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Play Therapy with Adolescents: Why Teen Symptoms Are Easy to Misread · 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.
• 0:48
  Cathi Spooner: Hey there.
• 0:48
  Cathi Spooner: Good morning.
• 0:49
  Cathi Spooner: Welcome to this week's episode of Next Level Play Therapy, where we talk about all things play therapy.
• 0:57
  Cathi Spooner: I'm Cathi Spooner.
• 0:58
  Cathi Spooner: I'm a licensed clinical social worker and a registered play therapist supervisor and today I wanna do something a little bit different than we usually do.
• 1:10
  Cathi Spooner: I thought it would be helpful to kind of do a case study with our therapist Jane, who is working with an adolescent client who's a little bit shut down.
• 1:24
  Cathi Spooner: And as play therapists what, what can we do to help this client?
• 1:30
  Cathi Spooner: And the first step, what we're gonna focus on today, excuse me.
• 1:34
  Cathi Spooner: Today's episode is more focused on making sure we're reading the cues accurately from our client, meaning, how are we making sense of those symptoms?
• 1:49
  Cathi Spooner: Because in order to figure out what to do, which is the treatment part, the intervention part, we first need to figure out what is going on and formulate our working hypothesis, also known as our case conceptualization, so that we know we know where to start and we know what to target.
• 2:14
  Cathi Spooner: One of the reasons I thought this would be helpful is because a lot of times what I find is especially in when we're doing case presentations or I'm doing consultations, so I have two online memberships, the uh, Play Therapy Academy is more of the deep dive.
• 2:36
  Cathi Spooner: We're getting down into the learning those core competencies of play therapy, learning a play therapy model, using it through each stage of the play therapy process.
• 2:50
  Cathi Spooner: And as we do that, one of the things that we're doing when we're doing case presentations is case formulation.
• 2:59
  Cathi Spooner: How do you think critically and analytically about what's going on with your clients so that when you are using your play therapy model, you're actually kind of targeting the roots of what the actual problem is?
• 3:17
  Cathi Spooner: So that's what we're gonna do today.
• 3:19
  Cathi Spooner: We are gonna kind of look at why, if you're only focusing on the symptoms, you are probably missing the deeper level issues.
• 3:31
  Cathi Spooner: And how is your play therapy, how is your theoretical model going to influence, how are you making sense of those symptoms.
• 3:43
  Cathi Spooner: We'll also talk a little bit about the role of culture when you're formulating your case conceptualization, and then some key questions you need to be thinking about.
• 3:55
  Cathi Spooner: And we are gonna do that with our case study today.
• 3:59
  Cathi Spooner: So I'm gonna go a little bit into trainer, kind of presenter, teacher mode, 'cause I'll do this in play Therapy Academy and Elevation Circle too.
• 4:07
  Cathi Spooner: I kind of a natural teacher at heart and I like doing teaching.
• 4:14
  Cathi Spooner: I like to break things down and kind of look at them a little more in depth.
• 4:20
  Cathi Spooner: So, um, if you're joining us live today, I would love to know who's here.
• 4:26
  Cathi Spooner: Post your name in the comments.
• 4:29
  Cathi Spooner: What population are you working with?
• 4:32
  Cathi Spooner: Where are you working?
• 4:34
  Cathi Spooner: Are you using play therapy?
• 4:36
  Cathi Spooner: What play therapy model do you tend to use?
• 4:40
  Cathi Spooner: And feel free to post in the comments as I'm going through the case study, share your thoughts.
• 4:48
  Cathi Spooner: If you're watching on the replay I would also love to know all of those things as well.
• 4:54
  Cathi Spooner: So post in the comments, your name, where you're from, all the things.
• 4:59
  Cathi Spooner: Add, add, join the conversation for those of you listening to the podcast episode feel free to follow me on Instagram at renewing Hearts Training.
• 5:12
  Cathi Spooner: Message me.
• 5:14
  Cathi Spooner: Um, send me an email pop over to my website.
• 5:18
  Cathi Spooner: I'll talk a little bit more at the end today about Play Therapy Academy for those of you who are interested, I'll also talk a little bit about Elevation Circle.
• 5:29
  Cathi Spooner: Enrollment for Elevation Circle is currently closed unless you're attending any of my trainings 'cause it's part of my trainings that I have next month in April two day sand tray training.
• 5:44
  Cathi Spooner: And then in June I have a, um, trauma training using play therapy.
• 5:50
  Cathi Spooner: And so Elevation Circle, when you do that, you get access to Elevation Circle to kind of help continue getting that support.
• 5:59
  Cathi Spooner: All right, so let's get started for today.
• 6:05
  Cathi Spooner: So today our topic is why, uh, play therapy with adolescents, why teen symptoms are easy to misread.
• 6:16
  Cathi Spooner: So the first thing that we're gonna focus on today, well, the main thing we're gonna focus on today is really looking at case conceptualization.
• 6:27
  Cathi Spooner: So case conceptualization is a really fancy word for how do you make sense of what is going on at the root of the problem, we're not focused on symptoms.
• 6:41
  Cathi Spooner: We're gonna go deeper.
• 6:43
  Cathi Spooner: And that's where case conceptualization comes in.
• 6:47
  Cathi Spooner: We are looking at all of the symptoms, the how, the who, the what, the where, the when.
• 6:54
  Cathi Spooner: Um, we are also looking at, um, your theoretical model because that's gonna influence how you're making sense of what is going on in the play therapy process.
• 7:09
  Cathi Spooner: So, Michelle, welcome Michelle.
• 7:11
  Cathi Spooner: Michelle says, I'm from Boise, Idaho and I'm applying for my LPC next month.
• 7:17
  Cathi Spooner: Very exciting, non-traditional student and have utilized therapeutic play techniques in a coaching business supporting Oh, that's so cool, supporting foster and adoptive and bio parents.
• 7:30
  Cathi Spooner: That is awesome.
• 7:32
  Cathi Spooner: I worked at a residential treatment program.
• 7:35
  Cathi Spooner: Um, for a little while when we moved to the West coast, 'cause I'm now in Nevada, Michelle, we're practically neighbors.
• 7:43
  Cathi Spooner: Um, and it was all, all of it was the residential treatment program.
• 7:49
  Cathi Spooner: We only worked with adopted youth and so there was a, that there was a lot of kind of coaching about how you do things a little bit differently.
• 8:02
  Cathi Spooner: And we also have, I hope I said your name right?
• 8:08
  Cathi Spooner: Um, integrative child psychotherapist, working with children and young people.
• 8:13
  Cathi Spooner: Oh, at the Tavistock?
• 8:15
  Cathi Spooner: Yes.
• 8:15
  Cathi Spooner: That's so cool.
• 8:17
  Cathi Spooner: Um, I. Uh, they're doing cool things there, um, and I use play therapy.
• 8:22
  Cathi Spooner: Well, welcome, welcome, welcome.
• 8:25
  Cathi Spooner: So, so Case, um, case formulas.
• 8:30
  Cathi Spooner: Now my mouth's not working.
• 8:31
  Cathi Spooner: Okay, so a little bit of self-disclosure here.
• 8:35
  Cathi Spooner: Um, here in the us if you're here in the US we ju and maybe over there in the UK, um, we, uh, we just went through a time change, so my brain is a little wonky doodles and I did not get much sleep last night'cause I'm, my sleep is off because of the time change.
• 8:56
  Cathi Spooner: And my dog, Luna is here in the my office with me.
• 9:00
  Cathi Spooner: So if you hear some really weird noises in the background right now, she's doing a lot of snoring.
• 9:08
  Cathi Spooner: Um, Luna and I went to the vet yesterday 'cause she was limping and it turns out Luna's got osteoarthritis.
• 9:17
  Cathi Spooner: So she's a little sore and kind of sleepy today'cause I gave her some meds.
• 9:21
  Cathi Spooner: But anyways, so you may hear a lot of snoring.
• 9:24
  Cathi Spooner: Probably not a lot of digging 'cause she'll usually do a lot of digging.
• 9:30
  Cathi Spooner: And sometimes if you're watching, especially if you're watching on it's, uh, LinkedIn or on YouTube, sometimes when Luna's moving around the office, you can see in the video background her little tail, like a little flag in the background, which is kind of funny.
• 9:48
  Cathi Spooner: Whenever I go back and look at, oh no, she's digging.
• 9:52
  Cathi Spooner: Whenever I look at the video background, I'll see that sometimes Luna.
• 9:56
  Cathi Spooner: Yeah, she'll be digging today.
• 9:58
  Cathi Spooner: Alright, so let's get started.
• 10:00
  Cathi Spooner: We are going to be talking about, um, we're gonna be talk, I'm gonna share my screen a little bit differently today.
• 10:12
  Cathi Spooner: We're gonna be taught and I'm, I went all fancy and um, made some slides.
• 10:18
  Cathi Spooner: So if you're watching on linkedIn or YouTube.
• 10:22
  Cathi Spooner: You can see my slides.
• 10:24
  Cathi Spooner: If you're watching here on Instagram, you'll not be able to see my slides, but you may wanna go over to my YouTube channel and watch over there.
• 10:33
  Cathi Spooner: It's, uh, Cathi Spooner Renewing Hearts on my YouTube channel.
• 10:37
  Cathi Spooner: Just look on the live tab, and for those of you watching on LinkedIn, if you ever wanna watch the replays or all my other past episodes, probably easier to watch 'em on, um, on YouTube, or you can listen to my podcast.
• 10:55
  Cathi Spooner: All right, let's get started.
• 10:56
  Cathi Spooner: So we have the case of of Ethan.
• 11:02
  Cathi Spooner: I'm gonna go through a little bit of a case presentation First.
• 11:06
  Cathi Spooner: We're gonna meet Jane.
• 11:07
  Cathi Spooner: Jane is the therapist.
• 11:09
  Cathi Spooner: She works with children and teens.
• 11:11
  Cathi Spooner: She's been providing counseling services for about seven years.
• 11:16
  Cathi Spooner: Um, so it feels comfortable for her using play therapy and expressive arts to help her clients engage.
• 11:24
  Cathi Spooner: She's been working with Ethan, our fictitious client for about five sessions, so he is fairly new to Jane, and Jane has been struggling to figure out the best way to help him since he doesn't engage much in the sessions.
• 11:41
  Cathi Spooner: She's feeling a little bit stuck like we all do.
• 11:45
  Cathi Spooner: Even now I've been doing this, coming up on, I have totally rounded the corner to 35 years almost.
• 11:54
  Cathi Spooner: I get stuck sometimes.
• 11:56
  Cathi Spooner: Um, so she's feeling a little bit stuck and not sure how to best help him, but she knows he is having a hard time, so she really, really wants to help him.
• 12:10
  Cathi Spooner: So meet Ethan.
• 12:12
  Cathi Spooner: Ethan is a 16-year-old male.
• 12:14
  Cathi Spooner: He was referred to therapy with Jane because he's having academic problems and he's increasingly becoming emotionally withdrawn.
• 12:25
  Cathi Spooner: Over the past school semester, he failed two classes and he is at risk of losing eligibility for extracurricular activities.
• 12:35
  Cathi Spooner: Teachers describe him as disengaged minimally, minimally participatory, and frequently staring off during class.
• 12:46
  Cathi Spooner: Assignments are incomplete or missing.
• 12:50
  Cathi Spooner: Okay, so if this, was the only information you had, and maybe this is what parents are reporting, and you did that psychosocial assessment.
• 13:03
  Cathi Spooner: And Ethan was there and he was pretty much shut down and you weren't getting much outta him, and you got some information from parents and this was the information.
• 13:13
  Cathi Spooner: What kind of clinical picture, AKA diagnosis would you be leaning towards at this point in time?
• 13:23
  Cathi Spooner: Right.
• 13:24
  Cathi Spooner: He is, um, failing classes.
• 13:27
  Cathi Spooner: He is staring off in class.
• 13:32
  Cathi Spooner: He is not completing assignments.
• 13:36
  Cathi Spooner: He's kind of minimally participating, kind of disengaged.
• 13:42
  Cathi Spooner: You might start wondering about possible A DHD.
• 13:47
  Cathi Spooner: You might also start thinking, maybe you might, thinking about depression.
• 13:54
  Cathi Spooner: Post in the comments, what you think would be some diagnoses that you would consider at this point.
• 14:03
  Cathi Spooner: Also, what questions are you still needing to know about like what questions do you still need to ask?
• 14:14
  Cathi Spooner: What information is missing that's going to not going to give you the full picture.
• 14:20
  Cathi Spooner: This is where our case conceptualization really makes a difference when we are doing Play Therapy Academy meetings, and also Elevation Circle, which is my other online membership when we're doing our Play Therapy Academy consultations and Elevation Circle.
• 14:40
  Cathi Spooner: One of the things we're doing is going through the case conceptualization, figuring out what on earth do these symptoms mean?
• 14:49
  Cathi Spooner: Because before we can figure out what to do, we really need to understand why Ethan is struggling.
• 14:56
  Cathi Spooner: So if we, if we go on and we get a little bit more information.
• 15:02
  Cathi Spooner: So, so now we're finding out a little bit of what's going at home.
• 15:07
  Cathi Spooner: Parents report at home that Ethan spends most of his time isolated in his bedroom.
• 15:13
  Cathi Spooner: Ethan reports, he doesn't have very much motivation.
• 15:17
  Cathi Spooner: He's not, he's having a hard time concentrating.
• 15:20
  Cathi Spooner: He's not sleeping very well, um, and he is just frequently tired.
• 15:29
  Cathi Spooner: You're noticing his affect in the sessions is kind of flat.
• 15:33
  Cathi Spooner: His eye contact is limited.
• 15:37
  Cathi Spooner: He denies any active pseudo suicidal ideation, but he does.
• 15:43
  Cathi Spooner: He does endorse feeling a little bit numb.
• 15:46
  Cathi Spooner: Um, and it says he's kind of over it, like, whatever.
• 15:50
  Cathi Spooner: So if you have, many of us had to have Ethan's in our sessions.
• 15:56
  Cathi Spooner: If we're walk working with teens, we have probably had clients like Ethan.
• 16:02
  Cathi Spooner: So this gives you a little bit more information.
• 16:06
  Cathi Spooner: He's got low motivation, he has a hard time sleeping, he has a hard time concentrating, and he just constantly feels tired.
• 16:16
  Cathi Spooner: He's kind of numb and withdrawn and he's out of it.
• 16:20
  Cathi Spooner: So this information we're getting, um, more information.
• 16:25
  Cathi Spooner: So how does that information influence your thinking about what's at the root of this?
• 16:33
  Cathi Spooner: So now we're starting to formulate our diagnosis and, um, I'm not one to say, you know, there's a couple of schools of thought on diagnoses.
• 16:47
  Cathi Spooner: Either you, you may be in the camp of diagnoses are a waste of time.
• 16:52
  Cathi Spooner: Clients aren't symptoms, they're people.
• 16:55
  Cathi Spooner: It's just for medical billing or pleasing the documentation gods.
• 17:02
  Cathi Spooner: Or you might be like, diagnosis is everything.
• 17:06
  Cathi Spooner: It forms your plan about treatment and you're gonna match your, your place, your treatment model with the presenting symptoms.
• 17:16
  Cathi Spooner: So you might be using more of a prescriptive model where you're matching symptoms and treatment model.
• 17:25
  Cathi Spooner: So this one, um, you're gonna be thinking about, uh, the symptoms.
• 17:32
  Cathi Spooner: I, I kind of am, I tend to fall in the middle camp, which means diagnosis isn't, I think diagnosis gives us kind of an a ballpark idea of what might be at the root of what's going on to help us get a clinical picture of what our clients are struggling with.
• 17:56
  Cathi Spooner: But diagnosis sometimes, a lot of times our clients don't match up symptom for, symptom for what's in the diagnostic manual, the DSM five, now we're at the tr.
• 18:12
  Cathi Spooner: Um, so then it doesn't always match up perfectly.
• 18:16
  Cathi Spooner: The DSM has gotten a lot better about identifying symptoms for children and adolescents.
• 18:24
  Cathi Spooner: When I started back in grad school, we were on the, when I graduated ma, with my master's degree, we were on the DSM three TTR.
• 18:35
  Cathi Spooner: That's a few decades ago.
• 18:37
  Cathi Spooner: Um, so the DSM has come, come a long way since then.
• 18:41
  Cathi Spooner: And I would say it's still hard because a lot of times it's not a perfect match.
• 18:49
  Cathi Spooner: The way that I look at it though, if when we're looking at our case conceptualization, we're kind of looking at building a clinical picture so we can figure out what's at the root of the problem.
• 19:03
  Cathi Spooner: And if we're thinking about Ethan's symptoms so far, then we've, we've got some symptoms, but there's a lot of information still missing.
• 19:13
  Cathi Spooner: So one of the things I think is like may I like to do when we're, especially when I'm kind of in training mode, um, is what?
• 19:23
  Cathi Spooner: What information do you need to get a better sense of what's going on with Ethan?
• 19:29
  Cathi Spooner: If you were to think about some of your questions you'd wanna ask, what would those questions be?
• 19:38
  Cathi Spooner: And feel free to type those if you're watching live or if you're watching on the replay, feel free to post those in the comments or just write those down on a piece of paper.
• 19:50
  Cathi Spooner: If we kinda workshop this, write'em down on a piece of paper.
• 19:54
  Cathi Spooner: If you're listening on the podcast, write those down on a piece of paper.
• 19:59
  Cathi Spooner: Um, just so you're kind of really getting into that, um, analytic mode.
• 20:07
  Cathi Spooner: So now we find a little bit more about what is going on with Ethan.
• 20:14
  Cathi Spooner: What we find out is that Ethan's parents divorced about three years ago, um, following a, a long period of conflict with parents, excuse me, conflict in the home.
• 20:32
  Cathi Spooner: He's currently estranged from his father and he has minimal contact with dad.
• 20:40
  Cathi Spooner: Communication between parents, excuse me.
• 20:47
  Cathi Spooner: You know what?
• 20:48
  Cathi Spooner: I didn't bring water in with me today.
• 20:51
  Cathi Spooner: So of course that's exactly when I get a tickle in my throat and I am having a hard time talking.
• 21:01
  Cathi Spooner: All right.
• 21:01
  Cathi Spooner: I'm gonna take a deep breath.
• 21:06
  Cathi Spooner: All righty.
• 21:07
  Cathi Spooner: So communication between Ethan's parents is tense.
• 21:12
  Cathi Spooner: We could classify this as a high conflict divorce situation 'cause parents are not getting along.
• 21:23
  Cathi Spooner: And Ethan reports feeling uncomfortable when either of his parents speak negatively about the other, so he avoids talking about it.
• 21:35
  Cathi Spooner: He, he says he doesn't feel sad.
• 21:39
  Cathi Spooner: He's fine, right?
• 21:40
  Cathi Spooner: He's over it, whatever.
• 21:43
  Cathi Spooner: Um, yet he kind of describes a sense of emptiness and detachment from his peers school, and he's not really thinking about future goals.
• 21:55
  Cathi Spooner: So how much more does that give you about what is going on with Ethan?
• 22:03
  Cathi Spooner: Gives you so much more information about what might be contributing to his, um, the struggles that he's having.
• 22:16
  Cathi Spooner: So the thing that we wanna think about at this point, we have, we, so we've gathered some information and now we're gonna move into, um, our case formulation.
• 22:32
  Cathi Spooner: One of the things that we haven't talked about in information that's missing is any cultural issues.
• 22:39
  Cathi Spooner: What, um, what cultural influences are within the family.
• 22:46
  Cathi Spooner: So let's say you have a family, maybe that's a very, very strong religious affiliation in the family, and divorce is not looked at as a good thing.
• 23:03
  Cathi Spooner: I, I would say most people would say divorce is very painful and, um, has a lot of grief and loss associated with it.
• 23:13
  Cathi Spooner: Now add on a layer of culture and let's say that Ethan is from a traditional Middle Eastern culture where that that particular faith denomination that he's from, it d divorce is looked at very negatively in the culture.
• 23:39
  Cathi Spooner: Um, and so now we're thinking about what are the extended family members thinking about Ethan's parents and the divorce, how much, how many layers does that add?
• 23:55
  Cathi Spooner: What is the influence of culture on what Ethan is dealing with?
• 24:02
  Cathi Spooner: And so let's say Ethan lives in a household, a three generational household, because the whole family immigrated here to the U.S.. We're here in the US and so now we have, uh, and they immigrated here at different times.
• 24:21
  Cathi Spooner: So, how does that influence your decision making or your case conceptualization?
• 24:30
  Cathi Spooner: Maybe parents immigrated first and then Ethan stayed behind with grandparents, or maybe Ethan and grandparents came over uh, a couple years later with parents or maybe one parent came first and the rest of the family stayed so many different, or maybe they all came together.
• 24:55
  Cathi Spooner: A lot of different things to consider in terms of factors that might be influencing what's going on with Ethan.
• 25:05
  Cathi Spooner: And also Jane is African American and maybe she's from a different faith, faith, um, discipline.
• 25:16
  Cathi Spooner: So maybe um, Ethan's religious culture is different than Jane's religious culture.
• 25:25
  Cathi Spooner: Also, Jane is African American and Ethan and his whole family are Middle Eastern.
• 25:32
  Cathi Spooner: So how are we navigating some of those cultural differences?
• 25:38
  Cathi Spooner: And for Ethan, what layers do the, uh, does his culture, what, what are the layers that that adds to the issues that he's dealing with?
• 25:50
  Cathi Spooner: This is all missing information, right?
• 25:52
  Cathi Spooner: This is all the information you're gonna wanna find out about in order to get a better sense of what's going on with Ethan.
• 26:03
  Cathi Spooner: So then the next thing we wanna do is also think about, um, what is your.
• 26:12
  Cathi Spooner: What is your, um, theoretical orientation?
• 26:17
  Cathi Spooner: What's your theoretical framework?
• 26:20
  Cathi Spooner: What model are you using?
• 26:22
  Cathi Spooner: So, in play therapy, he's an adolescent.
• 26:27
  Cathi Spooner: Um, what if you are using Adlerian play therapy?
• 26:32
  Cathi Spooner: If you're using Adlerian play therapy, you are gonna conceptualize ethan's presenting symptoms through that Adlerian lens.
• 26:42
  Cathi Spooner: And we might hypothesize that Ethan feels like he doesn't count.
• 26:48
  Cathi Spooner: Um, and maybe he lacks a little courage to speak up for himself, to let his parents know like, you guys need to get along 'cause you're making my life really stressful.
• 27:02
  Cathi Spooner: And I'm tired of it, and I feel like I have to watch what I say because one of you is gonna get mad and I'm tired of you getting mad at me, and I don't wanna have to relay messages between you.
• 27:16
  Cathi Spooner: And Dad, why have you disappeared?
• 27:19
  Cathi Spooner: Right?
• 27:20
  Cathi Spooner: Like, what is going on with that?
• 27:22
  Cathi Spooner: And so, um, we also don't know why Ethan was estranged from his dad.
• 27:29
  Cathi Spooner: What happened?
• 27:31
  Cathi Spooner: We know there was, there was years of conflict prior to the divorce, but what, what extent was there domestic violence?
• 27:39
  Cathi Spooner: Was there child abuse?
• 27:42
  Cathi Spooner: Was there verbal abuse?
• 27:44
  Cathi Spooner: We don't know any of those.
• 27:45
  Cathi Spooner: Was there another kind of abuse?
• 27:47
  Cathi Spooner: We don't know any of that information and all of that's gonna influence our thinking.
• 27:54
  Cathi Spooner: So what if you are looking at this through a CBT lens?
• 28:02
  Cathi Spooner: You are kind of looking at the presenting symptoms through CBT and that's gonna influence how you're making sense of what is going on with Ethan.
• 28:17
  Cathi Spooner: I'm a big fan of using a neuroscience and attachment lens.
• 28:21
  Cathi Spooner: I, I, I believe you can, you can add that layer of neuroscience and attachment to any play therapy model and get a, get kind of a, another, uh, flavor, so to speak to that theoretical lens.
• 28:41
  Cathi Spooner: If we are, if we're just using, uh, an attachment and neuroscience lens, how are we gonna make sense of Ethan and what's going on with him?
• 28:53
  Cathi Spooner: If I am conceptualizing this and formulating my working hypothesis, then I'm going, my initial working hypothesis or case conceptualization is gonna look at this from a neuroscience and attachment standpoint.
• 29:12
  Cathi Spooner: From an, from that standpoint, we're looking at, Ethan does not have a secure relationship with his dad for sure we're not sure about his relationship with mom.
• 29:26
  Cathi Spooner: What we do know is parents are the foundation for their children, and when you're in adolescence and your foundation is cracked to smithereens, then that's gonna influence the mental health of our client, who's an adolescent.
• 29:47
  Cathi Spooner: There was a, there was an article in the, as the Association for play Therapy Journal, it's, this is from the April, 2013, um, article and it, it's entitled Towards Secure Attachment in Adolescent Relational Development.
• 30:04
  Cathi Spooner: Advancements from sand play and expressive based interventions, and this was an article written by the late Eric Green, a Ian play therapist, Amy Myrick and David Crenshaw.
• 30:17
  Cathi Spooner: And they looked at, they used an an attachment lens to as their theoretical form formulation.
• 30:27
  Cathi Spooner: And, and in this article, they looked at literature, they did a whole literature review.
• 30:32
  Cathi Spooner: But here's what they found.
• 30:33
  Cathi Spooner: And I'm gonna read this because I think it, um, kind of, if I'm thinking about my case formulation or my working hypothesis, these are the things that I'm probably gonna be considering and that the research is supporting this, this lens.
• 30:50
  Cathi Spooner: So this is on page 90.
• 30:54
  Cathi Spooner: Recently the literature on parent adolescent attachment relationships has been demonstrate, has demonstrated associations between secure positive attachments and a, lower mental health difficulties.
• 31:11
  Cathi Spooner: B, meaningful relationships and C, increased career success.
• 31:18
  Cathi Spooner: In contrast, those adolescents who fail to form meaningful attachments with caregivers appear to struggle in these areas as new relationships develop and alter or dis dissipate over time, adolescents may experience variations and fluctuations in their mental wellbeing.
• 31:42
  Cathi Spooner: So it kind of, um, confirms this idea of adolescents needs secure attachments as well.
• 31:52
  Cathi Spooner: And without those secure attachments, it's going to influence their mental health.
• 31:59
  Cathi Spooner: So we have, um, oh.
• 32:02
  Cathi Spooner: Hi, this is, uh, someone from, uh, Canada.
• 32:08
  Cathi Spooner: Hello.
• 32:09
  Cathi Spooner: Can you please link that article or leave the title so I can look it up later?
• 32:13
  Cathi Spooner: I will.
• 32:14
  Cathi Spooner: I, yes, we will.
• 32:16
  Cathi Spooner: I'll have, uh, Brill put that in there, but the title is Toward a Secure, toward cer.
• 32:24
  Cathi Spooner: When my Mouth works, I'll be able to tell you.
• 32:27
  Cathi Spooner: Okay.
• 32:27
  Cathi Spooner: Trying again Towards secure attachment.
• 32:31
  Cathi Spooner: In adolescent relational development, attachments from sand play and expressive based, expressive play-based intervention.
• 32:43
  Cathi Spooner: The authors are Green, Mirik and Crenshaw.
• 32:46
  Cathi Spooner: This is from April, 2013, volume 22, number two, so if you're interested in looking it, it's actually a really good article.
• 32:56
  Cathi Spooner: I mean, it's kind of old at this point, 13 years old, but it's still relevant information because what we know is, teens need their, uh, secure attachment relationships just as much as parents do.
• 33:14
  Cathi Spooner: And in fact, Daniel Siegel wrote a book about the adolescent brain using his interpersonal neurobiology lens, uh, the book is called Brainstorm.
• 33:26
  Cathi Spooner: And one of the things.
• 33:28
  Cathi Spooner: Seagull highlights in his book Brainstorm is the need for secure attachment relationships with parents in order for, um, teenagers to thrive.
• 33:41
  Cathi Spooner: So if we look at divorce from an attachment rupture lens, and then you add on those extra layers of conflict and estrangement from dad and we don't know relationship with mom.
• 33:57
  Cathi Spooner: Then we can, we can conceptualize that Ethan is struggling and doesn't have a secure relationship with either parent, and that's gonna influence his day-to-day experience.
• 34:13
  Cathi Spooner: And so when you're using that information, you, you're thinking about, you're using this information.
• 34:20
  Cathi Spooner: Here's the reason that we do our case conceptualization from the beginning, and we adjust as we go along.
• 34:29
  Cathi Spooner: We do that because.
• 34:32
  Cathi Spooner: This is what's gonna inform our decision making about what we're doing in sessions when we're doing it.
• 34:41
  Cathi Spooner: And it's gonna be influenced by our theoretical model that we're going to use as that intervention piece.
• 34:49
  Cathi Spooner: So, um, skipping over the initial case formulation really I think handicaps us, and I see this a lot, a lot of what we do in Play Therapy Academy is really focusing on the core competencies.
• 35:10
  Cathi Spooner: One of those core Co or some of those core competencies is understanding child development, understanding your theoretical model, and using that for your case formula formulation.
• 35:24
  Cathi Spooner: Using that information through each stage of the play therapy process and what does that look like in the different stages?
• 35:31
  Cathi Spooner: So in Play Therapy Academy, we kind of take a deep dive in this, in Elevation Circle, we meet once a month, so it's um, and, elevation Circle is more because having a place to get support as a play therapist, we do a book club in there.
• 35:50
  Cathi Spooner: We do case consultation.
• 35:53
  Cathi Spooner: I'm gonna be adding some new features.
• 35:54
  Cathi Spooner: We're doing some mini trainings, like this month in Elevation Circle, we're gonna be, we have a mini training about identifying play themes.
• 36:04
  Cathi Spooner: So Elevation Circle is really kind of giving support.
• 36:08
  Cathi Spooner: So we don't have to do play therapy alone.
• 36:12
  Cathi Spooner: Play Therapy Academy does that, and we do a deep dive into developing those core competencies.
• 36:21
  Cathi Spooner: So, so the, these, these are really important skills that we wanna focus on to help us, um, make a difference with our clients.
• 36:35
  Cathi Spooner: So that is it for today.
• 36:38
  Cathi Spooner: I'm going to do a quick little recap for today.
• 36:42
  Cathi Spooner: Um, today we talked about our working hypothesis and why that's important, why you need your case formulation and you, you're looking at the symptoms, but you don't wanna get stuck on the symptoms.
• 36:56
  Cathi Spooner: You wanna go deeper.
• 36:58
  Cathi Spooner: Go to the deeper roots to get a better sense of what's going on, because otherwise what happens, what I see this all the time is you're gonna get stuck at some point.
• 37:10
  Cathi Spooner: I get stuck, and I've been doing this a long time.
• 37:13
  Cathi Spooner: I still get stuck.
• 37:14
  Cathi Spooner: When I get stuck though, I know I need to go back to my initial case conceptualization and kind of see where we are in the treatment process, what we've accomplished, and where we are and how, and kind of take a step back.
• 37:32
  Cathi Spooner: And get reoriented with my case formalization and understanding my play therapy model and what to do and when to do it.
• 37:42
  Cathi Spooner: And what we, we learned from this case study about our fictitious ca, our fictitious character or, uh, client and fictitious therapist, Jane, is that Jane is really working on identifying these, these, um, symptoms.
• 38:03
  Cathi Spooner: She's looking at family issues, and then she's using that neuroscience and attachment lens to to formulate that working hypothesis and figure out why Ethan is struggling, because that's gonna help inform Jane's treatment planning.
• 38:25
  Cathi Spooner: You can't figure out what to do until you first understand what's going on and what's at the root.
• 38:30
  Cathi Spooner: Don't stop at the symptoms.
• 38:33
  Cathi Spooner: And here's the other thing, working in, uh, in the play therapy field, where the child and adolescent field is, usually you're doing this work alone.
• 38:44
  Cathi Spooner: I can't tell you how many times I meet with people when they are scheduling their 30 minute video calls with me to see if Play Therapy academy's a good fit.
• 38:54
  Cathi Spooner: One of the things that I hear over and over and over is they're the only play therapist and they're, um, kind of having to do it alone and figure things out alone.
• 39:07
  Cathi Spooner: And so.
• 39:08
  Cathi Spooner: Um, doing that alone can be hard, and it doesn't even matter.
• 39:13
  Cathi Spooner: We, we, even if you're seasoned, doing it alone is hard.
• 39:18
  Cathi Spooner: We hold, we hold these hard stories in our nervous system all day long, session after session, after session, after session.
• 39:25
  Cathi Spooner: And so it can be nice to have a place to take that, to let go of some of it and get support so that you don't feel like you're doing it alone and you're not feeling like you're getting burned out because you do have that support.
• 39:41
  Cathi Spooner: So that is it for today.
• 39:43
  Cathi Spooner: If you're interested in Play Therapy Academy.
• 39:47
  Cathi Spooner: I do have some openings right now.
• 39:51
  Cathi Spooner: Um, I only have openings as people leave or, or graduate.
• 39:57
  Cathi Spooner: Um, so if you're interested in Play Therapy Academy and you want to do a deeper dive, learning those core competencies, developing a lot more confidence, knowing what you're doing and why you're doing it, and then being able to explain that to parents in a way that makes sense and sounds like you know what you're doing, and you can finally kick imposter syndrome to the curb, then schedule a 30 minute video call with me.
• 40:27
  Cathi Spooner: We'll see if Play therapy's a good fit for you.
• 40:30
  Cathi Spooner: If it's not a good fit, maybe Elevation Circle is a better fit for you and um, you can go on the wait list.
• 40:39
  Cathi Spooner: If you're interested in finding out more about Play Therapy Academy or elevation Circle, then pop over to my website at rh play therapy training.com.
• 40:52
  Cathi Spooner: That's RH play therapy training.com.
• 40:56
  Cathi Spooner: For Play Therapy Academy, you wanna click on the consultation page and that'll give you some information about which one might be a better fit Elevation Circle, or Play Therapy Academy.
• 41:10
  Cathi Spooner: It really depends on what your needs are at this time.
• 41:14
  Cathi Spooner: Elevation Circle is more like community focused and based and supportive.
• 41:20
  Cathi Spooner: We do different things to support, play therapists.
• 41:24
  Cathi Spooner: Play Therapy elevation Circle.
• 41:25
  Cathi Spooner: We get tons of support in there.
• 41:28
  Cathi Spooner: And I would say one of the things that most play Therapy Academy members say is their favorite is the group support that, that they get in there to take those deep dives.
• 41:40
  Cathi Spooner: I also have a Sand Tray training coming up.
• 41:43
  Cathi Spooner: If you're interested, this one's just a, uh, this one's a two day in-person.
• 41:47
  Cathi Spooner: It's in-person only.
• 41:50
  Cathi Spooner: Um, you can check out the training page on my website for that one.
• 41:54
  Cathi Spooner: And I also have another training coming up, healing trauma through play therapy, using a neuroscience and attachment approach.
• 42:03
  Cathi Spooner: So if you're interested in any of those trainings, pop over to my website at rh play therapy training.com.
• 42:12
  Cathi Spooner: That's Renewing Hearts Play Therapy training.
• 42:16
  Cathi Spooner: Um, or if you're interested in Play Therapy Academy, pop over there as well.
• 42:23
  Cathi Spooner: And I will see you next week.
• 42:25
  Cathi Spooner: Bye for now.
• 42:31
  Cathi Spooner: Thank you for joining me on this episode of Next Level Play Therapy.
• 42:36
  Cathi Spooner: I hope you found the discussion valuable and gained new insights and ideas to support your work helping children, adolescents, and families feel.
• 42:45
  Cathi Spooner: If you enjoyed this episode, be sure to subscribe to the podcast and leave a review.
• 42:51
  Cathi Spooner: Your feedback helps to improve and reach more people who can benefit from this information.
• 42:56
  Cathi Spooner: Remember.
• 42:58
  Cathi Spooner: Play therapy is a powerful tool for healing and growth.
• 43:01
  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.
• 43:12
  Cathi Spooner: If you have any questions or topics, suggestions for future.
• 43:18
  Cathi Spooner: I'd love to hear from you.
• 43:19
  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.
• 43:32
  Cathi Spooner: Thank you once again for listening to Next Level Play Therapy.
• 43:36
  Cathi Spooner: Until next time, keep playing, learning and growing.