The Neuroscience of Child Centered Play Therapy: Implications for School Counselors

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1 The Neuroscience of Child Centered Play Therapy: Implications for School Counselors Misty Solt, PhD, LPC-S, RPT-S, NCC, LCDC, BCN, CCPT-Supervisor; CPRT-Supervisor Ahou Line, M.S., NCC, CSC, LPC Intern Supervised by Jenifer Balch, PhD, LPC-S, RPT-S, CAS Kristina McCook, M.S., NCC, LPC Intern Supervised by Sarah Balint Bravo, M.Ed, LPC-S, RPT-S, NCC

2 Overview/Objectives 1. Define Play 2. Explain the elements of Child-Centered Play Therapy 3. The Brain on Play: areas of the brain impacted during CCPT 4. Case Study 5. Practical Implications for School Counselors

3 Definition of Play Play is defined as: Engaging in activity for enjoyment and recreation rather than a serious or practical purpose. taking part in (a sport). activity engaged in for enjoyment and recreation, especially by children. the conducting of an athletic match or contest *Our focus is self-directed play Reference:

4 Three Characteristics of (self-directed) Play 1. Mimics or approximates a common or important purposeful behavior 2. Voluntary, is pleasurable, and has no immediate survival role or obvious purpose ; and, 3. Takes place in a nonthreatening, low-duress context Play is a state of mind, rather than an activity. (p. 60) (Gaskill & Perry, 2013) (Brown & Vaughan, 2009)

5 More Characteristics of Play Feel playful Out-of-time In-the-zone Unique to self Pursuing the activity for the joy it brings Connects us to others Helps to promote mastery and learning (Brown & Vaughan, 2009)

6 Characteristics of Play Spontaneous Self-directed Intrinsically complete Variable (no standards) Creative Expression (Landreth, 2012)

7 Functions of Play in Play Therapy Fun Symbolic Expression Catharsis Social Development Mastery Release of Energy (Ray, 2011)

8 Self- Directed Play Can Reveal: What Child has Experienced What a Child Needs Child s Feelings & Reactions A Child s Self- Concept You can learn more about a person in an hour of play than you can from a lifetime of conversation. Plato

9 Self- Directed Play Can Help Children Provides for Mastery Allows Children to Cope Provides a Means for Problem-Solving Is Based on a Process Is not Bound by Rules Allows for the Expenditure of Energy Symbolic container

10 Moral reasoning Self-control Selfresponsibility Character Qualities Developed Through Play Resourceful Positive selfesteem Cooperative Purposeful Sociable Thoughtful Unselfish Empathic

11 A Playing Brain is a Brain that Learns Optimally! Play is not frivolous: it enhances brain structure and function and promotes executive function (ie, the process of learning, rather than the content), which allow us to pursue goals and ignore distractions. (page 1) Reference: Michael Yogman, Andrew Garner, Jeffrey Hutchinson, Kathy Hirsh-Pasek, Roberta Michnick Golinkoff (2018). The power of play: A pediatric role in enhancing development in young children. American Academy of Pediatrics 142 (3). Committee on Psychosocial Aspects of Child and Family Health, Council on Communications and Media.

12 Definition of A dynamic interpersonal relationship between a child (or person of any age) and a therapist trained in play therapy procedures who provides selected play material and facilitates the development of a safe relationship for the child (or persons of any age to fully express and explore self (feelings, thoughts, experience, and behaviors through play, the child s natural medium of communication, for optimal growth and development (page 11, Landreth, 2012).

13 Play Therapy: How does it work? The prefrontal cortex of the brain is not fully developed until an individual is in his or her mid 20s As such, talk therapy is not appropriate for children without the development of this portion of their brain Because of this, play therapy uses the skills that children do have at this stage in their development: nonverbal communication and creative self expression to create change Why we don't do Talk Therapy with children (Stewart, Field, & Echterling, 2016)

14 Child Centered Play Therapy (CCPT) focused on the inner dynamics of the child s process of relating to and discovering the self that the child is capable of becoming. (Landreth, 2012, p.55) Self-actualizing Tendency Person* Phenomenal Field* Self Perceptually-based Therapeutic growth conditions ( core conditions ) Self-directed What does it look like?

15 Child Centered Play Therapy (CCPT): Effectiveness Through meta analytic research, findings confirm the effectiveness of play therapy Child Centered Play Therapy approaches were found to be especially effective Several studies show that children who attend play therapy at school demonstrated an increase in feelings of academic competence in the classroom One specific study: Prior to play therapy intervention, 12 of the 18 children (67%) were identified as at risk for academic failure After 16 sessions, 9 of the 18 (50%) were identified as at risk for academic failure. After 26 sessions, 5 of the 18 (26%) were identified as at risk for academic failure. None of the participants moved from the normal range to clinical range throughout the experiment. In other words, none of the participants worsened academically throughout the experience. They either maintained or improved. Research: (Blanco, Ray, & Holliman, 2012)

16 The Vehicles for Change in CCPT Four healing messages I am here. I hear you. I understand. I care. A Relationship with the following core conditions 1. Empathy 2. Unconditional Positive Regard 3. Congruence These conditions allow for the child to move towards self-actualization Self-Direction Let the child lead. (Blanco, Ray, & Holliman, 2012)

17 The Therapeutic Relationship Belief in the child Respect for the child Acceptance of the child Hearing the inner child Acceptance of the child s will Focus on the child s needs Freedom for the child to make choices Respect for the child s boundaries Patience with the process

18 Quick Review: Brain Basics Brain Stem: basic body functions (heart rate, breathing, body temperature) Midbrain: located above the brain stem; responsible for fight/flight/freeze/faint response Limbic Region: Emotional center (gives meaning to feelings), connection with others, motivation Cortex: Executive/Higher Level Functions (abstract & symbolic thought, planning, consciousness, perspective); Middle Prefrontal Cortex integrates cortex, limbic region & brain stem (Siegel & Bryson, 2016)

19 The Brain on Play Source:

20 Jaak Panksepp Research on Play: The Brain on Play play arises first in the human brain stem, where survival mechanisms such as respiration, consciousness, sleep, and dreams originate. (p. 61)

21 Child-centered Relationship and Therapeutic Process (the Ideal) Warmth of Contact Communicated via Resonance Circuits Promotes Safety to Play Permission and Openness of Environment Activate Seeking Circuits (Jaak Panksepp, 1998). Activates Dopamine in Brain (purpose and enjoyment) Therapeutic Response Activates Systems for Bonding and Care Activates Oxytocin and GABA Empathic Presence= Yield Stronger Connectioncs Between Limbic System and Middle Prefrontal Area=Self- Regulation and Well-Being (Badencoh, 2008)

22 What s Happening in the Brain: Empathy Studies have shown that an individual s oxytocin levels in the brain rise quickly when laughing together, displaying affection, and showing empathy This increase in oxytocin can increase interpersonal trust, decrease fear, and increase emotional recognition Creates an environment that is optimal for the creation of neural pathways (which leads to increased neuroplasticity in a child s brain) (Stewart, Field, & Echterling, 2016)

23 What s Happening in the Brain: UPR A safe relationship is our most powerful neurobiological intervention (Perry, 2006) Awareness building Through tracking statements, play therapists help the child build awareness of things they may not have noticed before such as: Their facial expressions Voice tone Non verbals Decision making Creative abilities This top down and bottom up approach can help the child see themselves in a much more positive way (Stewart, Field, & Echterling, 2016)

24 What s Happening in the Brain: UPR The safety in the relationship with the counselor allows a child to approach and revisit emotional states that may be difficult and develop coping skills to adapt to those situations Research shows that when a child has an aroused limbic system, one way to alleviate this and to help regulate their brain is to make them feel understood and connected to an adult (Hong & Mason, 2016) (Stewart, Field, & Echterling, 2016)

25 What s Happening in the Brain: Congruence Because the therapist and the child are working towards integrating affect and cognition, this allows for both parties to help build a condition where the brain has the perfect amount of arousal to create change and learning Through play therapy, the client and the counselor cocreate a wordless narrative that focuses mostly on self awareness and transformation which allows the child to explore their own private logic and create a healthier narrative Children benefit from a therapist who demonstrates healthy emotional regulation Mirror neurons allow the child to regulate through mirroring which can alleviate a child s hyperactive nervous system (Stewart, Field, & Echterling, 2016)

26 What s Happening in the Brain: Allowing the child to lead Emotional arousal is necessary for consolidating and integrating neural pathways. Because children are able to lead, this allows for children to find their own sweet spot which allows for neuroplasticity Through play, the therapist tracks the child s feelings, nonverbals, and verbal statements which demonstrates resonance and increases oxytocin (Stewart, Field, & Echterling, 2016)

27 Practical Implications: What do we tell school professionals about the need for play? Are you just playing in there? o o o Because a child s brain is not yet fully developed, we are using the tools that they DO have: nonverbal communication and creative self expression as a vehicle for change Play is actually reshaping the child s brain circuits. These are laying the foundation for things that develop in the child s brain later in life including his/ her academic performance, mental health, and social skills In my time with the child, I will allow the child to lead and will track their behavior. This allows for increases in oxytocin which can benefit children in a number of ways including emotional regulation, increases in social bonding, and decreases in fear (Stewart, Field, & Echterling, 2016)

28 Practical Implications: How School Professionals can help Consider being trained in Child-Parent Relationship Training (CPRT) Leave the Agendas Behind (Occasionally) Have a Free Time (e.g., Friday Play Time ) Consider training teachers (Child-Teacher Relationship Training- CTRT) Get Outside Allow for Exploration Support Recess!

29 Practical Implications: What therapists should know Therapists should be aware of their own non verbal signals in all interactions with their play clients Paramount to the neurobiological effects between the client and the therapist Because the client is working on regulating their own brain, it helps to provide a genuine environment which is necessary for their brain development Children responding from the limbic system are more likely to benefit from relationally driven interventions and children reacting from the brainstem need a therapist who can help create an environment with safety, space, time, and movement to regulate to higher areas of the brain (Hong & Mason, 2016)

30 References Badencoh, B. (2008). Being a brain-wise therapist: A practical guide to interpersonal neurobiology. New York: W. W. Norton & Company. Blanco, P. J., Ray, D. C., & Holliman, R. (2012). Long-term child centered play therapy and academic achievement of children: A followup study. International Journal of Play Therapy, 21(1), doi: /a Brown, S. & Vaughan, C. (2009). Play: How it shapes the brain, opens the imagination, and invigorates the soul. New York: The Penguin Group. Crenshaw, D. A., & Kenney-Noziska, S. (2014). Therapeutic presence in play therapy. International Journal of Play Therapy, 23(1), Gaskill, R. & Perry, B.D. (2013) The neurobiological power of play: Using the Neurosequential Model of Therapeutics to guide play in the healing process. In (C. Malchiodi & D. A. Crenshaw, Eds) Play and Creative Arts Therapy for Attachment Problems Guilford Press, New York Hong, R., & Mason, C. M. (2016). Becoming a neurobiologically-informed play therapist. International Journal of Play Therapy, 25(1), Landreth, G. L. (2012). Play therapy: The art of relationship. New York: Taylor & Francis Group. Ray, D. C. (2011). Advanced play therapy: Essential conditions, knowledge, and skill for child Practice. New York: Routledge. Siegel, D. J., & Bryson, T. P. (2016). The whole-brain child: 12 revolutionary strategies to nurture your child's developing mind. Vancouver, B.C.: Langara College. Stewart, A. L., Field, T. A., & Echterling, L. G. (2016). Neuroscience and the magic of play therapy. International Journal of Play Therapy, 25(1), Yogman, M., Garner, A., Hutchinson, J., Hirsh-Pasek, K., & Michnick Golinkoff, R. (2018). The power of play: A pediatric role in enhancing development in young children. American Academy of Pediatrics 142 (3). Committee on Psychosocial Aspects of Child and Family Health, Council on Communications and Media.