Solution-Focused Play Therapy

A Strengths-Based Clinical Approach to Play Therapy

Elizabeth Kjellstrand Hartwig

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000223750
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Solution-Focused Play Therapy is an essential text that blends the process of play therapy with solution-focused therapy.

With a focus on child strengths and resources, this book identifies key concepts and principles in solution-focused play therapy (SFPT). The author provides neurobiological and developmental support for SFPT and guidance on how practitioners can transition from using a non-directive approach to a more directive and activity-based approach based on the developmental needs of the child. Chapters describe the 12 basic skills needed for employing this approach with children of all ages and their families. Harnessing a strengths-oriented approach, the author presents expressive ways to use key SFPT techniques, including the miracle question, scaling, finding exceptions, and end-of-session feedback.

Clinicians will come away from the book with a suite of interventions, strategies, handouts, and forms that can be employed with children of all ages and their families, from strength-based assessment and treatment planning to the final celebration session.

1

The Restorative Powers of Play

Foundations of Play Therapy

Having recently expanded her client base to include children, Alice was a little nervous that her play therapy skills were a bit rusty. She noticed that when she worked with children they were much more interested in playing with various toys and trinkets in her office than they were in talking about the presenting problem. As a solution-focused brief therapy (SFBT) practitioner, Alice felt comfortable using SFBT skills and techniques with adults, but had never learned how to apply these skills to children. In her graduate program, the professors emphasized that using nondirective play therapy skills with children was imperative. However, Alice felt disconnected to the children with whom she worked as she sat in a chair and reflected what children were doing and saying. During one play therapy session, a child named Francis asked Alice, “What should I draw next?” Alice decided to suggest an SFBT technique, even though it was directive. Alice replied, “Let's pretend that a miracle happened tonight while you were sleeping and your life was exactly how you wanted it to be when you woke up. Draw a picture of what your world would look like.” Francis, a seven-year-old, had been referred to play therapy after her 14-year-old brother, Ryan, had died following an eight-month battle with cancer. Francis launched into this picture with energy, drawing a colorful and elaborate picture of her family having fun at a theme park while her brother looked on, smiling, from heaven. Francis said, “My family would be able to have fun again. And Ryan would be happy for us.” In the two months that Alice had been working with Francis using a nondirective approach, Francis had never brought up Ryan or shown any play behaviors about loss or grief. Alice realized that using SFBT skills with children could help to integrate her beliefs about how both adults and children change in therapy: by identifying their own strengths and resources and using those to find solutions. After her session with Francis, Alice was eager to learn more about how to use solution-focused play therapy with children.

Solution-focused play therapy (SFPT) is a strengths-based approach to play therapy that helps children work through challenges and find solutions by identifying and building on internal assets and external resources. SFPT is grounded on the core belief that children already have the abilities they need to solve the presenting problem. SFPT practitioners support children in accessing, practicing, and honing those skills and resources. This theoretically based approach focuses on what children need to change or achieve, rather than on the problem that brought them to play therapy. As a systemic approach, SFPT values the involvement of caregivers, who include biological, step, adoptive, and foster parents, or others who are caring for children, as part of the clinical process. SFPT practitioners also welcome the support of teachers, school counselors, coaches, band directors, mentors, youth leaders, pediatricians, psychiatrists, and other people in children's lives who can help them reach their goals. Through the systemic process of SFPT, children are provided with a circle of support to achieve clinical goals.

SFPT grew out of solution-focused brief therapy (SFBT), a postmodern approach to counseling that was developed in the 1980s by Insoo Kim Berg, Steve de Shazer, and colleagues at the Brief Family Therapy Center in Milwaukee, Wisconsin. Thousands of professional counselors, marriage and family therapists, social workers, psychologists, school counselors, and other mental health practitioners use this approach throughout the world (BRIEF, 2020). The SFBT model was originally developed for clinical work with adults until Steiner and Berg (2002) applied the concepts of SFBT to their work with children. Many authors have subsequently contributed to the vast literature on SFBT with children, and there is now a multitude of books, articles, and studies on applying SFBT to clinical work with children (see Chapter 2). Over the course of this book, you will learn how to incorporate SFPT as a clinical approach as you seek to support children in your practice. You will embark on an expedition from the foundational concepts and skills of SFPT to the final celebration sessions with child clients. Let's first begin this journey by exploring the foundations of play therapy.

What Is Play Therapy?

The Association for Play Therapy (APT) defines play therapy as “the systematic use of a theoretical model to establish an 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” (2020, para. 3). Play therapy is a way of being with children in the process of counseling that honors the way that children communicate. Children use toys as their words and the play as their language (Landreth, 2012). In play therapy, children can choose to be verbal or nonverbal, and the practitioner provides a safe space where children can express themselves in a variety of ways. Practitioners use play therapy most often with children aged 3 to 12, with older children, pre-teens, and teens transitioning into activity therapy, a form of play therapy that offers more directive and verbal play-based activities. Throughout this book, you'll learn skills, techniques, and interventions that can be used with children of all age; however, our focus will be on the use of SFPT with younger children, a population that is often not fully addressed in the SFPT/SFBT literature.

Significant Contributions in Play Therapy

The field of play therapy emerged as developers of traditional psychotherapy approaches began to alter their work with adults to meet the needs of child clients. The first professional paper using the term play therapy was presented in 1921 by Hermine von Hug-Hellmuth, an Austrian psychoanalyst, who is regarded as one the first psychoanalysts to practice with children. Hug-Hellmuth believed that children's play was a necessary component to psychoanalysis and recognized that play allowed children to communicate nonverbally (Geissmann & Geissmann, 1998). Melanie Klein, an Austrian-British psychoanalyst, furthered the application of the psychoanalytic approach by recognizing play as the child's symbolic language and underlining the importance of providing toys that can be assigned meaning by the child (Johnson, 2016). Anna Freud, another Austrian-British psychoanalyst and the youngest child of Sigmund Freud, used play to build relationships with child clients and moved into working with children in more verbal ways, such as dream analysis and directive prompts for expressive art (Freud, 1965). Another early contributor to the field of play therapy was Margaret Lowenfeld, a British pioneer in child psychology. Inspired by H. G. Wells' (1911) book Floor Games, Lowenfeld developed “the world technique” (Thompson, 1990). This technique involved a large cabinet of figures and two trays – one filled with sand and the other filled with water and other objects that could be used for molding the sand. In her sessions, the children would take the figures from the cabinet and place them in the tray of sand to create “worlds.” This unique use of toys and sand provided children with new means of self-expression and exploration of their real-world experiences.

As play therapy became more prominent in the United States, the field of play therapy expanded to involve more practical techniques to integrate theoretical knowledge of psychology and child development. Virginia Axline (1947, 1964), a student of Carl Rogers, is credited as the “mother of play therapy” for her work in applying nondirective techniques to children. This model was originally called nondirective play therapy and has been further operationalized as Child-Centered Play Therapy (CCPT; Ginott, 1959). CCPT emphasized the concept of permissiveness in the playroom. This meant that the child was able to choose what to do in the playroom as the practitioner took on a permissive, less directive role. CCPT also explored the concept of limit-setting, and more specifically, how to set limits in the playroom when it was needed to provide safety for the child, the toys, and the practitioner (Bixler, 1949; Ginott, 1959). Clark Moustakas, a student of Axline's, found that while some of the CCPT principles fit his way of working with children, the nondirective stance in CCPT was at odds with his reciprocal and connected style of communication. Moustakas (1997) described this tension as follows:

I saw during my two years of intensive practice that sitting in a chair, observing, and reflecting content of children's play, or their thoughts and feelings, were not consistent with my way of being with people. I had been an active participant in my life with children and in my own play creations. How had I come to think that to be successful as a professional play therapist I had to suppress my natural bent for interactive communication, to fix my eyes, my body, my full attention on the other person? I realized that I had been carrying out a role, defined by others, not by me or the children with whom I met. I had not fully used my knowledge, talents, and experiences or my resources and strategies for entering into the world of childhood. (p. 12)

In response, Moustakas developed Relationship Play Therapy (1997...