A Constructivist Approach to Child-Centered Play ...

7 ro A Constructivist Approach to

Child-Centered Play Therapy

Richard E. Watts and Yvonne Garza Suppose you, an adult, went to see a therapist for help with a U.ULJ~""U, Suppose your visit to this therapist feels mandated and, for &cpU""

beyond your control, you have no choice over which

WUJ""~'''H you get to see. This would be difficult enough for most

Now suppose that this therapist, during routine intake discovered that you have a basic knowledge of and with a second language. You can speak well enough to "get by" 1ISing this second language, but cannot communicate with the level of comfort or emotional depth that you can with your first language. 'o;UT\nn"", that this therapist, having discovered your facility with a second language, announces that you may only talk with him or her in your second language. There you are: little sense of control over being there with this stranger who demands that you discuss difficult, personal, emotion-laden content using your second language. How would you feel? Angry, intimidated, and scared are a few feelings that come to mind. One would certainly not feel invited to engage in a fruitful therapeutic process given such a scenario. Yet this is exactly what happens to youn& children when they are required to sit in a chair and do "talk therapy' with an adult therapist. This is true even when we use toys and play media with young children as a means of "getting them to talk" about their problems. Most young children do not have sufficient cognitive development and expressive language skills to clearly express themselves. They typically are much more comfortable using toys and play media to express themselves. Play therapy allows young children to share their thoughts feelings, reactions, and attitudes in their most natural medium of communication: play (Landreth, 2002). '"

• We believe Landreth (2002) is the best introduction to child-centered play

therapy available.

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The purpose of this chapter is not to present a model of constructivist play therapy. Rather our purpose is to demonstrate the utility of the basic facilitative skills of child-centered play therapy within a constructive (constructivist and social construc tionist) therapeutic context with young children. We begin by presenting a rationale for the use of play in child therapy. Next we address points of congruence and resonation between the child-centered perspective and constructive therapies. The remainder of the chapter discusses basic principles and procedures from child-centered play therapy that may be useful for constructive therapists as they work with young children. WHY USE PLAY IN PSYCHOTHERAPY?

Children of every era have played to cope with and make meaning of the often difficult and meaningless situations in their lives. For example, children in Nazi concentration camps in Auschwitz during the Holocaust of World War II used play to cope as they prepared to die and as they witnessed the horrors of war (Sweeney, 1997). Children living during the "black plague" of the Middle Ages created the game "Ring around the Rosie." The "rosie" refers to the red blotches and lesions from contracting the plague; the "pocket full of posies" refers to the flowers for the dead and the practi~e of putting flowers into the pockets of plague victims to ward off the smell of death; and "ashes, ashes, we all fall down" alludes to the imminent death of the plague-stricken and the practice of burning the bodies of plague victims. (p. 21)

Children use play to comfort themselves and make sense out of their often tragic life situations. Play is essential to the development of cognitive, language, motor, and social skills in children (Kottman, 2001; Landreth, 2002). Play is the focal activity of childhood and children "do not need to be taught how to play, nor must they be made to play. Play is spontaneous, enjoyable, voluntary, and non-goal-directed" (Landreth, 2002, p. 10). Furthermore, children communicate through play. According to Landreth (2002): Children's play can be more fully appreciated when recognized as their natural medium of communication. Children express themselves more fully and more directly through self-initiated, spontaneous play than they do verbally because they are more comfortable with play.

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For children to "play out" their experiences and feelings is the most natural dynamic and self-healing process in which they can engage. (p. 14)

According to Schaefer (1993), play "has the power to not only to facilitate normal child development but also to alleviate abnormal behavior" (p. 3). Most children under age ten do not have the abstract reasoning and verbal abilities to clearly express their thoughts, feelings, reactions, and attitudes. Consequently, many therapists who work with children use toys and other play media to help young children communicate their experiences, reactions to experiences, desires and goals, and perceptions about themselves, others, and the world (Kottman, 2001; Landreth, 2002). According to Caplan and Caplan (1974), there are several unique attributes of play that appeal to children. First, play is a voluntary activity by nature. In a world full of requirements and rules, play is refreshing and provides a respite from everyday tension. Second, play is free from evaluation and judgment by adults. Children are safe to make mistakes without failure and adult reprimand. Third, play encourages fantasy and the use of imagination. In a make-believe world, children can exercise the need for control without competition. Fourth, play increases interest and involvement. Children often have short attention spans and are reluctant to participate in a lower interest, less attractive activity. Finally, play encourages the development of the phYSical and mental self (Caplan & Caplan, 1974, pp. xii-xvii). Play therapy is a useful and appropriate method for psychotherapy with young children. According to Kottman (2001), play therapy is useful for establishing and maintaining a therapeutic alliance with children; helping therapists understand children and their interactions and relationships; helping children express feelings that they are unable or unwilling to verbalize; helping children behaviorally and constructively express feelings of anxiety, frustration, or hostility; helping children learn and practice social skills; and creating an environment in which children feel safe to "test limits, gain insight about their own behavior and motivation, explore alternatives, and learn about COnsequences" (p. 4). Furthermore, Bratton and Ray (2000) presented comprehensive plar therapy literature review of 100 case studies 82 experimenta research studies. The case studies indicated clients inllay therapy consistently show more well-functioning an decreased levels of symptomatic behavior as 147

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compared with their behavior prior to entering play therapy. The experimental studies suggest that play therapy can be helpful for children with problems such as social maladjustment, conduct disorder, problematic school behavior, emotional maladjustment, anxiety/fear, negative self-concept, being "mentally challenged," and having a physical or learning disability. Therapists interested in using play therapy, however, may need to make a paradigm shift. This shift is from a primary therapeutic focus on conversation and verbal skills to a primary focus on using play, toys, play media, and metaphor for communi cation and to facilitate change. It appears to be a simple change to make, but is actually a complex conceptual shift that many adults find difficult (Kottman, 2001). Play therapists look at themselves, children, and the world from a different perspective than talk therapists do. Before they can begin to acquire the skills involved in using play to communicate with children, potential play therapists must learn a completely different way of understanding communi cation-to a symbolic, action-oriented model in which actions of puppets and animal figures are important pieces of information and in which a shrug, a smile, or a turned back can be an entire "coversation." (p. 20)

This is particularly true for therapists working with children ages three to ten (Landreth, 2002) and children from other cultures (Garza & Bratton, 200S). CHILD-CENTERED PLAY THERAPY AND CONSTRUCTIVE

THERAPIES

We begin this section of the chapter by briefly reviewing our understanding of constructivism and constructive therapies. There is a wide range of constructive Jerspectives, from more individually focused views of constructe reality to ones that view reality as socially constructed. According to Mahoney (2002,2003; Mahoney & Granvold, 200S) major 20 th -century constructivists include, but are not limited to, Alfred Adler, Walter Truett Anderson, Albert Bandura, Gregory Bateson, Jerome Bruner, James Bugental, Mary Whiton Calkins, Donald Ford, Viktor Frankl, Kenneth Gergen, Harry Goolishian, Vittorio Guidano, Hermann Haken, Sandra Harding, Yutaka Haruki, Friedrich Hayek, William James, Evelyn Fox Keller, George Kelly, Karin 148


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Knorr-Cetina, Humberto Maturana,Jean Piaget, Joseph Rychlak, Esther Thelen, Francisco Varela, Heinz von Foerster, Ernst von Glaserfeld, Paul Watzlawick, and Walter Weimer. Constructivist approaches share a common or similar epistemology and may be distinguished by their "operative assumptions about the nature of personal knowledge and its social embeddedness" (Neimeyer, 1995, p. 15). According to Mahoney (1995, 2002, 2003; Mahoney & Granvold, 2005), constructivism is "a family" of theories and therapies that emphasize at least five central features or themes: First, "human experiencing involves continuous active agency" (Mahoney, 2003, p. 5) and humans are proactive (and notlassively reactive) participants in their own experiences. Secon ,the majority of human activity is devoted to ordering processes or "the organizational patterning of experience; these ordering processes are fundamentally emotional, tacit, and categorical . . . and they are the essence of meaning making" (Mahoney & Granvold, 2005, p. 74). Third, human experience and personal psychological development reflect the ongoing operation of self-organizing or recursive processes that tend to favor the maintenance (over the modification) of experiential patterns. Because the "organization of personal activity is fundamentally self-referent and recursive," the person's body is a "fulcrum of experience and encourages a deep phenomenological sense of seljhood or personal identity" (Mahoney, 2003, pp. 74-75). Fourth, "self-organizing capacities and creations of meaning are strongly influenced by social-symbolic processes; that is, persons exist in living webs of relationships that are typically mediated by language and symbol systems" (Mahoney & Granvold, 2005, p. 75). Thus, one can affirm that knowledge is socially embedded and relationally distributed without emptying the aforementioned sense of selfhood or personal identity (Watts, 2003; Watts & Phillips, 2004). Fifth, hwnan development is a lifelong process of complex cycles and spirals of experiencing that is both "dynamic (always changing) and dialectical (generated by contrasts)" (Mahoney, 2002, p. 749). These complex cycles and spirals can "lead to episodes of disorder (disorganization) and, under some circumstances, reorganization (transformation) of core patterns of activity, including meaning making and both self- and social relationships" (Mahoney, 2003, p. 5). In regard to constructive therapeutic approaches, there are certainly some distinct differences. However, as Hoyt (1994) suggests, they share some distinct clinical practice characteristics, as welL 149

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These include: (1) A clear emphasis on the development and maintenance of a strong therapeutic alliance; (2) a clear focus on clients' strengths, abilities, and resources rather than their deficits, disabilities, and limitations; and (3) an optimistic and future-oriented perspective. Person-Centered and Constructive Therapies

Many authors espousing constructive theoretical perspectives have expressed concerns regarding the oppressive and colonialist nature of "traditional" therapies, including various models of play therapy. For example, Smith (1997) delineated four concerns. 1. Therapists using traditional approaches tend to limit the scope of the therapeutic dialogue by attending only to content that is consistent with their theoretical framework and/or is of interest to the therapists.

2. Therapists using traditional approaches may juxtapose their "preferred views of reality upon the clients in the name of empirical science" (p. 20). 3. When operating from the "expert posture" advocated by many traditional therapies, therapists may have difficulty perceiving when genuine change has occurred, as opposed to mere client acquiescence to authority (p. 21). 4. Traditional therapists "may become particularly fixed on certain theoretically predetermined content" (p. 21). Although these concerns may be accurate for many traditional approaches to therapy in general, and play therapy specifically, they are not appropriate for child-centered play therapy. The theoretical underpinning for child-centered play therapy is Rogers' person-centered therapy. Anyone remotely conversant with the person-centered approach is cognizant that person-centered therapists do not (a) limit the scope of the therapeutic dialogue, (b) juxtapose their preferred view of reality on clients, (c) operate from an expert position, or (d) fixate on theoretically predetermined content. Harlene Anderson (2001), developer of "collaborative therapy," made this abundantly clear in her article comparing 150


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person-centered therapy with her approach. Anderson, albeit using different nomenclature, demonstrated that the person-centered theory of Carl Rogers shares with constructive approaches the aforementioned clinical practice characteristics delineated by Hoyt (1994). For example, Anderson (2001) noted that The collaborative therapist, similar to Rogers, considers the client as the expert on his or her life and as the therapist's teacher ... IThe therapist] invites, respects and takes seriously what a client has to say and how they choose to say it. ... Both approaches share an appreciative and optimistic view of people and their capacity to be experts on their lives, and to resolve their difficulties in ways unique to them and their circumstances. (pp. 349-354)

Although these comments by Anderson are speCifically addressing similarities between collaborative therapy and person-centered therapy, we believe these comments are salient for understanding basic similarities between most constructive therapies and the person-centered approach.

Child-Centered Play Therapy and Constructive Therapies Constructive therapists assert that children are particularly vulnerable to having their voices discounted or ignored because adults wield significantly more power (l