Play Therapy

Ongoing foreign conflicts have exposed militaryconnected
children to stressors not generally faced by the
general child population. Although many children of service
members and veterans are resilient and successfully adapt to
these changes, frequent relocation, fluid family structure, and
ambiguous loss can become too overwhelming for many
children of military families and lead to pathological symptoms
that require them to receive treatment. This paper discusses
the use of family-based play therapy interventions
with military children. It will focus on the following areas:
(1) risks to the psychological and emotional health of children
of service members, (2) adverse effects of combat stress
reactions of military parents on their children, (3) traumatic
grief of children whose family member has died or been
grievously wounded, (4) family-based therapies currently in
the treatment of childhood grief and trauma, and (5) play
therapy as a means of treating bereavement and traumatization
of military-connected children and their families. A case
example demonstrating a couple and family therapist’s use of
family-based play therapy to deal with traumatic grief of a
military child is provid

Play therapists are increasingly being employed in schools, yet there is confusion among many health, education and social care practitioners about the role of play therapists. This paper explains how play therapists position themselves and what they do through an examination of the therapeutic relationship between the therapist and child. It discusses the core conditions of congruence, acceptance and empathy with reference to recent research. Play therapists vary their practice in terms of verbal or non-verbal interaction, the tools in their playroom and how they physically place themselves. This paper argues for placing an emphasis on the non-verbal mirroring of the child, the incorporation of expressive media such as paint, clay and sand into the play room and the positioning of the therapist within the play space.

Despite the importance of the therapeutic relationship between staff and youth in residential care, there is a dearth of information on how to improve the quality of those relationships. This evaluation study examined the impact of a play-based, trauma-informed training program for staff working in shelters for unaccompanied migrant youth. The play-based training is specifically designed to foster collaborative relationships and well-being among participants. We assessed staff's beliefs about relational capacities, job satisfaction, and adverse incidents at four sites piloting the program, complemented by qualitative interviews. We found statistically significant improvement in group beliefs about safety, trust, intimacy, and control; group beliefs about the shelters' capacity to address mental health issues; job satisfaction; and reduction in the incidence of restraints. These findings support the usefulness of therapeutic play-making skills for residential care staff working with vulnerable and traumatized youth, particularly when combined with clinical methods for addressing trauma.

Autism is defined by persistent deficits in social communication and social interaction in multiple contexts as well as restricted and repetitive patterns of behavior. There are also reported difficulties in the dynamic activation and modification of cognitive processes in response to changes in tasks' demands. Such difficulties are believed to be due to poor flexible cognition. This research aimed to assess and intervene in cognitive flexibility in subjects with autism. Ten subjects diagnosed with autism by psychiatrists, aged 5 years to 13 years and 5 months, were assessed in non-verbal intelligence through Raven's Progressive Matrices in pretest. They were also assessed in cognitive flexibility through Wisconsin Card Sorting Test (WCST) and in patterns of social interactions, behaviors, and communication through Autism Diagnostic Interview-Revised (ADI-R). An intervention program of 14 to 21 sessions was established to enhance cognitive flexibility. In posttest, they were assessed in WCST and ADI-R. All measures of cognitive flexibility improved in posttest except for failure to maintain set. Among the measures improved in posttest, perseverative errors and responses improved in posttest with statistical significance as well as categories completed. Total scores on ADI-R were lower in posttest as well as scores on communication abilities. The qualitative improvement showed by the individuals of this research concerning cognitive flexibility and also patterns of restricted behavior, social interaction, and communication abilities suggests that individuals with autism can benefit from the development of strategies for the enhancement of cognitive flexibility. Nevertheless, more research is suggested with a larger sample among subjects on the autism spectrum.

Many people, especially children, perceive MRI exams as threatening. They experience anxiety and stress during the procedure. Often this results in premature termination of the scan or low image quality. To avoid these adverse effects, it is common to sedate anxious patients. We present a playful virtual reality (VR) application for children (8-15 years) to counter anxiety and avoid sedation. Our approach uses a realistic virtual MRI scanner for desensitization and habituation to the MRI exam. To compensate the limited amount of profound knowledge about the design of child-tailored VR applications, we pursued a child-centered design process. Starting with expert interviews, we iterated through several development cycles and carried out focus group testings to evaluate prototypes of the VR application. Then, we conducted a field study with 13 patients under real life clinical conditions. Although results were non-significant, tendencies indicate a drop in the anxiety level after using the application. Furthermore, the application received strong support of the participating children, and medical professionals.

This study examined the effects of a game program of assertive behavior, helpful behavior, and self-concept in children aged 8 to 10. A pretest-intervention-posttest design was used with a sample of 126 experimental and 28 control subjects. Three instruments were administered before and after intervention: the Children's Assertive Behavior Scale, Sensitivity Scale, and the Adjective Check List. Assertive behavior, helpful behavior, and self-concept were the dependent variables. Intervention consisted of a group play-session carried out once a week during the whole academic year. The program's games encourage children to cooperate and share, as well as to develop creative play. The program included presentation, communication, help, cooperation, creativity, and emotional expression games. Results of multiple variance analyses suggest that the program caused significant improvement in assertive behavior (p < .001) and self-concept (p < .01). This paper reveals empirical ...

Purpose: The purpose of this study was to examine the effects of unstructured play activities on the anxiety levels of hospitalized children. Methods: A nonequivalent control group pretest posttest design was employed for this study. The sample included children (N = 165) ages 4–7 years admitted to a large pediatric referral center in the United Arab Emirates. The control group (n = 84) received usual care, while the experimental group (n = 81) engaged in age-appropriate unstructured play activities using disposable games and toys. Parents and siblings, if present, were encouraged to participate. Research assistants conducted the play activities twice a day, with 30-min morning and evening sessions. Anxiety was measured at baseline and at the end of days 2 and 3 with a translated form of the Short–State-Trait Anxiety Inventory for Children. Results: Anxiety scores in both groups were similar at baseline and decreased significantly over the 3 days. Compared with the control group, anxiety scores in the intervention group were significantly lower on day 2 (12.7 ± 2.3 vs. 10.7 ± 2.5, p = .003) and day 3 (10.6 ± 2.2 vs. 9.47 ± 2.4, p < .001). The greatest decrease occurred in the percentage of children in the experimental group with medium-level anxiety scores: baseline (n = 61, 75%), day 2 (n = 24, 30%), and day 3 (n = 0, 0%). Conclusions: This simple, low-cost play intervention implemented by nurses resulted in statistically and clinically significant decreases in the anxiety levels of children in an acute inpatient setting.

This article explores how the key concepts within Gestalt Equine Psychotherapy (GEP) and Humanistic Play Therapy (HPT) can be compatible modalities for working with children. The connections between GEP and HPT can be seen in their philosophical framework of viewing the self as an embodied, relational process, and the belief in the importance of play and experimentation within the therapeutic encounter. Both approaches emphasize the importance of the therapeutic relationship and trust that the child is able to self-direct his or her own growth and learning. Both GEP and HPT can draw from neuroscience research to provide evidence of the importance of authenticity, congruence, and coherence within both the therapist and the child in building the therapeutic relationship. Through the use of a case example, this article will demonstrate how HPT and GEP can become an integrated approach in supporting the developmental process of the client.