Playing to Heal: Building Client Connections Through Play Therapy

By Marta Franca, Collaborative Counseling Program Psychotherapist

“We are never more fully alive, more completely ourselves, or more deeply engrossed in anything than when we are playing.” - Charles Schaefer, Psychologist

As a psychotherapist in Acknowledge Alliance’s Collaborative Counseling Program and registered play therapist, I consider play therapy to be a valuable and important approach to working with children, preteens, and teenagers. Those unfamiliar with play therapy may be surprised to learn that it is an evidence-based approach with a long history of research, and has been shown to provide benefits and lead to positive outcomes in the treatment of a variety of mental health diagnoses

In my work with preteens and teenagers, I use a variety of play therapy interventions to facilitate communication, assist with developing the therapeutic relationship, and assess and develop treatment goals. Children usually come to therapy because their caregivers, teachers, or other adults in their lives demand it; not because they themselves want to be in therapy. It can be intimidating for a young person to talk to a psychotherapist, someone they do not know, about their feelings, emotions, and issues in their personal lives. In addition to feeling intimidated and uncomfortable, many children, especially young ones, do not have the verbal ability to express their emotions and describe what is happening internally. Play facilitates the communication process and provides children with an opportunity to feel comfortable and less stressed, especially during initial therapy sessions. As the University of North Texas Center for Play Therapy’s Dr. Garry Landreth said, “play relieves feelings of stress and boredom, connects us to people in a positive way, stimulates creative thinking and exploration, regulates our emotions and boosts our ego.” 

What is Play Therapy and How Does It Work?

According to the Association of Play Therapy (APT), “child play therapy is a way of being with a child that honors their unique developmental level and looks for ways of helping in the “language” of the child - play.” With play therapy, trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development” (Braverman, O’Connor & Schaefer, 2016).

Neuroscience research has shown that parts of the brain physically change when we are engaged in play activities. During play, we activate the part of the brain responsible for pleasure and trigger the release of the hormones dopamine, the pleasure and reward neurotransmitter, and oxytocin, which facilitates bonding (Vander Dussen, 2014). Play has also been shown to help increase levels of the GABA protein that is responsible for brain growth, and to help lower the stress hormone cortisol. As a result, play has been linked to numerous health benefits such as helping with attention, self-regulation, impulse control, stress management, problem solving, flexible thinking, empathy, and relaxation (Dargon, 2016). 

The Sandtray used by our therapists working with students at Peninsula Bridge

Putting Play into Practice

A few of my favorite play therapy interventions that I use with children in my practice include board games, the Squiggle drawing game and the Sandtray. Many people are aware of how entertaining common board games can be, but may not be familiar with the benefits they have when incorporated into play therapy. Strategy games like Checkers, Connect Four, Uno and Chess can help build connection, improve mood, develop social skills, teach healthy competition and build self-esteem. Chance games like Sorry! and Go Fish help in similar ways, while also being ideal for kids who are presenting withdrawn, shy behavior, social difficulties, and anxiety symptoms. Jenga is another popular game that has many therapeutic benefits just by the nature of the game; it requires us to slow down and focus in order to pull a block out without knocking the entire tower down. This game can help improve self-control and executive functioning, and can also be used to discuss how to handle frustration and work on managing impulsive behaviors.

The Squiggle game is a drawing game invented by pediatrician and psychoanalyst Donald Woods Winnicott, where two players start the game by drawing a random line or squiggle on their own piece of paper. They then exchange papers and finish each other's drawings. After the drawings are complete, the players are invited to talk about their drawings or develop a story using the drawings. In addition to facilitating communication and providing opportunities to explore the client's unconscious thoughts and feelings, it also helps with establishing the therapeutic relationship and releasing stress. The Squiggle game is also a great way to get everyone laughing since each player’s drawing can turn out to be quite unique and interesting. 

The Sandtray is a therapeutic approach I use with children and teens to facilitate the expression of emotions, feelings, thoughts, conflicts, life events, and many other aspects of their lives. Children engage with the Sandtray by being invited to create their own world in the sand. They do this by choosing different objects and miniature toys to place in the sand to represent different aspects of their lives, positive and negative life experiences, feelings and thoughts. The Sandtray creates a safe environment that allows young people to release fears and hidden memories into their conscious awareness. Without using words, the child can express thoughts and feelings by using the miniature toys to recreate a traumatic event that happened in their life, such as being bullied. Additionally, the sensory experience of touching the sand with their hands helps some children with self-regulation.

Enhancing Our Long-term Approach

When I joined Acknowledge Alliance four years ago, I was drawn to Acknowledge Alliance’s foundational belief that “when a child has a caring adult in their life who holds high expectations and believes in them, they can succeed despite adversities.” That core value aligns with my own belief in the importance of deep connection and developing a trusted, safe therapeutic relationship with my clients. In order for change and growth to occur, I believe that this type of positive relationship between the client and the psychotherapist must be developed, and is truly the foundation of psychotherapy. Play therapy facilitates that relationship development process. 

Acknowledge Alliance’s long-term therapeutic relationship-based approach allows me to incorporate my knowledge and training in play therapy to enhance and strengthen the psychotherapy services I provide to preteens and teenagers. It is an honor to be part of Acknowledge Alliance and to continue to provide long-term psychotherapy services to help young people in need.

References

The Association for Play Therapy, Inc. (2022). What is Play Therapy? Retrieved from https://www.a4pt.org

Braverman, D. L., O’Connor, K.J., Schaefer, E. C. (2016). Handbook of Play Therapy.

Dargon, C. (2016). Play Therapy Effectively Diagnose & Assess through Play. [Powerpoint Slides]. Retrieved from https://pesi.com

Vander Dussen, K. (2014, March 14). Neurobiology of Play: Why Play Therapy Matters. [2017 APT Annual Conference]. https://apt.digite//inc.com/apt/conferences/39/view