Play therapy provides a window into an unhappy child’s inner world.
When Sophie was six years old, she became afraid to be by herself. If she was in a room alone, she would become anxious. Her anxiety started in mid-August and by late September it had not abated.
In fact, it had worsened and carried over to school.
When her mother, Amy (who didn’t want their last name used), took Sophie for a checkup, the doctor offered to refer them to a therapist. “At this point, we had decided it wasn’t going to get better on its own, and even if it did, what would we be risking? Why not get help?” remembers Amy.
They went to see Stephanie Pratola, PhD, a registered play therapist based in Salem, Virginia. Pratola had Sophie play in a room alone for as long as she could, as Amy and the therapist watched on a video camera from an office down the hall.
At first, Sophie could only play alone for 30 seconds. But gradually, she was able to stay by herself for longer periods. Within two months, Sophie’s anxiety had melted away. “She was able to understand that she could control her fears by practicing,” says her mother.
Play as Healing
Sigmund Freud is credited with being the first to use play in understanding child psychology. Today, mental health professionals (and insurers) accept play therapy as an effective treatment. “I can’t imagine any therapist anywhere who doesn’t use play to some degree with children,” say Bill Burns, executive director of the Association for Play Therapy (APT).
“For kids, [play] is their primary language,” explains Scott Riviere, MS, LPC, RPT-S, a play therapist based in Lake Charles, Louisiana. Behavior, rather than words, is the main form of communication for most children until they’re five or six, he says. But even then youngsters tend to have a limited vocabulary.
“If you ask a kid ‘How are you doing today?’ kids are going to give you answers like ‘Good, fine,’” Riviere says. An adult might already be seeing a therapist and bring their child there, but the child might not talk much. “The therapist might label them as being guarded,” says Riviere, “but it might be that it’s just because they’re not speaking the kid’s language.” In contrast, Pratola points out, kids “are always expressing something through their play.” So watching a child play can help a therapist get to the root of the problem much more easily than by asking questions.
The experience Sophie had with play therapy corroborates that notion. “It was comfortable and familiar to Sophie,” says Amy. “Particularly when she was six, she wasn’t able to articulate what she felt. She was able to express it better through play.”
Play therapy was so helpful for Sophie that she was quite willing to go back to Pratola at age 9, when she became worried that her parents might abandon her. In these sessions, Pratola had Sophie choose dolls representing herself, her mother and her fears, which she called Mr. Meany.
Therapist and client would then replay actual events using the dolls, such as the time Sophie became anxious when her mother went out to the car to retrieve an item around Sophie’s bedtime.
Amy says, “Stephanie had us replay it doing what we actually did and what Sophie told herself at the time, and then redo it in a different way,” with Sophie talking back to Mr. Meany—and eventually learning to get the better of him.
Kids as young as two and as old as 18 can benefit from play therapy. It is helpful for just about any childhood problem: separation anxiety, behavioral problems such as aggression or withdrawal, attention deficit hyperactivity disorder (ADHD), depression, low self-esteem, reading difficulties. It can also help children deal with bullies, adjust to divorce or adoption, or deal with trauma such as abuse, illness or death of a parent, or surviving a car accident or natural disaster. “Toys are very safe and manageable,” notes Pratola. That makes it easier for kids to approach difficult feelings. “It puts them in a situation where they have complete control, and they can kind of figure things out,” says Riviere. It can also help older children verbalize their problems.
Help for Families
Play therapy can be used in the context of family therapy. Families often come in feeling defeated, says Pratola. “The child is having a problem and the heaviness is impacting the whole family.” Play helps family members interact in a lighter way. “It seems to work really, really well,” she notes.
Filial therapy can also help families. In this approach the therapist trains the parents in therapeutic play to use at home with their kids. “It’s very powerful. It affects a variety of problems and it tends to have long-lasting effects,” says Pratola. “It’s the most effective for childhood depression, separation anxiety, any kind of parent/child relationship issue and behavior problems.” According to Pratola, play therapy is increasingly used in adults, usually as a complement to more traditional therapy.
Any social worker, school counselor or therapist may use play therapy. But since 1992 the Association for Play Therapy has offered credentials that guarantee a therapist has received training and supervised experience. The two designations it bestows are Registered Play Therapist (RPT) and Registered Play Therapist-Supervisor (RPT-S). You can find a credentialed therapist in your area at the APT web site (www.a4pt.org, click on Directories) or by calling
Kids love play therapy, according to Riviere. “There’s no associated stigma,” he says. In his estimation, kids who have been in play therapy are much more likely to consider counseling in the future “because they had a great experience. They come in and say, ‘This is fun.’”