|
We can not start to improve until we know who we
are.
Self-knowledge
is the
beginning
of
self-improvement.
Spanish Proverb
When patterns are broken, new
worlds
emerge.
Tuli
Kupferberg
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Clinical
Articles
East Bay CAMFT . .
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"Playing
With
Your
Clients:
Play
Therapy
Benefits
Children
& Families"
by
Deborah
P.
Rogers
MFT
Published in
"The
East
Bay
Therapist"
March/April
2004
A child acts out a story about a
small
infant
who
has
to
sleep
on
the
roof
of
a
pretend
house,
cold
with
no
blanket,
while
saying:
“The
baby
might
fall
off
during
the
night.”
Another
child
creates
an
angry
drawing
of
a
house
filling
with
red,
roaring
flames,
and
tells
a
story
about
how
the
kids
are
in
the
house,
dad
is
asleep
and
the
kids
are
going
to
catch
on
fire.
It
is
incredible
how
quickly
a
child
will
show
you
what
feelings
are
circulating
inside
of
them—
and
inside
of
their
family—through
the
language
of
play.
Like the canary in the coalmine,
kids
have
an
amazing
amount
of
knowledge
about
the
subtle,
and
not
so
subtle,
feelings
that
are
present
in
their
family,
and
they
are
often
able
to
reveal
these
things
more
easily
than
guarded
adults.
This
article
takes
a
look
at
the
way
in
which
play
therapy
with
a
child
can
shed
light
on
the
issues
of
their
adult
parent,
benefiting
the
child,
the
parent,
and
the
family
as
a
whole.
But
first
a
few
words
about
play
therapy
itself.
The Language of
Children
Children learn about the world through play and they
also
use
play
to
process
their
feelings
and
worries.
Most
children
would
rather
not
spend
too
much
time
trying
to
talk
about
their
feelings
in
a
cognitive
way,
but
they
are
quite
skilled
and
comfortable
with
playing
out
their
feelings.
The
therapist’s
goal
is
to
decode
the
language
of
a
child’s
play
in
order
to
discover
their
underlying
feelings
and
needs.
It’s
actually
rather
similar
to
looking
for
the
disguised
messages
that
are
found
in
the
symbolic
language
of
dreams.
At first glance, a play therapy
session
looks
rather
similar
to
the
regular
play
activities
that
you
might
see
a
child
doing
at
home:
making
drawings,
playing
games,
creating
songs,
playing
hide-and-seek,
dancing,
or
story
telling.
Depending
on
the
particular
therapist’s
office,
the
child
is
often
able
to
choose
from
a
variety
of
toys,
sandtray,
drawing
supplies,
clay,
musical
instruments,
games,
puppets,
pretend
house
and
miniature
figures.
Some
activities
allow
the
child
to
play
alone,
or
in
a
parallel
way
with
the
therapist,
and
others
invite
interactive
play
that
is
cooperative
or
competitive.
The biggest difference between regular play and play
therapy
is
the
therapist’s
objective
of
guiding
the
child
toward
processing
their
difficult
feelings,
correcting
mistaken
beliefs,
developing
healthier
outcomes
and
moving
toward
healing.
Generally
speaking,
the
play
is
child-directed.
The
child
chooses
what
activity
they
would
like
to
do.
The
therapist
paces
with
the
child
and
narrates
some
of
the
play,
putting
the
child’s
feelings
into
words,
inviting
the
child
to
elaborate
on
things
that
are
happening
in
the
play
and
to
correct
any
of
the
therapist’s
comments
that
aren’t
accurate.
When the play therapist listens carefully and makes
comments
that
resonate
accurately
with
the
child’s
feelings,
the
child
will
often
continue
with
an
elaboration
of
the
story
and
will
give
important
details
about
their
family
experiences.
Children
are
in
the
room
with
you
100%
and
they
very
much
want
you
to
be
in
the
room
with
them
at
this
same
100%
level.
When
children
feel
accurately
understood
in
a
play
therapy
session,
they
sometimes
let
out
a
sigh
of
relief
and
leave
the
playroom
skipping
and
smiling
as
if
they
feel
totally
free
and
happy.
What
a
powerful
healing
experience
to
share
with
them!
A Case Example – Benefits Beyond the
Child
In session, Marion, a
35-year-old
working
mother,
begins
to
rattle
off
a
long
list
of
frustrations,
with
desperation
in
her
voice.
Marion
originally
entered
therapy
to
work
on
the
conflicts
she
was
having
at
the
office,
but
now
the
focus
has
shifted
to
the
recent,
acting
out
behavior
of
Daniel,
her
five-year-old
son.
Could
Daniel
be
enacting
some
of
the
unspoken
tensions
that
are
happening
at
home?
In addition to continuing her ongoing with Marion,
Marion’s
therapist
refers
Daniel
to
a
play
therapist
for
a
few
sessions,
and
gets
permission
for
the
two
therapists
to
discuss
the
case.
This
intervention
helps
to
calm
things
down
at
home,
and
it
also
provides
an
important
new
perspective
on
Marion’s
own
relational
conflicts.
So what might play therapy look like with this
child?
Themes
in
the
play
quickly
start
to
appear.
Daniel
insists
on
acting
very
bossy
in
session,
tries
to
tell
the
therapist
what
to
do
and
says:
“No,
no…
you
aren’t
doing
it
right!”
The
miniature
figures
that
he
plays
with
are
never
allowed
to
make
a
mistake.
If
a
figure
does
make
a
mistake,
the
character
dies
a
gruesome
death;
figures
die
in
the
sand
tray,
they
die
in
puppet
play
and
they
die
as
checker
pieces
when
they
are
aggressively
jumped
and
knocked
off
the
board.
Anybody
that
tries
to
come
and
help
these
various
figures
or
game
pieces
fails
repeatedly
and
ends
up
feeling
hopeless
and
getting
crushed.
Daniel’s
toy
physically
attacks
the
helping
character
and
says,
“Go
away,
you
can’t
help
because
you
will
die
too.”
This
child
is
rarely
able
to
relax
and
play
in
a
creative
and
lighthearted
way
and
has
trouble
tolerating
more
revealing
activities
such
as
drawing
a
picture
of
his
family
or
his
day
at
school.
The play therapist begins looking for the deeper
source
of
these
painful,
hopeless
feelings.
What
important
people
or
events
in
this
child’s
life
are
causing
him
to
feel
that
there
are
no
solutions?
In
the
midst
of
playing
out
a
particularly
stressful
story,
the
therapist
briefly
breaks
out
of
character
and
asks,
“And
who
in
your
house
has
the
most
rules?
Daniel,
now
immersed
in
his
feelings,
indicates
his
mother
and
tells
about
the
time
when
he
felt
particularly
frustrated
and
mad.
After a few play sessions, the two therapists discuss
their
mutual
case.
The
child’s
therapist
shares
information
about
how
the
child
perceives
his
mother.
Based
on
the
child’s
play
and
his
comments
about
his
mother,
there
appear
to
be
some
pretty
rigid
rules,
constant
lessons
and
stressful
interactions
at
home.
Marion’s
therapist
suspects
that
her
adult
client
is
bringing
this
same
rigidity
into
the
workplace,
and
is
causing
the
very
stresses
she
complains
of
herself. She
brings
this
new
piece
of
the
puzzle
into
her
work
with
Marion,
making
connections
between
Marion’s
other
interpersonal
relationships
at
the
office
and
at
home:
What
is
her
average
level
of
stress,
how
rigidly
or
creatively
does
she
approach
problem-solving
interactions
with
others,
and
what
are
her
beliefs
and
rules
about
how
a
child
should
behave?
The Healing Process
After Daniel plays out his
stressful
feelings,
with
the
play
therapist
seeing
and
reflecting
those
feelings
clearly,
he
begins
feeling
better.
In
addition,
the
therapist
models
appropriate
responses
as
she
talks
“for”
the
game
pieces
and
other
figures.
Daniel
learns
that
it
is
OK
to
have
these
feelings
and
also
learns
appropriate
ways
to
express
these
feelings
to
others.
In
one
session
the
therapist
speaks
for
the
dinosaur:
“Every
time
I
try
to
go
eat
some
grass,
the
big
lion
comes
and
pushes
me
over
so
I
can’t
eat.
That
lion
is
scary
and
I
don’t
like
it
when
he
hurts
me.
Stop
hurting
me
lion!
I
need
to
go
get
some
help
so
I
can
eat.
I’m
really
hungry.”
Once
Daniel
begins
to
internalize
these
simple
ways
of
expressing
feelings,
he
begins
to
apply
them
at
home.
His
mother
comes
in
to
her
session
one
day
and
says,
“I
was
really
surprised
this
week
when
my
son
told
me
that
they
didn’t
like
it
when
I
yelled
at
them”.
Yes!
Another
big
step
toward
healthy
family
communication!
The play therapist invites Marion and
her
husband
to
come
in
for
a
session
by
themselves
so
they
can
talk
about
their
frustrations
in
dealing
with
the
acting
out
behavior
as
well
as
talking
about
the
strengths
they
see
in
their
son.
At
another
point,
she
invites
the
parents
to
join
Daniel
in
a
play
therapy
session
so
the
family
dynamics
can
be
seen
first
hand.
Are
they
able
to
connect
with
their
child
through
the
language
of
play?
Are
they
expecting
him
to
act
like
an
adult
complying
with
lots
of
rigid
rules?
Things improve further as the play
therapist
teaches
the
parents
specific
parenting
and
communication
skills.
Marion
begins
to
develop
insights
about
how
her
rigid
parenting
style
is
negatively
impacting
her
child.
Marion’s
own
therapist
supports
these
insights
and
helps
her
realize
how
the
same
behaviors
affect
her
workplace
interactions
and
relationships
with
others
in
the
family.
So
coordination
of
interventions
between
therapists
can
be
quite
helpful
to
the
parent,
the
child
and
the
whole
family.
Working with children is very
special,
with
so
many
profound,
healing,
unexpected,
challenging
and
funny
moments.
There
just
never
seems
to
be
a
dull
moment
when
you
have
the
privilege
of
playing
with
your
child
clients...
and
it
can
enrich
our
work
with
their
adult
family
members
as
well.
TOP
California
Association
for
Play
Therapy . . . . . . . . . . . . . . . .
.
.
.
.
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.
.
"Play Therapy in Australia &
Japan"
Insights & Inner Views from
the
work
of
Australian
play
therapist
and
researcher
Dr.
Karen
Stagnitti
Featuring Columnist,
Deborah Rogers
MFT
Published in "The CALAPT Newsletter"
Volume
13,
Number
3,
Jan
2003
Dr. Stagnitti is a very active Senior Lecturer
in
Education
and
Training
at
the
Greater
Green
Triangle
University,
Department
of
Rural Health
in
Warrnambool,
Australia.
In
case
you
aren’t
that
familiar
with
Australia,
Warrnambool
is
located
on
the
southern
coastline,
west
of
Melbourne.
She
is
also
quite
dedicated
to
continuing
her
research
on
the
importance
and
success
of
using
play
in
order
to
best
help
children .
Important research findings have been generated by
Dr.
Stagnitti
on
the
positive
impact
of
using
child-initiated
pretend
play.
These
finding
were recently
published
in
the
January/February
2004
issue
of
the
American
Journal
of
Occupational
Therapy.
"Test-Retest
Reliability
of
the
Child-Initiated
Pretend
Play
Assessment",
was
written
by
she
and
Dr.
Carolyn
Unsworth,
both
from
Australia.
Then
in
March
2004,
The
Australian
Occupational
Therapy
Journal,
volume
51,
issue
1,
page
3,
carried
another
of
Karen
Stagnitti’s
papers
on
"Understanding
Play:
The
Implications
for
Play
Assessment."
Karen: So far in my
career,
the
play
therapy
experiences
that
I
have
had
are
in
working
with
children
in
Australia
and
children
in
Japan.
Deborah:
It
seems
like
there
might
be
quite
a
few
differences
in
play
therapy
between
those
two
parts
of
the
world!
What
are
some
of
the
special things
that
you
have
noticed?
Karen:
From
what
I
have
observed
during
play
assessments
and
in
some
of
my
play
intervention
sessions,
I
found
it
interesting
that
the
Australian
children
showed
a
wide
range
of
play
themes,
while
the
Japanese
children
did
a
lot
of
domestic
activities
within
their
play. As
an
illustration
of
this
point,
I
noticed
that
the
Japanese
children
did
not
recognize
a
toy
wrench
that
I
have
as
part
of
my
play
materials.
They
were
much
more
familiar
with
the
domestic
elements
of
life.
Whereas
all
of
the
Australian
children
easily
knew
what
the
toy
wrench
was.
In
Australia,
people
tend
to
"do
it
yourself"
whereas
in
Japan,
only
certain
people
know
how
to
fix
things
because
that
is
their
actual
job.
Deborah: What are some
of
the
most
exciting
and
valuable
elements
of
sharing
play
therapy
ideas
and
theoretical
approaches
cross
culturally?
Karen:
I think it
is
fascinating
to
discover
the
aspects of play that
occur
across
the
board
in
every
culture. I also enjoy finding the
unique
differences in the
child’s
play that reflect the society that the child
is
from.
Deborah: How involved do
parents
in
Australia
become in their
child’s
therapeutic
work?
Are
there
differences
between
how
the
mother,
father and
extended
family
participate?
Karen:
I have
noticed
that
in
play
intervention
sessions,
the
siblings
often
joined
in
and
I
didn’t
discourage
this
as
I
think
it
is
important
that
they
feel
included.
As
far
as
parent
participation
goes,
there
was
a
wide
range
of
responses.
There
were
parents
who
were
deeply
involved
and
also
parents
who
really
didn’t
see
the
relevance
of
play
to
their
child
at
all.
In
my
experience,
it
seemed
that
mother’s
tended
to
be
more
aware
of
what
the
child
was
capable
of
than
the
fathers.
Deborah: How did you become
interested
in
becoming
a
play
therapist?
Karen:
My
involvement
has
been
from
a
love
of
play
and
an
interest
in
how
complex
both
play
and
play
therapy
are.
One
of
my
passions
has
been
to
develop
assessment
tools
for
play
therapy.
I
feel
that
the
concept
of
play
would
be
taken
more
seriously
if
it
could
be
assessed
more
effectively.
To
that
end
I
have
spent
the
last
few
years
developing
a
play
assessment
tool
called
"The
Child-Initiated
Pretend
Play
Assessment"
which
so
far,
is
showing
good
reliability
and
validity.
From
this
assessment,
I
have
also
developed
a
play
program
to
help
children
develop
their
ability
to
play.
We
have been
getting
some
nice
results
with
children
that
have
Autism
and
other
developmental
delays.
Deborah: What are some
of
the
ways
that
you
would
describe
your
philosophy
of
how
a
child
heals
through
the
use
of
play
therapy?
Karen:
I
believe
that
play
is
important
to
a
child’s
development
because
it
encompasses
emotional,
social,
cognitive
and
language
aspects
of
development.
Play
is
the
natural
medium
that
children
use
to
communicate
in
their
world.
And
play
is
also
an
important
measure
of
the
child’s
development.
Deborah: What do you
find
are
some
of
the
most
interesting
points
about
working
with
children?
Karen:
I
enjoy
the
fact
that
playing
with
children
is
unpredictable.
You
never
quite
know
what
is
going
to
happen
in
a
session.
It
is
also
very
exciting
when
children
start
to
gain
insights
regarding
their
lives
and/or
develop
new
skills.
Those
are
very
special
times.
Deborah: Throughout your
career,
you
must
have
had
many
powerful
moments
that
have
touched
you
deeply.
Karen:
Yes,
once
I
saw
a
child
during
an
Axline
session,
who
let
it
be
know
that
she
didn’t
like
her
nickname.
The
nickname
was
something
demeaning
like
Dumbo.
Her Mum had no
idea
that
this
was
a
problem
for
her
daughter.
After
the
family
stopped
using
this
negative
nickname,
the
child’s
self-esteem
improved
considerably
and
interactions
with
other
members
of
the
family
improved
as
well.
Another
powerful
moment
happened
with
a
boy
who
had
Autism.
It
was
wonderful
when
this
boy
finally
began
to
gain
skills
in
his
ability
to
play
and
was
actually
able
to
spend
an
entire
hour
in
true
cooperative
play
with
4
other
boys
in
the
sandpit
at
his
local
preschool.
This
was
a
major
turning
point
in
his
interactions
with
his
peers.
Deborah:
What
do
you
feel
are
some
of
the
important
things
that
play
therapists
should
understand?
Karen:
I
believe
that
it
is
quite
important
for
play
therapists
to
learn
how
to
measure
play
effectively
so
they
can
show
the
improvements
that
their
child
clients
make
to
other
professionals
that
are
involved
in
the
case.
Deborah: What do you see as some of
the
most
common
mistakes
that
play
therapists
make?
Karen:
This
one
is
difficult
to
answer.
Some
play
therapists
feel
that
what
they
do
isn’t
as
important
as
other
therapies.
I
believe
that
this
is
a
mistaken
belief.
Deborah: What are your
views
on
the
degree
of
directiveness
that
is
best
in
working
with
a
child?
Karen:
For
children
who
have
no
idea
how
to
play, I
am
quite
directive.
As
the
child
begins
to
direct
his/her
own
play,
I
become
more
nondirective.
In my work, most of the
children
that
I see
don’t
know
how
to
play
unless
they
are
shown.
Deborah: We often invite our clients
to
discover various ways to
revitalize
their
lives
so they can
grow
and
create
health
for
themselves.
What
are
some
of
the
things
that
rejuvenate
you?
Karen:
I
am
fortunate
enough
to
live
near
a
beach and I
find
walking
on
the
beach
very
rejuvenating.
I
also
garden
and
I
enjoy
going
out to cafes
for
coffee
with
friends…
I
like
that a
great
deal!
Deborah: We are always
looking
for
new
and
interesting ideas of
activities
to
do
with
our
clients.
What
have
you
found
to
be
some
of
the most
powerful
techniques
in
working
with
a
child
and
their
family?
Karen:
I
have
found
using
pretend
play
a
powerful
technique
to
use.
Deborah: What are some
techniques
for
inviting
hesitant
children
to
participate
in
therapy?
Karen: I
have
been
given
a
crab
puppet,
where the
crab
is
inside
the
shape
of
a
shell.
The
fingers
go
through
the
shell
section
to
fingergloves,
which
pop
out
of
the
shell.
The
"creature"
in
the
shell
can
be
shy,
just
like
the
child,
and
need
encouragement
to
play. Also, I
sometimes
have
found
that
leaving toys
out
and
starting
to
play
with
them myself
will
often
encourage
a
child
to
join in, since
there
is
no
pressure
on
the
child
to do
anything.
Deborah: Overall, what
would
you
say
is
the
significance of play in
regards
to
mental
health?
Karen:
Play
allows
a
child
to
express
who
they are
and
who
they
could
be.
Play
also
allows the
space
that
is
necessary
for
a
child
to
explore
their
ideas
and
to
enter
other
worlds.
Deborah: What are a few important
points that you would like to pass
along
to
other
play
therapists?
Karen:
I
would
very
much
like
for
other
play
therapists to
know
that
what
they
do
is
so
vital to
children’s
health
and
development.
So, keep on
playing!
Many thanks to you, Dr.
Stagnitti,
for
sharing
your time
and
insights
with
our
CALAPT
readers.
And
appreciation
also
goes
out
to
our CALAPT
past-president,
Jessica
Stone,
for
making
this
interview
possible.
TOP
Note:
The use of this web site or
email
link
does
not
in
any
way imply
a patient-therapist
relationship.
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If you do what you've always
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