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Feb 22, 2016
childs Play: Understanding Trauma through a childs PlayNora R Cord M.A. Ed, PCC-SDayspring CounselingWhat is Play TherapyPlay therapy as defined by the Association for Play Therapy is 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. What is Play TherapyPlay therapy as explained in my office to parentsThe belief that children play their thoughts and feelings better than they talk about them. A play therapist believe that play is a childs language and toys are their words. Therefore a play therapist office will have many toys to assist a child in expressing themselves and their language. Why Therapist Use Play?Play is a fun, enjoyable activity that elevates our spirits and brightens our outlook on life. It expands self-expression, self-knowledge, self-actualization and self-efficacy. Play relieves feelings of stress and boredom, connects us to people in a positive way, stimulates creative thinking and exploration, regulates our emotions, and boosts our ego. (Landreth, 2002). Why Therapist Use Play?Play also allows children to rehearse skills and roles needed for survival. Learning and development are fostered through the play experience. (Russ, 2004).Psychoeducation BibliotherapyProvides an opportunity to do psycho education in a fun and engaging way. Allows you to address any misconceptions and clarify what is normal within the experience of a traumatic event. Builds rapport because you as a clinican understand what is happening and can explain it to not only the child but to the parent. PsychoeducationBrave Bart by Caroline H SheppardProvides clinician with the opportunity to educate child and parent on symptoms of Post Traumatic Stress Disorder. Done interactively can be an initial assessment tool for what symptoms the client is presenting with a time of intake. Does a nice job of explaining flashbacks in a way that a child can understand and make sense of. Good for use with complex trauma casesPsychoeducation A Terrible Thing Happened by Margaret Holmes, Sasha Mudlaff, and Cary Pillo.Another resource for educating the child and parent of the symptoms they may be experiencing after a trauma. Should be done interactively so that parent can understand and validate symptoms child is endorsing. Never identifies what the terrible thing was so it is a good resource for domestic violence, gang violence, community violence, shootings, traumatic accidents, etc.
PsychoeducationParental DisclaimerTypically in this period, I will give a parent my anger disclaimer. Anger is the backbone of healing. Until your child becomes angry about what has happened, no real change will occur. This means that your child will have a period of intense anger, it is not a fun stage to live through but when it comes, I want you to remember this conversation. Rationale: Preparing parents to handle what is coming in recovery, helps them stay the course and not pull their child because their behavior has become worse.PsychoeducationPerception Activity (family or group activity)Fill a tray with different small items; toys, things connected to their trauma, office items, etc.Have each individual look at the tray for 10 seconds.At the end have everyone write down what they see on the tray. Process what everyone wrote down and discuss how each one brings their own perceptions to the traumatic experience.Rationale: Help each member understand that although we all experienced the same things, we perceive it differently. Feelings (Affect Regulation)Candy land FeelingsUsing the board game, Candy land, explore the clients understanding of feelings. Red- Mad, Blue-Sad, Green- Scared/Worried, and Yellow Happy. Can be used during entire time working on feelings as individual will be able to explore more of their feelings as trauma work goes on. Rationale: Play at the beginning of work on feelings to get a baseline and then use as a teaching tool to explore more difficult emotions related to trauma. Therapist can model this in their answers. Feelings (Affect Regulation)Scary Night Visitors by Irene Wineman Marcus, Paul Marcus, and Susan Jeschke Dream Catchers: Popsicle sticks, glue, yarn to make or have family purchase a dream catcher. Discuss with client what he or she needs in their dream to feel powerful and have control over their nightmare. Provide tangible presentation of item next to bed such as a key to unlock a door, or a flashlight to see.
Feelings (Affect Regulation)NightmaresJessica and the Wolf by Ted Lobby and Tennessee Dixon; story of a little girl who has nightmares and needs help in addressing and Magic Wands: Using dow rods and shapes, with ribbon, have child create a magic wand to use to scare away their nightmares. Monster Spray: Spray bottle, water, food coloring, etc. Feelings (Affect Regulation)Go Away Monsters GameBoard game by Gamewright. Individual selects items out of a bag to create a room that is safe. If a monster is selected, individual tells the monster to go away and then places the monster in the jailRationale is to work on overcoming fear of monster and being able to stand up for oneself when unexpected things happen.Feelings (Affect Regulation)Feelings PuzzlesPuzzles that have different emotional faces that can change and discuss feelings. Feelings Boat Ending session activity for children who have a difficult time transitioning. Using boat to discuss good and bad emotions about session terminating for the day. Individual controls how hard or soft they hit the boat. Coping SkillsIdentify Coping SkillsProvide a list of various skills that individuals who have survived trauma often use. Give individual a highlighter and ask them to highlight those skills that are true for them. Discuss ways in which they have used or are continuing to use those skills. Coping SkillsMask ActivityDiscussing how individuals will hide their different emotions by creating a mask they wear in front of others. Provide student a ceramic or paper mask to decorate to illustrate how they hide themselves away.Process the beauty of the design they made but the pain it eventually causes as they are lost to the image they have to upkeep.
Coping SkillsHurt FeelingsRead The Hurt by Teddi Doleski. Discuss the hurts the child has experienced and ask him or her to create a hurt rock. Can be made out of paper or can be made out of pantyhose and stuffing. Have the child fill their rock with the amount of hurt he or she has experienced and then allow him or her to share the hurt they want to. Discuss ways to let the hurt out like the child in the story did.
Coping SkillsAnger PosterAnger is an emotion that masks many other emotions. Helping a child to begin to identify what feelings their anger masks, gives voice to those emotions and helps them begin to identify ways to manage and cope with those feelings. Normalizing anger in situations where it is appropriate. Coping SkillsAnger sometimes needs a physical outletHelping parents and caregivers understand that sometimes anger needs a physical outlet and children need a positive and safe way to physically get there anger out. Having a place to stamp out their anger with there feet, having a place to punch a pillow, having a place to punch a punching bag, a place to shoot hoops, run, walk, scream. However whenever any of this is happening it is important that the child be able to verbalize afterwards why they were doing it.NarrativeBeing a witness to their narrativeA survivor needs one witness to their narrative. Someone who can share the raw emotions of their experience and help them make sense of it. Can be done in play, sandtray, puppetry, drama, music, art, writing, there is no limit to how it can be done. Will be done over a course of sessions. No longer done at the beginning but after skills are built. Can use the TF-CBT workbook to assist with this. Relapse PreventionTrust ExperimentsWho is trustworthy/who is not?Using scenarios- determine if someone can be trusted with a secret or they can not be. Depending on age of child can be done with a real person, can be done with puppets, etc. Rationale: Traumatized children do not know who to trust and often have peer difficulty as a result. Helping them to understand ways to build relationships will help with this. Relapse PreventionStages of a RelationshipIndividual or group activity in which you have the person order the stages of a relationship from meeting the person to engaging in sexual relations. Goal is to help individual and group of abused children to consider the consequences of their behaviors and how these behaviors led to more and more risky behaviors. TerminationStepping down sessions. Helps clients who have come to rely on you to learn they are successful without you. Also allows you to praise their success and the ways in which the individual and family are handling themselves and the crisis. Create a plan together for termination. Discuss termination openly and how to re-engage in services. Also discuss times that family may need services. Booster shots- times when family may need additionally support to deal with experience such as a new developmental stage or milestone. TerminationCelebrate the workWhether successful completion or moving on to a higher level of care, celebrate the work done together. Create a board game of the work that client has done. Read Oh The Places You Will Go by Dr. Seuss and create a star which discuss ways you have seen the client learn and grow since beginning therapy. Provide client with a graduation certificate and note one specific goal he/she has improved on.