Archive for Anxiety

July Play Therapy Wrap-Up

Posted by Gary Yorke

· August 7, 2018

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This month produced a treasure trove of info and advice. Donna Hammontree outlined the differences between Rights, Responsibilities, Privileges, and Rewards. Knowing the difference between them is important to helping children and teens regulate their behavior. Donna cautions to be consistent when coaching your children/clients, and use positive reinforcement rather than negative. Read more here.

Articles

According to the University of Michigan, there is no correlation between pressuring you children to eat food they don’t want to eat, and positive results of any kind. Researchers say that picky eaters’ weight is unrelated to how hard their parents push them to eat “healthy” foods. likewise, their attitude towards those foods did not improved. You might just be fighting an uphill battle for no reason! Read full article here.

Living in the present has many advantages for children and adults alike. It can sometimes be easy to let worry and fear for what has been, or what could be, turn your day upside down. Rabbi Sam Frenkel’s mission is to use play therapy to help children overcome those worries by living in the present and focusing on today. Read full article here.

It can sometimes be hard to release the reins that keep a parent feeling in control of their children. But as a parent, your role is not to make your child’s decisions for them, but to teach them to make the right choices on their own. This can be exceptionally difficult because a parents first instinct will always be to ensure their child’s safety and happiness. Nancy Buck discusses how you can achieve that without being a helicopter parent. Read full article here.

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Categories : Anxiety, Feelings, Monthly Wrap-Up, Parenting, Play Therapy, Wrap Up

Tags : child development, childhood stress, counseling games, development, family roles, feelings, parenting, Play Therapy, play therapy intervention, therapy intervention

How Does Play Therapy Reduce Anxiety in Children? by Joseph Sacks, LCSW

Posted by Gary Yorke

· January 24, 2018

· No Comments

Is your child struggling with anxiety?

Is he or she visibly tense or nervous at different times during the day?

Does he put pressure on himself to get everything perfect, and is distressed when he makes mistakes or things don’t turn out just right?

Do your efforts to get her to relax only make things worse, making you feel powerless to help her?

Do you wonder about Play Therapy and anxiety regarding your child?

Anxiety is one of the most common disorders in children, affecting over 10 percent of those under 18. Unfortunately, it can rob a child of the happiness that he or she needs so much.

The good news is that Child-Centered Play Therapy, together with Parenting Counseling, can do wonders to reduce and even resolve childhood anxiety!

I have seen it bring improvement with many children!

How does it work?

Often anxiety in children is generated by when a child, because of certain stressors in his or her life, develops feelings of shame and being in a state of low self-esteem. These feelings of low self-worth lead to anxiety in several ways. It may lead some children towards perfectionism, where the child feels badly about himself and tries to redeem himself from those feelings by creating self-imposed pressure to be very good, to have amazing performance or near-perfect output.

The underlying psychological mechanism is that the child reasons,

“Feeling so badly about myself is intolerable and I feel helpless to remedy it. What can I actively do to fix it? I know, I will be such a good boy, I will work very hard to accomplish amazing things, and then I will be so accomplished that I will be so proud that I will automatically and necessarily feel great about myself! For sure I will no longer feel badly or ashamed.” Along these lines we find the genesis of perfectionism. The problem is that such a strategy can never work, because objective external accomplishments, no matter how great, cannot defuse the cause and fuel of his low self-esteem. So often even after accomplishing much, the child still feels badly, and then resolves to strive even further towards perfection. This can create great anxiety because after all, consistent, perfect performance is impossible, and the child will inevitably almost always fall short of his desired goals, creating great fear of failure.

To learn more about treating perfectionism in teens or older children, click here.

In addition his idealizing of perfect performance leads him to judge himself very harshly when he is imperfect,

generating much shame and anxiety over being stranded in a state of low self-esteem.

Furthermore, such children may have unfortunately been criticized by people in their life, and they feel they must get everything perfect and achieve amazing things to get themselves beyond the reach of any potential criticism. This pressure generates anxiety.

To learn more about the pitfalls of criticizing children, click here.

Another common cause of anxiety is fear of reprimands and disapproval of the adults in a child’s life.

Children feel very small and powerless compared to adults and they cringe and wither under fear of reprimands, scolding, disapproval and criticism. Some children are constantly worried about not meriting enough approval and avoiding rebuke, and this generates significant anxiety. They feel pressure that they are not Ok they way they presently are, and they constantly have to measure up.

To learn more about the pitfalls of scolding and reprimands, click here.

Sometimes children learn to be anxious by example,

important people in their lives display anxiety under stress and they learn to do the same, thinking, “They get anxious when such things happen, I guess I should be anxious too!”

Anxious children often engage in something called catastrophizing, where their fears spiral out of control, “Oh no, this is going to happen and then it is going to lead to that, and then that and everything is going to fall apart and be terrible!”

However in the Playroom all of this including perfectionism, low self-esteem, shame, fear of reprimands and disapproval, an anxious example and catastrophizing all get turned around!

How does Play Therapy for anxiety work?

In the Playroom, I don’t tell the child what to do, he or she completely makes all of his own decisions and I follow him, showing great respect and validation for all of his expressed feelings, desires, decisions and needs. This gives the child an exhilarating sense of control over his own life and destiny, leading him to think, “I don’t have to be anxious that things are not going to turn out well. I have the power to make things go the way I want and need, to make things go right!” In this way, his or her anxiety gets reduced right off the bat.

Furthermore, I demonstrate for the child in the Playroom and attitude of complete acceptance, validation and non-evaluation.

In other words, no matter what the child does, I don’t judge or evaluate him, I simply reflect back a pure acceptance of how he chooses to create his own experience. This leads the child to think, “The things I do are Ok, I’m fine just the way I am.”

This all is accomplished through the curious Play Therapy for anxiety technique called tracking,

where, similar to a sportscaster describing a game, I reflect back to the child verbally every feeling or desire expressed, decision taken or accomplishment earned. For example, when a child picks up a toy to examine it, establish temporary ownership over it, and considers how he is going to play with it, this is important business for him in his world! Therefore I reflect back and enthusiastic , “Oh, now you’ve got that!” This direct, emotionally charged statement shows the child I am celebrating with him his great accomplishment of realizing and honoring his own desire, of controlling his own destiny, of putting into action his own plan to empower himself! This tracking is done constantly for every action, and the character of the verbal expression I make is personally tailored to suit perfectly each move and decision he makes. Over time it does wonders for building self-esteem, because the tracking gives him a criticism and evaluation-free opportunity to view himself in a positive light. By gaining a simple awareness of the uniqueness and special value of each individual aspect of his self as it develops in the playroom, the natural result is the conclusion that “I am doing just great the way I am. I do good things, I don’t need to worry, everything is going to be fine!”

To find out more about how Play Therapy works in general, click here.

Once a 7-year old girl was in the Playroom and a toy broke.

I didn’t try and help or control her, I let her decide what she wanted to do which was to try and fix it. I then reflected back to her a description of each step in her efforts to fix it without judging or evaluation. She eventually was successful in fixing it and exclaimed herself proudly, “I know how to fix things!” That was the creation of true self-esteem right there! Real self-esteem is esteem that needs to come from the self, not the other. If I praise and evaluate a child, she will gain unhealthy other-esteem. The goal of tracking is to get the child to evaluate him or herself, that creates true self-esteem.

For a fascinating discussion of how celebration is better than praise, click here.

Tracking reduces perfectionism,

as my constant reflection and acceptance shows the child that mediocre, less than perfect performance is just as good as better performance. He learns the beauty of the mundane, the liberation and joy of being just average. He learns that it is not objective, measurable achievement that has real value, but rather it is the honoring of his own desires, his appreciating the uniqueness of his own experience, including his moment to moment feelings and the simple everyday activities of the self, that has true value. Together with my interpersonal celebration of each decision, feeling and simple accomplishment, this greatly relieves any shame he may have been feeling, and drives up his self-confidence and self-esteem, leading him to no longer feel the pressure to achieve perfection and amazing accomplishments.

For a discussion of the benefits of Play Therapy for a child’s emotional health, click here.

Reprimands, criticism, scolding and disapproval, except in case of danger, are practically non-existent in the Playroom.

This gets the child into the habit of being so completely respected, honored, accepted and approved of, that it goes a long way to counterbalance the ill effects of any reprimands he may have received in the past. This greatly reduces his fear and anxiety regarding reprimands. In addition amazingly, it gets the child so used to being treated well that he begins to demand others also treat him likewise outside the session. Once I had an 8-year old who told his father, “Don’t talk to me that way, you need to play with me like Joseph!” The father to his credit took the hint and made changes to his son’s benefit.

99 percent of the time, no matter what the child does in the Playroom, whether he’s unsuccessful at something, accidentally breaks a toy, throws something or spills paint on the wall, my reaction is very relaxed and anxiety-free. Therefore he or she learns the great example, that many different things may happen in life, but there’s no need to get anxious, almost everything is really Ok! One time a 4-year old girl was in the car on the way to our session, and she misbehaved a bit, and her mother said, “Hey you better behave or I’m going to tell Joseph!” She responded, “Oh, Joseph, don’t worry about him, he won’t get angry, he likes me!” She had truly developed the confidence that from me she would get no problems, only good things.

This also reduces catastrophizing, as the child learns from the playroom that things generally have a positive end.

There are so many fantastic benefits of Child-Centered Play Therapy!

Not only does Play Therapy reduce anxiety, but is totally resolves behavior problems such as tantrums, anger and defiance, reduces symptoms of ADHD and even depression, and generates a wonderful parent-child relationship! In addition it is also my kind heart and all the boundless acts of kindness I bestow upon a child in the Playroom that promotes healing. It is my greatest joy to help a child!

Furthermore, I work with teachers to help reduce academic pressure coming from homework and school. I used to be a teacher and I know how to talk to them. I have gotten teachers to reduce to workload at times when necessary which reduces pressure and anxiety.

The power of Parenting!

There is much that parents can do at home to reduce anxiety in their child. The most important thing to remember is to try to not be anxious yourself, or more specifically not to express anxiety in front of the child. This prevents the child from learning an anxious reaction by example. You need to cultivate the value that “Everything is Ok just the way it is. We have no problems! Everything about you, my child, and almost everything you do is just fine!” Problems may arise, but we take them in stride! We react to them with cool, calm acceptance.

In addition, it pays to avoid criticism, reprimands, scolding and disapproval like the plague! Usually whatever benefit you hope to gain through these things is outweighed by the damage done to the child’s emotional health. It’s wiser to tolerate mischief and mistakes with a smile!

During Parenting Counseling, I gradually get to know parents and their child, and how the whole family works, and instead of giving so much direct advice, I help parents to develop their own innate wisdom which I am convinced every parent possesses. In this way I help them to develop their own personally tailored plan to resolve their child’s issue. A plan they developed themselves is one they are more likely to cherish and implement.

To find out how Parenting can help reduce ADHD symptoms, click here.

Play Therapy for anxiety, together with Parenting Counseling are the amazing double tools which can resolve almost any child’s anxiety, and most other issues as well!

To find out more about Child-Centered Play Therapy, click here.

Please be advised that the above represents a parenting ideal, and I don’t expect parents to be perfect. So have patience with yourself and try to adopt new ideas gradually.

***

Joseph Sacks is a child psychotherapist in lower Manhattan. He specializes in using Child-Centered Play Therapy to resolve behavior issues such as tantrums, defiance, anger and ADHD. It is amazing how well Play Therapy works to resolve these issues!

In addition Joseph helps parents to develop their own unique parenting approach to resolve their children’s issues. The parent-child relationship is the most important element in any child’s life, and by simply tuning up that relationship, we can have a tremendously beneficial effect. Joseph has written over 120 fascinating and well-researched articles on parenting and Play Therapy, which can be found at Tribecaplaytherapy.com.

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Categories : Anxiety, Child Development, Communication, Feelings, Parenting, Play Therapy, Reader Submissions

Tags : anxiety, family roles, feelings, Play Therapy, play therapy dolls, play therapy gams, play therapy intervention, play therapy toys

December Play Therapy Wrap-Up

Posted by Gary Yorke

· January 3, 2018

· No Comments

Children need the freedom and time to play. Play is not a luxury. Play is a necessity. – Kay Redfield Jamison

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Thanks to Jennifer Taylor for the wonderful play therapy termination activity. Stumped on how to end play therapy with a client on a warm and optimistic note? Try creating a chain on intentions with your exiting clients and let them leave as lasting an impression on your therapy room as you have had on them! Each link is a added as a client leaves therapy and each has it’s own message of positive intention for live post therapy. As time goes on, the chain, and the optimism, grows! What a creative and fun way to provide closure for your client. Read more here!

Articles

In Perry Klass, M.D.’s article, she explains how exposure therapy can be instrumental in helping children to overcome anxiety. All children can experience worry and fear, but when that fear interferes with the child’s functioning, or inhibits them from learning or growing, It may be time to seek help from a professional. Dr. Stephen P.H Whiteside of the Mayo Clinic, believes that exposing a child to whatever is causing the anxiety in a controlled and supportive environment will help them to overcome their fear and learn to cope with new fears. Anxiety manifests itself differently in children, even physically. A child can suffer some headaches and stomach pains due to anxiety. Not every child requires intervention for their anxiety, read the full article to know the signs of anxiety disorders and when to get help here.

December is the season of giving, but for some, it becomes the season of buying- Toys. We’re all guilty of wanting to give the young ones in our lives the world, or at least all the toys in the world, but according to the University of Toledo, when it comes to toys for children, less is more. Toddlers and children who have few toys actually play with more focus and creativity, which causes them to develop their imagination earlier, which can help with problem solving later in life. So when play time rolls around, choose quality versus quantity. Read full article here.

Should you let your child believe in Santa? Research in the field of developmental psychology actually cites some benefits to not only letting your child believe in Santa, but encouraging them to question and provide answers to the magic surrounding Santa Clause and all his fantastical feats. When they do discover that Santa is but a beloved Christmas myth, studies have shown that it’s actually the parents who are more upset than the children, who tend to feel part of a savvy community of “knowers,” rather than feeling betrayed or lied to. Another tip: Just because the belief in Santa stops, doesn’t mean the caliber of gifts given has to. If the big presents come from the parents every year, then when your child stops believing in Santa, they wont worry about what that means for Christmas morning festivities. Read full article here.

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Categories : Anxiety, Behavior, Child Development, Feelings, Monthly Wrap-Up, Wrap Up

Tags : anxiety, child development, child play therapy toys, child therapy, therapy toys

What are the “Must Have” Toys for a New Play Therapist? By Jennifer Taylor

Posted by Gary Yorke

· September 11, 2017

· 1 Comment

Questions about “must have” toys get asked so many times by clinicians new to the field of play therapy. And, the answers can vary widely. I’ve given parents some of my favorite toys in the past.

Dr. Landreth’s “Must Have” Toy Categories:

The foundation for play therapy training for a lot of clinicians is Dr. Garry Landreth and Child Centered Play Therapy. He advises that play therapists include several toys from each of three categories. Note that this list does not include everything that would fit into each category (they are just examples) and also that you do need everything on any list

Real Life

Expressive/Creative

Aggressive/Emotional Release

Directive Play Therapists “Must Have” Toys

When doing more structured or directive play therapy interventions, you usually need things like:

“Must Have” Elements of a Play Therapy Space

It can be quite easy to find excellent toys everywhere you go. And Dr. Garry Landreth reminds us all to beware of the urge to get everything. He says in his book, The Art of the Relationship, “Toys should be selected, not collected.”

And I created this infographic to summarize my thoughts on creating the perfect play therapy space that you might find helpful.

Reframing The Question

But, I just recently heard it explained in a wonderful way by a colleague, Dr. Jessica Stone, who responded to this very question during a discussion board about the Play Therapy Summit. She gave me permission to share it with you:

Hi all, I like to take an approach of collecting gems along my way in this field. I am not sure I could identify the one thing my office couldn’t live without. It is complex. Is that my personal favorite thing? Or my client’s? Or the majority of my clients? What comprises a favorite thing?

I believe what we have in our offices needs to be a balance of 1) what is congruent with who we are, what we believe, what our theoretical foundation is, what our space allows comfortably, etc. and 2) what speaks our client’s language, what helps our clients speak, what speaks to our clients, what allows them to experience feeling heard, seen, important, and understood.

I like to take a gem from Maria Montessori and think of the tools in my office as a way of scaffolding within the office. There are items that fit where they are in this moment, items that help them move forward, and items that work when they need to regress a bit.

Sometimes these tools aren’t our preferred or favorite. Sometimes they are. As I look around my office in response to your question I think about the clients who use the majority of the tools in my office on any given day but I also think about that one client, the one who found the tool that meant the most to them and they used it in the most amazing way – whatever that meant for them – Jessica Stone, Ph.D., RPT-S”

As I was packing up my office to move out of the state this week, I found Dr Stone’s words especially helpful. I usually play loud music when doing tasks like this, but this time, I held each of the toys and remembered the children that used them and how they used them. It was a mix of joy and sadness as I reflected on all of those shared moments in this specific playroom.

Final Thoughts:

In the end, I would recommend selecting a few items from each of Dr. Garry Landreth’s categories and then considering Dr. Stone’s advice about seeing the value of all the different toys in the playroom. But, know that whatever you have is enough. As long as you are in the room, focusing on the relationship with the child and responding in an authentic manner

**The post What are the “Must Have” Toys for a New Play Therapist? appeared first on Jennifer Taylor Play Therapy.

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Categories : ADHD, Anger, Anxiety, Art Therapy, Behavior, Books, Child Development, Communication, Conflict, Depression, Feelings, Intervention Ideas, Play Therapy, Play Therapy books, Play Therapy Toys, Reader Submissions, Sandplay/Sand Tray Therapy, Social Issues

August Play Therapy Wrap-Up

Posted by Gary Yorke

· September 1, 2017

· No Comments

“Men should learn to live with the same seriousness with which children play.” – Nietzsche (philosopher, writer)

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Netflix has released an original show about teen suicide. 13 Reasons Why is about a teen girl who commits suicide and how she choose to share her decision with her peers and family. The show has been praised and criticized for it’s portrayal and highlighting of the tragic issue of teen suicide. If you have a child/teen who has seen, is watching, or is interested in watching the show, Jennifer Taylor has some tips on how to put the fictional show in perspective and discuss with them the key points of the story. Read Jennifer’s full article here!

Articles

Racial tensions in America are high as opposing movements are vying to be heard. It is so important to discuss these matters with your children so they understand what racism is, and how to cope with it. According to Erlanger Turner, Ph.D., children often model adult behaviors, so it is also important to understand your own feelings on the issue of racism, and present ways to cope with disappointment or anger. Read the full article here!

Adults are no strangers to stress. we face stressors and challenges everyday, and hopefully, we know how to cope and combat that stress. Children also experience stress, but it may manifest itself in as a physical affliction rather than emotional distress. Stress in children is often misinterpreted as illness or bad behavior. The Psychology Foundation of Canada has some tips and signs to help you identify when a child is stressed. Read the full article here!

As with any publicized violent or traumatic events, it is important to discuss with your children what it means and why it happened. The events in Charlottsville, VA. have sparked many concerns and discussions. LA Times reporter Sonali Kohli discusses tips from professionals about how to broach these difficult topics with your children, and why it is important to do so. Read full article here!

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Categories : Anxiety, Depression, Feelings, Monthly Wrap-Up, Parenting, Social Issues, Trauma and Grief, Wrap Up

The Parents’ Guide to Discussing ’13 Reasons Why’ With Your Child by Jennifer Taylor

Posted by Gary Yorke

· August 24, 2017

· 1 Comment

Netflix launched a new show at the end of March 2017 called ’13 Reasons Why” that has drawn a lot of buzz in therapy circles and parenting groups.

Like most popular culture, it succeeds at keeping you in suspense enough to watch multiple episodes in a row. In fact, your teens are probably staying up late watching it now (if they haven’t already).

Premise of ’13 Reasons Why’

According to Netflix, the premise of the show is

“After a teenage girls perplexing suicide, a classmate receives a series of tapes that unravel the mystery of her tragic choice.”

So, basically a girl (Hannah) commits suicide but instead of leaving a note, she leaves a series of tape recordings explaining how the other kids at her school contributed to her decision to take her life.

Each of them gets a piece of the responsibility or blame. The show combines snippets of Hannah’s life prior to the suicide with interactions of the remaining students afterwards told from the point of view of her “friend” Clay.

**Possible Spoiler Alert

Criticism of ’13 Reasons Why’

As you might guess, this show has elements that make some parents uncomfortable. Like most high schools around the country, this school has issues that parents don’t always like seen displayed so graphically.

Among the concerns are:

Underage alcohol use & binge drinking
Marijuana Use
Profanity
Sexual Content and Language
Homosexuality
Sneaking/Lying
Violence
Bullying
Rape
AND the big one: the suicide scene

Examples:

The show opens with a typical house party with kids drinking alcohol (one of many alcohol scenes). Later in the show, a girl is raped while passed out from drinking too much. Those who know about it do nothing.

One main character is frequently smoking weed from a bong and is often high at school.

Another group of kids come to the school costume contest dressed in scuba gear and call themselves “muff divers.”

In one scene, characters refer to Hannah has being “DTF” – which for my friends who have not had the guilty pleasure of watching MTV’s Jersey Shore shenanigans means “Down to F@ck”

And don’t forget, there is the rape and then it specifically shows Hannah’s suicide.

Cautions Against “13 Reasons Why’ From Experts

Despite the array of Tweets and the press that says that this show brings positive attention to the topic of suicide, experts are not convinced. In fact, many of the agencies or foundations that focus on depression, mental health and suicide are concerned that this show sends the wrong message about suicide.

Not The Right Way To Handle Suicide Coverage

This article explains how the show violates nearly all of the recommendations about media coverage for suicide from ReportingOnSuicide.org. These recommendations include NOT sensationalizing the suicide, NOT talking about the suicide note, AND not describing (or showing in graphic detail) the suicide method. ’13 Reasons Why’ gets it wrong on all counts.

Not An Accurate Depiction of Mental Health

Moreover, the show fails to address depression or mental health/illness in any significant way. Among the ’13 Reasons’ is not a history of mental health or depression (the most common risk factor in completed suicides). This is especially disappointing given that the executive producer, Selena Gomez, has been quite vocal about her own struggles with anxiety and depression.

Not Helpful For Perpetuating Survivor’s Guilt

Another big complaint is that it perpetuates the belief that the other students are to BLAME for Hannah’s suicide. While, it does an “okay” job of discussing the concept of survivors guilt, the students involved are mostly more concerned about keeping the story a secret and avoiding any consequences or repercussions.

Can Be A Trigger For People With Mental Health or Trauma

Due to the content, the discussions and images have reportedly been a negative trigger for some people who watch the show. This is not to say that people who watch ’13 Reasons Why’ will take their life; but more that it can trigger additional feelings of depression, loneliness and hopelessness.

Reasons Why You Might Want To Watch It

This show has prompted a lot of discussion among my therapist friends about the value of watching the show. There’s really only two main reasons that are cited:

It is helpful to be “in the know” about things that are popular with teens. (That’s the reason that I watched it)
The show can be a prompt for deep and meaningful discussions between therapists and clients and between children and parents. *Note: I said it CAN BE. In the actual show, teens and parents failed to have any significant positive discussions about Hannah’s death or the aftermath.But in real life, there have been meaningful discussions about it.

’13 Reasons Why’ Discussion Questions

My recommendation is that if your child is remotely interested in this show, that you watch it with your child.

Really, together. On the same couch at the same time! Then spend some time talking about the key points in each episode. Because this show is based on Jay Asher’s book of the same name, there are dozens of book club lists with discussion questions available if you look for them.

The Jed Foundation has also released this great list of talking points.

What Therapists Discuss

If you want discussion questions specifically used by child counselors, you can borrow some of the ones that came up in our discussion board. Included are:

What impact does Hannah’s suicide have on her parents, the school and her classmates?
Why do you think none of the students discussed the tapes with their parents?
What is the difference between shame and guilt? Which characters feel guilty for their actions and which are ashamed?
What might have happened if Hannah had responded differently to Tyler in the very beginning-could there have been a different butterfly effect?
What could Courtney have done differently or how could she have handled the situation differently rather than throw Hannah under the bus?
Does Hannah’s use of the tapes create risks for additional suicides? How do her actions affect the lives of the people on the tapes?
How does keeping a secret affect people? How do the characters change when they start to talk about or reveal their secrets?
How does the school counselor let the students down? What can you do if an adult doesn’t do their job well or isn’t helpful?
Who can you go to for support when you are stressed? What it is about that person/people that is the most helpful?
Have you ever thought about hurting yourself or taking your life?

AND BONUS – My Favorite Discussion Question of All Time

’13 Reasons Why’ is basically an updated version of one of my most memorable group activities from my Bachelor’s program at the University of West Florida. I vividly remember being asked to complete “The Drawbridge Exercise” and subsequently being labeled as “oppositional” due to my response.

’13 Reasons Why’ & The Drawbridge Exercise

The Drawbridge exercise tells a story about a woman who is told by her jealous husband not to leave the gates of a castle or she will be “severely punished.’ Shockingly, she leaves. And, of all places, goes to visit a lover. On her way back, a gateman is waiting and says if she attempts to cross the bridge, she will be killed. She then returns to the lover for help and he refuses. She asks several other characters for help and all refuse. Receiving no help, she returns to the bridge and is killed by the gateman.

The Question is “Who Is To Blame?”

In class, our group was then instructed to assign levels of responsibility for her murder to all of the people in the story that refused to help her, the husband that ordered the murder and the gateman himself. You are to rank them from 1-6 in order of “most responsible” to “least responsible.”

And that is a great discussion question for the cast members of ’13 Reasons Why.’

Who is the most responsible or least responsible for Hannah’s death? Can you rank the characters in order of blame? Are any of them at fault?

Now, obviously, there is a HUGE difference between homicide and suicide. I think we can all find it easier to assign blame in a murder.

Nevertheless, the concept that there is someone to BLAME is an ethical question brought up in the show. In ’13 Reasons Why’ the characters struggle with feeling like ‘we are all responsible for Hannah’s death” and that “Hannah made the decision to take her life and she is the one to blame.”

It is basically a new age version of “The Drawbridge Exercise.” And it is an interesting discussion about assigning blame or responsibility for tragedy.

But, back to the drawbridge…

Wondering What I Said?

Remember…I was 19 years old and thought the world was simple.

I said, “The only person responsible for the woman’s death is the gateman. He is number 1 through 6. Everyone else is zero.”

My instructor did not like that. He thought I wasn’t taking the discussion seriously. I was labeled oppositional.

Mental health experts will also disagree with a discussion question that assigns blame to survivors for a suicide. But, I think it is a good way to bring about a discussion about regrets. In this YOLO / NO REGRETS world that high schoolers are in, it might be nice to talk about how your actions have consequences, even if you didn’t have bad intentions.

Final Thoughts

Now that I am not 19 (thankfully), I see more gray areas than I did in my college Social Justice class. In therapy there are these things called “duty to warn” and “duty to protect” that hold me responsible for failure to act in cases of potential suicide or homicide or abuse/neglect.

But more than that, I see both sides. Our actions do have consequences. Too often we fail to see how we influence others (in both positive and negative ways). We are ultimately responsible for our own choices, but know this….

HOPELESSNESS is the biggest predictor of suicide. Without assigning blame, make an effort to do what you can to prevent hopelessness in those around you.

*Not sure when take a suicide threat seriously-read more here.

See more from Jennifer Taylor here: Jennifer Taylor Play Therapy.

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Categories : Anxiety, Behavior, Depression, Reader Submissions, Self-Esteem, Trauma and Grief

Tags : aggression, anger, child therapy, childhood stress, depression, feelings, mental health disorders, teens

July Play Therapy Wrap-Up

Posted by Gary Yorke

· August 4, 2017

· No Comments

“Play is the highest form of research.”

– Albert Einstein

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Donna Hammontree had some great reasons for keeping those creepy play therapy dolls in your playroom. Even though they may not be the playroom favorites, they can often be implemented by a child to portray someone or something related to fear, anger, anxiety, and even guilt. “They may hide the dolls, lock them up with my play chain, or throw them away in a pretend garbage can. Sometimes they add guards around the dolls to provide extra security. Or, we may dress up as a superhero and find the dolls together. This frequently leads to better coping at home,” said Hammontree of her practice with the dolls. Read the full post here!

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It’s back to school time and that means back to school stress. Each new grade comes with new challenges- and new fears. The best way to curb back to school anxiety is to talk to yours kids and make sure they know that just because they feel nervous about something doesn’t make it bad or scary. Its OK to feel that way about things. Dinner conversations and unstructured play time are the best ways to debrief and find relief from the stressors of new school experiences. Read full article here!

Childhood stress is on the rise according to Julia Grochowski. Stress in children does not manifest itself in the same ways as adults. When a child doesn’t have the language to express what they are feeling they may say that they feel badly physically. They may have a tummy or head ache. The best way to differentiate between a tress induced ache and a physical ache is to pay close attention to when the child is experiencing it. If it is consistently occurring during a time of possible stress (school, tests, homework, etc.) There is a good chance that the child is not being difficult or sick, but that they are stressed. Read full article here!

Teen years are some of the hardest to navigate for parent and child. Dr. Sheryl Ziegler says the best way to close the gap between you and your teen is with more listening and less criticism. Parents who have teens who are active on social media should also be familiar with the social media platforms. Focus on common experiences. Read the full article here!

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Categories : Anxiety, Child Development, Communication, Feelings, Monthly Wrap-Up, Parenting, Reader Submissions, Wrap Up

Tags : childhood stress, Play Therapy, play therapy dolls, play therapy intervention, play therapy toys, sand tray therapy, stress, teens

Using Creepy Dolls in the Playroom by Donna M Hammontree, LCSW, RPT-S

Posted by Gary Yorke

· July 19, 2017

· 1 Comment

Freddie Krueger. Chuckie. Jason.

Parents and children alike ask me, “Why do you have those in here?”

I respond, “Why do you think I have those in here?”

Gary Yorke, PhD, recommended 1 or more of the play therapy dolls as good resources for the playroom. I was skeptical but bought 3. Deciding to assess the use of them for myself, I have determined there are multiple uses for the creepy therapy toys.

To communicate anger

A child may use the doll to let a therapist/school counselor/teacher/parent know he is angry with the adult for any reason by shaking the doll at the adult.

The creepy doll may be thrown across the room or beaten up to express anger at any bad experiences or people.

To communicate that a person has scared the child

A child who has been traumatized may ventilate that fear by using 1 or more of the dolls. Sometimes that fear may come from watching scary movies; in that case, I guide care takers in being more selective in visual experiences.

To express identification with, ventilate about, or gain control over one’s own creepiness

Children on the Autism Spectrum or with physical differences may use the dolls to process how they are treated by peers on the school playground.

To express identification with the oppositional and defiant nature of the dolls

A child who presents with defiance, for whatever reason, may identify with the dolls and act out that oppositional stance.

To gain control of one’s anxieties and unrealistic fears

Some children ask me to hide the dolls as they are afraid of the dolls. I may do so in a very early session but soon have the child take responsibility for the fear and find a way to cope with the creepy dolls themselves. They may hide the dolls, lock them up with my play chain, or throw them away in a pretend garbage can. Sometimes they add guards around the dolls to provide extra security. Or, we may dress up as a superhero and find the dolls together. This frequently leads to better coping at home.

To communicate low self-esteem, worthlessness, guilt

Play using the dolls may involve being bad and in trouble. I work to validate the feelings in the play and then acknowledge the creepy doll’s life experiences, such as mistreated, hurt, surviving difficult times, trying to protect himself.

To express whatever the child needs to vent about

Children will use the dolls or avoid them to communicate thoughts and feelings about situations that I may never fully understand. Being client-centered and open to their experiences is the key.

The professional benefits from an individual and family assessment of the client and knowledge of the child’s experience to fully understand and best respond to the child’s play. On the other hand, being in the moment with the child and aware of the therapists’ own emotional responses to the client is often enough to further assess, validate, encourage an adaptive response by the child.

“Why do you have those in here?”

Therapist’s response, “Please tell me!”

***

Donna is a Licensed Clinical Social Worker and Registered Play Therapist/Supervisor in private practice, in Savannah, GA. Visit her website: http://www.donnahammontree.com/

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Categories : Anger, Anxiety, Autism, Behavior, Bullying, Child Development, Communication, Feelings

Tags : child play therapy toys, child therapy toys, play therapy dolls, play therapy toys, therapy toys

Cognitive Restructuring for Children By Donna Hammontree, LCSW

Posted by Gary Yorke

· January 4, 2017

· 1 Comment

calm-girl

Cognitive restructuring occurs regularly in the playroom as a child experiences the therapist’s full acceptance. Teaching cognitive restructuring, however, may expedite the process of having a child experience heartfelt self-acceptance. A useful analogy is that of a school teacher teaching classroom rules. The teacher will allow students to learn classroom rules throughout the first week of school through experience, but prior to that experience, the teacher will verbally share the rules, and may even write them out and post them.

Here are a few ways a play therapist can teach cognitive restructuring:

Identify and highlight for the child’s their cognitive distortion while tracking play.

“You don’t think you can do it.” (I am helpless or powerless.)

“So, nobody likes you?” (I am worthless.)

“Your teacher should do it your way.” (I should be in charge.)

Discuss how what we think affects how we feel and how we act.

Use drawings to illustrate:
1. Take 2 sheets of paper and draw an oval face with eyes on each sheet. Write Thought, Feeling, and Action on each sheet beside each face. On the 1^st sheet, write “I can’t do anything right” beside the word Thought. Have the child draw a face on the oval showing how the person would then feel. Then ask the child how a sad person would act and write a short answer for the child next to the word
2. Next, write the exact opposite of the cognitive distortion (this is a cognitive distortion too!) at the top of this same sheet. For example, “I do everything right!” The child will agree that this is not true. Let the child cross out this statement, or put an X next to it.
3. On the 2^nd sheet write, “I do some things right!” Help the child think of some things they do correctly. Identify the feelings that go with recognizing what they can do, and encourage the child to illustrate the feelings associated with these abilities on the face. Ask the child how this person might act, and the child’s response next to the word “Action.”
4. This activity can be repeated with the child’s cognitive distortion(s), followed by a rational thought developed by the therapist and child.

spry-sparrow-book-cover

Use bibliotherapy. Spry Sparrow: From Drab to Fab illustrates how having a negative cognition contributes to feelings of sadness and anxiety. In the story, Spry compares herself to others and thinks, “I am not good enough.” Spry’s mother helps Spry identify realistic, positive cognitions. Heartfelt change occurs for Spry when she accepts the positive thoughts as real for herself. Encouraging parents to read the book to a child helps the parent understand cognitive restructuring as well.

As the child plays, track the new thought as the child practices it behaviorally in session. For example, say, “Oh, you did that by yourself! You can do some things!”

At the end of the session, meet with the child and their caregivers and discuss the new thought. Ask the caregiver to reinforce the new thought: For example, when the child plays with a cousin, the caregiver might reflect that the cousin likes the child and ask the child to repeat, “My cousin likes me! Some people like me!”

Games such as Land of Psymon, The Positive Thinking Game, and Positive Thoughts are also fun ways to engage in cognitive restructuring.

landofpsymon drplaywellpositivethinking positivethoughts

A cautionary note: Some children are truly unloved and taught that they do nothing right. In these cases, these interventions may not be appropriate in the early stages of therapy, and will need to be preceded by other interventions. It is also important to note that Cognitive Behavioral Therapy has two parts: cognitive restructuring and behavioral change. Children are able to learn new beliefs about the world, their relationships, and themselves by understanding cognitive restructuring. They will also need to practice new behaviors, reinforced with new beliefs, to experience heartfelt change.

Celebrate feeling happier!

Donna is a Licensed Clinical Social Worker and Registered Play Therapist/Supervisor in private practice, in Savannah, GA. Visit her website: http://www.donnahammontree.com/

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Categories : Anger, Anxiety, Art Therapy, Behavior, Bibliotherapy, Books, Child Development, Communication, Depression, Feelings, Intervention Ideas, Play Therapy, Play Therapy books, Play Therapy Games, Reader Submissions

Grounding Kids For Having Anxiety by Cristina Margolis

Posted by Gary Yorke

· September 27, 2016

· 1 Comment

First thing’s first. The title is very misleading, but it got you to click on the link, didn’t it? 🙂

All parents know what grounding is. It’s what they do with their children who misbehave. Currently, my three year old is grounded from the iPad for hitting her sister. However, parents of children with anxiety may practice a different type of grounding.

Grounding techniques are used for adults and children who exhibit anxiety. Anxiety can be terrifying and make you feel like you are not in control. It is almost as if you are having an out of body experience. During an anxiety attack, you may freeze up and go into a complete panic. Not only does anxiety affect you emotionally, it can affect you physically. Your body may sweat and shake, you may have trouble breathing, your heart rate may increase, your hands and feet may tingle, and you may feel dizzy and nauseous. It is downright frightening, especially for young children. Fortunately, there are anti-anxiety attack techniques called “grounding.” They are given that name, because they keep you “grounded.” Their purpose is to help you reorientate yourself and bring you back to reality.

Children with ADHD often feel overwhelmed at times, which can bring on strong feelings of anxiety. According to a study done at the National Resource Center on ADHD, up to 30% of children with ADHD have also been diagnosed with an anxiety disorder. My own daughter with ADHD has anxiety attacks every now and then. I have tried numerous techniques to help her get through her anxiety attacks (including having her look at a calm down jar and spend time in her calm down space at home), but the following technique (what I refer to as “5, 4, 3, 2, 1, Blast off”) is great, because it can be used no matter where you are.

“5, 4, 3, 2, 1, Blast Off” – How To Help A Child Having An Anxiety Attack:

I tell her to look around and find five things she can see. I have her count them using her fingers.
I then tell her to find four things she can touch. Again, I have her count them using her fingers.
I tell her to find three things she can hear. Again, I have her count them using her fingers.
I tell her to find two thing she can smell. Again, I have her count them using her fingers.
I tell her to find one thing she can taste.
Blast Off! By the end of step 5, my daughter has “blasted off” her feelings of anxiety and is calm, cool, and collected. She is then able to talk with me about her problem and we come up with a solution together.

What are some other techniques you have used for your child or yourself to get through an anxiety attack?

* * * * *

Thanks to Christina Margolis for this awesome submission! Check out more from Christi at mylittlevillagers.com

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Categories : Anxiety, Child Development, Communication, Conflict, Feelings, Parenting, Reader Submissions

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