The same stressors that may devastate adults (i.e., divorce, relocation, death, relationship turmoil, etc.) can unnerve a child’s or adolescent’s sense of safety and overwhelm his/her coping skills. At times, a child’s or adolescent’s behavior may appear to have changed without an identifiable reason by loved ones. The child or adolescent may develop new fears, have nightmares, engaging in altercations, become withdrawn or secretive, partake in highly risky behavior, etc. Such behaviors may result in the worry, helplessness, and frustration of loved ones. They may grow increasingly distressed by the child’s or adolescent’s inability to “just say what is going on with him/her or cut it out”. Often also feeling the same stressor as their child or emotionally intertwined by their child’s behaviors, parents may be unaware that children and adolescent (particularly the younger they are) lack the ability to put words on their internal states. In addition, some may worry that if they reveal their inner truth they may be judged as unacceptable or not believed.
As a result of the above noted factors, therapy with children and adolescents may involve one or more of the following forms:
Depending on their developmental age, some children and adolescents easily engage in verbal exploration and problem solving with a trusted, impartial adult. They, similar to their adult counterparts, have the ability to verbalize their experiences, partake in investigating their stressors, and take steps in utilizing any insight or alternative thoughts and behaviors collaboratively reached between him/her and therapist.
It is professionally recognized that play is children’s most natural form of communication with toys acting as their words. From the first months of life children learn and find meaning through play. For example, by manually manipulating a flush toy an 8 month old learns how the toy feels, smells, and tastes. He/she will sharpen current motor skills and uncover new ones; feels joy in the presence of the toy and sadness and anger when it falls out-of-reach; and discovers self resources: alerting adults to his/her distress thus gaining their help (learning assistant seeking), learning to independently retrieve the toy (developing a sense of self-reliance), and/or relinquishing the toy (acquiring self-soothing). By the time they reach adulthood children and adolescents have had millions of such experience through solo and group play activities. Hence naturally, most children have an innate mean of revealing their inner states and reaching healing through play.
Play Therapy can be tailored to the needs of any age child. For instance, the therapy of a young elementary age child might involve playing with puppets, play-dough, or learning to identify his feelings on an emotion chart. A fifth grader on the other hand, might reveal her frustration over a game of Sorry. An adolescent may use a video game as an analogy to his life. While the use of play in therapy is more prevalent with young children, even older teens find addressing difficult experiences easier when the dialogue occurs over a board-game or a game of cards. In fact, the ease that results from not having to talk while directly facing someone is evident by countless parental anecdotes that their teenagers talk more during car rides (where they are sitting parallel rather than face-to-face to there parents).
Expressive Art Activities
As previously noted, children and adolescents often lack the cognitive maturity to reveal their internal world through verbal exchanges. At other times, they may have the words but struggle with uttering them due to shame or intense discomfort with what the verbalization may stir up within them once the experience is externalize and made audible. Expressive art activities, much like Play Therapy, is a bridge between the creator’s inner and outer world and a safe way for clients to process stressors at a comfortable distance. Whether it’s through drawings, collage, music, poem, story, or countless other means; art permits clients of all ages to tap into the nonverbal aspects of their psyches and communicate through symbols. The sole process of creating or sharing through art can be healing. When brought into the domain of psychotherapy, art can also be mutually explored. If deemed appropriate, therapists may invite clients to share about the course of making the art and the artwork itself thus providing client an opportunity to increase his/her self awareness.
Indisputably, caregivers are the most influential figures in the treatment of children and adolescents. In fact, I see caregivers as auxiliary therapists whose commitment, consistency, and unyielding love help transport the discoveries and tools from the therapeutic room to the real life dynamics of the youth. Subsequently, occasionally, rather than or in addition to working with a child or adolescent, I will invite caregivers for coaching sessions. During such sessions, I will guide caregivers on how to use therapeutic tools with their children at home and welcome their successes and setbacks for collaborative exploration and problem solving.