Multicultural Play Therapy

Making the Most of Cultural Opportunities with Children

Dee C. Ray, Yumiko Ogawa, Yi-Ju Cheng, Dee C. Ray, Yumiko Ogawa, Yi-Ju Cheng

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781000568387
• Edition: 1
• Topic: Éducation
• Subtopic: Éducation et orientation

Multicultural Play Therapy fills a wide gap in the play therapy literature. Each chapter helps expand play therapists' cultural awareness, humility, and competence so they can work more effectively with children of diverse cultures, races, and belief systems.

The unique perspectives presented here provide play therapists and advanced students with concrete information on how to broach issues of culture in play therapy sessions, parent consultations, and in the play therapy field at large. The book includes chapters on multiple populations and addresses the myriad cultural background issues that emerge in play therapy, and the contributors include authors from multiple races, ethnicities, cultural worldviews, and orientations.

Part 1

The Multicultural Orientation in Play Therapy

DOI: 10.4324/9781003190073-2

1 Cultural Humility and the Play Therapist

Dee C. Ray, Yumiko Ogawa and Yi-Ju Cheng

DOI: 10.4324/9781003190073-3

As we talked about writing this book, we started with our experiences as play therapists and in play therapy. All three of us are practicing play therapists, play therapist supervisors, and play therapy educators. We talked about our experiences with children who were similar to and different from us culturally. We talked about supervisees and their experiences with us and with their child clients. We talked about our students and our experiences in understanding, teaching, and modeling cultural self- and other-awareness. We all had experiences of missed opportunities, misunderstandings, and defensiveness. However, we also all had experiences of true encounters with children, students, supervisees in which we authentically and vulnerably made contact with another person, seeing all of the person. All of the person is comprised of hopes, dreams, beliefs, struggles, pain, joy, relationships, and so much more; and all of the person is comprised of multiple identities intersecting in complex ways and developed in cultural contexts. To really know a person, to really know a child, the play therapist seeks to understand all of the child, embraces the child’s worldview, and holds the utmost respect for that worldview. As discussions about the book progressed, we acknowledged our sincere desire to know children culturally and the reality that we are always limited in fully knowing another person. This is a humbling place to be. Yet, embracing this humility seemed to be the chord that struck all three of us. We cannot ever fully know the cultural experiences and perceptions of another but we seek to know with great curiosity, care, and empathy for the person. Hence, we have attempted to write this chapter and edit this book from this place of humility.

Let us start with the word “culture.” What is it? There are so many academic texts, popular books, and research studies conceptualizing culture that it can be dizzying to take it all in. We find that conceptualizing culture in its complexity may be more helpful than providing a singular definition. In synthesizing over 300 definitions across disciplines, Faulkner et al. (2006) defined culture as consisting of seven themes: structure/pattern (patterns or regularities among a group/norms for behavior), function (what culture does or accomplishes/outcomes), process (an active creation by group of people/ongoing actions), product (symbolic or material products produced by groups), refinement (moral development/intellectual attainment), power/ideology (focus on power as central characteristic of culture), and group-membership (shared understanding of world/shared communication system). The multiple and diverse definitions of culture are likely a main reason that any discussion regarding culture can become confusing and lead to misunderstandings. Faulkner et al. caution against attempting to provide one definition due to the variations in perspectives. For our purposes, we hope play therapists will see that culture can be a group defined by a specific similarity such as skin color, orientation, nationality, gender, culture can be ongoing process in which a group may be continually progressing in communication or productivity, or culture can be defined as power-holding/dominant groups in comparison with non-dominant groups. A child may see their culture as belonging to a group who looks like them, while the child’s parent may see that the child’s culture is defined as being in a powerless/oppressed position, while the play therapist may see the child’s culture as the ongoing development of childhood. When these three perspectives come together, the key is for the play therapist to have high awareness of the various perspectives and activate empathic understanding for each worldview. Coming back to our focus on cultural humility, the play therapist does not assume that the meaning of culture is the same for everyone.

In one example of cultural intersection, I (DR, a White play therapist) supervised a case in a school setting in which a Black child was being seen by an Asian play therapist who consulted regularly with a White teacher. As the child was leaving the playroom, he accidentally fell and suffered a serious injury to his face. The play therapist took the child to the school nurse who administered aid and then called the mother for the child to be taken to the doctor. I reviewed the incident carefully with the play therapist and it was clear that the therapist could not have prevented such an unexpected accident. In the meantime, the teacher had made quite a few assumptions about the play therapist, seemingly based on the therapist’s race, including that the play therapist must have been unassertive and unable to handle the child which led to the accident. The teacher shared this view with the mother, a Black woman. The mother was not only upset about receiving this information, but was also humiliated at the doctor’s office when it was assumed that she might have abused or neglected her child and had to defend herself to keep protective services from being called. The mother was understandably upset and immediately wanted play therapy services terminated. In this situation, as a White supervisor, I simply wanted to figure out how to problem-solve and did not initially consider all the cultural implications of the persons involved (example of the privilege I unknowingly operate from at times). So, I ensured that the play therapist had acted competently and that the child’s injury had been treated. It was only when I received calls from school administration about the mother’s complaints that I began to consider and explore all the cultural intersections taking place. Although, being White, I was familiar with previous experiences related to the teacher’s bias, the humiliation experienced by the mother in taking her child to the doctor was not something that had even come into my awareness. And, of course, there were implications for the play therapist who had done her job well and yet her competency was being questioned due to what appeared to be racial bias. I was humbled in empathizing with the mother’s experience and worldview and the therapist’s experience of the situation. It was humbling because it was a moment of in-your-face awareness of my privilege and how comfortable it is for me to see children as children, and not all the cultural intersections and meanings of those intersections that surround them. It was humbling because I felt an intense amount of White guilt in that I never had the experience of taking my child to the doctor and being worried that I might be reported to protective services – and more guilt relative to the teacher, a White woman like me, who acted with such prejudice and destructiveness. I was angry, sad, and guilty all at the same time. And yet, ultimately, this situation was about how to put the child first; a Black child who obviously felt connected to and positively regarded by his Asian play therapist. In order to put the child first, it was essential for me to put aside all my feelings and tap into the worldview of all the adults to work out a way for the child to continue with his therapist in play therapy. I needed to engage in the humility that I did not know what was best and my role was to bring together the perspectives of all involved.

What is Cultural Humility?

We hope to provide real-life play therapy examples of cultural humility in action but we also want to contextualize those examples in literature. The term cultural humility was coined by Tervalon and Murray-Garcia (1998) in the context of training medical professionals to work more effectively with culturally diverse patients. Hook et al. (2017) defines cultural humility as, “an awareness of one’s limitations to understanding a client’s cultural background and experience… an interpersonal stance that is other oriented rather than self-focused in regard to the cultural background and experience of the client” (p. 9). Through cultural humility, the play therapist honors the reality that there are a multiplicity of truths and experiences based on a person’s identities, background, and experiences. Hook et al. go further to discuss aspects of intrapersonal and interpersonal dynamics that make up cultural humility.

Intrapersonal dynamics include the therapist’s awareness of personal cultural identities and background and the impact of those identities and background on the ability to honestly evaluate personal reactions to clients. For example, if my five-year-old client begins to curse in session, do I have immediate thoughts that such cursing is wrong for a young child and must be the result of his low socioeconomic status? If this is my automatic thought, what do I do with it? Intrapersonal cultural humility calls for honest introspection regarding my biases toward people and communities who are impoverished and my rigidity in accepting the child as is rather than seeing him as just one of his “group.” What is the extent of my bias? How did I get to this bias? How do I work within myself to challenge this bias? Furthermore, the culturally humble play therapist is open to feedback and integrates feedback into self-evaluation. Feedback may come in the form of children, parents, supervisors, or supervisees.

Interpersonal dynamics involve my openness and curiosity toward others in therapeutic interactions, my willingness to engage in beliefs and values that are different from my own (Hook et al., 2017). Do I allow my biases to get in the way of truly knowing others, engaging in conversations that are difficult, or accepting others’ experiences? In order to practice the interpersonal element of cultural humility, I attempt to operate from a place of curiosity and respect when working with others. I want to know how the child sees the world, how the parent sees the world, and further how the child’s teacher or grandparent sees the world. My curiosity drives my willingness to engage in uncomfortable conversations that bring us closer together. In Chapter 2, we will talk more about how to move toward cultural comfort when operating from interpersonal cultural humility. Going back to the five-year-old who curses, holding interpersonal cultural humility means that I want to know more about what motivates this child from this child’s complex background to express himself through cursing. Instead of setting a limit which I may have done operating from implicit bias (i.e. lacking intrapersonal cultural awareness), if I am operating from high intrapersonal and interpersonal cultural humility, I will likely recognize my automatic thought as out of my control, forgive myself for harboring unacknowledged biases, commit to working on this bias outside of session, and move into engaging with the child with curiosity with a possible response of “You are using all kinds of words to show how you feel.” Such a response allows the child to continue to engage in expression to lead to therapist’s greater understanding of the child’s world. Of course, all of these dynamics take place in seconds flat in order to be present with the child but these are practices that help play therapists move toward greater depths of cultural humility.

Cultural Humility and the Philosophy of Play Therapy

As editors of this book, we believe one reason we were so drawn to the concept of cultural humility as part of the guiding framework for this book is that humility is a cornerstone of child-centered play therapy (CCPT), a humanistic developmentally appropriate intervention for children. One of our favorite quotes from Dr. Garry Landreth (2012) is that it is the play therapist’s job to “discover that which I don’t know that I don’t know I don’t know” (p. 81). A fun but accurate quote. The play therapist’s role is characterized by intense curiosity to fully know the child with no a priori assumptions coming into the relationship. The play therapist enters the relationship with the child with no preconceived notions about who the child is or the child’s worldview. The therapist recognizes that the best way to understand a child’s behaviors and emotions is to empathically discover the way in which a child sees his or her world (Ray & Landreth, 2019).

Originating from Rogers’ (1951) person-centered approach to therapy, CCPT holds that children enter the world with a self-actualizing tendency toward maturity, freedom, and self- and other-enhancing behaviors. Yet, as children develop and interact with others, they develop concepts of self, made up of perceptions from such interactions with their immediate and outside worlds. Interactions may or may not be congruent with the child’s self-concept. This part of the theory is especially salient to cultural understanding from a CCPT perspective. A child whose needs are met through immediate family members, who develops a strong attachment bond, and who lives in non-threatening circumstances is expected to experience self as congruent with interactions and assumed to be well-adjusted. However, a child who is of a non-dominant race may grow up in those same family circumstances yet receive negative messages about the way they look, experience daily microaggressions, and be forced to navigate unmanageable obstacles due to systemic oppression. For this child, the greater culture has introjected values that are likely to be intern...