Partners in Play

An Adlerian Approach to Play Therapy

Terry Kottman, Kristin Meany-Walen

• Publisher: American Counseling Association
• Year: 2016
• ISBN:
  9781119268994
• Edition: 3
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Play therapy expert Terry Kottman and her colleague Kristin Meany-Walen provide a comprehensive update to this spirited and fun text on integrating Adlerian techniques into play therapy. Clinicians, school counselors, and students will find this to be the definitive guide for using Adlerian strategies with children to foster positive growth and effective communication with their parents and teachers.

After an introduction to the basics of the approach and the concepts of Individual Psychology, the stages of Adlerian play therapy are outlined through step-by-step instructions, detailed treatment plans, an ongoing case study, and numerous vignettes. In addition to presenting up-to-date information on trends in play therapy, this latest edition emphasizes the current climate of evidence-based treatment and includes a new chapter on conducting research in play therapy. Appendixes contain useful worksheets, checklists, and resources that can be easily integrated into practice. Additional resources related to this book can be found in the ACA Online Bookstore at www.counseling.org/publications/bookstore and supplementary material Here

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Chapter 1
So, What Is Play Therapy and Why Should We Care?

We are so glad you asked. Officially, according to the Association for Play Therapy (2014), play therapy is “the systematic use of a theoretical model to establish the interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development” (para. 1). Formally, play therapy is an approach to communicating therapeutically with clients using toys, art materials, games, sand trays, and other play media, giving clients a safe and nurturing relationship in which they can explore and express feelings, gain insight into their own motivation and into their interaction with others, and learn and practice socially appropriate behaviors (Henderson & Thompson, 2011; Homeyer & Sweeney, 2011; Kottman, 2011; Landreth, 2012; Ray, 2011; Schaefer, 2011). Informally, play therapy is counseling clients (usually kids, but not always) with toys, stories, and art. VanFleet, Sywulak, and Sniscak (2010) said it most succinctly: “In play therapy, whatever form it takes, play is the therapy” (p. 12). The counseling in play therapy uses the natural language of children—play—as the basis for the therapeutic interaction. In the play, much of what the child does and says takes the form of symbolic, metaphoric communication about the relationships and situations in the child's world.

A play therapist is not looking for children to be able to discuss cognitively the meaning or content of their play, but recognizes that the subconscious issues of children float to the surface through play. Also, as the subconscious material arises, children utilize play and the environment created by the play therapist to “work through” issues that they need to address to regain emotional and social health. (VanFleet et al., 2010, p. 12)

Depending on the approach to play therapy, counselors can use many different ways to communicate with the client: free play, directed play, games, art techniques, metaphoric storytelling, bibliotherapy, drama therapy strategies, adventure therapy techniques, sand tray activities, prop-based play interventions, movement and dance, music, or any other creative process therapeutically. In writing this, we realized that if we described all of these strategies in detail, this book could get to be thousands of pages long and prohibitively expensive, so we needed to figure out how to give you access to the information without clogging up the first paragraph of our book with reference after reference. So we have created an appendix (see Appendix A) that lists references and resources for these processes. In Adlerian play therapy, we use all of these modalities in our work with children and their families (and sometimes their teachers too).

Rationale for Play Therapy

What makes play therapy therapeutic? Schaefer and Drewes (2013) listed the “therapeutic powers of play” as facilitating communication (self-expression, access to the unconscious, direct teaching, and indirect teaching); fostering emotional wellness (catharsis, abreaction, positive emotions, counterconditioning fears, stress inoculation, and stress management); enhancing social relationships (therapeutic relationship, attachment formation, social competence, and empathy); and increasing personal strengths (creative problem solving, resiliency, moral development, accelerated psychological development, self-regulation, and self-esteem). If you are interested in learning more about these therapeutic powers, Schaefer and Drewes (2013) have a chapter on each of them in their book.

Play therapy is a particularly appropriate approach to counseling children because play comes naturally to children. This is because most children under the age of 10 have not yet developed the abstract reasoning skills and verbal abilities to sit in the counselor's office and be articulate about their thoughts, emotions, and behaviors. Young children seldom have the ability or the comfort level to talk articulately about what is bothering them, but they are almost always comfortable using toys and play to express themselves through metaphors (Kottman, 2011; Nash & Schaefer, 2011).

Most young children have better developed receptive language skills than expressive language skills, and they can frequently comprehend concepts even when they do not know how to verbalize them. This discrepancy means that the counselor might be able to use words to successfully communicate ideas to children, even when they would not have the abstract verbal reasoning skills or the vocabulary to be able to articulate these ideas themselves. Because of this, the counselor can frequently combine play and verbalizations to communicate with children.

Everything the child does or says in the session communicates information about how the child views himself or herself, the world, and others (Kottman, 2011). The 6-year-old whose father is dying of cancer takes all the toy soldiers, lays them down on the floor, looks at you and says, “They died. Nobody could help them.” The 4-year-old bosses you around and is resistant to any suggestion that he should take turns or share power with you. The 8-year-old takes the father doll and has him push the mother doll down the stairs in the dollhouse, laughing while the child doll tries to stop him. The child's play and the child's verbalizations in play are metaphors representing the child's lifestyle and life situation. In Adlerian play therapy, your job is to observe the child in the playroom, understand how the child's lifestyle and life situation are represented through the play, and begin to articulate that understanding to the child. You will use a combination of interactive playing, verbal interpretation, and storytelling to communicate with the child.

For older elementary-age children, adolescents, and adults, who usually do have the capacity for describing what is going on with them, there are other reasons for using play therapy as an intervention. With older elementary-age children (sometimes referred to as “tweens”) and teenagers, play can be used to build the relationship simply because it is fun and joy filled (B. Gardner, 2015; Milgrom, 2005). This can sometimes short circuit the natural resistance of adolescents, who are often dragged (sometimes literally kicking and screaming) into therapy. Play therapy also provides a chance to allow adolescents to use the therapy relationship to “move back and forth along the developmental continuum while striving for health individuation and separation from a nonabusive and nonpunative adult” (Milgrom, 2005, p. 4). Being invited to use kinesthetic and visually engaging props, toys, art supplies, and other materials to express themselves also takes some of the pressure of sitting across from someone, making eye contact, and being expected to reveal their innermost secrets. Using play as the vehicle for communication also encourages adolescents to express their creativity and to learn through experience, which can instill a sense of ownership over what they are learning (B. Gardner, 2015; Kottman, Ashby, & DeGraaf, 2001). Being allowed to communicate symbolically through metaphor rather than be forced to communicate directly can help adolescents feel safe to explore and express painful and/or frightening thoughts, emotions, and experiences that they might otherwise want to hide or avoid.

Although most adults enter therapy of their own free will, they too can benefit from play therapy. According to Brown and Vaughn (2009) and Frey (2015), grown-ups need to play too. Play therapy can provide adults the opportunity to develop insight, reduce stress, improve communication, facilitate self-efficacy, and encourage mastery. It can also boost creativity, mind–body integration, happiness, cooperation, insight, and social skills. I (TK) combine play therapy with talk therapy in my sessions with adolescents and adults, and I find that play therapy facilitates relationship building, making the sessions more enjoyable for me and for the clients. Play therapy also helps to create and deepen insight, allowing clients to “get” things they would have normally resisted, and building bridges from the abstract conversations in our sessions to the day-to-day situations in the clients' “real” lives.

Setting for Play Therapy

The “perfect” setting for play therapy is a custom-designed playroom that you get to create for yourself with unlimited space, resources, and support. However, in the real world, it is the rare and lucky counselor who has an opportunity to work in such a setting. No matter where you work, the play space should reflect your personality and your philosophy about children and play therapy. It should also reflect the particular clientele you serve. Some counselors have very few toys and limited visual stimulation in their play space because they work with children who are easily distracted. Other counselors have many costumes and a stage in their play space because they, personally, are dramatic and like to use drama and enactments with their clients. Other counselors who have a need for order and structure, or who have limited space, have everything built in—shelves, kitchen appliances, and/or sandbox.

In Adlerian play therapy, the most important factor in playroom design is the attitude of the counselor. If the counselor feels happy, safe, and comfortable in the playroom, children will feel happy, safe, comfortable, and welcome. It is essential for the Adlerian counselor to remember to use flexibility and imagination to create a space in which the counselor can feel comfortable and clients can feel safe.

The “Ideal” Playroom

Landreth (2012) provided a thorough description of the practical considerations in designing that rare accommodation, the “ideal” playroom. He suggested that the ideal playroom would be approximately 12 feet by 15 feet (3.6 by 4 meters), with an area of between 150 and 200 square feet (approximately 14 by 19 square meters). This area gives the child room to move about, at the same time keeping her or him relatively close to the play therapist. A room this size could comfortably accommodate several children at one time if the play therapist wanted to work with a small group.

It is important to be able to provide the child with privacy in the playroom. In a play space where there are windows or a one-way mirror, it is helpful to have curtains or blinds so that the play therapist or the child can decide whether he or she needs some privacy if something sensitive is happening in the play therapy process.

It is also useful to have washable wall coverings and floors so that children can make messes without fear of negative consequences. Probably the best arrangement is to cover the floors with vinyl tile, which is an easy surface to clean or replace if necessary, and to paint the walls with a neutral color of washable enamel. However, when this is not possible (e.g., if the space is carpeted or you don't have unlimited money), you must consider how you will react if paint or glue or some other messy material is spilled on the floor. If this will be a major problem for you (or will put you in a place where you can't keep on maintaining a positive attitude toward the child who makes a mess), it would be wise to make accommodations (e.g., avoid using finger paints or pu...