Stages in Play Therapy
As a parent, you will play a crucial role in every phase of your child’s play therapy which, typically, proceeds through as many as seven phases.
During your very first meeting with your child’s play therapist, he or she will conduct an intake interview during which you will be asked questions about your child’s early development, current functioning and presenting problem. It is very important to be as open and honest as possible during the intake as this information will form the foundation of the play therapist’s understanding of both your child’s difficulties and the treatment plan. Most play therapists will also complete a separate intake interview with your child to get a solid sense of his or her experience of the problems and to make sure your child feels fully engaged in the treatment process right from the beginning.
Depending on the play therapist and your child’s presenting problem the therapist may decide to conduct a pre-treatment assessment. The assessment may be as simple as having you complete one or more questionnaires. Your child may be asked to complete a variety of pretreatment measures ranging from questionnaires, to drawings, to more formal testing. Sometimes the play therapist will choose to observe your child at play either alone or with you and/or other family members. However it is completed, the assessment process provides the play therapist with additional information about your child’s difficulties and the best ways to go about treating them. Assessments can also be very useful in helping the play therapist evaluate your child’s progress during treatment.
Having completed the intake and any pre-treatment assessments, your child will begin treatment. The first few sessions are referred to as the Introduction phase. During this phase your child will be getting used to the play therapist, the playroom, and the play therapy process. The more shy or anxious your child is, the more difficult this period may be. You can help by providing your child with a lot of encouragement so he or she will give the treatment a chance to begin working.
After anywhere from one to several sessions, your child will enter into the Tentative Acceptance phase of treatment. During this phase, your child will probably look forward to the play therapy sessions and be eager to enter the playroom and to interact with the play therapist. For you as a parent, this is usually one of the easiest treatment phases.
As the play therapy begins to work, your child will begin to make some changes. While these changes are necessary, they may not be easy. Initially, change makes all of us uncomfortable. We are trying to behave in ways we are not used to and may fluctuate between attempts to engage in healthy new behaviors and attempts to retreat to older, more comfortable patterns. This is called the Negative Reaction phase. Some children pass through this phase with virtually no problems. Other children go through a period where their problems actually get worse and they may actively resist going to the play therapy sessions. Once again, you may need to provide your child with a great deal of support to get through this phase. Let your child know you have confidence in the therapy process and his or her ability to be happier and healthier in the long run.
The Introduction, Tentative Acceptance and Negative Reaction phases may all pass quite quickly, potentially in as few as three or four sessions, or they may last for several months. Once these phases pass your child will enter the Growing phase. This is the most important and, usually the longest, part of the play therapy process. During this phase your child will come to better understand his or her difficulties, how to best resolve those difficulties and how to live a much happier and playful life. Surprisingly, this phase can be a bit difficult for parents. Typically, children will make significant advances and then slide right back into some of their problem behaviors or symptoms. These regressions can frustrate both children and parents. Again, everyone needs to trust the process, celebrate the gains and try not to worry too much about any occasional slips.
The last phase of play therapy is called the Termination phase. It begins when your child’s behavioral and emotional functioning have stabilized to the point that you, your child and the play therapist are all confident in your child’s ability to maintain those gains without regular play therapy sessions. Surprisingly, this phase can be difficult for children. Adults in therapy are pleased when their symptoms subside and soon realize they can maintain the improvement on their own. They see the end of therapy as a sign of their success. Children often enter therapy only reluctantly and do so at a point when they are experiencing all sorts of symptoms and distress. Gradually, they become comfortable with the play therapist and the play therapy process and begin to experience symptom relief, becoming happier and more playful. Then, just as things are going well, they find it time to end therapy. For some children, this feels more like a punishment than a reward and they may react with a temporary recurrence of their symptoms. Just as with earlier rough spots in the play therapy process, it will be important for you to maintain your confidence in your child’s ability to continue to be happy and healthy and to convey that confidence to your child. With everyone’s efforts, the end of therapy can truly be a celebration of your child’s gains and a genuinely happy and playful event.
No matter the particular course of your child’s play therapy, you will play a variety of very important roles all along the way. The play therapist will rely on you to help determine how well the therapy is progressing and to report any changes, good or bad, as they arise. Depending on the nature of your child’s difficulties, the play therapist may also ask you and/or various other family members to participate directly in one or more of your child’s play therapy sessions. This can be a great way for you, your child and the play therapist to work together to ensure everyone is getting the most out of the treatment. Lastly, the play therapist will also work with you and advise you in ways to support your child between sessions. After all, you are the most important person in your child’s life and no amount of play therapy can ever replace the support and guidance you are there to provide.
Kevin O'Connor, PhD, ABPP, RPT-S
Co-founder, Association for Play Therapy