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Archive for Reader Submissions

Rights, Responsibilities, Privileges, Rewards: Coaching Strategies by Donna Hammontree, LCSW, RPT-S

Posted by Gary Yorke 
· July 17, 2018 
· No Comments

Helping children learn to manage and regulate their behavior can be a challenge.  My colleague Mandy Miller, LCSW, shared her insights with me, and I use her system regularly when coaching parents, teens, and children. To start, everyone should be clear about what is a right, a responsibility, a privilege, and a reward.

Basic definitions
Rights:  food, shelter, clothes, love
Responsibilities:  respectfulness, completion of school and homework, doing chores, following adult directions
Privileges:  video games, cell phone access, television, crafts, time with friends, name brand clothes
Rewards:  ice cream outings, a trip to the toy store, having a friend over, trip to the park, choosing and playing a family game

After we are clear about our definitions, the next step is to shift from a negative approach, to a positive approach.  We want caregivers and parents to understand the benefits of focusing on earning privileges, rather than losing them. As an adult, if I drive my car responsibly, I earn and keep my privilege to drive.  If I choose to speed or run red lights, I may have to take city transportation or ride my bike.

Basic Guidelines
Consistency:  If 2 or more adults are involved in the home, everyone needs to be communicating and working together.
Short-term loss of privileges:  Privileges can be re-earned by changing the behavior quickly or by staying calm while engaging in or with something else.  Long-term loss of privileges can lead to hopelessness and increased defiance and oppositional behaviors.
Non-punitive:  The child either chooses to earn a privilege or not.  
Calm, caring and firm caregivers:  Adults need to stay emotionally untangled with any tantrums.  This means that the adult needs to remain calm, positive, and pleasant while not taking on the child’s emotions.  Parents should be coached in active listening: “I hear you are upset, and I’m sorry you lost your privilege … You feel really angry at me right now and are upset you lost your privilege.”  Parents should remain empathic and loving.

Additional Suggestions
Caregivers and parents may use this program exclusively within the home or the program may include activities outside of the home.  Children struggling outside of the home may benefit from having some of their privileges at home being made contingent on success at school or camp. For example, if the child has a green day, the child gets 1 hour of video games.  If the child has a “yellow” day, the child has to wait 15 minutes to start playing the video games for 45 minutes. Finally, if the child has a red day, the child has no video game time. The child can do anything else like play outside, read books, or play board games with the parent.  Time frames should match the child’s chronological or developmental age. If the school or camp day is included, teachers and parents will need to work closely together daily. Several days of success may be followed by additional privileges or reward activities.

Some children, especially younger ones, may need for the day to be divided into shorter parts, such as 8 a.m. to 10 a.m., 10 a.m. to noon, noon to 2 p.m. and so on.  Children with self-regulation and impulse control issues may benefit from even shorter periods of feedback.

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Categories : Behavior, Child Development, Communication, Reader Submissions
Tags : child therapy, development, feelings, parenting

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?

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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,

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“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.

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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,

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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,

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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.

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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!

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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!

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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

Play Therapy Termination Activity: The Chain of Intentions by Jennifer Taylor

Posted by Gary Yorke 
· December 21, 2017 
· 1 Comment

Termination of play therapy services can be difficult for the counselor and the child. The relationship formed during the months of therapy is one of the most important aspects of the process. Termination activities differ across settings:  some offices provide certificates and some simply said good bye.

Today, I will share a termination activity that has been quite popular in my office.

The truth is that it is also a goal setting activity. So, you can use it at the beginning and the end of therapy.

It started way back in January 2016….I like to call it the Chain of Intentions.

The Inspiration for This Termination Activity

The Chain of Intentions was inspired by a commercial that I watched about the My Intent Project.  According to their webpage,

We believe there is purpose inside each of us and we want our efforts to encourage people to share more truth and inspiration with each other. We are not a jewelry company – we are an intentions project-My Intent Project

Despite their claim not to be a jewelry company, they do in fact, make jewelry. The customer chooses a word of inspiration to have marked on a disc and uses that as inspiration or motivation in their daily life.

(Note…I have no affiliation with the My Intent project and have received no financial compensation from them…this is purely background).

So, I ordered one with my intention for my play therapy practice.

My word was FOCUS.

Focus on PLAY THERAPY.

See, I have a habit of saying yes to all opportunities. Those things were taking me away from my core mission which was to use play therapy to help children deal with trauma or other difficulties at home or in school.

I needed to FOCUS.

But, because I could not buy a necklace as a termination gift for each or my clients, I came up with a way to create a chain of intentions with all of the (willing) clients and students that came to my office.

Chain of Intention Instructions:

  1. I started by tying a very long piece of yarn to the air ducts in my office to form a string that went from one end of my office to the other. You could do this by tying it to a nail or a hook of any kind.
  2. Cut out strips of construction paper by folding in half vertically and then folding in half again. You will get 4 strips for each standard sheet.
  3. Using a marker, I wrote my word FOCUS and made the first circle around the piece of yarn. It was very sad and lonely all by itself. 
  4. As children noticed it and started to ask about it, I told them the story about the necklace that I just told you.   Now..even though I said this was a termination activity, it can also be a treatment goal activity.
  5. If a child wanted to create an intention as a treatment plan goal, I allowed them to make a strip with a word about what they wanted to achieve during their therapy visits. Children choose things like listen, happy, create, design, friends.   Make sure that the intention is positive. So no chains that say “Stop, no, don’t.”
  6. I had the child stand on a chair and link their strip onto mine (or the last one up) and then staple it themselves so that their word of intention was visible.
  7. At the end of therapy, the child would either create another strip (or do one for the first time if they were not interested in doing a goal strip) that said what they learned during the therapy. Or sometimes, it was a benefit or just something they wanted to continue working on. Their INTENTION after our services ended. Some wrote happy, friends, joy, connection, success. Again, I had the child write the word, put it up and staple it themselves.
  8. If children were too young to spell, they tried their best. Or they drew a picture. Sometimes, I wrote the word down and they copied it.

 

 

Thoughts on Termination

The end result was a way for them to leave something behind. A testament to the power of therapy and the work that was accomplished. A motivation for other children that success was possible. And a vision for their future about what could help guide them after therapy was over.

My goal was to get from one side of the room to the other. It took the entire year. My office is big! But as it grew, it became a fixture in the office and I am excited to take it down and start again. And a little sad to see it go. I am thinking that I can use it as a garland for my office Christmas tree. A symbolic way to honor the work of the year and transition into the intentions for the new one.

***

Thanks to Jennifer Taylor for an other great reader submission! Check out more from Jennifer at jentaylorplaytherapy.com

Have a post you would like to feature on our page? Let us know!

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Categories : Behavior, Child Development, Communication, Feelings, Intervention Ideas, Play Therapy, Reader Submissions
Tags : Play Therapy, sand play, sand play therapy, sand therapy, sand tray therapy, sandplay therapy, sandtray therapy, termination of play therapy, termination of therapy, therapy tools

September Play Therapy Wrap-Up

Posted by Gary Yorke 
· September 27, 2017 
· No Comments
“The activities that are the easiest, cheapest, and most fun to do – such as singing, playing games, reading, storytelling, and just talking and listening – are also the best for child development.” – Jerome Singer (professor, Yale University)

Blog

Wondering what the essential toys for a playroom are? We can help with that! In Jennifer Taylor’s post about playroom essentials, she highlights all of the staple items needed for a complete playroom. From sand tray miniatures to play therapy games, Taylor shows you what you could be missing and why it’s important to include these items in your playroom experience. View her list and links to the perfect playroom here!

Articles

We all want to praise children when they succeed, but according to new international research, how you praise your child could either motivate them to work hard, or motivate them to cheat. According to the study, published in Psychological Science, praising a child for simply being smart could actually cause them to feel pressure to perform up to high expectations, which may cause them to cheat, whereas complimenting a child’s effort will motivate them to work hard, and perform at their full potential. Read the full article here!

“The resilience of an individual depends on drawing resources from many other systems,” said University of Minnesota psychologist Ann S. Masten, PhD, who has studied the subject of child resiliency for 40 years. According to Masten, fostering resiliency in children is accomplished not only by the child’s innate ability to cope and problem-solve, but also by the relationships and support they receive outside of themselves. This article outlines all of the important factors that help a developing child boost resilience, and why you should care. Read the full article here!

Every parent contends with stress. Work stress, family stress, financial stress. It’s important not to let that stress trickle down to your children, says Katie Hurley. In this article she outlines different types of stress, how to identify your triggers, and most importantly, how to practice letting go of those things that are eating you up. When we feel stress, our children see and experience that stress with us, so it’s important to demonstrate coping skills to alleviate those tensions.  Read the full article here!

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Categories : Behavior, Child Development, Communication, Conflict, Feelings, Monthly Wrap-Up, Parenting, Play Therapy, Play Therapy books, Play Therapy Games, Play Therapy Toys, Reader Submissions, Social Issues, Wrap Up
Tags : child therapy toys, childhood stress, feelings, Play Therapy, play therapy dolls, play therapy toys, sand tray miniatures, sand tray therapy, stress, teens, therapeutic games for children, therapeutic games for teens, therapy games, 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

  • Play kitchens and play food
  • Doctor kits and band-aids
  • Dolls and Dollhouses
  • Animals, Cars, Trucks, People
  • Cash Register and Play Money

Expressive/Creative

  • Art supplies
  • Paint
  • Play-doh
  • Dress Up
  • Puppets and Puppet Theater

Aggressive/Emotional Release

  • Toy guns 
  • Foam swords
  • Rubber knives
  • Rope
  • Soldiers
  • Aggressive puppets or figures (sharks, dinosaur, alligator, etc)

Directive Play Therapists “Must Have” Toys

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

  • Books
  • Therapeutic games
  • Traditional board games
  • UNO cards
  • Playing cards
  • Cooperative Board Games

“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

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:

  1. It is helpful to be “in the know” about things that are popular with teens. (That’s the reason that I watched it)
  2. 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:

  1. What impact does Hannah’s suicide have on her parents, the school and her classmates?
  2. Why do you think none of the students discussed the tapes with their parents?
  3. What is the difference between shame and guilt? Which characters feel guilty for their actions and which are ashamed?
  4. What might have happened if Hannah had responded differently to Tyler in the very beginning-could there have been a different butterfly effect?
  5. What could Courtney have done differently or how could she have handled the situation differently rather than throw Hannah under the bus?
  6. 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?
  7. How does keeping a secret affect people? How do the characters change when they start to talk about or reveal their secrets?
  8. 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?
  9. Who can you go to for support when you are stressed? What it is about that person/people that is the most helpful?
  10. 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.

1 Comment
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

Blog

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!

Articles

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

Should Your Playroom Include Aggressive Toys Like Play Guns? by Jennifer Taylor, LCSW, RPT

Posted by Gary Yorke 
· June 6, 2017 
· No Comments

Play therapists widely regard the use of aggressive toys, including toys guns, as an essential element to the playroom. However, many parents are hesitant to allow their children to play with toy guns. Nearly all schools have banned the use of toys guns (or even pretend shooting) completely.

Over the years, I have had some toy guns (not realistic looking ones, though) and other times I have taken them out.  As a therapist, the use of toys guns is not essential, but the use of aggressive toys, is vital.

What is an Aggressive Toy?

Aggressive toys are anything that a child can use to get out pent up anger or hostility.  These toys can be used to role play fights or battles, good guy/bad guy situation, or other trauma re-enactments.

 

Examples of aggressive toys include:

  • Non-realistic toy guns

  • Rubber knives

  • Foam swords

  • “Mean” animals like sharks, dinosaurs, alligators, lions, etc.

  • Toy soldiers (two different colors)

  • Handcuffs

  • Rope (I use a jump rope with the handles removed)

  • Bop Bag

What is an Aggressive-Release Toy?

Aggressive-Release Toys are toys that are okay to destroy or break in some way. These toys help redirect actual aggression into a more acceptable alternative.

Examples of aggressive-release toys include:

  • Egg cartons (can be crushed)
  • Bubble wrap (can be popped)
  • Paper (can be ripped up)
  • Popsicle sticks (can be snapped or jabbed into clay)
  • Wet paper towels (can be thrown against wall outside or on easel)
  • Clay or Play-doh (can be pounded)

Why Are Aggressive Toys Useful In Therapy?

Expressing Anger

Children need a safe opportunity to express feelings of anger.  In the play therapy environment, children can use aggressive toys to play out things that are happening with people in their lives. BUT…when it is done with an animal instead of a doll person, it feels safer to the child.  It is the same feeling/movements/thoughts but it doesn’t feel as real.

Relieving Physical Tension

Also, when using aggressive release toys, children get to move their bodies in a way that helps relieve the physical tension that anger brings.  Pounding clay, stomping egg cartons, or swinging foam swords helps move the body in ways that release tension and the accompanying noise that the movement makes also helps reduce tension.

Learning Boundaries

Finally, aggressive play helps teach children boundaries.  In rough/aggressive play, children learn how hard to swing without actually hurting the therapist, or how fast to move without falling down.  They learn how to “take a break” if someone needs to rest and how to start back up again.  I have witnessed siblings learn how to set rules for “fair fights” using foam swords and how to negotiate cheating.

Sword Fighting Aggressive Play

My Kids Sword Fighting

Do Aggressive Toys Create Aggressive Children?

It depends on what research you read.  A few studies have shown that aggression may increase temporarily after playing with aggressive toys.  This DOES seem to be more true when you are talking about playing violent video games (different story there). But, long-term, there is no reliable evidence that toy guns create more aggressive kids.

In fact, the opposite holds more true.  If a child has an appropriate place to express and display anger, then they are less likely to use anger with their peers (or parents).  Telling children, “Don’t get mad” is not nearly as helpful as teaching them what to do when they are mad to diffuse it.  The use of aggressive release toys helps teach children what to do with their angry in a way that will not get them in trouble.

Children Will Find Creative Ways To Express Aggression

In fact, many therapists find that children will turn neutral toys like blocks or their fingers into guns, knives, or bombs in order to communicate their needs with whatever is available.  The expression often goes:

If a child needs a gun to represent something going on in their life, they will find something and turn it into a gun (either in shape or with the noises that they make) to communicate that need.”

What To Do If You Are Uncomfortable With Toy Guns?

  1. Set limits.  It might be that toy guns are only for target practice. “Guns are not for shooting at people.”  When I have any toy guns in my office, I NEVER shoot at children.  I have let them shoot at me, but I would not shoot back at them.  If they tell me to shoot them, I would act out thinking about it but being so worried that they would die or I would go to jail or some other bad  outcome.  A great play therapist, Lisa Dion, writes more about how to play aggressively with children in her book, Integrating Extremes: Aggression and Death in the Playroom. 
  2. Set different limits for different games.  You might say that you can not shoot at me in general, but then we make a specific limit for Nerf or laser style games where we have defined a goal or specific rules. These games typically have teams, time limits, and rules of engagement.  You discuss them in advance and determine that the shooting ends when the game ends.
  3. Make sure your guns look very fake.  Avoid anything that is at all realistic.  Guns that are bright colors, light up, or make silly noises all classify as fake guns.  Guns that shoot foam balls.
  4. Use the alternative aggressive toys.  If you are still not comfortable with toy guns, use the alternatives.  Foam swords are generally more fun than toy guns anyway.

A Side Note About Gun Safety:

Regardless of your use of toy guns, there is never a bad time to talk with children about what to do if they find a gun while playing.  Just recently, there was an incident here in Memphis where a child picked up a gun and shot his brother accidentally.

There are many factors in that case that have nothing to do with aggressive play or aggressive toys. And yet, the underlying fear is that if we let our children play with aggressive toys, things like this will happen.  So…

  1. Talk about actual gun safety.  Talk with your children about what to do if they ever encountered a gun outside of the playroom and what to do and not do about it.  You can discuss that they should never pick up a gun outside of the playroom and that they should notify an adult right away.
  2. Require gun safety from adults.  It’s okay to ask the parents of your child’s friends if they own any weapons and how/where they have them stored.  Same goes for grandparents or other relatives. Don’t just assume that they are responsible gun owners, make them prove it.  Everyone that I know that has any weapons in their home can easily tell me how they are keeping them safe.

Final Thoughts:

Recently, I polled a group of play therapists and they overwhelmingly reported that they not only had toy guns in their offices, but that they found them to be an essential component of a play therapy space. However, those that did not have toy guns felt that the same benefits were achieved through the use of other aggressive release toys (like ropes, knives and swords) without the complications.

PS.

Moreover, representing reality in the playroom is important.  The truth is that many children have parents that work with weapons (law enforcement and military) and others have been exposed to very traumatic events involving drug raids, shootings, or other community violence.

To deny access to those items or experiences seems to somehow convey that those feelings, thoughts or experiences are shameful, wrong, or not important.  The playroom is a place to overcome those feelings and any toys that facilitate that process are okay in my office.

Do you allow your children to play with toy guns?

***

Thanks to Jennifer Taylor for this great post!

To check out Jennifer’s website, click here!

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Categories : Anger, Behavior, Bullying, Communication, Conflict, Intervention Ideas, Play Therapy, Reader Submissions
Tags : aggression, anger, bop bags, development, feelings, Play Therapy, play therapy intervention, therapy toys

My Favorite “Non-Therapeutic” Games… Sorry! by Stacy L. Garcia, MA, LPC, NCC

Posted by Gary Yorke 
· May 31, 2017 
· 1 Comment

I’ve told you in my last two posts about how much I love using games in therapy, especially with children and adolescents. I’ve already explored how I use the games Jenga and Find It in therapy sessions, thus using otherwise “non-therapeutic” games and turning them into effective therapeutic interventions that I can use for multiple purposes. Like Jenga and Find It, I use numerous other “non-therapeutic” and therapeutic games to teach various topics and skills to my clients. If you’re new to reading this blog, the difference between “therapeutic” and “non-therapeutic” games is nothing more than what their intent and purpose were when they were created. “Non-therapeutic” games are those that you can find at your local department store in the game aisle, such as UNO and Scrabble. In my own experience, I have found that ANY game can be made therapeutic, just like any game can also be made educational. Today’s game is a popular classic among board games: Sorry! I use the game Sorry! to teach children to take responsibility for their behaviors and actions, as well as to demonstrate through role play how and when to apologize.

How to Play Sorry!

To start the game of Sorry!, each player chooses a pawn color and places his four pawns on the matching colored START circle. The included pack of game cards are shuffled and placed face down on the space marked “PLACE PACK” in the center of the game board. Then game play begins around the board. A player draws the top card from the pack and places it face up onto the “DISCARD” space on the board. He follows the card’s directions, moving his pawn a number of spaces. When a move ends on a square already occupied by an opponent, the opponent’s pawn is bumped back to his START.

Regardless of whether in his favor or not, a player must make a move with one of his pawns as directed by the card he has drawn. The player who first moves all four of his pieces from his START to his HOME of the same color wins the game. The frustration Sorry! usually elicits in its players is often attributed to the cards’ directions not being in one’s favor, as well as being bumped back to his START space, either as a result of his opponent or because he has drawn a Sorry! card forcing him to land in an unfavorable position.

How to Make Sorry! Therapeutic

Enter Therapeutic So Sorry! When playing the game in therapy, I add So Sorry! cards. Each time a pawn is bumped back to its START circle, the opponent who caused the bump back must draw a So Sorry! card. These are cards with questions and role play tasks in which the player has to either discuss or role play his taking responsibility for pretend behaviors and actions in which he should be “so sorry.” The set of cards also includes questions about the client’s own behaviors/actions and prompts them to explore whether he needs to take responsibility for said actions. To use the “So Sorry!” cards that I have, you can click here. Game play resumes as normal after the So Sorry! task has been completed.

Therapeutic So Sorry! is a lot of fun to play, and I’ve found it especially helpful when working with children who have difficulty taking responsibility for their actions and those with behavior and/or impulsivity disorders. It can also be used to reinforce appropriate social skills to use when having to take responsibility for one’s behavior. Best of all, the children I work with love playing the game just as much as I do!

***

Stacy Garcia, MA, LPC, NCC

“Following attainment of a B.S. in Psychology in 2001, I earned my M.A. in Counseling from West Virginia University in 2004. I returned later to obtain certification in School Counseling.

I have extensive experience in working with children and adolescents, though I also see adults. I also specialize in treatment of trauma-related issues and concerns (including PTSD), behavior disorders (such as Oppositional Behavior Disorder), and Attention-Deficit/Hyperactivity Disorder (ADHD). I am skilled at working with parents and families who are experiencing issues at home, focusing on each individual’s strengths and needs while they rebuild the family unit.”

1 Comment
Categories : Child Development, Communication, Intervention Ideas, Play Therapy, Play Therapy Games, Reader Submissions
Tags : board games, games, Play Therapy, play therapy intervention, therapy toys

10 Categories for Sorting Sandtray Shelves: How, What and Why by Amy Flaherty, LPE-I

Posted by Gary Yorke 
· May 19, 2017 
· No Comments

 

Confession time: I’m an addict.

What kind of addict you ask…

..the best kind: the sandtray miniature kind!!

I’m betting that if you are reading this super nuanced post about the details of doing sandtray therapy you should belong to a miniature meeting somewhere too, am I right??

Okay, so let’s get to it…

Last week I moved into a new, KA office where I have a spacious training room as well as a play therapy space.

I’m not gonna lie, moving sucked a big one, but one bright spot appeared in the whole process….

I got to rearrange and set up my miniatures just as I wanted them on brand new shelves!!

 

All My Pretties…

Since I’ve been doing sandtray therapy trainings for several years now (sign up here to grab your spot at my next training), many folks have asked the best way to arrange miniatures on shelves.

As an aside, don’t worry for you traveling, crammed-for-space-therapists- my next blog post will be just for you so be on the look out!

Now, back to the fun stuff.

I’m going to show you how I arrange my miniatures and tell you my logic behind my placements. Plus, you’ll get to see most of my miniatures up close and personal, which I can bet will give you some miniature envy (there’s no such thing as ‘enough’ miniatures!)

Okay! Roll up your sleeves and let’s dig in shall we?

1. Animals

To start, you can see my animal shelves below. I place my animals closest to the bottom because they are most used my younger kiddos.  Young kids are most likely to use animals rather than people so putting them on the bottom just makes practical sense.

Groupings of domesticated animals- try to put the horses and other types of animals together. Kids will often make families out of these. Horses get used a LOT.

Groupings with zoo/wild animals

Birds/Cats/Dogs My cat and dog miniatures are also used all the time. You can almost never have enough of these.

Scary spiders go at the bottom. These are a MUST for working with little boys.

2. Fantasy Figures

When I moved offices, I knew I had to dedicate more shelves to fantasy miniatures.  These are also a must-have for your sandtray collection because they get used with all ages.  Adults usually place them as metaphors or hobbies, but kids will tell lots of stories with the fantasy figures.

Don’t worry- by placing an Elsa miniature there you aren’t guaranteed to hear the whole plot of Frozen.  (Read this post to find out why).

Bottom to top shelves with fantasy figures. Nab these any time you see them!

Dragon shelf. Used for all ages but again little boys gravitate towards this shelf. Multiple-headed dragons are the best.

3. Transportation

If you work with kids AT ALL, you will likely have a difficult time keeping this shelf neat and tidy. Little boys typically LOVE to smash cars into each other.  Remember, even if they can’t tell you what is happening in the tray, it doesn’t mean that nothing is happening. The brain never misses a chance to integrate.

So many cars they are spilling out of the shelves

4.  People

When working with school age clients and older, having a variety of people is extremely helpful.  Try to collect as many different ages, skin colors, and diverse abilities as possible.

As you can see, I separated mine into gender and then had a shelf for groupings of people.  I also made a separate placement just for what I think of as “milestone markers,” such as birth, weddings, graduation.  Place these near the bottom so your kids can access people miniatures as needed.

My shelf o’ men. Not sure why I have more men than women? Interesting though..

Children shelf on the bottom (babies are grouped) and then the women shelf above it

Family shelf. Can you spot my favorite??

5.  Fences

I have an entire shelf devoted just to fences.  You really can never have too many fences.  Kids will often line the tray with fences and have fences inside of fences.  A variety of size and shapes are helpful. To find out more about fences in the tray, click here.

Fences on the top and treasure box/treasure shelf below

6. Treasure/Rocks

Just as fences get used in trays for all ages, so do treasure chests, treasures, and rocks.  I try to place these near the middle on my shelves.

Don’t worry about sorting all of your rocks because the kids will choose what they need anyway (and you will drive your OCD self INSANE if you make this a priority.)

 

7. Religion/Death shelves

Seems like an odd pairing at first huh? But, if you think about it, religion plays a key role in how we see death, so it makes sense to have these near each other.

Clients of all ages will use these- adults again, perhaps more metaphorically but these two shelves do get a lot of use in my play room.

In case you can’t see, they are in the middle shelves.

Death and religion shelves

 8. Miscellaneous

But what about all that stuff that just doesn’t have a category??

Round those up and put them on shelves you classify as “miscellaneous.”  Adults LOVE these shelves.  So many abstract thoughts and stories come from random miniatures.

Always keep an eye out at yard sales and flea markets for one-of-a-kind miniatures to fill these shelves. Often those miniatures where I have NO CLUE how they could be used end up being the most popular ones!

Some of my favorite shelves. Also near the middle

More miniature eye candy..

9.  Houses/Bridges

I place my houses at the top because these rarely get used by little ones, but adults love to populate their trays with houses.  A variety of houses is helpful for the client to find one that is “just right.”

Bridges are often used by adults to symbolize hope and connection.  Any time you see a bridge come into a tray, know you are on the right track.

Bridges, bridges and more bridges in my sandtray room

Some houses

More houses

10. Breakable/abstract ideas

I keep my breakable stuff on the top shelves. However, this doesn’t mean that stuff never gets broken. If you are super worried about it getting broken, it doesn’t belong in your collection. Put that on a bookshelf somewhere where you can admire it.

Adults will be the ones who use these. Even then, it’s not super common for adults to use them. I think I have these for myself, if I’m honest.

Breakable pretties

Hope this was helpful to you! Stay tuned for the next post about space-friendly set-ups for miniatures.

Now that you’ve seen mine- I want to see your miniatures! Put a picture of your collection or your most favorite miniatures in the comments and then we can all have miniature envy!

***

Thanks to Amy Flaherty and The Southern Sandtray for this great post!

Visit Childtherapytoys.com to for all of your sandplay and child therapy needs!

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Categories : Reader Submissions, Sandplay/Sand Tray Therapy, Uncategorized
Tags : Play Therapy, sand tray miniatures, sand tray therapy, therapy toys
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