Play therapy is most commonly used with children, and sometimes even with teens. All of our playrooms are equipped with sand trays, doll houses and many other expressive materials.  Play is the natural way that children express themselves. We try to understand the play, support the child’s willingness to play, and respond with understanding and helpful comments.   

A child feels comfortable with play and usually appreciates that the therapist is entering his world, rather than being forced into the adult world.  For instance, a child sets up a scene in the sandbox. He chooses from the hundreds of toy animals, people, cars and other vehicles, fences, signs and other items that are available for the sandbox. He may create a scene with domestic animals fenced in but threatened by a large bear.  We can talk to the child about his fear of a large figure, recognizing that the figure may represent a bully at school, a family member, or even the child’s own fearful inner images.  Sometimes children are afraid of their own imagination!  Sharing these fears, even at a symbolic level, can be comforting for the child and help him feel more in control.

Doll house play is another favorite activity. At times, a child whose parents are divorced may use two doll houses to enact the different experiences in his two homes.  The therapist does not have to say, “Your mommy cried when you went to your daddy’s.”   Instead, she can talk about how the doll house figures acted. The message gets through to the child better than if there were a direct discussion.

Though many teenagers can be very articulate about their problems, some feel more comfortable expressing themselves through creative play.  No one is telling them to act grown up when they are not feeling able to cope. Even if they verbalize their feelings, it can be comforting to mold clay figurines or run their hands through sand while they are talking, distractions that are soothing as they speak.  

Games also are useful in therapy. Some games are specifically designed for therapy. The Talking, Feeling, Doing Game, designed by Richard Gardner, is a board game. Players get points for responding to questions, some of which are fun and some of which evoke feelings that might be otherwise difficult to talk about.  Even standard board games like checkers can be useful in therapy, letting the child and therapist work on winning and losing and how one responds,  dealing with a wish to cheat, learning how to take turns, and learning how to teach another person how to play a game.

Therapists often use crafts such as drawing or working with clay as a way to help children express feelings they cannot put into words.  They use therapeutic stories, either ones already written or those they write with children, to help children explore their feelings or ways they can “change the story.”

Our therapists often combine traditional play therapy with other therapeutic approaches to help meet a child’s needs.  These approaches include teaching children behavioral techniques to reduce stress (such as imagining that they are in a safe place), to manage anger, or to get along better with family or friends.  They include “cognitive therapy” tools such as helping children to identify negative thought patterns (“Annie hates me and will never be my friend again”) and substitute more positive ones (“maybe Annie ignored me because she was having a bad day and will be friendly when she is feeling better.”)

When we see a child in therapy, we always involve the parents. Especially with a younger child, the parent becomes the therapist in the home. We work with parents to explore better ways for their children and family to deal with conflict, undue anxiety, depression, habit problems, and responses to loss, illness, death and divorce.  

When we begin counseling, we discuss confidentiality with the child and parents.  Confidentiality issues differ depending on a child’s age, maturity, and the intensity with which a child wants something to be private.  Very young children often expect what they discuss in counseling to be shared with a parent.  Older children may agree to share much of what is discussed, but ask that certain things be kept private (“I saw Jordan copy off Ashley’s math test, but don’t tell because my mother will tell Jordan’s mother and Jordan won’t be my friend)”.  Teenagers often feel a strong need for privacy.

We try to respect the child’s right to confidentiality. This can be a difficult issue: the parent may feel he has a “right” to know the specifics of what is going on in the child’s therapy, but the trust between the child and the therapist may be broken if we violate the child’s confidentiality.  If a child or teenager raises family problems that should be addressed in counseling, we often suggest a family session or tell the child we would like to meet with the parents.  Therapists work with teens about how to improve communication with their parents, and how teens can discuss sensitive issues with them directly.  In all cases, we tell children and parents that if a child is doing something dangerous to himself or others, we cannot keep that confidential.  If you have questions about confidentiality, do not hesitate to discuss them with the therapist.

Child therapy is an art that can be partially taught but relies on the intuition, imaginative powers and good sense of the therapist. We are proud to have on our staff many truly talented child therapists.