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Play therapy used in a family psychiatric unit in England is described, together with an evaluation of its treatment value and its usefulness toward a diagnosis. Individual play techniques are explored, and two case histories are given as examples of how the occupational therapist works with the child, the family, and other practitioners.
A wide array of new forms and combinations of play therapy have been developed. The aim of the second part of this paper is to present an overview of these newer approaches, including: focussed therapies for specific disorders; behavioural approaches like the Cognitive-Behavioral Play Therapy and the Parent-Child Interaction Therapy; various combinations with family therapy; and therapies especially for preschool children like Filial Therapy, Developmental Play Therapy and Thera-play. Following a phase of experiments and combinations, the empirical evaluation of many play-therapy forms is needed. Especially questions of the differential indication of specific play-therapies and their effectiveness in the therapeutical practice need to be studied.
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Play therapies are psychotherapies with the medium of play primarily for children under 12 years of age, which can be differentiated according to their theoretical constructs and actual practice. Play therapies have gained importance and relevance in the 1990's, reflected in a wide range of publications. Following trends can be discerned: narrow concepts defined by individual schools of psychotherapy have been left. Different forms of play therapy, as well as behavioural and family therapy have been integrated. Focussed short-term and therapies for specific disorders have been developed. The aim of the first part of this paper is to present an overview of traditional forms of playtherapy, with a focus on the Individual Therapy of A. Adler, the Analytic Psychotherapy of C. G. Jung, Sandplay Therapy of D. Kalff and child-centered (non-directive) play therapy.
Therapeutic play activities are designed to help children verbalize their hospital experiences so they can cope with the trauma of hospitalization. The purpose of the study was to determine whether a music therapy session was more effective than a medical play therapy session in facilitating this verbalization. Forty school-aged subjects were randomly selected to receive an individual music therapy or play therapy session. The two groups were equated on the following variables: sex, age, socioeconomic status, length of present hospitalization, session interruptions, type of illness and related number of prior hospitalizations, and prior Child Life involvement. The last two variables were thought to influence verbalization. The dependent variable was comprised of each patient's response to four critical incidence questions about hospitalization. Content analysis was employed to code each response as a three-digit number with numbers increasing as the verbalization became more involved. The chi square statistic revealed that music therapy elicited significantly more involved verbalization about hospitalization than did the play therapy session for each of the seven variables. Verbalization was unrelated to the patient's diagnosis and prior hospitalizations. Patients without prior Child Life involvement had more involved verbalization than patients with prior involvement.
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Play therapy allows children with developmental and health disabilities to discover what physical and emotional strengths they have in relation to their disabilities. Play therapy may be directive or nondirective, emotionally or physically focused. Suggestions for specific activities are presented for providing play therapy for children with disabilities.
Play therapy is a viable nursing intervention used in a multitude of settings and in a multidisciplinary fashion. Therapeutic play interventions can be directed or non-directed, as well as used in recreational, therapeutic, or dramatic forms. Children need play opportunities.
The present article discusses the difference between play therapy with toys and play therapy with games from a psychodynamic point of view. Toys are regarded as offering the child an opportunity to develop a variety of transference reactions, while games, because of their inherent competitive characteristic, restrain the scope of possible transference reactions. The authors claim that therapists should consider these eventualities when choosing which games or toys are to be available in the therapy room. This choice might determine, in advance, the initial characteristics of the patient's transference.
This article gives an overview of individual play therapy and relates the concepts of individual play therapy to group play therapy. A new model of group play therapy, an interactional model, is introduced. The article provides basic guidelines for beginning play therapists. An actual group is described and specific interventions for problems are suggested.
Institutionalized retarded children were randomly assigned to 11 sessions of directive play therapy (N = 5), nondirective play therapy (N = 5), or no treatment (N = 4). Student nurses were therapists. The Denver Developmental Screening Test was administered before and after treatment. For the Fine Motor and Personal-Social scales, a significant interaction effect (p smaller than .05) was found between treatment group and measurement period (pre vs. post). The interactions tended to support the hypothesis that play therapy was effective in increasing developmental level but not the hypothesis that directive therapy was more effective than nondirective therapy.
Discusses cognitive-behavioral play therapy (CBPT), a developmentally sensitive treatment for young children that relies on flexibility, decreased expectation for verbalizations by the child, and increased reliance on experiential approaches. The development of CBPT for preschool-age children provides a relatively unique adaptation of cognitive therapy as it was originally developed for adults. CBPT typically contains a modeling component through which adaptive coping skills are demonstrated. Through the use of play, cognitive change is communicated indirectly, and more adaptive behaviors can be introduced to the child. Modeling is tailored for use with many specific cognitive and behavioral interventions. Generalization and response prevention are important features of CBPT. With minor modifications, many of the principles of cognitive therapy, as delineated for use with adults, are applicable to young children. Case examples are presented to highlight the application of CBPT. Although CBPT has a sound therapeutic base and utilizes proven techniques, more rigorous empirical scrutiny is needed.
The Children's Play Therapy Instrument (CPTI), its development, and reliability studies are described. The CPTI is a new instrument to examine a child's play activity in individual psychotherapy. Three independent raters used the CPTI to rate eight videotaped play therapy vignettes. Results were compared with the authors' consensual scores from a preliminary study. Generally good to excellent levels of interrater reliability were obtained for the independent raters on intraclass correlation coefficients for ordinal categories of the CPTI. Likewise, kappa levels were acceptable to excellent for nominal categories of the scale. The CPTI holds promise to become a reliable measure of play activity in child psychotherapy. Further research is needed to assess discriminant validity of the CPTI for use as a diagnostic tool and as a measure of process and outcome.
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It has been recently shown that human adolescents with Attention Deficit/Hyperactivity Disorder (ADHD) have frontal lobe deficits, especially on the right sides of their brains (). ADHD is commonly treated with psychostimulants which may have adverse consequences. Hence, less invasive therapies need to be developed. In the present work, we tested the ability of right frontal lesions to induce hyperactivity in rats. We also evaluated the effects of chronic play therapy during early adolescence to reduce both hyperactivity and the elevated playfulness later in development. Play therapy was able to reduce both hyperactivity and excessive playfulness. In additional work, we found that access to rough-and-tumble play in normal animals could enhance subsequent behavioral indices of behavioral inhibition (i.e., freezing in response to a startle stimulus) that appeared to be independent of increased fearfulness and fatigue. Overall, these results suggest that (1) neonatal frontal lobe lesions can be used as an animal model of the overactivity in ADHD and (2) rough-and-tumble play therapy may be a new useful treatment for ADHD.
Play enhances a child's physical growth and development and contributes to the mastery of language and social skills. It is essential for the child's psychological development and maturation. An overview of the field of play and art psychotherapy is presented with an outline of the function of play for the physically ill child. Techniques of play and art therapy that nurses can use for children with cancer, including therapeutic play, are described.
Play therapy and filial therapy show promise as effective ways to provide direct services to Head Start, addressing the needs of the children, the families, and the Head Start teachers and staff. This paper examines the utility of play and filial therapies for the Head Start population, presents a systemic explanation for the benefit of filial therapy, and provides a case example for illustration.
This article discusses the use of play therapy and art therapy treatment techniques for persons in substance abuse treatment who have a history of incest victimization. While substance abuse treatment focuses on substance abuse, neglecting to address issues related to past incest contact may increase the potential for relapse. This population displays unique characteristics that may prevent them from participating in, or benefitting from, traditional treatment modalities (which are highly dependent upon the verbal interactions between clients and therapists). Play therapy and art therapy are discussed in terms of history, rationale, and benefits to clients.