311 | Two Questions, One Answer: Trust the Process in Child-Centered Play Therapy

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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 get

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a master class 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'm answering two questions from Joy in Maryland.

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And one is about slime,

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and one is about when we might refer out to another type of therapy.

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So very unrelated questions,

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but both

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helpful,

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so we'll dive into each.

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I'll read one at a time so we can kind of answer each one separately.

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And Joy,

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thank you so much for the email.

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So the first question about slime,

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I have some kids who play with slime for the majority of the session.

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I track and reflect and behave as I do in any other play session,

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but I do not notice as many themes during this play.

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Is this common?

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Am I missing something?

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Do you say you're doing anything differently when working with slime?

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We never say or do anything differently regardless

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of what's going on in a CCPT playroom,

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so that's an easy answer.

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No,

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never,

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never with exclamation points in capitals.

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We never change anything regardless of what's happening.

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That's the beauty of the model.

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We remain adherent and it's consistent and it's effective.

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So regardless of

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themes or no themes,

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play being the same,

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play being different,

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child presenting with XYZ,

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it doesn't matter.

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We're always consistent across the board.

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Kids that play with slime.

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God love all of you who

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have slime in your room.

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I cannot.

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So,

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if you all are slime CCPTs,

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here's a high five

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from the girl in Florida that says no way.

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I don't have any slime in my room,

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but I know lots of you all do.

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When a child comes in and plays with slime,

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it's almost always in competence

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theme,

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but let's hold on,

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let's,

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let's back the train up for a second.

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We have to be mindful,

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just because a child plays with something one time does not make it a theme.

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It needs to be consistent with sessions and across sessions.

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So it would be symbolic

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if it's just a one time scenario

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if it presents itself multiple times within session and across sessions,

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now we know it is theme.

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So just

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be aware sometimes we say,

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oh what theme is that?

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because something emerges,

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we can't assume that it's a theme there has to be consistency there.

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OK,

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so now we can keep going down the track.

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For those kids that come in and play with slime,

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it's almost always competence based.

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Now it can be rooted in some different things.

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Sometimes it's

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because they just want to show their

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mastery and they're proving that they're competent.

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Sometimes it's self challenging,

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they've never done it before,

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so they want to prove that they can.

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Sometimes it's safe.

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They're used to doing slime at home,

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so especially early on in sessions,

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you will see a child that might come

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in and gravitate towards something that requires nothing but

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comfort.

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I know how to do slime slime is easy,

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slime is predictable.

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Nothing in my unconscious is gonna come up that I'm not ready for or prepared for.

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Slime is safe.

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That's another reason sometimes kids will consistently play with slime.

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It is usually a temporary

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segment of play.

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Kids will not play with slime forever.

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That's a temporary snippet in the process.

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So the intention is

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we

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reflect,

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we track,

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we remain present,

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we remain engaged,

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we wait to see what unfolds.

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If you notice shifts taking place.

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We can point those out.

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We also want to be mindful of paying attention to anything that changes.

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So wherein maybe it used to be 30 or 35 minutes of the session,

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we played with slime,

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at some point it may reduce to 10 or 15 minutes.

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That's noteworthy.

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The need isn't as strong.

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The compulsion to do that is not overriding the whole session.

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It's just I still want to do it.

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I still need to do it,

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but I don't need to devote as much time.

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So we're going,

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when we see that very consistent repetitive play,

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we're always looking for what is changing.

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Is the child more free and uninhibited?

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Maybe the child is willing to mix glitter or colors or something,

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whereas before there was a lot of rigidity.

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We're always looking for the subtle changes.

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That's one of the things that we're able to observe change and growth.

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So I hope that addresses the slime question.

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As far as specific modalities,

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let's dive into that question,

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so let me read parts of the email.

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If a child has a specific phobia,

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would you refer them to ERP therapy in addition to play therapy or just

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provide provide toys and in this case

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the reference was specifically to emitophobia.

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Do we provide specific toys such as throw up a doctor

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kit for them to work through it on their own?

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I wonder the same thing about whether to trust CCPT for trauma

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or when to refer to EMDR.

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Are there situations in which you would add

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or refer for another type of therapy?

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Generally speaking,

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I'll get back to the specific phobia in a second,

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but let's talk about,

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for example,

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referring to EMDR.

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General rule,

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we change one thing at a time.

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If a parent pursues CCPT

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that needs to be the only difference,

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because as soon as you introduce a different type of therapy,

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for example,

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causality goes out the window.

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We want to try to mitigate the amount of change as much as possible.

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Parents say,

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hey,

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I really think my child needs therapy.

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There's a lot of trauma,

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this happened,

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this happened,

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whatever.

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CCPT is effective with trauma.

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And we certainly wouldn't want to introduce something else

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because then at that point what's what's causing change?

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We don't even know too many variables.

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Second consideration is

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we don't ever want the child to be overwhelmed

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with too much therapy and that very much happens.

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So if they're in CCPT

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that is emotionally draining,

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it's psychologically draining,

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it's mentally draining,

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it's physically draining,

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then sending them to a different type of therapy.

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That's going to be so much for a child to manage,

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and that is unethical at that point.

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We don't want to put a child in a compromised state

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where they can't attend to either therapy because

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it's just too much.

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So again,

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we're always trying to say one thing at a time.

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My standard

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in a scenario like that would be

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let's do an entire round of CCPT.

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We know that CCPT is effective for trauma

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and if we get to the end and we feel like maybe

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we need to pursue something else we can talk about that.

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And I rarely if ever have anyone that still pursues something else

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after CCPT because CCPT is effective.

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Getting back to specific phobias,

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phobia is just an irrational fear and an overwhelming level of anxiety.

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So we treat that no differently than

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any other anxiety-based

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presentation.

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We would not refer them to something else.

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We also would not provide specific toys.

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In other words,

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I've worked with children,

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with emitophobia,

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I've worked with children

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that refused to eat and were failure to thrive because they choked.

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And they said,

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I will not eat anything anymore,

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so I literally,

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I,

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I played several sessions with a kid with an NG

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tube taped to his nose in the back of his neck

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and the tube hanging out of the back of his shirt with a Ziploc bag on it

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because they'd put in a feeding tube for him.

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And

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I mean these are,

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these are serious food related phobias.

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I had one that had lost,

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I think like 16 or 17 pounds

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because he would only drink something,

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he would not chew any food.

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And they're all

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based in

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something that happened that was overwhelming and scary,

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and so then it became a phobia.

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In those scenarios,

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I never once put special kinds of toys in the playroom.

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But kids naturally worked through their food issues.

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So a standard CCPT playroom has food,

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a standard CCPT playroom has a doctor's kit.

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So we would not add anything

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to the playroom.

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I wouldn't

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intentionally put fake throw up in the room

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because I know that a child is scared of that.

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I would just let them

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process things the way that they need to.

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And the beauty of the playroom is if a child doesn't have what they ideally want,

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they'll make something work.

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So you don't have to have throw up for a kid to pretend that something is throw up.

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And that's why we provide the three categories of toys,

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and we trust the process.

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They will use what they need to in creative and clever ways

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if it's not present and they have to have it,

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otherwise,

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they don't have to have it and they'll use other things.

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So the general rule is one thing at a time,

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no changes,

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and we do believe and know based on research

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that CCPT works with phobias

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and with trauma.

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Therefore,

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we're going to trust the child,

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trust the process,

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trust the model,

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and we remain adherent.

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And kids will work through what they need to.

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So thank you,

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Joy,

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so much for both of those questions.

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Hope that that encourages and helps y'all.

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If you want to reach out,

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please do brenna@thekidcounselor.com.

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You can also,

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if you're in the states,

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call 813-812-5525 and I will answer a question

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from your voicemail.

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Otherwise,

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have a great week.

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We'll talk soon.

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Love you all.

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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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please go to www.playtherapypodcast.com.