Traditional family therapists

The American Journal of Family Therapy, 41:341–352, 2013 Copyright © Taylor & Francis Group, LLC ISSN: 0192-6187 print / 1521-0383 online DOI: 10.1080/01926187.2012.704838

Play-Based Activities in Family Counseling

JOSEPH D. WEHRMAN and JULAINE E. FIELD Department of Counseling and Human Services, University of Colorado, Colorado Springs, Colorado, USA

Traditional family therapists often work with family members of similar cognitive levels and exclude small children from the therapeutic process. Recent research indicates that children and families benefit when all family members can be involved in counseling (e.g., Thompson, Bender, Cordoso, & Flynn, 2011). Using an integrative intervention model, this article will focus on specific playbased activities which can be used to effectively include children in family therapy. A developmental, step-by step protocol is introduced and specific play-based activities are discussed.

Traditional family therapists often work with family members of similar cognitive levels and exclude small children from the therapeutic process. Recent research indicates that children and families benefit when all family members can be involved in counseling (e.g., Thompson, Bender, Cordoso, & Flynn, 2011). Using an integrative intervention model, this article will focus on specific playbased activities which can be used to effectively include children in family therapy. A developmental, step-by step protocol is introduced and specific play-based activities are discussed.

INTRODUCTION

Several family therapists are expanding their clinical practice to include family therapy techniques and strategies that benefit children. Nims and Duba (2011) note a current movement in the counseling profession to combine family counseling and play therapy so that all members of the family benefit from creative, therapeutic interventions. This combination may be referred to as “play based activities in family counseling” which emphasizes the use of creative, play oriented activities that all family members participate in together. In contrast, play therapy encourages children to work through their thoughts and feelings via play and focuses on the specific relationship building between child and counselor, communication through play, assessment, healing and growth (Orton, 1997). In the past and in some current practice, family counseling primarily focuses on adults in the family and adolescents who are developmentally capable of benefitting from traditional talk therapy that is insight oriented. Yet, the current trend which integrates children into family therapy has produced promising empirical results. Thompson, Bender,

Address correspondence to Joseph D. Wehrman, Department of Counseling and Human Services, University of Colorado, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918. E-mail: jwehrman@uccs.edu

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Cordoso, and Flynn (2011) found that using experiential activities while including children in family counseling led to an increase in positive family interactions and enhanced communication skills among family members. Despite this trend, family therapy with parents/caregivers and children can be challenging to facilitate as a counselor. The dissimilarity in age represents significant differences in language skills, cognitive development, understanding and reasoning and verbal processing which can dramatically affect the structure and format of the counseling session. Adults and children function in different cognitive worlds and often expect the other to understand their perspective or view. To further complicate the challenges, adults often invite or encourage children to participate in ‘their world’ resulting in often unsuccessful interactions (Wittenborn et al., 2006). Because of the power differential between adults and children, children are often expected to think, talk, understand and relate at the level of adult functioning. If the counselor does not tailor or does not know how to structure a session to be developmentally relevant for kids, young children who are less verbal may be left out or relegated to an observer role of the “parentified” conversation taking place in the session. As a result of their exclusion, children may engage in attention seeking or anxiety driven behaviors that are distracting to the adults. These family sessions can seem chaotic, less productive and feel overwhelming for both the counselor and the family members. Counselors may frequently be at a disadvantage when they attempt to plan for a family session which fully includes young children. Counselor training programs often encourage students to tailor their fieldwork experience to working with children and adolescents or adults, meaning more counseling experience with one age group over another. In practice, family counseling training and caseloads tend to focus on adults and less on working with children (Miller & McLeod, 2001). For example, the Research and Educational Foundation of the American Association for Marriage and Family Counseling (AAMFT) found in a large, randomized study that only 12% of participants’ caseloads included families. Caseloads were primarily made up of individuals and couples (Doherty & Simmons, 1996). Additionally, Smith et al. (1996) found that a significant error made by counselors was to not involve children in the process, while they were present, and work instead with only the parents or adults. This article will focus on specific activities and strategies for effectively including children in family therapy. Families benefit when all members are able to actively participate in the therapeutic process. Interestingly, many families enter counseling for the first time because their child (or children) becomes the “identified patient” or the individual targeted as the one which “causes” family discontent or dysfunction. This variable underscores the importance of including children to create new communication and relational patterns among all family members. The following article will explore specific play-based activities in the family counseling process as well as offer

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an integrative intervention model that can be utilized by family counselors while working with parents and children. A family case study is included to further illustrate these concepts.

FAMILY COUNSELING AND PLAY THERAPY

There are many benefits of involving parents and children in the counseling process (Baggerly & Exum, 2008; Glazer & Clark, 1999; Hill, 2006; Miller & McLeod, 1996; Smith et al., 1996). Working solely with parents and not involving children may reduce the effectiveness of family counseling (Rotter & Bush, 2000). Childhood distress and parental involvement are related (Miller & McLeod, 1996) and parenting style is associated with at risk behaviors. For example, children of parents who exhibit positive parenting styles tend to be less likely to engage in high risk behaviors than those of parents with negative or authoritative parenting styles. All of these factors point to the need to work with parents and children together in family counseling to foster enriched perspectives on understanding the family and family dynamics. Gil and Sobol (2005) found that by including children in family counseling, experiential, play-based activities can have a positive impact on therapeutic productivity. For example, if parents and children are using puppets to metaphorically represent the personalities of family members, they are able to break free of or transcend the typical way that they describe family problems or issues. Family member can take turns using his/her puppet to give voice to how they perceive one another in an indirect manner. Although language skills and cognitive capacity for critical thinking differs by family member, insight can be gained when family members and the counselor listen to how a “puppet” describes each person or interactions with each person. It may assist a child who is willing to have her puppet describe how sad dad is when he is “so tired and no one listens to him”. By being experiential, family members are less analytical and intellectual and more likely to become aware of the emotions that lie beneath the behaviors (e.g., the mom who consistently demonstrates anger toward her children; but, is actually worried about her children’s safety). Because the family is communicating through play, there may be alternatives to expressing challenging emotions like mistrust or shame (Gil & Sobol, 2005). Finally, the creative aspects of play may allow family members to “try on” new ways of relating to one another (e.g., more listening, more patience, less judgment, humor, democratic methods for decision making, etc.). Many research studies validate the importance of play for children in expressing feelings and gaining mastery over fears (e.g., Levine & Kline, 2006; Carmichael, 2006; Orton, 1997; Donovan & McIntyre, 1990). Play therapy “offers the child a powerful way of mastering his or her world and is crucial to cognitive development, personality formation, and social adaptation”

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