Child Therapy Procedures

Below is a discussion of the primary techniques I use in my therapy with children. It is important to understand that the primary experience and technique of child therapy, like adult therapy, is the relationship that develops between the child and the therapist. Without an effective, meaningful relationship, the particular techniques are mere exercises and are unlikely to have any therapeutic benefit. 

In my office, there are a variety of activities that children can use in play. I have an extensive sand-tray collection, art materials, a doll-house, furniture, and accessories, and a number of board games which I have chosen as having value in the therapeutic process.

Sand tray is a method by which children (and, sometimes adults) select from several hundred miniature figures to create a miniature world in a sand box. This work is largely done in silence, though I will usually (not always; see my comments about “silent witness,” in Play and Play Therapy) ask for the story of what they have created after they are finished. Sometimes, if there is a blatant connection to a life issue we have discussed, I may ask if they see that connection, and then explore the issue further with them. Usually, however, sandtrays are left undiscussed, because the theory and research about sandtray tells us that children work out issues within themselves through the very process itself of building a series of sandtrays.

I use art activities in much the same way, although I tend to be more active in their discussion and in drawing connections to concerns, problems, or the primary feeling the child seems to be expressing through the art. Crayons, markers, paints, clay, chalk, white boards, and mosaic tile are available for use. 

The doll-house is another free-flowing activity which allows for self-expression, comments about the interactions displayed, and exploration of issues which arise.
 
Board games are a means of engaging in a structured, rule-bound activity, and therefore allow for work on the processes of social interaction without a direct focus on painful events which may bring up anxiety. Also, board games allow for exploration of themes such as winning and losing, following rules, concentration, impulse control, and staying with an activity even when things are not going well. Games of chance, like Sorry, are particularly good in this respect, while skill-based games, like checkers, additionally allow for support for efforts toward mastery and healthy competition. 

And, of course, sometimes the child and I simply talk about their concerns. Listening, exploring, problem-solving, and support for the growth of self-esteem, self-management, and empathy toward others underlie these discussions.  There is reason to believe that simply being listened to plays a major part in the relief of pressures which can underlie behavior and pervasive mood. However, the intention here is to seek out and promote the subtle, or major, adjustments within the child or in the child’s life that will free her or him to regain and continue healthy development. Talking is an important first step in this process; some new action is usually the true means of change.