Chapter 11 Therapeutic limit setting

Basic Guidelines One of most important aspect, but one of most difficult. May be challenging because: Therapist feels insecure, and is slow to apply limits Therapist wants the child to like him/her But, limits provide boundaries and structure, so child will feel safe. Provides opportunity for learning self control Learn how to make choices Learn about responsibility

Limits should be minimal and enforceable Limits should be total rather than conditional (not you can mix just a little paint-either allow or don’t). State in calm, patient, matter of fact way Don’t use “in here, we …”, use “the BoBo is not for jumping on” Set limits as the situation warrants.

Rationale for Limits Limits provide physical and emotional security and safety Limits protect the physical well being of therapist and facilitate acceptance Any form of direct aggressive physical acting out or attack on the therapist should be prohibited. Limits facilitate the development of decision making, self-control and self- responsibility. The child’s feelings are respected, but the action may have limits placed on it. Limits anchor the session to reality and emphasize the here and now. Limits promote consistency Limits preserve the professional, ethical and socially acceptable relationship Limits protect the play therapy materials and room

Procedures Objective is to facilitate the expression of the motivating feeling, want or need in a more acceptable manner. Facilitator of expression rather than prohibitor of action.

Steps in Limit Setting Acknowledge child’s feelings, wishes, and wants. “You are feeling angry and want to show me how angry you feel” Communicate the limit, “but, the knife is not for using on people” Target acceptable alternatives “ you can use the knife on the puppet or the figures” Acknowledge Communicate limit Target acceptable alternatives

Limits allow child to express feelings, but not cause harm or fear of retaliation. Believe in the child and the belief that he/she will control actions.

When limits are broken: Breaking limits can be a cry for help Therapist needs to reflect feelings while stating with firmness what the limit is. Only have consequences for current session. Go through cycle several times Last step- child can choose to accept the limit or choose to lose that toy for the remainder of the session or leave the room (ultimate limit)

“If you choose to shoot me again, you choose not to play with the gun anymore today.” If child continues, “I see that you have chosen to not play with the gun anymore today. You can choose to put the gun on the shelf, or on the table” Repeat, if necessary

Go through examples pp. 278

Situational Limits Toys stay in the playroom Child stays in playroom for entire session except to go to bathroom or get water (suggest parent take before session) Child leaves after 5 minute reminder Personal items are not for playing