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Play Therapy Assessment Explained: How to Know If Your Play Therapy Sessions Are Working · Next Level Play Therapy: A Podcast for Play Therapy Excellence

0:02
Welcome to Next Level Play Therapy.
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A weekly podcast dedicated to supporting the next generation of child and adolescent therapists to provide exceptional play therapy services.
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We'll explore all things play therapy.
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To elevate your work with children and adolescents using the therapeutic powers of play.
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I'll discuss practical tips and ideas so you can provide a transformative experience for your young clients and make a real difference in their lives.
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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.
0:46
Hey there.
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Good morning.
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Today I wanna talk about assessment in play therapy.
0:53
Does it really matter?
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What do I mean when I say assessment in play therapy?
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And really how does assessment improve your outcomes that you can get in play therapy?
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So that's what I wanna talk about today.
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If you're watching me, please go ahead and post your name in the comments where you're from, what population you work with.
1:18
I would love to see who's here.
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Um, honestly, feel free to ask questions.
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Join in.
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I'd be curious how you use assessment in the play therapy process.
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What questions do you have about assessment in play therapy?
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That's what I wanna talk about and hopefully I'll be able to answer some of your questions and let's get started.
1:42
So, assessment in play therapy.
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What the heck does that mean?
1:48
So first, what that means is, um, what exactly, when I say assessment, what exactly am I talking about?
1:59
So there are different kinds of assessment in the mental health field, they have what we call more informal assessment and more formal assessment.
2:11
So the reason that assessment really does matter is because it's you, the way in which you go about gathering information, to better understand what's going on with your clients so you know how to help them by targeting the right area.
2:29
So imagine we do, there are so many different ways assessment takes place in our world, even outside of mental health.
2:39
And so to me it's always kind of confusing why we don't do that in mental health to get started all the time.
2:49
So I've been supervising people in play therapy and mental health for the last 15 years.
2:55
I've been in the mental health field for, as a child and adolescent therapist for about 30 years now.
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And so over that time, one of the things that I've calmed to realize is, one, the value of assessment and two, actually surprised how many people in the mental health field, especially in private practice, and the reason I say private practice is a lot of times if you're working for an agency or a government agency, they require it.
3:27
And what I find though is even when it's required a sometimes, kind of, a lot of times it's not necessarily understood why it's so important.
3:41
It's a lot of times it's just, oh, I gotta do this task and I'll get it done and I'll get my paperwork done without really taking into consideration the value of that task and why it's required in the first place.
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And so assessment is really gathering all of that information that you need to better understand what exactly is going on with your client.
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If you don't understand what's going on with your client, how are you gonna know what to target?
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A lot of times what I see happening is play therapists just get started and, and I understand why they do that, they wanna help their client, they wanna get things started right away.
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All of those are really good reasons.
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The thing is, what happens is if you don't really do that, uh, legwork, so to speak upfront, then the likelihood you're gonna miss some things is pretty high, and you might even go in a wrong direction.
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So.
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So take, think of it this way.
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Let's just say your car is not working and it's making these weird sounds and it's, it doesn't have the get up and go that it normally has something's going on.
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So you take your car to the repair shop, and let's just say the repair shop doesn't ask you any questions.
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They don't try to figure out what's going on.
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They just start fixing it.
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Without really understanding what the problem is.
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What do you think the likelihood is that they're gonna be able to target the right thing quickly and effectively?
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It's pretty slim.
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The same thing is true, let's say your air conditioning breaks down or your heating breaks down and you call the repairman comes, you know, they schedule between a four hour.
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Basically have to take the whole day off from work to have them come out.
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And let's say they come in, they don't ask you any questions.
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They just get started tinkering around in your HVAC system and there's a lot of different parts in your HVAC system.
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So if they're not asking questions and doing their assessment of problem, the likelihood they're gonna target the right area quickly to get good results is pretty slim.
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And here's the other thing, A, you can even have your, your professional come and let's just say they're not well trained or they don't really have, um, some really effective and accurate skills in their assessment process.
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It could actually go off track that way as well.
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So part of the assessment process is, is really knowing what to look for.
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Having that training that will help you know what questions to ask.
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If this, if the, your client answers the question this way, then in your mind you're like, oh, okay, then I need to ask this question.
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And depending on how they answer that question, then you're like, oh, okay, well, I need to go this way.
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That's all of that assessment process.
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But first you have to gather the information.
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So that's, that's the, that's why assessment is really, really important.
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The second thing is there are different kinds of assessment.
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There's what we call the more informal kind of assessment, which is typically your bio-psychosocial assessment.
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It's your, um, maybe you have some questionnaires or surveys that you give out you if they're gathered in more of an informal way.
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Here's the thing though.
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Even let's say you're doing your bio-psychosocial spiritual, cultural assessment, you really need to know what questions to ask if you are, and you really need to have an understanding of what different developmental stages are for children, what's typical at different developmental stages.
8:11
You need to understand the diagnoses for children, typical problems that children ex experience, what that looks like at each different stage.
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And that's one of the reasons why I, I created a course.
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It's called Getting Grounded in Play Therapy Case Conceptualization.
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I'm gonna talk a little bit more about that at the end.
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The reason that I created the course is because what I noticed is that play therapists, especially when you're new to the field, which totally makes sense.
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Um, when you're new to the field and you're just getting started, you're not necessarily sure what questions to ask and why you need to ask them.
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And so in the play therapy case conceptualization, I walk you through all of the different questions in each category.
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Why you need to ask them to help your assessment data gathering process be more thorough so that when you begin to formulate your case conceptualization, there's a higher likelihood you're going to be accurate in your case conceptualization.
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And your case conceptualization is what um, formulates, that's what you use to formulate your treatment plan.
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So if you get the first part wrong, then there's a good likelihood you're not gonna get as good of treatment outcomes as you can.
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Now, the other thing is, so what's the, that brings me to my next point for, oh, actually, I, I got ahead of myself, so let me back up.
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I forgot to talk about formal assessments.
10:00
So those are all ways that we gather informal information.
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And if you are not aware of this.
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There are the dsm, which now we're on DSM five tr.
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If you go to, I think the website is DSM five, I don't know if the TR is there or not.
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DSM five.org.
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To in the assessments.
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If you go on there, one of the nice things that when the DSM five came out is that they created these free assessment tools.
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They have assessment tools for adults as well as for children.
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And they're, they're like questionnaires basically.
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And what they did is they took, um, other longer versions of assessments and shorten them just to do like a quick questionnaire.
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And they have different levels.
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They're really, really helpful.
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I actually like to use them when I'm doing my intake.
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So for when I, 'cause I typically do, I typically just work with children, adolescents and families.
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And so when I'm that very first appointment, when I'm doing my bio psychosocial cultural spiritual assessment, I'm also giving out these questionnaires to gather more information because if you've ever done these assessments, you know, it's, they're kind of time consuming.
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I personally believe it's time we'll spent.
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Um, and sometimes we miss things in that assessment.
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So giving out these questionnaires, which you can print them off the website, they are free to use.
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They are, I love them.
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I think they're so useful.
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And then the other thing you can do is you can use these throughout the play therapy process to kind of see progress and get a sense of what's going on with the symptoms over time.
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Um, I love using them.
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I find them really, really useful.
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They don't take a lot of time.
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There's ones for the parents to fill out and there's one, depending on the age of the child.
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I think starting at age 11 to 17 years old.
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Then there, there are ones for the children to, uh, fill out.
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I typically have both child and parent or guardian, fill them out.
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If, if I have a, depending, sometimes 10 year olds can do it.
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Uh, for the older kids, I'll have both parent and child fill them out.
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If they're young I just have parents do the parent one.
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But there's, there's also ones on there for adults in different symptoms.
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Um, the other nice thing about that, uh, website, there's a whole cultural assessment process that they walk you through as part of your case conceptualization.
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That's really, really, really awesome.
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So if you haven't checked out those free resources for the DSMI would totally recommend doing those as part of your data gathering.
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So those are all informal.
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Um, and then there's the formal assessments.
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These formal assessments are typically um, standardized and they, there's been a lot of testing for the validity and reliability.
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They do a lot of standardization of them.
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They'll research them across different populations to to measure the validity and reliability of the instruments, and you typically have to be trained and have the expertise to use that assessment so you know how to do the scoring.
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So these would be assessments that are most likely gonna be done by, uh, a clinical psychologist.
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So the second, the second thing you wanna think about when you're thinking about assessment, what is it and why does it matter?
14:04
Why would it be important to take that time at the very beginning of the information gathering process.
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So case conceptualization and assessment go hand in hand.
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I like to say they're like peanut butter and jelly.
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Peanut butter by itself is awesome.
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Jelly by itself, depending on the kind is awesome as well.
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Put them together and you have a magical sandwich.
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Um, so, so what is case conceptualization?
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I've talked about that recently in my previous live episode.
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So if you're interested in hearing more about case conceptualization.
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Feel free to hop over to my YouTube channel, which is Cathi Spooner Renewing Hearts Consulting.
14:55
So I just as A-F-Y-I-I livestream every Wednesday into my Facebook group, which is called Play and Expressive Arts Therapy Playground.
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Facebook group is for mental health child and adolescent therapists who are using play therapy and expressive arts.
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So if that's something that is of interest to you, you're a child and adolescent therapist, you wanna use play therapy and expressive arts and you're on Facebook, feel free to hop over to my group, uh, play an expressive arts therapy playground.
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You do have to answer all the questions.
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If you leave any of the questions unanswered.
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You won't get in the group.
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Um, I say that because people regularly don't answer all the questions, uh, even though I say make sure you answer all the questions and then I always feel bad when they don't get in the group.
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But the questions are important, so just make sure you answer all the questions if you want to be in the group.
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Um, and I ha I live stream on my LinkedIn channel and my YouTube channel.
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Um, and then I also live stream into Instagram.
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So if you're on Instagram, you could probably find a lot of those, um, replays in my my grid, I think they're pretty easy.
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Or you can always click on the link in my bio.
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It'll take you over to my website.
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There's always the link there, or pop over to my YouTube channel.
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That's the easiest way to find them in the live, uh, in the, you just click on the live tab.
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If you're in my Facebook group, then you can click in the featured section.
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I keep all the lives, uh, all the replays.
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I pin them all in there just to make them easier to find.
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Um, so if you're interested more in case conceptualization, what it is, what, um, different aspects of it, feel free to pop over there.
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For today though, um, talking about assessment.
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Assessment and case conceptualization go hand in hand.
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So for the assessment part, you're gathering that data and the more ga uh, data that you gather, it's gonna likely improve the accuracy of your case conceptualization.
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And what do I mean by that case conceptualization is taking that information that you've gathered from your assessment and then you're analyzing and synthesizing that information to formulate an understanding of what exactly is going on with your client.
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Like what activates it.
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You're, you're looking for the roots, what are the roots of the behavior.
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And then you're also figuring out why it's happening.
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What, why is it happening now?
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Why is it happening in certain places?
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You're figuring out what the patterns are, so the, the more proficient that you are in knowing what questions to ask, um, and why it's important is gonna help you formulate your case conceptualization and increase the likelihood that it's gonna be accurate.
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The thing is assessment happens throughout the treatment process.
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I always think of myself as like a me.
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I call myself a mental health super sleuth, a mental health detective.
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I'm going in there.
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I'm looking for the clues, which are the data, and I'm trying to piece all of the puzzle pieces together to figure out what exactly is going on to solve the mystery of the problem?
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And so then we use that information from session to session, to session to session throughout each phase of the treatment process to recognize one I think we typically use, I look at it this way, like those first 90 days, I'm heavy into assessment mode to really get a sense of what's going on.
19:09
I'm using the play therapy sessions to see the themes and my clients' play, how they're interacting with me, what they say, what they don't say.
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All of those things are part of that informal assessment in those first 90 days.
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I'm also taking that information to help me figure out, okay, does let me match this up to my case conceptualization is there information that I am gathering that kind of makes me think, oh, maybe it wasn't what I was thinking it was gonna be, or I'm holding these possibilities of what it can be.
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Having more information.
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Which way do I really think I need to go or do all, all of them seem to be happening?
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Are they all playing a role in what's going on with my client?
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So the case conceptualization and assessment really do go hand in hand their separate components, but they interact and influence each other.
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And in the play therapy course that I've created, play Therapy case conceptualizations, what we do is I walk you through step by step that assessment process, what questions to ask, why you're asking them, and then I walk you through the case formulation, that case conceptualization process, taking that information to figure out what exactly is going on because you're gonna use that information is critical for your treatment planning to make sure that you're really targeting the right areas.
20:51
And so to me, getting this foundation, these are foundational skills that I, I find that we don't talk a lot about in the play therapy field, and I think it's really, really important.
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They are core competencies in play therapy, and so learning these skills will really improve the outcomes that you get.
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And so one of the things that I do in my Play Therapy Academy, so I have a, uh group consultation program, uh, called Play Therapy Academy, and we meet twice a month live video plus our courses in there as well.
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And we, we do this assessment process as a group.
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We'll ask everyone does a case key, um, presentation.
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We do two for each meeting.
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And we'll ask questions.
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We'll go through that assessment process.
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We'll go through that case formulation, and then come up with ideas and strategies to help the the client.
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So it's kind of like you, not only do you have my 30 years experience, you have everyone in the group and we have amazing group.
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So then I, and I'll talk a little bit more about that at the end as well.
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'cause I am opening up another cohort.
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So I have openings now.
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I'll talk a little bit more about that at the end.
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But these, these are the things that we do in order to get really thorough assessment and work on honing those case conceptualization skills.
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Because that information is what drives your treatment plan.
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And you use that information for an assessment process throughout the every phase of the change process so that, um, you get good outcomes.
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Really, I mean, make a difference in their life of your, your clients.
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To me, this is the, these are the skills we need to have in order to make that difference in their life and to help them.
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That's kind of what drives us, right, is, is seeing that change and that transformation for clients is really what keeps us going 'cause it's a hard profession.
23:06
So think about it this way as far as case conceptualization and assessment.
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So imagine you have parents and they're bringing their 8-year-old son to you because he has massive tantrums almost on a daily basis.
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That can last anywhere from 10 minutes to three to four hours.
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If you have been working with children, how many of you have had these kids on your caseload?
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We have all had them on our caseload.
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Um, so here's the thing.
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Here's where assessment comes in.
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Think and, and that case conceptualization.
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Think about how many re how many diagnoses, how many childhood problems share, irritability, emotion dysregulation, and oppositional behavior.
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How, how many childhood problems.
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Share those issues.
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How many diagnoses share those issues?
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Several.
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And this is where you go through and you're asking all of those questions to gather information to get a sense of, oh, what, what are the roots of this?
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So with those symptoms, irritability, emotion dysregulation, oppositional behaviors, those share the same roots, the same, um, symptoms and but have different roots, not the same roots.
24:39
I got that wrong.
24:40
So they have different roots.
24:41
Like a DHD can have emotion dysregulation that is part of executive function anxiety when they're freaking out, man.
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And it doesn't make any sense to you or trauma or attachment problems.
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It could be any combination of those.
25:00
So unless you are asking the questions, you're not necessarily gonna get a good understanding of where the roots are.
25:08
And how is that gonna measure up with your treatment plan if you're going, I can't tell you how many times I've seen people go kind of in the wrong direction or they get started'cause they wanna get started.
25:21
And then after those 90 days, even during those 90 days, they are lost, overwhelmed, confused, not sure what to do.
25:31
And then a lot of times when we have those conversations in Play Therapy Academy consultation groups, then what we'll do is we'll kind of take a step back, go through the questions, ask, explore case conceptualization they get right back on track.
25:49
Even when I do consultation with other people, this is the process that I go through and it's, it's amazing how right back on track people get and then you feel more comfortable, you feel more confident in what you're doing.
26:04
You don't feel your imposter syndrome goes away and your, uh, your fears that you're being a terrible play therapist all go away because now you have a plan.
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Now you have a better idea of what's going on that's really gonna make a difference and getting some of those good outcomes.
26:27
And the goal is we wanna make a difference, right?
26:30
That's what we wanna do.
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We wanna make a difference for a positive difference in the lives of children, adolescents, and families.
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So unless you do that thorough assessment and that assessment process throughout the treatment process in every phase, because you are gonna encounter some barriers or things come up along the way, that you're gonna have to go back to your case conceptualization like, what's going on here?
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Figure out what's going on and what needs to happen and move forward.
27:04
And then the next thing is, um, how do you know when to refer for more formal assessment?
27:14
And one of the things that I think about for that is if you are starting to notice that there's probably something else going on.
27:25
May be a developmental delay or there may be some learning challenges or maybe even sensory processing problems or some other, um, developmental thing or undiagnosed childhood dis problem, then you probably want to refer to someone who specializes in that area.
27:50
I always like to think of it in terms of like when you're sick, you go to your general practitioner.
27:56
They do their typical assessment and for typical kind of things, they usually can prescribe something or tell you what's going on and see what needs to happen.
28:07
If there's anything that is out of their scope of practice, then they'll refer to a specialist.
28:15
So that's kind of the same thing when we're working with kids is there are areas that are out of our scope of practice.
28:24
Like a clinical psychologist can do a really thorough neuropsychological assessment to really understand what might be going on like A DHD or autism or learning challenges or things like that.
28:42
If you suspect there may be some other processing disorders, then you wanna refer to an occupational therapist, a pediatric occupational therapist, who also has an expertise in sensory processing because one of the things my OT colleague friends have told me, um, is that it's not uncommon if there are some sensory problems, there may also be some gross motor and fine motor problems going on as well.
29:13
So referring to an occupational therapist can really be beneficial to figure out all of the roots of the problem going on.
29:24
Because if there are undiagnosed developmental or learning things or processing things going on for play therapy, our scope of practice is really more about identify like the co-occurring things that go along with that, like anxiety or depression or emotion regulation problems because of frustration or the negative self-talk that comes up.
29:48
So in play therapy, we can address those types of things, but there's knowledge and expertise by a specialist that we are not gonna have and a lot, so what's important to refer?
30:01
We, I think one of the things that I do is I know a list of questions to ask, um, in my head and I, in the, the case conceptualization course, I, I'll go over those as well and kind of teach you what those are so that when you're doing your information gathering, your data gathering, you can ask certain types of questions.
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And if there are enough, then the likelihood you're gonna run a ref want to refer to get further specialized assessment is pretty high.
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So that is it for today.
30:33
So I am Cathi Spooner.
30:35
I forgot to say this earlier.
30:37
So I'm Cathi Spooner.
30:38
I have 30 years experience in the child and adolescent mental health field.
30:45
And my area of expertise that I love, love, love, love, love is play therapy.
30:51
I love talking about play therapy.
30:53
I love learning about play therapy.
30:55
I love reading research about play therapy.
30:58
So I regularly refer to myself as a super nerd and I tell my kids I make nerdy proud.
31:05
My, my kids are young adults and I, when I say that, they always laugh, roll her eyes and like, oh my God, my mom's so weird.
31:12
So, uh, so I, uh, if you're interested in learning more about the Play Therapy Academy, and, uh, the case conceptualization course, I'm gonna talk about that.
31:27
I'll p I'll post some links.
31:28
You can pop over to my website, which is rh counseling.com.
31:37
If you go on the courses page, you'll see all the courses I have there.
31:41
Um, I have some foundational play therapy, uh, foundational play therapy course.
31:48
Play Therapy Case Conceptualization course, and another expressive arts course.
31:52
And if you pop over to the supervision page for services, that's where you can find out more about Play Therapy Academy.
32:02
Um, so just a recap for today.
32:07
Assessment is critical, um, to figure out what's going on.
32:15
And in order to do that, you really do need to gather enough information to actually figure that out.
32:21
If you leave out or skip over don't really recognize the value of it.
32:28
Maybe to you it's just a task that you have to complete for your agency.
32:32
Maybe think about it in a different way in terms of I can get some really good information right from the start of treatment that's gonna set me up for really understanding what's going on with my client to help them get really good outcomes and treatment.
32:51
And, um, and there there are different kinds of assessment.
32:55
There's the informal kinds of assessment, or if you suspect there might be something else going on and you need more specialized assessment for your client.
33:07
You want to have that conversation with parents and help them understand how it's gonna be beneficial.
33:13
Then you may want to refer your client for more, uh, formal assessment by a trained specialist or, uh, with who have that expertise.
33:25
And the other thing is really that assessment and case conceptualization go hand in hand.
33:34
Assessment the data gathering helps us, um, ensures that we get an accurate case conceptualization in place.
33:42
And then we are always in assessment mode, gathering information from session to session, and then seeing how that influences our case conceptualization if we need to make any um, I'll say course corrections along the way.
33:59
Then we make those adjustments.
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Um.
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So those, those go hand in hand and are really important in terms of getting good outcomes for treatment.
34:10
And then finally, the thing you wanna think about is when you need to refer for more formal assessment.
34:18
If it's something out of your scope of practice and you, you think there's something that's not by been diagnosed that are contributing to, the problematic symptoms and behaviors that your client is experiencing, then I, I would highly recommend thinking about who you need to refer to.
34:38
I think one of the things in the play therapy arena that we, we can provide for our clients is if you're networking with other professionals and getting connected with others, like occupational therapists, clinical psychologists, um, I know back in Virginia that I, I did a lot of work, uh, networking.
35:01
So I, I'm in Southern Nevada now.
35:03
We, we moved here almost seven years ago.
35:05
A lot of my experience was when I was living in Virginia.
35:11
And, uh, right outside the Washington DC area and we had tons of different kind of professionals there, which was really nice.
35:19
I, so vision processing, auditory processing, all of those are different specialty areas, occupational therapy, sensory processing, specially specialties in the OT field, physical therapy, speech therapy, um, autism specialists and clinical psychologists.
35:44
So even net making sure that we're networking with professionals.
35:48
And so when we do need to refer, then we, we have a, um, an idea who to refer parents to give names.
35:59
They, it's always their choice who they want to go with.
36:02
And I think you have to make that clear.
36:04
Make it clear, you know, they wanna ask questions, they wanna pick somebody they're comfortable with.
36:09
If their insurance matters, make sure they ask about that and how that works.
36:13
So those are all things I think are really important to think about, uh, when you're thinking about assessment and what is going on with your client to help them overcome and whatever challenges they're facing.
36:29
So that's it for today.
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If you found this information helpful, please feel free to share it across your social media platforms and if you're interested in the case conceptualization course, it's a self-paced course.
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You can take any time in your time zone when it's convenient for you.
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There were videos and experiential activities in the course.
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Um, that's true for the other.
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I have two other courses as well.
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If you're interested in Play Therapy Academy, I do have a second cohort that I have opened up.
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If you're interested in that, finding out more, you can hop over to my website at rrhcounseling.com.
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The courses are gonna be on the courses page.
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Play Therapy Academy Information is gonna be on the supervision page.
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If you're interested in Play Therapy Academy, feel free to schedule.
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I have a free 30 minute video, uh, consultation where we talk about play therapy academy, what it is, if it's gonna be useful to you, how it works and all that kind of stuff.
37:41
So just also an FYII am doing a little rebranding, so in May you will see a new name.
37:49
Um, it's gonna be new name, new logo, new website.
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It's the same me, same services, just a little rebranding.
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So the new name is gonna be Renewing Hearts Play Therapy Training.
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Currently my business is renewing heart counseling and consulting.
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I'm not doing the counseling anymore, so I thought it would be good to rebrand that.
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So that's coming up in May.
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Next week, I am going to have a guest, Claire Melanin.
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We both share a love of attachment and neuroscience.
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So Claire, uh, Claire's gonna be my guest to talk about different trends in play therapy, some of the things she's thi seeing and some of her, the work that she's doing.
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So, um, she's really good.
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Uh, play therapist.
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Very knowledgeable and so I'm very excited to have her on my, as my guest next week, I won't be able to live stream into Instagram, so if you're watching on Instagram for next week, if next week, if you wanna catch that, you may wanna pop over to my YouTube channel and you can watch it on my YouTube channel or join my Facebook group'cause I'll be able to live stream into there.
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So I will see you next week.
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Bye.
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All right.
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If you have any questions, feel free to post them in the comment and I will see you next week.
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Bye.
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Thank you for joining me on this episode of Next Level Play Therapy.
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I hope you found the discussion valuable and gained new insights and ideas to support your work helping children, adolescents, and families heal.
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If you enjoyed this episode, be sure to subscribe to the podcast and leave a review.
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Your feedback helps to improve and reach more people who can benefit from this information.
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Remember.
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Play therapy is a powerful tool for healing and growth.
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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 in relationships.
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If you have any questions or topics, suggestions for future.
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I'd love to hear from you.
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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.
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Thank you once again for listening to Next Level Play Therapy.
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Until next time, keep playing, learning and growing.