Play Therapy. ERIC Digest.
by Landreth, Garry - Bratton, Sue
In the process of growing up, children's problems are often compounded
by the inability of adults in their lives to understand or to respond effectively
to what children are feeling and attempting to communicate. This "communication
gap" is widened as a result of adults' insistence that children adopt that
means of expression commonly used by adults. Efforts to communicate with
children on an exclusive verbal level assume the presence of a well-developed
facility for expression through speech and thus confine children to a medium
that is often awkward and unnecessarily restrictive. Play is to the child
what verbalization is to the adult. It is a medium for expressing feelings,
exploring relationships, describing experiences, disclosing wishes, and
self-fulfillment. The problems children experience do not exist apart from
the persons they are. Therefore, play therapy matches the dynamic inner
structure of the child with an equally dynamic approach.
RATIONALE FOR PLAY THERAPY
Because children's language development lags behind their cognitive
development, they communicate their awareness of what is happening in their
world through their play. In play therapy toys are viewed as the child's
words and play as the child's language--a language of activity. Play therapy,
then, is to children what counseling or psychotherapy is to adults. In
play therapy the symbolic function of play is what is so important, providing
children with a means of expressing their inner world. Emotionally significant
experiences can be expressed more comfortably and safely through the symbolic
representation the toys provide. The use of toys enables children to transfer
anxieties, fears, fantasies, and guilt to objects rather than people. In
the process, children are safe from their own feelings and reactions because
play enables children to distance themselves from traumatic events and
experiences. Therefore, children are not overwhelmed by their own actions
because the act takes place in fantasy. By acting out through play a frightening
or traumatic experience or situation symbolically, and perhaps changing
or reversing the outcome in the play activity, children move toward an
inner resolution, and then they are better able to cope with or adjust
In a relationship characterized by understanding and acceptance, the
play process also allows children to consider new possibilities not possible
in reality, thus greatly expanding the expression of self. In the safety
of the play therapy experience, children explore the unfamiliar and develop
a knowing that is both experiential-feeling and cognitive. It can then
be said that through the process of play therapy, the unfamiliar becomes
familiar, and children express outwardly through play what has taken place
inwardly. A major function of play in play therapy is the changing of what
may be unmanageable in reality to manageable situations through symbolic
representation, which provides children opportunities for learning to cope.
THE PROCESS OF PLAY THERAPY
Given the opportunity, children will play out their feelings and needs
in a manner or process of expression that is similar to that for adults.
Although the dynamics of expression and the vehicle for communication are
different for children, the expressions (fear, satisfaction, anger, happiness,
frustration, contentment) are similar to those of adults. Children may
have considerable difficulty trying to tell what they feel or how their
experiences have affected them. If permitted, however, in the presence
of a caring, sensitive, and empathetic adult, they will reveal inner feelings
through the toys and materials they choose, what they do with and to the
materials, and the stories they act out. The play therapy process can be
viewed as a relationship between the therapist and the child in which the
child utilizes play to explore his or her personal world and also to make
contact with the therapist in a way that is safe for the child. Play therapy
provides an opportunity for children to live out, during play, experiences
and associated feelings. This process allows the therapist to experience,
in a personal and interactive way, the inner dimensions of the child's
world. This therapeutic relationship is what provides dynamic growth and
healing for the child.
Because the child's world is a world of action and activity, play therapy
provides the therapist with an opportunity to enter the child's world.
The child is not restricted to discussing what happened; rather, the child
lives out at the moment of play the past experience and associated feelings.
If the reason the child was referred to the therapist is aggressive behavior,
the medium of play gives the therapist an opportunity to experience the
aggression firsthand as the child bangs on the Bobo or attempts to shoot
the therapist with a gun and also to help the child learn self-control
by responding with appropriate therapeutic limit-setting procedures.
Without the presence of play materials, the therapist could only talk
with the child about the aggressive behavior the child exhibited yesterday
or last week. In play therapy, whatever the reason for referral, the therapist
has the opportunity to experience and actively deal with that problem in
the immediacy of the child's experiencing. Axline (1947) viewed this process
as one in which the child plays out feelings, bringing them to the surface,
getting them out in the open, facing them, and either learning to control
them or abandon them.
TOYS AND MATERIALS
Although desirable, a fully equipped playroom is not essential for children
to express themselves. What is important is that children have ready access
to play materials selected for the purpose of encouraging expression. All
toys and materials do not automatically encourage children's expression
or exploration of their needs, feelings, and experiences. Therefore, toys
should be selected, not collected. Play therapy is not used as a way to
pass the time or to get ready to do something else. The purpose is not
to engage the child's hands while trying to elicit some verbal expression
from the child's mouth. Consequently, careful attention should be given
to selecting play materials that aid in the following:
Exploration of real life experiences
Expression of a wide range of feelings
Testing of limits
Expressive and exploratory play
Exploration and expression without verbalization
Success without prescribed structure
Mechanical or complex toys would not fit these objectives and so are
avoided. Play materials that require the counselor's assistance to manipulate
are inappropriate. Many children in need of play therapy have poor self-concepts
and are overly dependent. Play materials should not reinforce such problems.
Landreth (1991) has provided a list of specific toys and materials.
SETTING LIMITS IN PLAY THERAPY
Limit setting is a necessary and vital part of the play therapy therapeutic
process. Although the procedures for setting limits may vary, the setting
of therapeutic limits is part of all theoretical approaches to play therapy.
The structure of therapeutic limits is what helps to make the experience
a real-life relationship. Limits in play therapy have both therapeutic
and practical benefits in that they preserve the therapeutic relationship,
facilitate the child's opportunities to learn self-responsibility and self-control,
among many other dimensions, and provide the child and the therapist with
a feeling of emotional security and physical safety. This feeling of emotional
security enables a child to explore and express inner emotional dimensions
that perhaps have remained hidden in other relationships.
Play therapy is not a completely permissive relationship because children
do no feel safe, valued, or accepted in a relationship without boundaries.
Boundaries provide predictability. Therefore, children are not allowed
to do anything they want to do. A prescribed structure provides boundaries
for the relationship that the play therapist has already determined are
necessary. The play therapy relationship has minimal limits. Messiness
is accepted, exploration is encouraged, neatness or doing something in
a prescribed way is not required, and persistent patience is the guiding
principle. The child's desire to break the limit is always of greater importance
than actually breaking a limit.
Because play therapy is a learning experience for children, limits are
not set until they are needed. The child cannot learn self-control until
an opportunity to exercise self-control arises. Therefore, placing a limitation
on a child pouring paint on the floor is unnecessary unless the child attempts
such an activity. Limits are worded in a way that allows the child to bring
himself or herself under control. The objective is to respond in such a
way that the child is allowed to say "No" to self. "You would like to pour
paint on the floor, but the floor is not for pouring paint on; the pan
on the table is for pouring paint into" recognizes the child's feeling,
communicates what the floor is not for, and provides an acceptable alternative.
The child thereby is allowed to stop himself or herself.
PLAY THERAPY RESEARCH AND RESULTS
Play therapy is not an approach based on guess, trial and error, or
whims of the play therapist at the moment. Play therapy is a well-thought-out,
philosophically conceived, developmentally based, and research-supported
approach to helping children cope with and overcome the problems they experience
in the process of living their lives. Play therapy has been demonstrated
to be an effective therapeutic approach for a variety of children's problems
including, but not limited to, the following areas:
abuse and neglect
aggression and acting out
deaf and physically challenged children
dissociation and schizophrenia
emotionally disturbed children
enuresis and encopresis problems
fear and anxiety
mentally challenged children
self-concept and self-esteem
social adjustment problems
The popular myth that play therapy requires a long-term commitment for
many months is unfounded as is shown in case studies and research reports
reported by Landreth, Homeyer, Glover, and Sweeney (1996) in their book,
Play Therapy Interventions with Children's Problems.
Prospective play therapists have to be adequately trained. Most play
therapists have a master's degree in counseling, psychology, or social
work, although other disciplines also are represented in the field. A master's
degree representing some area of the helping profession with emphasis on
the clinical or counseling aspects of therapeutic relationships is a general
prerequisite. Within or in addition to such a program, training should
incorporate the areas of child development and basic counseling skills
including acquisition of a theoretical approach incorporating a rationale
for behavior change consistent with the play therapy approach utilized.
The program of study should include extensive training in the area of play
therapy and a supervised practicum experience with children in play therapy.
FUTURE TRENDS IN PLAY THERAPY
The field of play therapy is growing and is now represented by the Association
for Play Therapy, an international professional organization. A national
Center for Play Therapy has been established at the University of North
Texas. Increasing numbers of elementary school counselors and therapists
in private practice and agencies are incorporating play therapy into their
work with children. There is a trend in family therapy to address social
and emotional values of developmental as well as family group session issues.
In filial therapy, parents are trained to use play therapy procedures with
their children. This method is well researched and has proven to be effective
in ameliorating children's problems through enhancing the parent-child
Play therapy is based on developmental principles and, thus, provides,
through play, developmentally appropriate means of expression and communication
for children. Therefore, skill in using play therapy is an essential tool
for mental health professionals who work with children. Therapeutic play
allows children the opportunity to express themselves fully and at their
own pace with the assurance that they will be understood and accepted.
Axline, V.M. (1947). Play therapy: The inner dynamics of childhood.
Cambridge, MA: Houghton Mifflin.
Landreth, G.L. (1991). Play therapy: The art of the relationship. Munice,
IN: Accelerated Development.
Landreth, G.L., Homeyer, L., Glover, G., & Sweeney, D. (1996). Play
therapy interventions with children's problems. Northvale, NJ: Jason Aronson.