Latest / Next Level Play Therapy: A Podcast for Play Therapy Excellence / Play Therapy Case Conceptualization: Trauma, Attachment & Behavior

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Play Therapy Case Conceptualization: Trauma, Attachment & Behavior · 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 so you can provide a transformative experience for your young clients and make a real difference in their lives.
• 0:33
  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.
• 0:48
  Welcome to this week's episode of Next Level Play Therapy, where we talk about all things play therapy, especially using a neuroscience and attachment lens.
• 0:59
  So if you have ever left a session thinking to yourself,"I saw what happened in there, I see the behaviors, and I have no idea what's driving those behaviors," then you're not alone.
• 1:14
  Actually, this is something we talk a lot about in my online membership programs to support each other, to sharpen our play therapy skills, go deeper to get better results for our clients.
• 1:28
  Because the thing is, we're not supposed to stay stuck here, and one of the things that I've found is it's really hard to do this by yourself sometimes, especially if you feel like you're the only play therapist in your community.
• 1:43
  So that's one of the reasons I do these podcast and live stream episodes so that we can connect and also talk about things I think that are really important in the play therapy community.
• 1:57
  So in this live stream episode, or if you're listening to the podcast or you're watching the replay, we're gonna be talking about case conceptualization and how to use that in play therapy to get deeper impact, and why it makes all the difference for being able to get unstuck and get really long-lasting results for healing for your young clients.
• 2:30
  So today, we're gonna be talking about a fictitious client.
• 2:37
  I have a case study,'cause I think that would be really useful.
• 2:41
  If you're watching on the li- the Instagram s- um, live stream or video replay, you may wanna pop over to my YouTube channel, Cathi Spooner Renewing Hearts.
• 2:56
  Because I'm gonna show some PowerPoint slides, and you won't be able to see them on Instagram.
• 3:02
  If you're listening to the podcast, same thing there.
• 3:06
  You may wanna pop over to my YouTube channel and watch on that channel.
• 3:12
  What... So if you're going to my YouTube channel, Cathi Spooner Renewing Hearts, then you'll wanna click on the live tab.
• 3:19
  That's where all the live replays are, and there's a bunch of 'em.
• 3:23
  So if you've not really thought about case conceptualization before, I talk a lot about that in previous episodes, so you may wanna go check those out.
• 3:36
  So for those of you who are joining today, I would love to see who's here, what population do you work with, where do you work, what type of play therapy, or maybe you're using expressive arts.
• 3:53
  What type of play therapy or expressive arts are you using?
• 3:58
  And, um, maybe join the conversation.
• 4:02
  Post your comments.
• 4:03
  If you find the information useful, please feel free to share it across your shows, social media platforms.
• 4:11
  That helps more people get the information.
• 4:16
  And if, uh... Feel free to message me.
• 4:19
  I love to hear from people.
• 4:21
  Feel free to send me a message, or if you're on Instagram, send me a DM. If you're on LinkedIn, send me a message, and post in the comments.
• 4:34
  All righty.
• 4:35
  So let's get started for today.
• 4:38
  So here's the thing.
• 4:40
  Why does, why does case conceptualiz-...
• 4:43
  That's a mouthful.
• 4:45
  Why does case conceptualization matter?
• 4:49
  Well, it, it makes a difference for you to really make sense of what's going on in the play therapy room.
• 4:58
  What is at the root of those behaviors?
• 5:00
  And that's, that's the target we're aiming for, understanding what is going on beneath that behavior surface.
• 5:11
  One of the things that we talk about a lot in Play Therapy Academy, and also we just had this really awesome case consultation meeting in our... in Play Therapy Elevation Circle about room wreck behaviors and really breaking down what is going on with that because you can't figure out what to do until you figure out what's going on, what's at the root of it.
• 5:40
  And so that's one of the things that we talk a lot about in- Play Therapy Academy and Elevation Circle, those are my online programs, because I really feel like this is not a profession done well alone.
• 5:57
  I feel like we need a, um, a system of support, other play therapists who get it.
• 6:04
  'Cause one of the things I hear a lot for people joining Elevation Circle and, um, is that they feel like they're the only play therapist in their agency or in their community, and it's kinda hard to know what to do when you feel like you're getting stuck, or maybe you're getting a little burned out and second-guessing.
• 6:26
  So this is where your case conceptualization matters because without clear case conceptualization, you're gonna chase the behaviors, you're gonna second-guess yourself what you're doing in your play therapy sessions, and you're gonna feel like you don't have any direction and kind of feel like you're lost.
• 6:46
  And with play therapy case conceptualization, you're going to feel like you're more grounded, you're gonna be more intentional, and feel like you're more effective.
• 6:59
  So let's get started with the case study.
• 7:04
  All right, so for today, um, so just so you know, I'm Cathi Spooner.
• 7:10
  I'm a licensed clinical social worker and a registered play therapist.
• 7:14
  I have been in the child and adolescent mental health field since 1992, so I've been in for a while.
• 7:22
  I've always worked with children and adolescents and families.
• 7:29
  And so I'm gonna, um, talk a little bit about why some of these things matter today.
• 7:39
  All right.
• 7:39
  So first of all, Carla.
• 7:41
  Let's meet Carla, and I am gonna be sharing my slides.
• 7:45
  There we go.
• 7:46
  Before we meet Carla, we wanna meet our play therapist, Sarah, who is also a made-up person.
• 7:53
  Um, and Sarah really...
• 7:53
  Sarah's a play therapist.
• 7:59
  She enjoys working with children.
• 8:02
  She's been providing play therapy services for about six years now.
• 8:09
  She feels pretty comfortable using play therapy and expressive arts modalities with her clients to help them heal.
• 8:18
  So Sarah has been working with Carla, our fake client, for about five sessions now, and she has been struggling to figure out the best way to help Sarah heal since she doesn't really engage much in the play therapy sessions.
• 8:38
  So- Sarah's been feeling a little bit stuck and not sure if what she's doing is helping.
• 8:45
  She's feeling a little bit lost because Carla is not really engaging in the sessions.
• 8:54
  All righty, let's...
• 8:59
  There we go.
• 9:00
  I'm thinking you guys can still see this.
• 9:02
  It's a little bigger now.
• 9:04
  So I use, uh, StreamYard to, uh, live stream, and I'm still trying to figure it out when I'm using the PowerPoints how that works.
• 9:15
  So, um, I am... Oh, there we go.
• 9:19
  All righty.
• 9:20
  So, um, let's... All right.
• 9:26
  So, s- um, she, Sarah's been working with children and using play therapy because she really wants to help children thrive.
• 9:36
  She believes firmly in the power of play therapy because she's seen so many clients benefit from it.
• 9:45
  So Sarah did not meet...
• 9:48
  She didn't do her initial session.
• 9:50
  She didn't do that first session just with the caregiver to gather all of the information because she really wanted to get right into the play therapy sessions, get to know Carla, see what was going on.
• 10:04
  So she didn't do that information gathering in person with the caregiver, but she did get some information from the caregiver over the phone, and she had the care- caregiver fill out an online history, so she gathered some information that way.
• 10:23
  Um, Sarah's been using child-centered play therapy to get to know care- uh, Carla, but she feels like she's probably doing it wrong because Carla isn't really interacting with her.
• 10:35
  So she tried asking Carla some questions about her school, her favorite color, her favorite things to do in an effort to get Carla to open up and feel a little bit more comfortable.
• 10:49
  This actually resulted in s- Carla getting a little more quiet and asking where her caregiver is.
• 10:58
  So Ther- Sarah thought it might be helpful to include some directive activities 'cause she was thinking, "Well, maybe that's a way to get Carla to open up a little bit." And Carla was really minimally engaged and was still very reluctant to stay in the play therapy session alone with Sarah.
• 11:19
  So Sarah felt like she was letting down Carla and that maybe she wasn't a good play therapist.
• 11:27
  She started second-guessing herself.
• 11:30
  Raise your virtual hand if you ever feel like this is you and you have experienced this in your play therapy sessions.
• 11:39
  Honestly, this is something we talk a lot about in Play Therapy Academy.
• 11:43
  So Play Therapy Academy, we do a deeper dive, we meet a lot more.
• 11:49
  It's this much smaller group.
• 11:51
  We do a deeper dive.
• 11:52
  We learn play therapy, um, skill building and competencies.
• 11:58
  We do a little bit as this as well in Elevation Circle.
• 12:01
  Elevation Circle is more focused on providing support to each other, giving feedback and ideas.
• 12:07
  So we d- we'll do some case conceptualization and breaking it down just because I don't feel like you can do play therapy very well unless you have some version of that.
• 12:19
  So this is something we talk a lot about and give support to each other.
• 12:25
  All righty.
• 12:26
  Oh, dang it.
• 12:28
  All righty, so I apparently w- if you're looking at my, my slides, you're seeing they're a little wonky on here.
• 12:36
  So what's been happening in the play therapy sessions...
• 12:40
  I'm gonna switch back and see if that... Nope, that didn't help either.
• 12:44
  All righty, but at least I can see the comments.
• 12:46
  All right.
• 12:46
  So in the play therapy sessions, um, actually I'm gonna make it bigger 'cause it didn't help.
• 12:55
  Here's what Carla's been doing.
• 12:57
  Carla has attended about five play therapy sessions, and during the play therapy sessions, she initially refused to separate from her caregiver.
• 13:09
  She eventually agreed to stay if the caregiver was in the session or s- and then eventually just sitting outside of the playroom, so the door a little bit cracked and, and the caregiver sitting right there by the door, and then Carla repeatedly checked to make sure the caregiver was still there.
• 13:31
  Carla didn't talk very much.
• 13:33
  She explored the dollhouse.
• 13:36
  She was placing the dollhouse children in one area of the dollhouse, and then she put the adults in a separate room.
• 13:45
  And then she would briefly kinda scan the playroom, exploring other toys in the playroom, but not really not engaging much in what wa- in the toys.
• 13:59
  So most of the engagement was with the playhouse.
• 14:02
  So if you're looking at this and you have this information so far, what are you thinking that Carla is struggling with, and is play therapy actually working?
• 14:16
  So what would your thoughts be about that?
• 14:19
  If you're watching the live, go ahead and livestream or even the replay Go ahead and post, post that in the comments.
• 14:28
  So what I really want you to do, if you're kinda multitasking here, come back, focus, really think about what might be going on here, and then kinda make some notes to yourself, and we'll see how that goes as we're progressing.
• 14:46
  But I really want you to think about this.
• 14:48
  Start thinking about what is going on in this session.
• 14:53
  So we can kinda tell Carla is a little reluctant, not really feeling comfortable in the session.
• 15:00
  She needs her caregiver around, so she's not really engaging with, um, Sarah, the play therapist, and she really is not comfort- and Carla's really not comfortable being in there.
• 15:14
  So what, uh, so the presenting issues.
• 15:18
  So here's some, a backstory about Carla, and think about what your initial diagnosis would be or what Carla might be struggling with.
• 15:28
  So Carla's a seven-year-old female referred to therapy with Sarah because she's having nightmares almost every night.
• 15:37
  She's clinging, refusing to go to bed.
• 15:40
  She's withdrawn at home, and em- uh, emotionally and socially.
• 15:46
  She's hiding food in her room and becoming distressed when redirected about food can only be in the kitchen.
• 15:55
  So she gets a little upset about that.
• 15:58
  So if you're looking at these behaviors, you've got some of that information from, uh, the, your session fr- with the playroom.
• 16:08
  Now you've got a little bit more information about Carla.
• 16:13
  What would your initial diagnosis be?
• 16:17
  What would your working hypothesis be about what is going on with Carla?
• 16:23
  This is where you're really starting to think, um, clinically, looking at the deeper roots of what might be going on and what might be happening in the playroom.
• 16:37
  So here's some more information about what we're finding out.
• 16:41
  Oh, sorry, my slides.
• 16:43
  I thought I... So for the record, I did check my slides, but sometimes when they download or I upload them differently, it changes the formatting.
• 16:52
  So sorry about that.
• 16:53
  They're kind of a little hard to read.
• 16:56
  Um, so here's some more information, and then how does this influence what you're also thinking about in terms of what's at the root of these behaviors?
• 17:08
  So Carla's been in foster care for about 12 weeks after experiencing neglect related to parental substance abuse, and parents were homeless.
• 17:19
  So most of Carla's life, her parents were abusing drugs and alcohol, and as a result of their drug and alcohol issues, they, the-- Carla and her family were homeless.
• 17:34
  Carla hasn't really spoken with foster care w-- I mean, sorry.
• 17:38
  Sarah hasn't really f- spoken with the foster care worker, and the foster care-- and the foster parents don't know much about what happened or what's the plan for Carla's reunification with her birth parents.
• 17:53
  Carla's supposed to have weekly supervised visitation at the local park.
• 17:58
  Parents are not consistent in their attendance.
• 18:01
  And when during visitation, Carla's slow to warm up to her father and tends to avoid contact with him.
• 18:10
  After visitation, Carla's usually more clingy and difficult to soothe.
• 18:16
  So think about how that influence, now that in- information influences your thinking about what are at the roots of the problem.
• 18:26
  And here's the other thing that I notice.
• 18:28
  This comes up a lot in play therapy consultation as well, s- um, in Play Therapy Academy.
• 18:38
  S- we haven't really talked about this much in Elevation Circle so far.
• 18:43
  If you're working with children who have been placed in foster care and you're the play therapist, you really need to have contact with the foster care worker.
• 18:57
  Here in the United States, the foster care worker, foster care system, if the child's in foster care, then the foster care system, the state or the county, the government entity, is the legal guardian.
• 19:11
  They're the ones you also need to be finding out what the plan is, some of the backstory to get a better understanding of what happened that led to that child being placed in foster care.
• 19:27
  You really need to be consulting with the c- foster care worker.
• 19:32
  You really need to be building a solid working relationship with that foster care worker, because if you don't know what the plan is for reunification, then you're not-- you're kind of missing a big piece of the puzzle about what's supposed to be happening.
• 19:49
  All right.
• 19:50
  So what information are you missing?
• 19:54
  And here's the other thing, the thing that I find when you don't do that initial case, uh, that initial, um, psychosocial history and use it as a way to go take a deep dive in what's been going on, and I always recommend when the younger the child, when the kids are little, just do it with the adult caregiver.
• 20:21
  Don't have the child in there because, two, they're really uncomfortable.
• 20:26
  They usually don't last the entire time.
• 20:30
  Half the time the caregivers are whispering 'cause they don't want the child to hear you.
• 20:35
  And so you could kind of, you could get a whole lot in- more information faster if you just met with the caregivers for that first session.
• 20:44
  I usually ask if, uh, if s- if they're a little older, like middle school or high school, I'll usually ask the caregiver how they think that child would do because we're gonna be talking about what's wrong.
• 20:56
  We're getting, get into the, all of that information gathering.
• 21:02
  So here's, here's the, some of the missing information that might help you better understand Carla.
• 21:09
  So what's the information about the foster care worker that helps you understand the extent of the neglect?
• 21:17
  What's known about the dynamics between the birth parents and the extent of the par- uh, parental substance abuse?
• 21:25
  Like, did they have periods of sobriety?
• 21:29
  Has Carla always been with both parents?
• 21:33
  Did parents split up?
• 21:35
  Was there domestic violence?
• 21:36
  Was there a lot of arguing?
• 21:38
  Were there periods where they weren't homeless?
• 21:41
  All of this is really important information.
• 21:45
  Is, was Carla exposed to any physical or sexual abuse in addition to the neglect?
• 21:51
  Have foster parent ... So what have foster parents tried for soothing Carla's distress, especially at bedtime?
• 22:00
  What, and how does Carla interact with foster parents?
• 22:04
  And are there any other children in the home?
• 22:06
  How does Carla interact with them?
• 22:09
  This and is there any way to find out any developmental history?
• 22:15
  Was there any fetal exposure to drugs or alcohol?
• 22:21
  All of this information can be helpful.
• 22:27
  All righty.
• 22:27
  So why is case conceptualization important for treatment planning?
• 22:33
  Here's the trap that most play therapists fall into, is that they tend to stay at the behavioral level.
• 22:42
  You start focusing and labeling clingy, avoidant, resistant Food hoarding, sleep disturbance.
• 22:52
  And then what tends to happen is once you start labeling that and focusing on that, you're really just tempted to fix the behavior and not really go down to the deeper roots.
• 23:08
  So here's how case conceptualization can shift the influence of your play th- and can be shifted and influenced by your play therapy theoretical model.
• 23:23
  So your case conceptualization is going to be influenced by your play therapy theoretical model.
• 23:30
  For example, if you're a child-centered play therapist, you're gonna be thinking about this from a child-centered play therapy lens, and that's gonna influence what you do in the play therapy sessions, how you do it, when you do it, and why you do it.
• 23:48
  It's also gonna help you understand where you are, what stage of play therapy are you in, or maybe you're using Adlerian play therapy, or Gestalt play therapy, or Jungian play therapy, or CBT, or maybe you're using more of a neuroscience and attachment lens for your play therapy sessions, and you're using an integrative model blending together EMDR, maybe IFS, so some parts work.
• 24:18
  Maybe you're blending a little Gestalt play therapy in there.
• 24:22
  All of those are gonna influence how are you making sense of what's happening in the playroom, and then that's gonna influence what are you gonna do, when are you gonna do it, how are you gonna do it?
• 24:37
  So then we're not really focusing on the behavior, we're looking at behavior as the communication.
• 24:44
  So instead of asking, "How do I stop the behavior?" Then you start asking, "What is this behavior trying to solve?
• 24:56
  What need are they trying to get met?
• 25:00
  What are they communicating with that?" So I'm gonna walk you through kinda quickly some of the steps of case conceptualization, and then if you're interested, I'm gonna tell you a little bit more about...
• 25:13
  I have a play therapy training coming up for, um, using a trauma and attachment- lens to work with children, uh, a neuroscience and attachment lens that's trauma informed when you're working with children who've experienced trauma and neglect.
• 25:32
  So it's called Healing Trauma Through Play: A Neuroscience and Attachment Lens.
• 25:38
  I will talk a little bit more about that training if you're interested.
• 25:41
  We go into a really deep dive into the case conceptualization, meaning looking at what the neuroscience and the attachment theory tells us to help us understand the behavior, and then a treatment, uh, a treatment approach, a play therapy approach using an integrative model that's trauma informed, that's gonna help you know what to do in each stage of the play therapy process.
• 26:11
  We'll do lots of examples for play therapy activities, and the registration also includes 60 days for free of Elevation Circle so that you don't have to feel like you leave the training and then you're kind of all on your own again.
• 26:27
  You can get some ongoing support after the training.
• 26:31
  So from step one for play therapy, your initial case conceptualization, you are moving from looking at the behavior to figuring out what is the purpose.
• 26:43
  So let's, let's translate Carla's behaviors into a trauma informed lens.
• 26:50
  So she's clinging and maintaining proximity for safety.
• 26:56
  She needs that foster care mom to feel safe.
• 27:00
  That's why she's clingy, because she doesn't feel safe.
• 27:05
  The nightmares, probably she might be having some unres- um, some of that unresolved trauma getting activated at night, and again, we're looking at safety, needing one of her caregivers who she feels safe with to be near her because sh- her, that trauma activation system has gotten implemented.
• 27:29
  Food hoarding.
• 27:30
  She's hiding food.
• 27:31
  This is a little girl who was homeless, so there probably is a lot of food insecurity.
• 27:38
  Did she have access to food?
• 27:41
  What was, um, what was her experience about how often she had food or how often she got hungry and didn't have food?
• 27:52
  Also withdraw.
• 27:53
  When she's going into that withdrawal mode, she's kind of shutting down and really conserving her energy to kind of make sure that she can be safe and not really sure what's going on in the environment, so she's kind of withdrawing a little bit more a- again, for safety, and not, she's not sure what might be happening.
• 28:19
  And that checking for foster mom is really her checking for safety and having that attachment figure, that adult that she feels safe with to help her feel safe.
• 28:33
  So now we're not really gonna focus on the nightmares or the food hiding.
• 28:38
  We're gonna figure out how to help Carla feel safe.
• 28:44
  All righty, so, um, how are we bringing then that neuroscience lens?
• 28:52
  Well, now we're looking at Carla's brain is not organized around curiosity and exploration.
• 29:00
  It's more organized, her nervous system has been shaped by her brain's predictive responses to managing chronic instability, and it's organized around survival.
• 29:15
  The brain is predictive.
• 29:17
  It gets into this feedback loop between the brain and the body in a predictive way to know what to do and how to respond.
• 29:27
  And so now what does that mean about Carla's behavior?
• 29:31
  It means her threat detsec- detection system is constantly overactive.
• 29:37
  Her capacity s- for self-regulation is underdeveloped because she didn't... Where our working hypothesis would be if her parents were using drugs and alcohol and they were not functioning enough to earn money and, and keep food, shelter, and clothing in place for Carla, then we're looking at the fact that they probably were not present to help calm her and help her fee- feel safe.
• 30:06
  So her ability to self-regulate, one, she's six, so she's gonna need her grown-ups anyway to help her with that, and two, it hasn't been developed because they were hypothesizing that caregivers probably weren't really present.
• 30:26
  And so transitions like bedtime or separation trigger those alarm states.
• 30:34
  So now we're at step three.
• 30:37
  What has Carla learned about relationships?
• 30:40
  Well, we can, we can hypothesize with our initial case conceptualization that those early expo- e- those early attachment experiences likely taught her that caregivers are not consistent or they're unavailable, that her needs are probably not going to get, get met, and that safety is not predictable.
• 31:03
  So now let's look at her d- her behavior in the play therapy sessions and at home let's- Let's look at that in a different light.
• 31:14
  So what do we see now?
• 31:16
  We see difficulty separating, constantly checking for caregiver presence, hesitation to engage fully in new environments.
• 31:25
  So that's not dependence, this is attachment insecurity doing exactly what it was designed to do, to keep connected enough to survive.
• 31:37
  This is Carla trying to survive, and she's in survival mode because she's not felt safe.
• 31:45
  So step number four, now we're looking at some of that information that you've gathered from the playroom.
• 31:54
  Let's look at the playroom to assess these themes and their re- relevance for Carla's experience.
• 32:01
  So what we saw in the play themes showing up is that Carla separated the children and the parents in the dollhouse.
• 32:10
  So maybe what we're holding as the possibility for this play therapy theme is in her internal world, what she's playing out and trying to make sense of are her experiences, and her experiences being that disconnection, emotional distance, lack of a felt sense of safety within these relationships.
• 32:39
  And what about her e- limited inter- interaction with the toys and that limited interaction with Sarah, the play therapist?
• 32:49
  What that tells us is she's still assessing safety.
• 32:52
  She's not yet feeling safe enough to even go deeper into engaging in the play therapy process because she's still always assessing for safety.
• 33:06
  So now we can look at that behavior in the playroom and at home.
• 33:14
  Now we're looking at that through a different lens, and she's not...
• 33:19
  It's not that she's not playing in the playroom, it's that she doesn't feel safe yet.
• 33:25
  She needs to feel safe.
• 33:28
  So that gives us more information to think about.
• 33:32
  Now, what are we gonna do?
• 33:34
  Now we're building that case conceptualization for our working hypothesis.
• 33:39
  This is where we kind of bring all of that together, and now we're thinking about Carla is a child who has adapted to chronic neglect and instability.
• 33:50
  Her current behaviors reflect survival strategies that are rooted in fear of abandonment, expectation for unmet needs, lack of internalized safety, and dependence on external regulation.
• 34:06
  So her early- her play themes Are reflecting separation, disconnection, and monitoring for safety.
• 34:15
  So now we can look at what's going on.
• 34:17
  Is Sarah doing a terrible job?
• 34:20
  No.
• 34:21
  What needs to happen is Sarah needs to understand what's going on, use this information to figure out what she needs to do, which is also gonna be based on her play therapy model.
• 34:36
  So our working hypothesis now is Carla's behaviors are adaptive responses to early childhood disruption and chronic environmental threat, maintained by a predictive brain allocating energy resources based on no consistent experiences of safety and getting basic needs met.
• 35:01
  That's at the root of the behavior, and that's where the focus in treatment needs to be.
• 35:08
  So your working hypothesis is about what is at the root of the behavior and what are the patterns that are sustaining that play f- uh, that behavior, and this is gonna be influenced by your play therapy model.
• 35:23
  So if we're using that neuroscience and attachment-informed lens versus a behavioral lens, then we're looking at the root of the problem is based on needing to establish a sense of safety and trusting that her basic needs are gonna get met, rather than changing and putting rules around the food, putting rules around bedtime, doing some behavior management, which is probably not going to work.
• 35:54
  And so the treatment planning focuses on the roots and the patterns of the behavior.
• 36:03
  So instead, uh... So for the treatment planning, instead of how are we gonna stop the food hoarding, we're gonna ask, "How do we help her feel that her needs are gonna get consistently met while ret- maintaining some healthy boundaries where needed?" And instead of how are we gonna get her to sleep by herself, we're asking,"How do we creana- create enough safety that separation doesn't feel dangerous?" And instead of how do we get her to engage in the play in play therapy sessions, we ask,"How do we help her nervous system settle enough to, to feel safe so that she can engage in the play therapy process?" So that is it for today.
• 36:51
  So today we focused on the, um, the case conceptualization and kinda walking you through that process of Um, developing your initial case conceptualization, also known as your working hypothesis, and that's gonna help you figure out what to do for your treatment planning.
• 37:16
  So next week what I'm gonna do in the weekly live stream is I'm gonna, uh, walk you through how do we take this information from the case conceptualization, and how do we use that neuroscience and attachment, um, theory lens to implement a play therapy treatment?
• 37:36
  What do we do in the sessions?
• 37:37
  When do we do it?
• 37:38
  How do we do it?
• 37:39
  And who's gonna be involved, and how are they gonna be involved?
• 37:43
  So, um, that is it for today, focusing on case conceptualization.
• 37:48
  Why is it information...
• 37:48
  Why is it important to gather all of that initial history information?
• 37:57
  Skipping that part really does not help Carla feel better faster.
• 38:04
  Actually getting all of that information will help you form your case con- your initial working hypothesis, and then you take those play therapy sessions to continue that process, continue gathering that information.
• 38:21
  In fact, your case conceptualization is gonna happen throughout the treatment process, and you're always adjusting that so that you can stay focused on what is at the root of be- behavior, has change happened, and when you get a little lost, you go back to your case conceptualization.
• 38:43
  So that is it for today.
• 38:46
  If you are interested in, um, learning more about my upcoming training, Healing Trauma Through Play Therapy, A Neuroscience and Attachment Approach, then registration is still open.
• 39:03
  The training is online and virtual.
• 39:06
  We're gonna go take a little more deeper dive into the neuroscience and attachment aspects of trauma and neglect so that you have a better understanding of the behaviors that you might be seeing, and also how to use play therapy to help your clients heal.
• 39:25
  I'm gonna, um, show you an atta- a, an integrative play therapy model where I'm gonna walk you through how to use a trauma- -based approach with play therapy, integrating some of the more updated neuroscience and attachment information.
• 39:44
  I've been consulting with a cognitive and neuroscientist researcher to make sure the information is on point now that we've been learning a few things about what may not be so accurate, but what, what can we keep that's actually informed by research, and then how do we take, take that information and use it for play therapy.
• 40:13
  So if you're interested, Healing Trauma Through Play
• 40:16
  Therapy: A Neuroscience and Attachment Approach, registration is still open.
• 40:23
  Therapy: The training takes place virtually and in person in St. George, Utah.
• 40:28
  Therapy: There's also a recorded version that'll be available after the training 'cause I wanna make sure to include all of the updated information about where trauma is actually stored, and it's not in the body, and just some of the updated information we've learned about the whole polyvagal debate that's been going on.
• 40:48
  Therapy: What can we keep from that?
• 40:49
  Therapy: How can we use that information?
• 40:52
  Therapy: And just kinda integrating some, some parts work in there, some, uh, information about that, lots of activities.
• 41:02
  Therapy: And registration includes 60 days of Play Therapy Elevation Circle because I feel like it's really important to have ongoing support when you are doing play therapy, even after training, so that when you go home and you think three weeks later, you're like, 'What did we talk about in that training?' Or, 'Oh, I really wish I had somebody to talk to about this,' then you have that opportunity.
• 41:31
  Therapy: So that is it for today.
• 41:34
  Therapy: If you're interested in the training or maybe you're interested in the online programs that I have going on, the memberships, pop over to my website at rhplaytherapytraining.com.
• 41:47
  Therapy: That's rhplaytherapytraining.com, Renewing Hearts Play Therapy Training dot com.
• 41:50
  Therapy: Check out all of the things on the website.
• 41:55
  Therapy: There's lots over there, and I will see you next time.
• 42:03
  Therapy: Bye for now.
• 42:09
  Therapy: Thank you for joining me on this episode of Next Level Play Therapy.
• 42:13
  Therapy: I hope you found the discussion valuable and gained new insights and ideas to support your work helping children, adolescents, and families heal.
• 42:23
  Therapy: If you enjoyed this episode, be sure to subscribe to the podcast and leave a review.
• 42:28
  Therapy: Your feedback helps to improve and reach more people who can benefit from this information.
• 42:34
  Therapy: Remember, play therapy is a powerful tool for healing and growth.
• 42:39
  Therapy: 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.
• 42:50
  Therapy: If you have any questions or topic suggestions for future episodes, I'd love to hear from you.
• 42:57
  Therapy: 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.
• 43:09
  Therapy: Thank you once again for listening to Next Level Play Therapy.
• 43:13
  Therapy: Until next time, keep playing, learning, and growing.