265 | When and How to Use Enlargement in CCPT & Tracking Progress in CCPT (What to Do When Stages Aren't Clear)

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You're listening to the Play Therapy Podcast with Dr. Brenna Hicks,

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your source for centered and focused play therapy coaching.

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Hi,

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I'm Dr. Brenna Hicks,

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The Kid Counselor.

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This is the Play Therapy Podcast where you

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get a masterclass in child-centered 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,

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I am answering questions from Terry in Ireland.

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Terry,

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thanks for emailing.

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And a couple of

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questions that came in from Terry and

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not really related,

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so we're gonna kind of tease these apart as separate questions.

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So the first is,

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can you go into some more detail on enlargement,

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the when,

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the how,

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etc.

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and also self-esteem building responses?

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Should these techniques come at later stages?

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Basically the more advanced techniques outside

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of basic reflective responding tracking behavior

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and reflecting content.

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All right,

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so,

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Thanks,

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Terry,

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for the email.

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I think that

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a really helpful rule of thumb

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is that we have our reflective responses,

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which are what?

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Pop quiz?

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Yes,

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thank you all.

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Reflecting behavior,

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sorry,

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tracking behavior,

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reflecting content,

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reflecting feeling.

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OK.

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So we have that.

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That's our standard.

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We use that at almost any moment in the playroom because it's always at our disposal.

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Then we have our four pillars.

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Which are pop quiz.

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Reflecting feelings,

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choice giving,

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limit setting,

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encouragement,

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those are our standards.

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Those are considered the basics of CCPT.

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So when we think about

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what would we use consistently no matter where we are in the process,

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it's going to be those two

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as well as the be with attitudes which are pop quiz.

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Thank you.

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I'm here,

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I hear you.

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I understand,

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I care and I delight in you.

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So,

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we're always operationalizing,

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be with attitudes

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through the use of the reflective responses

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and the pillars.

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So in light of the self-esteem building responses,

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that is essentially

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encouragement,

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Terry.

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So yes,

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self-esteem building responses are a little bit different

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because they tend to

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focus on what the child is actively doing,

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and encouragement is sometimes done at the end of something.

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But they are both to build.

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The child's sense of capacity and capability

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and they're used largely interchangeably most of the time.

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So you would absolutely do all of those things from

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the very first session all the way through the last.

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All of the reflective responses,

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all of the pillars,

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and operationalizing it would be with attitudes,

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OK.

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As far as this enlargement,

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we want to think about

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the enlargement as a deeper

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part of the process and therefore later on in the process.

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In other words,

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a child's not going to be ready to go deeper when

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they haven't even

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gotten ready to do their work yet.

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They're not going to be ready to go deeper when they're still in resistance.

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They're not going to be ready to go deeper when

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they're still building a rapport and a relationship with you.

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Therefore,

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we typically reserve enlargements for later in the process

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at the very least in the work phase.

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And there's a process to it,

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and essentially what we're doing is

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looking beyond the surface level.

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And getting to the deeper meaning and the why behind

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what is happening.

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In other words,

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at any given moment,

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a child might be expressing a feeling,

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might be doing something,

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so a behavior of sorts.

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And or saying something

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which in those scenarios

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we use reflective responses,

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but that is still kind of high level

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we're acknowledging an emotion,

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a conversation or a behavior,

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but what about why the child is saying something?

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What about why the child is behaving in a certain way?

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Why the child is expressing a feeling?

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Now we're getting into enlargement.

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What is the deeper part

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of what's going on?

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That's what we're looking to do when we enlarge.

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So in that scenario,

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we would,

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and this happens really fast in real time,

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this is a split second

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awareness.

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So

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something happens,

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we immediately interpret the why behind it and we respond with an enlargement.

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So that might look something like.

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It's important to you to have everything the way you want it to be.

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Or

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It feels good when you can control what happens in here.

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Now we're talking about deeper stuff

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because yes I could say you're ordering me around.

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That would be a tracking of behavior.

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I could say,

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you're telling me to get up and go over there.

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That would be a reflection of content.

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I could say,

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you're happy

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that you get to

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make me do what you want.

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Reflection of feeling.

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But it feels good

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to have all the control in here.

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Now we're at a much deeper level.

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We're not just scratching the surface of what's happening.

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So you do want to reserve those enlargements for later on

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in the process and you have to assess the child's readiness.

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Some kids will not be ready to receive those.

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So it needs to be a very gradual and patient

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process

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where

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you wait until you think the child can receive it,

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then you throw out an enlargement,

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and then you gauge the child's readiness and reaction.

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And if you get a sense that

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it didn't settle or they weren't able to receive it,

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then you wait a little while before you try again,

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and you just default back to the pillars

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and the reflective responses in the meantime.

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So thanks for that question,

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Terry,

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and then the second question.

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Is it possible for a child to not move through the obvious stages of play?

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And if it is not clearly defined and you are somewhat confused,

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can you use changes in the relationship

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to mark progress and changes in how the child acts and talks,

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for example,

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not cleaning up anymore or not asking permission anymore

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as your guide rail both for charting progress in

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the playroom and determining whether to begin termination.

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All right.

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Yes,

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it is possible for a child not to be obvious in their movement.

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We never expect nor need

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a child

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to

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make it clear,

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OK,

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we're in initiation,

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now we're in resistance,

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now we're in work,

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now we're ready to move into termination.

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Those are more of

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I don't wanna say philosophical,

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that's probably not an appropriate word,

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but

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they're more hypothetical,

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that's a better word,

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they're more hypothetical in nature.

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Yes,

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those phases exist and yes we can often determine

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what phase

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the child happens to be in at any given time,

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but there are kind of constructs that we use from our side of things,

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not necessarily that we need to see them

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for the child to be making progress.

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So there are often times when a child will go in a different order,

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they will bypass a phase and come back to it.

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They will go really quickly through 2 and then

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dive into the 3rd and then have to backpedal.

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So it's never a 1234,

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and it's never as linear as we would like it to be.

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Sometimes

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we think that a child went through resistance,

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but we're not really sure.

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Sometimes we think a child has moved into work and we're not really sure.

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It's really just kind of a

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child by child scenario where we're always evaluating what's happening.

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And to speak to your point,

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Are we able to

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look at changes in the relationship to mark progress?

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Absolutely.

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We don't need to know which phase

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the child's in to see changes in the relationship.

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Can we use changes in how the child acts and talks?

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Absolutely.

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We're always looking for those

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shifts.

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If they don't clean up anymore,

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huge change.

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If they don't ask permission anymore,

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huge change.

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So we would absolutely document that as major shifts,

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and arguably that means they're in work phase.

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If you're seeing those kinds of shifts,

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then they're absolutely in work.

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And

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we know at the beginning,

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they're

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going through the initiation and warm up.

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We know that.

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So

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even if they go through it really quickly,

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they will likely continue to go through it,

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even if they've moved on to a different phase,

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they will revisit

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the rapport and the trust and the bond.

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That's

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the premise of CCPT.

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The relationship is at the heart of all change.

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So they have to have an established relationship.

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We know they're going to go through that.

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We know every kid is going to deal with resistance in some way,

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but sometimes it's only at school,

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sometimes it's only at home,

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sometimes it's only in the playroom.

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There's no way to predict what that looks like,

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so sometimes we don't see it,

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and that's OK.

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And then

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determining whether or not to begin termination.

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There are 4 considerations that we want to look

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for

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before we decide whether or not we're ready to terminate.

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Pop Quiz,

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what are they?

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Hm,

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this one might have been harder.

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I,

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I'm assuming you all yelled at me,

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but I don't know.

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OK,

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so there are no new themes presenting consistently over sessions,

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we're seeing no new themes emerge.

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We see no shifts within existing themes,

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so whatever theme is present at that point in treatment,

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we don't see any shifts

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taking place.

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The presenting issues or original concerns

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have either reduced or have disappeared.

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And we see regulation across all environments.

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So if parents report that things are going well at

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home and at school and at church and at extracurriculars,

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you report that things are very stable and steady in the playroom.

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There are no new themes,

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there are no shifts within existing themes,

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and,

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and parents say that whatever reasons that they brought the

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child in for in the first place have improved,

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then we know that we're ready to move into termination.

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But quite honestly,

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all the things that you described,

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Terry,

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as far as not cleaning up anymore,

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not asking permission anymore,

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changes in the way the child acts and talks,

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those are the indications that you would be able to tell the parents

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that you feel like

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things have been

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improving and changing in the playroom.

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So it's very much collaborative.

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We want parents to weigh in,

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and we want to weigh in,

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and we want to make sure that everyone is on board,

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that we're ready to start that termination phase.

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So thank you so much for

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the email.

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I really appreciate it and I hope that that's helpful for each and every one of you.

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One of the things that I love is when I get

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stories from playrooms.

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So I would like to end with sharing an email from Krista

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and Krista emailed and said that

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she has been listening in Kentucky.

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So

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hello to all of those of you in Kentucky.

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I have

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quite a few friends actually that are huge wildcat fans,

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like they drive blue cars and

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have all things blue for the wildcats.

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So I know how

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your fandom is around there.

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So it's nice to have you,

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Krista.

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Thank you.

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So let me read a little bit of her email.

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She gave me permission to share this with you.

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And I hope that this really encourages you because these are,

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these are the outcomes of the time and energy that you are investing

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in training and listening and growing in CCPT.

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Every minute that you spend listening to this podcast,

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it is your investment in

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your practice of CCPT

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and she shared a story of how it impacted her practice

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and I was given permission to share it with you.

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I hope this email finds you well.

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I'm at a private practice in Kentucky.

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I'm still relatively new to play therapy,

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but I was introduced to it during my internship and to be honest,

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I felt completely out of my depth at the time.

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While my supervision was helpful,

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I struggled to connect with the approach until a friend recommended your podcast.

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Listening to your episodes was a game changer for me.

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It helped play therapy click in a way that supervision alone hadn't.

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Your insights not only deepened my understanding,

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but also helped me fall in love with the process,

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and it has allowed me to embrace working with

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younger children in a way that I hadn't expected.

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That's so exciting.

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OK,

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so here's the story.

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This week,

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I had a session that reminded me of the episode

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where you described a client who completely destroyed your playroom.

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During my session,

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my young client was overwhelmed with big emotions,

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throwing toys,

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screaming,

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spitting,

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and kicking.

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I found myself drawing on your words and experiences which helped me stay calm,

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centered,

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and fully present.

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And like your client,

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mine eventually calmed down,

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chose to build with blocks,

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and even cared for me with the doctor toys.

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It turned into a really meaningful session,

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and I couldn't help but think of how your story had prepared me for that moment.

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So that is always my hope,

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and I'm so thrilled

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when I get stories like that because

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You have to be prepared for the unknown.

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And things are easier when they don't catch us off guard.

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So every single podcast that you listen to,

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it is equipping you for something that might occur in the future,

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and you will feel better prepared,

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you will feel more confident,

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you will feel more capable,

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and you will fall back on

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what you've heard and what you've learned

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and what you've gained from the work that you're putting in.

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So Krista,

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thanks so much for that email and for letting me share that.

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To all of you,

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every single time you walk into a playroom,

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it's an opportunity to

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fall in love all over again with what we do.

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And it's easy to get caught up in the skills and the knowledge and the training and

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all kinds of things.

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But the reality is,

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every single hour,

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it's a gift to us

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to be

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in that room with that child and have the honor

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of being included in their healing journey.

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So every single time,

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it's an opportunity to fall back in love

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with why you are all in on CCPT,

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which is,

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if we are CCPT.

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It's just a matter of being.

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You just be with the child.

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And magical things happen.

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So,

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love y'all.

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00:14:16,380 --> 00:14:17,260
We'll talk again soon.

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Bye.

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

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Brenna Hicks.

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For more episodes and resources,

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00:14:24,929 --> 00:14:29,650
please go to www.playtherapypodcast.com.