let’s play: an introduction to working therapeutically with children

LET’S PLAY: AN INTRODUCTION TO WORKING THERAPEUTICALLY WITH CHILDREN

©Stephanie Jeans 2014 www.indabacounselling.co.uk

“Before becoming a counsellor for children it is important to have an understanding of the nature and purpose of counselling children.” (Geldard 2008)


Mental health statistics• 1 in 10 children and young people aged 5 - 16

suffer from a diagnosable mental health disorder - that is around three children in every class

• More than half of all adults with mental health problems were diagnosed in childhood. Less than half were treated appropriately at the time

• Over 8,000 children aged under 10 years old suffer from severe depression

• 7.7% or nearly 340,000 children aged 5-10 years have a mental disorder


• 2.2% or about 96,000 children have an anxiety disorder

• 0.2% or about 8,700 aged 5-10 year-olds are seriously depressed.

• 4.9% or nearly 215,000 children have a conduct disorder

• 1.6% or about 70,000 children have severe ADHD

(Green, H., McGinnity, A., Meltzer, H., et al., 2005)


• Basic physical care

• Protection

• Security, guidance, support & control

• Love, affection & respect

• Stimulation to learn & access to schooling

• Autonomy & responsibility

CHILDREN’S NEEDS


CHILDREN’S RIGHTS

THE CHILDREN’S ACT (HMSO, 1989)

Child’s welfare is paramount & adults must ascertain wishes & feelings of child. Legally, courts to consider emotional needs. Local authority agencies required to protect children.

UNITED NATIONS CONVENTION ON RIGHTS OF A CHILD (1991)

Concerned with rights to life itself & to a reasonable quality of life. Categorized as protection, provision & participation

BACP

“The rights of the child need to be respected, a sense of self & identity fostered & the personal efficacy of the child increased.”

©Steph Jeans 2014 www.indabacounselling.co.uk

DISTRESS: Anguish or affliction affecting the

body, spirit or community; to subject to severe pain or pressure; to afflict or exhaust; to cause pain or anxiety to.

(Oxford English Dictionary, 1983)


1. Loss

2. Chronically disturbed relationships

3. Events that change the family status quo

4. Events which require social adaptation

5. Acute negative events such as trauma

Unhappiness can fall along a dual continuum of persistency & intensity.

(Garmezy & Rutter, 1983)

SOURCES OF STRESS (OR ‘WORRIES’) CAN BE CATERGORISED INTO FIVE MAIN GROUPINGS:


POSSIBLE EFFECTS OF EXTREME STRESS

Sharpe & Cowie, 1998


• When people (children) have nowhere to express, explore or learn about their feelings, they often decided to remain silent, bottle up or swallow their feelings

• This leads to a constant state of unease which can damage psychologically or physically

• Alternatively they may ‘act out’ their feelings in destructive ways (Sunderland & Engleheart, 1993)


“Tom tied a kettle to the tail of a cat, Jill put a stone in a blind man’s hat, Bob threw his grandmother down the

stairs: And they all grew up ugly and nobody

cares.” (Cattanach 1994)


MISUNDERSTOOD

• http://www.youtube.com/watch?v=xMMFkX7iZfA

The other side of the story…

… so how can we help?


http://www.youtube.com/watch?v=xMMFkX7iZfA

http://www.youtube.com/watch?v=xMMFkX7iZfA

WHY PLAY?

“In the process (of play) we change ourselves and

our view of the world. We dare to change because

our autonomy is not challenged or threatened….

children’s needs to play are greater since their

autonomy is less.” (McMahon, 1992)

“Play therapy can be helpful in reducing anxiety &

improving self-esteem & cognitive skills.” (Sherr & Sterne, 1999)


• Play is the language of a child as they do not have cognitive or language skills to verbally express themselves

• Play is vital to a child’s development as it’s how they make sense of their world

• Is how children first develop a sense of self & the world around them

• Play is a dynamic process in which a child can explore, grow & change both as an individual & in relation to experience


• Children can ‘play out’ their feelings & problems & process their experiences

• Can take risks, try new roles, dare to be someone else

• Grapple with new experiences & ideas which increases their power & autonomy

• Gives children freedom as they can choose to think or talk however they want

(Place2Be, 2008)


There are three stages in the development of play: (Cattanach, 1995)

Embodiment Play This is solitary & is about playing through the senses & the body


Projective Play

Project meaning into objects & people around them, & tend to play this way in parallel play, alongside others


Dramatic Play

Is co-operative & social as different roles are played


THE PLAY THERAPY ROOM (Geldard 2008)


• Counselling skills combined with media help the child to tell their story, directly or indirectly

• Telling their story raises the child’s awareness of both current & past unresolved issues

• Media, such as toys, sand tray, and stories provide an activity to hold interest and help the child stay focused

• Media may allow children to connect with their emotions & may act as a vehicle through which they can express them

MEDIUMS TO FACILTIATE PLAY


“In all creativity, we destroy & rebuild the world, & at the same time we inevitably rebuild & reform ourselves.” (Rollo May, 1985)

http://kids.nationalgeographic.co.uk/kids/stories/peopleplaces/playpumps/





ATTRIBUTES OF THE CHILD-COUNSELLOR RELATIONSHIP (Geldard, 2008)

1. A connective link between the child’s world and the counsellor

2. Exclusive

3. Safe

4. Authentic

5. Purposeful

6. Non-intrusive

7. Confidential (subject to limits)


THE MOTHERLY ELEPHANT

There was once a kindly elephant who accidentally stood upon a hen. She was much distressed, especially when she looked down and saw all the little chickens, running around cheeping.

“Poor little creatures. I will be a mother to them.”

And gathering the chickens tenderly underneath her, she sat down upon them.


“The therapist does not attempt to direct the child’s actions or conversation in any manner. The child leads the way. The therapist follows.” (Axline, 1947)

• Be permissive, so the child is fully free to express feelings uninhibited

• Be alert to recognize expressed feelings in order to reflect these back

• Maintain a deep respect for the child’s ability to solve their own problem

• Avoid attempting to hurry therapy along


POINTS TO CONSIDER

• Contracting: as important as with adult clients• It establishes necessary boundaries to anchor the

therapy in the world of reality so child is aware of their responsibility in the relationship

• Supervision: Choose a supervisor who has experience working with children

• Supervision provides space to untangle the complexities of a session, the child’s world & keeps work safe

• Touch: Ask yourself if the physical contact is necessary, appropriate & reasonable?


CHILD PROTECTION

• A therapist cannot call themselves a Play Therapist unless qualified and registered with the Professional Standards Authority http://professionalstandards.org.uk/

• This is one branch of counselling that is

statutorily (government) regulated and is subject to a fine of up to £5000


http://professionalstandards.org.uk/



INFORMING ADULT PRACTICE• Thinking creatively can help adults ‘tell their story’

• Children do not have an adults’ social awareness & so one can learn to be more comfortable with silence. There can be a reduced self consciousness about ‘getting it right’ with adult clients as children seem less judgmental

• The temptation to ‘work too hard’ instead of letting the client do the work increasingly comes into awareness as it is less easy to interpret and make assumptions when counselling children

• Instinctive responses, such as to be a parent, a teacher, a fixer, or just plain curious, are heightened, and as such more evident to consciousness.


• Patience improves, especially when working with the ‘not knowing’

• Any unfinished mental and emotional issues as a child can lead to anxiety, confusion, fear, emptiness and unhappiness, reasons for which are not apparent to the adult (Whitfield, 1987)

• Thus can help adult clients recognise, heal & nurture their inner child as ‘repressed traumatic experiences in childhood are stored up in the body and, although remaining unconscious, exert their influence even in adulthood.’ (Miller, 1983)


STORY IDEAS


RECOMMENDED READING


SUPPORTwww.theplace2be.org.uk The Place2Be

http://www.youngminds.org.uk/ Young Minds

http://www.nspcc.org.uk/ NSPCC

http://www.everychildmatters.co.uk/

http://www.nspcc.org.uk/help-and-advice/for-parents-and-carers/guides-for-parents/listening-to-children/listening-to-children-pdf_wdf90723.pdf?utm_source=download&utm_medium=guide&utm_campaign=listening Guide for Parents: Listening to Children

http://www.nspcc.org.uk/help-and-advice/for-parents-and-carers/guides-for-parents/keeping-your-cool/keeping-your-cool-pdf_wdf90721.PDF Guide for Parents: Keeping your Cool


http://www.theplace2be.org.uk/

http://www.youngminds.org.uk/

http://www.youngminds.org.uk/

http://www.nspcc.org.uk/

http://www.nspcc.org.uk/

http://www.everychildmatters.co.uk/

http://www.nspcc.org.uk/help-and-advice/for-parents-and-carers/guides-for-parents/listening-to-children/listening-to-children-pdf_wdf90723.pdf?utm_source=download&utm_medium=guide&utm_campaign=listening




http://www.nspcc.org.uk/help-and-advice/for-parents-and-carers/guides-for-parents/keeping-your-cool/keeping-your-cool-pdf_wdf90721.PDF



REFERENCESAxline, V. M. , 1969. Play therapy. New York: Ballentine Books.Bruner, J., 1983. Child’s talk: learning to use language. New York: NortonCattanach, A. , 1994. Play Therapy: where the sky meets the underworld. London: Jessica

Kingsley Publishers.Cattanach, A., 1995. Drama & Play Therapy with Young Children. The Arts in Psychology, 22, (3),

p 223-228. Geldard, K. & Geldard, D., 1997. Counselling Children . London: Sage. Gibbons, A., 2002. The Edge . Great Britain: Dolphin.Hayden, T., 1995. Tiger’s Child . London: HarperCollins.Ironside, V., 1996. The Huge Bag of Worries . Great Britain: H odder.Miller, A., 1987. The drama of being a child: the search for the true self. Great Britain: Clays Ltd. Green, H., McGinnity, A., Meltzer, H., et al. (2005).

Mental health of children and young people in Great Britain 2004. London: PalgravePrever, M., 2010. Counselling & supporting children & young people. London: Sage.Sharpe, S. & Cowie, H., 1998. Counselling & Supporting Children in Distress . London: Sage.Smyth, D., 2013. Person-Centred therapy with children & young people. London: Sage.Sunderland, M., & Engleheart, P., 1993. Draw on your emotions: Creative ways to explore,

express & understand important feelings. Milton Keynes: Speechmark Publishing Ltd.Whitfield, C., 1987. healing the child within: discovery & recovery for adult children of

dysfunctional families. Florida: Health Communications Inc.


http://www.hscic.gov.uk/pubs/mentalhealth04

let’s play: an introduction to working therapeutically with children

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