Category Archives: Infant Family Support Services

What is child play therapy?

Play is the natural language of children and is a metaphor, or symbolic expression, of what is going on in their lives.  Play is to children what verbalization is to adults. Play therapy is a type of therapy that, as the name suggests, involves playing. It has been around for a long time, even in an academic context. 

Recently, play therapy has been refined and targeted to a variety of different disorders, from autism spectrum disorder (ASD) to attention-deficit hyperactivity disorder (ADHD). Play therapy has also been used in normal functioning children and adults to great effect.

Play therapy is a well-researched and effective therapeutic approach. Play therapy enables children to communicate their feelings, experiences, and ideas through play, their natural medium of expression. 

What Is Play Therapy?

Play therapy is one form of psychotherapy with children. This is a method in which professional psychotherapists, who may be psychologists or clinical social workers, help children overcome emotional and behavioral difficulties through different forms of ‘play’ or activities. Play therapy allows children to express and process feelings, thoughts, and experiences through their natural desire to play. Therapeutic play empowers the child to overcome challenges without demanding words, explanations, or adult reasoning. Play therapy can be used to help children deal with traumas, family issues, emotions, and developmental challenges.

The child play therapist will often work with the child’s parents and siblings to increase insight and communication skills with their child. As understanding increases and communication approaches shift, there is often a reduction in the child’s concerning behaviors. This may lead to a marked increase in household happiness and overall resiliency gains for all family members.

What kind of problems is play therapy effective for?

Play therapy can be used to treat children with several kinds of problems. It is particularly effective for children who have:

  • Experienced physical or emotional trauma
  • Experienced physical, emotional or sexual abuse
  • Witnessed conflict or have been bullied
  • Been severely punished by teachers or authority figures
  • Witnessed armed conflicts or natural calamities
  • Been displaying behavior or conduct issues
  • Experienced significant life changes (loss of parents, parents’ divorce, or separation from family)
  • Had trouble reaching developmental milestones
  • Issues with anxiety or sadness
  • Trouble coping with their immediate environment

Sometimes play therapy may also be used to assess how effective pharmacological or therapy has been with a particular child. The therapist will be able to pick up indicators from play sessions before and after treatment and compare them to understand how much the child has benefited.

What happens during a play therapy session?

Each play therapy session lasts anywhere between 45 minutes to an hour.

During a play therapy session, the child is taken to the playroom and asked to explore some toys that are age-appropriate. When the child is allowed spontaneous expression through play, they may pick up toys that indicate their emotional states, or draw something to share their challenges. Children from families which have conflict may draw the picture of a happy family; children who have conduct problems may pick up a gun to shoot a doll or mimic other acts of violence using the toys provided.

The therapist observes the child play with the toys and writes down their interpretations. Sometimes, the therapist may choose to do a group therapy session based on the child’s needs. Group therapy could involve the child playing with other children of a similar age, or with their own family.

Why It’s Used

Children lack the cognitive and verbal skills to talk about some issues. Grief, for example, can be very complex and a child may have trouble putting their thoughts and feelings into words.

Play therapy gives the child catharsis and gives them insight into their own issues. By allowing the child the freedom to express what they’re going through, play therapy can help the child to:

  • Learn basic or advanced motor skills
  • Learn decision-making and problem-solving skills
  • Learn social skills
  • Release excess energy
  • Understand their emotions and their problems
  • Gain more confidence through self-expression
  • Enhance their imagination and creativity

 

End Words

As adults, when we have emotional issues or mental health problems, we are often able to recognize that something is out of sorts; sometimes, we are even able to share our emotions with others. But with children – particularly those who are very young – this may not be possible.  It is then more effective to use play, a medium that comes very naturally to the child, to explore their issues.

Any mental health professional (psychiatrist, psychologist, or psychiatric social worker) who has had special training in play therapy can conduct a play therapy session. If you’d like to find a professional for child’s play therapy, you can get in touch with  The Center for Connection

Newborn Behavioral Observation

I am often asked what an NBO, or Newborn Behavioral Observation, is and why I do them. I was certified to practice the NBO in 2013 through the Brazelton Institute, and find it one of my most useful tools to use with new parents and their babies.

During the NBO I spend about 90 minutes with each family, though so many interesting topics come up we could easily spend more time if we had it. Usually Mom and/or Dad are present with the baby for the NBO, but any family member or caregiver can participate.

We start off by talking about what the family has already learned about the baby.  The NBO can be done at any time from birth to three months so the family may have had just those nine months before the baby was born to get to know him or her, or more time since birth.

The purpose of the NBO is to get to know what is unique about each baby. It is not an evaluation or a comparison to other babies or to what is “normal,” but a way to give each baby his or her own voice. Together we discover this baby’s preferences and vulnerabilities; this baby’s strengths and challenges. I explain what all infants experience when they leave the protected world of their mother’s body and emerge into a new world where they are bombarded with new stimuli and are learning every moment. With this general knowledge as a background, we look at how this baby has come into the world and how he or she is experiencing sensory stimuli.

There are eighteen structured observation items on the NBO for us to look at together. If we can start while the baby is asleep, we will look at his or her ability to protect sleep against visual and auditory stimuli. We’ll watch how the baby transitions from sleep to being awake, and at the baby’s own capacity and strategies for self-regulation. We’ll watch the baby’s body and facial expressions for clues about how he or she is handling things, and discuss how the baby’s parents or caregivers can support the baby where needed.

Throughout the NBO we’ll watch the baby’s skin color and movements for signs of stress, and together monitor the baby’s motor tone and activity level. We’ll talk about and listen to baby’s cry, what crying means, and what it feels like for both parent and baby. I will put on a glove and let the baby suck on my finger to see how the baby reacts to the new taste and feel, and also to see how strong the sucking response is. This often leads to conversations about how feeding is going and how the baby can be supported to have good breast- or bottle-feedings.

We also look at how the baby is prepared to interact in the social world. I will see if the baby is interested in tracking my red ball, and how she or he responds to my face and voice, and to the faces and voices of family members. We’ll see how baby responds when he or she hears a new sound nearby. Together, we’ll listen to what the baby has to tell us, sharing information with each other as we watch and interact.

In general, people seem to have an expectation that when babies are born they are all pretty similar.  I have found that nothing is further from the truth! From the moment of birth, every baby is his own special person, and it is so much fun to learn to watch for his individuality and help parents learn how to respond to best meet their baby’s needs. When parents start feeling as though they know and understand their babies, they feel more confident as parents, and the relationship is able to thrive. Learning to parent a new baby is a challenge, but the NBO provides tools to make the transition smoother for everyone.

Recently a couple called me for an NBO with their new baby. We had done an NBO with their first child two years ago.   When I asked what the biggest thing they took away the first time was, they said, “Confidence!” They described feeling like they understood their baby better and had more insight to what he needed. Their second baby was very different from the first, and the second NBO gave us a lot of opportunities to learn new strategies that supported the new baby, and gave us all insight into how he is different, not just from his brother, but from every other baby. That’s a special feeling indeed!