Stages of Play Therapy
Are you curious about what is going on behind the playroom door each week?
As play therapists, we are trained to observe, assess, teach, and support children in communicating their inner worlds — the ups, the downs, the confusing parts, the scary parts — in a way that is most comfortable to them, PLAY! Children express themselves through the language of play with the use of toys, games, art, sandtray, and other developmentally appropriate means to address the social and emotional concerns that they are experiencing. Throughout the journey of play therapy, children learn to identify and express their feelings, improve their communication skills, hone their self-regulation skills, and expand their problem-solving skills to live happier lives.
Let’s break down the process of play therapy into manageable chunks to help you identify where your child is in their treatment.
It takes an average of 20 sessions for most children to COMPLETE their therapeutic goals (Carmichael, 2006; Landreth, 2002)
The first phase of play therapy is commonly referred to as the initiation phase or exploratory stage.
This is the most crucial time in your child’s mental health journey as it lays the foundation for all future therapeutic work to occur. The initial 4-6 sessions are spent building a trusting relationship and fostering an environment of safety for your child to express themselves freely. Children learn what to expect in each session, develop a bond with their therapist, learn the roles of each participant, and become familiar with the toys and techniques that will be utilized.
Children explore the playroom and the toys, questioning what things they can and cannot do in the playroom. Some children will have the desire to touch and try out everything they see to gain an awareness of what is available for them. Other children will be hesitant and uncertain about what their role is in the playroom and look to the therapist to take the lead.
Through empathic responses, encouragement, and returning responsibility, the therapist will empower the child to take risks, initiate play, and ultimately take the lead. Children will also experience the permissiveness of the playroom, where limits are rarely set except to avoid injury to themselves, the therapist, or damage to property.
Some children walk into the playroom and instantly feel comfortable, it is a room filled with cool toys right? Some children will take more time to adjust to their surroundings. You can help your child by being patient and respecting their pace. It can feel very overwhelming to be left alone in an unfamiliar room with a new stranger. Sometimes you might be invited back for part of the session to invite the feeling of safety in this new place. Pay attention to your child’s nonverbal communication, reflect their feelings, and encourage them to participate in the process.
While trust is being built between your child and the therapist, you will often experience a weight lifted off of your shoulders. Your child will be excited to attend their weekly session, and you might notice less behavioral concerns. Once your child feels comfortable expressing themselves, understands their role in the process, and has developed the security required for further therapeutic work, they move into the next stage of play therapy.
The next stage is referred to as the resistance phase, aggressive stage, or negative reaction stage.
These adverse names might sound alarming, but they represent the shift from the comfortable to the uncomfortable - the loss of the familiar - CHANGE.
Now that there is a stable foundation to work from, the central therapeutic issues that are causing the behavioral symptoms to occur become the focus of treatment. All of the pleasantries and easiness that have developed up until this point are now shifting. Children are confronted with the recognition of their maladaptive habits, and they have to make the decision to put in the work or keep fighting because it feels difficult. This is where you might experience your child no longer wanting to attend therapy. Validate the concerns they express, share your confidence in this process, and encourage their capabilities — they can do difficult things.
This stage is highlighted by emotional self-expression, as they are learning how to communicate what they are feeling in their bodies in ways that are deemed “acceptable” by society. Children might have more emotional outbursts, desire more control, make more mistakes, and regress in their behaviors they’ve previously mastered. These signs are all part of developing emotional intelligence, confidence in self, self-control, and discovering more adaptive ways of interacting with others.
“When the kids are melting down, I try to remind myself,
I get grumpy when I’m hungry, too.
I get anxious with change, too.
I feel frustrated when things don’t go my way, too.
I get overwhelmed when things seem big, too.
We’re all learning.
And we all need a little patience, a listening ear and a lot of grace.”— MommyMannegren
The above stages might last only a few sessions or they might last a few months. Each child is different in the time they need, and we have to instill trust and respect for their personal growth. Keeping in regular communication with your therapist during this time is helpful in understanding how you can support your child in the process, and yourself! :)
The next stage is the growing phase or work phase.
This is typically the longest phase of play therapy. Your child shows up to each session ready to put in the hard work required for personal growth. They are learning, healing, stepping out of their comfort zone, and making changes. You will notice positive advances in their self-esteem, behaviors, communication, and overall outlook on life. They will utilize effective coping skills with little prompting, demonstrate self-regulation, and build resiliency and flexibility with change.
With these moments of growth also comes the occasional setback or regression, which can be confusing to caregivers. We are reinforcing new behavioral patterns, or neural pathways in their brain, and it is normal to expect times when the old habits will creep back in. These are the times to practice empathy and remain consistent with your expectations. You have seen your child be fully capable in the past, and it’s important to remind them of their new skill set and be there for them emotionally when they are just being human - we all make mistakes.
Lastly is the termination phase.
This occurs when children are consistently demonstrating their new skills with ease, and behavioral and emotional needs have stabilized in multiple environments. Typically, you will decrease the number of sessions to every other week or once a month to see if your child can maintain their progress with less support.
This can be a difficult time for your child as the secure relationship they’ve developed with their therapist will start to change with fewer appointments. While caregivers and therapists are feeling happy about all of the hard work that has occurred, children often feel like terminating is a punishment for making positive changes.
Your child is now equipped and prepared to handle what life throws at them, and your therapist will create opportunities in the last sessions for a healthy and happy closure. Children will reflect on their journey in the playroom and develop further confidence in all that they have accomplished - this is a time of celebration!
Caregivers can expect some minor regressions after termination, but generally, children adapt to the change and recognize the strength they have inside themselves. Feel free to reach out to your child’s therapist with any new or ongoing concerns after termination to discuss the best way to support your child.
Looking for even more resources? Check out this page from the Association for Play Therapy.
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WRITTEN BY JACLYN SEPP, MA, LPC-S, RPT-S™, NCC, RYT® 200 (SHE/HER/HERS)
Jaclyn believes that all human beings, no matter how small, deserve a place to be accepted for who they are, which drove her to establish Ensemble Therapy in 2015 with the mission to bring high quality therapeutic services to children, teens, and their families in Central Austin. Jaclyn is a Licensed Professional Counselor Supervisor (LPC-S), Registered Play Therapist Supervisor™ (RPT-S™), National Certified Counselor (NCC) and Registered Yoga Teacher (RYT® 200). She received her Master’s Degree in Professional Counseling from Texas State University (CACREP Accredited Program) and her Bachelor’s Degree in Psychology with a Minor in Applied Learning & Development from The University of Texas at Austin.
