An Introduction to Play Therapy
This article is based upon material presented at the 2001
Kingston Summer Play Therapy Institute by Dr Mark Barnes IBECPT CPT-P. Now
retired, Mark has done more than anyone else in recent years to promote the
cause of play therapy throughout the world and to raise the standards of
training and education in play therapy. PTUK is privileged to be associated
with his work. His views on the Directive v Non-Directive approaches are
especially thought provoking.
Keep the Bigger Picture In Mind
Play therapy is one piece of a total picture. It is an
important piece, but still, just one part of a larger process. There are other
areas and people to be dealt with, either by the therapist or by colleagues. As
work proceeds with the child, it is also important for someone to be involved
with other people in the child’s environment. We have seen a play therapy
service in a school in the UK run by well trained, very experienced, well
intentioned therapists founder because of a break down in communications with
Children of all ages 0 – 100
Play therapy techniques can just as easily be adapted for
adults and their inner children. We have, for example, observed the dramatic
changes effected upon adults who have completed a sand tray. Positive results
were obtained in a far shorter time than the use of talking therapy could have
achieved. Obviously there are certain adaptations that have to be made for
different age groups but, in general there are few limitations in tapping
playful or creative impulses in the healing processes. Until now 3 years has
been assumed to be the youngest age at which a child could benefit. However the
exciting developments in filial play and the latest research into how young
children learn and think suggests otherwise.
Remember that the entire mental health field is brand new.
It is hardly a century old and therapy with children is really so new that
there is no excuse for getting locked into dogmatic beliefs about there being one wonderful model that works. Take everything you hear in the field
with a grain of salt. There are mountains of theories and philosophies of working
with children but relatively few facts. Models are based on theories.
Unfortunately when much of a theory has been disproved, we are sometimes still
left with the models. A critiquing mind is vital for a therapist.
The techniques and methods are the tools in the tool chest
of a healer. The more skills or tools one has the better one can adapt to new
situations, difficulties or problems. These tools are also resources. The more
resources, inner and outer, that we have access to the less likely that we will
burn out. However it is no use knowing the theory of a tool without the
practical experience of using it, initially under safe conditions.
Healing Comes From the Heart
Do not feel that you have to have all the right tools before
beginning. You will never have all the resources you could hope to have but you
will always have access to your own inner voice. Professionals in the most
wonderfully equipped play therapy settings can still do a poor job. Toys do not
make the therapy. A truly skilled therapist could work with only the air and
There are many people that we are in contact with in
connection with our work: parents, teachers, social workers, care workers,
doctors etc. Some may not have heard of play therapy. Many will not be
convinced of its value. We therefore need to undertake an educational job. Part
of this process is showing that play therapy is not some new fangled technique
but one that has strong historical roots.
In giving a background on play therapy, it does not
necessarily mean that all or any of the methods mentioned are still in use or
that they necessarily work. What we are looking at here are our roots, the
beginnings of therapy with children. Some of the methods would definitely not
be used today. They are given to indicate the growing process of our
understanding of work with children.
H Hug-Hellmuth (1919)
First used play directly in the therapy of children.
Murdered by a client, who was her nephew and living with Hug-Hellmuth as an
Melanie Klein (1932)
Incorporated play into her sessions with children as a lure
Structured Play Therapies (late 1930s)
Used play therapy as a direct substitute for words. Common
- A psychoanalytic framework
- At least a partial belief in the cathartic value of play
- The active role of the therapist in determining the course
and focus of therapy
Not connected to the Minuchin systemic family therapy model
known as structural family.
Otto Rank (1936)
Stressed the importance of the so-called birth trauma in
Jessie Taft (1933) &
Frederick Allen (1942) &
Clark Moustakas (1959)
Adaptations of Rank’s thinking to work with children in play
Through therapy the child is given the opportunity to
establish a safe, consistent relationship with a therapist in a safe setting.
This approach tended to emphasise the child-therapist relationship and
de-emphasise the significance of past events. Still maintained a strong tie to
Developed release therapy to deal with children with
specific trauma – made materials available to re-enact the trauma.
Developed a technique called active play therapy, which was
used with impulsive/acting out children. It was thought that expressing rage
and fears through play would lead to more socially accepted play.
Set up play much like Levy, but was much more directive.
Directly recreated the event in play to aid the child’s release.
Developed this approach for therapy with adults.
Modified the client centred approach into a play therapy
technique for children. Client centred play therapy aims at resolving the
imbalance between the child and his/her environment so as to facilitate natural
Keep in mind that, contrary to the beliefs of adherents,
this approach is anything but non-directive when it comes to interpretations
and analysis of a child’s play.
Wrote an article Limits Are Therapy which began a
movement where the development and enforcement of limits was considered the
primary vehicle of change in therapy sessions. Therapist sets the limits with
which she or he is comfortable. For example, the child should not be allowed
- Destroy any property in the playroom other than play
- Physically attack the therapist
- Stay beyond the time limit of the session
- Remove toys from the playroom
- Throw toys or other material out of the room
Ginott (1959, 1961)
Felt that the therapist, by properly
enforcing limits, can re-establish the child’s view of her/himself as a child
who is protected by adults.
Today we know that setting and enforcing limits is an
important part of both parenting and therapy. A child without limits is an
abused child. Without limits there is no sense of safety, boundaries or
protection in the world. Children without limits cannot trust adults to behave
in a consistent manner. We owe children limits. This is not to imply rigidity
or inflexibility. Limits should stem from loving concern for a child not for a
desire for power over the child. A child should have as few limits as possible
but as many as necessary.
One of the consequences of testing the limits should, under
no circumstances, ever involve physical punishment, spanking etc. Physical
punishment only represents inability to properly establish and enforce
reasonable limits earlier. It is a message in the clearest possible manner to
the developing child that physical abuse is legitimate and that hitting someone
is something that mum and dad both condone and practice.
However, therapy does not mean anything goes. Therapy should
be a lovingly and carefully guided process. There is a time for many different
pieces to the process. It must not deteriorate into “cupcakism" where the
therapist does only what pleases the child and does nothing that would make the
child dislike him/her.
1960s, 70s, 80s, 90s
- Creative arts – art, music, dance, movement
- Dreamwork, sandplay
- Nature, spirituality, pet-facilitated therapy, relaxation,
social skills, impulse control
- Group work
Family involvement, family play therapy
Since much of current play therapy practice is based upon Virginia
Axline’s work it is worth quoting her basic rules.
Must develop a warm and friendly relationship with the
- Accepts the child as she or he is.
- Establishes a feeling of permission in the relationship so
that the child feels free to express his or her feelings completely.
- Is alert to recognise the feelings the child is expressing
and reflects these feelings back in such a manner that the child gains insight
into his/her behaviour.
- Maintains a deep respect for the child’s ability to solve
his/her problems and gives the child the opportunity to do so. The
responsibility to make choices and to institute change is the child’s.
- Does not attempt to direct the child’s actions or
conversations in any manner. The child leads the way, the therapist follows.
- Does not hurry the therapy along. It is a gradual process
and must be recognised as such by the therapist.
- Only establishes those limitations necessary to anchor the
therapy to the world of reality and to make the child aware of his/her
responsibility in the relationship.
There is an ongoing debate in the play therapy field over
which approach is better – non-directive or directive. There are two issues of
concern. First, there is not one right way to proceed in our work with
children. Contrary to the dogmatic views of some theorists in the field, many
approaches work with children. Second, it is highly questionable that there is
really any such thing as non-directive therapy. The term non-directive is a
A therapist should be fairly non-directive in the
therapeutic process, often quite directive with regard to the methods used in a
session, and as non directive as possible with regard to the interpretation of
the material which arises during a session, and quite directive in the issues
of safety and best interests of the child.
Therapists who call themselves non-directive or
client-centred are often only non-directive in terms of what they do in a
session. They suddenly become very directive in interpreting and analysing the
client’s inner world and reflecting back to the child.