Neurobiology and Play Therapy

Neurobiology and Play Therapy
Lisa Cowart LPC, RPT-S, NCC Please do not reproduce any portion of this presentation

Neurobiology The study of cells of the nervous system and the organization of those cells into functional circuits that process information and mediate behavior. ScienceDaily

Play Therapy and Neurobiology
Understanding neurobiology is important because the way the brain processes and stores information impacts play therapy treatment modalities that we choose to most effectively help the client heal or reach their goals. Goal of play therapy is to integrate memories in various parts of the brain and to target certain parts of the brain to build new neural pathways to help individuals make more sense of their bodies and have more control. Play therapy is a treatment modality that assist in integration and building new pathways.

Neuroplasticity

Neuroplasticity Development of new connections within the brain that develops as a result of exposure to new experiences and allows for modifications which opens door for therapeutic change Functions to allow us to adapt to change

Neuroplasticity Neurogenesis (formation of cells)- begins in utero and is rapid during second and third trimesters and by the time we are born 99% of our neurons (billions) exist. Adults do form new neurons stimulated by exercise and enriched environments but diminished by stress. How these neurons mature depend partly due to experience Neurons migrate along glial cells (support cells)to part of brain and have a final position, impacted by genetics and environment (rapid from in utero to 1st year and is almost complete by 3 years) There are 100 billion neurons or brain cells and for each neuron there are ten glia cells. Trauma and Brain Neurobiology presentation +neurobiologu+presentaion&aqs=chrome..69i j0j8&sourceid=chrome&ie=UTF-8 adoptionsupport.org/wp-content/uploads/2012/12/Module-5-PPT.pptx Perry, B.

Neural Plasticity continued
Differentiation of cells is a process where cells change and become more specialized and are impacted by changes in neurochemistry. It begins in utero in first trimester and is almost finished by age of 3 but does last throughout life. This is impacted by the mother’s neurochemistry as well as the child’s. Apoptosis- death of neurons use it or lose it impacted by environment or genetics, neurons die with no activity. (Neglectful environments impact the death of neurons)

Neural Plasticity continued
Arborization- growth, branching out, integrate patterns and determine it’s activity based off what receives and processes Synaptogenesis- Synapses (neuron to neuron connections) are formed which send signals to other neurons (by allowing neurotransmitters or chemicals in the brain to transmit messages)and form a connection- guided by genetics and environment, strength and connection is based off use. Synaptic Sculpting – neurons grow closer together the more they are used and connections are stronger and work faster. Synapses form or die throughout life. Myelination occurs as glial cells wrap around the axons connecting the neurons strengthening the connection Trauma and Brain Neurobiology presentation

These neurons or brain cells form specialized networks like webs connecting very specialized systems in our bodies. This results in the architecture of our brain. Perry, B.

Neurodevelopment is Impacted
Experience (toxins, nutrition, nurturing, trauma, neglect) Genetics (temperament receives more nurturing, intelligence requires fewer repetitions)

https://www. thermofisher
Neurotransmitters or chemicals in the brain can include norepinephrine and epinephrine (noradrenaline and adrenaline) associated with fight flight responses which send signals to various parts of the brain in stressful situations. If the stress response system is over activated repeatedly due to life stressors it can change the development and architecture of the brain and how it functions and responds. What functions in the brain originally helped a child cope might after repeated exposure to trauma might cause a child to become hypersensitive scanning the environment repeatedly for threats impacting a child’s ability to focus and could cause them to appear more aggressive because they may over interpret threats and react as a way to protect themselves. Perry, B

Think about A child whose mother is terminally ill while she is pregnant A child whose mother is grieving while pregnant or right after birth A child whose mother is experiencing domestic violence during or after her pregnancy Bruce Perry- two brothers with similar genetics developed differently due to environment

Brain Plasticity Neural growth
Derived from exposure to new experiences and stimuli Allows for reparative experiences Promoted by counseling interventions Neuroplasticity occurs across one’s lifespan Rapid rates from ages 0-6 While a child is young the foundation for neural pathways are formed and lay the ground work for future functions Play and social relationships are necessary for healthy brain development (Wheeler and Dillman, 2016)

In Play Therapy Sessions
Opportunity to teach and model new behaviors to assist our clients in learning how to react in their world outside of our play sessions. Teaching children to make thoughtful decisions and not to just react to the world around them. Impulse control and decision making is learned from others around us. By using games in play therapy we can teach a child to stop before acting or doing. Practice taking a minute to evaluate the decision before choosing the behavior. Repetition of interventions in play therapy helps build new synapses. So positive therapeutic targeted treatment planning combined with repetition is the key in play therapy. Perry, B 26

In Play Therapy We help create new associations to build neural pathways Our brains are wired to make associations and form templates Our senses help us form what we perceive something to be by using sight, sound touch, scent. (is this dangerous person or situation, am I safe) Previously if a child’s heartrate was racing the child may react by lashing out in survival mode because the child may have grown up in an unsafe world but if the child learns in play therapy when the child’s heartrate is racing to first notice it, then breathe before reacting to help move from brainstem to cortex to help uses all parts of the brain to determine decision to react and how to react.

Review Windows of opportunity for growth
Use it or lose it (the systems in your brain repeatedly activated will change and the ones that are not activated do not change) hence the power of play therapy in creating new repeated activation to build new synapses creating change Experience or lack of experience impacts organization Organization of the brain takes place in an order determined by genetics but can be impacted by environment First few years of life very important Healthy stimulation is important There is plasticity which allows the brain to adapt and change allowing for therapeutic interventions

Development of the Brain

https://www. google. com/search

Lower brain is related to reptilian like lizards very primitive
Middle brain is animal like, relating to cats and dogs The outer areas are most complex and most unique to human brains is the frontal cortex Perry, B

The brain develops from the inside out with it becoming more and more complex as each piece builds upon the foundation.

Brain Develops Hierarchal
Bottom Up Brain Stem- body temperature, heart rate, blood pressure, most simple of the brain architecture, Cerebellum- muscle coordination and balance. Midbrain or diencephalon- appetite, sleep, and arousal. Limbic System- emotions, reactivity, and affect regulation, actions, attachment. Our emotional responses that guide our behavior are regulated by the diencephalon and limbic system. (hatred, fear, love). Perry, B. Cortex- abstract thought, verbal, decision making, insight. Most intricate of the brain architecture. (Gil, 2013)

In Play Therapy Notice which part of the brain the child’s symptoms indicate they are struggling with: Regulation- brainstem Sleep would related to midbrain Social and relational deficits related to limbic and cortex

These systems work together to provide us with how we interpret our world. So no system is working without the other.

Caution The brainstem lower more primitive forms first and moves sequentially through formation to cortex higher function conscious decisions The cortex is more easily to adapt to change ie changing beliefs is easier than the brainstem or limbic regions that involve primitive survival and emotional areas The brainstem is organized very early in life based off our genetics and experience. So change is very difficult. The cortex is more flexible and adaptable throughout life. This takes repetition patience and frequencies with specific interventions that target that area in mind Focusing on regulation and attachment before moving toward cognitive approaches B. Perry

Neurodevelopment Organization
How much love or nurturing you experience How much exposure to others and places How much stimulation How early the experience (early childhood verse adolescents or adulthood-just changes but not organization)

Sensitivity How strong the experience is
Flexible stress response capacity Healthy stress is moderate, predictable, strengthening- learning a word Overloaded can cause deterioration, disorganization, dysfunction- extensive trauma (Perry, B)

Patterns and Timing During Critical Periods
Language- child raised as a dog Growth hormone- child who did not grow until experienced physical affection and nurture Touch- premature babies who receive massage and skin to skin contact go home earlier from the hospital as sensory pathways are critical. Even in adults massage can reduce stress hormones. Perry, B

Each portion builds upon the other
If a child experience a lot of trauma then the brain will organize more on the bottom survival and if receive more healthy lifestyle then brain is more open to build at the top

High stress and low nurturing equates to less compassion and self-control. This is a result of the way the brain organized as it developed in response to it’s environment.

Questions or Comments?

How Does This Relate to Play Therapy

Play Integrates Parts of the Brain
Play impacts different parts of the brain, a variety of regions like motor, auditory, sensory (Levy) Play therapy combines the part of our brain that does not have words to articulate our experiences with the part of our brain that does have words to articulate experiences.

Implicit Memory Forms prenatally Architecture of self
Outside of consciousness Mental modes of behavior, images, and emotions guide anticipatory planning Riding a bike Driving a car

Explicit Memory Appears around age 2 Symbolic thought processes
Consciously recalled Adds sense of time Autobiographical recollection Sense of self Words (Wheeler and Dillman)

Play Therapy is a Valuable Medium
As a play therapist you are the play partner helping in forming and then reforming the child’s experience because each experience/memory is re-encoded each time they are activated Rather than processing the event in explicit thought using verbal approaches to therapy, play is an implicit mode to process experience producing therapeutic change as it integrates implicit and explicit memory or thought (Levy) It is fast way to process and operates outside of focal attention and verbalization, unconsciously change occurs. (Levy) Verbal explicit awareness is not necessary for change to occur, implicit modes are thought independently be able to produce change (Levy)

Play Promotes Integration
Play therapy has the power to integrate implicit and explicit memories which helps the child to make sense of their internal world and communicate their needs to outside resources Fosters reorganization of neural structures Behavioral and affective patterns are not primarily coded verbally and therefore not able to be addressed solely explicitly (talk therapy) (levy) Helps find words to associate with feelings body sensations that make up memory in order to articulate to others to better get needs met Play is metaphorical and through play therapy the implicit unconscious memories expressed metaphorically are brought to explicit memories creating verbal words and conscious by the therapist reflecting the experience grounding it into autobiographical story. Levy, Alan J.

Play Therapy Can essentially be a faster treatment modality
Play is processing information in all different parts of the brain all at once allowing for an integrated process that is not conscious in the client’s immediate awareness. In play therapy, change can occur without the verbal component. In play therapy, change can occur without having to articulate to the therapist. Integration contributes to health, growth and restoration. (Siegal)

Play Therapy Creates a Safe Relationship with Children
Safe secure play therapy relationships increase brain development and growth at any stage of development which is the process of neurobiology. When a child feels safe, they are able to process information at a higher level in which then they can start making connections of experiences and are better able to put words to experiences creating more a of a narrative in which they can define and understand. Creative unsolicited play is critical to child’ development including cognitive, social emotional, neurobiological and physical aspects of the brain. Interpersonal neurobiology supports play therapy as it is interconnection between brain, mind and relationships with others. There is an energy between social environment and the nervous system of others and the informational flow of brain, mind, and relationships. (Siegal)

Sense, Process, Store, Perceive and Act
All based off of our response to internal and external environments Forms of energy are transformed into patterned activity of sensory neurons This is done so through our five senses These patterns connect and impact the way our brain process and reacts to the world If you grow up in an unsafe environment then you may stay in a state of fear that is functioning from a more primitive areas of the brain that are not conscious Examples of children processing smiles or smells differently than a child who grew up in a safe environment Perry B.

States

Muscle People cannot learn if in a state of fear or survival mode
Think of the brain as a muscle, if too tense nothing can come in

In state of fear or survival then functioning from a more primitive lower brain, brainstem
Can be hyperarousal or hypoarousal states, either makes it difficult to learn or take in information If in reflexive state a child’s reaction to the environment like a smell in your office a tilt of your head may be as reflexive as us withdrawing our finger from a hot stove Brain stores previous patterns of sensory neural input that are associated with threat and react without conscious thought process (Example child may have a threat reaction to a sound or touch that a therapist may have thought was soothing) This is state memory or memories connected to bad experiences based of previous sensory input Perry, B

Polyvagal Theory (Porges)
3 neural system that continuously match responses to the environment 1 Freeze-immobilization, playing dead 2 Fight-engage or Flight, run away, get away 3 Homeostasis- when sympathetic nervous system is calmed and higher order neural process achieved (this is what we are trying to achieve in play therapy so individuals can learn and grown and change) (Wheeler and Dillman)

Hypo and Hyper Arousal States
When Hypo-aroused – we have gone to our parasympathetic system and we Freeze. May dissociate, numb, lack energy or motivation, you may feel they are being defiant or uncooperative When Hyper-aroused- We go into fight or flight mode and our sympathetic nervous system has taken over. May become aggressive, agitated, moving around a lot, you may feel defensive, threatened, or lack of control When in these states we want to help the client move toward the other state to become more online or regulated so as to have more control of their world and be able to learn, think, make conscious decisions and choices, be able to articulate verbally, be in touch with their body, feel grounded. Colordaoplaytherapy.com/tag/emotional-regulation/

Moving Toward Regulated State
Must have regulation to have cognitive engagement and therapeutic change Using somatosensory route providing patterned, repetitive, rhythmic input. Perry, Gaskill, 2014

Vagus Nerve Our visceral organs have neural connections from both parasympathetic and sympathetic nervous system with most of these far reaching neural fibers connections traveling from the vagus nerve. (Porges.) There are two vagal pathways from our brainstem that were created sequentially as we evolved. Vagus activation creates responses that when activated respond automatically.

Vagus Nerve We have a (1st) reptilian unmyelinated vagus that is protected by a (2nd) newer myelinated vagal circuit which is more cognitive and organized. If we get triggered we can lose regulation of the newer vagal circuit and revert back to more primitive fight flight freeze. We are not consciously aware of those specific triggers, could be facial expression, a smell. Porges calls this neuroception when we do not have an awareness of the response. (Perry ex. Child’s becoming so unregulated that she shut down and her heart stopped after exposure to a perpetrator and Porges example where a woman passed out) Dissociation is related to the ancient vagal nerve being triggered, shutting down, protects one and increases pain tolerance.

Online How do we get our clients online?
How do we get their brains to open up and be open to receiving information? Which state are they in?

Activities to help hypo-aroused
Think stimulating, faster paced, energy Use more energetic tones Movement- throwing the ball, dancing, hula hooping, shake it out, skipping, jumping rope Touch- grounding, stomp feet, knead dough, fast deep massage of arms or legs Sight- lights on and up Touch- rough surface, brush arms more rapidly, cold water Eating- pop rocks, crunchy fruit or veggies, pretzels Movement sound- Play faster music, or do faster drumming Coloradoplaytherapy.com/tag/emotional regulation

Activities to help hyper-aroused
Think sensory and calming and slower paced and calming vagus nerve Use soft tone and slower movements Touch and vagus nerve- blanket, wrapping arms around self for hugs Movement- rocking slowly Movement-Slower Breathing, longer deeper Movement-Yogo

Activities to help hyper-aroused continued
Touch or sound-Water play funnels Touch and sight-Sand play funnels Sound and sight– soft music or video of sea creatures Change temperature- something warm or cool Eating- something soothing warm or cool Touch- sensory basket with feather, soothing textures, lotions for massage, nail polish

Beyond awareness Life long connections of senses and cues of threat that may rapidly without knowledge of the individual alter their emotions, behaviors, and physiology. This impacts child success in the world as they grow up Relationships at work home school etc. are impacted Smells Sight Sounds Touch Taste Perry B.

States If fear or threat- then cortical modulatory networks may be shut down therefore decreasing or ceasing conscious intentional modulation of behaviors. This results in impulsive primitive poorly regulated behaviors. Depending on a child’s developmental history they may have grown up with less cortical-network-building experiences such as neglect, abuse, chaos. They may be underdeveloped in the cortical areas resulting in impulsive globally dysregulation. (may be intentional or unintentional life circumstances) adoption, parental illness, war, poverty, In order to plan, gain insight and have self-reflection, an intent behind behaviors, the child needs a regulated organized accessible cortex. Perry, Gaskill 2014

Other systems Many systems of the children who may be lacking and have compromised functional capacities may also be placed in systems like foster care, educational systems, juvenile etc. may continue to live in chaotic environments that do not know how or are not set up to assist the child in developing a healthy neural system. Reinforces negative associations. Perry B.

Trauma Can interrupt and increase stress responses and delay development in children Some parts of the brain do not develop enough and other parts overdevelop like the survival area and interfere with higher parts of the cortex development.

Entering a calm state (like hand)
The mind is more open and able to accept new information The brain is functioning on a higher level of frontal lobe, frontal cortex Thinking is more rational and able to make decisions Learning can occur

Creating Safety Play sanctuary (Kestly)-Calm, inviting, nurturing, predictable, safe, stable, allows for creativity Play Therapist, attuned with client and client’s need, getting on clients level, uses space, tone of voice, gestures that appropriately match the need of the client

Mirror Neurons Our bodies respond to other’s bodily movements with a mirror effect or synchrony, like when a baby smiles when his mother smiles Like when we notice our body language in a counseling session is mirroring our client, like arms crossed or leaning forward, you can tell when people are in sync with one another, connecting It is the part of our brain that helps us learn to connect with others and form empathy for others All our senses interpret what the other person is feeling by the person’s tone of voice may be agitated, movement rocking back and forth, smell of the person sweating, our bodies my instinctively regulate to theirs and want to become agitated or anxious if we are in tune with that person or we can choose to regulate our system, speak in soft voice, take deep breaths to help them regulate to our calm system, so we use mirror neurons to help them regulate

Mirror Neurons Thinks of yourself as the oxygen mask, you must regulate and model regulation for our client and client’s caregivers to regulate. (coloradoplaytherapy/tag/emotional regulation) Attunement- must be attuned to ourselves and our clients. Attunement is being aware and responsive to others, being sensitive, paying attention to non-verbal cues, synchronicity with others and interacting. If we attune to our clients needs we are reflecting their feelings and emotions so they feel connected. We may track their movements and adjust ours. Our tone of voice changes to their needs. Limit setting is adjusted to their needs. What state are they in hypo or hyper? If we are modeling self care – our clients attune to our regulatory systems neurons fire in their brain (mirror neurons that activate when observing others perform an action, same neurons that fire when we perform that action) when they see us nurturing ourselves. It helps them develop pathways in their brains of how to nurture themselves. If we model respect for the client, others or our bodies this creates a mirror effect.

Want Brain to be More Open and Flexible
Goal of Play Therapy is to assist the brain in becoming more open and flexible allowing integration can occur. We use the safe play therapy relationship to bring about homeostasis state to allow our client’s brains to be more open and flexible and able to adapt and change.

What Part of Brain Activated or Under Stimulated
Symptoms Behaviors Define your target are for treatment planning Neurosequential Model (Perry, B.)

Most Play Therapy Engage in Verbal dialogues Which engage cortex
Traditional psychodynamic or CBT therapies may fail as they are attempting to support the development of cognitive regulatory control but have failed to address lower brain under developed networks which are not yet capable Perry, Gaskill, 2014 Many address insight, awareness, behavioral change, problem solving, relational and experiential techniques which targets limbic and cortically oriented symptoms. (Gaskill, 2010)

Cortically Mediated Issues (Top- Down)
Guilt Shame Self-esteem Greif Loss Gaining an understanding of Developing acceptance of New perspective Planning Decision making Executive Processing Insightful reflection Trauma experience integration Narrative development Social development Affect enhancement (Perry B., Gaskill R.)

Many children Especially children and caregivers who have experienced trauma are initially engaging from the brain stem Breathing may not be regulated Motor functioning may not be in control Cortex is offline- not thinking just reacting So they are unable to process verbally Child is functioning from a near-reflexive state- just reacting to environment Gil, 2013

Areas have been missed The non-cortical components of social and emotional trauma have been missed significantly and have not been considered until people have began focusing on the fundamental principles of neurobiology and neurodevelopment. (Gaskill, 2010)

Ladder

Improve and Regress Ladder
Baseline at start and then regressed, regressed Intervention and stability improve plateau, improve plateau Takes long term commitment on caregivers and understanding progression is actually occurring as it is slow Slow and repetitious Can have set backs

If an individual perceives a threat then a reduction in blood flow from the frontal lobe and a shift to activation in the subcortical regions of the brain. This alters cognition, social, emotional, and motor functioning. So the brain no longer functions from the upper level and down. The decisions are as less calculated and more primitive and impulsive for survival. Perry, Gaskill.2014

If trying to help a child learn social skills and regulation the best group for that child is not other children with difficulties in that area it is with children who have mastered social skills and regulation and children who are educated about the other child’s difficulties so they can be more direct in helping shape that child’s behavior while understanding they come from a limited background. (Perry) Children with dysregulation should be paired with children with regulation.

Can you think of a time where you were just reacting not thinking and therefore engaging from your brain stem? Some people heights, closed spaces, snakes, spiders, dentist Maybe you reacted by just getting out of there or flight, maybe you shut down and froze and could not move, maybe you were combative Can you imagine functioning in this state most of your day? Could you learn? Or interact well with others?

Questions or Comments?

Regulating lower areas of brain (bottom-up)
Positive repetition Rehearsal of healthy interactions Low one to one ratio Foundational experience May seem regressive Children may have missed or incomplete neural networks Somatosensory- Music, dancing, walking

How to get Cortex Online
Must create safety Comfort Relationship Predictable Consistent Slow Get on their level Use a soft voice Gil, 2013

Brain is Like a Muscle Start with small repetitions and build on those adding more and more as you can tolerate to build stronger muscles

Start by Regulating Brainstem Using Brain Based Activities- Think Sensory
Breathing Drumming Yoga Guided Imagery- bubbles, honey melt over Balloon Blowing Pinwheels Theraplay Finger painting Play dough Mucle relaxation Biodots

Rhythm Rhythm assist in regulating our bodies
Improves sleep wake cycles Decreases stress hormones Routine and predictability is valuable in regulation Use play therapy approaches that include music and movement

Play Therapy and Regulation
Role model regulation- name it, show it, time and time again Dance with your client, stop and start Go for a walk with your client- name what you see using all of your senses Burrito- wrap child up with a blanket and ask what they need to feel safe i.e warm, love, calm voice, music, Teach child to take brain breaks, or their caregivers and teachers Breathe with fidgit spinner Balls that stretches in and out Coloradoplaytherapy.com

Butterfly Hug http://kidsrelaxation.com/uncategorized/butterfly-hugs/
1. Think of a memory you would like to lessen the emotion associated with. Rate the strength of your feelings on a scale of 1 to 10 2. Cross your arms in front of your chest with the tips of the fingers of each hand resting just below the clavicle on each side. Hand point more vertically toward neck not arms. 3. Gently close your eyes or look softly down. 4. Gently tapping on each side alternating. You can stop at any point. 5. Breathe deep and slow while you are gently alternating the tapping. Just notice, what comes to you, do not judge, just notice, any feelings, any images, any physical sensations or feelings in your body. Go with it, where ever it takes you. Now slowly open your eyes and stop tapping (do with your client but to yourself and stop after about 40 taps and check in) 6. Now think of the feeling associated with the memory and rate it again. See if it feels weaker this time when you think about it. 7. Repeat.

Butterfly Hug You can do this with safe place imagery using all the senses, following you could draw the safe place as a reminder You can do this with imagining accomplishing something

Guided Imagery -Floating on a Cloud
Imagine a fluffy cloud floating. Notice it come down gently beside you. Image what your cloud looks like, what color is it, what shape is it, what does it feel like to your fingers and toes, what does it smell like. Climb onto your cloud and let it slowly float up. See where it takes you, notice what you see, what you hear, what your smell. No let your cloud float to a special quiet place where you feel safe and secure and loved. Notice what you see, what you smell, what you hear or feel.

Rainbow Breathing Breath in one color of the rainbow slowly filling yourself with that color Slowly breath out the black toxins until it is all out Breathe in the next color Continue until you have gone through all the colors

Breath Like a Bee Cover your ears with your thumbs and your eyes with your fingers Now keep your lips closed and slightly open your teeth Now inhale slowly closing your throat so you can hear your breath And Exhale slowly while making a low humming sound like a bee

Kimscounselingcorner.com Pintrest

Toolbox Allow the child to pick from different shaped boxes whatever they are drawn to Spend time decorating a box with different pleasant colors and soothing texture Now fill the box with reminders of what brings you comfort using your five senses Touch- feather, stuffed animal, stress ball, scarf or blanket Smell- lavender, favorite chap stick, lotion, See- snow globe, landscape, Taste- mint, lollipop, cocoa, marshmallows Hear- music, rain stick,

What you need to make a paper towel roll rain stick:
A sheet of paper A piece of aluminum foil A piece of plastic wrap Popcorn kernels or dry beans Tape Markers and/or stickers

Rainstick How to make it:
1. Draw pictures on one side of a colored piece of paper (note, only about 1/3 of the end of the page will show once wrapped around the paper towel tube.) 2. Crumple up a long, thin piece of aluminum foil and insert it into the paper towel tube. The aluminum foil will act as the barrier to keep the beans or popcorn kernels moving through the tube at a slow rate, making the rainfall sound. 3. Put a doubled-up piece of plastic wrap over one end of the paper towel tube, and tape in place. 4. Pour a tablespoon of dry beans or popcorn kernels into the open end of the tube, then seal the end with a doubled-up piece of plastic wrap. Tape plastic wrap in place.

Rainstick 5. Tape decorated paper to the paper towel tube, then wrap around tube, securing end with tape. 6. Decorate tube as desired with tape or stickers. Tip back and forth to hear the sweet sound of rainfall!

Instructions ¾ water 1 bottle glitter glue And ultrafine glitter
Submergable LED light

Lava Lamp Etsy, 3 parts oil, 1 part water, 10 drops food coloring

Magical Moves 45 printable yoga cards etsy teach children yoga

Magical Moves Teach Children Yoga Etsy 45 Printable cards

Play Therapy Can Only Make Progress if Child is Not in Alarm State
Dysregulated children will not likely be able to process using words, reasoning, or ideas These will not impact regulatory networks Focus on primal language; repetitive, soothing patterned sensory experiences

Environment Environment may need to be restricted
Stimuli must match child’s developmental level to foster success Enjoyment Play must be fun and stimulating in order to develop new pathways and synapses (healthy stress) Decreasing trauma related associations or overgeneralizations by providing new positive opportunities many times over and over to create new neural networks (Perry B., Gaskill R.)

Items Caregivers can Purchase
Hammock (Vagus Nerve) Weighted blankets (Vagus Nerve) Shirts (Vagus Nerve) Sensory brush with bristles that the child can brush self

Summary of Play Therapy and Neurobiology

Remember Play therapy takes numerous sessions and is progressive based off layers of building neural networks Play therapy may not be successful if short term as it takes time for children to build these neural networks Building and changing neural networks requires repetition and is the foundation to the underlying neurophysiological therapeutic change that occurs in play therapy Outcomes tend to be more successful if caregivers are included in treatment A team approach may be required by teachers, caregivers, social workers, occupational therapist, therapist, all of which are implementing the repetitive therapeutic processes numerous times throughout the week in many environments Perry B., Gaskill R.

More Tips to Remember With trauma you may have to spend numerous sessions even up to a year working on regulation of the brain stem, midbrain, and limbic system or longer You may take steps forward and backward Individuals must feel a sense of control in regulation and safety before processing from the cortex (Perry, B., Gaskill, R.)

Assess What Part of the Brain
Choose to engage and use interventions and activities to enhance that part of the brain Brain is like a muscle- we have to work out the area that we identify in need and use repetitive activities and interventions to build new synapses and connections and associations in play therapy We have talked about the value of play therapy making connections Is the issue; emotional regulation, social interactions, sleep Choose the intervention that best matches the area that needs targeting Animal assisted therapy, Music therapy, Massage therapy, Therapies emphasizing touch like in Theraplay, Occupational therapies Gil, 2013

How Do You Get Online/ Regulate
Mindfulness Breathing Yogo Exercise

Remember Attunement Practice self regulation Role modeling
Take care of self

References Buczynski, R., Porges, S, The Polyvagal Theory for Treating Trauma Siegal, D. (2009), Mindful Awarensss, Mindsight, and Neural Integration Perry, B, (2006), Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children Gaskill, R., Perry B. (2014), The Neurobiological Power of Play, Using the Neurosequential Model of Therapeutics to Guide Play in the Healing Process Szalavitz, M., Perry, B. (2006) The Boy Who was Raised as a Dog Ford Sori, C, Schnur, S. (2013) Integrating a Neurosequential Approach in Treatment with Traumatized Children: An Interview with Eliana Gil Levy, A, (2011), Neurobiology and the Therapeutic Action of Psychoanalytic Play Therapy with Children Wheeeler, N., Dillmon Taylor, D. (2016), integrating Interpersonal Neurobiology with Play Therapy Hong, R., Mason, C. (2016), Becoming a Neurobiologically-Informed Play Therapist Gaskill, R. (2010) Neurobiology of Play Therapy

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