Thursday, July 17, 2008

Play Therapy with Children

Therapy with children is different than therapy with adults. How can Virginia Axline’s play therapy be helpful when counseling young children? Cite references.

In her book “Play Therapy,” Virginia Axline says that children express themselves naturally through play, whereas adults express themselves verbally. Children ‘play out’ their emotions and issues, because words are an inadequate and awkward medium for them. Axline’s specific approach is called “Non-Directive Play Therapy,” which is composed of 8 specific principles that create a safe and self-directive experience for children in therapy.

Kranz (1993) says that Axline’s book is “one of the most widely used and best known resources in the field.” He explores the great impact that Axline’s book has had on the field of child counseling by stating “Axline’s book Play Therapy, published in 1947, serves as a model in instructional techniques for many students wishing to learn basic skills utilizing play therapy as an assessment and treatment tool. Her insight, examples, and direction give guidance and substance to future clinicians who want greater knowledge and skill in working with troubled children.” As Kranz states, this book is one of the most influential resources in the child counseling field, and it has been shown, over time, to be helpful to troubled children.

Non-directive play therapy was inspired by Carl Roger’s “Person-Centered Therapy,” which takes a self-directive stance, giving much of the healing responsibility to the client, while the therapist is non-directive. In a non-directive play therapy session, the child chooses how they would like to spend their time. They may be silent, talk, play by themselves, or play with the therapist. This freedom in therapy exists because the non-directive play therapist sees each individual as capable of solving their own issues and having the growth impulse to become a more mature person. A non-directive play therapist allows the child to completely be his or herself and accepts them fully, without trying to change or judge them. The therapist also clarifies the emotional attitudes of the client by reflecting what they express. By allowing the client to be his or herself, accepting him or her fully, and clarifying attitudes, the therapist creates a space where the client can become more self-directive and confident.
Principles

Non-directive play therapy is not made up of a set of specific techniques, as by it’s nature, it does not have a specific direction. Rather, Non-Directive Play Therapy is based on 8 “principles.” Ramirez, Flores-Torres and Kranz (2005) site Axline’s (1947) 8 principles. They are:
1. The therapist must develop a warm, friendly relationship with the child, in
which good rapport is established as soon as possible.
2. The therapist accepts the child exactly as he is.
3. The therapist establishes a feeling of permissiveness in the relationship so that
the child feels free in expressing his feelings completely
4. The therapist is alert to recognize the feelings the child is expressing and
reflects those feelings back to him in such a manner that he gains insight into his
behavior.
5. The therapist maintains a deep respect for the child’s ability to solve his own
problems if given an opportunity to do so. The responsibility to make choices and
institute change is the child’s.
6. The therapist does not attempt to direct the child’s actions of conversation in
any manner. The child leads the way; the therapist follows.
7. The therapist does not attempt to hurry the therapy along. It is a gradual
process and is recognized as such by the therapist.
8. The therapist establishes only those limitations that are necessary to anchor the
therapy to the world of reality and to make the child aware of his responsibilities
in the relationship.

Axline’s first principle for therapists practicing non-directive play therapy is establishing a rapport with your young client. She states that “the therapist must develop a warm, friendly relationship with the client, in which good rapport is established as soon as possible” (Axline, 1974). This principle seems simplistic enough, as one would think all the therapist needs to do is be inviting, friendly and caring towards the client. However, Axline notes instances where a therapist attempts to develop a warm relationship, when in fact they are not following other principles, such as accepting the child as they are. She mentions an situation where a therapist is inviting a child to play with toys, but the child refuses. The therapist is trying to be friendly, and states, “Lots of children come up here and enjoy our playroom.” While the therapist thinks they are establishing rapport, they are forgetting to accept the child as they are, realizing that the child may not want to play right now. In consequence, establishing a rapport must consist of treating the child client with warmth, while following all of the other non-directive principles. How the child is treated with warmth will depend on each specific client.

Another principle of non-directive play therapy is accepting the child completely. Axline says that there are often parts of a child that a parent rejects, especially if the child is in therapy. This is because parents usually send their children to therapy to get “fixed” in some way. In order for the child to feeling completely comfortable expressing his or herself, they must feeling fully accepted by the therapist. The therapist shows complete acceptance with their attitude. This is done by creating a calm, steady and friendly relationship with the client. The therapist does not show impatience, does not criticize, and also does not praise the child. Criticism and praise are mentioned in The Child Leads The Way, and they are also very important for Accepting the Child Completely. For the child to feel safe enough to open up to the therapist, they must never feel criticized by them. Also, the child must not feel like they are trying to impress the therapist, and thus the therapist must not offer them any praise. These tactics all create a safe, calm and steady environment for clients, a feeling of full acceptance, and the allowance to express emotions that may be difficult to share otherwise.

In Axline’s non-directive play therapy model, it is important for the therapist to create a feeling of permissiveness for the child, meaning the therapist is highly non-judgmental. This allows the child to feel like they can fully be his or herself and express his or herself completely. An example of permissiveness is a therapist saying, “You may play with these toys in any way you like for an hour.” Axline presents another example of permissiveness, by showing how a non-directive play therapist may introduce paints and the other materials in the playroom. The therapist can say, “The paints on this easel are used to paint pictures. Here are the large sheets of paper. Here are the paint rags…. Now you may play with anything in the playroom in any way you want to. You will have an hour all your own.” (Axline, 1974) This style is very different than directive play or art therapy, where the therapist may ask a child to draw a picture of their family, and interpret is based on specific guidelines. Non-directive play therapy presents a blank slate for the child in terms of what they choose to paint or play with and how they want to express themselves through art or play.

A next of Axline’s play therapy principles is recognizing and reflecting the child’s feelings. Axline states, “When the therapist catches the feeling that is expressed [through play] and recognizes that feeling, the child goes on from there and the therapist can actually see the child gain insight.” In noticing what a child is feeling and reflecting it back to them, the child can gain insight into their own behaviors, just as adults do. She says that when recognizing and reflecting the child’s feelings, the non-directive play therapist must be careful not to interpret these feelings, but rather to reflect them objectively. This can be a difficult task, as if the therapist translates the child’s
symbolic behavior into words, she is interpreting because she is saying what she thinks the child has expressed in his actions…. A cautious use of interpretation, however, would seem the best policy, with the therapist keeping the interpretation down to a minimum, and, when using it, basing it upon the obvious play activity of the child. Even then, the therapist’s response should include the symbol the child has used (Axline, 1974).
A therapist can still reflect a child’s feelings in an objective and cautious way, with minimal interpretation. This allows for the child to gain their own insight into their behavior, not clouded by the therapist’s perceptions.

Axline believes that it is important for the non-directive play therapist to maintain respect for the child when counseling them. She states that change in an individual’s behavior can only occur when an individual has achieved an insight on their own, allowing them to want to change. If a child is respected in therapy, and treated as an independent being that is responsible his or her self, then change can naturally occur. The child is able to express his/herself freely, and the therapist respects them for their individuality. Axline says, “Regardless of what he picks up [in the therapy room], there are no objections from the therapist.” This gives the child the freedom to be himself or herself, with pure respect from the therapist. The child may have never been given the opportunity to feel respected by a responsible adult, and thus they could not blossom and change in healthy ways. Axline’s non-directive play therapy gives children this opportunity.

Another principle of non-directive play therapy is the child leads the way, while the therapist follows. This principle says that the therapist should never ask any probing questions unless the child brings up a topic that is upsetting them. If this is the case, the only appropriate question would be “Do you want to tell me about it?” (Axline, 1974) Also, the therapist never gives help or directions unless the client specifically asks for them. These tactics, like all the other principles of non-directive play therapy, allow the child to be more self-directive in the therapy session. The therapist also never praises or criticizes the client, as both praise and criticism may inspire the client to act a certain way. For example, if the therapist were to praise a client’s artwork, the client may try to create drawings to win more praise from the therapist, rather than for their own release or catharsis. Similarly, the therapist should never criticize the client, as this may create a feeling of discouragement or inadequacy.

A next of Axline’s principles is that therapy with a child cannot be hurried. She states, “The law of readiness operates in the therapy session. When a child is ready to express his feelings in the presence of the therapist, he will do so. He cannot be hurried into it. An attempt to force him to do so causes him to retreat.” The therapist must be patient with the child, as each individual comes into readiness to express themselves at a different pace. If a child has a period of “seemingly uneventful play” in a therapy session, Axline suggests the therapist be patient with the child. She says this period may be one where the child is “gaining the readiness to express themselves. If the therapist can just let them alone, let them take their time, she will be rewarded for her restraint.” Again, as the other principles suggest, it is important for the therapist to let go of any agendas, and let the child dictate when they are ready to open themselves up in therapy. If the expression comes from a place of self-motivation, it will be much deeper than if the therapist pushes the child to open up.

Axline’s final non-directive play therapy principle is the value of limitations in therapy with children. She does not believe that very many limitations should be put on the child during therapy, however, a few limitations are very important. For example the child should not be allowed to damage the room, ruin the play materials or attack the therapist. These are similar limitations that exist in the world at large, and thus Axline believes the therapy room should not be any different. The child and therapist must treat each other with a level of respect, and the therapist must provide for the child a sense of security. An obvious limitation that exists in the therapy is session is the length of therapy. The child must be clearly shown that therapy only lasts and hour, and they must strictly adhere to that boundary, even if they are in the middle of playing. These limitations create a sense of constancy for the child, which can be helpful for them in the long run.

In conclusion, non-directive play therapy offers young clients a safe space where they can be themselves, open up and learn to become more self-directive. The principles of establishing rapport, accepting the child completely, permissiveness, recognition and reflection of the child’s feelings, maintaining respect for the child, the client leading the way, not hurrying therapy, and the value of limitations all facilitate feelings of safety and openness, and in turn inspire self-direction.


References

Axline, V.M. (1974). Play Therapy. New York: Ballantine Books.

Kranz, P.L. & Lund, N.L. (1993). Axline’s eight principles of play therapy
revisited. International Journal of Play Therapy, 2(2), 53-60.

Ramirez, S.Z., Flores-Torres, L.L., & Kranz, P.L. (2005). Using Axline’s
eight principles of play therapy with Mexican-American children.
Journal of Instructional Psychology, 32(4), 329-337.

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