play and reciprocate that to the child (Shaeffer, 2011, p. 192).
EPT also harnesses the power of play for therapeutic purposes. In short, a picture is worth a thousand words and a therapist may enter that picture in ways that are not possible for an expression of an idea such as “I was so scared when this happened (Shaeffer, 2011, 193-194).” Metaphors and symbolism of toys or pictures also allow the child to express ideas with more emotional control over the level of arousal associated with traumatic memories (Shaeffer, 2011, p. 193). This is a good point about play therapy in general that emphasizes the importance of its use with adults as well as children.
EPT is best for children who have disorders that are related to some experience that was traumatic. Some of these include ODD, PTSD, SAD, AD, OCD, and elimination disorders (Shaeffer, 2011, p. 196). ADHD may sometimes be a misdiagnosis for these disorders as traumatic experiences can affect attention and focus.
EPT is a newer concept in play therapy but there is evidence to support its effectiveness. There are studies of relationship therapies that are experiential models and they have evidence of positive outcomes (Ray & Bratton, 2010, C. Norton & Norton, 2002). Another study which was very important in overcoming my skepticism and concerns, especially considering any court involvement, proved that the metaphors and symbols children use in their play are consistent with the actual events of trauma even at an early age of 2 years, for example (Paley & Alpert, 2003). Of course any disclosure of a child’s therapy and notes is used with discretion or by Judge’s subpoena. Decisions based upon the child’s play are considered in light of the whole case as well as the research and discretion given the ‘private’ and even ‘secret’ nature of therapy. There is also research on how the brain’s memories and processes are activated therapeutically through EPT (Shaeffer, 2011, p. 197-198).
Ray, D. & Bratton, S. (2010).What the research shows about play therapy: Twenty-first century update.
In Braggerly, D.. Ray, & S. Bratton (Eds.), Child-centered play therapy research. Hoboken, NJ: Wiley.
Norton, C., & Norton, B. (2002). Reaching children through play therapy: an experiential approach (2nd ed.) Denver, CO: White Apple Press.
Paley, J., & Alpert, J. (2003). Memory of infant trauma. Psychoanalytic Psychology, (20)2, 329-347.
Schaeffer, Charles E. (2011). Foundations of Play Therapy. 2nd Ed. Wiley and Sons
Rachel Hofer, MS