Play Therapy for Children Ages 3-12

Introduction

Over the last century, play therapy has gained popularity in the field of medicine as a healing and therapeutic tool. Such credence resulted from numerous studies and researchers, which each time resulted in positive outcomes. During that period, play therapy was proved to be quite efficient in most of the cases, where one of the few critical concepts on which play therapy was focused on being “a primary means through which children experience and “make-meaning” (Urquiza, 2010, p. 4).

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Owing to the fact that play therapy is focused on the exploration of children’s simple forms of communication in their natural environment, a special interest in the subject’s content was developed, in order to establish its similarity and contrast with adults’ styles of communication. Such notion was derived from the basis that, the effectiveness of play therapy is nearly matched to that attained by verbal communication psychotherapy among adults.

It can be stated that important part of a child’s life are formed by the process of play therapy, mainly through the expansion of the range of the child’s options, when using different objects creatively. For example, children usually stumble upon new meanings of the environment around them as they play with toys, dolls and teddy bears. When these objects are manipulated in play, children discover the meaning of different actions and find meanings of words among themselves just as adult do understand the meaning words used in their vocabulary and translate them into actions. Therefore, it is generally believed that play is the children’s means of communicating with therapists.

There are various good benefits and advantages associated with play therapy, as indicated by various independent empirical researches. The list of researches related to the aforementioned field include such authors as Anna Freud and Melanie Klein, who are considered as the originators of play therapy, Virginia Axline (D. C. Ray, 2006, p. 136), as well as various associations of play therapy, among which is the Association for Play Therapy (APT), which “established play therapy as a specialized treatment modality within the field of mental health” (Bratton, Ray, Rhine, & Jones, 2005, p. 377). Accordingly, it can be stated that the validity of these and other researches is dependable such aspects as the methodology used and applicability in child therapy.

A positive correlation between play therapy and children’s healing or restoration was shown in a number of cases and studies, where it was found through a review conducted to assess the efficiency of 93 controlled outcome studies between 1953 and 2000 that play therapy was a statistically viable intervention (Bratton, et al., 2005). Hence, it can be stated that the main focus of play therapy is in addressing various problems encountered by children, their families and their communities.

The interventions proposed through play therapy were found to offer therapy to children suffering from posttraumatic stress, chronic illnesses, e.g. diabetes, autism, grief, and depression (Jones & Landreth, 2002, p. 117). There are other areas of successful application of children play therapy, such as helping children build resilience and adapt to stressful conditions and completing restitution from post traumatic stresses, which were caused by a loss and/or domestic violence.

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In most recent observations, it was found that the list of applications of child play theory is topped by cases of children’s’ sexual abuse and in cases of homelessness (Ciottone & Madonna, 1996, p. 78). In such studies the researchers are able to better comprehend the prevalence and importance of problematic events on children. Since the successes of these cases are connected to a close bond between the patient and his/her therapist, establishing a god rapport with the child in the first few minutes of the conversation is critical to successful treatment of the child. Essentially, play therapy is a means of creating a close association between a therapist and the child in order to facilitate healing.

Accordingly, the ambiguities, associated with subsequent adoption process, are to be broken through such associations, specifically in terms of overcoming the adverse experiences faced by the child (Jones & Landreth, 2002, p. 117). Additionally, an important role of play theory can be seen through its positive contribution to children growth and development is (Daniel, 2008, p. 19). During play, non-verbal signs are used by children to pass messages. With a good supervision by therapists, better understanding of the surrounding is developed, as children are in a better position for rehearsing their hidden or explicit emotional adaptation and social skills.

In many of play therapy techniques, dated back to 1900s, play is depicted as a tool for aiding the healing process. Additionally, major contributions in the play therapy field include the 1900s development by Sigmund Freud. These developments were popular in the beginning of last the century, although these developments would be later modified by Anna Freud. Other major contributions to the field of play therapy can be seen through the works of Klein Melanie and Virginia Axline. Both scholars explored the application Gestalt theory and found play therapy beneficial for children, both at home and at school, without significant variations.

There were other approaches, however, which were founded upon the concept already in use, borrowing their main principles and theoretical frameworks (Daniel, 2008, p. 19). Some approaches, such as the psychoanalytic therapies, were based on intensely designed theoretical ideologies with prepared training and performance execution, while for others, like the structured therapies, further explanation is required. Although in some aspects those approaches might be perceived as complex, they are nevertheless realistically applicable in play therapy (Jones & Landreth, 2002, p. 119).

Brief Historical overview

Play therapy is an essential concept in the treatment of children. In particular, the therapy can be considered useful in cases where children’s awful conditions of emotional distress are addressed. Children are seen as the helpless part of the human community, for whom special care and attention is needed. There are more reasons to support the implementation of play therapy and its high level of acceptance today than in the 1900s. The main reason might be seen in the availability of evidence-based studies, which are focused on children, especially in terms of the practical aspects of play therapy (Bratton, et al., 2005, p. 376).

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Despite the existence of historical aspects, which might be considered particularly important to the advances in the field of play therapy, the focus of the literature review shall be on the major developmental stages, exemplified in attempts to advance the theory of play. There are six major stages through which the processes of play therapy are described, namely in terms of their applicability to the subject of early childhood development (D. Ray, Bratton, Rhine, & Jones, 2001, p. 86).

The first stage, known as the psychoanalytic intervention, was dominant in play therapy aspects of child development in the 20th century. According to its founder, Dr. Sigmund Freud, children skills and interests can be identified through the utilization of the psychoanalytic approach in a very short span of time. For instance, in play therapy, children’s awareness and curiosity can be easily stimulated by various actions, which can be can be seen as a prerequisite of psychoanalysis. It is suggested in this model that psychotherapy assessment is useful as an intervention for managing some health related problems in children. The turning point for the popularity of such theory was soon after the model was developed in 1903.

Anna Fraud was one of the founders of the psychoanalytic theory along with her father. According to their psychoanalytic theory, play’s value was perceived as emotional, through allowing the reduction of anxiety in children (Hughes, 1999, p. 24). Along with Freud, Melanie Klein was also among the contributors to the psychoanalytic approach toward play theory. The mutual points in the works of Freud and Klein can be seen through the focus on free association, as one of the basic precepts of adult analysis, and as a substitution of child’s natural tendency to play (Gil, 1994, p. 6). In the psychoanalytic approach to play therapy, the emphasis is put on the therapist’s ability to interpret the symbolical child’s play to “manifest internal concerns” (Gil, 1994, p. 7).

The role of the therapist can be also seen in the identification of the source of the prevailing condition and the focus on the experiences of the children. Such approach can be implemented through children’s participation in artistic games (Bratton, et al., 2005, p. 379). It can be seen that the foundations of Sigmund studies on children’s play were used as the background of subsequent studies by Anna Freud, Melanie Klein and other prominent researchers and play therapists. The success of this stage in Early Childhood Development (ECD) and play therapy is equally accountable for other contributions, some of which were not related to Sigmund’s early work (D. Ray, et al., 2001, p. 86).

It was noted that in certain cases many of the psychiatric disorders were the outcomes of conflicting unconscious thoughts, and that these problems were solvable. The most likely outcome from playing is reinforcement of children’s thought processes. When children play under unrestricted conditions, the child’s consciousness to express his/her earlier incidences is inflicted by the therapist’s presence. In such cases, the therapist has the ability to examine the child and recommend an appropriate therapy model (Bratton & Ray, 2000, p. 48).

The role of interpretation in 1930s was found to be insignificant, an aspect that can be seen through the works of Solomon and Hambidge. At that time, it can be stated that the focus was shifted toward structured therapies. The differences in the structured therapies can be seen in the way the expression of fear and rage by a child, without negative consequences, has a healing effect. Additionally, the usage of toys in enacting the child’s trauma through play as argued to have healing effects as well (Gil, 1994, p. 9).

An important contribution to the field of play therapy was made by the relationship therapy, in which the main aspect was the emphasis on the expression of feelings in play and the relationship between the child and the therapist, which was pioneered by Clark Moustakas. The significance of the relationship theory can be seen through the emphasis on the experience between the child and the therapist (Moustakas, 1992). Additionally, such approach was also advanced through the works of Taft and Allen, based on studies carried out by Leblanc and Ritchie. According to Leblanc and Ritchie (2001), there was no need to emphasize on the past or the unconscious, but rather the emphasis should be put on the significance of the relationship between a therapist and his/her client(s) (Leblanc & Ritchie, 2001, p. 149).

The client-center model of psychotherapy, which can be seen as the foundation of the non-directive therapy, was advanced by Carl Rogers. The underlying concept of this therapy was centered on the children inner ability to develop self-response mechanism to social changes in their environment. Influenced by Carl Rogers’ approach, Virginal Axline, a student of Rogers, was the first to start applying these client-centered principles on children during her works in a non-directive manner. The main points in such approach were in the statements that children struggle to grow and attain individual capacity of self-control, awareness and self-direction (Scott, Burlingame, Starling, Porter, & Lilly, 2003, p. 7).

The relationship theory was followed by the behavior theory, which main elements were derived from the learning theory. The behavior theory was perceived as a radical shift in the theory of psychoanalysis, where the roots of the theory can be found in the utilization of the findings of Hullian learning theory and Pavlovian experiential research by Joseph Wolpe, Arnold Lazarus, and other others, in cases with phobic clients (Jordan, 2008, p. 107). Those works were followed by the contributions of Albert Bandura, based on which several cognitive behavior approaches were developed in the 1970s. The main concern of the behavior approaches can be seen through the focus on problematic behaviors, in which play therapy was used to trace the causes of such behavior in children.

The work of Axline, and the non-directive approach might be separately emphasized through its usage in the works of Gary Landreth. Based on the view on play therapy as a living relationship in Axline (1969), in which such process was defined as “one in which the child plays out feelings, thus bringing them to the surface, getting them out in the open, facing them, and either learning to control them or abandoning them when appropriate” (Landreth, 2002b, p. 530), Landreth expanded on the theory of play therapy through the introduction of a new model.

Such model expanded the basic principles of Child Centered Play Therapy (CCPT) and filial therapy, conceptualized by Louis Guerney, into a 10-session model titled, Child-Parent Relationship Therapy (Drewes, Carey, & Schaefer, 2001). Accordingly, a brief review of Axline’s approach and the CCPT concept might be required.

Virginia Axline Techniques

As a student of Carl Rogers, and later a colleague, Virginia Axline had a better experience in the person-centered therapy, established by Rogers. The non-directive therapy can be seen as an extension of the latter, where the lead of the child was followed. The application of such approach with children was through non-directed play, i.e. the decision of what toys and activities to use was the initiative of the child without the influence of the therapist. In child-centered approach, the therapist does not control or influence child’s choices, likes, thoughts and feelings.

The arguments of such approach in that the behaviors of children are developed because of self-realization at a tender age (O’Connor & Braverman, 2009, p. 123). The children are in a better position to make important decisions and develop their own resolutions, when their feelings are expressed freely. In a therapeutic context, non-directive play allows the child to re-experience the un-pleasant situations in a manner that “will release the child’s inner directional, constructive, forward-moving, creative, self-healing power” (Landreth & Sweeney, 1997, p. 17).

In that regard, non-directive play can be used as a mediation technique, in which the child becomes the mediator for change. Such approach was investigated in cases in which the mediation was concerned with the effects of domestic violence, where the study was found to be successful (Scaletti, 2005).

Axline’s contribution to non-directive play therapy can be traced to her list of eight basic principles were developed as a guidance to play therapy. The principles included in the list were merely operational guidelines for therapists to follow, with practical directions such as the ability to establish a friendly relationship with the child, the acceptance of the child without prejudice, the progressive creation of a feeling of tolerance, and the identification and reflection of these feelings back to the child, in order to get insights into his/her behavior. Further principles include the respect for children’s capacity to resolve personal problems, and the identification of the responsibility for adjustment in the child’s environment.

The principles’ precautions include the avoidance of attempts to direct the client/child to rush the procedures and to establish the limits that can only secure the session to world of reality. Those principles are focused on the creation of awareness among the children, concerning their own responsibility (O’Connor & Braverman, 2009, p. 123). It should be noted that despite the fact that the aforementioned principles were developed over 50 years ago, they are still practically relevant today.

The concepts of CCPT were derived from customer-centered approach, which was developed by Axline and further expanded by Landreth. The model advanced by Axline entails the presence with the child under therapy as opposed to influence over children’s actions (O’Connor & Braverman, 2009, p. 123). The specific objective of the approach is to set the targets in a safe environment, in which children are able to express themselves freely. As children are encouraged to verbalize their experience, their decision-making skills are improved.

The children are to be treated without any specific conditions, related to their behavior or their medical history. Through the examination and treatment process, children use dolls, toys and puppets to express their thoughts or feelings. When children communicate through play, the role of a therapist is to help them feel better, since their feelings are in tune with their characteristic behavior (Scott, et al., 2003, p. 12). There are four major therapeutic messages for the children, which include the assurance of the presence with the child, to make the child feel that he/she is in a central position in the session. Accordingly, one of the main points is for the child to acknowledge that he/she is listened to.

Furthermore, the therapist must express care and show deep and sincere sympathy for the child. During the child-centered processes, the child is allowed to lead discussion, in which the therapist would follow (Leblanc & Ritchie, 2001, p. 152). Play can be perceived as a tool for the therapist, through which better outcomes can be achieved, since play enables the therapist to understand the experiences that the children go through. In that regard, diagnostic analysis is preceded by the identification of children’s needs (Daniel, 2008, p. 19).

The major stages, evident via the play therapy include:

  1. the exploratory phase,
  2. the aggressive phase, and
  3. the dramatic phase.

The exploratory phase is the period when children are non-committal; they are more creative and quite inquisitive about playing objects. In the aggressive phase, the child under psychotherapy may articulate or take actions about their feelings, related to their family, a situation or even self (Bratton & Ray, 2000, p. 76). During the dramatic phase, children are able to communicate their anxieties, fears, and the relationship play.

As stated earlier, in relationship play, the emphasis is put on the relationship between the psychotherapist and the child. A close relationship is developed between the child and the therapist, which is eventually turned therapeutic in nature (D. Ray, et al., 2001, p. 88). Children deal with their emotional experiences and thoughts through the symbolism of the playing objects. Accordingly, the latter results in that the gap between abstract thoughts and real experiences is bridged (Bratton, et al., 2005, p. 145). In that regard, the children are able to convert some unmanageable things to manageable – symbolically.

Two types of plays might be created in a non-directive play therapy, adjusted and mal-adjusted. In adjusted play, it is implied that the child plays freely and spontaneously, with a wide variety of materials at his/her disposal to their activities. In such way, the child will be comfortable in the process of playing with the therapist present as well (Leblanc & Ritchie, 2001, p. 152). Children make independent choices, and in this case, the act of playing is self-initiated as the sense of independence and self-control is demonstrated through the expression of emotions and thoughts. A particular way of disclosing children’s dilemmas is formed through play, through which expressions of feelings exhibited (Ryan & Needham, 2001, p. 438). In that regard, adjusted play is deemed as a non-repetitive form of play, associated with fantasy.

Nonetheless, when the child’s play is maladjusted, characterized by post trauma, the child in question will play carefully and deliberately. Intense feelings, repeated disruptions, fantasy generation, and conflicting themes might be displayed during the playing process. In such cases, children might become highly reliant on the therapist and demonstrate high anxiety during the therapy process (Landreth, 2002a, p. 25). The experience of maladjusted type of play might show low autonomy sense and poor decision-making skills by children. Additionally, these children might show intense emotional reactions and a limited emotional range. The maladjusted play, therefore, tends to be more repetitive as well and more fantasy is enjoyed (Daniel, 2008, p. 19).

The main differences between the two types of play can be seen through the intensity and extent of play, rather than children’s attitudes. However, the expression of a negative attitude is common among children in the maladjusted type of play. When the play session is chaotic, characterized by negative activities, the maladjusted character in a child will be expansively depicted through such chaotic and negative characteristics.

Nonetheless, the difference is formed through the time and intensity of play, where the child can shift between those two types. The latter accordingly implies that the two types are observable intermittently. Contrary to the objective-oriented counseling, which goal is aimed at completing the duty with the acknowledgement of the need of an instantaneous environment, play is inherently absolute. The latter is not relied on the external compensations, incorporated into the world to match children’s perception about play.

In general, there are several rules proposed by Axline that are characteristic of her non-directive approach. It should be acknowledge that mainly these rules guide the practical aspects of play therapy, rather than the theoretical. In that regard, a common point in the criticism in regards of CCPT can be seen through the lack of theoretical links through which the relationship between the therapist and the child is explained (Phillips, 2010, p. 21).

The latter can be contributed mainly to the lack of the description of the procedures performed during the child-centered procedures by researchers (Baggerly & Bratton, 2010, p. 34). The main points in Axline’s approach are focused on the development of warm and friendly type of connection between the counselor and the child, in order to enhance their expressions. Additionally, there is a need for the therapists to accept the child as he/she is and/or present themselves to be; the therapist should show a feeling of approval of child’s actions so that the child is able to express him/herself freely.

The therapist should also remain vigilant so as to realize and recognize the child’s emotions and then reflect on them in a way that the child will find it easier to gain an insight into his/her behavior. The therapist has to desist from attempts to manipulate, direct, or rush the activities of the child. Therapy is a gradual process and as such, attempts to rush it would only bring in limitations, which are difficult to overcome in practice.

Gestalt Play Therapy Techniques

The development of Gestalt theory can be mainly attributed to studies in the development of children and the evolution of play undertaken by Laura Perls, Fritz Fredrick Perls and Paul Goodman in 1940s. As it will be discussed in the present section, their theory was found to be egocentric in its approach (Blom, 2006, p. 46). In such approach, self-consciousness strategies, during the interaction between the patient and the therapists, were encouraged.

In that regard, there are many aspects encompassed in the theory itself, although the main focus is put on the responses of the child toward variations in play situations. Contrary to the usual attitude of environment interpretation, the main considerations are directed toward any changes in behavior, from exposure to other conditions. The main aim of Gestalt approach is to allow clients to become aware of their activities, where they can find out how to change them, and at the same time learn, acknowledge and value themselves (Blom, 2006, p. 46).

Gestalt therapy is based on creativity and art that encourages awareness, responsibility and insight into the child’s attitudes, via direct and genuine communications between the counselor and the child. The therapist acknowledges the feelings of the child and complements his/ her actions in order to maintain an interactive session. Active participation is encouraged in this type of therapy, where the child should be aware of his/her problems and then develop a clear understanding from the event (Blom, 2006, p. 46). With the guidance of the therapies, the methods used are derived from the context, aimed to expand awareness, freedom and creativity (Jordan, 2008, p. 84).

Gestalt theory can be perceived as a humanistic approach in the therapeutic application of play, specifically in cases of children suffering from trauma, stress, chronic diseases and depression. Fritz Perls was among the first pioneers of child therapy in the 1960s. Perls’ model was advanced faster and became more directly applied in practice. The objective of the shift was to ensure that children are able to learn from the experiences they gone through. Similarly, the children should acknowledge the elements of their personalities, depicted by their feelings, from their original deprivations (Blom, 2006, p. 48).

Human development is viewed in Gestalt therapy as a process that involves the movement form support on the environment toward self-support. Accordingly, the Gestalt developmental assessments were of great importance in guiding the interactions between children and therapists (Woldt & Toman, 2005, p. 156). In that regard, the therapeutic nature of the implementation of Gestalt theory is based on the belief that children are fundamentally healthy, while any symptoms shown can be seen creative adjustments to challenges without creative support. The role of the therapist is in the identification what supports are absent, and how these supports can be provided (Woldt & Toman, 2005, p. 158). Despite the increased role of the therapists in the therapy, the main emphasis is placed on the child’s individual responsibility (Blom, 2006, p. 56).

Gestalt therapy was mainly focused on procedures, i.e. what is going on, rather than on the content, i.e. the matter under discussion. Nevertheless, as the popularity of the model increased in the 1970s and the 1980s, a re-alignment was reached with academic curricula. Such re-alignment was found applicable in psychotherapy and organization.

It is pertinent to recognize that in Gestalt therapy it is acknowledged that individuals usually suppress or retrain some of personality elements at some point in life, because such attributes are not acceptable by the society. In the regard, the latter might contribute to the fact that some of the children’s emotions remain unnoticed, and thus, their issues remain unresolved for so long. The application of Gestalt therapy is found helpful in the explanation of such unfinished business (Ogawa, 2004, p. 19).

One of the main techniques, commonly used in the application of Gestalt therapy, is the empty-chair procedure. Such technique is used to assist the child in self-exploration. The requirements for such procedure imply that the therapy room should have an extra empty chair. During the visits to the therapist, the child is tested on the way the exploration in child’s mind takes place. Primarily, the virtual role is made significant in role-play as the therapist is able to gain an insight into the child’s cognitive processes.

When the child speaks to a virtual person on the empty chair in the presence of the therapist, the child is conscious enough to consider the previous questions asked by the doctor in the process of conversation. Additionally, the child might attempt to project the actions or the dialogues of the virtual person on the chair. The advantage of such technique is that it allows the person to develop an integrated character.

The “I” Language is another technique, which is considered effective in therapy. The implementation of this technique implies the dialogue is spoken from a first person perspective during the therapy. The references in second person perspective – “you and your” are replaced with the word “I” in the sentences that the children make. In particular, such technique is found helpful developing personal accountability in child’s feelings, thoughts, and associated actions. Such aspect leads to children working on their emotions immediately (Ogawa, 2004, p. 21).

The third technique is revolved around the implementation of “Incomplete sentences”, which can be used to assist children to converse their feelings and emotions. Children are given the opportunity to realize how they help or cause harm to themselves. For instance, the usage of lines such as, “I am able to assist myself when I___________________”, or “I can adversely hurt myself in the event that I__________”.

Finally, Bipolarities is another technique that might be used to help children gain awareness. The top dog and the underdog tactics are the most common elements of such technique. The top dog is defined as a righteous person and an authoritarian investigator who know things best (Ogawa, 2004, p. 21). In the underdog design, the individual is allowed to manipulate others through active, self-protective or apologetic actions, where phrases are used such as, “I worked hard to”, “I want…”, or “I try so hard…” The top dog, on the other hand, takes the role of a bully, using phrases that place the responsibility on others. For instance, “you should…” or “you do not have to…”

Several important dysfunctional boundaries were identified through Gestalt model, which include confluence, retroflection, projection and introjections. Since such boundaries form the core of the problems, they might assist in developing solutions from the therapy approaches, according to Gestalt theory (Josefi & Ryan, 2004, p. 534). Confluence in Gestalt approach is apparent in cases when the child tries to pretend that there are no differences existing between different people or different systems. The role of the therapist in Gestalt model is to help the patient distinguish personal needs from separate needs of a confluent association (Wilson & Ryan, 2001, p. 210). Such separation allows the child to attain awareness, and thus, the child is able to work out his/her problems. Other approaches include introjection, projection and retroflection.

Compare and Contrast: Child Centered Vs Gestalt

The functions of both approaches are based on the argument that play serves as a communication process, in which full expression is allowed, according to the way children think and act. Both approaches are critical in the solution offered to the healing process, especially when the prevailing situation is the one that caused both physical and emotional pain (Carroll, 2002, p. 178). The approaches are overlapped in the time span of their research and development.

Carl Rogers, for instance, concluded his study about child-centered therapy in 1951, based on the works that he begun in early 1940s. His works were mainly concerned about the “client” and the process, as they had the main responsibility to guide the process of therapy. Virginia Axline assisted in the development of this approach as well, with her main contributions are in applying the theory in practice with children. The Gestalt therapy, on the other hand, was also developed in1940s by Fritz and Laura, and its key focus was on the “relationship” between the client and the therapist (Josefi & Ryan, 2004, p. 534).

The child-centered approach, as explained by Axline, is based on the fact that similar to adults, children have inalienable autonomy; they can establish relationships that should not be interfered. According to such approach, children are able to express themselves freely through exploration, where the therapist is allowed only to show his/her interest.

The key concept in Gestalt therapy is in the phenomenological means created through awareness. Trough awareness, observation, performance and emotions are differentiated from deducing and rationalizing the preexisting attitudes. The main issues are derived from observation, with the client in focus, rather than, interpretations and explanations (Carroll, 2002, p. 178). The latter implies that communication motivation perspectives.

Such differences in perspectives become the center of the process of therapeutic intervention as the dialogue proceeds. The main objectives of the intervention are to allow the child to become aware of his/her actions and the way those actions are performed as well as to learn how changes are implemented and accommodated. Accordingly, the self-awareness of the child should be learned to be shown (Josefi & Ryan, 2004, p. 534).

In child centered therapy, the way a child feels and acts reflects the child’s beliefs and the ability to respond to therapy to certain limits. The focus of the child-centered model is aimed at the child’s immediate actions, experiences, thoughts and feelings, in which the therapist does not interfere in any way. Children have to figure out the aspects learned on their own, where after several attempts they should achieve a breakthrough, after which these aspects will be mastered with time (Guerney, 2001, p. 16).

In that regard, the child is enabled to gain control over his/her frustrations, since the struggle are equally compensated. Gestalt theory helps to create awareness in a phenomenological manner. Thus, the Gestalt approach depends more on the process of therapy to generate results and draw a concise analysis, rather than the actual conversation. The emphasis is on what is being carried out, the thoughts and the emotions at that particular moment, instead of ‘what could have been?’ and so on (Wilson & Ryan, 2001, p. 210).

Both models have unique advantages, which are exclusive for each of them, while there are also some mutual advantages, which are applicable for play therapy models collectively (Guerney, 2001, p. 16). The major benefit from the application of the Gestalt model is that the procedure provides the child with the ability to independently and freely select his/her options, a greater liveliness and improved physical and mental wellbeing. Gestalt theory also contributes to the knowledge about life transformations through enhanced survival techniques. Gestalt approach is also applied in schools, due to its compatibility with the principles of the holistic approach in counseling.

Such approach is commonly used in school settings, with the cognitive, religious, physical and expressive processes recognized and acknowledged (Carroll, 2002, p. 178). Gestalt theory challenges the individual to be more responsible and become aware of their personal process though the emphasis on empowerment (Guerney, 2001, p. 16).

Child-centered approach is vital through its focus on the dev elopement of the child’s independence, regardless of the environment the child is set to face, e.g. at home, at school or at other social places. The children practice how to exercise self-control and master their character, sentiments and thoughts. There many problematic conditions in life, to which children are exposed. In that regard, the main aspect in healthy living is how these children deal with such situation (Guerney, 2001, p. 16).

Thus, it can be stated that the child-centered approach is outcome-oriented, where the progress or the improvement observed are evaluated from the time of the beginning of the play therapy and then at its end. The child-centered model is effective in treating several conditions in childhood (Bratton, et al., 2005), where play therapy had a success in the treatment of children of alcoholic parent, those with chronic illnesses, those stressed and those suffering from grief and trauma (Carroll, 2002, p. 178).

Implications

Playing is an essential part of a children’s activity during their growth and development process. Children who undergo play therapy are able to learn easily how to manage their emotions, whenever they experience the same in traumatic events. Play therapy as a general concept can be differentiated, in terms of the theoretical advances, which are currently applied in clinical practice for children (Dripchak, 2007, p. 126). Such diversity reflects the idea that there are many therapeutic transformation mechanisms intrinsic to play. In that regard, the approaches presented in the paper can be utilized in different setting s and different purposes.

Playing with objects, for instance, provide children with safer therapeutic environment, in which they are allowed to make discoveries about themselves and establish situations that foster recognition and nurturance. The unique modality can help to establish a new world for children, in which resiliency, regulation and the child’s sense of protection and adaptableness are promoted (Costas & Landreth, 1999, p. 42).

The children through play can explore their own abilities as well as other objects through uncomplicated and non-objective oriented play repetitions. Infants might play by themselves or with their toys, while toddlers, on the other hand, might engage in play through their presence besides other children and without direct participation (Davenport & Bourgeois, 2008, p. 4). Such form of play allows toddlers and infants (about the age of three years) to learn how to concentrate, build up social capabilities and intellect.

Through playing, preschool children are able to nurture and refine their motor skills, enjoy mastery of concepts, learn and develop simple educational skills like drawing, counting and reading (Daniel, 2008, p. 19). Play therapy for elementary school children, on the other hand, might be helpful in their involvement in formal and non-formal games with their friends, where children will explore and make their own playing activities because of improved cognitive ability.

Conclusion

It can be stated the components of cognitive development are shown to be connected to play, e.g. problem solving skills, academic achievements, competence in social and linguistic skills and representation capability (theory of the mind). Play allows children to consolidate other elements of life together in their own way and according to their simple experience. In that regard, the utilization of play theories in psychotherapeutic work enables approaching the issues of concern from a different perspective. In that regard, the spectrum of play therapy benefits is sufficiently wide to be used for many aspects and in different ways.

The context which was presented in this paper was mainly focused on children, and thus, the application of such therapy has benefits on several dimensions. The utilization of play situations allows the therapists to identify the causes of poor academic performance, aggression, traumas, and other problems. It should be noted that play therapy is also used as a method for intervention, where the problems are not only identified, but also solved.

Even though the type of play is usually varied according to every child, the common play therapy is the child-centered technique which was discussed in the paper. The major elements of such therapy are there environment in which play takes place and the type of relationship the therapist is able to build with the child. Healing from chronic illness is also supported by such approaches, since they utilize a holistic strategy.

The importance of play is acknowledged on the children’s cognitive level, where the children’s tendency towards play is associated with creativity and imaginative thinking in life. Play is also an integral part in the education setting as it enables the school to meet the emotional and social development needs of the children. Children adjust to school setting faster when playing is essential part of the curriculum. Thus, it can be concluded that play is an important aspect in children’s development process, and thus, the utilization of play in therapy is a confirmation of a successful implementation of the therapeutic powers of play in psychological purposes.

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