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Archive for Therapy Practices

Cooperative & Noncompetitive Games

Posted by Gary Yorke 
· October 19, 2017 
· 1 Comment

Cooperative and non-competitive games are ideal for children and families, and are often used by therapists, counselors, and teachers. In a non-competitive game there are no winners or losers, usually information is exchanged.  Probably the most popular non-competitive game used by clinicians is the Ungame. Another non-competitive game, this one developed for therapy, is The Nurturing Game.

                                   

Cooperative games usually have a specific goal that needs to be accomplished, and can only be accomplished when players are working together. Another way of looking at cooperative games is that all players win, or all players lose.  They can be used with children who can’t tolerate losing, have cooperation difficulties, or need to work on their communication skills.  A popular cooperative game used by therapists is The Mountaineering Game. The goal of this game is to reach the top of the mountain. If greater difficulty and complexity is desired players can work together to first ascend the mountain, and then descend the mountain.

The value of cooperative games was demonstrated in a study by Bay-Hintz and Wilson (Bay-Hintz, April K. and Wilson, Ginger B. ,2005. “A Cooperative Games Intervention for Aggressive Preschool Children.”  In Reddy, Linda A., Files-Hall, Tara M, and Schaefer, Charles E. (Eds.) Empirically Based Play Interventions for Children). They studied the use of cooperative games in a preschool class. Cooperative games were played for thirty-minutes per day in one group, and competitive games were played in the other. Two other groups played cooperative games for part of the study, and competitive games for part of the study.  In all conditions where cooperative games were introduced cooperative behavior during free play increased. Cooperative behavior decreased during periods where competitive games were played.  The games used in this study included group games like cooperative musical chairs and Family Pastimes board games (see below).

Both cooperative and non-competitive games facilitate therapy by becoming the place where therapist and client interact with each other. Non-competitive games typically involve more discussion and disclosure, while cooperative games require social skills and effective communication to achieve success.

The Ungame: Non-competitive games, such as The Ungame, are designed specifically to foster communication. It is available as a board game, and as a separate card games for Kids, Teens, and Families.  The Ungame is ideal for a therapy session as the length of play can be predetermined at the start of the game. So, if there are only fifteen minutes left in the session the game can still be played and the session can still be quite productive.  In addition, playing the Ungame fosters skills such as sharing, interacting, and listening.

The Ungame board game includes two levels of “general cards,” a board, pawns, and a die. Level one cards tend to be light-hearted and non-threatening, and Level two cards tend to require more thought and self-revelation. Level 2 cards ask questions about feelings, values, and memories.  The Ungame card games also consist of level one and level two cards and may be used with the board game. Simply substitute the general cards that come with the game with one of the card decks. The card game includes Choice, Question and Comment cards, which are also spaces on the board game, so these cards should be removed when using them with the board game.

The Ungame is easy to play. Players take turns rolling the die, count spaces and then respond to the prompt on the space they land on. If they land on an Ungame space, they pick up a card, read it aloud, and respond. If they land on a Question space they may ask any player any question they like. If they land on a Comment space, they may make a comment about anything they like. As a therapist, I usually use the Question space to seek clarification about an earlier response or find out something about the child. Choice spaces allow the player to make a comment, ask a question, or pick up an Ungame card. Level 1 cards are typically non-threatening and ideal for building cohesion in a group and rapport between the players.  They facilitate discussion and learning how to express oneself. Level 2 cards tend to evoke more emotional and in-depth responses and are better used once clients have begun to feel comfortable.

Ungame Variations

Getting to Know You – Hide & Seek with Ungame cards – The therapist chooses which deck is going to be played with, and hands a portion of the deck to the child. Better readers can be given more cards, weak or young readers, only a few cards. The therapist may choose to stack the deck prior to the session. The therapist chooses three cards he’d like the child to answer and the child chooses 3 cards they would like the therapist to answer. The child hides her cards first, then the therapist hides his cards. Child and therapist then take turns looking for the cards. When a card is located it is responded to.

Getting to Know You – Rock, Paper, Scissors, with or without Ungame cards – Follow the same procedure as above, but instead of choosing 3 cards, go through your stack and identify a few questions you’d like to ask. Next, play Rock, Paper, Scissors. Whoever wins the round, gets to pose the question. This game can also be played without cards. Participants simply ask whatever question they want of the other participant.

The Squiggle Game is a cooperative activity and was developed by D. W. Winnicott.  Winnicott was a pediatrician and a child analyst.  He developed to the Squiggle Game to be played in the initial interview with a child.  He developed this activity as a way for the therapist to make contact with the child.  He did not develop any fixed rules, as he wanted clinicians to feel free to adapt it to their style and enhance it a way that worked best for them. Clinician and child take turns making a squiggle, and then turning it into a picture of something. Child and counselor are free to complete as many, or as few, as they choose. Many variations of the Squiggle game have been developed over the years (as a Google search will reveal). One interesting discussion can be find in the following online article:

www.focusing.org/chfc/articles/en/thurow-interaction-squiggle-total.htm

The Nurturing Game is another non-competitive game that not only fosters communication but also promotes activities that encourage nurturing behavior.  The Nurturing Game is suitable for adults and children ages 6 and older to increase self-awareness, communication skills, and appropriate use of personal power. Participants respond to questions regarding awareness of self, feelings, giving and receiving praise, as well as practicing appropriate touch. Each Nurturing Game contains cards and directions that are published both in English and Spanish. There are two “tracks” on the game, one for adults and one for children. In addition to responding to cards there are Praise (Sun) spaces and Hug (Heart) spaces. I recommend that male therapists use the heart spaces to give a high five, fist bump, or “say something positive” about one of the other players.

More cooperative games

Mountaineering, There’s a Growly in the Garden, & Bambino Dino: These three cooperative games are published by Family Pastimes.  Family Pastime games have a specific goal that is achieved when participants play together, not against each other.

The most popular Family Pastimes game purchased by therapists is The Mountaineering Game.  Participants work together to reach the top of the mountain. For an added challenge, game participants can also try to work their way back to the base of the mountain.  The rules of the game compel the players to talk and work together. There is only one pawn which players take turns moving. There are two types of cards, mover cards and equipment cards. At the beginning of the game players must decide how to distribute the cards.  Neither player has enough mover cards nor equipment cards to get the pawn to the top of the mountain.  Since players take turns moving the pawn, each move affects what the other players can do.  As the pawn travels up the mountain it can become stuck and players must work together to move the pawn off various obstacles. This is a fun game to play with siblings and gives the therapist an opportunity to witness how they work together. Cooperation games can also be sent home for family members to play together during the week.

Two very popular games for children ages 4 to 7 (and older depending on the child’s emotional maturity) are Bambino Dino and There’s a Growly in the Garden. In the first game, Bambino wanders into a valley to get food, just as water begins to rush in. Participants work together to save Bambino from the rushing water. Players take turns rolling the dice. The color on the top of the dice determine if the player will get a barrel to remove water, food for Bambino, or more water will be added to the valley. It helps if players work together, discussing which cards to use and when to remove water.  Players may also share barrels to remove the water.

                                                                  

In There’s a Growly in the Garden participants work together to plant flowers, and then prevent the Growlys from pulling them up! The game starts with an empty garden. Players take turns adding Flowers, Scarecrows to block the Growlys, or Special Things that also block the Growlys.  Players need to watch out for Growlys, who turn up randomly, and pull up flowers if they’re not blocked by a Scarecrow or Special Thing.

Family Pastime publishes numerous games, these are just three examples. In addition, there are dozens of fun activities and games available from ChildTherapyToys.com. When using these games, it is advised that the therapist become thoroughly familiar with the rules and how to play before bringing it into the play room. The games are not complex but the rules are nearly impossible to figure out on the fly.

 

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Categories : Behavior, Feelings, Intervention Ideas, Play Therapy Games, Self-Esteem, Social and Emotional Competence, Therapy Practices
Tags : cooperative games, Play Therapy, play therapy gams, therapeutic games for children, therapeutic games for teens

Play Therapy Chalkboard

Posted by Gary Yorke 
· November 6, 2015 
· No Comments

The Play Therapy Chalkboard is one of the most interesting, useful, and popular products sold by childtherapytoys.com. In June we asked our Facebook fans how they use, or would like to use, the Play Therapy Chalkboard. What an innovative, eclectic, and creative group of fans we have! We were inundated with great suggestions, and we wanted share some of them with our blog readers. Many of our fans noted that the Play Therapy Chalkboard is an ideal tool to be included in the playroom for non-directive therapy. Clients will often figure out on their own what they want to express and how to use the chalkboard. The Play Therapy Chalkboard was recommended for clients of all ages, preschool to adult.

Quite a few of our fans thought the Play Therapy Chalkboard would be a great tool for identifying emotions and developing behavioral regulation when strong emotions are being felt. For example, “with an anxiety group I run, I would use it for lessons on the areas of the body they feel anxiety (or even anger), identifying the things they have control over (write it on the body) vs. the things out of their control, coloring shades of emotions and writing to help students practice strong affirmations (write them on the body) to say to their worries. With a friendship skills group, it could be used to write adjectives to be a good friend/look in one, writing “I feel” messages, and conflict resolution ideas (split the body in half) with before/after scenarios.” One fan suggested color coding feelings and having the child locate each feeling in the part of body they feel it along with a relational episode or time they felt each feeling. The Play Therapy Chalkboard could also be used to differentiate between our inside feelings that only we know are present, versus the feelings we show on the outside to the world and how/why these are different. Our fan commented, “this helps illustrate how we can erase and restructure feelings within ourselves to reaffirm our thoughts, feelings, and perceptions, and how our feelings are all a fluid part of us but no one feeling defines all of us.”

Another fan thought the Play Therapy Chalkboard could be used as a Feelings X-Ray, marking where the feelings live in the body, and how big a space they are taking up. Like an X-ray shows our bones which are usually hidden from view, the Feelings X-Ray would show the feelings we can’t always see from the outside. One Facebook fan suggested using the Play Therapy Chalkboard to explore a child’s self-perception, describing and drawing their traits on the chalkboard. Another fan suggested numerous interventions that could be accomplished with the Play Therapy Chalkboard: “encouraging children to use the chalkboard to list things that make them happy, identify facial expressions/emotions, write a message to their problem, identify where they feel their hurt, or draw the bully, a perpetrator, someone from a dream, or someone who has passed away.” Another great idea was to ask clients to draw “The Me I Wish Others Could See.” This activity could be used with adult clients, as well, and it could be expanded to asking the client to draw how others see them and how they see themselves. Children and parents could draw how they perceive each other for emotional connection sessions. Many fans suggested including the Play Therapy Chalkboard in their sessions to describe trauma. One fan stated, “this would be a great way to explain how things like anxiety can cause things to happen on the inside (stomachaches, headaches, etc.). It is also a great way to show physical and emotional wounds.” Another fan said, “I would also use it for sexually abused and grieving kiddos to ‘take away’ the hurt by having them use the chalk to X out where their pain is.”

Many of our fans suggested uses for their specific workplace or specialties. For example, “as a child life specialist, I would use it to help a child understand their body, illness or injury and medical treatment in the hospital. I would also give children opportunities to reflect their understanding and feelings about their medical situation.” Another clinician suggested combining the Play Therapy Chalkboard with EMDR, and using it to identify where memories have manifested in their bodies along with feelings and thoughts. A school counselor suggested using the chalkboard in a school setting to talk about boundaries and personal space. An art therapist suggested that it could be colored to represent mental states, feelings, and expand narratives being shared with the therapist.

Here’s another fun way to use the Play Therapy Chalkboard, published in our blog August, 2014: https://myplaytherapypage.com/positive-postings-with-the-play-therapy-chalkboard/

Play Therapy Chalkboard & Chalk (Commercial Grade)

Please feel free to leave your comments and suggestions below.

 

 

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Categories : Anxiety, Behavior, Feelings, Play Therapy, Therapy Practices

Engagement: The First 24 Hours

Posted by Gary Yorke 
· April 18, 2015 
· No Comments

We are only allowed the opportunity to work with our young clients when their parents return them for therapy. For this reason, the initial visit is critical. However, clinicians need to think about engaging parents and their children before that first visit. Engagement with our clients begins before we even meet them. Our website, our reputation, our phone presentation, the staff at the front desk, and the initial paperwork all serve to introduce and engage our clients. While the identified patient is the child, we must engage, or “sell” the parents on what we do. Here are some suggestions:

  • Return calls as soon as possible. We hear regularly from new and prospective clients that other therapists did not call them back.
  • Listen to your staff when they answer the phone and give out information.
  • Be clear about what you do and why. For example, “I use play to work with kids because that’s their normal means of communication. I also use games to promote certain skills and I meet with parents regularly.”
  • Pre-paperwork should clearly outline office policies, payment schedules, and in our case we indicate what we do at the first interview. We also ask for school report cards, evaluations, school notes, progress reports, and reports. This indicates an interest in the whole child and provides valuable information to the clinician.
  • Have a neat and clean waiting room, with an area that suggests that children are welcome.
  • Have an office that is comfortable for children. Don’t have an office where you have to worry about things getting broken, furniture getting climbed on, or drinks getting spilled.

Since parents spend a lot of time sitting in the waiting room we have strategically placed laminated articles about play therapy, and another about the use of games, in the waiting room. The play therapy article is borrowed from http://www.a4pt.org/?page=PTMakesADifference. The article about the use of games in therapy was published in The National Psychologist and is available from Dr. Yorke (gary@childtherapytoys.com).

The initial interview is critical to successfully engaging children and parents in the therapeutic process. My approach to the initial interview is to prioritize the needs, opinions, and feelings of the child, and engage them quickly. If the child is six or older I always meet with them first, and I usually do not let parents talk me out of that. Why? Because I want the child to know that they are the center of my attention and focus, and I care about what they have to say. Additionally, I have found that children will be more open if they know I haven’t yet talked to their parents.

At the first meeting I enter the waiting room and I say the child’s name. I do my best to avoid eye contact with the parents until I make contact with the child. I then ask the child to introduce me to their parents. “Is this your mom? Is this your Dad?” I outline to the child what’s going to happen next. “I’m going to talk to you for a few minutes first, and then I’ll come and get your parents. I’ll follow you to my room. It’s this way” (and I point the way to my office.) Once in my office I explain this is an assessment visit and a chance to find out why they are coming to see me, and what I can do to be helpful.

The first interview with a child lasts 20 to 45 minutes. At the end of the child’s first visit I explain what’s going to happen next, and what I’m going to ask their parents. I ask if there’s anything they want me to tell their parents, or not tell their parents. At the beginning of the second session I may ask if the child would like to know what the parents talked about. Before we finish I’ll show the child the playroom, sand tray and miniatures, and games. I explain to the child that they’ll have an opportunity at the next session to decide what they want to do, and I won’t be asking them a bunch of questions the next time.

At the end of the parent’s first interview I summarize what I think their concerns are, and make sure I understand. I explain to them what my impression is, and what my goals are. I explain that the child will be playing in sessions, and if the child tells them all we do is “play,” that’s OK. I let them know that I want to meet with their child 3 or 4 more times before I meet with them again. I explain how I do therapy. I ask if I have correctly understood their concerns and are they OK with the plan. Once a parent affirms that a clinician understands the problem, and agrees with the treatment plan, the probability of that child returning for therapy is extremely high. However, many parents are struggling with their own anxiety, depression, or stress and may forget or become confused shortly after the first session. Clinicians should be prepared to repeat the process of listening, clarifying, and summarizing as often as necessary.

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Categories : Communication, Play Therapy, Therapy Practices

January Play Therapy Wrap-Up

Posted by Jacob Wilburn 
· February 1, 2015 
· No Comments

-Getting noticed online these days is all about content, and therapy practices are no exception. Publishing articles or posting to a blog is a great way to make your practice stand out. Here are a few quick tips (from a therapist blog, of course) on doing just that.

-There was a fascinating article in the New Yorker this month about “Affective Computing”; the use of computers to read and interpret facial expressions and discern human emotions. Apparently the technology has been particularly successful in helping children with autism. By translating the facial expressions that the children couldn’t otherwise decode, their social and emotional competence can be greatly improved.

-Two children in Georgia coping with the unimaginable trauma of their mother’s murder at the hands of their father are being helped along with play therapy intervention.

-We have countless articles on the subject in the articles section, but here’s another great explanation of what play therapy is and how it can be used.

-A child born with a condition that left him with serious movement problems has learned to walk with the aid of a NASA-designed “space suit,” which corrects movements and reflexes. But it’s not space-age technology alone that’s helped Georgie take his first steps: “It’s all through play therapy so he doesn’t realise he’s doing any work.”

-Embrace Hope – Sandy Hook Assisted Equine Therapy is an organization started in response to the school shooting in 2012. This article explains the history and function of this great organization.

–This is a very interesting piece on what it’s like to use play therapy with prisoners.

-Looking for learning opportunities and continuing education credits from your home or office? Kids, Inc. has several webinars scheduled for March.

-This podcast episode about using natural play therapy for autism is well worth the twenty minutes!

-In defense of the mean kids! The mother of a “mean kid” tells her story of discovering the source of the “meanness” and addressing it through play therapy and other intervention methods.

-Statistics showing the number of children one-to-five years-old who have been exposed to violence are quite staggering. This article suggests that these children are not receiving the proper treatment they need due to a lack of mental health services available in preschools. It raises a good point: addressing these issues early could prevent worsening issues down the road, and it could save a lot of money and resources.

–This article agrees with the previous, and also details the steps that can be taken to treat childhood mental illness early on.

-This is a great story about a researcher who found additional support about the efficacy of play therapy.

-Another organization harnessing the power of LEGO to help children with social and emotional issues!

-I think this blogger says it well!

-We have updated our Puppet page at ChildTherapyToys.com. Come check out our extensive cast of characters!

Don’t forget that this week (2/1-2/7) is National Play Therapy Week! Do your part to boost awareness!

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Categories : Monthly Wrap-Up, Play Therapy news, Therapy Practices, Wrap Up

In case you missed it: APT ‘History Speaks’ video series

Posted by Gary Yorke 
· December 14, 2014 
· No Comments

The Association for Play Therapy launched History Speaks, a great new resource for play therapists, a few years ago. The series consists of a collection of videos of prominent child clinicians answering questions about play therapy and their own practices, and discussing the history of play therapy and APT. The first set of recordings includes Charles Schaefer, Louise Guerney, Dianne Frey, and Lessie Perry. Recent additions include talks with Phyllis Booth, Garry Landreth, and APT President and CEO William M. Burns. The videos can be viewed at the link above, or on the APT YouTube channel (Assn4PlayTherapy). Play therapists will find some interesting stuff in these interviews. It’s great to hear from veterans who have seen the organization, and the technique itself, change over the years. I’m looking forward to more.

For more play therapy videos and resources, check out the regularly-updated video section of myplaytherapypage.com.

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Categories : History of Play Therapy, Play Therapy, Resources, Therapy Practices

Websites from TherapySites.com

Posted by Gary Yorke 
· April 5, 2013 
· No Comments

When was the last time you flipped through the Yellow Pages? A decade? More? These days, if someone is in need of a particular service, their first move is often straight to the internet. As many therapists are now aware, this most certainly extends to their practice, and having an alluring and effective website is more important than ever. Since people no longer have to settle for the scant information provided in a phonebook, the information, functionality, and presentation of a practitioner’s website has become crucial to attracting new clients and maintaining a strong client base.

Of course, the idea of creating and keeping up with a website can seem quite daunting. And, indeed, developing an exceptional one is no easy task. Luckily, however, there’s TherapySites.com, which provides the excellent and affordable service of doing all the hard stuff for you, helping you launch and maintain a site that attracts as many potential clients as possible, and lends your practice the credibility it deserves. The features offered can also make a huge difference in the efficiency of how your office is run. They deliver credit card processing, appointment requests, search engine optimization, and more. Does having all new patient paperwork completed before they arrive sound good to you? I must say I find it pretty appealing, and certainly the patient would be appreciative as well.

Right now, ChildTherapyToys.com has arranged a very SPECIAL deal with TherapySites that allows for a one-month free trial for anyone who wants to check it out. All you have to do is enter the following promo code: promoCTT.

ChildTherapyToys.com has also partnered with TherapySites to bring you a FREE educational webinar that will teach you how to better market your services online and make more money with your website. Register now!

The truth is, the internet has made competition fierce, and an informative, versatile and effective website can make all the difference to a person in need of service they can trust. Here are a couple of articles from TherapySites that detail what they can do for your practice, and why it’s so important that it be done:  

Websites for Therapists – Why You Need a Website

How To Bring Your Therapy Practice Into the 21st Century 

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Categories : Play Therapy, Therapy Practices

Cheating in Play & Child Therapy

Posted by Gary Yorke 
· June 25, 2012 
· No Comments

An awareness that there are rules tends to emerge around age four. However, the ability to follow rules may not emerge in a typically developing child until age 6 or 7. We should expect children in therapy to cheat. It is useful to think of cheating in the same way we would think of any other activity in the play room. It is a creative act, and an attempt to deal with some internal struggle. Young children (6-7) often haven’t yet learned to follow rules or tolerate losing, and older children frequently lack the robust self-esteem and social skills to adequately follow the rules of structured games. Cheating also represents the transition from magical wish-fulfillment to realistic management of the environment and acceptance of limits on one’s power and control. Some children have not had the opportunity to develop a tolerance for losing due to excessive permissiveness at home. Other children, coming from a harsh and punitive environment, may avoid cheating out of fear and anxiety. A child or adolescent may “need” to win because they are in a struggle to maintain self-esteem or experience some level of control over their environment.

Some clinicians, such as Richard Gardner, believe cheating should be stopped immediately. Others allow cheating to unfold and watch to see what happens. Jill Bellison (Children’s Use of Board Games in Psychotherapy) discusses it with the child, but makes no attempt to intervene.

I do not think children have to be confronted or corrected about cheating. They already know it is wrong, or are in the process of learning that it is wrong. However, I don’t think it is advisable to be silent about cheating either. I think it’s important that clients believe they are in the room with a competent adult, and not some dupe. However, some children need to cheat, to work out feelings of unfairness, being short changed, never getting their way, or for a sense of superiority. I may note how much fun a child is having “tricking” me, or how the new rules are going to work out very well for the child! The therapist should maintain a therapeutic attitude. That is, focus on the child, not on winning or losing. Pay attention to the child’s experience and reaction to the game, and avoid evaluative comments about your performance or the child’s performance.

As children progress through therapy the discussion about cheating may change. Children who have a significant degree of peer conflict in their life, or difficulty maintaining peer relationships, will need to think about how their approach to game play affects their relationships. I might ask them what would happen if I were with a peer. I may ask them if they can handle losing, or should we put the game away. In some cases I point out to the child that my job is to help them act their age, and if they can’t follow the rules we should find something else to do. This type of intervention shouldn’t be made until it is clear that the child trusts you and believes that you have only good intentions.

How a child cheats is important. Sometimes they are just testing the waters. Is this really a different kind of relationship? Is this really my time, where I get to decide what we’re going to do? Some children are overtly manipulative, others attempt to cheat covertly, others cheat only when frustrated, and some children cheat for the sheer delight in being oppositional. As we observe a child’s style of cheating we can begin to learn about their frustration tolerance, ability to delay gratification, problem solving ability, character development, and coping strategies. An indulged child may cheat overtly and without guilt, because they have a sense of entitlement. A needy child my initiate cheating immediately and often, avoiding any discomfort associated with losing, or not getting enough. Oppositional children may also cheat overtly, often with a sense of bravado, and almost no guilt, while guilt ridden children may cheat, confess, or even manipulate the game so the therapist can win.

Of course some children won’t cheat. This is often a reflection of maturity and adequate self-esteem. However, some children simply can’t cheat. A child who rigidly adheres to the rules, and insists on play only, avoiding any conversation or reflection, is saying a lot about may be going on with them. Placed in the context of that individual’s life, we can begin to learn how they manage stress, conflict, and strong emotion.

Related to cheating is the issue of allowing the child to win. As a representative of reality, and as an active participant in a child’s social and emotional development, this does not seem like a good idea. It might be more appropriate to stick to games of chance, where child and therapist have an equal chance of winning, thus providing the child with opportunities to develop some tolerance of losing. Alternatively, the therapist may choose to focus on cooperative and non-competitive games. Of course, some children will persist on a game until they actually do beat the therapist.

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Categories : Play Therapy Games, Therapy Practices

The 10 Most Important Things a Play Therapist Should Know

Posted by Gary Yorke 
· March 22, 2011 
· No Comments

I was recently asked for my input on the ten most important things a play therapist should know. Here’s my list. I hope you’ll add to it or present a list of your own in the comments section.

1)  Know and understand at least one theory of Play Therapy really well.

2)  Read Winnicott, Harry Stack Sullivan, and some of Richard Gardner’s early work.

3) Learn the classics: Mutual Storytelling Game and The Talking, Feeling, and Doing Game, and then add to your repertoire of interventions.

4)  Know when play therapy is not what a child needs.

5)  Be a child clinician first, and someone who uses play therapy to help children second.

6)  DSM-IV-TR and play therapy are compatible.

7)  Everyone who does play therapy needs to know a good child psychiatrist.

8)  Don’t “act” like a play therapist. Get comfortable with yourself, and bring that person to play therapy.

9)  It’s not original but it bears repeating: Play Therapy needs to be more therapy than play.

10)  Sometimes Play Therapy is magic! We just don’t know why it works sometimes.

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Categories : Play Therapy, Therapy Practices

Should clinicians identify themselves professionally as Play Therapists?

Posted by Gary Yorke 
· June 27, 2009 
· No Comments

Should clinicians identify themselves professionally as “Play Therapists?”  I would say “no” unless it is the clinician’s intention to limit their practice to that single intervention and the clinician is prepared to refer clients not appropriate for  play therapy to someone else.  Of course, I’m making an assumption that other forms of intervention may be more appropriate for addressing and treating some issues and diagnoses.  Unfortunately, our profession still has clinicians trying to fit a “square peg in a round hole.”

There are three reasons why I think we should not identify ourselves professionally as play therapists:

1)      When we seek licensure it is not as a “Play Therapist.” Rather, we are licensed as Psychologists, Social Workers, or Licensed Professional Counselors.   Our licensure has status and meaning to fellow clinicians and referral sources that the title “Play Therapist” will never convey. When we identify ourselves as Play Therapists we suggest that is all we do. Hopefully, that s not true for most clinicians!

2)      From a pragmatic point of view, I believe we obtain more and better quality referrals, by being identified by our licensure title. It allows us to become known as clinicians who have a variety of intervention strategies to treat our clients. Play therapy should be one technique or intervention that we can intelligently apply to the treatment of an individual.

3)      Effective treatment planning and communication of an appropriate treatment plan is not facilitated by an identifying ourselves as Play Therapists. Play therapy is a generic term and there are many ways of doing play therapy.  Back in the stone age of managed care therapists in our town were routinely dismayed when a case manager denied more sessions for play therapy.  “Play therapy” was a red flag for case managers.   Along the same lines, clinicians who tried to sign up on panels as “Play Therapists” were frequently denied membership on panels or didn’t receive referrals from insurance company case managers.  Unfortunately, writing treatment plans that are accepted by case managers continues to be an underappreciated talent in graduate school and training programs. The Practice Planners series has rescued us from one of the most tedious and painful aspects of practice.

I’d be curious to know how others identify themselves professionally if they have found any benefit in identifying themselves as Play Therapists.

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Categories : Play Therapy, Therapy Practices

Why Parents Prematurely Terminate Therapy

Posted by Gary Yorke 
· November 22, 2008 
· No Comments

Wouldn’t it be great to know why a parent pulls a child out of therapy prematurely? Sometimes it’s obvious; chaotic environment, lack of resources, lousy treatment plan, or a disagreement with the therapist. But sometimes parents just cancel or no show and we never hear from them again. Certainly we can call them and we may get some useful information, but even that can be suspect. However, there is a time that I think we do get some clear and helpful feedback. That’s when we hear about the child’s last therapist. This week I heard from a child that his previous therapist tried to act “cool”, but really wasn’t. OK, check, don’t act fake. I hope I have that one down by now. Often, the parents will report that nothing changed. Again, check. That’s a valid complaint. Monitor progress. And there’s the rub. I hear over and over again about child therapists who do not talk to the parents. I ask, “what was the therapist’s impression?” I get a either a vague summation or a report that the therapist never gave any feedback. Ok, “what was the therapist working on?” Again, the parent doesn’t know. Alright then, “what were the doing in therapy?” Parent’s response, “they were just playing and the therapist was letting them do whatever they want.”

So here I begin to think some play therapists are really letting kids down and could do a better job. Parents need to be educated about play therapy, play therapists need to have clear goals, and they need to monitor progress. A great tool for educating parents about play therapy is the brochure from The Association for Play Therapy (which we should all belong to). The brochure is available for purchase, or download the following page from their web site: http://www.a4pt.org/ps.playtherapy.cfm?ID=1653. I like to meet with parents at least for a few minutes every 3-4 sessions. I get the child’s permission, I review confidentiality, and give feedback to the child about we discussed. If there is a need for extensive discussion I will schedule a parent meeting.

Add your comments. How do you work with parents and ensure children stay in treatment?

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