183 | Navigating Child and Adult Therapy Coexistence in a Group Practice: Expectations, Communication, and the 'Why'

Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy

In this episode, I address a question from an anonymous listener who called in. This listener works in a multi-disciplinary practice where child-centered play therapy coexists with adult therapy. The practice owner is considering implementing restrictive rules for children's behavior in common areas, raising the listener's concerns about potential shame or guilt for families.

I discuss three main points to handle this situation: setting clear expectations, effective communication, and understanding the 'why' behind the proposed changes. I emphasize that working with children inherently involves noise, mess, and emotional dysregulation, which must be accepted when choosing to include child therapy in a practice.

I stress the importance of setting expectations from the beginning and having personal conversations with existing clients about any changes, rather than simply posting signs. I also explore potential reasons for the owner's concerns, such as safety, liability, or client discomfort, and how understanding these can guide appropriate solutions. Finally, I offer practical suggestions for noise reduction in the practice without restricting children's behavior.

If you would like to ask me questions directly, check out www.ccptcollective.com, where I host two weekly Zoom calls filled with advanced CCPT case studies and session reviews, as well as member Q&A. You can take advantage of the two-week free trial to see if the CCPT Collective is right for you.

Ask Me Questions: Call ‪(813) 812-5525‬, or email: brenna@thekidcounselor.com Brenna's CCPT Hub: https://www.playtherapynow.com CCPT Collective (online community exclusively for CCPTs): https://www.ccptcollective.com Podcast HQ: https://www.playtherapypodcast.com APT Approved Play Therapy CE courses: https://childcenteredtraining.com Twitter: @thekidcounselor https://twitter.com/thekidcounselor Facebook: https://facebook.com/playtherapypodcast

2024-08-08 16 min Transcript

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Transcript

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You're listening to the Play Therapy Podcast with Dr

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Brenna Hicks. Your source for centered and focused play therapy coaching.

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Hi, I'm Dr

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Brenna Hicks, The Kid Counselor.

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This is the Play Therapy Podcast where you get a master class in child-centered,

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play therapy

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and practical support and application for your

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work with children and their families.

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In today's episode. I am answering a listener question who called in to the

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voicemail line

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and she asked to be

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anonymous and she asked for me not to read

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well or to

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have you all listen to the entire voicemail

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for protection because other people at her place of employment,

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listen to the podcast as well.

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But I'll give you the gist of her question and then I will

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share some thoughts.

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So the,

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the start of the question was that when she began at her place of employment,

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she was the first child centered play therapist.

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And subsequently, there have been more that have come on.

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So now there are quite a few child centered play therapists

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at the practice, but the practice also sees

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other clients. So they have adults and I assume probably couples and

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individuals that obviously are going to want a more quiet

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therapy environment,

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but there are enough child centered play therapists there that there are quite a

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few children and their families that are coming in for sessions as well.

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And so the,

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the owner of the practice

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said that because of the kids and the noise

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and the distractions and the disruptions and the behavior

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that the owner was thinking about putting up signs

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in the lobby

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that

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in my opinion, were quite restrictive.

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And so, you know, it's

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children must be accompanied at all times.

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Even into the restroom, children are not allowed to run up and down these hallways.

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Children are not allowed to be in the sta on the stairs,

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children are not allowed to be loud.

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If your children cannot be allowed, you need to take them out or they cannot be quiet

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and they continue to be loud, they need to be removed from the building and go outside

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and I'm not really sure what other components were intended to go on the sign,

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but essentially trying to

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make it clear that when families with their children, are there,

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either clients or siblings of clients,

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there are going to be rules in place for the behavior and the noise level.

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And so the the listener's question was,

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is that going to somehow create shame or guilt for families?

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And what are my thoughts on having signs like those

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and just overall suggestions on what to do to handle that.

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So, first of all, thanks. So much for calling in and,

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and letting me answer this.

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So

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we're gonna hit three main topics here and I'll kind of

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cover those first and then go back to each one separately.

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So I think really importantly is expectations. So we're gonna talk through that

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the communication process is going to be invaluable and then also

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making sure that the why is involved in all of this.

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So those are the three main topics that I'd like to cover. But

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let me kind of circle around to it.

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So I want to share some other thoughts before I get to those main points.

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So let's start with first,

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when children are coming for play therapy,

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there are usually

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this regulation issues.

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So

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we kind of

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have an understanding that if children are needing therapy,

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there's likely disregulation of some kind.

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And often if children are coming to play therapy,

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it's also a parenting issue.

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So either parents are lacking their confidence, they are ill equipped,

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they are handling things in ineffective way.

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There's usually a parenting side of this as well.

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And then finally,

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if the situation is pretty dire at home and they reach out for therapy

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more often than not, the entire family is burned out,

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they're overwhelmed,

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they're stressed,

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they're emotional.

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So you combine those conditions together

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and you can almost predict

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that there are going to be behavioral issues

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with the client,

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with the client's siblings or with the client's parents or all of the above.

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So I think it's really important to recognize that

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children are loud, children

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are emotional,

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children make messes. I mean, there are just standards of child behavior and that's

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in the best case scenario.

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And then when you have children that are struggling and

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families that are struggling and parents that are struggling,

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that's going to just be par for the course.

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So I wanna make it really clear that when

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you choose to work with children,

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which the owner of this practice has chosen to see children

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and the owner of this practice has chosen

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to have child-centered play therapists

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as part of staff.

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So by choosing to work with children,

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you are also choosing

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noise

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and mess

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and dysregulation

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and behavior and emotion

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and everything that goes with children.

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So and I don't mean that to be

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harsh, I don't mean that to be critical.

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But

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the act of choosing

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to see children at a practice

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is the act of choosing accepting

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what comes with working with children.

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So I think there's likely a crisis going on in the owner right now

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over.

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Should I really continue to see children when it's disruptive to the adults?

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And which one should I prioritize?

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And if I get rid of children,

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you know, the adults will be happier, but children really need to be seen.

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So should I really not see children?

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I suspect there's a little bit of an existential crisis going on

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with the owner of the practice because if you choose children, you choose noise,

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that's just the way that it goes.

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So I think we needed to be really clear on that and that's for all of us. Right?

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If we are going to be the play therapist, if we're going to be a CCPT

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at a group practice in an environment where there are other clients

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and other therapists and other sessions going on,

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there is inevitably going to be a disconnect between the quiet talking

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sessions

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that adults are having

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with the loud play sessions that kids are having

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and the lobby dynamic changes and behavior and emotions are different

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between children and adult clients. So

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this

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goes with the territory

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is what I'm trying to say and

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there's no way around it.

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So then the options become, how do we best handle this,

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which are the three points that I wanted to share

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in the first place. So let's start with

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setting expectations.

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Almost any situation

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can be addressed

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by

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clear expectations,

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but they need to be clearly expressed and the expectations need to be known

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from the very beginning.

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So at this point,

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if parents have already been coming, already,

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been bringing their children already been bringing siblings of clients

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to all of a sudden, set up expectations that were not made clear. At the beginning,

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there can be

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a negative outcome there

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without fail. Setting expectations from the very beginning

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is the way to preserve the relationship.

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I stress this in the coaching program all the time,

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we have to make expectations known and clear as soon as possible

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to prevent any potential obstacles and barriers.

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So setting expectations is going to be a huge piece of this moving forward.

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My second thought is communication.

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So

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when

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you already have existing clients,

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it's going to be really important

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for either you

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my listener, which I don't know your name. So I'm sorry, I'm calling you, you but

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you as the listener are either going to have to have personal conversations

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with

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each of the families

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and then all of the other child centered play therapists,

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there are going to have to have personal conversations with their families.

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This is not a, you post a sign and it just surprises people kind of scenario.

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This is you have a personal conversation with existing clients

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and you communicate what's going on

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because

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again, just like families can handle almost anything. If expectations are known,

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families can handle changes and can handle complying with limits

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if there's a personal conversation that takes place.

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But this is a communication issue.

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It's a failure of communication on part of the practice.

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And so now to fix that

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there needs to be personal,

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intimate, honest conversations rather than just a sign that shows up on a wall

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that can be misread, misperceived. The tone is not known when it's written.

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When you speak to someone, it preserves the relationship.

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So you might wanna say

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Hey, I just wanted to let you know,

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the owner of the practice has been a little bit concerned about the

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noise level because they're seeing adults as well at the same time.

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And so the owner has asked that

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we try to keep the noise level down and if your child starts to get upset in any way

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that we might encourage you to have them go outside so that the noise isn't so loud

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and we just don't want kids to be,

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you know, unaccompanied for safety's sake

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and blah, I, if you have that kind of conversation, and again,

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this needs to come from the,

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the therapist because the therapist already has a relationship with these people.

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Parents already are in a relationship with their therapist.

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So you're going to get a lot further having a personal conversation

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from someone that already has a relationship with them.

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Then all of a sudden a sign just showing up

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and then my final thought is,

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you know, as always the why matters,

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what, what is the purpose of the having this new set of rules?

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Is it for safety?

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Are they concerned that if a child is walking down the hallway unattended,

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that it's a safety issue.

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If they're climbing stairs unattended, it's a safety issue.

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If they are in the bathroom alone, something could happen.

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Is this a safety concern? I'm not saying that it is. I'm saying we have to drill down.

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What exactly is the reason that this is needing to be addressed.

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Is it a liability issue?

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Is there a concern that

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someone's going to

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do something that they shouldn't, something's going to get broken?

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Someone, a child's going to walk into a session

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and be disruptive.

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Ok. There are all kinds of reasons that, that might be a concern.

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What about discomfort of the other clients? The adult clients

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have any of the clients raised concerns,

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have they said?

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Oh my gosh,

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I don't even like coming here because it's so noisy or I can't even

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think because I'm trying to tell you what's going on in my life.

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And all I hear is, you know, whistles and tambourines

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or is it a discomfort issue on part of the owner,

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the owner every time that the owner hears noise

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internally is in a state of discomfort?

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Oh my gosh, this is just unacceptable. This is, this is not ok.

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We cannot have this level of, of noise in here.

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And I have no idea how we're gonna handle this, et cetera, et cetera.

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So

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why

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is the reason?

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Therefore the, why dictates

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the solution?

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So we have to know what's going on

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if it's a safety issue that is communicated

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to parents,

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if it's a liability issue

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that is communicated to the parents.

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If it's a discomfort of clients issue,

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that is communicated to the parents,

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we've had several adult clients

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express discomfort with the level of noise

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when they're trying to have their session.

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You know, their sessions are usually pretty quiet

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and obviously kids are not. And

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the way that it's presented matters, it needs to be neutral,

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it needs to be light hearted,

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it needs to be just a statement of fact, there's no guilt, there's no shame,

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there's no blame.

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There's no, there's nothing other than,

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hey, I just wanted to make you aware.

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We've had a couple of people say that it

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was really difficult for them to have their talk sessions

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because of the noise level. So we're trying to just let parents know

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that we're trying to keep the noise volume down a little bit

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and kids need to be with parents at all times just so that we can make sure that they

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stay in the lobby and they don't get closer to

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those therapy sessions because obviously the noise gets louder,

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the further back down the hallway, you go

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blah, blah, blah, blah,

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blah, write a script

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and make sure that every therapist is saying the exact same thing

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to the parents

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because there needs to be consistency in communication

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and there needs to be an effective and appropriate

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way to handle this that preserves the relationship.

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So final thought

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in lieu of conversations and or signs,

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there are a lot of things that can be done

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on the owner's behalf for noise reduction.

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So you can have white noise machines in the talk therapy rooms

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that will drown out some of the noise.

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You can have music playing down the hallways and in the lobby

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which will drown out some of the noise.

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You can have TVs on in the lobby that will drown out some of the noise.

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You can put sound absorbing panels

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in the play rooms or in the adult rooms.

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You can make sure there are door sweeps on the doors at the

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bottom to make sure that no noise is carrying under the doors.

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If you're on hard floors, hard floor surfaces

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that carries and echoes. So you would want to put rugs down.

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There are all kinds of ways that you can dampen the noise a little bit.

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Even if you

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allow the noise to continue at the same volume,

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there are things that can be put in place to mask that

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for the owner, for the adult clients, for everyone involved.

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So those are my thoughts.

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So thank you so much for calling in.

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I hope that all of you find that helpful because I know many,

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many of you work in situations

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and environments where

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you feel a little bit concerned about the level of noise.

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So I think that this is a really helpful topic to discuss

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because you can't get around noise when you work with kids. So

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anyway, thanks so much for the voicemail. I really appreciate that.

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And last thought before we wrap up for today,

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if you would like to be able to ask me questions directly

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instead of waiting for me to answer them on an episode.

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Please consider joining the Collective, go to ccptcollective.com

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and you will be able to be with a whole bunch of other CCPTs and

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have live Q and A and all kinds of interaction

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with child centered play therapists around the world. It's an amazing group.

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It's so much fun. So

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anyway, love you all so much. Thanks for spending time with me this week.

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We'll talk again soon. Bye.

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Thank you for listening to the Play Therapy Podcast with Dr Brenna Hicks.

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For more episodes and resources.

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Please go to www.playtherapypodcast.com.

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