Latest / Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy / 436 | Should You Ever End a CCPT Session Early? (Clarifying Ultimate Limits in CCPT)

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436 | Should You Ever End a CCPT Session Early? (Clarifying Ultimate Limits in CCPT) · Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy

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  You're listening to the Play Therapy Podcast with Dr.
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  Brenna Hicks,
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  your source for centered and focused play therapy coaching.
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  Hi,
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  I'm Dr.
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  Brenna Hicks,
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  The Kid Counselor.
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  This is the Play Therapy Podcast where you get
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  a master class in child-centered play therapy
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  and practical support and application for your
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  work with children and their families.
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  In today's episode,
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  we are going to talk about something that has come up
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  in the last couple of weeks
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  that I want to clear up
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  a potential misconception.
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  So I'm constantly trying to evaluate things that I've said
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  and
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  whether or not they've been interpreted correctly or understood correctly and or
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  what are the common misconceptions in CCPT
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  that I feel compelled to address.
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  And so one of the ones that came up in the last couple of weeks
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  is
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  when a child
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  chooses to not comply with limits multiple times.
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  Do we set an ultimate limit of you've chosen not
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  to have the rest of your play time today?
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  And
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  the other branches of CCPT,
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  i.e.,
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  Cochran's and potentially Van Fleet,
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  I don't really know that for sure,
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  but I know for sure Cochran's
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  teach that a child can choose not to have the rest of their playtime.
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  Basically,
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  ultimate limit would be
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  if you choose to do X again,
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  you choose not to have the rest of our playtime today.
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  Landreth does not teach that.
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  And
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  I think part of the misconception is that in
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  the 2nd edition
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  of Art of the Relationship,
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  It seems as though
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  he says that a child can lose the rest of their play time.
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  However,
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  this is why it's important to read new editions of
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  texts.
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  Because if we go to the 4th edition,
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  Which was just recently put out.
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  I'm actually flipping back to the
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  front of the book.
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  Hold on,
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  I'll tell you.
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  Fourth edition was published
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  2024.
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  So,
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  within the last two years,
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  There is an updated segment
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  that
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  was mentioned in the 2nd edition that provides clarity as to what Landreth meant.
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  And
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  there is never
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  A reason
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  To
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  end a session early.
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  Let's go back to CPRT content because Landreth wrote CPRT content as well.
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  CPRT content teaches parents a child cannot lose
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  play time and they cannot earn playtime.
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  So logically
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  that would carry over to
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  Clinical work as well.
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  Now let's talk about some other considerations about
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  10 minutes into a session
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  saying,
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  OK,
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  you've chosen not to have the rest of our play time today.
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  When parents are bringing their child for
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  a therapeutic hour.
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  And they're paying you for a therapeutic hour.
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  How do you think that's gonna go if you walk out 10 minutes later and
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  say the child has chosen not to have the rest of their play time today?
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  How do you think that's going to go
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  from the parent's perspective,
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  and what do you think is gonna happen to that child?
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  In the car ride home when they get home
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  on the way to the next appointment a week later.
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  How do you think that conversation's gonna go
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  when they spent money
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  and the kid took advantage of 10 minutes of it because the therapist
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  said you've chosen not to have the rest of this play time?
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  What about for those of you that bill managed care third-party insurance?
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  You're gonna bill for a therapeutic hour when the kid was there for 10 minutes?
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  What about the slippery slope nature of this
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  where the kid realizes
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  all I have to do is throw a block at her head 3 times?
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  All I have to do is hit this guy in the face 3 times
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  and I get to go home and play video games instead?
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  OK.
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  And then every single week they come and they
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  know that that's their ticket out of the playroom.
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  None of this makes logical sense in the spirit of CCPT.
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  And I understand if you go back and read the second edition,
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  it's it's confusing
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  and it seems to contradict
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  what I'm saying.
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  So that's why we're going to talk through what's in edition 4.
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  Because it makes it much more clear
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  what Landreth is trying to say here.
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  So I'm on page 325 for those of you that have the 4th edition.
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  I'm in the therapeutic limit setting chapter on page 325,
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  and I'm gonna read
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  a couple of paragraphs
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  because I wanna make sure that we have an understanding
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  a child does not
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  lose the rest of their play session.
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  So
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  on page 325,
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  when a child persists in expressing or pursuing the original behavior.
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  And continues to break an established limit,
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  verbalizing an additional step to the limit setting sequence may be necessary.
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  Before explaining this step,
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  a caution is in order.
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  Too often therapists become overly involved in
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  trying to force the acceptance of the limit
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  and move much too quickly
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  to implement this final step.
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  Let me pause there for a second.
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  Do you know how rare it is that you would have to
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  move to an ultimate limit with a child in a playroom?
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  Rare
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  Hardly ever few and far between,
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  whatever the synonym you'd like,
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  it is rare
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  that we should be moving to an ultimate limit in the playroom.
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  In 21 years,
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  I would say less than a dozen times have I moved to an ultimate limit in the playroom.
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  That means that if you're
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  setting ultimate limits frequently,
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  if you would get to a point where you would even consider saying
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  if you choose to do that again,
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  you choose to end your play session,
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  there's a lot of internal work that you need to
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  be doing because we should not be getting there.
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  Landreth is cautioning against it right here.
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  So let me continue.
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  By the way,
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  what I'm about to read is in bold
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  in the book.
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  Patience is the rule of the day.
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  In most instances,
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  the first 3 steps should be gone through in sequence
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  at least 3 times.
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  You,
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  you,
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  you heard at least,
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  right?
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  That that's not
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  You know,
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  when you hit 3,
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  we're done.
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  It's
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  at a minimum of 3 times before verbalizing the final step,
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  and here's the important
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  bolded sentence here.
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  The final step should rarely be used.
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  So if you find yourself moving to ultimate limits a lot with your children,
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  I think there's a lot of internal evaluation and a lot of internal
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  evaluation and a lot of internal work that you need to be doing.
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  Are you intolerant?
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  Are you impatient?
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  Are you rushing the process?
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  Do you have too many rigid expectations?
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  Do you have agenda?
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  Do you get frustrated and emotional and you're trying to
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  save yourself from the discomfort of what's going on?
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  There's a lot to look into
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  if you're moving to ultimate limits in the playroom.
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  Now let me continue
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  in the book.
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  After going through ACT a minimum of 3 times,
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  often more,
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  he says.
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  Please don't think 3 is a hard and fast rule
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  that like,
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  OK,
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  we've hit 3,
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  we're moving on to ultimate limit.
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  You may need to do 7,
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  you may need to do 12.
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  At
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  minimum 3 times,
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  often more.
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  An ultimate limit or final choice is presented to the child.
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  The therapist either indicates the child can choose by his behavior to
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  have the item placed off limits for the rest of the session
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  or
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  in very rare instances
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  presents leaving the room as the ultimate choice.
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  Now,
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  parenthetical reference comes next also in bold print.
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  Let me hasten to point out that leaving the playroom
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  should only be used as an absolutely last resort.
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  This option is so rarely appropriate
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  that perhaps I shouldn't even have mentioned it.
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  End parenthetical reference and bold print.
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  I'm gonna read it again
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  because I don't want anything to be misconstrued and I don't want
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  anything to be misconstrued and I don't want any practice to be adopted
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  that is not based on true CCPT in the Landreth lineage.
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  So I'm gonna read that part again.
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  Let me hasten to point out that leaving the playroom should only be used
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  as an absolutely last resort.
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  This option is so rarely appropriate
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  that perhaps I shouldn't even have mentioned it.
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  You wanna know what that tells me
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  and what it should tell all of us?
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  We don't use it as an option.
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  The final sentence in this segment says leaving
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  the playroom is not needed as an option
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  unless the child is banging on the two-way mirror.
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  Painting on a wall
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  or similar level of destructive behavior.
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  We don't have two-way mirrors in our room.
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  That's a UNT center for play therapy thing.
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  We don't have two-way mirrors
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  in our rooms.
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  We should be able to set a limit and make sure that a child is not painting on a wall.
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  And we should be able to control destructive behavior with regular limit setting.
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  So,
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  basically what Landreth clarifies in the 4th edition
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  is
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  we do not
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  use leaving the playroom
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  as an ultimate limit.
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  There are all kinds of other choices that we have.
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  To
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  give a child time and space to wrestle with complying with the limit,
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  and it's not just 3 times y'all.
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  3 is the minimum.
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  Patience is the order of the day.
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  Why?
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  Because it takes kids a while to regulate.
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  It takes kids a while to regulate.
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  It takes kids a while to process a choice.
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  It takes kids a while to wrestle
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  with something that they really want to do,
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  but they know that they shouldn't.
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  Takes kids time to make sense of is this going to damage relationship?
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  What's the consequence tied to this action?
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  Kids aren't rational.
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  Kids aren't cognitive,
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  so it takes them a bit,
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  and sometimes it takes them lots of rounds.
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  And you stay calm.
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  And you execute the limits according to the model
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  ACT.
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  And you provide choices.
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  You can absolutely move to an ultimate limit if you have to,
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  but the ultimate limit should not be
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  you're choosing to lose play time for today.
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  Landreth says it happens so infrequently,
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  I probably shouldn't have even mentioned it.
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  So,
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  that's the clarity that he provided
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  compared to the 2nd edition
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  because
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  he's basically saying this really isn't an option.
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  And
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  what do we teach a child
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  if we say,
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  OK,
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  you've chosen not to have your play time for the rest of the day?
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  Well,
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  we teach them that they can use that to their advantage.
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  If they don't want to come and play,
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  then man,
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  that's their ticket out.
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  But we've also taught them that
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  we don't have the tolerance.
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  To
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  be patient and wait for them to regulate themselves.
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  We've taught them that we actually do have expectations
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  because
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  if you're choosing not to do what I'm asking you to do,
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  then you're choosing not to be able to play today.
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  And let's go back to what we learned in CPRT.
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  A child cannot lose nor gain
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  or earn play time.
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  Why?
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  Because that's the unconditional nature of it.
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  If we're trying to unconditionally accept a child,
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  we unconditionally accept even the hardest behavior.
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  Because we recognize it as necessary and therapeutically valuable.
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  So please do not get caught in the trap that that's your get out of jail free card.
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  For those of you non-Monopoly people,
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  that's a board game reference.
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  So please do not think,
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  OK,
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  well if it gets so bad that I can't handle it,
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  then the child's just not gonna have the rest of the playtime.
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  That is not how
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  that is meant to be as a CCPT.
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  So we're going to reset the ultimate limit,
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  we're going to reset the regular limits,
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  we're going to be patient,
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  and we're going to say,
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  you're choosing not to have that for the rest of the play time today.
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  You're choosing not to have the sand the rest of the play time today.
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  You're choosing to not have the paint for the rest of the play time today,
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  and you
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  put it out of the room.
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  But there is never a reason.
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  To say you're choosing not to have the rest of your play time.
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  If
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  you're getting to that point,
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  that's,
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  you need to do your work before you can do this work kind of moment.
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  Because I have never in 21 years
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  ended a session early with a child,
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  and I'm still living and breathing to tell you about it.
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  You will be fine.
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  I don't care how hard the session is.
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  You will be fine.
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  Remain adherent to the process.
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  Remain adherent to the model.
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  And you will be OK.
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  You might have to set a lot of limits and you may
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  have to remove a lot of
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  toys and objects that the child chose not to have for the rest of the play time.
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  I've had sessions where there was a pile outside the
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  door of all the things the child chose not to have
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  during that session.
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  That wasn't an easy session,
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  but I never once got to a point where I said,
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  if you do that again,
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  you're choosing to not have the rest of your play time.
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  You can get through it.
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  You just have to know the process.
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  So,
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  please trust the model,
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  trust the process,
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  trust yourself,
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  trust the child.
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  That's what CCPT is all about.
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  And
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  walking out to a lobby 10 minutes into a session and saying,
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  OK,
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  your child's chosen not to have the rest of their play time today.
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  That is not the optic that we want,
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  and that certainly does not convey the
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  unconditional acceptance that CCPT is all about.
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  So I hope that that provides some clarity.
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  I hope that that makes sense.
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  Hope that you have a little different
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  perspective on limits and ultimate limits now.
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  If you want to reach out,
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  I'd love to hear from you,
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  brenna@thekidcounselor.com.
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  I love y'all.
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  We'll talk again soon.
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  Bye.
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  Thank you for listening to the Play Therapy Podcast with Dr.
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  Brenna Hicks.
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  For more episodes and resources,
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  please go to www.playtherapypodcast.com.