Theraplay® – The Practitioner's Guide

Vivien Norris, Dafna Lender

• Publisher: Jessica Kingsley Publishers
• Year: 2020
• Print ISBN: 9781785922107
• eBook ISBN: 9781784504885

The Definitive Guide to Theraplay® for Practitioners, officially endorsed by the Theraplay® Institute

Theraplay is an intervention that focuses on enhancing the connection, trust and joy between a child and a parent. It involves interactive, playful activities using simple face-to-face reciprocal interactions, and involves using all of the senses, including rhythm, movement and touch.

This comprehensive guide outlines the theory, reflection, and skill development of the practitioner - the true power house of Theraplay. By maintaining a focus on practice throughout, embedding theory into practice examples, it brings the spirit of Theraplay to life. Part 1 covers the key principles of the intervention; Part 2 addresses Theraplay in Practice: how to use the Marschak Interaction Method (MIM), how to set up a room and choose activities and considerations for working with different client groups; Part 3 encourages the reader to engage in their own development and the stages involved; and Parts 4 and 5 provide a wealth of useful resources, checklists, handouts, sample sessions and an up-to-date list of Theraplay activities.

Whether you are a Theraplay practitioner, or simply want to find out how this remarkable intervention works, this book is essential reading.

Introduction

Chapter 1 Introduction

Chapter 2 Theraplay® Guiding Principles

Chapter 1

Introduction

Theraplay is an intervention that focuses on enhancing the connection, trust and joy between a child and a parent. The method involves interactive, playful activities using simple face-to-face reciprocal interactions, and involves using all of the senses, including rhythm, movement and touch.

In writing this book, we have searched for a structure that will both faithfully represent the Theraplay approach in practice and be of most use to the reader. The basic Theraplay “method” may seem straightforward and yet within sessions the practitioner is faced with frequent decision points that may have a wide range of impacts, unique to each child-parent pair. The effort of trying to understand and helpfully respond to a child’s moment-to-moment reactions in any given interaction is as complex a task as in any in-depth therapy process.

The paradox of Theraplay is its combined simplicity and complexity. The simple activities and structured framework allow people to quickly access the model and understand the core elements. Theraplay can in some cases be impactful without an in-depth understanding of why it works, and this makes it highly accessible. At the same time, the attention to detail and observation of constantly shifting moments allows endless possibilities in terms of understanding the complexity of relational interaction.

It can be helpful to differentiate between the “nuts and bolts” of Theraplay, how it is set up, the structure of sessions, the activities and so on from the reflection and constant adjusting that is going on in the practitioner’s mind behind the scenes. Where the practicalities may be seen as the “method,” what lies behind this—the theory, reflection, deepening of skill development of the practitioner—is the power house. Our focus in this book is to try to build a picture of the power house that feeds into this apparently simple approach. This book focuses on work with children and their parents, though Theraplay itself can be used with a wide range of populations. We have kept a practical and practitioner-based focus throughout the book while embedding theoretical constructs and reflection into our discussion and we hope that this captures the spirit of Theraplay as it actually happens.

It is not possible to cover all areas or eventualities in one book and we refer you to other publications where relevant, including your Level One Theraplay training handout.

Who is the book for and how is it organized?

This book is intended as a guide to practitioners who have completed the core Theraplay training provided by accredited Theraplay Institute trainers. It could also be helpfully used as an accompaniment to the training. Our aim is to deepen your understanding about the key principles involved in Theraplay practice and to add insight for those of you who wish to understand the Theraplay approach in more depth. It is not an alternative to undertaking the training but, we hope, a useful addition. The book may also be of interest to therapeutic practitioners working in different modalities and to those who wish to know more about Theraplay practice. We have approached writing this book by asking ourselves the kinds of questions we might ask during and following a session or in supervision, such as:

• What do I think the child might be experiencing in this moment?

• How about the parent?

• Why did I decide to do that activity in that way?

• What was I hoping for and how did it go?

• Do I think my response helped the child feel more or less comfortable? What makes me think that?

• What was it about the way I adjusted my responses in that moment that might have had the impact?

• Are the child’s non-verbal body responses congruent with what the child seems to be expressing verbally?

This list could go on. A great deal of the work in developing sensitive Theraplay practice involves very close observation of the child and parent and a high level of self-reflection in terms of our own responses and behaviors. Theraplay practice makes significant use of video recording of sessions for reflection, unpicking what may be going on moment to moment, trying to build a picture by tracking patterns and sequences, noticing “moments of meeting” between the child and practitioner or child and parent and trying to understand elements of strength and vulnerability for all involved. As the practitioner becomes more skilled in the process of delivering Theraplay and in this micro-analysis of interactions, she becomes more able to be highly attuned within the sessions and to adapt and provide work with sensitivity and purpose. Much of the work relies on practitioner intuition, getting a “feel” for what might be helpful, as well as being able to develop and learn through the training and supervision process. People differ widely in their capacity to do this. We hope that this book brings to life some of the reflection behind the scenes and the dilemmas, challenges and joys of participating in Theraplay.

The book is divided into different parts. Part 1 covers the overarching Theraplay principles. We have woven a range of theoretical constructs into our summary of the principles that guide the work.

Part 2 considers the “nuts and bolts” of Theraplay in practice and reflects on these elements. Starting with the Marschak Interaction Method (MIM) assessment (a structured observational assessment that forms the initial part of a Theraplay intervention) and moving on to how to set up the room, choose activities and manage a wide array of situations with both children and parents, our aim is to provide a sense of the lived experience of engaging in Theraplay. Throughout this section of the book we have included some typical practice questions and case examples.

Our case examples are used to enliven the discussion and are drawn from both specific experiences we have had in sessions or supervision and also invented examples based on experience. All examples are anonymized. In most examples, we talk in the first person, as if we were actually in the room at the time, to help create a feeling of “in the moment reflection” about how the situation is unfolding. We hope this gives an experience as close as possible to live supervision.

Part 3 looks at the development of a Theraplay practitioner and considers the typical developmental phases a practitioner might go through when learning about the Theraplay approach. There are parallels, too, in the experiences reported by children and parents. We then move on to look at the supervision process.

Part 4 provides some examples of completed supervision forms. The Theraplay approach rests on some basic underlying assumptions that can challenge prior expectations about what therapeutic help might look like. For this reason, it can be experienced as quite a shift in approach.

Part 5 provides a range of different useful resources, including checklists and handouts for parents, examples of sessions for different age groups and an up-to-date list of Theraplay activities.

Notes on terminology

“Parent” is used throughout the book to describe the range of caregivers who provide an everyday parenting role for the children they are caring for, including birth parents, foster carers, adoptive parents and residential workers—anyone who is caring for children in a parenting capacity.

“Child” refers to children of all ages. When referring to children, we have alternated between male and female throughout the book. We acknowledge that there are children who are non-binary in their gender identity.

“Practitioner” is the term used to describe the professional who is delivering the Theraplay intervention. The practitioner may have a wide range of additional core qualifications. When referred to in the text the pronoun we use is “she.”

“Student” refers to someone who is learning about Theraplay and is not yet fully qualified. Within this context, the Theraplay student will already be a professional working with children with a range of other qualifications.

The case examples of work presented come from a range of sources. Some are invented for the purposes of illustrating a point, others are amalgamated examples from our practice, all heavily disguised.

We have described a wide range of activities and perspectives throughout this book. We would like to acknowledge that the way in which families interact and play and the roles professional helpers may take differ greatly across families and cultures. We are inevitably influenced by our own culture and appreciate that adaptations may be needed to suit different contexts.

In writing this book, we have drawn on the work of a wide range of academic and clinical professionals. We have included a full reference list at the back and refer to specific authors when their work is first mentioned within the introductory section of the book, which is more focused on theoretical links. We have not repeated referencing in the more discursive section of the book as it breaks the flow of discussion. We acknowledge the deep influence others have had on our thinking.

Chapter 2

Theraplay® Guiding Principles

CHAPTER PLAN

This chapter will discuss the following areas:

Theory base summary

Safety and reciprocal social engagement

– The social engagement system primer

Attunement and co-regulation

– Use of face-to-face play

– Provision of care and nurture

– Intersubjectivity—emotional communication about us

– Relationship repair following breaks in connection

Creating more positive inner working models and attachment patterns

– Attachment system

– Shifting intimacy demand

– Activation of the attachment system

– Gentle challenge of unhelpful patterns of relating

Guiding principles in practice

– Making sense of the child’s responses and behavior in the context of relationships

– Theraplay® attitude

– Using the Theraplay® dimensions as a framework

– Following the Theraplay® protocol

– Including parents

– Keeping the non-verbal focus

– Tracking sequences and patterns

– Creating predictability

– Building in success

– Adapting to cultural differences

Adaptations to Theraplay® practice

Theraplay® research

Summary

Theraplay is an experience of safety, social engagement, regulation and security. The key to Theraplay’s efficacy is not the activities! The activities are just...

Table of contents

• Cover
• Title Page
• Contents
• Foreword by Phyllis Booth
• Part 1: Introduction
• Part 2: Nuts and Bolts
• Part 3: Becoming a Theraplay® Practitioner
• Part 4: Examples of Completed Supervision Forms
• Part 5: Resources
• Glossary
• Authors
• References
• Index
• Join Our Mailing List
• Acknowledgements
• Dedication
• Copyright
• By The Same Author
• Endorsements