SOCW-6111-Discussion Wk8

SOCW-6111-Discussion Wk8

SOCW-6111-Discussion Wk8

Discussion 1: Play Therapy

Children who have been abused or traumatized in some way may benefit from working with a therapist. Children often reenact trauma through repetitious play in order to establish mastery over their emotions and integrate experiences into their history on their own terms. Through the use of toys and props, children may naturally share their emotions and past experiences without feeling the pressure they might encounter with traditional talk therapy.


For this Discussion, review the course-specific case study for Claudia and the Chiesa (2012) and Taylor (2009) articles.

· Post an explanation of ways play therapy might be beneficial for Claudia. 

· Using the insights gained from the articles, describe ways you might have worked with Claudia to address her fears and anxiety related to the mugging she witnessed.

Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

References (use 3 or more)

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Ruffolo, M. C., & Allen-Meares, P. (2013). Intervention with children. In M. J. Holosko, C. N. Dulmus, & K. M. Sowers (Eds.), Social work practice with individuals and families: Evidence-informed assessments and interventions (pp. 41–69). Hoboken, NJ: Wiley.

Taylor, E. R. (2009). Sandtray and solution-focused therapy. International Journal of Play Therapy, 18(1), 56–68.

van der Kolk, B. A. (2003). The neurobiology of childhood trauma and abuse. Child and Adolescent Psychiatric Clinics, 12, 293–317. Retrieved from

van der Kolk, B. A. (2005a). Child abuse & victimization. Psychiatric Annals, 35(5),374–378. Retrieved from

van der Kolk, B. A. (2005b). Developmental trauma disorder. Psychiatric Annals, 35(5), 401–408.

Gil, E. (1991). The healing power of play: Working with abused children. New York, NY: Guilford Press:

Chapter 2, “The Child Therapies: Application in Work With Abused Children (pp. 26–36) (PDF)

Chapter 3, “The Treatment of Abused Children” (pp. 37–82) (PDF)

Discussion 2: Transference and Countertransference

Specific skills and knowledge are essential for a social worker working with children. Understanding transference and countertransference is crucial to a healthy therapeutic relationship. Both transference and countertransference can be evident in any client–therapist relationship, but are especially important in working with children because of a common instinct among adults to protect and nurture the young. The projection or relocation of one’s feelings about one person onto another, otherwise known as transference, is a common response by children (Gil, 1991). Countertransference, a practitioner’s own emotional response to a child, is also common. SOCW-6111-Discussion Wk8

For this Discussion, review the Malawista (2004) article.

· Post your explanation why transference and countertransference are so common when working with children. 

· Then, identify some strategies you might use to address both transference and countertransference in your work with children.

Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

References (use 3 or more)

Chiesa, C. (2012). Scripts in the sand: Sandplay in transactional analysis psychotherapy with children. Transactional Analysis Journal, 42(4), 285–293.

Ruffolo, M. C., & Allen-Meares, P. (2013). Intervention with children. In M. J. Holosko, C. N. Dulmus, & K. M. Sowers (Eds.), Social work practice with individuals and families: Evidence-informed assessments and interventions (pp. 41–69). Hoboken, NJ: Wiley.

Taylor, E. R. (2009). Sandtray and solution-focused therapy. International Journal of Play Therapy, 18(1), 56–68.

Malawista, K. L. (2004). Rescue fantasies in child therapy: Countertransference/ transference enactments. Child and Adolescent Social Work Journal, 21(4), 373–386.

  • attachment




    Working With Children and Adolescents: The Case of Claudia

    Claudia is a 6-year-old, Hispanic female residing with her biological mother and father in an urban area. Claudia was born in the United States 6 months after her mother and father moved to the country from Nicaragua. There is currently no extended family living in the area, but Claudia’s parents have made friends in the neighborhood. Claudia’s family struggles economically and has also struggled to obtain legal residency in this country. Her father inconsistently finds work in manual labor, and her mother recently began working three nights a week at a nail salon. While Claudia is bilingual in Spanish and English, Spanish is the sole language spoken in her household. She is currently enrolled in a large public school, attending kindergarten. SOCW-6111-Discussion Wk8

    Claudia’s family lives in an impoverished urban neighborhood with a rising crime rate. After Claudia witnessed a mugging in her neighborhood, her mother reported that she became very anxious and “needy.” She cried frequently and refused to be in a room alone without a parent. Claudia made her parents lock the doors after returning home and would ask her parents to check the locks repeatedly. When walking in the neighborhood, Claudia would ask her parents if people passing are “bad” or if an approaching person is going to hurt them. Claudia had difficulty going to bed on nights when her mother worked, often crying when her mother left. Although she was frequently nervous, Claudia was comforted by her parents and has a good relationship with them. Claudia’s nervousness was exhibited throughout the school day as well. She asked her teachers to lock doors and spoke with staff and peers about potential intruders on a daily basis. SOCW-6111-Discussion Wk8

    Claudia’s mother, Paula, was initially hesitant to seek therapy services for her daughter due to the family’s undocumented status in the country. I met with Claudia’s mother and utilized the initial meeting to explain the nature of services offered at the agency, as well as the policies of confidentiality. Prior to the





    meeting, I translated all relevant forms to Spanish to increase Paula’s comfort. Within several minutes of talking, Paula notice- ably relaxed, openly sharing the family’s history and her concerns regarding Claudia’s “nervousness.” Goals set for Claudia included increasing Claudia’s ability to cope with anxiety and increasing her ability to maintain attention throughout her school day. SOCW-6111-Discussion Wk8

    Using child-centered and directed play therapy approaches, I began working with Claudia to explore her world. Claudia was intrigued by the sand tray in my office and selected a variety of figures, informing me that each figure was either “good” or “bad.” She would then construct scenes in the sand tray in which she would create protective barriers around the good figures, protecting them from the bad. I reflected upon this theme of good versus bad, and Claudia developed the ability to verbalize her desire to protect good people.

    I continued meeting with Claudia once a week, and Claudia continued exploring the theme of good versus bad in the sand tray for 2 months. Utilizing a daily feelings check-in, Claudia developed the ability to engage in affect identification, verbalizing her feelings and often sharing relevant stories. Claudia slowly began asking me questions about people in the building and office, inquiring if they were bad or good, and I supported Claudia in exploring these inquiries. Claudia would frequently discuss her fears about school with me, asking why security guards were present at schools. We would discuss the purpose of security guards in detail, allowing her to ask questions repeatedly, as needed. Claudia and I also practiced a calming song to sing when she experienced fear or anxiety during the school day. SOCW-6111-Discussion Wk8

    During this time, I regularly met with Paula to track Claudia’s progress through parent reporting. I also utilized psychoeduca- tional techniques during these meetings to review appropriate methods Paula could use to discuss personal safety with Claudia without creating additional anxiety.

    By the third month of treatment, Claudia began determining that more and more people in the environment were good. This was reflected in her sand tray scenes as well: the protection of good figures decreased, and Claudia began placing good and bad





    figures next to one another, stating, “They’re okay now.” Paula reported that Claudia no longer questioned her about each indi- vidual that passed them on the street. Claudia began telling her friends in school about good security guards and stopped asking teachers to lock doors during the day. At home, Claudia became more comfortable staying in her bedroom alone, and she signifi- cantly decreased the frequency of asking for doors to be locked. SOCW-6111-Discussion Wk8





    7. What local, state, or federal policies could (or did) affect this case?

    Chase had an international adoption but it was filed within a specific state, which allowed him and his family to receive services so he could remain with his adopted family. In addi- tion, state laws related to education affected Chase and aided his parents in requesting testing and special educa- tion services. Lastly, state laws related to child abandonment could have affected this family if they chose to relinquish custody to the Department of Family and Children Services (DFCS).

    8. How would you advocate for social change to positively affect this case?

    Advocacy within the school system for early identification and testing of children like Chase would be helpful.

    9. Were there any legal or ethical issues present in the case? If so, what were they and how were they addressed?

    There was a possibility of legal/ethical issues related to the family’s frustration with Chase. If his parents had resorted to physical abuse, a CPS report would need to be filed. In addi- tion, with a possible relinquishment of Chase, DFCS could decide to look at the children still in the home (Chase’s adopted siblings) and consider removing them as well.

    Working With Children and Adolescents: The Case of Claudia 1. What specific intervention strategies (skills, knowledge, etc.)

    did you use to address this client situation? Specific intervention skills used were positive verbal support

    and encouragement, validation and reflection, and affect identification and exploration. Knowledge of child anxieties/ fear and psychoeducation for the client and her mother were also utilized. Child-centered play therapy was utilized along with sand tray therapy to provide a safe environment for Claudia. SOCW-6111-Discussion Wk8





    2. Which theory or theories did you use to guide your practice? I used theoretical bases of child- (client-) centered nondirective

    play therapy. 3. What were the identified strengths of the client(s)? Client strengths were a supportive parenting unit, positive peer

    interactions, and the ability to engage. 4. What were the identified challenges faced by the client(s)? The client faced environmental challenges. Due to socioeconomic

    status, the client resided in a somewhat dangerous neighborhood, adding to her anxiety and fear. The client’s family also lacked an extended support system and struggled to establish legal residency.

    5. What were the agreed-upon goals to be met to address the concern?

    The goals agreed upon were to increase the client’s ability to cope with anxiety and increase her ability to maintain attention at school.

    6. Did you have to address any issues around cultural compe- tence? Did you have to learn about this population/group prior to beginning your work with this client system? If so, what type of research did you do to prepare?

    Language barriers existed when working with the client’s mother. I ensured that all agency documents were translated into Spanish. It was also important to understand the family’s cultural isolation. Their current neighborhood and culture is much different than the rural Nicaraguan areas Claudia’s parents grew up in. To learn more about this, I spent time with Paula, learning more about her experience growing up and how this affects her parenting style and desires for her daughter’s future.

    7. What local, state, or federal policies could (or did) affect this situation?

    The client and her parents are affected by immigration legislation. The client’s family was struggling financially as a result of their inability to obtain documented status in this country. The client’s mother expressed their strong desire to obtain legal status, but stated that lawyer fees, court fees, and overwhelming paperwork hindered their ability to obtain legal residency. SOCW-6111-Discussion Wk8





    8. How would you advocate for social change to positively affect this case?

    I would advocate for increased availability and funding for legal aid services in the field of immigration.

    9. How can evidence-based practice be integrated into this situation?

    Evidenced-based practice can be integrated through the use of proven child therapy techniques, such as child-centered nondirective play therapy, along with unconditional positive regard.

    10. Describe any additional personal reflections about this case. It can be difficult to work with fears and anxiety when they

    are rooted in a client’s environment. It was important to help Claudia cope with her anxiety while still maintaining the family’s vigilance about crime and violence in the neighborhood.

    Working With Children and Adolescents: The Case of Noah 1. What specific intervention strategies (skills, knowledge, etc.)

    did you use to address this client situation? I utilized structured play therapy and cognitive behavioral

    techniques. 2. Which theory or theories did you use to guide your practice? For this case study, I used cognitive behavioral theory. 3. What were the identified strengths of the client(s)? Noah had supportive and loving foster parents who desired to

    adopt him. He quickly became acclimated to the foster home and started a friendship with his foster brother. He started to become engaged in extracurricular activities. Noah was an inquisitive and engaging boy who participated in our meetings. SOCW-6111-Discussion Wk8

    4. What were the identified challenges faced by the client(s)? Noah faced several challenges, most significantly the failure

    of his mother to follow through with the reunification plan. He has had an unstable childhood with unclear parental role models. There may be some unreported incidences of abuse and trauma.

  • attachment


    The Child Therapies: Application in Work

    with Abused Children

    Closer than the moon, even closer than the depths of the seas, the minds of children seem to most people not only mysterious, but impenetrable. -J, ALEXIS BURLAND & THEODORE B. COHEN

    Child therapy is described by Sours (1980) as “a relationship between the child and the therapist, aimed primarily at symptom resolution and attaining adaptive stability” (p. 275). Child therapy, as a separate and distinct type of work, has been evolving since 1909, when Freud first attempted psychotherapy with the now historic patient Little Hans. The term child therapy is often used interchangeably with the term play therapy although play was not used directly in the therapy of children until 1920 when Hermine Hug-Hellmuth




    27 Applying the Child Therapies

    began using play for the diagnosis and treatment of childhood emotional problems (Schaefer, 1980). Melanie Klein and Anna Freud formulated the theory and practice of psychoanalytic play therapy some 10 years later.

    While most child therapists agree that play is the most effective medium for conducting therapy with children, others (Freiberg, 1965; Sandler, Kennedy, & Tyson, 1980) have raised questions as to whether play produces structural change, have pointed to the nebulous quality of play, and have dismissed it as consisting ofneither dream material nor free association. Schaeffer (1983) contends that “it is some­ what difficult for anyone interested in play and play therapy to gain a clear understanding of what is meant by the term play because no single, comprehensive definition of the term has been developed” (p. 2). However, the potential benefits of play are well documented. In his literature review Schaeffer found descriptions of play as “pleasurable,” “intrinsically complete,” “independent from external rewards or other people,” “noninstrumental, with no goal,” and “not occurring in novel or frightening situations.” Schaeffer suggests that play is person- rather than object-dominated.

    Schaeffer (1980) further asserts that “one of the most firmly established principles of psychology is that play is a process of development for a child” (p. 95). Play has been alternately depicted as a mechanism for developing “prob­ lem-solving and competence skills” (White, 1966); a process that allows children to “mentally digest” experiences and situations (Piaget, 1969); an “emotional laboratory” in which the child learns to cope with his/her environment (Erikson, 1963); a way that the child talks, with “toys as his words” (Ginott, 1961); and a way to deal with behaviors and concerns through “playing it out” (Erikson, 1963). Nickerson (1973) views play activities as the main therapeutic approach for children because it is a natural medium for self-expression, facilitates a child’s communication, allows for a cathartic release of feelings, can be renewing and constructive, and allows the adult a window to observe the child’s world. Nickerson points out that the child feels at home in a play setting, readily relates to toys, and will play out concerns




    with them. Chethik (1989) makes an important point about the use of play as therapy: “Play in itself will not ordinarily produce changes…the therapist’s interventions and utiliza­ tions of the play are critical” (p. 49). In addition, the clinician must serve as a participant-observer, rather than a playmate. I believe that play in therapy must be facilitated by an involved clinician in a meaningful way. Some of the most frequent errors made in child therapy are allowing a child to play randomly over an extended period of time, ignoring the child’s play, and providing the kind of toys that do not promote self-expression. SOCW-6111-Discussion Wk8

    As interest in child therapy has grown and as the num­ ber of child-specific referrals has increased, a variety of therapeutic techniques, games, and toys have also evolved. Play therapy has blossomed into a multifaceted and exciting field of study.


    As mentioned earlier, Sigmund Freud in 1909 was the first to use play to uncover his client’s unconscious fears and concerns. Hermine Hug-Hellmuth began using play as a part of her treatment of children in 1920 (Hug-Hellmuth, 1921) and 10 years later, Melanie Klein and Anna Freud formu­ lated the theory and practice of psychoanalytic play therapy. This type of play therapy continues to be one of the most respected forms of child therapy, usually conducted by analysts.

    Psychoanalytic Play Therapy

    Anna Freud and Melanie Klein wrote extensively about how they incorporated play into their psychoanalytic technique. Whereas the former advocated using play mainly to build a strong positive relationship between child and therapist, the latter proposed using it as a direct substitute for ver­



    29 Applying the Child Therapies

    balizations. The primary goal of their approach was “to help children work through difficulties or trauma by helping them gain insight” (Schaefer & O’Connor, 1983). Anna Freud has repeatedly pointed out that “the essential task [of therapy] is to remove the obstacles that impede [the child’s] development and to allow his progressive develop­ mental forces and ego resources to complete the task of development” (Nagera, 1980, p. 22). Klein (1937) felt that an analysis of the child’s transference relationship with the therapist was the main source of insight into the child’s underlying conflict. SOCW-6111-Discussion Wk8

    Freud and Klein took the basic concept of free associa­ tion, one of the basic precepts of adult analysis, and in its place substituted the child’s natural tendency to play (Nagera, 1980). They proposed that play uncovered the child’s unconscious conflicts and desires and that play was the child’s way of free-associating. While Klein proposed that the child’s play is “fully equivalent” to the adult’s free associations and “equally available for interpretation,” Freud’s theory viewed play not as an equivalent to adult fre<) associations but as an ego-mediated mode of behavior “yield­ ing a substantial body of data” but requiring supplementa­ tion from a variety of sources, including parents (Esman, 1983). Psychoanalytic play therapy, predicated on the analysis of resistance and transference, emphasizes the use of interpretation, recognizing the child’s ability to use play symbolically to manifest internal concerns. Nagera (1980) documents that even though significant differences existed in the theoretical tenets of Freud and Klein in the beginning, throughout the years there has been more of a convergence between the two theories. Fries (1937), a student of Anna Freud’s, delineates the distinctions between the two theories, emphasizing Freud’s preference to withhold inter­ pretation.

    Esman (1983) describes the focus of play in psychoana­ lytic child therapy: “It allows for the communication of wishes, fantasies, and conflicts in ways the child can tolerate affectively and express at the level of his or her cognitive




    capacities” (p. 19). He goes on to say that the therapist’s function is to “observe, attempt to understand, integrate, and ultimately communicate the meanings of the child’s play in order to promote the child’s understanding of his or her conflict toward the end of more adaptive resolution” (p. 19). SOCW-6111-Discussion Wk8

    Structured Play Therapies

    In the late 1930s, a more goal-oriented therapy, known as “structured therapy,” was developed. This therapy emerged from a psychoanalytic framework and from a belief in the cathartic value of play and the active role of the therapist in determining the course and focus of therapy (Schaefer & O’Connor, 1983).

    Anna Freud had initially found the use of affective release useful, but on the basis of later experience she en­ couraged this type of work only in cases of severe traumatic neuroses. David Levy (1939), stimulated by Anna Freud’s conclusion and by Sigmund Freud’s concept of “repetition compulsion,” introduced the concept of “release therapy” for children who had experienced trauma. Levy helped the child recreate the traumatic event through play. The goal of this type of play was to help the child assimilate the negative thoughts and feelings associated with the trauma by reenact­ ing it over and over again. Levy cautioned against using this technique too early in therapy, before a strong therapeutic relationship had been formed. In addition, he took care to avoid “flooding,” in which the child is overcome by strong emotions and thus unable to assimilate them.

    Other well-known contributors to the literature on struc­ tured therapies include Hambidge and Solomon. Solomon (1938) thought that helping a child express rage and fear through play without experiencing the feared negative con­ sequences would have an abreactive effect. Hambidge (1955) was even more directive than Levy, who provided toys to facilitate the child’s recreation of the trauma: Hambidge facilitated the child’s abreaction by directly recreating the event or life situation in play. SOCW-6111-Discussion Wk8



    31 Applying the Child Therapies

    Relationship Therapies

    Otto Rank and Carl Rogers, also considered non-directive therapists, were the major proponents of relationship therapy, which is based on a particular theory of personality “which assumes that an individual has within himself not only the ability to solve his own problems but also a growth force that makes mature behavior more satisfying than im­ mature behavior” (Schaefer, 1980, p. 101). This type of therapy promotes the full acceptance of the child as he/she is, and stresses the importance of the therapeutic relation­ ship. Moustakas (1966), another prominent leader in the field of child therapy, emphasizes the genuineness of the therapist as pivotal to the success of therapy. He strongly advocates the importance of the here-and-now as the nucleus of therapeutic success. Axline (1969) also gives credence to the importance of the therapeutic relationship, viewing it as the “deciding factor” (p. 74). Axline’s writings, particularly the widely touted book Dibbs in Search of Self (1964), have clearly delineated the benefits and desirability of nondirec­ tive therapy.

    Behavior Therapies

    In the 1960s the behavior therapies, based on the principles of learning theory were developed. Such therapies apply the concepts of reinforcement and modeling to relieve behavior problems in children. The behavioral approaches are precise­ ly concerned with the problem behavior itself, not with the past or with feelings that might have preceded or accom­ panied the behaviors. No attempts are made to achieve affective release, to do cathartic or abreactive work, or to help children express feelings. Behavioral approaches are applied directly to children in the playroom or are taught to parents for use in the home. This type of therapy has broad applica­ tion to childhood problems, particularly those that stem from a lack of adult guidance and limit setting. Within this framework play is used as a means to an end, not as inherent­ ly valuable in and of itself. SOCW-6111-Discussion Wk8




    Group Therapy

    Slavson (1947) experimented with group situations in 1947, guiding latency-age children through activities, games, and arts and crafts designed to help them “release emotional and physical tensions” (p. 101). In 1950, Schiffer developed what began to be known as “therapeutic play groups” (Rothenberg & Schiffer, 1966) in which children could interact freely with minimal intervention from the clinicians. The unique aspect of this type of therapy, according to Schaefer (1980), is that “the child has to learn to share an adult with other children” (p. 101). Group therapy enjoys a certain contemporary popularity, partly because it can be provided at lower cost and partly because there has been a growing belief in the effectiveness of this modality. Yalom (1975) documents numerous “curative” benefits provided by group therapy, including the following: installation of hope, universality, imparting of information, altruism, corrective recapitulation of the primary family group, development of socializing tech­ niques, imitative behavior, interpersonal learning, group cohesiveness, catharsis, and existential factors. Kraft (1980) elucidates that effective group treatment must contain the following elements:

    Leadership, preferably with male and female co-therapists, involves developing cohesiveness, identifying goals for the group, showing the group how to function, keeping the group task-oriented, serving as a model, and representing a value system. In carrying out these tasks, the leader may offer clarification of reality, analysis of transactions, brief educational input, empathic statements acknowledging his own feelings and those of members, and at times delineat­ ing the feeling states at hand in the group. (p. 129)

    Group therapy has traditionally been believed to have application to the treatment of abusive parents (Kempe & Helfer, 1980). A treatment approach used effectively with abusive parents is known as Parents Anonymous (PA), founded in California in 1970. PA uses a formerly abusive parent as a group facilitator in addition to the mental health professional. There are currently over 1,200 PA groups in the United States.



    33 Applying the Child Therapies

    Another very well-known treatment model, Parents United, relies heavily on the group format. Parents United was established in 1975 by Dr. Hank Giarretto as the self­ help component of the Child Sexual Abuse Treatment Pro­ gram (Giarretto, Giarretto, & Sgroi, 1984), now known as the Community as Extended Family. Separate groups are formed for the incestuous parents and for the non-abusive partners. The children’s groups are known as Daughters and Sons United, and the groups for adult survivors are known as Adults Molested as Children (AMAC) groups. There are currently over 135 active Parents United programs across the United States. SOCW-6111-Discussion Wk8

    Mandell, Damon, et al. (1989) wrote a useful and timely book on group treatment for abused children, with parallel treatment for caretakers. Throughout the book the authors use different play techniques to help the children open up about their abuse and to build trust among themselves. They defined the objectives of group treatment as follows:

    • Define acceptable behavior of group members and intro­ duce a respect for boundaries.

    • Promote group interaction and reinforce cooperative efforts.

    • Introduce and encourage the discussion of common exw periences to reinforce a feeling of togetherness and promote group cohesion for both children and caretakers.

    • Improve self-esteem through validation of individual feelings and ideas, acknowledging each member’s im­ portance in contributing to the group experience.

    • Help group members to understand the purpose of the group.

    • Enhance caretakers’ capacity to begin to view their children with increased sensitivity, understanding and empathy. (p. 27)

    Another pilot project, by Corder, Haizlip, and DeBoer (1990), used structured group therapy to treat sexually abused children ages 6 to 8, and focused on issues comparable to those of Mandell and associates. The goals in the pilot project included integrating the trauma, improving self-es­ teem, improving problem-solving skills, self-protection for




    the future, improving ability to seek help, and enhancement of the child’s relationship to the nonabusive parent.

    In another preliminary group project with sexually abused boys, Friedrich, Berliner, Urquiza, and Beilke (1990) advocate more open-ended therapy and selection of group members by developmental level (not chronological age) in order to promote better peer interaction.

    Group therapy is not without its controversy. I have often heard the concern that the group might inadvertently en­ courage the child to overidentify with the victim role and that groups have the potential of “contaminating” one child with the emotional concerns of another. Yet another concern, which I share, is that sometimes groups are run in random ways, go on for indefinite periods of time, lack clear goals, and suffer from inconsistent and inexperienced leadership. However, these concerns are discussed in the book by Man­ dell and associates and do not undermine the potential benefits of the group experience. SOCW-6111-Discussion Wk8

    Sand Tray Therapy

    No summary of the major models of child therapy would be complete without making note of the significant contribution of Dora Kalff (1980), who created sand therapy. Sand therapy, based on the principles ofJungian therapy, sees the sand tray as symbolic of the child’s psyche. The sand therapist inter­ prets the child’s use of symbols and placement of objects in the tray and observes the child’s passage through distinctive phases of healing. While many child therapists use sand play in their therapy, this type of play therapy stands alone, embedded in its own theory and technique.


    The theoretical frameworks highlighted earlier-the psycho­ analytic, existential, behavioral, and Jungian-are the major frameworks for conducting child therapy; almost every known technique can be subsumed under one of these head­



    35 Applying the Child Therapies

    ings. It is important to distinguish between the child therapies and the child therapy techniques. The child therapies are based on a theoretical framework; the techni­ ques are chosen to implement therapy based on those con­ ceptual frameworks. Some of the child therapies are flexible enough to incorporate a variety of techniques whereas others restrict the therapeutic approach.


    Yet another way to categorize the types of therapy employed with children is to differentiate between directive and non­ directive styles of play therapy. Nondirective or client­ centered play therapy, promoted by the relationship therapists, is nonintrusive; it parallels the client-centered approach created by Carl Rogers (1951). Axline (1969) is credited with the creation of this specific kind ofplay therapy, and she distinguished between nondirective and directive therapy by simply stating, “Play therapy may be directive in form-that is, the therapist may assume responsibility for guidance and interpretation-or it may be nondirective; the therapist may leave responsibility and direction to the child” (p. 9). The child is allowed and encouraged to choose the toys to play with and is given the freedom to develop or terminate any particular theme. Guerney (1980) cites two major fea­ tures of client-centered therapy: First, the client-centered approach is “viewed as promoting the process of growth and normalization” and, second, the therapist “must rely on the child to direct this process at his or her own rate” (p. 58). The non-directive therapist observes the child’s play, often af­ firming verbally what is seen. Guerney states, “The realiza­ tion of selfhood via one’s own map is the goal of non-directive play therapy” (p. 21). SOCW-6111-Discussion Wk8

    The nondirective therapist cultivates hypotheses that are tested over time; interpretations are used sparingly and then only after a great deal of observation. Nondirective therapists give the child concentrated attention and refrain




    from answering questions or giving directives. Axline (1964) demonstrates the use of nondirective therapy in her classic work Dibbs in Search of Self. Nondirective techniques are always helpful in the diagnostic phase of treatment and, as Guerney (1980) points out, have been shown to be effective with a wide range of problems.

    The basic difference between the nondirective and direc­ tive approaches rests in the clinician’s activity in the therapy. Directive therapists structure and create the play situation, attempting to elicit, stimulate, and intrude upon the child’s unconscious, hidden processes or overt behavior by challeng­ ing the child’s defensive mechanisms and encouraging or leading the child in directions that are seen as beneficial. Nondirective therapists are “actually controlled, always centered on the child, and attuned to his/her communica­ tions, even the subtle ones” (Guerney, 1980, p. 58). Directive therapies are by nature more short-term, more symptom­ oriented, and less dependent on the therapeutic transference than are nondirective therapies.

    The directive therapies are multitudinous and include, among other things, behavior therapies, Gestalt therapy, filial therapy, and family therapy. Certain specific techni­ ques, such as puppet play, story-telling techniques, certain board games, and various forms of artistic endeavor, lend themselves to being employed in therapy in different ways: A nondirective therapist might provide the child with ample opportunities for art work or story telling with puppets whereas a directive therapist might ask the child to draw specific things or tell an exact story. SOCW-6111-Discussion Wk8

  • attachment