ADVANCED INTEGRATIVE PLAY THERAPY - CLASS 4 Geoff Goodman, Ph.D.

HOLISTIC EXPRESSIVE PLAY THERAPY An integrative approach to helping maltreated children  Introduction – maltreated children  Chronic maltreatment  Vulnerable to further incidents of trauma because caregivers are unavailable to provide protection  An integrated model of play therapy  Limitations of verbal therapy with this population  Experimentation with nonverbal materials  Maltreated children not interested in drawing  Began using a wide range of expressive materials that these children liked better  Integration of experiences with patients and therapist’s personal journey for self- knowledge and self-healing

HOLISTIC EXPRESSIVE PLAY THERAPY An integrative approach to helping maltreated children  Holistic expressive play therapy approach  All humans have an innate kernel of wisdom – “true nature”  True nature has capacity for self-healing on all levels: physical, emotional, cognitive, and spiritual  Formation of secure attachment with therapist  True nature recognized, protected, nurtured  Serving as a platform for growth  What do maltreated children see in their caregivers’ eyes?  True nature not reflected back  Instead, a distortion of their true nature is reflected back, especially when needs are expressed

HOLISTIC EXPRESSIVE PLAY THERAPY An integrative approach to helping maltreated children  Unresolved trauma creates emotional blocks  Cannot be transformed without expert help  These blocks create layers of defenses that prevent connection with true nature (i.e., innate wisdom and guidance)  Adversely affects play capacity  Therapist provisions  Safe and protected space  Create opportunities for positive memories (helps patient to internalize a safe place)  Resolution of traumata (completed using symbols expressed through play)  Inside-out healing – release of inner tensions and repressed feelings  Outside-in healing – creation of soothing environment for patient  Family therapy so that wound does not get reopened by caregiver

HOLISTIC EXPRESSIVE PLAY THERAPY An integrative approach to helping maltreated children  Practical application of Holistic Expressive Play Therapy  Holistic Expressive Play Therapy includes all the factors necessary to create a safe environment – emotional womb  Attunement  Protection  Nurturance  Flexible boundaries  Holistic Expressive Play Therapy demands that therapist has the ability to attune herself to both patient’s and her own wisdom to create methods needed for that patient  Holistic Expressive Play Therapy is child-centered  Therapy reinvented for each patient  Whether following child (nondirective) or  Leading child (structured)  Therapy helps child to “stand the pain without dissociating…or acting it out” (p. 82)  Caregiver involvement  Coach parent on forming reparative relationship with child  Joint sessions with parent and child later in treatment

HOLISTIC EXPRESSIVE PLAY THERAPY An integrative approach to helping maltreated children  Therapeutic relationship  Attunement to child’s needs is essential to the effectiveness of the therapeutic process  Constant adjustment of two variables  Containment  Freedom  Ingredients needed to explore inner and outer world  Milieu  Soothing, harmonious environment  Coopt nature  Animal participation  Expressive activities – provide choices in the playroom by offering a wide variety of modes of expression  Painting  Sandtray therapy  Movement  Drama

HOLISTIC EXPRESSIVE PLAY THERAPY An integrative approach to helping maltreated children  Closure  Closing ritual (e.g., snack, song, candle lighting)  Opportunity to reflect on session  Photograph images created by child

SOCIAL SKILLS PLAY GROUPS FOR CHILDREN WITH DISRUPTIVE BEHAVIOR DISORDERS Integrating play and group therapy approaches  Introduction  Quality of childhood peer relations predicts future academic, emotional, and social adjustment  Social competence – capacity to initiate, develop, and maintain satisfying relationships with peers  Social skills – specific skills needed to develop and maintain social competence  Cooperation and initiating conversations  Conflict resolution and social problem solving  “Social skills are typically taught in a group setting, so children receive immediate reinforcement for appropriate modeling” (p. 95)  Methods used for positive emotions and skill-building  Games  Metaphors  Stories  Role-plays

SOCIAL SKILLS PLAY GROUPS FOR CHILDREN WITH DISRUPTIVE BEHAVIOR DISORDERS Integrating play and group therapy approaches  Integrating the therapeutic powers of group and play therapy  Group therapy (Yalom & Leszcz, 2005)  Instillation of hope – awaken ability to change and expectation of successful therapeutic process  Universality – group members not alone in their problems  Imparting information – group members receive information from peers and group leaders  Symptoms and diagnoses  Coping skills  Altruism – giving and receiving support  Corrective recapitulation of primary family group  Vicarious learning – observing and imitating behavior of peers and therapists in group  Interpersonal learning – play out typical interactional patterns in group  Group cohesiveness – therapeutic bonds insure group members’ motivation to persevere in therapy  Catharsis – release of negative emotions in positive setting  Existential factors – acceptance of issues outside of group members’ control (e.g., death, illness)

SOCIAL SKILLS PLAY GROUPS FOR CHILDREN WITH DISRUPTIVE BEHAVIOR DISORDERS Integrating play and group therapy approaches  Play therapy (Schaefer & Drewes, 2009)  Communication – play is child’s natural form of communication  Emotional regulation – alleviate intensity of negative feelings through play  Relationship enhancement – play creates a positive emotional bond among group members  Moral judgment – in play, group members can develop rules for interacting with each other  Stress management – play allows a group member to overcome fear of an upcoming event by playing it out with others  Ego boosting – in play, group members are in control and are larger than the objects they are controlling, enhancing inner locus of control  Preparation for life – trying out multiple approaches in play  Overcome fears  Promote mastery  Find appropriate solutions to task  Self-actualization – play allows child to think for self, learn about desires, limits, and needs, develop insight and confidence

SOCIAL SKILLS PLAY GROUPS FOR CHILDREN WITH DISRUPTIVE BEHAVIOR DISORDERS Integrating play and group therapy approaches  Play group therapy for social skills deficits in disruptive children  Teaching children social skills in a peer group setting that involves play reflects a more naturalistic setting than individual talk-based therapy  Play encourages reduction of social anxieties and increase in emotional regulation  Coaching model of play group therapy  Education to teach new skills  Practice to increase skill performance  Performance review with therapists  Both individual and group instruction and practice  Outside practice promoted by homework assignments

SOCIAL SKILLS PLAY GROUPS FOR CHILDREN WITH DISRUPTIVE BEHAVIOR DISORDERS Integrating play and group therapy approaches  Manualized 10-week psychoeducational model used  Coaching  Modeling  Operant conditioning  Reinforcement techniques  Three-phase modeling procedure  Therapist-to-therapist  Therapist-to-child  Child-to-child  10 social skills covered in the curriculum  Starting and joining conversations  Group entry  Handling rejection  Assertiveness  Social problem solving  Cooperation  Complimenting

SOCIAL SKILLS PLAY GROUPS FOR CHILDREN WITH DISRUPTIVE BEHAVIOR DISORDERS Integrating play and group therapy approaches  Awareness of feelings in the self  Awareness of feelings in others  Good sportsmanship