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.  

First Principles

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 the teachers.  

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.  

Avoid Dogma 

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 Toolset

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 emptiness.

Historical Background

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.  

Pioneers and Relationship Theories  

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 adopted son.  

Melanie Klein (1932)

Incorporated play into her sessions with children as a lure into therapy.    

Structured Play Therapies (late 1930s)

Used play therapy as a direct substitute for words. Common factors:

  • 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 human development. 

Jessie Taft (1933) & Frederick Allen (1942) & Clark Moustakas (1959)

Adaptations of Rank’s thinking to work with children in play therapy.

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 psychoanalytic theory.  

Levy (1938)

Developed release therapy to deal with children with specific trauma – made materials available to re-enact the trauma.  

Soloman (1938)

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.  

Hambridge (1955)

Set up play much like Levy, but was much more directive. Directly recreated the event in play to aid the child’s release.    

Client Centered Approach

Carl Rogers Developed this approach for therapy with adults.  

Virginia Axline  

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 self-improving growth. 

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.  

Limits

Bixler (1949)  

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 to:  

  • Destroy any property in the playroom other than play equipment
  • 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.    

Recent Influences

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  

Axline's Basic Rules

Since much of current play therapy practice is based upon Virginia Axline’s work it is worth quoting her basic rules.  

The therapist:  

Must develop a warm and friendly relationship with the child.

  • 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.  

Directive v Non Directive Approaches  

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 misnomer.    

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.

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