"What if He Will Not even Let Me Relate to Him?"
us begin by considering those children referred for Theraplay who clearly try
to escape relating to their therapists. They may do this through refusal to participate,
appealing to others, attempting to attack the therapist, or trying to run away.
They may attempt to hurt themselves, become hyperactive or bizarre, go limp, cry,
or masturbate. These behaviors, if left unchecked, interfere with, or altogether
preclude, an intimate relationship between therapist and child, at least in the
immediate future. (Traditional forms of child psychotherapy may indeed advocate
the therapist's acknowledging the child's uneasy state of mind, but in general,
except for reflecting his feelings or interpreting his underlying wishes, fears,
and impulses, they encourage him to move at his own pace.) Theraplay may acknowledge
how the child is feeling but seldom allows him to move at his own pace. The Theraplay
therapist, on the contrary, rather than "permitting" the child to remain
in his private world, insistently tries to extricate him from it. The Theraplay
therapist, rather than acting as though he were another (albeit healthy) part
of the child's inner self, persists in making his unique, differentiated presence
felt. Like the autonomy-enhancing parent, the Theraplay therapist puts a stop
to "unhealthy" behavior. The therapist in the Theraplay session actively
prevents the child from being hyperactive, from running away, from hurting himself
or his therapist, from angrily withdrawing, and from behaving peculiarly. The
Theraplay therapist always repositions the child so that there can be good eye
contact and so that the activity can be redirected toward self-esteem and fun.
if He Particularly Resists My Nurturing and Indulging Overtures?"
of children denying their need for nurturance are included in the list of clearly
recognizable escape maneuvers. Particularly characteristic of these children is
the intensity of their drive. Unhindered, they either hit hard, curse loud, withdraw
angrily, and run fast, or they ceaselessly reason, argue, and debate. The Theraplay
therapist, always in the spirit of fun, must often be as loud, as hard, as fast,
or as immune to legalisms as they are legalistic. Because "saving face"
is so especially important to these children, nurturing activities should be offered
both imaginatively and playfully. Baby bottles, for example, could be used first
for squirting the milk from a distance in the manner of a competitive sport.
often than not, Nurturing is a most effective form of Theraplay, not only for
little boys who make experienced sexual overtures or verbalize obscenities far
beyond their years but also for flirtatious little girls with precocious come-ons;
for both, baby food feeding, soft blowing, rocking, and nursing bottles are appropriate
"What if He Particularly Denies My Efforts
Behaviors of children denying their need for structure
tend to be more subtle, more adept, more beguiling. Before the therapist has had
a chance to recognize how it happened, for example, the child has rearranged the
rules. Since the value of Theraplay for a child who does this lies in his being
the recipient of someone else's rules and structure, the Theraplay therapist must
be constantly in control and vigilant of the child's efforts to defeat him. Children
who deny their need for Structure may do so by (1) attempting to take the initiative,
(2) defying the therapist, or (3) "engaging" him. Initiating may include
telling the therapist what to do or deciding what he himself will do. Defying
the therapist includes countering the therapist's suggestion with one of his own
or, in response to a therapist-initiated activity, pleading pain, incompetence,
boredom, or obedience ("My mother won't let me"). "Engagement"
includes "cute" behavior, scintillating discussion, insightful observations,
scholarly questions, and bringing toys, books, or food from home. Any experienced
child therapist will quickly recognize how difficult it is to resist and divert
these maneuvers. Indeed, traditional child therapy may capitalize on them. Seen
by traditional therapists as expressions of the child's real inner life, these
behaviors are often utilized as the key to further exploration of fantasy, wish,
dream, and memory. The Theraplay therapist, however, views these maneuvers as
tactics employed by the child who, fearful of giving himself over to someone else's
lead, uses these ways to maintain his familiar position of vigilant control over
himself and his world. The therapist, having recognized the maneuver, must insist
on staying in charge. Even at the risk of invoking a temper tantrum, he must "stick
to his guns." Although he must not do this cruelly or arbitrarily or inappropriately
with regard to the child's capacities, he must try his best to be firm and consistent,
yet patient and kind.
1. Initiative. In the event that the
child initiates what the therapist was about to do anyway, the therapist must
quickly change his own plan or at least be prepared to modify it.
Defiance. If the child defies the therapist by resisting or challenging the initial
therapeutic overtures, the therapist must nonetheless persist. He should get caught
up neither in arguing nor in defending his position. "This is what we're
going to do today," he says, "so let's get started." The temper
tantrum results when the child is confronted with demands obviously at odds with
what he wants at that moment. The therapist must stay with the child through the
tantrum and not allow it to dissuade him from his plan for the therapy. While
flexibility, spontaneity, and alertness to cues coming from the child are important
ingredients of the Theraplay therapist's behavior, these should not be used as
crutches to avoid unpleasant confrontations with the child. There is no need for
discussion, apology, or backing off, nor does Theraplay subscribe to sending the
child off to a room to reflect on his behavior. Rather, the issue stands, the
tantrum having persuaded no one. The therapist assures the child that he is right
there with him (thereby letting him know that he is "safe" and that
this behavior does not make him "bad"). He communicates that he will
hold him firmly if he is in danger of hurting the therapist or himself, and in
the meantime he acknowledges that this state of things has its painful aspects
for which he (the therapist) can provide relief.
The word "engagement" has been placed in quotes because it represents
resistance rather than genuine engagement. Its motives are not to enjoy the company
of the other, but to make him a slave. "Engagement" consists of flattery,
of offering interesting discussions, humorous anecdotes, news items, fantasy or
dream revelations, and questions. The "engaging" child is irresistible-every
child therapist's model patient. It is far easier for the therapist to respond
to the proffered goodies than to persist with his original intent by ignoring,
changing the subject, deflecting the theme, and so on. The skilled Theraplay therapist
expects the "engagement" play from particular kinds of patients and
thus is prepared, gently but firmly, to regain the structuring position.
Jernberg, Ann, Theraplay: A New Treatment Using Structured Play for Problem Children
and Their Families, Jossey-Bass Publishers, San Francisco: 1979.
Reflection Exercise #4
The preceding section contained information
about how a child resists a play therapist. Write three case study examples regarding
how you might use the content of this section in your practice.
Peer-Reviewed Journal Article References:
Meany-Walen, K. K., Cobie-Nuss, A., Eittreim, E., Teeling, S., Wilson, S., & Xander, C. (2018). Play therapists’ perceptions of wellness and self-care practices. International Journal of Play Therapy, 27(3), 176–186.
Turner, R., Schoeneberg, C., Ray, D., & Lin, Y.-W. (2020). Establishing play therapy competencies: A Delphi study. International Journal of Play Therapy, 29(4), 177–190.
Winburn, A., Perepiczka, M., Frankum, J., & Neal, S. (2020). Play therapists’ empathy levels as a predictor of self-perceived advocacy competency. International Journal of Play Therapy, 29(3), 144–154.
Online Continuing Education QUESTION
Children who deny their need for structure may display what behaviors?
Record the letter of the correct answer the .