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Section 18
Resisting the Play Therapist

Question 18 | Test | Table of Contents


"What if He Will Not even Let Me Relate to Him?"
Let 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.

"What if He Particularly Resists My Nurturing and Indulging Overtures?"
Behaviors 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.

More 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 activities.

"What if He Particularly Denies My Efforts to Structure?"
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.

2. 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.

3. "Engagement." 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.

Personal 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.
Reviewed 2023

Update
Corrigendum: The relationship between children's scale
error production and play patterns including pretend play

- Ishibashi, M., & Uehara, I. (2022). Corrigendum: The relationship between children's scale error production and play patterns including pretend play. Frontiers in psychology, 13, 1040479. https://doi.org/10.3389/fpsyg.2022.1040479


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.

QUESTION 18
Children who deny their need for structure may display what behaviors? To select and enter your answer go to Test
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