When is play therapy advisable?

Play therapy is recommended for children between the ages of 3 and 11 who present a variety of emotionally-based issues. This includes problems relating to peers, problems with appropriate expression of childhood depression, anxiety, adjustment reactions to specific life events, school difficulties that have an emotional component, deficits in self-esteem, persistent withdrawal, more severe character pathology, attention deficits disorders, developmental disorders and age-inappropriate behaviors. When a child experiences any of these difficulties, and symptoms are recurrent or continual, treatment may be indicated.
The following factors are considered when determining whether or not treatment is indicated:

  • how long the problem has persisted
  • if the problem is interfering with family life
  • if the child is experiencing significant internal distress, even though there may be no overt symptoms
  • if past attempts to help to the child overcome the problem have failed
  • if the problem is disruptive to the child’s daily functioning
  • if the problem is interfering with academic performance
  • if the problem is interfering with normal maturation
  • if the problem is unusual for the child’s developmental stage
  • if the problem is actually embedded in a pattern of symptoms

Play therapy can be successfully conducted with mildly retarded children or exceptionally bright ones; but in every case, the child must have sufficient intellectual capacity to form a relationship with a helping adult. The child must also have the capability of self-reflection. In other words, he or she must be able to observe his or her own behaviors, thoughts and feelings, rather than simply being told about them. This is important because the first step in psychoanalytic therapy is the observation of one’s own internal and external self, so that one can begin to understand the origins of problems and conflicts.

The therapist identifies whether the child’s problem stems from internalized conflict or is stimulated by the environment. Specific environmental event(s), for example, can affect a child’s development and can contribute to a collection of symptoms and behaviors. Or a child may respond to a source of stress with an internal and accepted belief, which encourages a collection of misbehaviors, emotions and thoughts.

For example, a 5-year-old girl becomes distressed by the birth of a sibling. She has not learned to tolerate her angry feelings and thus becomes flustered. She begins to wet her bed nightly, even though she is ashamed. The bed-wetting thus represents a maladjusted symptom.

Psychoanalytic play therapy teaches her (in simple, child-appropriate terms) about the expression of aggression. It helps her cope and understand that her bed wetting is a compromise between direct expression of her sibling rivalry, guilt about her aggression and fear that she will disappoint her parents and lose their love if she should express her anger toward her sibling.

This example shows the obvious importance of working with the parents as well as the child.

If you have any questions about the mechanics of Play Therapy, the specifics of an issue that might be affecting you and your family, or anything related, please feel free to call me.