Integrative Play Therapy with Individuals, Families and Groups

Shlomo Ariel

• Publisher: Routledge
• Year: 2019
• Print ISBN:
  9780367187682
• eBook ISBN:
  9780429582431
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Integrative Play Therapy with Individuals, Families and Groups is a complete theory-to-practice introduction to a comprehensive integrative model of play therapy, developed by Shlomo Ariel. It synthesizes numerous concepts, methods and techniques found in the various branches of play theory and research under a unified conceptual and linguistic roof of information-processing, cybernetics and semiotics. The author's tenet is that any case, whatever the presenting difficulties, can be treated by such an integrative, multi-systemic approach.

This book abounds with vivid observations and case descriptions, followed by discussions in a fictional inter-disciplinary seminar. Every chapter is followed by a brief summary, homework assignments and a classified list of relevant publications.

Integrative Play Therapy with Individuals, Families and Groups will generate immense interest throughout the play therapy community. It can serve as a textbook for budding play therapists and as a reference book for more experienced practitioners.

Part 1

Theoretical and methodological foundations

Chapter 1

My favorite play therapy mix

The kind of play therapy I espouse has the following attributes:

• (a) It is not informed by a single theory (psychoanalytic, cognitive-behavioral, systemic, etc.) but by a synthesis of many theories. Every case is multi-faceted, having dark corners and blind alleys into which different theories turn their selective spotlights. All these theories can be synthesized in such a way that the spotlights would be directed at all the relevant corners and alleys.
• (b) It follows from the above assertion, that the play therapy (or, for that matter, any therapy) with each case should not be restricted to one setting. Individual, family and group play therapy can be conducted with the same case, simultaneously or in sequence.
• (c) It also follows from the above assertions that different kinds of difficulties and syndromes should not necessarily be treated by play-therapeutic or other methods specially designed to tackle a specific kind of presenting problem. Every set of symptoms, e.g. post-traumatic stress disorder, phobias, depression, conduct disorders, etc., is multi-determined. It is the product of a complex interaction between genetic and developmental agents, personality traits, conscious and unconscious conflictual cognitive and emotional processes, life events and circumstances, family and social dynamics, culture, ecology, etc. Therefore, any suitable play-therapeutic methods and techniques can be used with any kind of presenting difficulties. The choice of play-therapeutic vehicles is governed by a deep understanding of the case, not just by focusing on the external symptoms. Such understanding is achieved by a multi-systemic diagnostic assessment.
• One might argue against this approach that, considering studies that have proven the efficacy of target-oriented, evidence-based play-therapeutic (and other) treatment methods, the best choice would be applying just such proven methods in working with each case. For example, play-therapeutic methods using habituation, catharsis and abreaction have been found to be effective in treating post-traumatic stress disorder. Cognitive-behavioral play therapy has been shown to be effective in treating obsessive-compulsive disorder. Theraplay has been found to be useful in treating reactive attachment disorder. My view is: All these studies are based just on statistical generalizations. They cannot take into account the totality of the factors that affect the difficulties in each specific case. Indeed, it is useful to use proven techniques, but only as part of a treatment plan tailored specifically for each case.
• (d) A play therapist is not just a reflecting or interpreting observer of the clients’ play. She is an active participant in the individual, group or family’s spontaneous play. As an active participant, she is an equal partner and a co-creator of the clients’ play. The play therapist can still reflect on or interpret the clients’ play, but as an insider with a make-believe role.

Here are some of the reasons why I prefer such active involvement: In most cases, play is a private, intimate, sometimes secretive activity. Group play is also a private activity, shared only by the group members. In many cases players do not want a stranger, even if the stranger is a play therapist, to watch their play and comment on it. They feel this to be as intrusion into their private domain during their intimate moments. I have often witnessed children in play therapy hiding underneath a table or behind big pillows to prevent the therapist from prying into their play, meddling with it and knowing what it is about. Many children are happy to share their play with the therapist only if he has been admitted to their play as a partner, on their own terms. Furthermore, the therapist’s tracking, reflections and interpretations are usually wasted on the players, because they are too absorbed in their own play to listen and even more so to process what they have heard. True, there are quite a few cases in which children play for the therapist as audience, like actors on stage. I do not claim that such a show is never of any therapeutic value, but sometimes it is no more than showing off, with the truly important contents left unexpressed.

Another advantage of the therapist’s active participation in the clients’ play is the wealth of therapeutic means that can be applied, and the great flexibility made possible. Play in general and make-believe play in particular are singularly rich and flexible media of expression and communication. Play speaks through words, actions, objects and materials. Roles and modes of behavior can be flexibly changed at will. An unlimited number of events and situations can be made up freely. A creative therapist who actively participates in the clients’ play can invent a great variety of therapeutic moves. She may choose positions such as “a script writer”, “a producer”, “a director”, “an actor”, “a stage manager”, “a stage designer”, “a musician” and so on. As an actor, the therapist can play various roles such as “the dangerous monster” or “the submissive sheep”. She can roll on the carpet, dance, sing, shout, cry, laugh, do pantomime, wear various hats and masks, change costumes and fancy dresses, what not. And above all, playing is great fun, much more so than sitting on the sidelines and making learned comments.

These attributes of my approach can be illustrated by the following case and the ensuing discussion:

Case 1.1 Rusella

Rusella (9) was the laughing-stock of her classmates. They used to call her Miss Piggy and Dummy. She was overweight and had difficulty walking, because of a congenital hip dysplasia. Her habit of deliberately talking in a baby voice definitely did not improve her social situation. The children were mimicking her manners of walking and talking. So were her mother and fourteen-year-old brother, who thought it was funny. But while in school she would respond to the harassment with blows and kicks, at home she would join her mother and brother’s laugher when they imitated her, so they saw it as an amusing game that Rusella enjoyed too. Often her mother assigned her the task of taking care of her two-year-old sister. The rest of the time her mother simply ignored her, as if she didn’t exist.

Rusella’s father left home when she was seven. He was visiting his children at their mother’s home irregularly. During visits, the children’s parents would behave as if they had never parted. When Rusella’s father was around, Rusella would speak with him in what she tried to make sound like a man’s voice. She seldom spoke in her normal gender and age-appropriate voice.

Rusella underwent speech therapy that made no difference. She was later referred by her school counselor to the child and adolescent mental health clinic in her home town. The presenting complaint was violence against her female classmates. She was treated individually by Lailah, a clinical psychology intern, under my supervision. Her mother got parental guidance from Daniel, a social work intern, once in two weeks. Her father refused to come to parental guidance.

In the first sessions, Rusella spoke with Lailah in a baby voice, but afterwards began speaking in a normal voice. She told Lailah that even though she was being ridiculed, she felt better about herself when she spoke in a baby voice. Only when she used that voice, she could say whatever came to her mind. She also shared with Lailah that when she was speaking in a baby voice, the children could not understand what she was saying, and that made her feel better. She also said that it was easier for her to talk with her father in a man’s voice and was quick to make it clear that she was not at all afraid of her father.

Interdisciplinary seminar

Lailah, Daniel and two other interns – Anna, a creative arts therapist, and Ethan, a school psychologist (the names are fictitious) – participated in an interdisciplinary seminar, under my guidance. The seminar served two purposes: group supervision and being a forum for theoretical and methodological discussions.

In one of the first sessions, Lailah presented Rusella’s case. Daniel added information about his parental guidance meetings with Rusella’s mother. Here are some verbatim quotes from parts of the discussion:

Lailah: I’ll read out to you some parts of my notes:

Session 1.1 Lailah and Rusella

Rusella picks a big gorilla doll and a little rabbit doll and sits on the carpet, not in front of me but at a right angle from me, with the dolls between her legs. She makes the rabbit doll approach the gorilla doll and face it. Then she acts as if the rabbit is saying something, in a loud and angry voice. It was impossible to understand what it was saying, because it spoke gibberish.

I say, “The little rabbit is angry at the gorilla.”

Rusella ignores me. She makes the gorilla grab the rabbit and throw it away v...

Table of contents

• Cover
• Endorsements
• Half-Title
• Title
• Copyright
• Contents
• Preface
• Acknowledgments
• Introduction
• PART I Theoretical and methodological foundations
• PART II X-raying make-believe play
• PART III The manifold magic of make-believe play
• PART IV Planning a multi-systemic play therapy
• PART V How to do it?
• List of cases, sessions and observations
• Index