1.  Objectives of the relationship o Establish a safe atmosphere for the child o Understand and accept the child’s world o Encourage the expression of the child’s emotional world o Establish a feeling of permissiveness o Facilitate decision-making by the child o Provide the child with an opportunity to assume responsibility and to develop a feeling of control  Making contact with the child o Am I safe? o Can I cope? (What are the expectations?) o Will I be accepted?

2.  The initial encounter in the waiting room o Don’t engage in conversation with parents o Crouch down and greet child at her eye level o Make eye contact and smile o Take the child to the playroom; parents will be there waiting o The reluctant child You can have 1 more minute or 3 more minutes Parents can accompany child to the playroom Therapist talks for the parent Last resort – parent carries child to playroom

3.  Developing the relationship in the playroom o Introduction to the playroom Don’t explain too much “You can play with the toys in a lot of the ways you would like to” “in a lot of the ways” communicates limits on behavior (i.e., boundaries) o Allow the child to lead Enter child’s physical space (including floor) only when invited by child Therapist’s chair is the only neutral space Allowing child to lead affirms belief in the child’s ability to be constructively self-directing Children do not learn self-direction and responsibility when the therapist provides solutions or direction Suggest a character to play an abusive role vis’-a-vis’ the child

4.  Hearing nonverbal expressions – listen with your eyes and ears  Respecting the child’s space  Physically tracking the child – toes should follow nose  Reflecting nonverbal play behavior: tracking o Tracking – put into words what therapist sees and observes child doing o Tracking conveys interest in the child  Reflecting verbal content o Therapist summarizes or paraphrases and reflects back the child’s verbal interaction o Reflecting helps therapist immerse herself in the child’s world  Reflecting feelings o Always focus on child’s feelings: “You don’t like what’s in this playroom, and you want to leave” o Allow child to make decisions about playing

5.  Responding to the reluctant, anxious child o When the child is nonverbal, the therapist should be verbal o Do not inhibit child further by therapist silence  Questioning techniques of children o Children ask questions to make contact and build relationship o Don’t answer questions that have not been asked o Trying to anticipate what children are communicating through their questions rather than answering them facilitates expression and exploration  Explaining observation mirror and recording – not necessary for younger children  Taking notes during session – don’t do it

6.  Preparing to end each session o 5-minute, 1-minute caution o Prepare parent if child has paint on themselves  Basic dimensions of the relationship (four healing messages) o I am here – I am fully present o I hear you – I will listen fully with eyes and ears o I understand – Communicate this understanding to child o I care – Caring releases child’s innate growth potential

7.  Sensitive understanding: being with o No problem-solving o No evaluation  Caring acceptance o Child learns to depend on others for support o Child develops their own sense of adequacy and independence o No advice, suggestions, or explanations are given o Empathic responses free child to be more creative o Child’s feelings are experienced with less intensity if therapist accepts them because child has also begun to accept them o Child can begin to integrate positive and negative emotions in a more focused and specific way

8.  Distinctive qualities of therapeutic responses o Brief and interactive (10 words or less) o Focused on the child o Interactive and conversational o Match the flow and emotional intensity of the child o Help the child go on o Reflect nonverbal play behavior (tracking) “You’re listening to your heart” Therapist communicates involvement with child o Reflect content Reflecting back the verbal interaction with the child Child feels heard and understood

9.  Reflect feelings o Therapist communicates understanding and acceptance of the child’s feelings o Child learns that all feelings are acceptable  Build self-esteem o Therapist responds in ways to build self-esteem “You know how to count” “You’re working hard on that” o Child feels capable, facilitates development of intrinsic sense of self, and builds up intrinsic motivation  Match child’s level of affect o Therapist’s tone of voice and degree of affect match affect and intensity of child o Mismatches can cause the child to respond disingenuously

10.  Avoid asking questions o Child should not be expected to generate insight o Child comes to play therapy lacking insight o Questions can be turned into statements  Facilitate decision-making and return responsibility o “That’s something for you to decide” o Experience of decision-making strengthens child’s self-concept and provides experiences that can be incorporated into changed self- representation o Therapist returns responsibility to child, facilitates decision-making, and elicits child’s creativity  Responses are personalized o Use second, not third person or plural o Keep focus on child

11.  Avoid labeling toys o “You just put that right in there” o Labeling toys anchors child to therapist’s reality and interferes with child’s creativity and fantasy  Are nonevaluative and do not praise o Praise = external evaluation o Praise deprives child of internal motivation o Praise increases dependency on the therapist, inhibits creativity, and lowers self-esteem o “You’re proud of your picture” o Describe what is seen; prize what has been produced; focus on child’s affect