1. Directive/Non-Directive Play therapy: What is its Relationship to Group/Family Play Therapy?
Sabra Starnes, LICSW,LCSW-C, RPT-S

2. Learning Objectives Define the terms Directive and Non-Directive Play Therapy Participants will relate training and experience to Choice of Modality in Play Therapy Participants will learn how these approaches relate to Group Play Therapy

3. A Short History of Work with Children
Child Guidance Movement – 40’s and 50’s
Hospitalization
Community Mental Health – 60’s and 70’s
Schools seen as primary prevention and assessment sources – 80’s –
Youth Service bureau movement
Family Systems Movement
Psychiatry and Managed Care – Era of mental health as big business.

4. A Short History of Models of Play Therapy
Little Hans - Freud's work with a phobia
Virginia Axline (1947) - Play Therapy
Bernard G. Guerney, Jr. (1964). Filial therapy
Clark Moustakes, (1973). Children in Play Therapy - relationship based
D.W. Winnicott, (1977). The Piggle: The psychoanalytic treatment of a little girl.
A.M. Jernberg, (1979). Theraplay

5. Frameworks Psychoanalytic Relational Jungian Adlerian Gestalt
Family Systems
Client Centered - Child Centered
Cognitive Behavior Therapy
Solution Focused

6. Anna Freud used play therapy to replace free association (talk therapy) around She was also the first to recognize that children should have a different method of therapy (i.e. play therapy) than the traditional adult therapy.

7. How is it therapy?
Play therapy differs from regular play in that the therapist helps children to address and resolve their own problems.
Through play therapy, children learn to communicate with others, express feelings, modify behavior, develop problem-solving skills, and learn a variety of ways of relating to others.
Play provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development.

8. Directive Play Therapy
The clinician provides structure and guidance to the session using play-based approaches.

9. Child-Centered Play Therapy
Immediate and present experience with the child
The therapeutic process is lead by the child
Through a shared relationship the therapist conveys acceptance of the child which frees them to develop confidence and self-awareness

10. Child Centered & Directive
Competency in Child centered Play Therapy is a must for application of techniques
Axline’s 8 Principles of Child Centered Play Therapy
Must develop a warm and friendly relationship with the child.
Accepts the child as he or she is.
Establishes a feeling of permission in the relationship so that the child feels free to express his or her feelings.
Is alert to recognize the feelings the child is expressing and reflects these feelings back in such a manner that the child gains insight into his/her behavior.
Maintains a deep respect for the child’s ability to solve his/her own problems and gives the child the opportunity to do so. The child is responsible for his/her own choices and personal change.
Does not attempt to direct the child’s actions or conversations in any manner. The child leads the way, the therapist follows.
Does not hurry the therapy along. It is a gradual process and must be recognized as such by the therapist.
Only establishes those limitations necessary to anchor the therapy to the world of reality and to make the child aware of his/her responsibility in the relationship

11. Child Centered & Directive
Rapport is essential prior to using techniques in play therapy treatment
Directive Approach – technique application is not random, its curative and used to service needs of child and based on the identified treatment goals
Why Directive Techniques?
Time limits
Behavior modification

12. Typical Goals of Therapy
Enhance child’s self control, self-concept, and self-efficacy.
Help child become aware of his or her feelings.
Have a place where child can feel safe in exploration of self.
Learn and practice self- control and alternative behaviors.
Develop capacity to trust adults.
Develop capacity to relate to an adult in an open, positive and caring manner.

13. According to Bergen (1998) PLAY IS NOT… A waste of time
A babyish activity
Something done only with toys
Something to do when there’s nothing important to do
PLAY IS….
A basic skill that helps children’s knowledge grow
A natural part of everyone’s life
A chance to make believe

14. 7 Essentials in Play Therapy
Establishment of a positive relationship with the child
Expression of a wide range of feelings
Exploration of real-life choices
Reality of testing limits
Development of positive self-image
Development of self-understanding
Opportunity to develop self-control

15. Therapeutic Powers of Play
Self expression
Power/Control
Direct and Indirect Teaching
Competence and Self Control
Abreaction
Sense of Self
Stress Inoculation
Creative Problem Solving
Catharsis
Fantasy Compensation
Positive Emotion
Reality Testing
Attachment and Relationship Enhancement
Behavioral Rehearsal
Rapport Building
Empathy
Schaefer (1999.)

16. Child Centered Play Therapy Approach
Here and now
Developmental
Person
Affect
Understanding
Accepting
Spontaneity
Therapist is not the expert

17. Child Centered Approach
Action
Attitude change
Child’s direction
Child’s wisdom

18. Principles of Growth & Development
Continuous process
Predictable Sequence
Don’t progress at the same rate (↑ periods of GR in early childhood and adolescents & ↓ periods of GR in middle childhood)
Not all body parts grow in the same rate at the same time.
Each child grows in his/her own unique way.
Each stage of G&D is affected by the preceding types of development.

19. Child centered Guidelines
Making tracking responses
Child stands on the chair
Child looks out the window
Child asks therapist “what does this do?”
Child asks how old are you?”
Setting limits

20. Using Directive Play Therapy with Families and groups

21. Directive Play Approach
There and Then
Remedial
Problem
Cognition and behavior
Explaining
Correcting
Therapist is the expert
structure

22. Directive Play Therapy Approach
Talk
Behavior Change
Therapist’s instruction
Therapist’s knowledge

23. Erikson theory (psychosocial development)
Infancy stage 
Toddler stage 
Preschool stage 
School-age stage 
Adolescence stage 
Trust versus mistrust.
Autonomy and self esteem versus shame and doubt.
Initiative versus guilt.
Industry versus inferiority.
Identity and intimacy versus role confusion.

24. Erik Erikson A Neo-Freudian
Adheres to some of Freud’s ideas, but focuses more on social influences.
Stage Theorist
Focus on Crisis Resolution
At each stage a crisis must be resolved
If the crisis is not resolved, the individual may lack the positive characteristic in the stage.

25. INITIATIVE vs. GUILT 3 – 5 years Preschoolers learn to initiate tasks
Q Favorite word?
One becomes more independent

26. COMPETENCE/ INDUSTRY vs. INFERIORITY
6 years – puberty
Child completes tasks themselves
Learning on your own
Important Event: school
Q What is an inferiority complex?

27. IDENTITY vs. ROLE CONFUSION
Teens – early 20s
Teens refine sense of self
Test new roles and incorporate them into an identity
Q Know anyone that is very different now vs. when they were pre teen 10,11 and 12?
Important events: forming relationships with friends

28. Atmosphere of Playfulness
Role of the leader is to smile, be emotional and have fun.
DO IT! Rather than say it!
Negative and positive behaviors are accepted unless someone is being hurt
When you have a problem behavior, make it an activity and have fun to promote acceptance.
Group rules are used to manage behaviors
Cooperative activities
Be up-beat and engaging

29. Structuring the Directive or Child Centered Play therapy sessions
Opening
Limit setting
Time
Closing
Check ins with parents/guardians

30. Curative Factors of Play Therapy
Relationship building/attachment
Catharsis/Self-expression
Trauma processing
Skill building (direct learning, modeling, and reinforcement of healthy behaviors)
Helps develop problem-solving skills
Identity development (safe place to develop)
Positive activities (especially helpful for depression)
(Schaefer & Drewes, 2009)

31. Qualities of an effective play therapist
Deep empathy
Positive regard
Genuineness
Flexible
Willingness and openness
Understanding of the stages of development
Comfort in getting “down and dirty”
Training and Supervision in various modalities
Registered Play Therapist

32. Effectiveness of Play Therapy Interventions
Play therapy interventions have demonstrated effectiveness in treating and/or addressing:
Anger Management (McGuire, 2001; Ogawa, 2004).
Grief and Loss (LeVieux, 1994; Webb, 2003).
Divorce and Family Dissolution (Pedro-Carroll & Reddy, 2005).
Crisis and Trauma (Ogawa, 2004; Tyndall-Lind, 2001).
ODD and CD
Depression
Anxiety
ADHD
PDD/ASD
Emotional competence (feelings identification, expression, and regulation)
(Bratton, Ray, Rhine,& Jones, 2005)

33. Types of Play Therapy Materials
Dolls, puppets, plastic figurines
Sensory-Based items
Therapeutic and no therapy games
Blocks, puzzles
Paints, Play-Doh
Pretend play materials
Sand tray
Hand made games and activities
Dress up clothes

34. Methods of Play Therapy
Sand Tray
Imaginative Play
Puppet Play
Art/Crafts
Bibilo therapy
Psychodrama
Therapeutic Games

35. Playing therapeutic games in family sessions

36. Working with the Parent/Guardian throughout treatment

37. Stages of treatment
Assessment
Beginning
Middle
Termination

38. Directive vs. Child Centered?

39. Using Directive Play Therapy with Families and groups

40. Final thoughts….

41. Use books for doing Directive and Child Centered Play Therapy

42. Play Therapy Supervision
I provide individual an group distance and face to face Play therapy supervision towards your supervision hours towards becoming a Registered Play Therapist
*35 hours of supervision with a RPT-S vs 50 hours of supervision with non RPT-S
Contact information or

43. The Extended Play-Based Developmental Assessment (EPBDA, Gil)
It consists of meeting individually with youth, allowing them to become comfortable with the setting and therapist. This therapeutic assessment may be concluded between 8 and 12 sessions and includes clinical observation, children’s participation in a variety of play-based activities, attention to and interpretation of thematic material in children’s play, completion of paper-pencil tests, if appropriate, and therapeutic dialogues.

44. The EPBDA has shown to be particularly useful for very young children who are less verbally expressive, for hesitant or ambivalent children who may feel compromised by demands for verbal communication, and for adolescents who may be unable or unwilling to verbally participate in an assessment or therapy.

45. Resources Gil, E. (1994). Play in family therapy. New York: Guilford.
Johnson, L., Mcleod, E.H., & Fall, M. (1997). Play therapy with labeled children in the schools. Professional School Counseling, 1(1),
Kottman, T. (2001). Play therapy: Basics and beyond. Alexandria, VA: American Counseling Association.
Lambert, S.F., LeBlanc, M., Mullen, J.A., Ray, D., Baggerly, J., White, J., & Kaplan, D. (2005). Learning more about those who play in session: The national play therapy in counseling practices project. International Journal of Play Therapy, 14(2), 7-24.
Landreth, G. L. (1991). Play therapy: The art of the relationship. Muncie, IN: Accelerated Development.

46. Play Therapy
For more information on play therapy visit the Association of Play Therapy website:
References:
Association of Play Therapy (2008) Association of play therapy. Clovis, CA.
Schaefer, C.,& Drewes, A. (2009). Therapeutic powers of play. New York, NY: John
Wiley and Sons.
Bratton, S., Ray, D., Rhine, T., & L. Jones ( 2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes. 36,
Bergen, D.B. (1998). Play as a medium for learning and development: A handbook of theory and practice. Olney , MD: Association for Child and Education International.

47. Web Site Resources Association for Play Therapy http://www.iapt.org/
Filial Therapy
Canadian Play Therapy Association
Midwest Play Therapy Institute
Transpersonal Sandplay

48. References
  Jennings, J., Pearson, G., & Harris, M. (2000). Implementing and maintaining school-based mental health services in a large, urban school district. Journal of School Health, 70(5),   Kot, S., Landreth, G. L., & Giordano, M. (1998). Intensive child-centered play therapy with child witnesses of domestic violence. International Journal of Play Therapy, 7(2),   Landreth, G.L. (1993). Elementary School Guidance & Counseling, American School Counselor Association: Special issue on counseling and children’s play, 8(1) ,   Landreth, G.L. (2002). Play therapy: The art of the relationship(2nd ed.). New York: Brunner-Routledge.   Landreth, G.L. (2013). Innovation in play therapy: Issues, process, and special populations. New York, NY: Brunner-Routledge.

49. References
  Jennings, J., Pearson, G., & Harris, M. (2000). Implementing and maintaining school-based mental health services in a large, urban school district. Journal of School Health, 70(5),   Kot, S., Landreth, G. L., & Giordano, M. (1998). Intensive child-centered play therapy with child witnesses of domestic violence. International Journal of Play Therapy, 7(2),   Landreth, G.L. (1993). Elementary School Guidance & Counseling, American School Counselor Association: Special issue on counseling and children’s play, 8(1) ,   Landreth, G.L. (2002). Play therapy: The art of the relationship(2nd ed.). New York: Brunner-Routledge.   Landreth, G.L. (2013). Innovation in play therapy: Issues, process, and special populations. New York, NY: Brunner-Routledge.