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What is Case Conceptualization in Play Therapy? · Next Level Play Therapy: A Podcast for Play Therapy Excellence

• 0:02
  Cathi Spooner: Welcome to Next Level Play Therapy.
• 0:04
  Cathi Spooner: A weekly podcast dedicated to supporting the next generation of child and adolescent therapists to provide exceptional play therapy services.
• 0:14
  Cathi Spooner: We'll explore all things play therapy.
• 0:17
  Cathi Spooner: To elevate your work with children and adolescents using the therapeutic powers of play.
• 0:23
  Cathi Spooner: 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
  Cathi Spooner: 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
  Cathi Spooner: There.
• 0:47
  Cathi Spooner: Hey there.
• 0:48
  Cathi Spooner: Good morning.
• 0:49
  Cathi Spooner: Today I wanna talk about a term that may bring you back to your graduate school days.
• 0:58
  Cathi Spooner: I heard this term when I was, this was years ago probably.
• 1:03
  Cathi Spooner: 15, 16 years ago now when I was taking on a, a master's level counseling student who was doing her field placement with me, and we met with the field liaison and the field liaison throughout this term, case conceptualization and clinical decision making.
• 1:24
  Cathi Spooner: That's the other one, but case conceptual conceptualization.
• 1:28
  Cathi Spooner: It's kind of a mouthful.
• 1:30
  Cathi Spooner: And I remember thinking.
• 1:32
  Cathi Spooner: Oh, I wanna know more about what you're talking about.
• 1:34
  Cathi Spooner: And I think I know, and that is such an important term.
• 1:39
  Cathi Spooner: And so I was kind of hooked from there thinking about it, because to me, I like structure.
• 1:45
  Cathi Spooner: I like a little roadmap to know what's going on, how to formulate my, um, understanding of what's going on with my clients, because that's what helps me get them from.
• 2:01
  Cathi Spooner: Beginning, middle, and all the way successfully to the end of treatment.
• 2:07
  Cathi Spooner: And this is true in play therapy as well.
• 2:10
  Cathi Spooner: And so having some structure that will, um, be like your roadmap and your way of understanding what's going on with your client, to me is a really, really foundational and essential skill to have.
• 2:29
  Cathi Spooner: Counseling in general, and in this case in play therapy.
• 2:34
  Cathi Spooner: And so that's what I wanna talk about today.
• 2:38
  Cathi Spooner: And one of the biggest mistakes that I see play therapists making, and I see it pretty regularly, which is what gave me the idea.
• 2:49
  Cathi Spooner: I didn't see anything like this in the play therapy arena, like any of the play therapy trainings.
• 2:55
  Cathi Spooner: And yet I know it's a foundational skill and I know from doing 15 plus years of supervision and consultation with play therapists that this is kind of, um.
• 3:10
  Cathi Spooner: An essential thing that if you don't have it, you're gonna get lost.
• 3:15
  Cathi Spooner: And that's one of the things I would see regularly over and over.
• 3:20
  Cathi Spooner: Is that people that I was supervising, they would get kind of lost in the beginning and they weren't sure which way to go or what to do.
• 3:30
  Cathi Spooner: And they were, um, not even sure really what was going on with their client.
• 3:35
  Cathi Spooner: They were kind of getting started doing the individual play therapy sessions without really taking the time.
• 3:44
  Cathi Spooner: To get that treatment process off to a good start and formulate their case conceptualization, because that's also, also gonna play a role in your clinical decision making.
• 4:00
  Cathi Spooner: So if you're joining me live today, go ahead and post your name in the comments.
• 4:06
  Cathi Spooner: I'd love to see who's here.
• 4:09
  Cathi Spooner: Um, what population do you work with?
• 4:12
  Cathi Spooner: What.
• 4:14
  Cathi Spooner: What play therapy and expressive arts modalities are you using?
• 4:20
  Cathi Spooner: And I would love to know if you, um, in any of your play therapy trainings or any of your play therapy, if you've already become an RPT, if you have had any training or courses in case conceptualization, in play therapy.
• 4:41
  Cathi Spooner: Um, so post that in the comments.
• 4:43
  Cathi Spooner: Let's see who's here.
• 4:45
  Cathi Spooner: I'm Kathy Spooner.
• 4:46
  Cathi Spooner: I'm a licensed clinical social worker and a registered plate therapist supervisor here in the United States, and I have been in the mental health field for over 30 years now, and my big passion.
• 5:01
  Cathi Spooner: For being a mental health professional is to help children and adolescents and their families heal.
• 5:07
  Cathi Spooner: That's what got me into the profession.
• 5:10
  Cathi Spooner: And then back in the 1980s when I was a special ed teacher and I learned about this thing called play therapy, I thought, bonanza, that is it for me.
• 5:21
  Cathi Spooner: And then I, uh, went on to get my master's degree, and then it took some time to find play therapy because.
• 5:27
  Cathi Spooner: It wasn't really very accessible back then in the 1980s or in the early 1990s.
• 5:34
  Cathi Spooner: So welcome Keisha.
• 5:37
  Cathi Spooner: Working with, oh, you're getting your RPT, so Keisha's on Instagram, um, certification.
• 5:43
  Cathi Spooner: Oh, you're in Maryland.
• 5:44
  Cathi Spooner: So Keisha, I orig.
• 5:46
  Cathi Spooner: So I'm in southern Nevada now here in the United States on the west coast, but I am from the east coast on the northern Virginia, Washington DC area.
• 5:57
  Cathi Spooner: So that's awesome.
• 5:59
  Cathi Spooner: I've been to Maryland many times, so that's cool.
• 6:02
  Cathi Spooner: I always like connecting with, with people from the east coast.
• 6:06
  Cathi Spooner: Um, yeah.
• 6:07
  Cathi Spooner: So post your name in the comments.
• 6:10
  Cathi Spooner: What population are you working with?
• 6:12
  Cathi Spooner: I go live.
• 6:13
  Cathi Spooner: I live stream every week on Instagram, LinkedIn, and in my uh, Facebook group for mental health professionals using play therapy and expressive arts.
• 6:27
  Cathi Spooner: If you're interested in, you're on Facebook.
• 6:29
  Cathi Spooner: It's called Play and Expressive Arts Therapy Playground.
• 6:33
  Cathi Spooner: If you're a mental health professional using play therapy and expressive arts.
• 6:37
  Cathi Spooner: You wanna be in the group, it's a free group.
• 6:40
  Cathi Spooner: You do have to answer every single question, though.
• 6:43
  Cathi Spooner: If you don't answer all of the questions, then you're not gonna be admitted into the group.
• 6:49
  Cathi Spooner: I see people regularly not answer all the questions, and it kind of kills me, and I, I used to message people and say, Hey, but then I never got a response.
• 6:57
  Cathi Spooner: So.
• 6:58
  Cathi Spooner: So now I just make sure I tell people, make sure you answer all the questions.
• 7:03
  Cathi Spooner: Um, and I'm also live streaming on my Instagram channel platform.
• 7:09
  Cathi Spooner: So welcome, welcome, welcome.
• 7:11
  Cathi Spooner: If you find the information useful and helpful, please feel free to like it and share it across your social media if you're interested.
• 7:21
  Cathi Spooner: And on LinkedIn, it's kind of hard to see any of the replays.
• 7:26
  Cathi Spooner: Um, from previous livestream episodes.
• 7:29
  Cathi Spooner: So if you're interested or you just like YouTube, you can pop over to my YouTube channel.
• 7:35
  Cathi Spooner: All of the replays are on my YouTube channel.
• 7:39
  Cathi Spooner: Kathy Spooner, renewing Hearts Consulting, and you just go into the live tab and all of the replays are there.
• 7:47
  Cathi Spooner: If you're in my Facebook group, you can go into the featured section and all the lives are there.
• 7:54
  Cathi Spooner: It's pretty easy to find the replays on Instagram 'cause you just go into my little, what do you call that thing where you can see all my posts?
• 8:05
  Cathi Spooner: Um, that's where you go.
• 8:07
  Cathi Spooner: So, so let's get started.
• 8:10
  Cathi Spooner: First and foremost, I would love to hear what are your questions about case conceptualization and what are your questions about how that applies?
• 8:20
  Cathi Spooner: To play therapy.
• 8:22
  Cathi Spooner: Like I said, this is not something I saw very often.
• 8:26
  Cathi Spooner: Actually, I didn't see this anywhere when I was getting my credential for RPT back in the, um, early turn of a century.
• 8:37
  Cathi Spooner: So if you have questions, post your questions, what are those?
• 8:41
  Cathi Spooner: If you're joining me live.
• 8:43
  Cathi Spooner: Go ahead and post your name in the comments.
• 8:46
  Cathi Spooner: I'd love to see who's here.
• 8:47
  Cathi Spooner: Where are you from?
• 8:49
  Cathi Spooner: If you're watching the replays, go ahead post your questions.
• 8:53
  Cathi Spooner: Where are you from?
• 8:54
  Cathi Spooner: What po uh, population you work with, and we'll keep the conversation going.
• 8:59
  Cathi Spooner: Okay?
• 8:59
  Cathi Spooner: So first and foremost, so I, I did wanna say so on, if you're watching me on Instagram, I am gonna show some slides.
• 9:07
  Cathi Spooner: Um, I use Streamy Yard to live stream directly into my Facebook group and, uh, LinkedIn and my YouTube channel.
• 9:18
  Cathi Spooner: Um, you won't be able to see them on Instagram, but I'll make sure I describe them and, um, just so you can know what I'm talking about.
• 9:27
  Cathi Spooner: Okay.
• 9:27
  Cathi Spooner: So first and foremost, what.
• 9:31
  Cathi Spooner: The heck is case conceptualization.
• 9:34
  Cathi Spooner: Case conceptualization is a really fancy term.
• 9:37
  Cathi Spooner: For, essentially you are gathering information from your clients, and this is, you wanna make sure you do this before you even get started doing play therapy.
• 9:51
  Cathi Spooner: This is really that psychoso, that psychosocial.
• 9:54
  Cathi Spooner: Uh, bio-psychosocial, spiritual cultural assessment that you do at the beginning.
• 10:00
  Cathi Spooner: That one should take you back to your graduate school days.
• 10:04
  Cathi Spooner: But you really wanna make sure you do that at the beginning because that's where you gather all of the information that you need in order to better understand what's going on with your clients.
• 10:17
  Cathi Spooner: If you don't ask all of the questions, then you're not really gonna have a full understanding of.
• 10:24
  Cathi Spooner: Probably what's going on with your client, because you're going to use that case formula, uh, case conceptualization, which is you gather all of the information in your bio-psychosocial, cultural, spiritual assessment, and then you're gonna analyze it and synthesize it to make sense of.
• 10:45
  Cathi Spooner: Hmm.
• 10:47
  Cathi Spooner: I think this is what's going on with my client because they meet all of the diagnostic criteria for this diagnosis.
• 10:56
  Cathi Spooner: And so let me just say a little thing about diagnosis.
• 11:00
  Cathi Spooner: I, I know there are lots of belief systems about di um, diagnosis, and I know I've heard from people say, oh, I don't do diagnoses or.
• 11:12
  Cathi Spooner: I don't like doing diagnoses, so I give them the adjustment disorder because, you know, BA essentially diagnoses is, is not a good thing.
• 11:22
  Cathi Spooner: I don't wanna label them.
• 11:24
  Cathi Spooner: And then there are some who are kind of really strict that way.
• 11:28
  Cathi Spooner: I fall in the camp of, we need to diagnose.
• 11:32
  Cathi Spooner: I mean, if you were going to the doctor and you had some kind of thing going on with you, you would probably want a diagnosis to make sure your doctor was giving you the right medication.
• 11:44
  Cathi Spooner: Like for example, if you went to the doctor and you had this really bad pain in your arm.
• 11:49
  Cathi Spooner: You would wanna know if it's a broken arm or maybe a ligament.
• 11:54
  Cathi Spooner: Those are two, two different things going on.
• 11:58
  Cathi Spooner: Or you would wanna know if you've got some like internal, um, thing going on or some autoimmune disease you would wanna know because that diagnoses is gonna be linked to.
• 12:13
  Cathi Spooner: Some treatment approaches.
• 12:16
  Cathi Spooner: Um, and that's, that's why diagnoses is important.
• 12:20
  Cathi Spooner: It's not the end all be all.
• 12:22
  Cathi Spooner: I'm not in the camp where, um, you know, you have to pinpoint exactly to the right one because.
• 12:30
  Cathi Spooner: Sometimes it takes it a little while to get to fully, it's like a, you know, like Shrek it, it's like an onion.
• 12:38
  Cathi Spooner: You gotta peel it back in layers and you won't always know from the very beginning.
• 12:43
  Cathi Spooner: But if you gather enough information in the beginning to formulate your working diagnoses in the beginning, you're gonna be staying in that information and assessment gathering mode.
• 12:57
  Cathi Spooner: Throughout the treatment process because you may find out if, if you kind of get the initial presenting symptoms stabilized, you may find out, oh, there's something else that was actually feeding that we couldn't get at it until we got through that first layer of the onion, so to speak.
• 13:17
  Cathi Spooner: So.
• 13:19
  Cathi Spooner: Your, your gathering of the information helps you to figure out what's going on with your clients, so, so you can then figure out what treatment approach you want to use, and that does come with the diagnosis.
• 13:34
  Cathi Spooner: And diagnosis is important because it helps us align with certain treatment approaches that work best with that particular.
• 13:47
  Cathi Spooner: Issue that your client is dealing with.
• 13:49
  Cathi Spooner: And I'm gonna talk about that, um, in a, in, in a little bit.
• 13:54
  Cathi Spooner: I wanna read who's here.
• 13:56
  Cathi Spooner: Um, hey, I think I'm pronouncing it.
• 14:01
  Cathi Spooner: Aya, you emailed me.
• 14:02
  Cathi Spooner: I was so excited that you emailed me, um, oh, in South Africa.
• 14:07
  Cathi Spooner: Thank you for this topic.
• 14:09
  Cathi Spooner: Student psychologist, case conceptualization is an important area of focus and not I agree.
• 14:15
  Cathi Spooner: I totally agree.
• 14:16
  Cathi Spooner: And I was in South Africa back in 2008.
• 14:21
  Cathi Spooner: It was one of, it was such an amazing trip.
• 14:24
  Cathi Spooner: So I have like a gazillion.
• 14:27
  Cathi Spooner: I was in, um, Johannesburg and the Cape Town area, and then we went to Kruger National Park as well.
• 14:34
  Cathi Spooner: So it was a really, I went with social workers, actually, it was a hundred social workers.
• 14:39
  Cathi Spooner: I would never travel with a hundred people again, and it was amazing trip.
• 14:43
  Cathi Spooner: So.
• 14:44
  Cathi Spooner: That's awesome.
• 14:45
  Cathi Spooner: Uh, I, and I totally agree, which is why I, when I was thinking, because I do a lot of supervision now, consultation, and I have an online.
• 14:56
  Cathi Spooner: Play Therapy, supervision, consultation group and program.
• 15:00
  Cathi Spooner: It's called Play Therapy Academy.
• 15:02
  Cathi Spooner: And in one of the things,'cause I've been supervising and consulting for about 15 years now, and what I realized is that when I'm supervising people, they don't really have some of these basic, basic case conceptualization.
• 15:20
  Cathi Spooner: And what does that look like in play therapy?
• 15:22
  Cathi Spooner: Foundation and so what I did in Play Therapy Academy.
• 15:27
  Cathi Spooner: Is I have created a whole series of courses which are available if you're not in Play Therapy Academy.
• 15:34
  Cathi Spooner: These are available just as the courses themselves, like, uh, it's a whole series called Getting Grounded in Play Therapy Excellence.
• 15:44
  Cathi Spooner: And there are, um, there's probably, I think there's gonna be like definitely five.
• 15:50
  Cathi Spooner: M kind of mini courses in the training.
• 15:54
  Cathi Spooner: You can buy each of them separately.
• 15:56
  Cathi Spooner: All of these are gonna be available in Play Therapy Academy as part of the Play Play Therapy Academy, I wanted to make sure that these courses were available to everybody who needed them, whether or not you were in Play Therapy Academy.
• 16:10
  Cathi Spooner: So that's why I did it this way.
• 16:12
  Cathi Spooner: So the first course that's available now in that series is called Getting Grounded in Play Therapy Foundations.
• 16:20
  Cathi Spooner: And that one really lays the groundwork of what is play therapy?
• 16:24
  Cathi Spooner: What are the core skills that you need?
• 16:27
  Cathi Spooner: What are some of the ethical and cultural considerations you need to consider?
• 16:31
  Cathi Spooner: And then the next one in the series, which is coming out in March.
• 16:36
  Cathi Spooner: Is called case conceptualization in play therapy.
• 16:40
  Cathi Spooner: That one is, I'm in the, um, middle of getting that one created and recorded and, and get it ready for people to purchase because I really think it's an important.
• 16:52
  Cathi Spooner: It's an important topic and um, what I find when people take the time to really do that, case conceptualization, really gather all of the information, then what happens is they end up, and this is my next point, which is they get much better treatment outcomes.
• 17:15
  Cathi Spooner: You know, one of the things that I've been finding, and I I always do a lot of research when I'm doing any of my.
• 17:21
  Cathi Spooner: Um.
• 17:23
  Cathi Spooner: Preparation for the courses.
• 17:24
  Cathi Spooner: 'cause I like to have the most up-to-date information.
• 17:28
  Cathi Spooner: What is the research saying?
• 17:29
  Cathi Spooner: And I like to put that in there.
• 17:32
  Cathi Spooner: Um, so one of the things that I've been finding as I have been doing the research for case conceptualization and clinical decision making, because the second course is case conceptualization and we also look at clinical decision making in there.
• 17:51
  Cathi Spooner: Is the different bias that we're all prone to bias.
• 17:56
  Cathi Spooner: But here's one of the things that I found really, really interesting and I'm gonna, um, probably in the next couple of weeks, the, my live streams.
• 18:07
  Cathi Spooner: I'm gonna do a little, I'm gonna talk about the, what the research has said.
• 18:12
  Cathi Spooner: So some of the, excuse me, research that I found, I'm gonna.
• 18:17
  Cathi Spooner: Talk about that in some of the upcoming livestream episodes.
• 18:21
  Cathi Spooner: But, um, bias and overconfidence bias is for people who have been doing it for a while, play therapy and counseling.
• 18:30
  Cathi Spooner: Um, with experience, they are much more prone to overconfidence bias.
• 18:36
  Cathi Spooner: And that's basically, you kind of think you know what you're doing, so you don't really, um.
• 18:43
  Cathi Spooner: Look at some of the details and the specifics or how it's working or not working you.
• 18:49
  Cathi Spooner: And there there's a whole bunch of other kind of bias bias that is really important for us to think about.
• 18:56
  Cathi Spooner: I think, I think, you know, as I've been reading through it, I've kind of realized, oh, I, I think I kind of.
• 19:02
  Cathi Spooner: Do these things.
• 19:03
  Cathi Spooner: I just didn't know there was a name for it.
• 19:05
  Cathi Spooner: And reading through this, my thought was, oh, I, I can actually do better with this now that I'm even more aware of what it is.
• 19:12
  Cathi Spooner: So I'm gonna put that one in my upcoming.
• 19:16
  Cathi Spooner: Um.
• 19:17
  Cathi Spooner: Upcoming training.
• 19:18
  Cathi Spooner: Oh, okay.
• 19:19
  Cathi Spooner: Say you're from Johannesburg.
• 19:21
  Cathi Spooner: Yes.
• 19:21
  Cathi Spooner: I had a really awesome time there and actually when I was in Virginia on the East coast, uh, the church that I went to at the time was really multicultural.
• 19:31
  Cathi Spooner: Um, we had 27 different countries represented.
• 19:34
  Cathi Spooner: That was one of the things.
• 19:35
  Cathi Spooner: But the pastors, um, are from Johannesburg and their kids, so that was really cool.
• 19:41
  Cathi Spooner: I feel like I have kind of a tie to Johannesburg through that way.
• 19:45
  Cathi Spooner: Um.
• 19:46
  Cathi Spooner: Really beautiful city.
• 19:47
  Cathi Spooner: It's so beautiful.
• 19:48
  Cathi Spooner: It was such an awesome trip there.
• 19:51
  Cathi Spooner: Um, so one of the things that we need to think about when we are using case conceptualization, one, we have to be aware of the bias.
• 20:02
  Cathi Spooner: Um, I think that's always a thing we have to keep in mind.
• 20:06
  Cathi Spooner: Hey Carla, so I see you on, um, Instagram Welcome and, uh.
• 20:13
  Cathi Spooner: The other thing is like, what do we do with the information is, uh, sorry, I got distracted chatting with Carla.
• 20:21
  Cathi Spooner: Um, what do we do with that information?
• 20:25
  Cathi Spooner: Well, in my mind we go into, um.
• 20:29
  Cathi Spooner: Detective mode.
• 20:31
  Cathi Spooner: So we're gathering the information, we're going into detective mode to better understand, okay, my clients are reporting these symptoms.
• 20:41
  Cathi Spooner: What does that mean?
• 20:44
  Cathi Spooner: So if, if you are watching me on, um, my YouTube channel, Instagram, I mean, um.
• 20:53
  Cathi Spooner: Facebook or LinkedIn, you're gonna see my slides, but I'm, for those of you on Instagram, I'm gonna describe them to you.
• 21:00
  Cathi Spooner: In my mind, when you are doing case conceptualization, you're re, it's like a detective.
• 21:06
  Cathi Spooner: You're like figuring out where all the data is, what they mean.
• 21:11
  Cathi Spooner: You're kind of analyzing them and making sense of them and figuring out how does that apply to your clients?
• 21:19
  Cathi Spooner: And one of the.
• 21:22
  Cathi Spooner: One of the issues, if you're in play therapy and you work with children and adolescents, the likelihood you're gonna get kids on your caseload who struggle with emotion regulation problems is super high.
• 21:34
  Cathi Spooner: Like you're gonna have.
• 21:36
  Cathi Spooner: Quite a few clients, most likely on your caseload with emotion dysregulation problems.
• 21:43
  Cathi Spooner: So here's the thing.
• 21:45
  Cathi Spooner: They come in their, their parents are reporting.
• 21:49
  Cathi Spooner: My child throws these tantrums.
• 21:52
  Cathi Spooner: They can last anywhere from 10 minutes.
• 21:56
  Cathi Spooner: To two hours or all day.
• 21:59
  Cathi Spooner: And they get aggressive and they yell and they say mean things or they'll make these statements like, I'm gonna jump off the roof, or You just wish I was dead.
• 22:11
  Cathi Spooner: All of these things are very alarming to their parents.
• 22:16
  Cathi Spooner: And if they're, and I use parents and guardians kind of interchangeably.
• 22:21
  Cathi Spooner: Um, 'cause some kids don't live with their.
• 22:24
  Cathi Spooner: Biological parents or their adoptive parents, they may be in a different situation.
• 22:31
  Cathi Spooner: So, so we have these that report.
• 22:34
  Cathi Spooner: That's why they're coming.
• 22:35
  Cathi Spooner: They're coming because they have these emotion dysregulation problems.
• 22:39
  Cathi Spooner: But here's what we know.
• 22:41
  Cathi Spooner: We know anxiety and depression can result in some emotion dysregulation problems.
• 22:47
  Cathi Spooner: We know kids on the autism spectrum and kids who have sensory processing problems, they can get dysregulated.
• 22:55
  Cathi Spooner: We know kids who've experienced traumatic experiences, they can get dysregulated.
• 23:02
  Cathi Spooner: We know kids with A DHD who have executive function problems and emotion dysregulation.
• 23:10
  Cathi Spooner: Is an executive dysfunction, uh, is an executive function.
• 23:15
  Cathi Spooner: Thing.
• 23:16
  Cathi Spooner: So if they're dysregulating, it might be part of that A DHD executive function, um, issue going on with them.
• 23:24
  Cathi Spooner: We know could be oppositional defiant disorder or disruptive mood dysregulation disorder.
• 23:31
  Cathi Spooner: We know kids who are of gifted intelligence.
• 23:35
  Cathi Spooner: They may be.
• 23:36
  Cathi Spooner: Struggling with anxiety, and that might result in some dysregulation.
• 23:40
  Cathi Spooner: There are any number of things that can be.
• 23:46
  Cathi Spooner: Underneath and causing this emotion dysregulation.
• 23:51
  Cathi Spooner: And so one of the things that we're doing when we're doing our case conceptualization is asking all of the questions and getting all of the history to get a better sense of where are the roots?
• 24:03
  Cathi Spooner: Like what's going on?
• 24:05
  Cathi Spooner: What's causing this, where's this coming from?
• 24:08
  Cathi Spooner: You know, when does it happen and why does it happen?
• 24:12
  Cathi Spooner: So some of the things, so, so for emotion dysregulation, emotional vulnerability, we have autism kids on the autism spectrum, they struggle with cognitive inflexibility, social reciprocity problems.
• 24:26
  Cathi Spooner: They can get overwhelmed by their sensory system.
• 24:29
  Cathi Spooner: We know kids with anxiety disorder, they can have cognitive.
• 24:33
  Cathi Spooner: Distortions that activate their fear.
• 24:37
  Cathi Spooner: Like I've had kids say to me, um, this was years and years.
• 24:41
  Cathi Spooner: Like kids have said.
• 24:43
  Cathi Spooner: A lot of these I've heard multiple times from multiple clients.
• 24:46
  Cathi Spooner: So it's not necessarily any one client that I'm talking about as much as I I, over the last 30 years, I've seen this a lot.
• 24:54
  Cathi Spooner: Um, like some kids who have some kind of phobia, like they may worry, they walked by a table.
• 25:00
  Cathi Spooner: It, it was like 20 feet away and there was.
• 25:04
  Cathi Spooner: Cleaning solutions.
• 25:05
  Cathi Spooner: Somehow it got in their mouth and now they're gonna die.
• 25:07
  Cathi Spooner: Or they worry if they go to school while they're at school, their parent is gonna die, and then they're not gonna have anybody.
• 25:13
  Cathi Spooner: And so they get dysregulated at school.
• 25:15
  Cathi Spooner: They can't tolerate being separated from their parent.
• 25:19
  Cathi Spooner: All of these things, um, can cause that emotion dysregulation.
• 25:26
  Cathi Spooner: Um, so Carla says, when does it.
• 25:29
  Cathi Spooner: Happen.
• 25:30
  Cathi Spooner: How does it develop?
• 25:31
  Cathi Spooner: What have you done?
• 25:32
  Cathi Spooner: Yes, Carla, absolutely take care of this.
• 25:35
  Cathi Spooner: What age?
• 25:36
  Cathi Spooner: All of those things.
• 25:37
  Cathi Spooner: Absolutely.
• 25:39
  Cathi Spooner: Um, and Carla also says we also have to evaluate Yes.
• 25:44
  Cathi Spooner: Parental competencies so we can do the, um, yes.
• 25:49
  Cathi Spooner: The play therapy, kind of that environmental play therapy hypothesis.
• 25:54
  Cathi Spooner: Absolutely, Carla, for sure.
• 25:57
  Cathi Spooner: Um.
• 25:59
  Cathi Spooner: And so we also have trauma.
• 26:01
  Cathi Spooner: We know if their trauma gets triggered, that's gonna activate not being safe.
• 26:06
  Cathi Spooner: Their, um, hypo arousal system is gonna be like off the chain.
• 26:11
  Cathi Spooner: Their danger, danger, alarmed alarms are going off.
• 26:14
  Cathi Spooner: We know what depression could be.
• 26:16
  Cathi Spooner: Sadness, some hope, irritability.
• 26:19
  Cathi Spooner: Um, crankiness.
• 26:20
  Cathi Spooner: Snappiness and also mood regulation.
• 26:24
  Cathi Spooner: There can be some biological.
• 26:27
  Cathi Spooner: Components for the mood regulation.
• 26:30
  Cathi Spooner: And so if.
• 26:32
  Cathi Spooner: You know, especially with like emotion, uh, A DHD and autism spectrum and we know that that can be overwhelming and they feel like they can't really control their body and they're always getting in trouble if they're a DHD.
• 26:46
  Cathi Spooner: Um, and the emotion dysregulation.
• 26:48
  Cathi Spooner: People think their conduct disorder.
• 26:50
  Cathi Spooner: I can't tell you how many times I have heard a little 5-year-old get diagnosed with conduct disorder.
• 26:58
  Cathi Spooner: Kind of drives me crazy because when you really go there and look, it's not conduct disorder, it, the motion regulation problem is probably coming from undiagnosed A DHD or they might be on the autism spectrum.
• 27:12
  Cathi Spooner: So these are, these are things we need to keep in mind, um, and when we're thinking about some of those biological components.
• 27:21
  Cathi Spooner: We need to be thinking about executive function and that prefrontal cortex and higher cognitive functioning are involved with planning time, space management, cause and effect, problem solving, and the ability to stop and think.
• 27:38
  Cathi Spooner: Some of this is age, like a five-year-old is not gonna be as.
• 27:43
  Cathi Spooner: Um, proficient as maybe a 10-year-old or a 15-year-old.
• 27:46
  Cathi Spooner: So you gotta think, like Carla was saying, those develop developmental things and also Carla said, yes, parental stress.
• 27:54
  Cathi Spooner: Absolutely.
• 27:55
  Cathi Spooner: The kids are like little sponges.
• 27:57
  Cathi Spooner: They have to pick up on all of that.
• 27:59
  Cathi Spooner: So that's some of the systemic stuff for sure.
• 28:02
  Cathi Spooner: Um, any of that sensory processing, their little sensory systems are gonna get overloaded.
• 28:09
  Cathi Spooner: If they're, um, if they're get kind of black and white thinking all or nothing, what's going on that they can't have some of that flexibility to shift.
• 28:19
  Cathi Spooner: And we also know with kids who are in the gifted intelligence range that they have that asynchronous development meaning.
• 28:28
  Cathi Spooner: They are chronologically one age, but maybe cognitively because they're much more advanced.
• 28:36
  Cathi Spooner: If they're intellectually gifted, they may be maybe in second grade.
• 28:42
  Cathi Spooner: But cognitively, they may be more like in third grade.
• 28:46
  Cathi Spooner: So you got a little, uh, kindergartner or first grader doing kindergartner or first grade work, but their little brain can do third grade work or maybe even fourth grade work.
• 28:59
  Cathi Spooner: They are bored out of their minds.
• 29:02
  Cathi Spooner: Um, it's kind of hard.
• 29:03
  Cathi Spooner: They get frustrated.
• 29:05
  Cathi Spooner: It's really, you know, think about a job that I remember, a job I had.
• 29:08
  Cathi Spooner: I just.
• 29:09
  Cathi Spooner: Stood at the cash was when I was a teenager, stood at the cash register all day long and it was like a super duper slow store.
• 29:17
  Cathi Spooner: It was like an eight hour day standing there doing nothing all day long.
• 29:21
  Cathi Spooner: I thought I was gonna lose my mind.
• 29:24
  Cathi Spooner: It's the same for kids who are gifted.
• 29:26
  Cathi Spooner: They, and especially if they have some emotional intensity to them that, um, these are all things that can be underlying and it's important to.
• 29:38
  Cathi Spooner: Um, consider and do all of that information gathering in the beginning to really understand what's going on.
• 29:47
  Cathi Spooner: Because when you understand what's going on, then you're gonna be able to use interventions and a treatment approach that's gonna help you get the results that you need.
• 29:59
  Cathi Spooner: And one of, like Carla was saying, yes.
• 30:02
  Cathi Spooner: Family.
• 30:02
  Cathi Spooner: Um, we need to work with the whole family.
• 30:05
  Cathi Spooner: Carla and I are totally in sync on this.
• 30:07
  Cathi Spooner: We've chatted about this a few times.
• 30:09
  Cathi Spooner: Actually, Carla took my training on family plate therapy.
• 30:13
  Cathi Spooner: Um, oh, I think that was back in October, which is where we met, which was really cool.
• 30:17
  Cathi Spooner: That was a live webinar.
• 30:18
  Cathi Spooner: I did, I am gonna do that one again and I'm not sure when, in 2023.
• 30:24
  Cathi Spooner: Um, that's exactly, we need to really understand systemically what's going on, and I, I am a huge proponent if your case conceptualization does not include looking at child in context.
• 30:39
  Cathi Spooner: And working with parents and, and integrating parents into the play therapy process, then you've missed a big piece of what needs to happen, and that's part of that case conceptualization in my mind.
• 30:54
  Cathi Spooner: When I'm conceptualizing what's going on with my clients, I'm also conceptualizing.
• 31:00
  Cathi Spooner: How parents or guardians need to be involved and what is that gonna look like?
• 31:04
  Cathi Spooner: And it, that decision making is how it changes over time.
• 31:08
  Cathi Spooner: But all of those are really important.
• 31:11
  Cathi Spooner: And if you skip that case conceptualization part.
• 31:16
  Cathi Spooner: Then you are kind of operating without a roadmap and you're just kind of, um, doing things hoping they work.
• 31:23
  Cathi Spooner: And sometimes they, they probably will work until you get a challenging case that's not super easy, then you're gonna be probably lost if you haven't gotten your case.
• 31:35
  Cathi Spooner: You know, done that initial legwork of gathering all of the information.
• 31:41
  Cathi Spooner: So that is it for today.
• 31:44
  Cathi Spooner: Um.
• 31:45
  Cathi Spooner: I'm gonna do a little recap and then I'm gonna tell you a little bit about some of the courses, like I mentioned, play Therapy Academy and this Getting Grounded in Play Therapy.
• 31:54
  Cathi Spooner: Excellent series that I have going on right now.
• 31:58
  Cathi Spooner: Um, first and foremost, what is Case Conceptualization?
• 32:02
  Cathi Spooner: It is essentially taking all of the information, uh, about, um.
• 32:09
  Cathi Spooner: What's going on with your clients?
• 32:11
  Cathi Spooner: Some of that social history you wanna make Sure.
• 32:15
  Cathi Spooner: Um, gathering any cultural history.
• 32:17
  Cathi Spooner: It's really important, I think, also to gather some of that spiritual.
• 32:21
  Cathi Spooner: History.
• 32:22
  Cathi Spooner: 'cause sometimes that might be part of the problem, but sometimes that might be a, a resource for the family.
• 32:29
  Cathi Spooner: 'cause during this case, conceptualization, we're identifying resources as well because we wanna help our clients access those and support those.
• 32:39
  Cathi Spooner: And when you, when you take the time to do that information gathering and do that case conceptualization.
• 32:49
  Cathi Spooner: Then that plays into your treatment planning about what needs to happen, how it needs to happen.
• 32:54
  Cathi Spooner: What kind of play therapy modalities are you gonna use?
• 32:57
  Cathi Spooner: Who's gonna be involved in the treatment process?
• 33:00
  Cathi Spooner: And then you lay out your plan in order to get started.
• 33:05
  Cathi Spooner: The clinical decision making, which we didn't talk a lot about this time, and I'll, I'll, I'll talk about that in some upcoming lives, is how you kind of stay in, in detective, clinical detective mode throughout the change process and do that decision making as you go along.
• 33:23
  Cathi Spooner: Um, so a Facebook user says, I had a look at your courses.
• 33:26
  Cathi Spooner: Love to do them, like some guidance on how to become an RPT in South Africa.
• 33:32
  Cathi Spooner: You know what, um, post, you can either message me or post in my Facebook group.
• 33:39
  Cathi Spooner: I will get back to you and I'll, um, we can chat about that.
• 33:44
  Cathi Spooner: Um.
• 33:45
  Cathi Spooner: So that is it for today.
• 33:47
  Cathi Spooner: If you found the information helpful, please liken it and share it across your social media.
• 33:52
  Cathi Spooner: You can always find all the replays to my live streams and on my YouTube channel.
• 33:59
  Cathi Spooner: I have a bunch there.
• 34:00
  Cathi Spooner: Um, replays on my YouTube channel.
• 34:03
  Cathi Spooner: Kathy Spooner renewing hearts.
• 34:05
  Cathi Spooner: Consulting.
• 34:06
  Cathi Spooner: If you're in my Facebook group, go up there in the featured section.
• 34:10
  Cathi Spooner: You can find 'em all there.
• 34:12
  Cathi Spooner: All right.
• 34:13
  Cathi Spooner: If you have any questions, feel free to post them in the comment, and I will see you next week.
• 34:19
  Cathi Spooner: Bye.
• 34:20
  Cathi Spooner: Thank you for joining me on this f. Of next Level play therapy.
• 34:25
  Cathi Spooner: I hope you found the discussion valuable and gain new insights and ideas to support your work helping children, adolescents, and families heal.
• 34:34
  Cathi Spooner: If you enjoyed this episode, be sure to subscribe to the podcast and leave a review.
• 34:40
  Cathi Spooner: Your feedback helps to improve and reach more people who can benefit from this information.
• 34:46
  Cathi Spooner: Remember.
• 34:46
  Cathi Spooner: Play therapy is a powerful tool for healing and growth.
• 34:50
  Cathi Spooner: 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.
• 35:01
  Cathi Spooner: If you have any questions or topics, suggestions for future.
• 35:06
  Cathi Spooner: I'd love to hear from you.
• 35:08
  Cathi Spooner: 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.
• 35:21
  Cathi Spooner: Thank you once again for listening to Next Level Play Therapy.
• 35:25
  Cathi Spooner: Until next time, keep playing, learning and growing.