“Play Therapy… It’s Not All Fun and Games”
On Monday, March 29, Dr. Susan Hook, founder and executive director, Samaritan Health and Wellness Center, Inc. and Dr. Joel Montalvo, director of counseling Services and clinical pastoral counseling, Samaritan Health and Wellness Center, Inc. discussed the benefits of play therapy for child wellness.
Integrated Primary Care Behavioral Health Model
It’s a model you don’t see very often, but it is a good model because it helps improve patient outcomes related to improved mental health. It means that the medical professionals and mental health professionals are in the same office and work together as a team. According to recent statistics, only six states in the U.S. are above the recommended 14 psychiatrists for every 100,000 people. Mental healthcare is difficult at best to access. Primary care is really the entry point for people who have mental health issues.
3 Different levels of integrated primary care:
- Coordinated: Medical professionals can do minimal mental health intervention, and then the patient would have to make an appointment with a mental health provider. Many patients don’t follow through.
- Co-located: The medical provider is in one part of the office, and the mental health professionals are in another area. The providers have minimal conversation and collaboration, but they are in the same building.
- Fully integrated: Mental health and medical professionals are in the same office space and collaborate daily. Patients can come in for a medical issue, but they may also access mental health care. The providers work together, as a team, to care for each patient.
Pediatric Counseling Using Play Therapy Techniques
Play therapy is a method of counseling that allows children to express their emotions, improve communication, and solve problems.
- Uses children’s natural abilities to express their feelings and resolve conflicts through play.
- Allows families and children to work through issues including abuse, neglect, bereavement, depression, and anxiety.
- Children live and learn through the language of their play.
- 1 in 4 preschool children struggle with some type of psychosocial stress or social and emotional issue.
- Ages 0 to 3 are the most formative years in the development of the human brain.
How Children Communicate through Play
Play is a child’s language. It is fun and enjoyable, expands self-expression, and connects a child with others in an expressive way. Play is the child’s language, and toys are their words.
- Encourages creativity and self-expression.
- Play therapy is a structured theoretical approach to therapy that builds on normal learning and communication of a child.
- Children express what is troubling them through play when they don’t have verbal communication skills.
- Play provides children with a safe outlet, allowing an expression of thoughts and feelings related to their stress or behavioral issues, applicable to the child’s development.
Stages of child development:
- 3-year-olds like to copy adults in showing affection. They are capable of a wide range of emotion and can separate easily from their parents.
- 4-year-olds can put themselves in other roles, playing Mom and Dad. They are more creative, and make believe and cooperative play is preferred. They may have difficulty distinguishing between real and make believe.
- 5-year-olds want to be like their friends. They like rules, and they love to sing, dance, and play act. They show independence and they can cooperate but be demanding as well.
- School age children have developed verbal communication and they can express their emotions verbally and through play.
Examples of Play Therapy
- Ball play. In group therapy, take turns throwing the ball and as participants catch the ball, they have to say something that makes them happy.
- Doll play. Therapist might present a child with a stuffed animal or patient can bring their own to comfort them.
- Block play. Therapist might construct a wall and allow the child to throw a ball and knock it down to express some of their anger.
- Puppet play. Therapist presents the patient and family puppets and asks them to pick a puppet to represent them. Then the family is asked to act out their story. It can reveal family dynamics that the patient is unwilling or unable to discuss with the therapist.
- Drawing. Communicate the feelings that no one sees and the ones that everyone sees using different colors to express different emotions. Use different colors to express different emotions such as: yellow for joy, blue for sadness, red for anger, green for disgust, purple for fear and orange for confusion. An example of what can be revealed: One boy drew a red bedroom with booby traps, which he said where to protect his mother from the man who was hurting her.
- Clay play uses the same colors to represent emotions. Ask children to build an animal to represent a family member and the color to represent an emotion. One girl made a red rabbit for her mother, representing how her mother moved from house to house and was angry.
Empowering Parents and Caregivers
- When you want to communicate with children, you must give them your full attention.
- American Academy of Pediatrics recommends two hours of technology a day total (phone, computers, cell phone, computer games). Parents need to set the example.
- Dinner time is a great time to talk about the events of the day and to interact as a family. When you encourage children to talk about everyday things, they feel like there’s a sense of openness. When heavier things like anger or depression come along, they will be more likely to communicate.
- Pay attention to their body language and tone. Be good listeners and observers.
- Be a good role model in showing children how to listen.
- Consider what your child can understand. Talk to their developmental level and attention span.
- Do not rush to solve problems. Allow the child to think about solutions themselves.
- Give children an opportunity to participate in family conversations.
- When giving feedback, make it positive instead of critical.
- Show them that you care about what they think and feel. Let them feel heard.
- Allow your children to express themselves and communicate how they feel. Listen without negative feedback because it makes them feel pushed away. It makes them feel alone and that no one understands how they feel.
- Validating children’s feelings is so important.
- Children need to know that parents are not there to always fix things. Encourage children to consider their own solutions.
- Pay attention to the way your children are playing. The way we behave, we are conditioning their way of thinking. Listen to the words they are using and what they are trying to express.
QUESTIONS FROM VIEWERS:
Q: What ages would you recommend for children’s play therapy?
A: Dr. Montalvo: I recommend a child who is 4 or 5 years old, because it is better for them to communicate through play.
Q: What tips do you have for using this with teenagers?
A: Dr. Montalvo: I use this game called the “ungame.” It has two types of questions. Some are icebreakers. Some are more about emotions. Or just sit down with your teenagers and have a conversation. Teenagers often communicate with adults other than their parents. They feel like they are not accepted by their parents, even though their parents may not be rejecting them. Teenagers are likely to say things to parents that will make them upset, but parents need to have self-control and give children the opportunity to talk and then valid date their feelings.
Q: Do you accept Medicaid and how many locations?
A: We do not bill any insurance, but if your child or children need counseling, please call our office at 239-257-3094. We have a Pediatric Counseling Fund to help parents who cannot pay the counseling fee. We are located in Cape Coral at 643 Cape Coral Parkway. One location.
Q: How do you use play therapy via zoom?
A: We do offer Telehealth counseling at Samaritan but employing play therapy techniques this way would be difficult especially for younger children.