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How to Get Great Results in Play Therapy · Next Level Play Therapy: A Podcast for Play Therapy Excellence

• 0:02
  Welcome to Next Level play Therapy, a weekly podcast dedicated to supporting the next generation of child and adolescent therapists to provide exceptional play therapy services.
• 0:14
  We'll explore all things play therapy to elevate your work with children and adolescents using the therapeutic powers of play.
• 0:23
  I'll discuss practical tips and ideas.
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  So you can provide a transformative experience for your young clients and make a real difference in their lives.
• 0:34
  So get ready to take your play therapy skills to the next level and make a lasting impact in the lives of children, adolescents, and families.
• 0:47
  Hey there, welcome to this week's episode of Next Level play Therapy.
• 0:54
  And joining me live today is Lily, my dog Lily.
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  She's been having a rough time.
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  She's getting old.
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  Um, and she can't really see very well.
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  So just be aware, my dogs are in the house.
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  So Luna's in here too.
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  She's kind of hanging out in the background.
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  If you hear, if you hear any strange noise, like Luna is already starting to dig, um, then you just know that Luna's in the background and she may be digging around.
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  She may be doing some moaning.
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  She may be rolling around.
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  Lily, Lily's going to be wondering around so you may hear some strange sounds.
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  in the background.
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  So welcome to this week's episode of Next Level play Therapy.
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  Today I want to talk about a topic that's probably going to remind you of your graduate school days.
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  We're going to be talking about this concept or this Um, skill that really is foundational.
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  And if you think about that analogy of the house, strong foundation, safe and secure house, weak foundation, not so safe and secure house.
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  So I consider the topic that we're going to talk about today.
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  as important to build a really strong foundation as part of your skill play therapy skill competency.
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  And the topic today is case conceptual case conceptualization.
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  And why is that so important for play therapists?
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  So case conceptualization is essentially your ability to take all of that information that you gathered during that initial assessment, take all of that information to figure out and form your hypothesis about what is at the root of the problem.
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  So what is going on that is causing this problem, contributing to this problem, and what patterns in your client's life are sustaining this pattern or in this behavior.
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  So what is it that's going on underneath of the behavior that's activating it and continues to sustain and maintain it?
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  That's your case conceptualization.
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  One of the questions I get asked all the time in play Therapy Academy and when I'm doing trainings is, what should I do about this problem?
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  Well, you can't really answer that question of what to do until you've really gotten a good sense of what's actually going on.
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  And that is your case conceptualization.
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  And that is what we are going to talk about today in this week's episode of Next Level play Therapy.
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  So if you're joining me live, I would love to know who's here, uh, post your name in the comments.
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  Where are you from?
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  What population do you work with?
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  Oh, I got a sneeze.
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  My sneeze got stuck.
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  Anyways, um, so what population do you work with?
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  What play therapy modality are you using?
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  Because your play therapy modality it influences your case conceptualization.
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  So that is something that's really important to think about.
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  In my online play therapy consultation program, that's one of the things that we focus on is helping play therapists really identify and begin using with their clients, uh, play therapy theoretical model because your theoretical model is going to influence your case conceptualization.
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  And it's also going to influence what you're going to do in sessions, how you make sense of what's happening in each stage of the change process.
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  What are you going to be doing in each stage of the change process?
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  So they all tie together.
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  And getting that really good solid foundation starts with your theoretical orientation and your case conceptualization.
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  So the, the Association for play There, I'm going to read a definition.
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  The, uh, I read this last week too, but I think it, I think it's beneficial to read it again.
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  The play therapy association, sorry, my mouth is not working today.
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  So, the associate for play therapy, identified core competencies that play therapists need in order to have all of the skills that are going to make them successful in helping their clients.
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  So in their core competencies, which if you go on their website and do a search, you'll be able to find these.
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  They're called play therapy competencies.
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  So competency two, these are considered play therapy, clinical play therapy skills, and competency two C says, apply assessments that highlight various aspects of the child and or system and the play therapy process.
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  For example, conceptualization, diagnosis, family dynamics, treatment suitability and effectiveness, and termination.
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  So your treatment suitability and effectiveness is part of your treatment planning process and you need to develop your case conceptualization in order to do your treatment planning process.
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  So you can see how all of these tie together and they're all going to be influenced by your plat therapy theoretical model, even when you're using an integrative model.
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  So the thing is, how do you get that case conceptualization started?
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  And this is where your very first diagnostic intake session matters.
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  Your first session is really supposed to be and it's important to take that time to gather all the questions to ask all the questions to go into detail to get a better sense of what are the presenting problems?
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  What is it that's bringing them in?
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  What are the family relationship patterns doing that three generational family history, getting developmental history, getting education and academic history, like how are they doing with school?
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  Also gathering any cultural information to do your cultural formulation and see how that may or may not influence what's going on with your client.
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  All of these things are really important, and if you find yourself struggling and feeling a little bit lost in the play therapy process, there's a good likelihood that's Because you probably didn't do your case conceptualization from the beginning.
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  So you probably didn't gather all of that information and ask all of the questions to get a good sense, a good starting point of understanding and formulating, I call it your hypothesis, that working hypothesis about what's going on and why is it happening then and if so, if you're feeling lost, it's probably cause you skipped this step.
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  And I find this happens a lot, which is why I like to talk a lot about it because One of the things that I've noticed since I started play Therapy Academy back a few years ago, um, so play Therapy Academy is my online play therapy consultation program.
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  We have courses in there, we meet twice a month, with people from all over the country, sometimes outside of the country.
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  Um, and what we do in there is really help play therapist develop those core competency skills that are going to give them confidence, get rid of imposter syndrome, help you make a difference in the lives of your clients.
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  So one of the things that I noticed is people come from all over.
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  They come from different backgrounds and different supervisory experiences.
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  And one of the things that I began to realize is that there's a missing piece that people are coming to play Therapy Academy with.
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  And that is that core skill of case conceptualization and taking that time to formulate your case conceptualization.
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  Which is why I created, uh, Getting Grounded in play Therapy Case Conceptualization, which is an online course to walk you through all the steps and in the first part of the course, I walk you through all of the questions that you need to be asking.
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  All of the questions you need to be getting answers about and why you need to ask these questions.
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  What is it about these questions that's going to help you get to the root of the problem?
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  And understand patterns that are going on that are sustaining the problem.
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  So I always like to use the analogy of, um, going to the doctor.
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  Like when my kids were really little, they're grown adults now, but when they were really little and I was a new mom and, you know, little ones get sick all the time and I especially my first my oldest my first child I you know, you're nervous about everything I wanted to do a good job being a mom take care of my child make sure nothing happened to him because I loved and adored him and thought the world rose and set on this child.
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  Same with my second child So I would go to the doctor and when, when the doctor asked a lot of questions, I felt so much better because I could tell the doctor was trying to gather information to make a good assessment.
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  So he or she could prescribe treatment that was going to get at the heart of what's going on.
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  And what I found is sometimes when I would go and the doctor didn't ask a lot of questions and then they just wrote a script and I, I went home and it didn't really work that well.
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  And I remember thinking, Oh, if I could just, if I just knew better questions to ask, then I would make sure to get the results that I need and I could understand this, but I like to understand things.
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  The more I can understand it, the more it helps me navigate things.
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  That's how I look at it.
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  I ask a lot of questions, which sometimes, irritates people.
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  It's not my intent to irritate people.
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  It's my intent to understand because if I can understand that I can navigate the situation, if I can formulate my case conceptualization, then I can navigate the situation.
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  So what I found was I would leave and I, and I found myself thinking before I had a doctor's appointment, I would go and write down all my questions to make sure when I went, I got all my questions answered because if I didn't know the right questions to ask, I wasn't going to get them answered.
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  And then I realized what I really wished was that my doctor asked the questions.
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  Like, in my mind, I thought, well, they're, they're professionals.
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  They're supposed to know what to ask me.
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  And the ones that did that, I always felt more confident.
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  So how does that relate to play therapy?
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  One of the things that I find happening is that play therapists feel like if they ask a lot of questions, then they're going to offend or annoy the parents or the child.
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  And I, I always, usually in my very first diagnostic session, I don't have the child present.
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  That gives us some privacy to ask a lot of questions.
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  Sometimes the child is there, but especially if they're older, but if they're young, then I have, I tell parents not to bring the child so that I can gather all this information and, um, It doesn't create any discomfort for the child.
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  And depending on how you ask the questions, right?
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  We're still therapeutic.
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  We're still formulating that therapeutic rapport in the first session.
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  So I want to ask questions in a way that helps parents understand what I need in order to help their child.
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  So that's what you're so asking all of those questions.
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  And what I found is the more I ask the questions and the parents can tell that I'm really trying to understand to help me figure out how to help their child, then that helps them feel more confident with me.
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  It doesn't drive them away.
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  It actually builds that therapeutic rapport, knowing the right questions to ask and why you need to ask them is really important.
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  And then, knowing what to do with that information to do your case conceptualization is also important.
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  So learning to develop those core competencies.
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  With that assessment and clinical case formulation, which includes diagnoses, um, then, then that actually helps to build that strong foundation of change that you're looking for, for your clients.
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  So the other, the other thing is, um, I forgot to add my little banners here, is core.
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  So what we're talking about our core competencies for play therapy assessment.
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  What we're talking about is the importance of formulating your case conceptualization and how that actually helps you to accomplish your goal of getting really great results for your clients in play therapy.
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  The thing is your play therapy case conceptualization is going to be heavily influenced by your play therapy theoretical model.
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  So you really want to identify a play therapy model that you are going to use, at least in the beginning if you're just brand new, at least learn at least one model before you start adding things on to it.
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  Um, because most of us use an integrated model.
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  But you start with one.
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  I always encourage start at least with one and then you can add on from there.
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  Your case, even with an integrative model, like I use an integrative model and I would say I use child centered play therapy when I'm working with younger kids.
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  With older kids, I'm using more of an integrative model and I use a neuroscience and attachment lens.
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  Um, understanding the change process, then I'm going to be understanding what I need to do in each stage of the change process.
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  Based on that theoretical model.
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  Because theory drives application, my theoretical model is going to help me understand what the problem is and why is it happening, and then help me understand what do I need to do in each stage of the change process.
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  So definitely your case conceptualization is going to be influenced by your play therapy theoretical model.
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  So the second thing that I wanted to talk about today is really more of a barrier, um, kind of, um, I'll call it a mistake for lack of a better word, uh, that's going to interfere with your ability to have that strong foundation of case conceptualization.
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  And that is really devaluing the assessment process or maybe not understanding the value of the assessment process.
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  Because what I find happens is play therapists really want to help their clients so they want to get started right away.
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  Want to make sure that parents know play therapy is going to work and it's valuable.
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  So they want to demonstrate that it's valuable by, by starting that very first session using play therapy.
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  And then they'll kind of gather information as they go along over time.
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  Maybe what usually ends up happening is they feel lost.
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  Somewhere, usually in the middle or usually in the beginning sometimes because they haven't done that initial case conceptualization process.
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  They haven't taken that first session to gather all of the information and what that's going to do is, it's going to really make it a little more challenging to figure out and identify the roots of the problem and then what are the patterns that are sustaining it because you won't have gathered all of the information that's going to help you understand all of the nuances and all of the things that are contributing to this problem.
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  The thing about case conceptualization is we do our initial case conceptualization at the beginning.
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  When we've, we've done that diagnostic appointment, assessment is ongoing throughout the play therapy process and having your initial case conceptualization gives you that starting point to understand what's going on and help you figure out what to do and what, what you're dealing with and how to integrate parents and then throughout the change process, you're going to be gathering more information as you go along.
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  And that's going to influence your initial case conceptualization.
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  You might need to adjust it.
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  You, when you, I always say when, like, when I get lost sometimes, even I've been doing this, like three decades.
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  I still get lost.
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  Really some of the complicated cases sometimes.
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  I have to go back to my case conceptualization to get myself reoriented and back on track or realize, Hmm, I might need to change this.
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  Or, or revise it a little bit because I've now realized something else is going on.
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  So yes, assessment is ongoing.
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  And that initial case conceptualization is important to be able to get the results that you want.
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  And so one of the things that we do in play Therapy Academy is practice doing that.
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  I will have, when anybody presents a case, and we have two people that present a case every time, so they get a lot of individual attention plus the benefit of the group, um, knowledge.
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  And and resources.
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  And then I'll walk them through that process of doing their case formulation.
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  Like how does your play therapy theoretical model understand that what the problem is and how are you applying that play therapy model in this situation?
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  So we do a lot of that in play Therapy Academy and the, the course that I created Getting Grounded in play Therapy Case Conceptualization gives you all of those skills, uh, walks you through all of the skills that you need.
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  And I'll talk a little bit more about that at the end.
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  And if you're interested in play Therapy Academy or, um, the, the course Getting Grounded play Therapy Case Conceptualization.
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  I'll talk a little bit about those at the end.
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  The third thing that I wanted to talk about is when you're gathering that information in the very first session, and you have parents there, and you're asking about what's bringing them in, you want to make sure you're getting information about the symptoms, and when you're asking about the symptoms, you want to ask, you want to think about these three things that I'm going to say.
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  And hopefully these will be like burned into your brain to think about these when you're doing your case conceptualization, or gathering information about the symptoms, and that is frequency, intensity, and duration.
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  So symptom frequency, duration of the symptoms, like when it happens, how long does it happen, how often does it happen, and what is the intensity of it?
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  So asking the right questions during that diagnostic session gives you the information to figure out what the roots are.
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  And gathering that information about symptom, frequency, intensity, and duration provides that information that you need for that differential diagnosis process.
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  So for example, there are several types of anxiety.
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  And asking specific questions about, um, frequency, intensity, and duration, as well as what activates these symptoms is gonna give you a better understanding of what kind of anxiety it is.
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  Is it social anxiety disorder or generalized anxiety disorder?
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  Is it separation anxiety disorder, or generalized anxiety?
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  You, the, and, you're, you're going to be addressing those a little bit differently.
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  So like social anxiety, you're probably going to be focusing on that.
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  It might look a little different with generalized anxiety disorder or separation anxiety disorder.
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  There's a lot of overlap in the way you treat these, especially depending on your play therapy model and understanding what it is you're focusing on for the change process gives you a better idea of where they are in the change process, because you'll be looking at a reduction of frequency, intensity, and, and duration to get a better sense of, is this actually working?
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  You're understanding what is it actually that you're focused on in terms of knowing whether or not play therapy is working.
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  That's one of the factors.
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  There's a lot other, but that's one of them.
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  So that is it for today.
• 26:18
  Uh, if you found this information helpful, please feel free to share it across your social media platforms.
• 26:25
  If you're watching on YouTube, please feel free to hit that subscribe button and notification bell so that you notified.
• 26:36
  Um, and Also, feel free to share these if you're listening on the podcast, please feel free to leave a review.
• 26:47
  I'd love to hear your feedback and how, um, how this has helped you or not.
• 26:54
  Hopefully it has helped you.
• 26:57
  So let me do a quick recap about what we talked about today.
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  And that is, you're, one of the core competencies that you're developing is your clinical case conceptualization skill, which also helps with diagnosis.
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  This is going to influence your treatment planning, which ultimately results in your actual treatment plan.
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  So these two go pretty, uh, case conceptualization and treatment planning go pretty hand in hand.
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  In order to have a good treatment plan, you really need to have some strong case conceptualization so you know what you're targeting in that treatment plan.
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  But that's another discussion, treatment plans.
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  Um, and if you're interested, I have talked about some of those things in previous live stream episodes.
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  So if you're, watching on YouTube, you can go back and watch some of those replays.
• 27:53
  If you're listening on the podcast, you can go back and find some of those previous podcast episodes.
• 28:00
  The first thing is you, so developing your core competency for assessment, clinical case conceptualization, really provides you with the foundational skills of figuring out what is going on with your client and why is it happening because those are the things you're going to target for the change process or at least identifying what you're, what you're kind of measuring, even if it's more kind of, um, observational measuring and self report measuring from parents in your parent sessions.
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  Then you, you want to make sure to have, have that case conceptualization to have a good idea of what's going on with your clients.
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  And your play therapy theoretical model is going to influence your case conceptualization.
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  So you want to make sure to focus on developing some really strong, uh, case conceptualization skills, which starts with that first diagnostic session and knowing what questions to ask and why to ask them.
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  The, the, the second thing is making sure that you understand the value of doing that assessment and that actually skipping that first assessment can result in not having a good idea about what's going on and feeling a little bit lost along the way.
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  And actually it does help that to build that rapport when you know what questions to ask and why you need to ask them when you're in that first session and you're you're exploring these things, then it's going to knowing the right questions to ask.
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  is going to help you build rapport with parents.
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  Now you have to use your therapeutic rapport building skills, especially if you have, excuse me, parents who may may be a little guarded or reluctant.
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  You know, you're working on building safety while you're also asking the questions.
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  Those two things can happen at the same time.
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  Um, And then finally, when you're asking questions about the symptoms, think about frequency, intensity, and duration of the symptoms.
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  How often is it happening?
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  How long does it last when it happens?
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  And what would you say is the intensity?
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  I, I always use a kind of that, uh, like you're 1 to 10 scale.
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  So if you were to rate the intensity, generally speaking on a, on a scale of 0 to 10, 0 means it doesn't bother you at all.
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  10 means it's so bad you think your head's gonna pop off and burst into a million pieces.
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  How would you rate the intensity?
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  So that gives you some idea of what's going on with those symptoms coming in and it will also help you get a better sense when you're doing that differential diagnosis process.
• 31:21
  Uh, is it, this type of anxiety or this type of anxiety.
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  Is it oppositional defiant disorder?
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  Or is it generalized anxiety?
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  Um, you're, you're, you're asking information about what's activating the symptoms.
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  When does the have a symptom happen?
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  Where does it not happen?
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  All of those things are going to give you an idea of what, what may be going on with your clients with that symptom.
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  So that is it for today.
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  If you are interested in play Therapy Academy, I currently have three openings left.
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  I have a Saturday group and a Wednesday group.
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  I have two openings in the Wednesday group and one opening in the Saturday group.
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  play Therapy Academy is my online play therapy consultation program.
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  I kind of Look at it like, uh, like a VIP experience.
• 32:24
  What do you need in order to feel competent and confident and get rid of your imposter syndrome that you don't know what you're doing and in any day now somebody's gonna find out you're a big ol fraud and they're gonna fire you, which would mean you're a big ol failure.
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  And you'll never make a difference in anybody's lives.
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  So if any of that sounds familiar, you probably have a bad case of imposter syndrome and play Therapy Academy.
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  We meet twice a month.
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  Uh, we always do case presentations.
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  We walk through the case presentation.
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  You'll do your case conceptualization.
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  You'll, you'll have the support of not only my 30 plus years in child and adolescent mental health, but also the wisdom of the group to help you learn how to develop those really awesome play therapy skills so you can make a difference in the lives of children and feel confident doing that.
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  Also, including how do you build strong relationship with parents?
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  A lot of times, imposter syndrome gets activated in work, in the work with parents.
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  So, we talk a lot about that, uh, we talk a lot about that.
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  So, play Therapy Academy, we do the online consultation group meetings.
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  Also, there are courses included in the program.
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  And we also have a group chat feature to get support from the, uh, from the group in between sessions.
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  So a lot of really solid, strong, uh, support to feel confident and learn your skills along the way.
• 34:08
  So if you're interested in that, if you're interested in play Therapy Academy, then you'll want to schedule a free 30 minute video call with me so that we can talk about how play therapy can benefit you if it's a good fit for you, making sure that it is something that you want to commit to and you think it would be useful for you and help you accomplish your goals.
• 34:36
  So if you're, if maybe you don't need Play Therapy Academy, you, you just need some skill building that would be, um, Getting Grounded in Play Therapy Case Conceptualization.
• 34:51
  Play therapy, this course Getting Grounded in play Therapy Case Conceptualization is one of the courses that's included as part of the Play Therapy Academy membership.
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  But if you're not in Play Therapy Academy and you don't want to, you don't need the program, you still can have access to the courses.
• 35:12
  You can purchase those separately from Play Therapy Academy.
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  So Getting Grounded in Play Therapy Case Conceptualization.
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  Walks you step by step through the process it walks you through all of the questions you need to ask and why do you need to ask them.
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  It then it helps you take that information and walks you through the process of formulating your case conceptualization.
• 35:41
  And because your play therapy model influences your case conceptualization, I, there's some case studies in there and I walk you through step by step using four different theoretical models, play therapy models with some case studies to help you see how that's, how that's applied.
• 36:06
  So if you're interested in the Getting Grounded in Play Therapy Case Conceptualization, pop over to my website at rhplaytherapytraining.
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  com.
• 36:19
  forward slash, uh, sorry, rhplaytherapytraining.
• 36:24
  com forward slash courses.
• 36:27
  And then you'll, you'll scroll down until you see Getting Grounded in Play Therapy Case Conceptualization on there.
• 36:34
  And then you can register for that course.
• 36:37
  If you're interested in Play Therapy Academy.
• 36:41
  Then pop over to my website at rhplaytherapytraining.
• 36:47
  com forward slash supervision and you'll learn a little bit more about Play Therapy Academy.
• 36:55
  Also you'll see where you can click on the button and schedule that free 30 minute video call with me to see if it's a good fit for you.
• 37:05
  Also, we're going to post links in the comments below, so feel free to click on those.
• 37:11
  Feel free to leave a comment, and I will see you, bye for now.
• 37:18
  Thank you for joining me on this episode of Next Level play Therapy.
• 37:22
  I hope you found the discussion valuable and gained new insights and ideas to support your work helping children, adolescents, and families heal.
• 37:32
  If you enjoyed this episode, be sure to subscribe to the podcast and leave a review.
• 37:37
  Your feedback helps to improve and reach more people who can benefit from this information.
• 37:43
  Remember, play therapy's a powerful tool for healing and growth.
• 37:48
  Whether you're a new play therapist or experienced, I encourage you to continue your learning journey to unlock the potential of play in your own work and relationships.
• 37:59
  If you have any questions or topics, suggestions for future episodes.
• 38:04
  I'd love to hear from you.
• 38:06
  Connect with me on social media and visit my website at Renewing Hearts play Therapy Training to stay updated on upcoming episodes, trainings, and resources.
• 38:19
  Thank you once again for listening to Next Level play Therapy.
• 38:22
  Until next time, keep playing, learning, and growing.