The Trauma Reaction Cards are a therapeutic tool to assist children and adolescents in understanding and identifying their reactions to traumatic or stressful life experiences. These colorful and illustrated cards are categorized into the four domains of trauma reactions: Behavior Reactions, Body Reactions, Brain & Thinking Reactions, and Feelings Reactions.
To be used by qualified professionals only.**
Is your child struggling with anxiety?
Is he or she visibly tense or nervous at different times during the day?
Does he put pressure on himself to get everything perfect, and is distressed when he makes mistakes or things don’t turn out just right?
Do your efforts to get her to relax only make things worse, making you feel powerless to help her?
Do you wonder about Play Therapy and anxiety regarding your child?
Anxiety is one of the most common disorders in children, affecting over 10 percent of those under 18. Unfortunately, it can rob a child of the happiness that he or she needs so much.
The good news is that Child-Centered Play Therapy, together with Parenting Counseling, can do wonders to reduce and even resolve childhood anxiety!
I have seen it bring improvement with many children!
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.
“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.
generating much shame and anxiety over being stranded in a state of low self-esteem.
Furthermore, such children may have unfortunately been criticized by people in their life, and they feel they must get everything perfect and achieve amazing things to get themselves beyond the reach of any potential criticism. This pressure generates anxiety.
To learn more about the pitfalls of criticizing children, click here.
Another common cause of anxiety is fear of reprimands and disapproval of the adults in a child’s life.
Children feel very small and powerless compared to adults and they cringe and wither under fear of reprimands, scolding, disapproval and criticism. Some children are constantly worried about not meriting enough approval and avoiding rebuke, and this generates significant anxiety. They feel pressure that they are not Ok they way they presently are, and they constantly have to measure up.
To learn more about the pitfalls of scolding and reprimands, click here.
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!
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.
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.”
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.
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.
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.
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.
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.
There is much that parents can do at home to reduce anxiety in their child. The most important thing to remember is to try to not be anxious yourself, or more specifically not to express anxiety in front of the child. This prevents the child from learning an anxious reaction by example. You need to cultivate the value that “Everything is Ok just the way it is. We have no problems! Everything about you, my child, and almost everything you do is just fine!” Problems may arise, but we take them in stride! We react to them with cool, calm acceptance.
In addition, it pays to avoid criticism, reprimands, scolding and disapproval like the plague! Usually whatever benefit you hope to gain through these things is outweighed by the damage done to the child’s emotional health. It’s wiser to tolerate mischief and mistakes with a smile!
During Parenting Counseling, I gradually get to know parents and their child, and how the whole family works, and instead of giving so much direct advice, I help parents to develop their own innate wisdom which I am convinced every parent possesses. In this way I help them to develop their own personally tailored plan to resolve their child’s issue. A plan they developed themselves is one they are more likely to cherish and implement.
To find out how Parenting can help reduce ADHD symptoms, click here.
Play Therapy for anxiety, together with Parenting Counseling are the amazing double tools which can resolve almost any child’s anxiety, and most other issues as well!
To find out more about Child-Centered Play Therapy, click here.
Please be advised that the above represents a parenting ideal, and I don’t expect parents to be perfect. So have patience with yourself and try to adopt new ideas gradually.
***
Joseph Sacks is a child psychotherapist in lower Manhattan. He specializes in using Child-Centered Play Therapy to resolve behavior issues such as tantrums, defiance, anger and ADHD. It is amazing how well Play Therapy works to resolve these issues!
In addition Joseph helps parents to develop their own unique parenting approach to resolve their children’s issues. The parent-child relationship is the most important element in any child’s life, and by simply tuning up that relationship, we can have a tremendously beneficial effect. Joseph has written over 120 fascinating and well-researched articles on parenting and Play Therapy, which can be found at Tribecaplaytherapy.com.
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.
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.
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.
