Play Therapy Theories and Perspectives

A Collection of Thoughts in the Field

Robert Jason Grant, Jessica Stone, Clair Mellenthin, Robert Jason Grant, Jessica Stone, Clair Mellenthin

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000192278
• Edition: 1
• Topic: Psychology
• Subtopic: Autism Spectrum Disorders
• Index: Psychology

This book explores the multitude of thoughts, theories, opinions, methods, and approaches to play therapy in order to highlight the unity and diversity of theory and perspective in the field.

Each chapter is a common question related to play therapy to which ten established and experienced play therapists share their thoughts, theoretical perspectives, and opinions. The key characteristics of a well-trained play therapist, the role of technology in play therapy, the importance of speaking the client's language, and many more frequently asked play therapy questions and topics are explored. The reader will learn about the umbrella of play therapy thought and practice and connect with perspectives that might align with their own theoretical preferences.

This book will be of interest to a wide range of mental health professionals working with children and adolescents. Those new to play therapy and those who are seasoned veterans will appreciate, value, and hopefully be challenged by the differing viewpoints surrounding many play therapy topics.

Part I
Perspective

1 Do You Have a Primary Play Therapy Theory or Approach You Use the Most and Why?

Jeff Ashby, PhD, RPT-S

I self-identify as an Adlerian play therapist (Kottman & Meany-Walen, 2016) and naturally resonate with the teleological, strengths-based approach of Adlerian play therapy (AdPT). I began my career treating primarily adults and adolescents and only came to play therapy mid-career. In this transition I was mentored by Dr. Terry Kottman, PhD, the originator of Adlerian play therapy (e.g., Kottman, 1999). While Kottman is the original author and developer of AdPT, as a supervisor and consultant, she was (and is) gracious in helping play therapists understand and develop their own style. She encourages folks to practice from the theoretical perspective that complements their style and allows them to conceptualize client issues from a coherent and consistent framework. In describing my natural assumptions and beliefs about human beings, and how I conceptualized and formulated treatment plans for adult and adolescent clients, Dr. Kottman would consistently point out, “That’s Adlerian”.

In addition to a comfort in conceptualizing from an Adlerian perspective, the structure of AdPT, including the four identified phases of therapy, combined with the flexibility of approach (e.g., a combination of directive and nondirective techniques), has allowed me the freedom to develop my own style while remaining theoretically consistent. AdPT rests on several tenets of Adlerian psychology. These are as follows: (1) people are self-determining and creative, (2) people perceive reality subjectively, (3) behavior is purposeful and goal-directed, (4) people have a need to belong and are best understood in the context of their social settings (e.g., family), and (5) because of the common separation between self-perception and one’s ideal self, people have a tendency toward feeling inferior (Ansbacher & Ansbacher, 1956; Kottman & Meany-Walen, 2016). These assumptions, in combination with other Adlerian principles, offer me a framework to understand the child, frame the child’s distress, and formulate a plan to intervene. They help me decide what to do next and give me a roadmap when I’m lost with a client.

My goal in play therapy is to understand clients in terms of their lifestyle (Kottman & Meany-Walen, 2016). Lifestyle is an Adlerian construct that includes a person’s beliefs about self, others, the world, and behaviors based on those beliefs (Carlson et al., 2005). The process of AdPT includes four phases: (a) an initial phase of building the relationship, (b) a phase devoted to an exploration and understanding the client’s lifestyle, (c) a third phase designed to help the client develop insight into their lifestyle, and (d) a final phase in which the play therapist facilitates client reorientation/reeducation (Kottman & Meany-Walen, 2016). In AdPT, I can utilize a wide range of techniques, depending on the phase of treatment, presenting problem, and lifestyle assessment of the client, and include other members of the client’s system.

Robert Jason Grant EdD, RPT-S

I primarily use AutPlay therapy. It is an integrative family play therapy approach that is focused on working with children and adolescents with autism spectrum disorder and related conditions. Theoretical foundations of AutPlay include behavioral therapy methodology and play therapy theories such as filial play therapy, Theraplay, cognitive behavioral play therapy, and child-centered play therapy (Grant, 2017). Most of the population that I work with in a private practice setting are children and adolescents diagnosed with autism or a related condition. I use AutPlay therapy because it is designed for the unique needs and issues that children with autism present.

I began my play therapy journey learning about child-centered play therapy (Landreth, 1991). I have found that most play therapists seem to begin with this theory and consider it a foundational approach. Child-centered play therapy was the first play therapy theory that I learned fully and felt the most competent implementing. I then began to learn other theories and approaches. Throughout the years, I have systematically become an integrative play therapist. I often integrate various play therapy theories and approaches, along with protocols outside of play therapy theories such as social stories, autism movement therapy, and EMDR.

Integrative therapy combines different therapeutic tools and approaches to fit the needs of the individual client. Integrative play therapy is based in integrative therapy theory and philosophy. The play therapist explores methods for blending the best play therapy theories and treatment techniques to resolve the most common psychological disorders of childhood (Drewes, Bratton, & Schaefer, 2011). An example would be that I might be implementing AutPlay therapy protocol and decide that a client would benefit from and respond well to a social story; thus, I would integrate a social story into the AutPlay protocol. This would require that I am knowledgeable in AutPlay therapy, social stories, and the process of integrating protocols.

I would encourage those beginning play therapy to start with learning foundational approaches such as child-centered play therapy (Landreth, 1991) and filial therapy (VanFleet, 2014). Once the therapist feels comfortable with those approaches, I would encourage them to explore other play therapy theories and approaches moving into learning about integrative and prescriptive approaches, ultimately finding their fit in terms of what approach(es) they feel the most comfortable with and what seems to best fit the clients they are serving. A caution about integrative and prescriptive approaches – the therapist should be well trained and knowledgeable in the theories they are prescribing or integrating. The therapist should not try to be prescriptive or integrative with theories or approaches in which they are not fully knowledgeable.

Heidi Gerard Kaduson, PhD, RPT-S

When I started my career (almost 30 years ago) I was taught like most play therapists that play therapy was done using the nondirective method. I became increasingly aware, however, of how it did not fit many of the children I was treating who were referred for behavior difficulties. I had been trained in all of the theories and began to use a more prescriptive approach in order to meet the needs of each individual child. The prescriptive approach was first introduced to play therapists in the book The Playing Cure: Individualized Play Therapy for Specific Childhood Disorders (Kaduson, Cangelosi, & Schaefer, 1997). This approach uses the application of the therapeutic powers of play (Schaefer & Drewes, 2014) to the common psychological disorders of children and adolescents.

Prescriptive play therapy is founded on a set of basic principles that serve as fundamental cornerstones of the approach (Kaduson, Cangelosi, & Schaefer, 2020): differential therapeutics (some interventions are more effective than others for certain disorders); eclecticism (employing elements from a range of theories and/or techniques with the aim of establishing an intervention tailored to a particular client’s characteristics and situation); integrative psychotherapy (blending together the healing elements from different schools of play therapy into one combined approach for the treatment of a specific client); and prescriptive matching (matching the most effective play interventions to each specific disorder or presenting problem (Norcross, 1991). However, it also includes having the clinician select a therapeutic change agent that is designed to reduce or eliminate the cause of the problem, as well as an Individualized Treatment (tailoring the intervention to meet the needs of a specific client – not to just treat the presenting problem but the person who is suffering from it). Empirically supported play therapy treatments are listed in Table 1.1 (Kaduson et al., 1997, 2020).

Table 1.1 Interventions with Empirical Support for Specific Childhood Disorders

Childhood Disorder	Intervention w/Empirical Support
Fears/phobias	Systematic desensitization
PTSD	Release play therapy
Aggression	Play group therapy
Adjustment reaction	Release play therapy
Oppositional	Parent-child interaction
ADHD	Cognitive-behavioral
Sexually abused	Abuse-specific play therapy
Selective mutism	Cognitive-behavioral
Anxiety	Cognitive-behavioral
OCD	Cognitive-behavioral
Obesity	Play group therapy
Reactive attachment	Theraplay/child-centered
Anger	Cognitive-behavioral
Chronic illness	Filial
Children of divorce	Play group therapy
Bereaved	Play group therapy
Children of alcoholics	Play group therapy
Foster/adoptive	Filial
Peer relationship	Play group therapy

Whenever a preschooler is referred for treatment, I will start with a nondirective, or child-centered approach. However, if the child needs more assistance in order to use pretend play to heal himself, or is past the preoperational stage of development where pretend play is natural, then I will decide what type of interventions are needed and which theoretical approach can best assist the child to play and work through psychological difficulties. I truly believe that every child has the ability to heal through play. My approach stems from a number of play therapy theories and techniques which informs the selection of an intervention best suited to overcome the client’s presenting problems. I tailor this therapeutic intervention to the characteristics and preferences of the individual client to achieve an individualized approach.

Jennifer Lefebre, PsyD, RPT-S

I employ a developmental, attachment-based perspective in looking at a child’s presenting competencies as well as within their struggles. I believe understanding the importance of attachment and neurobiology, particularly with our youngest clients who have suffered from trauma, is vital to our ability to have relationships with them and their families. My theoretical orientation is grounded in attachment theory (Bowlby, 1982, 1988), various neuroscience theories (Perry, 2009; Porges, 2004; Siegel, 1999; van der Kolk, 2014), and play therapy (Axline, 1969; Landreth, 2002; Schaefer & Drewes, 2014).

Siegel’s interpersonal neurobiology and Porges’s polyvagal theory combine well with Bowlby’s Attachment theory in order to understand the connection between our bodies, minds, and the interplay within our relationships. The social engagement system is a playful mixture of activation and calming that helps us navigate these relationships. When combined with Perry’s neurosequential model and van der Kolk’s understanding of how trauma rewires the brain and affects the mind and body, we have a comprehensive approach to the child and family based on the core principles of neurodevelopment and traumatology.

Play promotes child development by building relationships, increasing social skills, developing empathetic connection, and building problem-solving capabilities (Landreth, 2002; Schaefer & Drewes, 2014). Children engage in play across cultures and play transcends language and ethnic barriers, allowing for the therapeutic powers of play to facilitate, initiate, and strengthen change. I typically take a gradual, nondirective approach when possible, integrating evidence-based trauma and play therapies (i.e., Theraplay^®, ARC, SMART, EMDR, and trauma-sensitive yoga) when needed.

Clair Mellenthin, MSW, RPT-S

I adhere to an integrated, systemic, prescriptive approach in my play therapy practice. My main theories of influence are attachment theory (Bowlby, 1969) and bioecological systems theory (Bronfenbrenner, 2005). I believe that it is critical that as clinicians, we take into account the environmental f...