Game Play Therapy, 3rd Edition by Jessica Stone, Charles Schaefer

Game Play Therapy

Therapeutic Use of Games with Children and Adolescents

Third Edition

 

Edited by

Jessica Stone

&

Charles E. Schaefer

 

 

 

 

 

 

 

 

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About the Authors

Adam Davis, MA Ed., serves as executive director of Game to Grow, a nonprofit organization in Seattle using games for therapeutic, educational, and community growth. He earned his master's degree in education with a focus in drama therapy from Antioch University Seattle and is a recognized member of the North American Drama Therapy Association. Mr. Davis has also served as a public school teacher and a zoo tour guide and developed a program utilizing video games to teach dialectical behavioral therapy skills to youth in South Seattle. Game to Grow recently launched Critical Core, a role-playing game kit designed to help youth on the autism spectrum build social skills.

Yolanda Fountain, PhD, LPC, RPT-S, ACS, NCC, is the owner of Play Wellness LLC in Roswell, Georgia. She earned a PhD in Counselor Education and Supervision from Mercer University and a Postgraduate Certificate in Working with Survivors of Violence, Torture, and Trauma from the University of Maryland. Dr. Fountain is a Licensed Professional Counselor, a Registered Play Therapist and Supervisor, an Approved Clinical Supervisor, and a National Certified Counselor. She has extensive experience in higher education as a counselor, professor, and clinical supervisor and teaches at Mercer University and Georgia State University. She participates in speaking engagements, has written professional publications, and has presented over 150 trainings locally, nationally, and internationally on multiple topics related to mental health (wellness and illness).

Robert Jason Grant, Ed.D., is a licensed Professional Counselor, National Certified Counselor, Registered Play Therapist Supervisor, and Advanced Certified Autism Specialist. He owns and operates the Robert Jason Grant Ed.D. AutPlay Therapy Clinic. He is the creator of AutPlay Therapy and is an international trainer and speaker. Dr. Grant is the author of several books and articles related to autism and play therapy.

Heidi Gerard Kaduson, PhD, is a licensed clinical child psychologist and a Registered Play Therapist Supervisor. She received her PhD from Fairleigh Dickinson University and is licensed in New York and New Jersey. Dr. Kaduson specializes in evaluation and intervention services for children with a variety of behavioral, emotional, and learning problems. She has specialized in attention-deficit/hyperactivity disorder, pervasive developmental disorder, posttraumatic stress disorder, and learning disability for over 25 years. Dr. Kaduson has a private practice in New Jersey and is Director of The Play Therapy Training Institute, Inc. She has authored and edited many books on play therapy and has trained and/or supervised thousands of individuals around the world.

Jamie Lynn Langley, LCSW, RPT-S, is in private practice outside of Nashville, TN. She specializes in working with children ages 3 to 18 and their families utilizing play therapy, in which she includes all types of interventions to promote healing, such as expressive arts, games, and sandtray, as well as incorporating nature-based activities. Ms. Langley cofounded the Tennessee Association for Play Therapy in 1993 and has since served as its president. She supervises students and therapists in play therapy and clinical social work, and provides various trainings on play therapy. Ms. Langley is an Adjunct Professor at both Lipscomb University and Middle Tennessee State University.

Clair Mellenthin, LCSW, RPT-S, is a Registered Play Therapist Supervisor and the past president of the Utah Association for Play Therapy. Throughout her career she has focused on providing therapy to children, teens, and their families. Ms. Mellenthin is the director of Child and Adolescent Services at Wasatch Family Therapy. She serves as an adjunct faculty member at the University of Southern California MSW program. She is the author of Play Therapy: Engaging & Powerful Techniques for the Treatment of Childhood Disorders and My Many Colors of Me Workbook. In addition to being an experienced play therapist and professor, she frequently presents professional play therapy and family therapy trainings and appears on local and national TV and radio as an expert on children and family issues.

Sonia Murray, DipSW, holds a Diploma in Social Work and is a Registered Play Therapist and Supervisor. She has worked in a specialist school for children with complex social, emotional, and behavioral difficulties focusing in education, child abuse, social, emotional and behavioural difficulties, children's mental health, childhood trauma, parenting program, and play therapy. Ms. Murray trains nationally and internationally on topics related to play therapy, understanding behavior, play, communicating with children, behavior management, and positive parenting. She has also contributed to a number of publications, including chapters in The Use of Therapeutic Stories and Turning Points in Play Therapy and the Emergence of Self: Applications of the Play Therapy Dimensions Model.

Sueann Kenney-Noziska, MSW, LCSW, RPT-S, is a Licensed Clinical Social Worker and Registered Play Therapist Supervisor specializing in using play therapy in clinical practice with abused and traumatized children, adolescents, and their families. She owns and operates her own private practice and is also part of her community's multidisciplinary team on child abuse. Ms. Kenney-Noziska is internationally recognized for her work. She has developed many trauma-informed interventions for clinical work, is a contributing author to several publications, and has testified as an expert witness in the areas of child abuse and trauma at both the state and federal level. She is an international speaker and has trained thousands of professionals in order to ensure that other therapists have the tools they need to successfully work with our most vulnerable populations.

Mary Anne Peabody, Ed.D., LCSW, RPT-S, is currently an Associate Professor and Chair of Social and Behavioral Sciences for the University of Southern Maine, where she teaches a variety of undergraduate courses and graduate-level play therapy courses. Dr. Peabody has served in numerous leadership roles at both the national and branch level of the Association for Play Therapy. She is the author of numerous articles and book chapters in the field and continues to train both nationally and internationally. Her current research interest expands play-based methodology into higher education settings.

Charles E. Schaefer, PhD, RPT-S, is Professor Emeritus of Clinical Psychology at Fairleigh Dickinson University in Teaneck, NJ. He is cofounder and Director Emeritus of the Association for Play Therapy. Dr. Schaefer is the author/coauthor of more than 100 research articles and author/editor of over 70 professional books, including Handbook of Play Therapy, Second Edition; Foundations of Play Therapy, Second Edition; The Therapeutic Powers of Play, Second Edition; Essential Play Therapy Techniques: Time-Tested Approaches; Short-Term Play Therapy, Third Edition; and Play Therapy for Preschoolers.

Jessica Stone, PhD, RPT-S, is a Licensed Clinical Psychologist and Registered Play Therapist-Supervisor in Colorado. Dr. Stone is an author, mentor, supervisor, national and international speaker, board member, and innovator. She is the co-creator of the Virtual Sandtray App for tablets and virtual reality. Her practice specializes in working with gifted people, those who have experienced loss, attachment difficulties, pre-/peri-/postnatal concerns, and the responsible integration of technology into therapeutic settings. Recent publications include chapters in The Handbook of Play Therapy, Second Edition and Integrating Technology into Modern Therapies, as well as editing the latter.

Jennifer Taylor, LCSW, RPT-S, is a Licensed Clinical Social Worker and Registered Play Therapist-Supervisor. Ms. Taylor holds a master's in Social Work from Florida State University and a bachelor's in Social Work from the University of West Florida. She is an Adjunct Professor at the University of Memphis. She has a private practice focused on providing mental health and play therapy training and consultation to other mental health professionals.

Holly Willard, LCSW, RPT-S, is the owner of Grandview Family Counseling, a private practice in Bountiful, UT, specializing in working with traumatized children, teens, and their families. She has an extensive background working with clients in various clinical settings from school counseling, residential care, foster care, outpatient clinics, and private practice. Ms. Willard has been an Adjunct Professor for the University of Utah and Westminster College and contributes to local television news and radio. She is a Registered Play Therapist Supervisor, certified in trauma-focused cognitive behavioral therapy, and is trained in eye movement desensitization and reprocessing. Ms. Willard was president of the Utah Play Therapy Board from 2016 to 2018 and presents nationally on play therapy topics.

Gary Yorke, PhD, is a Licensed Psychologist and has been in private practice in Austin, TX, for over 25 years. He and his wife cofounded Austin Behavioral Health Center, which provides play therapy and assessment services to children and adolescents. Dr. Yorke is also president and founder of childtherapytoys.com, an internet-based store for child clinicians. He is author of My First Therapy Game, The Social and Emotional Competence Game, The Social and Emotional Competence Card Game, My Medication Workbook, and the Yes I Can! series of communication and counseling games. In addition, Dr. Yorke has edited and revised numerous therapeutic games. He has presented workshops on storytelling, attention-deficit/hyperactivity disorder, child therapy, assessment, bipolar disorder, Asperger's disorder, and the use of games in child and play therapy.

PART ONE
INTRODUCTION

 

CHAPTER ONE
Game Play Therapy: Theory and Practice

CHARLES E. SCHAEFER and JESSICA STONE

HISTORICAL PERSPECTIVE

Children and people across the world have been playing games throughout recorded history. Indeed, archeologists have discovered 5000-year-old board games from Egyptian times. Games not only provide players with a source of amusement and entertainment, but they make important contributions to our general well-being and mental health. The Greek philosophers Aristotle and Plato knew the importance of games in fostering learning and development. Plato recommended that “in teaching children, train them by a kind of game and you will see more clearly the natural bent of each.” Recently child therapists have begun to realize that games are an untapped therapeutic resource. The playful aspects of games strengthen players' motivation to engage in therapy and maximizes the therapeutic effect through better client involvement.

GAME PLAY IN PSYCHOTHERAPY

Loomis's (1957) article describing the use of the game of checkers was the first published article on the therapeutic use of conventional games. Loomis used checkers as a means of handling children's resistances to therapy and introducing interpretations. The first made-for-therapy board game was The Talking, Feeling, Doing Game by the child psychiatrist Richard Gardner, published in 1973. It is still one of the most popular tools used in child psychotherapy. Because games are designed to be enjoyable and interesting, they are powerful motivational tools for children to engage in the work of therapy.

In particular, latency-aged (aged ∼5–onset of puberty) children are drawn to board games. Stone (2016, p. 313) asserts that “some of the important aspects of playing games include communicating verbally and nonverbally, reciprocal respect, learning how to share, patience, taking turns, and having fun while connecting with others.” When children reach elementary school age, they become more reality oriented, so structured games become more attractive to them than sensory play or fantasy play with dolls.

The use of therapeutic games by child and adolescent therapists has increased dramatically in the past few decades, and the number of available games has mushroomed. There are now over 1000 games available for treating the psychological and social problems of youth. Game play therapy is a frequent treatment choice for youth by therapists of diverse orientations, including psychoanalytic (Bellinson, 2002), Gestalt (Carroll & Oaklander, 1997), Adlerian (Kottman & Meany-Walen, 2016), and cognitive-behavioral (Knell, 1997).

GAME PLAY THERAPY: BASIC CONCEPTS

DEFINITION OF A GAME

A game can be defined as an interactional activity of a competitive or cooperative nature involving one or more players who play by a set of rules that explain the content of the game. According to Schaefer and Reid (1986), games have six basic characteristics:

  1. Playing a game is an enjoyable activity.
  2. Games have an as-if quality that separates them from real life and allows for fantasy experiences.
  3. Rules exist or are created that define and restrict the behavior of the players and add organization and structure to the game.
  4. A contest is implied or explicit in games, in that players complete either with each other or with themselves in order to achieve a goal.
  5. Games, by virtue of their structured makeup, pose a challenge to players. At the lowest level, the challenge is to play with other people in a self-controlled, cooperative fashion. More complex games require more in terms of emotional control, intellect, and social skills.
  6. Game playing usually involves interaction between two or more players.

TYPES OF GAMES

Games can be classified into three main types in terms of what determines the outcome (Sutton-Smith & Roberts, 1971): (i) games of physical skill, in which the outcome is determined by the players' motor activities; (ii) games of strategy, in which rational choices among possible courses of action determine the outcome; and (iii) games of chance, in which the outcome is uncontrolled by the players (e.g., guesses or some sort of artifact such as a die or a wheel).

THERAPEUTIC POWERS OF GAME PLAY

Among the multiple therapeutic benefits of game play are the following:

  1. Therapeutic alliance. Experiencing mutually positive affect through playing a game together helps establish rapport and a working alliance between therapist and child.
  2. Self-control. The focus of many games is to help the child learn self-control coping skills, such as anger management, and relaxation (Swanson, 1986).
  3. Moral development. Games are activities in which the fundamental elements of moral development–rule conformity and acceptance of group socialization norms—are integrated components of the play process (Piaget, 1965; Serok & Blum, 1983).
  4. Self-expression. The intense affective involvement that commonly accompanies game playing, together with their separation from reality constraints, tends to result in the expression of feelings, thoughts, and attitudes that ordinarily would not be disclosed (Capell, 1968). Moreover, integrating games with the expressive arts (e.g., Winnicott's Squiggle Game [Ziegler, 1976]), facilitates a child's self-expression by combining elements of drawing, storytelling, and game play.
  5. Executive functioning skills. Strategy games like mancala help children learn to slow down, pay close attention, stop and think, plan ahead, and anticipate consequences of their actions (Diamond & Lee, 2011).
  6. Mood elevation. Among the numerous positive emotions triggered by game play are excitement, enjoyment, interest, flow elation (flow), and fun.
  7. Self-esteem. Accomplishing the goals of a game gives players a sense of achievement and competence.
  8. Stress release. For children under stress, such as those about to undergo a medical procedure, games provide a form of escape from reality for a while.
  9. Attachment formation. Playing nurturing games enhances attachment feelings between caregivers and children.
  10. Social skills. Games are ideal situations for teaching a range of social skills, including taking turns, sharing, cooperation, conflict resolution, and good sportsmanship (Oden & Asher, 1977).

ADVANCES IN THE PRACTICE OF GAME PLAY THERAPY

There have been a number of major advances in the field since the publication of the second edition of Game Play: Therapeutic Use of Childhood Games (Schaefer & Reid, 2001). Among the most significant are these five:

  1. There has been a great increase in the number and quality of readily available therapeutic games for children and adolescents.
  2. There are now “disorder-specific” games designed to treat all the common presenting problems of youth, including internalizing disorders (e.g., anxiety, depression); externalizing disorders (e.g., aggression, attention-deficit/hyperactivity disorder); and developmental disorders (e.g., autism spectrum disorders). This matching of specific game treatments for specific disorders improves their efficacy as well as the practice of short-term psychotherapy.
  3. The clinical use of electronic games with children and adolescents has expanded rapidly with proven effectiveness.
  4. In addition to specifically designed psychotherapy games, a growing number of commercially available games are being modified for therapeutic purposes.
  5. In the past, game play therapy was used an as ancillary intervention to other forms of therapy. Currently, game play therapy is used more and more as the sole or primary intervention for a variety childhood disorders.

SUMMARY AND CONCLUSION

Game play therapy is an exciting and rapidly expanding clinical frontier. This structured form of play therapy appeals to child and adolescent therapists because of its time-limited nature, popularity with youth, and efficacy for such specific disorders, such as aggression, anxieties, fears, and attention-deficit/hyperactivity disorder. Games can be adapted for clinical, group, and school setting.

Designed for both beginning and experienced clinicians, this practical guide book provides expert guidance on how to select and apply games to maximize their therapeutic potential. Indeed, the wide scope of therapy games enables one to implement all major therapeutic powers of play.

REFERENCES

  1. Bellinson, J. (2002). Children's Use of Board Games in Psychotherapy. Northvale, NJ: Aronson.
  2. Capell, M. (1968). Passive mastery of helplessness in games. American Imago, 25, 309–330.
  3. Carroll, F., & Oaklander, V. (1997). Gestalt play therapy. In K. O'Connor & L. Braverman (Eds.), Play therapy theory and practice: a comparative presentation (pp. 184–203). New York, NY: Wiley.
  4. Diamond, A., & Lee, K. (2011). Interventions shown to aid executive functioning development in children 4 to 12 years old. Science, 333, 959–964.
  5. Gardner, R. A. (1973). The Talking Feeling Doing Game. Cresskill, NJ: Creative Therapeutics.
  6. Knell, S. M. (1997). Cognitive-behavioral play therapy. In K. O'Connor & L. Braverman (Eds.), Play therapy theory and practice: a comparative presentation (pp. 79–99). New York, NY: Wiley.
  7. Kottman, T., & Meany-Walen, K. (2016). Partners in play: an Adlerian approach to play therapy (3rd ed.). Alexandria, VA: American Counseling Association.
  8. Loomis, E. A. (1957). The use of checkers in handling certain resistances in child therapy and child analysis. Journal of the American Psychoanalytic Association, 5, 130–135.
  9. Oden, S., & Asher, S. R. (1977). Coaching children in social skills for friendship making. Child Development, 48, 495–506.
  10. Piaget, J. (1965). The moral development of the child. New York, NY: Free Press.
  11. Schaefer, C. E., & Reid, S. E. (1986). Game play: therapeutic use of childhood games. New York, NY: Wiley.
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  15. Sutton-Smith, B., & Roberts, J. M. (1971). The cross-cultural and psychological study of games. International Review of Sport Sociology, 6, 79–87.
  16. Swanson, A. J. (1986). Using games to improve self-control deficits in children. In C. Schaefer & S. Reid (Eds.), Game play: therapeutic use of childhood games (pp. 233–242). New York, NY: Wiley.
  17. Ziegler, M. D. (1976). Winnicott's Squiggle Game: its diagnostic and therapeutic usefulness. Art Psychotherapy, 3(3–4), 177–185.