Therapeutic Play Continuum - Defining
Play Therapy - A description of the
variables that define the applications of play used to improve children’s emotional
well-being and mental health.
Play Therapy, Playtherapy, Applications
of Play, Play, Defining Variables, Therapeutic Play
Therapeutic Play Continuum - Defining
Twelve variables are used to help to
define each level in the continuum. These variables are then used in a matrix
which provides contextual
Alternatively see the simplified
The 12 defining variables are:
- Objectives of the application
- Types of Intervention
- Description & Role of the Provider
- Age Range (Emotional)
- The Degree to which Psychological Theories are applied
- Clinical Supervision
- Safety Issues
- Play or Creative Art Content (Proportion)
- Quality Management Aspects
- Code of Ethics
- Degree and Type of Training
The objectives of the use of play are a
good place to start defining each level. The role of play ranges, through a
number of levels of the continuum, from enjoyment and self-development pure
play at one end to acting as an adjunct to talking therapies at the other end.
One way of defining the objectives of therapy where mental health and emotional
state is involved is the level of the client’s functioning. Another way of
describing objectives is the severity of the condition/s that play is intended
See examples below.
|Degree of Condition
||Hospitalisation for a minor operation.
||Temporary impairment of well-being; minor loss of functioning.
||Relationship issues: friendships, sibling rivalries.
||Some loss of well-being, ongoing impairment of functioning preventing
the child reaching their full potential.
||Stress and trauma.
||Child feels emotionally unwell, has considerable impairment of
functioning, problems need to be dealt with promptly to prevent further
||Repeated physical and sexual abuse from several sources.
||Mental illness or disorder; child at risk and unable to function as a
If conditions at any level are not
treated and resolved with appropriate intervention then they may progress to a
This attribute indicates the type of
intervention, if any, used to achieve the objective. Some interventions are
therapeutic, others are not. This attribute also leads to consideration of the
nature of activities that are required.
In these definitions it is assumed that
there is a provider of care of some kind to provide, supervise or mediate the
play activities. In the vast majority of cases this will be an adult but in
some cases it could be another, normally older, child. This attribute helps to
distinguish the level of skill required for the different applications of play.
This attribute is useful to separate
some applications from others. The emotional age of the child, rather than the
actual age, should be used.
One of the most important
distinguishing points is the amount of knowledge that is needed of the
informing psychological theories.
The more that interventions use
psychological based techniques the greater the necessity for clinical
supervision to make the client and therapy practice safe.
A further distinguishing factor is the
environment in which play is used. Is it for example a clinical or non-clinical
The environment together with the type
of intervention will determine the safety considerations - physical, emotional,
Another consideration is the extent to
which play is used in the application. This may range from 100% where play is
the sole activity to perhaps less than 5% where play is used as an adjunct to
another type of therapy or activity.
In any application where play is administered there is a need for some form of quality management which may
range from simple basic monitoring to quite complex clinical
governance procedures and systems.
Where any professional worker is
involved with children observance of an ethical
framework or code of ethics is essential. This may be one of a professional
organisation such as PTUK or that of an employing organisation.
All of the above factors, when
considered for a particular application of play, give a good indication of the
degree and type of training required.