Therapies The Integrative Approach
The Integrative Approach
Fundamental to aiding positive change in child therapy is treating each case individually. Where play therapy may be ideal for one child CBT may be more appropriate for another. But each time the same principles of listening to the child’s needs is paramount for positive change.
Our goal is to create a therapeutic relationship through play and talk, encouraging children in groups or individually to express feelings that have become a source of conflict and distress; such as ‘why can’t I live with my parents?’ or ‘I’m frightened to go to school’ or ‘why don’t I have many friends?’. In the therapeutic sessions your child is offered an understanding and insight to their internalised narrative, facilitating their ego development.
In the course of therapy it normally becomes evident the child’s conflict within an environment, this may be specific to the family home or school or after school club and its then appropriate to offer helpful advice to those concerned, as always focusing on the child’s needs but staying empathic to those who care and are concerned for the child’s well-being.
Providing a practical but an empathic response to families and school staff supports the child or young person rather than changing them to suit the environment. Every child is unique and as adults we should change our responses to support rather than use strategic procedures from behaviourist principles to shape and reinforce ideas that are not always beneficial to the individual child.
For children who have become ‘stuck’ in their thinking they may benefit from trauma-focused cognitive behavioural therapy to move them forward due to a traumatic event such as a family death, a car accident or house fire. Symptoms usually include; nightmares, bed wetting, not wanting to leave the house, eating patterns change and withdrawal from everyday activities that were once considered a happy experience. Based on the notion of “processing” old self-beliefs in a healing environment created with the therapist together the processing of the past events (beliefs and memory) is more likely to occur spontaneously; but it’s not for everyone and as therapists we need to consider the difficulties associated with the fact that the intervention involves doing something that the child or young person wishes to avoid.
For families struggling with past attachment issues whether biological or adoptive Daniel Hughes and his PACE principles provide long-term solutions for the whole family.
By understanding the capacity of the brain to activate new neural connections and ultimately new pathways is facilitated only when a safe therapeutic relationship is established and down-regulation of the fear response is effectively addressed (Rossouw, 2011) PACE supports a consistent ethos within the family home. The ‘bottom-up’ approach looks to establish safety through down-regulation of over-arousal from the reptilian brain (the fight, flight or freeze part of the brain) which results in an increase of blood flow to the left frontal cortex for effective activation of cognitive abilities (the top, higher functioning part of the brain). It therefore makes sense that a safe mind is a curious mind and in children we need to promote this sense of trust and safety all the time not just within a therapeutic session.
Dan Hughes , Dan Siegel and Kim Golding have made huge progress in the field of child psychotherapy, educating therapists and parents in the importance of nurturing attachments for positive neurological changes. As a practitioner in Hughes, Dyadic Developmental Practice his ‘bottom-up’ approach to nurturing a safe and trustworthy environment focuses on facilitating a coherent individual and family narrative that are central in the development of attachment security.
Playfulness/Patience Acceptance Curiosity Empathy which is taught to parents or staff open to understanding and changing their thinking towards their child’s behaviour in response to past attachment trauma.
Alongside family-focused therapy it may be beneficial for the child to attend play therapy sessions to understand their past before embracing a secure and loving connection. Play therapy is a way of helping troubled children cope with distress from an event or a continuous situation in their life. Using play as the medium of communication between child and therapist the method is based on the central assumption that play is the place where children first recognise the separateness of what is ‘me’ and ‘not me’ and begin to develop a relationship with the world beyond the self.
‘It is the child’s way of making contact with their environment, creating a fictional world to make sense of their own‘. Ann Cattanach.
The general principles of Play Therapy are based on Carl Rogers (1951, 1955) model of psychotherapy - client centred therapy with emphasis placed upon the relationship between therapist and client based upon genuineness, acceptance and trust. Largely influenced by this person centred approach, Axline (1969, 1971) developed a new therapeutic approach for working with children – non directive Play Therapy. Utilising the person centred theoretical foundations, Axline devised a clear and succinct Play Therapy theory and method and her eight principles of the therapeutic relationship are used today by PTUK trained Play Therapists.
These principles are extended into Creative Play for older children. This predominately non-directive approach allows the teenager to be them self in a safe and non-judgmental environment. Through the use of different creative mediums the young person can work through their internalised conflict whilst being fully supported.
Who can play therapy help?
Research has found Play Therapy to be an effective therapeutic approach for a variety of children’s difficulties including:
· Abuse and neglect
· ADHD and ADD
· Adjusting to family changes
· Aggression and acting out behaviours
· Autism (other than severe autism)
· Bonding and Attachment
· Bullying (victim and bullies)
· Chronic illness/hospitalisation/surgery
· Confidence and self-esteem
· Excessive anger, fear, sadness, worry and shyness
· Foster, adoption and identity issues
· Grief and loss
· Making friends
· Near death experiences
· Physical symptoms without any medical cause, such as soiling
· Physical disabilities
· Prenatal and birth trauma
· School difficulties
· Selective mutism
· Separation anxiety
· Sexual Abuse
· Sleeping and eating difficulties
· Social adjustment issues
· Trauma
Referrals
Referrals will be accepted from parents (or carers), GP’s, teachers, social workers and other professionals.
