PLAY THERAPY

INTRODUCTION :
 Childhood is the morning time of creativity are receptive to all the wonders of the
world around them.
 They have a spirit of adventure and sense of wonder and unquenchable curiosity.
Child is a natural explorer and the method he/ she uses is play.
 The child’s work is play. It is his/her means of discovering the world and
himself/herself.
 The child uses all his/ her sense organs for this purpose.
 The play environment is an ideal atmosphere for learning.
 The nonthreatening world of imagination provides the children an environment to try
familiar and new things.
 Toys are the tools to implement play and these toys should include recreational
equipment, tools for exploring the world of nature,games, puzzles, musical
instruments, books, record, etc.
 Play can therefore be defined as an instinctive preparation for adulthood.

DEFINITION :
 It is form of therapy that uses toys such as building blocks, dolls, puppets, drawing,
sandpit, etc, with the purpose of helping the child recognize, verbalize and express
 emotions. The therapist plays an active role of observing the child and recognizing the
themes of the play in order to understand the problem of the child. The therapy helps
the child gain an understanding of the problems affecting him/her and gaining an
insight of how the conflicts, emotions and problems may be handled more effectively.
 Play therapy is the purposeful use of play to provide information for assessment and
subsequent interventions. It is a natural stimulation and common mode of growth and
development among children.
 Play is the language of childhood and the communication medium for assessing
developmental and emotional status which will aid in determining the diagnosis and
therapeutic interventions which have to be implemented.

HISTORY:
 The first person to recognize the importance of play was Plato even before
Christ who stated the importance of play as a means of effective observation.
 Later in the 18th understanding children which he has mentioned Rousseau
also re- emphasized play as a means of understanding children which he has
mentioned in the book titled EMILE.
 The first published evidence of play as therapy was that of Freud titled Little
Hans. Hermine Hug- Hellmuth was the first person to formalize play as
therapy in 1921.
 Melanie Klien in 1955 began using this therapy to assess children below 7
years.
 In 1942, Carl Rogers introduced nondirective play.
 In 1950, Verginia Axline who was mentioned by Roger expanded this play
therapy .
 In 1982, the Association for play therapy was established.

GOALS :
 Establish rapport with children.
 Reveal the feelings that children are unable to verbalize.
 Enable children to act out feelings of anxiety or tension in a constructive
manner.
 Understand childrens relationship and interactions with significant other in
their lives.
 Teach childrens adaptive socialization skills.

PRINCIPLES OF PLAY THERAPY :

The principles that must be followed while implementing play therapy are as follows :

 Accept the child as they are.

 Establish a warm and friendly relationship.
  Identify the child’s feelings and reflects them back, so that the child gains insight
into his/her own behavior.
 Accept the child’s ability to solve personal problems.
 Set limits to the child so that she that he/she learns reality and achieves security.
 The therapist respects the child’s ability to solve problems when given an
opportunity. The therapist must also give the child the opportunity to make
decisions make choices for change.
 The purpose of the therapy is not to control the direction of the conversation but
to allow the child lead the course and the therapist follows.
 The therapist establishes only those limitations that are necessary to anchor the
child to the world of reality and to make the child aware of his/her responsibility
in a relationship.

INDICATIONS :
 Low self-esteem.
 Excessive anger, worry, sadness, or fear.
 Behavior which is immature for the child's age.
 Failure to learn or other school problems.
 Behavior which interferes with making friends.
 Problems with eating, sleep, or elimination.
 Preoccupation with sexual behavior
 Physical symptoms such as headaches and stomach aches which have no medical
cause.
 Difficulty adjusting to family changes
 Childhood emotional problems , especially those under 12 because their
devepolmental level makes them less able to verabalise thoughts and feeling.
 Talking about not wanting to live
 Excessive shyness
 Experiencing trauma such as:
 Chronic illness
 Illness or injury of a family member
 Divorce or separation of parents
 Death of a close family member or friend
 Disasters such as accidents, fires, or flooding
 Hospitalization
 Birth Trauma
 Painful or frightening medical procedures
 Physical, emotional, or sexual abuse
 Witness to domestic violence
 Witness to abuse of other children
FUNCTIONS OF PLAY :
 To study the child’s relationship with sibilings and other family members and friends.
 To study the hidden aspects of child personality.
 Provides a chance for exploring causative factors of child’s problems.
 To provide an opportunity for the child to act out conflicts and other fantasy
situations.
 To elicit child’s fears and fantasies.
 To help in release of pentup emotions and tensions.
 To help child to establish good interpersonal relationship with other children and
promote teamwork.
 To improve emotionl growth and development of children.
 To help child develop more adaptive ways of coping.
 To help cognitive or intellectual development .
 To encourage muscle activity and therefore promotes muscle strength and muscle
tone development.
 Play also promotes the development of skills and balancing in various positions.

CLASSIFICATION OF PLAY :
Play may be classified into two ways. They are as follows :
1. According to the content :
 Social affective : In this kind of play , the child takes pleasure in relationship
with people. Infants learn to provoke adults , emotions, and responses with
behaviour such as smiling cooing and initating games.
 Sense pleasure : This is kind of play in which pleasure is obtained through the
stimulation of the sense organs like light, colour, taste, and odour. This attracts
the child’s attention, stimulates their senses and promotes pleasure.
 Skill play: Here , the child develops skills through repetitive action in a game.
This is evident when the child is learning a new ability.
 Unoccupied play : Here, the child does not actually play but focuses his /her
attention momentarily on anything that strikes his / her attention and intrest.
 Dramatic or pretend play : This begins in late infancy and is predominantlty
a type of play used by preschoolrs. Here the child acts out the events of daily
life through which he/ she learns the role and identities of member of the
family and society. This provides a medium for learning adult roles and
activities.
2. According to social character :
 Onlooker play : The child does not actually play but watches what others are
playing.
  Parallel play : The child plays independently , but among other children . the
child plays with the toys like those of other children and is neither influenced
by nor influences other children. They play beside but not with the other
children.
 Solitary play : The child plays alone with toysdifferent from others .They
enjoy the presence of other children but make no effort to get close or speak
to them.
 Association play : The children play together and are engaged in similar or
identical activity , but the activity is not organized neither there is a division
of labour .There is no mutual goal otr leadership assignment.
 Cooperative play : This type game is organized . The child plays in a group
with other children .They discuss and plan activities for the purpose of
accomplishing an end.The group is closely formed and there is a marked
sense of belonging.

TYPES OF PLAY THERAPY :

 INDIVIDUAL PLAY THERAPY :
Individual play therapy focuses on healing ,strengthening individual children.
They may also engage in individual play with children, with the purpose of
illuminating their concerns in order to communicate them to other family
members .

 GROUP PLAY THERAPY :

Small groups of children with similar difficulties grow together through semi
structured activities all within safe and warm environment provided by
therapist. A course of group Play Therapy is typically 6 weekly sessions that
 last 40 minutes and up depending on the children's ages & needs.

 FREE PLAY THERAPY :

 The child will be given freedom to choose the toys and play activity.
 The therapist Will observe the selection of play items and activities of the
child in free play.

 STRUCTURED PLAY THERAPY :

Play situation will be organized. It explore more information and how the child
reacts to the structural situation, the way of grasping.
  UNSTRUCTURED THERAPY :
 Preplanned situations or specific plans will not be activated. The child’s nature
and reacting to the stimuli, exploring behavior of the child will be observed.

 DIRECTIVE PLAY :
The play situation will be created by therapist and the child will be allowed to play ,
the therapist will give directions to solve the problems and make the child to learn
problem solving techniques.

 NON-DIRECTIVE PLAY : The child will not receive any directions, he will be
free choice to select the games patterns and play, the therapist will observe the child’s
activities and identifies the problems of the child .
PHYSICAL SET-UP OF THE PLAY ROOM :
 It is desirable to have a room set aside or furnished for the play room, this is not
absolutely necessary.
 Sometimes the corner of the regular classroom or corner of an unused ward can be
used for play therapy.
 In this situation ,where there is a small budget, the play material may be placed in a
suitcase and brought out for each meeting .
 If money and space are available to furnish a special play therpy room, following
suggestions are offered :
 The room should be soundproof, if at all possible.
 There should be a sink in the room.
 The window should be protected by grills or screens.
 The walls and floors should be protected with the material that is easily cleaned.
 If possible, the room can be wired for photographic recordings and provided with the
one way screen so that observations can be made without child being aware of the
observers.

PLAY MATERIAL :
The play material that have been used in the past with varying degrees of success include
the following:

 Nursing bottles
 Doll family
 A doll house with furniture
 Toy soliders and army equipment
 Animals
 Play house material including table, chairs and cot
 Doll bed and stove
 Ten dishes, pans and spoons
 Doll clothes, cloth basket
 A large rag doll, puppets and a puppet screen
 Crayons
 Clay, finger paints, sand ,water and toy water gun
 Little cars and air planes
 Toy telephone and clay work
 Old newspapers, drawing paper, inexpensive cutting paper and pictures of people.

QUALITIES OF A PLAY THERAPIST :

 The therapist must have a warm, friendly, personality and must like children.
 The therapist must be disarming , not threatening and capable of establishing a
quick rapport with children , the therapist must be appealing though not
provocative.
 The therapist must accept the child with all his faults , in the way he is at that
particular moment and not for what he can be and should be .
 The therapist should be able to extend the impression of permissiveness to the
child, disarming the child and making him feel free to express his feeling
completely.
 The therapist must be sensitive about receptive enough to recognize the child’s
feeling and even understand the feelings through his facial expressions, even if
they are not verbalized.
 The therapist must be capable of reciprocating the child’s feelings and reflect
them back to him when required to allow the child the child to gain insight in
to his behaviour and allow personality and emotional growth.

FUNCTIONS OF THE THERAPIST :

The functions of the therapist are as follows :

 Establishing a rapport :
The therapist must must develop a warm, friendly relationship with the child in
which a good rapport is established as soon as possible.
 Accepting child completely :
The attitude of the therapist should be that of acceptance. This is manifested in a
calm , patient, nonjudgemental, noncritical and friendly relationship with the
child .She avoids play on words.
 Establishing a feeling of permissiveness :
Permissiveness implies choice to use or not to use the material according to the
child’s wishes.
 The child feels free to express his/ her feelings completely.
 The therapist allows the child to play in any way he/ she wants and he/she shows
him /her the materials available.
 Recognition and reflection of feelings :
The child’s play is symbolic of his/her feelings and whenever the therapist
attempts to translate symbolic behaviour into words, the therapist should be alert
enough to recognize the feeling experienced by the child, reflecting those
feelings in such a way that promotes the child’s insight his/ her behaviour.
 Maintaining respect for the child :
This involves respecting the child’s ability to solve his/ her own problems, when
encouraged to do so.
 It also involves choices that the child can make for himself/ herself .
  The child has the privilege of selecting toys he /she wishes to play with, thus
making choices and decisions for himself/ herself.
 The child is given a chance to gain his/ her equilibrium and he / she achieves
self- confidence and self- respect and builds up his / her own self – esteem.
 Allow the child to lead the way :
 The parents should not attempt to direct the child’s actions or conversations in
any manner.
 The child leads the way and the therapists follow adhering strictly to the
nondirective policy.
 He / she neither praises nor criticizes the child, so that the child does not feel
discouraged and inadequate .
 The value of limitations :
Limitations are used with intelligence and consistency used to safeguard the
child from possible misconceptions, confusion, guilt feelings, and insecurity.

ADVANTAGES OF PLAY THERAPY :

 It grants the individual the individual the permissiveness to be himself/ herself.
 It accepts self completely without evaluation of pressure of change.
 It recognizes and clarifies the expressed emotional attitudes by a reflection of what
the patient has expressed.
 It helps the child to accept himself/herself as he/she is and promotes growth through
the therapy.
 It provides a psychologist and the teacher with a technique for understanding and
helping maladjusted children with problems.
 It provides the child a natural way to deal with life.
 It provides an opportunity for problem children to communicate in the form of play ,
which in turn may reveal attitudes , conflicts and innermost thoughts and needs.
 It is a matter of releasing tension through the expression of hostility.
 It stimulates creative expression and self – expression.
 It helps the child to learn to confront reality and to adjust most successfully to life
situations.
 It decreases anxiety or fear by enabling the child face and familiar with the situations
that have given rise to the anxiety .

BIBLIOGRAPHY :
 Dorothy D. Theodore , textbook of mental health nursing ; volume 1, published by
Reed Elsevier India Limited, page no: 393-401.
 Pawan Sharma , essentials of mental health nursing ; published by Jaypee Brothers
Medical Publishers Limited , page no :129-132.
 Margaret Jordan Halter, foundations of psychiatric mental health nursing ;
published by Elsevier , page no : 177.
 Senthil Thirusangu , textbook of mental health and psychiatric nursing ;published by
AITBS Publishers , page no: 324-326.