175 | Play Therapy Challenges: From Credentials to Limit-Setting

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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, I'm Dr. Brenna Hicks, 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. I'm answering several questions from Sarah in Florida.

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Hello to my fellow Floridian. How exciting.

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And

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Sarah is in a school four days a week.

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So she is the in school therapist for a therapeutic unit in the district.

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So a really interesting role

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and really interesting dynamic.

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So she has been given toys and a playroom.

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She's very grateful for that. I would be too.

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And this is specifically with children who are having difficulty, self

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regulating and managing themselves in the classroom.

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So then she gets to see them for services

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and

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with the goal of integrating them back into regular classrooms.

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So really interesting dynamic. And Sarah thanks so much for reaching out

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and she actually wrote in with four questions.

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So this is like a mini lightning round all from the same listener.

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But all of these questions are so helpful.

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So I actually think that if we dive into these one at a time,

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it really will be beneficial.

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So,

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let me read a little bit of the email and

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then the specific questions and then we'll dive in.

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I'm reaching out to you for the first time.

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I stumbled on your podcast a few months back and they've been life changing.

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I've been trying to devour and listen to all of them as fast as I can.

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I have a couple of questions for you. So glad you found us, Sarah.

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All right.

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So the first question since I am not yet a licensed therapist

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and I do not have an RPT-S meaning supervisor for RPT.

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Can I still do play therapy and it be effective?

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I'm trying to devour your podcast courses and practice best I can

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so I can make a difference in therapy with my kids.

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All right. So

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I'll give you the simplest easiest answer. Yes. Now I'll go into more detail.

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So I actually get this question a lot. So I'm chuckling.

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Not because, you know,

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it's a silly question just because I think so

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many people have this in the back of their mind

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that if you don't have some kind of

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credential associated with being a play therapist,

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that you can't call yourself a play therapist,

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which is Bologna.

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So here's what you need to know all of you.

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It does not matter whether you are licensed or unlicensed,

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it does not matter whether you are RPT or not.

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It does not matter if you are CCPT certified in any way.

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Play therapist is the type of therapist that you are.

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It's no different than saying you are an occupational therapist.

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You are a physical therapist, you are a speech therapist, you are whatever,

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any type of therapy,

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there's

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a name associated with it to differentiate, right?

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So being a play therapist

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means you are a therapist that provides play therapy.

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There is no

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proprietary nature of the term play therapy.

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You do not have to be licensed, certified, registered,

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none of that to say you are a play therapist

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as a related aside, it

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is often helpful to say that you are a children's counselor

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and then say and play therapist

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because many people do not understand what a play therapist is.

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But if they see children's counselor and play therapist in your description,

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they understand that play therapy is somehow related to counseling children.

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So we have found that if you double those together,

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it is a little bit more easy for the general population to understand.

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However, you can say that you are a play therapist

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just because you practice play therapy.

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The second part of your question, is it effective?

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Yes,

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regardless of your credentials, regardless of your license.

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If you are using the child-centered model to the best of your ability,

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you are adhering to it to the best of your ability

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and you are continuing to build your skills to the best of your ability,

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it is effective

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and here's why

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because it's about the relationship.

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Do skills matter, of course.

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Do you need to be sound clinically?

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Yes.

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Should you never stop learning and never stop growing as a CCPT? Of course not.

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However,

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if you focus on the relationship,

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that is why CCPT works because everything flows out of the relationship.

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So even if you don't feel Sarah,

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that your skills are maybe as elevated as you would like them to

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be and that you're working to get them at some point someday,

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if your focus is to adhere to CCPT and to make sure that the relationship is paramount

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CCPT will be effective

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across the board. So I hope that, that encourages every single one of you

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that may not be certified, registered, licensed, whatever

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you are a play therapist if you provide play therapy

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and it works,

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if you let the relationship lead the way.

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OK. Question number two.

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Do you ever explicitly teach self regulation

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breathing, for example, or mindfulness techniques for children at all in CCPT.

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Simple short answer.

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Never

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more detailed answer to come.

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There's a little bit more to the question.

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This is something I explicitly teach my older kids and teens

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that I worry kids may not inherently learn without explicit instruction.

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OK.

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So I'm not sure Sarah what you mean by quote older kids, teens,

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I'm hoping you're saying 14 and up

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if you're saying, let's say 11 and up,

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you need to be doing CCPT until 14,

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3 to 14 is the window for CCPT.

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And do we ever explicitly teach self regulation breathing, for example,

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or mindfulness techniques at all?

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No,

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that's directive.

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It is not child-centered

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and it is agenda driven.

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We're trying to coach them, train them, teach them, instruct them

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that flies in the face of CCPT.

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What will happen? However, is children will naturally learn to self regulate

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and it might not be through breathing, it might not be through mindfulness.

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In fact,

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it won't be because those are cognitive

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approaches and kids aren't cognitive or rational.

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So are they going to go? I need to take some deep breaths right now. No,

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but what they will do is develop coping.

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They will develop an emotional vocabulary

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that helps them communicate differently.

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They will develop the capacity to regulate when they get

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upheaved.

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They will understand what it means

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to

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have other orientation and worldview so that they

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don't just impulsively act out of their emotions.

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One of the universal outcomes is increased regulation.

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So we know that CCPT creates increased regulation in children,

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but it has nothing to do with us teaching it to them.

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They figure it out for themselves.

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So we never ever, ever

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go that route with CCPT and certainly not with kids under 14.

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Now, older teenagers. So 15 and up,

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they do have abstract reasoning, they do have rational thought,

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they are able to process things more cognitively.

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So with older teens techniques like that might be helpful.

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But

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in truth, unless I have a child that starts with me under 14 and then continue,

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continues with me after 14.

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And interestingly enough, I have like three seniors in high school right now,

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which is crazy because they drive themselves to the

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office and we sit and talk for an hour

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and it's just crazy, but I started with them when they were 11, 12, 13. So

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I do not work with older teens unless they continue

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with me all the way through their high school years.

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But

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if you are seeing older teens in the school system,

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then that would potentially be an option for those types of kids.

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But 14 and under exclusively CCPT and no agenda driven curriculum or directives.

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Ok. Question number three.

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Will CCPT make a difference for kids who are currently in trauma.

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For example,

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I had several this year in foster care and

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they transitioned to different foster homes were abused et cetera

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or whose parents are not engaged.

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A consistent problem with the home situation not changing.

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Ok. This is probably another one of my most frequently asked questions

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from therapists all over the world. So

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the short answer is yes, it will make a difference.

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What we know about situations

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that

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kids are facing at any given time

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is that even when the circumstances don't change,

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even when the environments remain static, even when the caregivers do not engage,

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even when they are consistently in a

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chaotic or traumatic or difficult environment,

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they are building resilience,

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they are building coping,

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they are building a sense of self, they are building problem solving skills,

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they are building regulation.

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They are expanding in their emotional vocabulary

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on and on and on. So what we believe in and what we

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celebrate

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is that even in the midst of dysfunction and chaos and turmoil and all of these things

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that kids are still learning how to better handle

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being in that situation.

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I mean, look,

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if we could wave a magic wand and take every circumstantial or environmental

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stressor out of kids lives while they're in play therapy with us.

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Wouldn't that be amazing?

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I mean, I would love to rescue kids from the craziness of their situation sometimes.

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But what we know and what we

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have evidence that proves that it works

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is that even in the midst of all of that,

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kids are building the capacity to better handle, better adjust

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and better process what's going on

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because a dysfunctional environment

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is only as difficult for the child as their coping skills.

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The more they know they can handle things, the more they trust themselves,

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the more they accept their circumstances,

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the more they believe in their own problem solving capabilities.

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All of a sudden that environment doesn't seem so overwhelming anymore.

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The greater, their emotional IQ and their emotional vocabulary,

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it doesn't seem so difficult to handle

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anymore because they're better regulated emotionally.

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So we know that even when things don't change CCPT

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is still helpful and it is still effective.

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So we never try to change the circumstances or the environment.

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We provide the

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opportunity for the child to change within

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those environmental circumstances and they will.

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All right.

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And then last and final question,

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what do you do for kids who want to destroy your room every time?

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Oh, the million dollar question,

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how do I set limits?

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I had 16 year old child this year who was throwing and trying to break everything,

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spitting in the sand, putting everything in his mouth, et cetera.

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The playroom in itself was triggering.

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It seemed and I had to finally take him to an empty room with only a few toys.

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Would you suggest that or what recommendations for kids like that?

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With intense anger and aggression all the time?

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All right.

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So gosh, there's a lot to unpack there, Sarah.

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So I'll try to hit these in some semblance of an order. That makes sense.

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OK.

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Number one, a child will never want to destroy your room every time.

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So even if you see a pattern of that, even if the destruction is repetitive,

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even if the aggression is pretty consistent,

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it will be a temporary short lived scenario.

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No child is destructive and aggressive every

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session throughout the entirety of treatment.

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Might they be in it for a stretch? Yes.

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But it will never be every time.

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So I think maybe with this particular child

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it was just seemingly that way, but over time it will reduce.

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So we have to be mindful that every situation with a child in a playroom is temporary.

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Ok.

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How do you set limits? I'll get to that in just a second.

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So the child was throwing, breaking things, spitting,

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putting everything in his mouth.

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Ok. Those were all isolated behaviors

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and not particularly all of them were destructive.

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He wasn't trying to destroy everything when he was spitting in the sand.

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He wasn't trying to destroy everything when he was putting things in his mouth.

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Is it all dysregulated behavior? Absolutely.

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But isolated behaviors that require separate limits.

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So you would set a limit on

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throwing things

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if that was necessary.

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So remember we have three unwritten rules

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about limits and then we have three questions we ask ourselves

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and you all should know that by now.

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So if you don't go back and listen to earlier episodes,

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so when we go through the three unwritten rules and the three questions,

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if it was necessary to set a limit for throwing toys, then you would set a limit on that

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breaking toys would be another limit that was

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required spitting in the sand would be another limit

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and putting things in his mouth would be another limit.

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You would need to see these as isolated behaviors because it's easy to go.

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Oh my gosh,

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this kid is just doing absolutely everything he

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possibly can do to make this session crazy.

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Ok. Yes, in the grand scheme,

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but every incident is its own isolated scenario in the playroom.

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So we always want to make sure that each behavior that requires a limit gets its

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own limit and we don't string them together

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and we don't associate one with the other.

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OK.

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Then your next comment is the playroom seemed triggering to the child.

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I'm actually going to

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politely disagree.

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I think

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the child was really, really struggling

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and

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the playroom and the relationship and the permissiveness and the safety

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and all of the things that a

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playroom affords a child

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that made it very, very difficult to the for the child to control himself.

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I don't think the playroom was triggering.

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I think the playroom provided an environment

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that he never finds himself in,

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which is one where there's high levels of permissiveness, high levels of freedom,

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high levels of autonomy,

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no expectations, no judgment, no consequences.

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And he's never practiced self regulation before. He has no idea what it looks like.

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So when you have a child that is in that situation

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and feels very uncomfortable, very out of sorts

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and doesn't have the capacity to self regulate at this point,

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everything is going to go haywire.

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So

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you mentioned, would I suggest that you take him to an empty room with only a few toys.

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No,

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the playroom is the playroom

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and your therapeutic hour is spent in the playroom.

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You can't earn it, you can't lose it.

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So might you have to set an ultimate limit on a specific toy?

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Absolutely. Might you have to cover up the sand tray

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because he chose after three times to continue to spit in the sand.

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And might he choose not to have access to the sand tray for the rest of that session?

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Yes.

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If he's throwing blocks across the room,

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might he choose not to have blocks for the rest of that session?

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Yes.

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Whatever he puts in his mouth,

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might he choose not to have access to that for the rest of the play session?

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Yes,

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but

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the limits are only needed when they're needed

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and they are isolated events.

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So he may end up choosing to not have a lot of things for his playtime,

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but he's able to stay in the playroom because that's where therapy takes place.

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So we don't ever want to try to take a child out of the

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environment because how is the child going to learn to practice self control?

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How is the child going to learn to practice complying with limits?

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How is the child going to learn to practice self regulation

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if we just whisk them away from the environment where

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they're having a difficult time doing those very things?

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The best thing for a child in that scenario is to

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stay in the environment that's the most difficult for them.

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So they can learn what it feels like

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so they can practice it.

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So how would we set limits in that kind of scenario?

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You are really

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throwing blocks

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all over the room?

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But the blocks are not for throwing because I could get hurt

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or because they can leave marks on the walls or because

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it could break the miniatures, whatever you need

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to set the limit on.

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So, is it your safety? Is it the walls?

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Is it the

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whatever they're throwing themselves could break,

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that's the neutral limit, right? A is not for B or X is for Y.

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So you're really throwing those blocks hard,

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but the blocks aren't for throwing because I could get hurt

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or whatever the scenario is,

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you can choose to throw the blocks at the floor

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if you have carpet or some kind of flooring

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that can handle blocks being chucked at it.

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That's

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I'm throwing out hypotheticals. You have to make it work for your space.

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You can choose to throw the blocks at the floor or you can choose to throw

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the stuffed animals as hard as you choose. Which do you choose?

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So is it, I really need to throw the blocks

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then throwing it at the floor would be the appropriate alternative.

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Is it that I really need to throw something as hard as I possibly can?

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Then stuffed animals would make sense for that need.

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So we try to give alternatives that map back to the need or desire for the child?

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Ok. So spitting in the sand,

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oh you're spitting in the sand but the sand

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isn't for spitting in because other kids use that.

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You can choose to spit in the garbage can or you

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can choose to play in the sand without spitting in it.

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Which do you choose

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again?

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Is the need to spit or is the need to play in the sand and he's just really deregulated.

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So depending on the circumstance, we would offer an appropriate alternative.

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So that is how we set limits, be mindful that each one is separate and we can't

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string them together in our heads because then it feels like

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the kid is just bucking every potential

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limit in the playroom and we don't wanna have that

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impression because that can skew our approach to unconditional acceptance

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and permissiveness and safety and all the things that we have been talking through.

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So

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Sarah, thank you so much for the email. Thank you for the questions.

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I hope that all of you found that helpful

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and this is something that

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we are constantly trying to work on, right?

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What do we do in different situations?

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How do we handle doing this professionally?

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That is,

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that's always the goal I want to read one final thing that Sarah

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wrote in the email because I think this just kind of sums up

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the the whole child-centered model,

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your podcasts have literally changed my practice.

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I've always been interested in play therapy but leaned more towards Adlerian.

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However, I was finding that put me in charge too much.

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In the beginning of the year.

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I was trying to get kids to sit and do directive worksheets and projects

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and bribe them with candy to co-operate. It was completely ineffective.

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I've seen the benefits of CCPT and even just a few sessions with my other clients.

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Thank you so much for putting all this out there.

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That's why we do what we do y'all

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because we trust the kids are going to figure it out for themselves

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and we don't need to bribe them. We don't need to negotiate with them.

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We don't need to try to make them do something.

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They'll sort it out for themselves and that's the beauty of CCPT so.

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All right, y'all love you. Thanks for spending time with me this week.

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Have a lovely weekend. We'll talk again soon. Bye.

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Thank you for listening to the Play Therapy Podcast with Dr

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Brenna Hicks for more episodes and resources.

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Please go to www.playtherapypodcast.com.