Latest / The Play Therapy Circle / Episode 13 - Stages of the Therapeutic Process in CCPT

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Episode 13 - Stages of the Therapeutic Process in CCPT · The Play Therapy Circle

0:00
Hi there and welcome to the Play Therapy Circle.
0:04
Before we begin, Please note this podcast is for
0:07
informational and educational purposes only.
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It does not provide therapeutic advice and listening does not
0:14
create a client therapist relationship.
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All views expressed are my own and any case example shared have
0:21
been de identified to protect privacy.
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If you're seeking personal support, please reach out to a
0:27
qualified mental health professional in your area.
0:33
Hi and welcome to an episode of the Play Therapy Circle.
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I'm Kylie Ellison, a therapist, clinical supervisor and play
0:42
therapy trainer, and I'm so grateful you're here.
0:45
This podcast is a space for thoughtful, soulful
0:49
conversations about child centred therapy, play based work
0:53
and what it means to show up with presence and compassion,
0:57
both for our clients and for ourselves.
1:00
Whether you're a seasoned play therapist, a student just
1:03
starting out, or someone deeply passionate about working with
1:07
children, you belong here. Hello everyone, welcome to the
1:14
Play Therapy Circle podcast. I'm your host, Kylie Ellison,
1:18
and I am so glad you are here. Happy Friday, you guys, happy
1:24
podcast launch day. We are doing things a little
1:28
differently today. I am recording this on the day
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we're launching the episode because we've had some tech
1:36
issues you guys this week. So our first encounter with tech
1:40
issues. So it is very early today.
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If I sound any different, that's because I've just woken up and
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we are getting into it and doing this podcast because we want to
1:51
get it out to you guys. Today we are going to dive in.
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I hope that you have had a wonderful week.
1:58
I can't believe that it's another week and it's another
2:01
episode. I am so excited for the weekend
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and I hope for anyone listening that wherever this reaches you,
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you are also having a lovely week that is so important.
2:13
I am very excited about this episode today because it is
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definitely part of the nuts and bolts of play therapy practise
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and especially child centred play therapy practise when we
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talk about the topic of stages in child centred play therapy.
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So I am really mindful of the fact that for beginning play
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therapists especially, having a tool to be able to communicate
2:38
to parents, to be able to explain progress in a way that
2:43
protects confidentiality is so helpful when it comes to stages
2:47
of play. But I'm also really mindful of
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the fact that children don't progress in a linear manner in
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child centre play therapy. So even for us as seasoned play
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therapists, we understand the stages of play, but it's always
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good to have a refresher because this can be a part of our
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practise that can really help us to ground us in our approach,
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give us that confidence in what we're doing, especially if we're
3:16
feeling stuck, and really help legitimise and quantify the work
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that we're doing in a very child centred, child LED humanistic
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form to counselling, right? So This is why we do what we do
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and especially when it comes to the stages.
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So today I want to cover what each of those stages are.
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And when I talk that through, I want to mention I guess what to
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look out for and some of the pitfalls that we obviously can
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sometimes haven't happen. So making sure that we are
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understanding how to assess these stages is really helpful
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as well in our work. So let's without any further ado
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get into it So we know that stages and I want to preface
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this conversation by saying very much with my framework for
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practise in child centre play therapy.
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I am going to lean into the Nodling and Cochrane model of
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exploratory, aggressive, regressive and mastery.
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So I just want to caveat that because I know there are
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variations out there. So please use what works for
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you. But just to clarify, that's the
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one I'm going to talk about today.
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But I think one of the most important things, as I said
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earlier, is the understanding that stages in play therapy are
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not linear. So kids are going to bounce in
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between each of those stages. But like I said, it does help us
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to give us a scaling tool, a way or a concept to express to
4:44
parents how much progress has happened in play therapy and to
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give them as much as us that reassurance when it feels like
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we're stuck. I think that's something even
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for experience therapists you would know well when you have
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had a client that you have been doing 10/15/20 sessions or more
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of the same type of play and really feeling a little bit like
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it's Groundhog Day. So the way that we look at these
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stages is very much to take more of a helicopter view, to kind of
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pull back and look holistically across that continuum of
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sessions, to have an understanding of where kids are
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travelling in their work. So it does give us that
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reassurance as well as the parents.
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It is definitely something where children will move back and
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forth. I often explain to supervisees
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that you will often find progress impacted by what is
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happening outside of play therapy.
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So when we are seeing changes like for foster kids, a change
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in placement, a death in the family, introduction of family
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contact, yeah, just changes outside of play therapy that are
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significant for the child, moving schools, whatever that
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looks like, it will no doubt have an impact on where the kids
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are travelling in their play therapy work in those stages.
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So having an awareness of that and being able to explain that
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to parents is really good. OK, let's get into the different
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stages. So like I said, I lean into the
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Nodaling and Cochrane model. So the first stage we talk about
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is the exploratory stage. So this is definitely when I
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describe it. In explaining this concept, I
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like to think of this stage as more around the child, exploring
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the room, getting to know the toys, getting to understand us
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and the role that we play in that therapy process.
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Because a lot of children come from other experiences of
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therapy where the therapist has asked questions or been more
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directive. So there is definitely a shift.
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And sometimes I notice it very subtly or very overtly where the
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child is out. You're not going to ask me
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questions. OK.
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So there is literally kind of this light bulb moment, I think
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for some of our kids, not all but some of them, where they
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realise that therapy looks very different in a child centred
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play therapy playroom. So they're definitely exploring
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the room. It often can be described as, I
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guess, cautious play where they are testing limits.
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So they are watching to see our reaction to things, trying to
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understand what they can and can't do.
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And there's not necessarily a lot of engagement with the
7:26
therapist or much kind of eye contact verbal communication
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with us. And that's OK for us as play
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therapists, we are definitely helping to convey and support
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the sense of safety in the room, consistency in the room.
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And we are very much leaning into our tenants of CCPT, of
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congruence, empathy and unconditional positive regard.
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So it's very much the skills of tracking.
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We might use some act limit setting that we've talked about
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in a previous episode, but I often think that when I'm
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observing exploratory sessions, there's sometimes an absence of
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that really intense emotional expression or intense content.
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That's another way of describing it.
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So it really is about them exploring the room and
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understanding the relationship. So we're doing a lot of those
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tracking reflections, like you're just exploring the room,
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you're just getting to know the space, you're just understanding
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how this works. All of those reflections are
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really helpful to essentially establish that relationship with
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a client. That's the purpose really of
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that exploratory stage, for them to feel that sense of safety, to
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move into the second stage. What are some of the pitfalls
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that we can encounter in the first stage?
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It can be related to feeling a sense of the child not engaging
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with us and feeling like maybe this isn't going to work or
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feeling that quietness or lack of verbal communication or
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verbal interaction with us is resistant or incompatibility
9:03
with child centre play therapy, right?
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And it's very important that we are staying true to the
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modality, trusting us, trusting the process, trusting the child
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that every child is going to have a different amount of
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sessions that takes them to move through these stages.
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That's really super important guys.
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And I really want to emphasise if you are struggling with this
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at the moment or really feeling like a child is stuck, to go
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back to our tenants and recognise how this approach
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works and this modality works when it's at the pace of the
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child. And so those number of sessions
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don't really exist in a common sense.
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So when I'm doing an initial console, which we're going to
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talk about in future sessions, but when I do an initial
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consult, I very explicitly say I'm not going to put a number to
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this because I don't want to set myself up to fail or the child
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up to fail in that process. So we really do espouse to our
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modality with that. So if we were, and being a
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humanistic Corridorian practitioner to my core, this is
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even hard for me to resist. But if we were to put a number
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to it, generally speaking, it may be say two or three sessions
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that we would expect a neurotypical child without a
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trauma history and without all of these other presenting issues
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to be able to start their therapy work.
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So that is where we begin our journey.
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And so looking at that exploratory stage is the first
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part. When children have a step
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established that relationship, they then move into the second
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stage of play, which is the aggressive stage.
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So what does the aggressive stage look like?
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I like to again explain it across that continuum, to say
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that once kids have established that sense of safety and the
10:52
beginnings of a relationship with us, they immediately go
10:55
into that second stage to test the negative aspects of self.
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So what do I mean by that? What often happens once they
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have understood how play therapy works is they then want to test
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whether we are somebody that is going to stay with them and
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stick with them and not reject them.
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So they try to show us all of these negative sense of self,
11:20
maladaptive coping mechanisms, ways of engaging that are not
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socially acceptable or healthy to see our reaction, see what
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our response will be and see whether we are going to stay the
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course and be with them in the grand scheme of things.
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Which I find incredible with kids and it's why I love child
11:40
centre play therapy so much, is the fact that regardless of the
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child's background, regardless of where they're at, regardless
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of their presenting issues at their core, kids have this
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innate Dr towards that self actualization principle of
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moving towards being able to resolve their issues or to see
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themselves ultimately at their core as good.
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And so all children tend to move through this same process of
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building this relationship and then really testing that
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therapeutic alliance to then be able to move into that third
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stage where they are then able to really become vulnerable and
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talk about those kind of core issues that they're struggling
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with. So it's incredible to be witness
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to that. It's such a privilege and an
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honour as a child centre play therapist to watch children in
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real time move through these stages.
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But this second stage can be, I think in my own reflections of
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kind of the last 10 years and those teachers that I've
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connected with, I do find that that second stage is probably
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the toughest for me. And the reason I say that is
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because as a play therapist, what we need to do is be able to
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stay calm, congruent, consistent and use lots of limits because
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that is going to be tested in the second stage of play.
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So that aggressive stage really comes to a lot of that boundary
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pushing, defiance, limit testing, very provocative play,
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really trying to get that response from us.
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So it's very important again, in this approach that we are, as I
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said, leaning into that understanding that we trust the
13:24
child, we trust us and trust the process and really grounding
13:27
ourselves in the skills that we have.
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So using reflecting feelings, using that limit, setting that
13:33
ACT model helps us to have some tools in our toolkit to be able
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to respond and navigate it with the child.
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So using lots of that, reflecting feelings,
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communicating the limit and targeting the alternative
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behaviour is a lot of the language that we're using along
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with reflecting feelings to let the child know we understand
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that they are showing us some really tough stuff right now and
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that we, I hear you, I see you, I understand and I care, as Gary
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Landers would say. So some of the pitfalls we can
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fall into in this second stage often relates to taking some of
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those behaviours personally, overreacting or overcorrecting
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some of those behaviours. So really getting and accessing
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clinical supervision is so important during this time to
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really return yourself to the modality and remove yourself, I
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guess, from that personal aspect of the play to understand, And
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the way that I sometimes do that as well, really understanding, I
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guess that conscious and unconscious mind and some of
14:37
that play we're observing in real time is to view it from the
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lens that what they are showing us is often what they understand
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the world is like and what they understand relationships are
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like. So oftentimes kids will show us
14:52
those negative aspects of self, say if they've been exposed to
14:56
domestic violence and they understand that how to engage
15:00
with another is to put people down or to control the
15:03
relationship or to yell. All of those things that they
15:07
have observed in real time and taken on board and not
15:10
necessarily understood that it's not necessarily healthy or
15:15
socially appropriate to do so. We get to see that in real time
15:18
and we get to role model what an appropriate responses look like
15:22
and how to support them appropriately.
15:24
So we get this beautiful window of opportunity to help with that
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healing and reparations. So it is such a privilege and an
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honour. The third stage we move into
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then is the regressive stage. So like I was saying before,
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it's very vulnerable, connected attachment work in this third
15:43
stage. So the way kids do it is
15:46
obviously testing that relationship in the second stage
15:48
to make sure we are somebody solid that's not going to give
15:51
up on them, that's going to show up every week for those sessions
15:55
and be consistent. And then they move into that
15:57
third stage where they say, OK, I can see that you're somebody I
16:00
can trust, let me show you into my world.
16:04
And I find that so incredibly powerful.
16:07
And so I don't necessarily find the third stage physically
16:12
taxing for me. I find it more emotionally
16:15
taxing. And what I mean by that is that
16:18
the content of the play shifts into more symbolic work, and it
16:23
can be very raw and vulnerable and important to the child's
16:28
journey. And so being able to again, take
16:31
care of us outside of play therapy, whether that's personal
16:34
therapy or clinical supervision, to be able to stay present and
16:38
authentic and accepting of the child when they show us this
16:41
really important material in the third stage.
16:45
So it's lots of theme work around nurturing, care,
16:48
connection, good versus evil, safety and security, fears and
16:53
anxiety, lots of those things we see in the third stage.
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So what does it mean for us and what are we required to do as
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child centre play therapist? Because we're talking about
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attachment work, it requires deep attunement, and so that
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requires us to be present and be able to lean into our approach
17:15
at a deeper level to be able to really establish that connection
17:19
with the child so they feel comfortable to open up and be
17:22
vulnerable. So we're doing a lot of
17:24
reflecting feelings again in this third stage and lots of
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making meaning statements to really deepen that work and help
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the child to know that we see what they're showing us.
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So what can be some of the pitfalls in this third stage?
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It can definitely be around interrupting some of that
17:43
symbolic play, say with questions because at this third
17:47
stage there's lots of that ambiguity.
17:50
It makes sense to the child, but it sometimes doesn't make sense
17:53
for us. And so making sure that we are
17:58
sitting in the uncomfortable, sitting in the silences,
18:01
accepting and being comfortable with the silences as a child
18:04
centre play therapist is going to be super, super important.
18:08
So again, if that is a struggle for you, navigating that with
18:13
your supervisor in clinical supervision is so helpful in
18:16
this space. So then we move into the final
18:19
stage, which is mastery, what we call mastery in that fourth
18:21
stage, and it definitely shifts again in the content.
18:25
So in the third stage, what I forgot to mention was what we
18:29
see is oftentimes, not always, but oftentimes an absence of
18:32
aggression. So when we are looking at these
18:35
different stages, that first stage is often, you know,
18:38
exploratory in nature. So we're not seeing deep
18:40
therapeutic content in the first stage of play.
18:43
We move into that aggressive stage where it's lots of more of
18:45
that physical aggression, that power and control in terms of
18:48
themes. When we move into that third
18:50
stage, I often say that it's almost like that absence of
18:53
aggression and it's really that attachment, deep attunement
18:56
work. In the final stage, we sort of
18:59
look at it similar to the beginning that there is then
19:02
that move away from that intense therapeutic content.
19:06
There's an absence again of that as we move into transitioning
19:09
out of play therapy. So we're looking at increased
19:13
relational capacity, talking about endings, showing
19:17
indicators in their play that they are moving to mastery and
19:21
that they are moving to the end of the therapeutic work, mastery
19:24
themes, all of that good work that we see at the end.
19:27
And again, what I preface this by saying is we are looking at
19:32
the continuum of that therapeutic intervention, right?
19:35
So we would not expect a child at the third session to be in
19:40
mastery. But if we are looking at session
19:42
45 or beyond and every child is different.
19:46
So I hate doing numbers, but if we're looking at way down the
19:50
track a year from now, we can have more confidence in saying
19:54
this child is definitely not still in the exploratory stage.
19:57
They have definitely moved through a lot of work and we can
20:00
now start to look at is this mastery?
20:03
So what are we doing as play therapists?
20:05
Again, we're still doing a lot of reflecting feelings and maybe
20:09
at times that making meaning statements, but we wouldn't
20:12
expect a lot of limit setting or some of those other skills in
20:16
child centre play therapy. So we are in a sense recognising
20:21
that the child is coming to an end with working closely with
20:23
parents and caregivers to have a process to help them to exit.
20:27
But we are preparing them potentially for the end of their
20:31
therapy journey, reflecting on that growth and celebrating that
20:34
progress along the way. So it is very important in terms
20:38
of pitfalls that we are avoiding the ending because of our own
20:44
discomfort or our own resistance, right?
20:47
Because we as play therapists have been through a journey of
20:51
growth alongside the child. That is what I love.
20:54
I mean, again, I love so many aspects of child centre play
20:56
therapy guys, but that is one of them where I love that I am a
21:00
better person for having connected with that child.
21:04
There is something that I carry in terms of that journey that
21:08
will enhance my practise, that will deepen my work, that will
21:12
make me a better person as well. So how cool is that?
21:15
So we may have some resistance if we're not ready to say
21:19
goodbye as well. So again, seeking that clinical
21:22
supervision, getting that external kind of viewpoint to
21:25
help give us some clarity is very helpful there too.
21:28
A very quick guys overview of the stages of play, but what I
21:34
want to do is just summarise I guess some of what we've talked
21:38
about today. So definitely what can happen is
21:41
that children will transition in and out of these different
21:45
stages and certainly it will be often impacted by stress or
21:51
changes outside of play therapy. So they're not going to go in a
21:54
linear manner. And it certainly does give us
21:57
that framework to be able to provide feedback to parents
22:02
whilst still being able to maintain that therapeutic
22:05
alliance and confidentiality which is really important.
22:09
It really does help us as well to maintain consistency in the
22:13
playroom, to have confidence in our approach and not to rush the
22:18
process. That is definitely something
22:21
especially for our beginning play therapists that I know can
22:24
be really tough if we don't have, and I like to liken it to
22:27
a catalogue of experiences of all of the teachers that I've
22:31
encountered in my playrooms. In the back of my mind, I've got
22:34
all of these beautiful children who have shown me what play
22:37
therapy is all about and how play therapy looks.
22:40
And so if you don't have that, it can cause that anxiety and
22:44
that doubt for yourself that we are stuck in this and
22:48
potentially in your relationship in the work with a particular
22:51
client that you don't feel like you're making progress.
22:53
So it definitely helps us to stop and pause and not
22:56
necessarily feel like we have to rush the process because we've
23:00
got this framework to follow. And sometimes I guess it's
23:04
helpful to normalise that regression when we do see that
23:08
bouncing between stages as well. So what I want to express in
23:13
talking about these stages is it's definitely a guide, but we
23:18
don't live by it by Bible, right?
23:21
It's very important that we recognise that we are engaged in
23:26
a humanistic approach to intervention in child centre
23:29
play therapy. And so not every child is going
23:32
to beautifully fit into each of those stages, but it is a great
23:36
starting point to help us to navigate that therapeutic work.
23:40
We're definitely helping ourselves to be able to
23:43
recognise those markers by using this concept, to be able to hold
23:48
steady to our approach and to be able to have those responses
23:51
ready to be able to respond to kids.
23:54
So look, that is a very brief overview, guys.
23:58
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We love to hear from you guys. If you want to hear more content
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along this topic, we would love to hear about that as well.
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Next week, we're going to talk a little bit about the parent
24:26
therapist relationship. You guys a really great topic as
24:30
we move into talking about working with parents and what
24:34
that involves. So I hope that will be useful
24:36
for you guys too. I hope today has been useful.
24:39
Thanks for sticking around and listening along.
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I hope wherever this finds you in the world that you are having
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a good day, that you're having a good week, and that you have a
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wonderful weekend. Be kind to each other and be
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kind to yourselves. We love our Play Therapy Circle
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community and we appreciate your support.
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Go well, look after yourselves and each other, and I will talk
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to you guys again soon. Bye.
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Thank you so much for being here for another episode of The Play
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