The Therapist's Notebook Volume 3

More Homework, Handouts, and Activities for Use in Psychotherapy

Catherine Ford Sori, Lorna L. Hecker

• Publisher: Routledge
• Year: 2008
• Print ISBN: 9780789035226
• eBook ISBN: 9781135695743
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The Therapist's Notebook Volume 3 includes clinician field-tested activities for therapists who work with individuals, children and adolescents, couples, families, and groups. The reproducible handouts are designed to be practical and useful for the clinician, and cover the most salient topics that counselors are likely to encounter in their practices, with various theoretical approaches. Each chapter includes a "Reading and Resources for the Professional" section that guides readers toward useful books, videos, or websites that will further enhance their understanding of the chapter contents. This book is an excellent tool for both experienced and novice counselors for increasing therapeutic effectiveness.

Section IV:

Families and Groups

– 17 –

The Family Boundaries Game

Kimberly Laninga, Rita L. Sanders, and Dreena E. Greenwood

Type of Contribution: Activity

Objective

The Family Boundaries Game is a life-size board game that the therapist constructs to familiarize family members with the idea of the family as a system. Several objectives may be accomplished through the use of this game.

The first objective is for family members to recognize both their own uniqueness and their special role within the family. The second objective involves an introduction to the subject of boundaries, facilitating a discussion of rules and roles within the family (Minuchin, 1974). This occurs as a family participates in an activity that requires them to follow rules and guidelines, take turns, and answer questions that are designed to elicit candid and subjective responses from family members. A third objective of this activity is to promote movement in the family in two ways. As family members act as game pieces, they must physically move from one space to the next, thereby promoting literal movement. Additionally, many families who enter therapy are “stuck.” For example, a family may have a maladaptive style of communication due to boundaries between the subsystems that are too rigid. Participation in the Family Boundaries Game enables them to break a pattern such as this by allowing family members to speak freely. In this way, there is figurative movement within the family from a place of little communication or continual arguing to allowing family members to express themselves without fear of recrimination, which is one component of appropriate boundaries.

Rationale for Use

Information and insight alone may or may not be enough to facilitate change within a family system. According to Gil (1994), the aim of play therapy is to provide an avenue for children to connect with and articulate their emotions in a more adaptive way. Additionally, more difficult emotions may be processed and harmful behaviors replaced with healthier ones. Gil contends that family play aids the therapist in assessing and gathering additional information regarding the family. Family play therapy also helps bypass the normal defenses that many adults, as well as children, have in place, since it is often safer and easier to talk about difficult issues through the metaphors represented in play. This encourages more open communication and meaningful understanding among all family members.

Many adults tend to lose their playfulness as they grow older, and in relationships choose to limit their exchanges to reasonable discussions. In general, it is more difficult for children to engage in that type of interaction since their primary means of communicating is not through language, but through play. In fact, young children’s level of cognitive development can limit their ability to understand and actively participate in talk therapy. Many therapists are unsure of just how to engage both children and adults in sessions in ways that are meaningful to all family members (Sori, 2006). For families to find a common ground, it may be more beneficial for parents to enter the world of their children through the use of play (Gil, 1994). This game provides the family with a safe activity in which change can take place, and it incorporates elements of both play and discussion, thereby bridging the gap between the adult and child worlds.

The use of the life-size game board with the family members functioning as game pieces introduces boundaries to the family in a fun, nonthreatening, metaphoric way. Permeable boundaries within a family are a vital, necessary part of successful family and individual functioning (Hecker, Mims, & Boughner, 2003). Rigid or enmeshed boundaries may be in place for a variety of reasons, including but not limited to a lack of understanding, inappropriate hierarchies, or parents’ lack of differentiation from their families of origin.

Having family members physically move from one space to the next will help them consider the importance of personal space, as well as encourage a connection to one’s physical body, while facilitating a deeper, more honest, and personal response when answering the questions. In families where hyperactivity or impulse control are issues, this game can be beneficial in teaching self-control by compelling members to wait to take a turn. The questions in the Family Boundaries Game (see Handout 17.2) help family members gain insight into themselves and others in the family. The therapist can then use members’ responses to facilitate discussion of appropriate versus inappropriate boundaries. In addition, the therapist can comment on observations of family members’ verbal and nonverbal communication and interaction while the game is in progress.

This game provides a fun and safe outlet for family members to move around and interact with each other in a new way, therefore lowering the natural tendencies to resist change in a well-established system and opening up new possibilities for change. For instance, in a family system with rigid boundaries, this activity may provide access to other family members that typically may not be available. In family systems with diffuse boundaries, this activity provides structure with rules and physical boundaries that may be lacking within the system.

The Family Boundaries Game may also assist families who may be adjusting to a new family structure. Changes in family structure have increased within the past few decades (Carter & McGoldrick, 1999), and the traditional family structure is no longer the norm. Today’s family households may take many forms, including single divorced parents, single unmarried parents, remarried families, unmarried partners, grandparents raising grandchildren, foster families, gay or lesbian partners, and widows or widowers. Within these family structures, family members may live in the household all or part of the time, such as in the case of parents with joint custody of children (Carter & McGoldrick).

Although structures have changed considerably over time, many families may expect the family system to work the same as the traditional family structure, due to lack of role models and information on forming functional nontraditional families (see Hecker & Sori, 2006). This activity provides families with a method to experiment and adjust to different ways of operating. Therapists can tailor the questions in Handout 17.2 to meet the unique needs of the families with whom they are working, whether families whose boundaries are rigid or enmeshed or families who need help in adjusting to a new structure.

Another benefit of this game is the building of stronger bonds among family members. As with any achievement, developing good relationships requires effort. By encouraging honest responses, without judgment, appreciation for each other may be further enhanced.

Materials Needed

See Handout 17.1.

Instructions

The game board is set up by attaching poster boards end to end in the chosen configuration by using string or yarn. The game may be set up in any configuration by the therapist. Examples of various configurations may include a square, a zigzag, or an “L.” The number of family members and available space may determine the layout and quantity of squares. Handout 17.2 contains questions that can be photocopied on card stock and then cut out. These question cards are placed upside down in a pile within reach of the board. Players take turns selecting a card, answering the question, and then rolling a die. All players are given two pass cards at the start of the game, which can be used to “pass” on questions they do not want to answer. Determination of who goes first is at the therapist’s discretion or can be established with a roll of the die.

If parents need to be empowered in an effort to establish an appropriate hierarchy within the family, the therapist may ask a parent to go first. If a child does not understand the rules of the game or a particular question within the game, he or she should be directed to ask the parents (not the therapist) for help in order to help establish parental authority.

The player selects a question from the pile of cards and answers it accordingly or uses one of his or her two passes to skip answering. The questions are designed to encourage members to explore various aspects of themselves, such as likes and dislikes, what sets them apart from others in the family, and what they think and feel about their family. See Handout 17.2 for a list of possible questions. Ideally, therapists should tailor questions specifically for the family with whom they are working.

After answering or passing, the question is returned to the bottom of the pile. Questions may be answered multiple times by different family members. If necessary, questions can be shuffled. After answering, the player then rolls the die and moves ahead the appropriate number of spaces. If a player lands on directive space, he or she follows the instruction and his or her turn ends. If a player lands on a blank space, his or her turn ends. This process is repeated for each player until all family members have reached the end.

The therapist can also be selective in choosing questions already included in the play therapy that are best suited for the situations of that particular family. Not all of the questions included must be utilized. Therapists can always enhance the Family Boundaries Game with additional questions that reflect the many different situations that families may encounter.

If a player lands on an occupied space, he or she must move back to the last available unoccupied space. This is an important concept when discussing boundaries because, within families, each member must be allowed to have his or her own space. However, if the two family members are willing to negotiate the boundaries and occupy the same space, sharing is permitted. The following rules apply:

• Players roll to see who goes first (unless otherwise indicated).
• Each player, in turn, selects a card, answers the question, and then rolls the die.
• Each player has two passes.
• Two players may not share the same space without agreement and negotiation of the space.
• Game is complete when all players have reached the finish line.

Therapists may introduce the Family Boundaries Game by inviting the family to play a game together that may help them get to know both themselves and each other better and that will help facilitate an examination of how they relate to one another. As they play the game, they should be honest in their answers and really listen to how others answer their questions. They may also want to think about how they would answer others’ questions. The object of the game is not winning or losing. Instead, the object is for everyone to cross the finish line feeling as if he or she has not only gained a voice within the family, but also has heard the others. The clinician can give token prizes (e.g., stickers or suckers) to everyone at the end of the game.

Clinical Vignette

Fourteen-year-old Marcia and her family came to counseling because she had become sullen, was caught smoking, consistently broke curfew, and was hanging out with older teenagers who had little supervision. Her parents, Kenny and Susie, were in their late 30s. Susie admitted to searching her daughter’s room on numerous occasions, reading her journal, and going through her purse, while Kenny was covertly monitoring her instant messaging and e-mails. Fueling their behavior was the fear that Marcia might become pregnant or addicted to drugs. This fear was leading to enmeshed boundaries. In addition, Marcia’s 12-year-old sister Maria habitually barged into Marcia’s bedroom without knocking and “borrowed” her clothes without asking. This infuriated Marcia, but neither Kenny nor Susie saw a problem with Maria’s behavior, and in every way considered Maria an obedient child.

Marcia had little autonomy or space to herself, and communication with her parents had broken down. Maria’s failure to respect her sister’s space and belongings was ignored as the parents focused all their energy and attention on monitoring Marcia’s behavior. Maria’s apparent bids for attention were being overlooked.

When talking to the therapist, Marcia indicated that she felt as if she had no privacy, that her parents wanted her to be just like them, and that they did not trust her. Marcia stated that Maria could “do no wrong” in their parents’ eyes. She wondered aloud why she should have to share her clothes with Maria.

It was important for the family to begin recognizing the need to allow Marcia a certain amount of freedom and privacy, while maintaining appropriate limits. Marcia, in turn, needed help to see how her actions were contributing to her parents’ controlling and invasive behavior. Maria also needed suitable and age-appropriate limits, while being encouraged to discover her personal strengths, likes, and dislikes.

Since communication between Marcia and her parents consisted mainly of arguing, the therapist suggested playing the Family Boundaries Game. She introduced the game in the following way:

Since there seems to be a lot of arguing, I think it would be good to find a way to minimize that. I have a game that the family can play together, yet each person will be able to maintain his or her individuality. There are no winners or losers in this game since everyone will cross the finish line before the game is over, so in that way, it’s not really competitive. The idea is to be as honest as possible in answering the questions and to listen to what the others have to say without judging their answers. When others are taking their turns, no one else gets to respond to what they say. It would be a good idea to think about how you would answer the questio...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright
• Dedication
• Contents
• Preface
• Acknowledgments
• Editors
• Contributors
• Section I: Children and Adolescents
• Section II: Adult Clients
• Section III: Couples
• Section IV: Families and Groups
• Index