Lubbock Adolescent Counseling: Play Therapy for Teens and Tweens

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Play therapy is an evidence based practice for children and adolescents and has many techniques for counselors to perform. (Bratton & Ray, 2000; Bratton, Ray, Rhine, & Jones, 2005; Gallo-Lopez & Shaefer, 2005; Roaten, 2011).

Working with a teen is very different than working with an adult client due to biological, developmental, and psychosocial tasks. Developmental tasks of teens include: physical maturation, sexual relationships, peer groups, emotional development, formal operations cognitive development, and identity development.

Because of the development of formal operational thought, preteens often vacillate between play that is more common to younger children and activities that appeal more to teenagers.

Play therapy can benefit preteens and teens struggling with depression, abuse, grief, addiction, adoption, ADHD, trauma, family stress, anxiety, relationships, problems with peers, identity, self-esteem, sensory processing issues, body image, anger issues, parent’s divorce, autism, etc.

Rather than teens doing therapy, they EXPERIENCE therapy. It is an opportunity to safely distance the self from problems through activity, creativity and imagination. Using a teen’s interests through play, sandtray figures, and expressive techniques will stimulate the teenager's desire and need to be expressive and create identity--which is central to this developmental stage. The positive therapeutic relationship that develops between a teenager and a counselor brings healing, forward movement, and relief of emotional stress. 

Expressive arts are a great tool to address new thoughts and feelings or communicate and rework perspective. It can include art, music, or movement such as yoga or dance.

Games and activities can be used to deal with anxiety, power and control issues, self-esteem, relationships and difficult behaviors. 

Sandtray invites adolescents to explore the uncertain world between childhood and adulthood and to explore the internal world and subconscious in a creative way by choosing miniature figures to place in a tray of sand. Sandtray allows clients to become mindful and allows clients the opportunity to blend memories, fantasies, wishes, and emotions without verbal constraints. (Rae, 2013)

“Appropriately structured creative art activities provide preteens with opportunities to change perceptions about self, others, and the world as they try out new roles and solutions...Furthermore, [they] facilitate a process of self-development, providing the preadolescent with the inner resources to cope with future difficulties.”
— — Bratton & Ferebee

Group therapy is quite effective for making friends, improving communication skills and learning coping skills from peers who experience similar challenges. When the opportunity is available to pair 2 or 3 preteens or teens, group activity therapy can be beneficial.

Trained play therapists can use play therapy with tweens and teens to

  • Informally assess a client’s psychosocial and psychological functioning

  • Build rapport

  • Explore and facilitate expression a client’s inner world and emotions

  • Build skills through psychoeducation

  • Develop mastery, identity, and empowerment

  • Relieve a client of stress

Communication and Connection With Our Kids

We as adults often wonder how to best communicate with the tiny humans in our lives, whether they are our own children, nieces or nephews, our best friend's kiddos, or the kids we work with on a daily basis. Each child communicates in a way that works best for themselves and how they are developing and it can be difficult to understand what they are needing or wanting from you as an adult. Being able to communicate effectively with the tiny humans in our lives is essential to them feeling heard and understood. 

The book, How To Talk So Kids Will Listen & Listen So Kids Will Talk by Adele Faber and Elaine Mazlish, is a helpful tool to understanding the intricacies of childhood communication. It also contains helpful and amusing cartoons that show healthy and effective communication styles. In this article, I will review and highlight some important pointers from the book that may help you understand and communicate more effectively with the tiny humans in your life. 

The first thing the book talks about is helping children deal with their feelings. Feelings are part of everybody's everyday life and it shouldn't come as any surprise to know that children experience emotions just like we do. They are going through a whole new experience in life: constantly changing, growing, and developing. These new experiences can be really exciting but often also really overwhelming. One of the authors writes, "steady denial of feelings can confuse and enrage kids". When learning to communicate with children, it is essential to listen to what they are feeling. 

Our authors suggest four tips on helping with feelings and they include: 

1. Listen with full attention 2. Acknowledge their feelings with a word: "oh, I see, mmhmm" 3. Give their feelings a name: "you're feeling angry", "you're feeling sad" 4. Give them their wishes in fantasy: "you wish you could go take a nap right now because you're so sleepy" 

While, given certain situations, these tips may not be easily employed, they may be a good place to start. 

Another topic the book talks about is engaging cooperation. Sometimes, it can feel useless asking or telling your child to do something you want them to do. You try every means of communication you know and they still don't listen or obey. So how do we get our kiddos to listen to us and cooperate with what we are trying to say? 

Faber and Mazlish list some tips here to help engage cooperation: 

1. Describe what you see or describe the problem: "the light is on in the bathroom" 2. Give information: "walls are not for writing on, paper is for writing on" 3. Say it with a word: "Jill, your lunch!" (in this instance, less is more) 4. Talk about your feelings: "I feel so frustrated when I start to say something and can't finish." 5. Write a note: written on the bathroom mirror "Help! Hairs in my drain give me a pain!" 

Engaging with the children in your life at any age allows them to feel heard and gives them the space to learn how to work with you. 

Learning these and other communication tips can be helpful in understanding your children and working with them in a healthier manner. Every child desires to be heard and every adult wants to be able to understand them. If you are a parent or an adult who works with or interacts with children regularly, you might find books such as this one helpful in communicating! 

The women who wrote this book also wrote one on interactions with teens called How To Talk So Teens Will Listen & Listen So Teens Will Talk. A lot of the same communication skills are written about but from the perspective of talking to teenagers. 

Reference: Faber, A., & Mazlish, E. (1999). How to talk so kids will listen & listen so kids will talk:with a new afterword: "the next generation" by Joanna Faber. New York: Scribner.

By: Katy McAlpine, MEd, LPC-Intern

(Under the Superivision of Kelly Martin, MEd, LPC-S, RPT-S

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How to Handle Hitting and Biting


There is a message in the misbehavior of hitting and biting. It's normal for toddlers and preschoolers to have difficulty managing big feelings and impulses. Often times we misinterpret a child's aggression as being intentional or an attempt to manipulate. Instead, look at aggression as your child's way of communicating. Our young people are still developing vocabulary and do not have the skills to sophisticatedly express overwhelming feelings. Hitting and biting can be a child's way of saying "I need space!" or "I'm jealous that you are playing with that!" or "I want to make my own choices!" Biting may also be an attempt for a child to experiment and test his body's capabilities.

Here are ways to offer your support for your child's emotional development when he or she is hitting or biting.

1. React calmly. When you witness or hear about your child hitting or biting, your first reaction may be tensing your body, heart racing, or your face feeling hot. Breathe and exhale and gently move your child away from the situation. Attend to the child who was hurt with empathy and tenderness.

2. Prepare. Watch your child carefully and take mental notes of things that seem to make your child feel stressed, overwhelmed, frustrated, or sad. Look for patterns such as in transitions, time of day, and other triggers such as overstimulation. Frequent biting in toddlers and older children can often be related to sensory processing issues and an attempt to receive oral stimulation.

3. Use empathy. Use feeling words to build your child's emotional vocabulary. "You're so disappointed that it's time to go!"

4. Set the limit and teach. "You wanted a turn on the slide. Your hands are not for hitting. Next time you can say, Can I have a turn please?" or "No biting-biting hurts! Teeth are for food!"

5. Redirect: Sometimes our children need our support to make a healthy choice. It may mean gently intervening mid-swing at another child. Try using humor and being light hearted "Woah, we're not painting on people today silly, only paper!" Find an alternative for a child to bite when she feels the urge: chewies, ice, biting blanket.

6. Repair. Many natural reactions are to follow up with punishment, but instead, use this time for connection and learning. Give a hug. Sit quietly for a few minutes. Evaluate your child's needs: hungry? tired? Once your child is calm, talk about what happened by putting feeling words into the situation. Forced apologies are meaningless. Build empathy in your child by asking him or her what might make the hurt child feel better.

7. Use connection. If you feel your child is acting aggressively for attention or connection, give him lots of undivided attention throughout the day. Read a book, draw together, allow your child to help with simple tasks, create special moments together.

8. Consider speech and language milestones. Often times a child feels frustration in communication. Is your child meeting his milestones in speech and language?

9. Repeat: Spending time helping your child build the skills and vocabulary is time well spent. Healthy habits may take time to develop.

(Tips compiled from imperfectfamilies.com; Ages and Stages in Parents magazine).

Connecting With Your Child Through Play

Play can be the long-sought bridge back to that deep emotional bond between parent and child.  Play, with all its exuberance and delighted togetherness, can ease the stress of parenting. Playful parenting is a way to enter a child’s world, on the child’s terms, in order to foster closeness, confidence, and connection.
— Lawrence Cohen

Children need to play. It’s their work and way of learning skills, making sense out of their world, and processing their emotions. Children release complicated emotions through play. Laughter specifically reduces stress hormones and increases bonding hormones. Laughter can quickly restore an affectionate connection between adult and child. Play helps parents and kids feel closer, helps kids learn lessons better, and increases cooperation.

Connecting with your child through play can be as little as 2 minutes or as long as 10-20 minutes. Here are some ideas to help you get started.

1.     Play hide and seek

2.     Hold your child in your arms and dance

3.     Play a tunnel activity (similar to London Bridge)

4.     Give a pillow ride (sit on a big floor pillow as you drag him/her around the room, maintaining eye contact)

5.     Play catch! Roll a ball back and forth, bat a balloon back and forth

6.     M&M hockey (use bendy straws and blow M&Ms across the table, then the opponent feeds the person who scores a piece of candy)

7.     Play toys (follow your child’s lead, refrain from asking questions, use undivided attention)

Parents as Soothing Agents

When our little people are overwhelmed by big emotions, it is our job to share our calm, not join their chaos.
— L.R. Knost

Parents and caregivers are critically important in helping children regulate their emotional states. Often, however, it is the very tantrums and meltdowns that spike parents' own anxiety reactions, leaving them unable to respond effectively as soothing agents. You might find yourself attempting to calm your child down through persuasion, coaxing, arguing them out of the anxiety, or rescuing them from the emotion. What if parents stopped trying to change behavior, and changed how they thought about parenting? Parents have the power to adjust their own thoughts and feelings about the struggles of parenting and about what a child's behavior is trying to communicate.

Dr. Dan Siegel proposes "Connection before correction." Parents need to first listen to the child, acknowledge her feelings, and offer guidance. The acronym SOOTHE (developed by Goodyear-Brown, Ashford, and van Eys) helps parents remember strategies to responding to emotional symptoms.

S = soft tone of voice, soft tone of face

0 = organize the child's experience

O = offer choices or a way out

T = touch or physical proximity

H = hear what the child is needing

E = end and let go

Elevation of a parent's voice will only feed the escalation of a child's tantrum. "If parents can choose to lower their voices, use a soothing tone, and remain calm, they will be anchoring the child's experience beneath the current level of escalation." (Paris Good-Year Brown in Play Therapy with Traumatized Children).

A lack of structure intensifies anxiety and dysregulation. Consistent schedules and soothing routines help to organize your child. Offering a narrow range of choices to a child helps to manage the emotion that arises during a decision making process, as well as provide a positive sense of control. A simple touch or physical proximity is meant to reaffirm children and keep the parent child relationship intact. Hearing what your child is communicating is discerning what the child's need is. This discernment will guide your response. Does your child's behavior communicate a need for attention? power? to feel adequate? rest? a snack? Lastly, Dan Siegel (2003) talks about the toxic ruptures that can occur between parents and children when upset occurs but it is never processed. Parents need to acknowledge their right to their own feelings of anger and exhaustion, but also let go of it, and remain responsive to their child after the meltdown has occurred.

Once connection is built, parents can move to the next step and discuss the issue. Helpful questions that encourage connection are: "What happened? How did this anger feel inside your body? How did this feeling make you react? What would be another choice for next time you feel sad?"

If you are interested in more helpful tips, we recommend "The Whole-Brain Child: 12 Revolutionary Strategies to Nurture Your Child's Developing Mind" by Daniel Siegel and Tina Payne Bryson. "Peaceful Parenting, Happy Kids: How to Stop Yelling and Start Connecting" by Laura Markham)

Play Therapy Poster Gallery

Kelly Martin, child counselor and play therapist of the Playroom Lubbock, along with Deborah Faith Photography created a sense of what a child experiences in a play therapy or activity play therapy session. You are invited to click and browse through our play therapy posters and learn why and how play therapy matters and is effective. (Children used in photos are not actual clients. The playroom is our actual play therapy playroom).

How do You Find the Right Therapist and Prepare for Your first Session?

Deciding to seek help for something you or your child are going through can be really hard. It may be your idea to seek treatment and go to therapy or it might not. The idea may be well received and provide relief or it may produce reluctance and uncertainty. Either way we want to provide some tips and insight in your search for a therapist and for your treatment journey. 

Read more

When In Doubt, Connect

A few words on what to do when you don't know what to do. The following blog post is suitable for anyone who has a relationship in any capacity with someone else. I hope that keeps it broad enough. In my practice I facilitate strengthening the parent/caregiver/child relationship. However, the following same principles apply to romantic relationships, friendships, teacher/student interactions, workplace relationships, etc...

 

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It's not often that I quote myself, but when I do, it's because I struck a chord I needed to hear myself. In parenting or in other relationships we may find ourselves at a loss, confused, desperate, hopeless, discouraged, or hurt. It's in those times that we should respond with love and connection.

How do goals of behavior affect our responses?

I  frequently talk with parents about a child's goals for misbehavior--that behavior is goal directed and children are trying to fulfill a need. Adults do the same thing except our misbehavior looks differently, but is rooted in the same needs.

In our relationships and interactions with others, we automatically assign a story to our beliefs about ourselves, about others, and about our situations. These beliefs will trigger emotions which trigger a reaction. This reaction is trying to fulfill a need.

When we are are feeling discouraged, challenged, hurt, confused, or hopeless in our relationships, it would serve us well to reflect on what might be the other person's goal and what might be our goal.

Power/Control, Inadequacy/Fear of Failure, Revenge, Attention

1. Goal: power and control. The belief behind power/control is: I belong or I am valued when I am in control or proving no one can boss me. 

2. Goal: avoid inadequacy. The belief behind inadequacy/fear of Failure is: I don't believe I can belong so I'll convince others not to expect anything from me. I am helpless and unable. It's no use trying because I won't do it right. OR I will do everything I can to avoid being perceived as inadequate.

3. Goal: hurt, get even. The belief behind revenge is:  I'll hurt others as I feel hurt. I can't be liked or loved.

4. Goal: attention. The belief behind attention is: I am valued only when I am being noticed. I'm only important when I'm keeping you busy with me.

What's the best response?

To change a negative attitude you're holding about an individual, you'll need to uncover the underlying belief or goal that's creating your unhappy feelings. Begin by asking whether you believe people, in general, are doing the best they can. Researcher Brene Brown has discovered that believing that you and others are doing the best you can requires compassion. "You may not be absolutely sure about the intention behind someone's behavior, including your own. But being compassionate is about cultivating the attitude that normally people do their best with the tools they have. Compassion allows us to believe that we can all learn from our mistakes, enabling us to grow and change." (ThePropelPrinciples.com)

What's the most generous possible interpretation of the intentions words, and actions of others? (Brene Brown)

Equally, what's the most generous possible interpretation of our own actions? 

1. Identify goals of behavior with the most generous possible interpretation.

2. Evaluate whether your reaction is responding to their need/goal AND whether your reaction is self serving your goals of behavior. Are you reacting out of your own sense of inadequacy, need for control, from feeling hurt, or to be recognized?

When in doubt, do something that connects or communicates love.

When we feel at a loss for an appropriate response or don't have the time or emotional energy to calculate goals or beliefs, respond in a way that connects, preserves a relationship, or communicates love. (Remember, another person's response to your extension of connection does not determine your adequacy or value).

Offering connection or love does not imply permissiveness nor does it allow someone to take advantage of or walk all over you. Brene Brown recommends Living BIG: Boundaries, Integrity, Generosity. "Setting boundaries means getting clear on what behaviors are okay and what's not okay. Integrity is the key to this commitment because it's how we set those boundaries and ultimately hold ourselves and others accountable for respecting them." (Brene Brown, Rising Strong).

How Do We Start the Play Therapy/Counseling Process? What parents can expect

When parents begin to notice a child's functioning or well being is being affected by a life circumstance or behavior, speaking to a mental health professional is an appropriate first step. At the Playroom Lubbock we do not require a pediatrician referral. You can simply call our office to ask questions, tell us a little bit about your concerns, and book your first appointment. In fact, when you call inquiring about play therapy/teen activity therapy you will speak directly to Kelly Martin, LPC. Once you book your appointment, Kelly will send via email the necessary consent forms and intake paperwork through a secure client portal. Unless you have custody papers or prior assessment evaluation reports, you do not need to bring any other paperwork to the first session. 

  The first session 

The first session is a parent only session with our children's counselor and play therapist, Kelly Martin. There are several topics that will be discussed during this 45 minute session: 

  1. Kelly's practice policies and privacy policies
  2. Stages of play therapy
  3. Background history of the child
  4. Goals the parents have for both the child and for themselves  
  5. A treatment plan for therapy

  

Warm and inviting office for parent sessions. 

Warm and inviting office for parent sessions. 

The fourth session 

Prior to the 4th session, Kelly will send a parent report form for the parent to complete. This gives them the opportunity to record changes, rate progress, and jot down questions or concerns. Every 4th session Kelly and the parents/guardians come back together for a session to discuss progress, changes, review goals, and to provide support to keep the therapy process moving forward. We continue this cycle of 3 child therapy sessions followed by a parent session. 

 Value of the parent

Parents and guardians are also an agent of change in the therapy process. Parents know their children best and their insight, perspective, and observations are valued and helpful to the counselor in her work with their child.