Just like adult therapists, not all kid therapists are the same. A therapist's training, approach, and experience influences how a therapist works. Over the years, I have used multiple different approaches, methodologies, and techniques when working with kids and their families. All approaches have their benefits and drawbacks. Ultimately, I have found that non-directed, child-centered play therapy resonated most with my clients. With this approach, kids enjoy coming to therapy, they learn to believe in themselves, do hard things, improve their emotional vocabulary, and learn how to recognize and regulate their own emotional states. Parents often share their surprise and delight with me when they witness moments of growth as a result of the work kids do in therapy. Read on to understand more about the approach, how it works, what to consider when starting therapy, as well as what you can do to encourage your child's growth.
Non-Directed, Child Centered Play Therapy
This evidenced based approach is an experiential based treatment which surpasses the traditional boundaries of verbal therapy. Play is essential for children's brain development. With a non directed, child-centered play, kids lead what activities they use and what problems they address in therapy. It is critical that they have this control, because one key to behavioral change is autonomy. Having control is not running around wild with no limits. Limits are a healthy and important part of child therapy. Limits create containment and safety. So while they lead the way, they are also contained and held in safety. For a child to experience developmentally appropriate autonomy so they can address problems, I consider it a gift. They don't often experience this in their daily lives, which is often structured, busy, and directed by the big people in their life. Autonomy plus a contained, attuned and therapeutic space - it's a game changer.
Play gives kids opportunities for exploration, creativity, problem-solving, and social interaction. In play therapy, kids experience as a way to process and learn, as opposed to being directed on specific topics. Directions and instructions, often given to a kid from adults, is generally a cognitive approach.Have you ever had an experience where you knew something, but it didn't seem to change the way you behaved? Well, that's cognitive knowledge. The aim here is embodying the knowledge. When kids experience and play for learning, they don't just absorb information or understand it cognitively; they embody it, living and breathing what they learn.
In therapy, experiencing an accepting and caring environment is critical element number 2: relatedness. The environment and therapist gives implicit permission for them to be free to express themselves. No fear of criticism or rejection. It's a unique human connection. Can you imagine what message they receive from that? You may have guessed it. Someone is there, just for you, believes in you, and delights in who you are.
Benefits of child therapy
With a child-centered approach, there are common outcomes which parents can typically anticipate;
Improved esteem, sense of "I can do hard things", believing in themselves. This is key number three for behavioral change: a sense of competency.
Better able to regulate their emotional states. Think less explosions and less belly aches when they are not really sick.
Expanded feeling vocabulary. There are more emotions than just mad, sad, worried, and happy. It's powerful to be able to identify and communicate to others how you are feeling.
Expanded world-view. It's normal for kids to have a smaller world view, but with this approach their understanding of social nuance and dynamics is supported so it can expand. They can try out different perspectives; build empathy, understand new perspectives, try out different endings to stories. Imagine your kid's relationships deepening and learning how to resolve conflicts in clear and respectful ways.
Parental support: it's tough to raise kids, especially in this world. Parents get support from therapists too. Often parents can collaborate with the therapist on different ways they can communicate, understand, or approach their child. At the very least, they learn they aren't alone and there's another adult who actively cares for their kid and wants to see them grow and succeed. It really does take a village.
Kid's brains learn and grow at a remarkable rate.
When working with kids, I capitalize on neuroplasticity: the brain’s ability to reorganize itself in response to new experiences. In childhood, the brain’s neuroplasticity is the highest it will be in their life. Over time, brains undergo a natural and normal process of synaptic pruning. This pruning eliminates weak and unused connections to reinforces stronger connections. The pathways that are left optimizes brain function. Imagine a gardener who dead heads their plants or trims the tree. Pruning helps organism streamline energy and growth.
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The activities kids experience in therapy, like imaginary play, art, storytelling, dance and music, activate, integrate, and enhance multiple regions and networks of the brain.
Sensorimotor networks: physical movement, sensory perception, coordination, tactile experiences
Emotional: Limbic system: emotional processing
Executive functioning, prefrontal cortex: cognitive flexibility, emotional regulation, social cognition, problem solving, organizing
Attachment & social networks : empathy, social connection
Default Mode Network: self-awareness, insight, introspection
Reward Circuitry: feel good, motivation
Essentially, the different activities kids engage in during play therapy allows for a whole-brain approach. The therapist helps guide and facilitate the process. The kiddo does the heavy lifting of facing difficult emotions and challenging their brain to grow and think in new ways. Art itself has been seen to help foster kid's natural brain development. Now, when we add an attuned, caring adult who helps them tolerate limits, learn about themselves, and delights in who they are = magic happens.
Considerations of kids in therapy
I hear a lot about concerns of too much therapy for kids these days. I get this. And for me, this circles back to where we started. The type of therapy matters.
In my approach, kid's aren't told they have "problems" or given labels about what's "wrong" with them. In fact, not much direct verbal discussion on why they are in therapy happens. Adults often don't give kids enough credit for their unique intelligence. But kids consistently demonstrate to me, without words, that they are struggling with something. How do I know this? I see it in their play. A kid who continues to present the same play story over and over again is working it out from different angles, trying to understand what has happened, or trying to tolerate the big feelings that arise to see if they can really face their fear and accomplish it. The play story shifts over time and eventually, it's resolved in a way that makes sense to them.
Regardless, there are some very real considerations to having your kid enter therapy.
Therapy is on the kid's timeline. This can be tough for parents as they, understandably so, want change to have happened yesterday. While there are averages to how long kids are in play therapy for, it really depends on the kid, what's happening in their life, and the parent's involvement (willingness to change with their kid). The goal is not for the kid to be in therapy forever. Generally it is focused on address a specific problem. Other times, kids need more support as they move developmental phases or a significant life event. It all depends. Parents can expect to see some changes develop, some regression, and then more changes. It might be a slower process, but its generally more meaningful and successful for kids.
Parents often want the kid to talk with the hope that it will help things get better. Believe it or not, talking isn't always helpful. Talking is a cognitive and verbal activity and can be necessary at times, but in play therapy - it's not critical that the child directly verbalizes what's going on. Sometimes this can overwhelm the kid and cause shut-down or activate flight/flight responses. If parent's (or other adults, therapists, teachers) don't really grasp that playing IS the therapy, that play IS the way they are communicating, then problems can arise in the commitment to trusting the kid's process, and remember - we are asking them to do the hard work and change.
There's a time and financial investment. This is not always do-able for families due to financial limitations or busy work schedules. If either of these are barriers for you, talk to your school or other community programs where your kid may already be attending, and ask for what therapeutic supports they can assist with. Don't forget, as their primary caregiver - you are the biggest asset they have in their life. What you do, say, and how you show up, it matters. If you are not their caregiver, you still matter too. The more caring adults that believe in a kid, regardless of their behavior, drastically improves their resiliency. You matter.
Perhaps most important, it's not all about the kid - it's about the family. I expect and communicate with my families that parents need to be involved. This involves meeting regularly with the therapist to talk about observations, challenges, and actively get support on other behavioral changes that parents may need to make. A solid therapist will not shame or judge you - rather help you recognize that most of what you feel and face is really normal for parents. After all, you are another complex human system with your own stuff to bare. Sessions for parents are not only are designed for support, but it helps the therapist better understand the child holistically, which ultimately helps the child get better treatment, make changes faster, and lead to a stronger foundations which supports them as they grow in life.
Can't get your kid to therapy just yet? Here's some tips on how to support their mental health.
Be their mirror. Try reflecting their feelings to them. If they are telling you a story about something that happened at school, maybe take a guess on what they were feeling. For example, "You were mad when your friend took your toy" or "it was embarrassing when they teased you." Often I encourage parents to slow down and see below the surface. Hold back on solving the problem for them. Have you ever had an experience where someone went into problem solving mode when you really just needed to talk? It's a bit like that. Help kids identify the feeling(s) + what may have activated it in their social world. You're building important self awareness skills.
Draw, paint, and create with them. It doesn't matter if you have fancy supplies or are any good at it. In my office, my recycling bin is one of the most used art supplies. Try letting kids lead and encourage them to figure out how to assemble things, explore how paint or notice how it feels to touch various textures, and maybe even let them create a story about what they made. Practice not telling them what to draw, do, or fix it for them. Don't ask them to explain or identify things. Stay away from "Tell me what color that is" or "What are you making?" Let them do it "wrong" or not know. Try just observing and delighting in who they are and where they are at in life. Practice trusting in their intelligence to work it out. Also, they know you are witnessing them. That is powerful.
Focus on encouragement rather than praise. Encouragement reinforces to the kid that you know they can do hard things, you believe in them, and you see how hard they are working. It helps reinforce a growth mindset.
Understand what is getting activated in you and work towards soothing and regulating your own nervous system first. This helps you help them with their nervous system. It's normal for our systems to shift into different states. You can model recognizing and attending to your own emotions. Ultimately, model caring for yourself. Kids learn a whole lot from what their parents do. Practice taking care of yourself and it will trickle down to them.
Closing thoughts: an evidenced based approach that nurtures growth.
When kids engage in painting, storytelling, and imaginative play, every action serves as a window into their inner world. With attentive observation and permission from the child, I get the honoring in join them in their inner world. We play out underlying themes and emotions. In play they get to explore, reassess, understand, and make sense of their experiences.
Key points to remember:
The three keys to behavioral change are embedded in play therapy (autonomy, relatedness, capability).
Play therapy is a whole brain approaches where kids embody new ways of being as opposed to just understanding concepts.
Parents need to invest in their kids, this includes their time and money. Parents need to invest in their own emotional growth and healing too.
Non-directed, child centered play therapy is an evidenced based approach that generally feels safer and is more tolerable for kiddos. There are tons of benefits of child therapy. Kids often enjoy coming to sessions and take ownership in their own healing. That is transformative power.
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