What is Play Therapy / Play and Creative Arts Therapy?
Play Therapy is a form of counselling for children and young people, which utilises play as a means to help children express underlying thoughts, feelings and experiences. It is therefore a developmentally appropriate counselling service for children and does not rely on them having to verbalise feelings directly. When adults experience difficulties they may seek help from talking therapies, but for children this can feel intimidating. Consequently, Play Therapy is often offered to help children to communicate feelings and experiences at their own level and pace, which they may not have had chance to process.
When children experience unsettling events, their feelings can become overwhelming. This can be a confusing and worrying time for them and their families. Play Therapy provides children with a confidential space to explore their feelings and make sense of their life experiences. Play Therapy aims to empower children by helping them to acknowledge their feelings in a constructive way and give them strategies for coping with the difficulties they may face.
The Play Therapist will use a combination of non-directive and directive therapy during sessions and this is dependent on the age of the child and the reasons for the referral.
Non-directive (child-led) therapy involves the child leading the session and allows the child to express and work through their difficulties in a way that suits them.
Directive therapy involves the therapist providing creative activities which may assist the child to explore or address any difficulties they may be experiencing.
The trusting and non-judgemental relationship between child and therapist allows the child to have the freedom to be themselves and express their inner struggles, therefore promoting healing.
Session types
Individual: 1:1 Play Therapy sessions will last for about 45 minutes. Sessions are weekly, at an agreed time. Therapy may involve a combination of non-directive (child-led) activities and activities directed by the therapist which relate to the referral reason. Short or long-term support can be agreed and depends on the reason for the referral. For children who are presenting a moderate to high level of need, a minimum of 18 sessions is usually recommended. Review meetings will be held with the referrer and the child's parent/carer.
Group Play Therapy: The therapist works with up to 4 children who are presenting a similar difficulty (e.g. anxiety) or with children who have experienced a similar life event (e.g. bereavement). The group meets weekly for about an hour, for 6 – 8 weeks. Group sessions are often more directive to address the referral reason.
Clear Sky Children's Charity's video highlights how Play Therapy can help children who are experiencing emotional and/or behavioural problems
Who can be referred?
Research shows Play Therapy is an effective method of support for many children over four, due to its responsiveness to unique and varied developmental needs. Children who are presenting emotional and/or behavioural difficulties, which may be spilling out into their everyday lives as worrying or challenging behaviours may be referred, including those who:
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are experiencing changes at home e.g. parents separating
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suffer from anxiety, low self-esteem or stress
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have suffered a loss or bereavement
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are withdrawn or continually unhappy
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have a long-term illness
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may struggle having a disability
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struggle socially
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have nightmares or disturbed sleep
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are adopted / fostered or in the process of this
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have experienced trauma or abuse
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are at risk of being/ are excluded from school
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are young carers
The child must not already be undertaking any other form of counselling, although they may be on the waiting list for CAMHS. If it is felt the reason for the referral is related to adoption, to meet the requirements of The Children’s Adoption Act, we need approval from the Adoption Support Agency. This may be obtained from the child’s social worker.
What happens during therapy?
The therapist aims to create an emotionally secure and accepting environment, where the child can be themselves. The therapist shows them consistent warmth, empathy and respect, which helps with the formation of the therapeutic relationship.
During therapy clear boundaries are set so the child knows to look after themselves, the therapist and the space. The child can then play in an unrestricted way. Often when the child feels safe and secure, they begin to communicate feelings and experiences through their play. Sometimes the child may re-enact or play out life experiences to make sense of their past and cope with their future. The therapist interacts with them in their play, following their lead and helps them to make sense of their world. The therapist does not ask lots of questions or make judgements as each child will work in their own way. Within the therapeutic environment, children often express underlying feelings, build resilience and develop coping strategies, therefore helping to alleviate the original difficulties.
How effective is Play Therapy?
We use Goodman's (2005) Strengths and Difficulties Questionnaire (SDQ) to assess the child's mental health pre and post therapy, as well as evaluations from staff, parents/carers and children. Based on the SDQ's completed post therapy, about 80% of the children referred show a positive change post therapy. We produce yearly impact reports to highlight the effectiveness of Play Therapy.
Play Therapy can help children in a number of ways, depending on the reason for referral. The outcome of Play Therapy may be general (e.g. raised self-esteem, less anxious) or more specific such as a change in behaviour or improved relations with family and friends. As children are working through underlying difficulties, referrers and parents often report the child seems happier following Play Therapy and a happier child is more likely to connect with others, engage with school and achieve.
In Play Therapy children:
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receive additional emotional support and experience a consistent therapeutic relationship, where their thoughts and feelings are central.
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have the freedom to explore and express feelings and experiences in a way that suits the child.
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are able to process and work through feelings that may have been impacting on their behaviour within school and home.
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may re-enact or play out difficult life experiences in order to make sense of their past and cope with their future.
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may learn to express feelings in constructive ways.
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have the opportunity to be in control, make choices and take responsibility, which may improve self-esteem and confidence.
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may learn to manage relationships and conflicts in more appropriate ways.
The Therapy Room
Sessions usually take place within the child's school. Play Therapy uses a variety of equipment and activities, to help children to express their thoughts, feelings and experiences, either directly or symbolically. The use of unconstructed materials such as paint, clay and sand, plus a wide range of miniature figures are important, as it allows their imagination to run free.
Art/Crafts
Roleplay/Games
House/Stories
Sand/Play figures
Testimonials
The child is more confident and participates in class more
The pupil is less anxious now
Play therapy provided a neural space where they knew they were safe and they were able to release inner issues
The therapist always shares appropriately with regard to safeguarding issues
The therapist is faultlessly professional and has an amazing relationship with the children
Play therapy provided a safe environment to enable my child to process her past. Over time she has become calmer in herself
Zoe always kept me up to date with progress
At home we have seen a huge difference in his behaviour
Zoe helped me as well as my son, as I could talk things through
My child started the sessions shy and withdrawn, but her confidence developed and she is much more open about her feelings now
Teachers
Parent / Carers
Going to see Zoe helped me to feel better
Happy times
When I was feeling stressed I could go and see Zoe and I felt calmer
I loved the art activities
I have learnt ways to feel better when I am upset
Zoe listened to me
I enjoyed my sessions and feel more confident now