318 | Mastering CPRT Announcement + Q&A: CCPT Termination Criteria (How to Know When a Child Is Truly Ready)
Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy
Mastering CPRT is open for registration - go to playtherapynow.com and use the code "CPRT100" to get $100 off for 10 days. It goes up to full price after 10 days, so grab this offer today!
In this episode, I answer a question from Orla in Ireland about what to do when a child says they don't want to come to therapy anymore—and how to communicate that to parents. I break down two case examples and explain why child-led termination isn't reliable in CCPT, especially early in treatment. More often than not, these moments reflect resistance rather than readiness, and they can surface in any phase of therapy.
I walk through the clinical criteria we use to determine true readiness for termination, share specific ways to guide parents through resistance and avoidance, and offer practical tips on structuring expectations using 5-session increments. I also talk about the importance of preserving the therapeutic relationship, even when kids push back. If you've ever felt unsure about how to advise families during the messy middle of the work, this episode will help you feel more confident and clear in your CCPT decision-making.
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If you would like to ask me questions directly, check out www.ccptcollective.com, where I host two weekly Zoom calls filled with advanced CCPT case studies and session reviews, as well as member Q&A. You can take advantage of the two-week free trial to see if the CCPT Collective is right for you.
Ask Me Questions: Call (813) 812-5525, or email: brenna@thekidcounselor.com Brenna's CCPT Hub: https://www.playtherapynow.com CCPT Collective (online community exclusively for CCPTs): https://www.ccptcollective.com Podcast HQ: https://www.playtherapypodcast.com APT Approved Play Therapy CE courses: https://childcenteredtraining.com Twitter: @thekidcounselor https://twitter.com/thekidcounselor Facebook: https://facebook.com/playtherapypodcast
Common References: Cochran, N., Nordling, W., & Cochran, J. (2010). Child-Centered Play Therapy (1st ed.). Wiley. VanFleet, R., Sywulak, A. E., & Sniscak, C. C. (2010). Child-centered play therapy. Guilford Press. Landreth, G.L. (2023). Play Therapy: The Art of the Relationship (4th ed.). Routledge. Bratton, S. C., Landreth, G. L., Kellam, T., & Blackard, S. R. (2006). Child parent relationship therapy (CPRT) treatment manual: A 10-session filial therapy model for training parents. Routledge/Taylor & Francis Group. Benedict, Helen. Themes in Play Therapy. Used with permission to Heartland Play Therapy Institute.
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0 00:00:00,460 --> 00:00:04,309 You're listening to the Play Therapy Podcast with Dr. Brenna Hicks, 1 00:00:04,469 --> 00:00:08,220 your source for centered and focused play therapy coaching. 2 00:00:08,550 --> 00:00:08,720 Hi, 3 00:00:08,829 --> 00:00:09,890 I'm Dr. Brenna Hicks, 4 00:00:09,899 --> 00:00:10,590 The Kid Counselor. 5 00:00:10,710 --> 00:00:13,550 This is the Play Therapy Podcast where you get a master class 6 00:00:13,550 --> 00:00:16,989 in child-centered play therapy and practical support and application. 7 00:00:17,084 --> 00:00:19,104 For your work with children and their families. 8 00:00:19,475 --> 00:00:20,235 In today's episode, 9 00:00:20,315 --> 00:00:23,145 I am answering a question from Orla in Ireland. 10 00:00:23,434 --> 00:00:24,575 I did not do that on purpose. 11 00:00:24,635 --> 00:00:26,204 They actually came in in that order, 12 00:00:26,315 --> 00:00:27,075 I promise. 13 00:00:27,635 --> 00:00:30,555 So I know we've had two questions from Ireland back to back, 14 00:00:30,625 --> 00:00:31,034 but 15 00:00:31,594 --> 00:00:32,395 just coincidence, 16 00:00:32,473 --> 00:00:33,924 not that I planned it that way. 17 00:00:34,275 --> 00:00:36,985 But Orla's question is about. 18 00:00:38,090 --> 00:00:40,479 Kids saying that they want to be done with therapy 19 00:00:41,049 --> 00:00:44,250 and how we handle that and specifically what we say to parents. 20 00:00:44,650 --> 00:00:47,569 So not only how do we understand if a child is ready. 21 00:00:48,400 --> 00:00:51,990 And what do we need to communicate to parents about a child's readiness. 22 00:00:52,110 --> 00:00:53,459 But before we get into that, 23 00:00:53,669 --> 00:00:54,389 as promised, 24 00:00:54,470 --> 00:00:55,529 it is July 7th, 25 00:00:55,630 --> 00:00:56,659 2025, 26 00:00:56,950 --> 00:00:58,700 and that means we are launching 27 00:00:58,869 --> 00:01:03,349 the complete 16 hour CPRT course today through Corewell. 28 00:01:03,509 --> 00:01:07,065 Very excited about that and For my email newsletter subscribers, 29 00:01:07,224 --> 00:01:08,574 my podcast listeners, 30 00:01:08,785 --> 00:01:11,705 and my collective members and my coaching participants, 31 00:01:11,824 --> 00:01:13,135 you all get $100 off. 32 00:01:13,305 --> 00:01:13,745 So 33 00:01:14,144 --> 00:01:15,014 for 10 days only, 34 00:01:15,224 --> 00:01:17,214 July 7th through July 17th, 35 00:01:17,305 --> 00:01:18,334 $100 off, 36 00:01:18,544 --> 00:01:20,614 the code is CPRT100 37 00:01:20,864 --> 00:01:21,944 CPRT100 38 00:01:21,985 --> 00:01:24,495 So the letters CPRT 39 00:01:24,785 --> 00:01:27,135 and the numbers 100, 40 00:01:27,144 --> 00:01:28,785 CPRT100. 41 00:01:29,620 --> 00:01:30,209 Only 42 00:01:30,379 --> 00:01:32,610 letters and numbers don't spell anything out. 43 00:01:33,059 --> 00:01:34,449 CPRT100, 44 00:01:34,459 --> 00:01:39,410 you will save $100 and you will get access to the entire course as a thank 45 00:01:39,410 --> 00:01:43,370 you for being a part of my tribe and being a part of The Kid Counselor family. 46 00:01:43,860 --> 00:01:44,900 So if you have been waiting, 47 00:01:44,940 --> 00:01:46,529 I know so many of you have. 48 00:01:47,019 --> 00:01:48,410 And thanks for your patience, 49 00:01:48,529 --> 00:01:51,849 thanks for giving us time to work out the technical glitches and all 50 00:01:51,849 --> 00:01:55,599 things related to the the back end of the programming of the course. 51 00:01:55,849 --> 00:01:59,800 Corewell has never offered a comprehensive course like this before, 52 00:02:00,010 --> 00:02:02,680 where you get videos in modules. 53 00:02:02,930 --> 00:02:06,930 So a huge thank you to them for partnering with us and actually kind of 54 00:02:06,930 --> 00:02:11,330 creating this type of course on their site from scratch for the CPRT curriculum. 55 00:02:11,759 --> 00:02:13,929 So CPRT100 for 10 days, 56 00:02:14,059 --> 00:02:15,809 July 7th through July 17th, 57 00:02:16,020 --> 00:02:17,009 please take advantage of that. 58 00:02:17,059 --> 00:02:19,600 It will go up to regular price after that 10 days. 59 00:02:19,779 --> 00:02:21,250 So if you're thinking about it, 60 00:02:21,419 --> 00:02:23,009 you might as well save the $100 61 00:02:23,259 --> 00:02:25,979 and you still get the 16 CEUs for less money. 62 00:02:26,820 --> 00:02:27,050 All right, 63 00:02:27,130 --> 00:02:30,610 so let me read parts of Orla's email and then we'll dive into 64 00:02:30,610 --> 00:02:33,759 processing when a child just says they don't want to come anymore. 65 00:02:33,940 --> 00:02:36,199 I have a burning question that I'd loved your insight on. 66 00:02:36,449 --> 00:02:39,089 How do we know when a child is truly ready to end therapy? 67 00:02:39,169 --> 00:02:41,690 I understand the average number of sessions is around 20. 68 00:02:41,729 --> 00:02:42,570 Let me pause there. 69 00:02:42,660 --> 00:02:42,960 Orla, 70 00:02:43,050 --> 00:02:44,949 it's actually 30 to 40 now. 71 00:02:45,369 --> 00:02:47,330 So the average has changed. 72 00:02:47,369 --> 00:02:48,660 It used to be 20, 73 00:02:48,850 --> 00:02:51,399 and recent research has said 30 to 40. 74 00:02:52,210 --> 00:02:54,380 So I just wanted to make sure you were aware of that, 75 00:02:54,470 --> 00:02:55,539 we need to 76 00:02:55,800 --> 00:02:57,350 extend that time frame. 77 00:02:58,080 --> 00:02:59,699 I understand the average number of sessions, 78 00:02:59,779 --> 00:03:00,610 I'll change it for you, 79 00:03:00,619 --> 00:03:01,929 is around 30 to 40, 80 00:03:02,059 --> 00:03:04,419 but I've had a couple of recent cases that left me wondering. 81 00:03:05,470 --> 00:03:05,990 In one case, 82 00:03:06,059 --> 00:03:07,539 I worked with a boy who said straight off the 83 00:03:07,539 --> 00:03:09,610 bat that he didn't want to be in play therapy, 84 00:03:09,820 --> 00:03:12,089 and he was only doing it because he got to miss school, 85 00:03:12,339 --> 00:03:15,330 but he engaged in play nonetheless and processed some deep stuff. 86 00:03:15,580 --> 00:03:17,500 I stayed fully child-centered throughout it all. 87 00:03:17,539 --> 00:03:18,179 At the review, 88 00:03:18,259 --> 00:03:20,139 his parents reported great improvements. 89 00:03:20,339 --> 00:03:21,020 He was happier, 90 00:03:21,139 --> 00:03:21,649 sleeping better, 91 00:03:21,779 --> 00:03:22,419 more confident, 92 00:03:22,429 --> 00:03:23,850 and more regulated overall. 93 00:03:24,259 --> 00:03:28,089 I suggested continuing therapy as he still seemed to be working through things, 94 00:03:28,419 --> 00:03:29,750 but after one more session, 95 00:03:29,820 --> 00:03:31,449 he said he didn't want to come back. 96 00:03:31,479 --> 00:03:32,979 We had only done 6 sessions. 97 00:03:33,449 --> 00:03:34,190 In another case, 98 00:03:34,270 --> 00:03:35,630 I worked with a 6 year old girl who 99 00:03:35,630 --> 00:03:38,660 initially came in with anxiety and people pleasing behaviors. 100 00:03:38,750 --> 00:03:39,979 For the 1st 6 sessions, 101 00:03:39,990 --> 00:03:41,990 she played games where we took care of babies in 102 00:03:41,990 --> 00:03:44,619 daycare and made sure they weren't misbehaving or messy. 103 00:03:45,110 --> 00:03:46,110 At the 6-week review, 104 00:03:46,190 --> 00:03:48,500 her parents said she was completely back to her happy, 105 00:03:48,600 --> 00:03:50,869 confident self with no anxiety or school issues. 106 00:03:51,529 --> 00:03:53,289 I recommended continuing, 107 00:03:53,300 --> 00:03:54,460 and we did 6 more. 108 00:03:54,649 --> 00:03:55,720 In the second phase, 109 00:03:55,729 --> 00:03:56,720 her play changed. 110 00:03:56,929 --> 00:03:57,860 She became messier, 111 00:03:57,929 --> 00:03:59,160 which was unusual for her, 112 00:03:59,289 --> 00:04:00,410 more assertive and angry, 113 00:04:00,449 --> 00:04:01,759 and at times very quiet. 114 00:04:02,009 --> 00:04:03,830 Her play was a lot more fragmented, 115 00:04:03,910 --> 00:04:05,960 and she wasn't people pleasing to me at all. 116 00:04:06,330 --> 00:04:08,619 It seemed like she was doing deeper processing. 117 00:04:08,929 --> 00:04:10,399 Yesterday was her 12th session, 118 00:04:10,449 --> 00:04:12,529 and she told me she's had enough and doesn't want 119 00:04:12,529 --> 00:04:15,039 to return because she has other things to do. 120 00:04:16,100 --> 00:04:17,010 She also made, 121 00:04:17,140 --> 00:04:17,839 she's 6. 122 00:04:17,899 --> 00:04:18,690 That's hilarious. 123 00:04:18,950 --> 00:04:20,608 She also made a huge mess in the room, 124 00:04:20,660 --> 00:04:22,170 even dumping out the trash can. 125 00:04:22,940 --> 00:04:23,609 My question is, 126 00:04:23,619 --> 00:04:25,890 do we trust the child's sense of when they're done? 127 00:04:26,299 --> 00:04:26,649 No. 128 00:04:27,489 --> 00:04:28,299 There's the simple answer. 129 00:04:28,380 --> 00:04:28,540 I'll, 130 00:04:28,649 --> 00:04:30,570 I'll go into further detail in a minute. 131 00:04:30,929 --> 00:04:34,059 Should I avoid getting too focused on a specific number of sessions, 132 00:04:34,100 --> 00:04:35,529 or is this the type of resistance, 133 00:04:35,579 --> 00:04:36,269 a sign 134 00:04:36,700 --> 00:04:37,739 they need more support? 135 00:04:38,149 --> 00:04:40,000 Any insight you can share would be so appreciated. 136 00:04:40,109 --> 00:04:42,869 I have another kid who has been doing lots of process and play 137 00:04:42,869 --> 00:04:45,619 who has decided that he doesn't want to come to therapy anymore too. 138 00:04:45,910 --> 00:04:48,239 I'm finding this type of attrition so hard and I'm 139 00:04:48,239 --> 00:04:51,059 completely at a loss as to how to advise parents. 140 00:04:52,140 --> 00:04:52,380 All right, 141 00:04:52,500 --> 00:04:52,980 so, 142 00:04:53,179 --> 00:04:53,380 gosh, 143 00:04:53,459 --> 00:04:53,820 Orla, 144 00:04:53,859 --> 00:04:55,929 this is a very layered question. 145 00:04:56,019 --> 00:04:57,339 So we're gonna dive in and we'll, 146 00:04:57,380 --> 00:04:58,970 we'll do our best to work through this. 147 00:04:59,420 --> 00:04:59,579 All right, 148 00:04:59,660 --> 00:05:02,410 so now that we understand that the average is 30 to 40, 149 00:05:02,619 --> 00:05:04,779 and you were operating on the 20 session model, 150 00:05:04,820 --> 00:05:07,109 I think this might already answer your own question 151 00:05:07,500 --> 00:05:08,489 because 6 sessions in, 152 00:05:08,500 --> 00:05:09,640 12 sessions in, 153 00:05:09,859 --> 00:05:12,209 the likelihood that they are done is 154 00:05:12,489 --> 00:05:13,429 slim to none, 155 00:05:13,440 --> 00:05:16,100 even just from a statistical standpoint. 156 00:05:16,980 --> 00:05:18,549 But with the case of the boy, 157 00:05:18,630 --> 00:05:19,339 for example, 158 00:05:19,589 --> 00:05:21,790 he said that he didn't want to be in play therapy and 159 00:05:21,790 --> 00:05:23,660 he was only doing it because he got to miss school. 160 00:05:23,829 --> 00:05:23,950 All right, 161 00:05:24,029 --> 00:05:24,109 well, 162 00:05:24,149 --> 00:05:26,220 there's a power control grab straight off 163 00:05:26,790 --> 00:05:27,470 from the beginning. 164 00:05:27,940 --> 00:05:31,450 But then he engaged and processed some deep things. 165 00:05:31,700 --> 00:05:32,000 OK, 166 00:05:32,140 --> 00:05:32,369 well, 167 00:05:32,459 --> 00:05:33,929 that's exactly what we expect. 168 00:05:33,980 --> 00:05:37,000 A child's going to be very power and control hungry at the 169 00:05:37,000 --> 00:05:40,250 beginning when he realizes that you're giving him power and control, 170 00:05:40,500 --> 00:05:43,109 he has no need to try to fight for it so much, 171 00:05:43,380 --> 00:05:46,179 and they know that they need and want to work on things, 172 00:05:46,380 --> 00:05:47,109 so he did. 173 00:05:47,380 --> 00:05:49,619 And of course parents are going to report improvements. 174 00:05:49,700 --> 00:05:51,369 That's exactly what we expect 175 00:05:51,899 --> 00:05:53,500 because as he works through things, 176 00:05:53,540 --> 00:05:54,820 he becomes more regulated. 177 00:05:56,010 --> 00:05:58,049 Now that is in the 1st 6 sessions. 178 00:05:58,089 --> 00:06:00,559 It sounds as though he dove in really quickly. 179 00:06:01,130 --> 00:06:03,670 We know that the phases are inevitable, 180 00:06:04,010 --> 00:06:08,799 so we have those 4 phases and we know that kids will work through every single phase. 181 00:06:09,250 --> 00:06:10,049 He dove in, 182 00:06:10,130 --> 00:06:12,480 it seems as though straight into work phase. 183 00:06:13,209 --> 00:06:14,100 But what we know, 184 00:06:14,190 --> 00:06:18,339 just like the stages of grief is that you can't go around or bypass the phase. 185 00:06:18,630 --> 00:06:19,470 So therefore, 186 00:06:19,670 --> 00:06:21,899 he dove straight into work and then was like, 187 00:06:21,910 --> 00:06:23,140 wait a second, 188 00:06:23,390 --> 00:06:24,190 this was too deep, 189 00:06:24,299 --> 00:06:24,670 too much, 190 00:06:24,750 --> 00:06:25,149 too far, 191 00:06:25,269 --> 00:06:25,709 too fast, 192 00:06:25,829 --> 00:06:26,630 too overwhelming, 193 00:06:26,790 --> 00:06:27,809 to fill in the blank. 194 00:06:28,109 --> 00:06:28,859 So now, 195 00:06:29,109 --> 00:06:29,739 hold on, 196 00:06:29,910 --> 00:06:30,820 I need to backpedal. 197 00:06:30,950 --> 00:06:32,100 I need to back up, 198 00:06:32,390 --> 00:06:34,820 and I don't even really have a relationship with you yet. 199 00:06:34,989 --> 00:06:37,670 I haven't even really faced the resistance of this yet. 200 00:06:38,160 --> 00:06:39,019 And 201 00:06:39,350 --> 00:06:41,070 because he dove in so quickly, 202 00:06:41,339 --> 00:06:43,700 of course we would anticipate parents would see changes 203 00:06:43,700 --> 00:06:46,690 in behavior because he actually started doing meaningful work, 204 00:06:47,179 --> 00:06:49,450 but he went to the 3rd phase 205 00:06:49,859 --> 00:06:50,890 and now he's saying, 206 00:06:51,049 --> 00:06:51,380 wow, 207 00:06:51,540 --> 00:06:52,019 OK, 208 00:06:52,140 --> 00:06:54,100 this is getting a little more serious now, 209 00:06:54,140 --> 00:06:58,100 this is getting a little bit more deep and dark and overwhelming. 210 00:06:58,709 --> 00:07:00,589 I don't really know how I feel about this. 211 00:07:01,109 --> 00:07:02,519 Can I really even be vulnerable? 212 00:07:02,630 --> 00:07:04,339 Can I really even trust this person? 213 00:07:04,510 --> 00:07:07,779 Can I really open up and let all this raw stuff out? 214 00:07:07,820 --> 00:07:08,950 How is she going to handle it? 215 00:07:09,070 --> 00:07:10,380 How am I going to handle it? 216 00:07:10,549 --> 00:07:11,429 Am I ready for this? 217 00:07:11,510 --> 00:07:12,920 Am I able to do this? 218 00:07:13,390 --> 00:07:15,109 All of these questions are now swirling. 219 00:07:15,230 --> 00:07:15,670 So of course, 220 00:07:15,709 --> 00:07:16,649 he's going to say, 221 00:07:16,839 --> 00:07:16,950 yeah, 222 00:07:16,989 --> 00:07:18,140 I don't want to do this anymore. 223 00:07:18,910 --> 00:07:21,070 This is resistance after work. 224 00:07:21,149 --> 00:07:24,100 Do you see how we don't always go in a 1, 2, 3, 4 order? 225 00:07:25,049 --> 00:07:26,540 That's what's going on there. 226 00:07:26,750 --> 00:07:28,339 Let's dive into the six year old girl. 227 00:07:28,510 --> 00:07:30,980 She came in with anxiety and people pleasing behaviors. 228 00:07:31,230 --> 00:07:31,940 Makes sense. 229 00:07:32,190 --> 00:07:34,829 She played games where you took care of babies in daycare. 230 00:07:34,989 --> 00:07:35,149 All right, 231 00:07:35,230 --> 00:07:36,910 if this next line doesn't 232 00:07:37,250 --> 00:07:38,339 just speak volumes, 233 00:07:38,869 --> 00:07:41,350 made sure they weren't misbehaving or messy. 234 00:07:42,609 --> 00:07:47,279 That is literally a picture of her own self temper and her own self-control, 235 00:07:47,450 --> 00:07:48,720 and her own self regulation. 236 00:07:48,850 --> 00:07:50,649 I can't misbehave and I can't be messy. 237 00:07:52,109 --> 00:07:54,260 She's in real time sorting out, 238 00:07:54,470 --> 00:07:58,910 making sure that other kids do not do the things that she would never let herself do. 239 00:08:00,179 --> 00:08:01,799 And at the six-week review, 240 00:08:01,880 --> 00:08:03,429 her parents said that she 241 00:08:03,839 --> 00:08:05,079 had totally transformed. 242 00:08:05,160 --> 00:08:07,790 There were all kinds of improvements in a positive direction. 243 00:08:08,000 --> 00:08:11,200 That's exactly what we expect because she dove into deep work. 244 00:08:12,320 --> 00:08:15,250 So then you convinced mom and dad that she needed to continue. 245 00:08:15,519 --> 00:08:17,790 So she continued for 6 more sessions. 246 00:08:18,320 --> 00:08:19,709 Then she becomes messier, 247 00:08:19,920 --> 00:08:21,429 then she becomes assertive and angry, 248 00:08:21,519 --> 00:08:22,829 and then she becomes quiet. 249 00:08:23,119 --> 00:08:23,350 Then 250 00:08:23,839 --> 00:08:24,679 she's fragmented, 251 00:08:24,760 --> 00:08:26,040 she's not people pleasing. 252 00:08:27,269 --> 00:08:28,440 Now all of a sudden, 253 00:08:28,769 --> 00:08:30,619 she's letting herself explore 254 00:08:31,029 --> 00:08:32,219 ideal versus actual. 255 00:08:33,450 --> 00:08:36,239 She's becoming more of what was prohibited. 256 00:08:36,580 --> 00:08:38,250 She wouldn't let anyone at the daycare 257 00:08:38,539 --> 00:08:39,840 misbehave or be messy. 258 00:08:40,049 --> 00:08:42,080 Now she's misbehaving and being messy. 259 00:08:42,659 --> 00:08:44,200 That's a reduction in anxiety. 260 00:08:44,450 --> 00:08:46,000 That is ideal versus actual. 261 00:08:46,210 --> 00:08:48,559 That is testing the water of what does it feel 262 00:08:48,559 --> 00:08:51,010 like to do the thing that would be most forbidden 263 00:08:51,330 --> 00:08:53,479 to a highly anxious people pleasing child. 264 00:08:53,859 --> 00:08:55,119 It's overwhelming. 265 00:08:55,690 --> 00:08:56,690 All of a sudden she's like, 266 00:08:56,799 --> 00:08:56,919 wow, 267 00:08:57,169 --> 00:08:58,099 I can't handle this. 268 00:08:58,130 --> 00:08:59,229 This is too much. 269 00:08:59,609 --> 00:09:00,599 I have other things to do. 270 00:09:00,650 --> 00:09:01,719 I'm not gonna come back. 271 00:09:03,020 --> 00:09:03,460 All right, 272 00:09:03,659 --> 00:09:05,280 another form of resistance. 273 00:09:05,739 --> 00:09:06,489 We can see it. 274 00:09:06,739 --> 00:09:07,809 Keep in mind, 275 00:09:08,289 --> 00:09:10,969 resistance comes at every phase. 276 00:09:11,340 --> 00:09:13,280 Resistance is its own phase, 277 00:09:13,739 --> 00:09:17,349 but resistance can be witnessed in the initiation phase. 278 00:09:17,419 --> 00:09:20,020 It can be resistance in the work phase. 279 00:09:20,059 --> 00:09:22,109 It can be resistance in the termination phase. 280 00:09:22,780 --> 00:09:24,859 And then we have the actual resistance phase. 281 00:09:26,010 --> 00:09:28,929 We understand that it is its own separate entity, 282 00:09:29,049 --> 00:09:32,080 but it's also evident in all of the phases. 283 00:09:33,010 --> 00:09:34,789 So I think that's what's going on there. 284 00:09:34,890 --> 00:09:37,210 And then she makes a mess in the room. 285 00:09:37,820 --> 00:09:38,229 OK, 286 00:09:38,460 --> 00:09:40,299 she literally said that the kids weren't allowed to 287 00:09:40,299 --> 00:09:42,460 be messy and then she makes a mess. 288 00:09:42,700 --> 00:09:45,580 You can see how that would absolutely unnerve her. 289 00:09:45,780 --> 00:09:47,299 It would completely catch her off guard. 290 00:09:47,460 --> 00:09:49,369 She would feel ill equipped to handle it. 291 00:09:49,859 --> 00:09:51,929 It's meaningful work that she needs to do, 292 00:09:52,059 --> 00:09:53,250 but it's scary to her. 293 00:09:53,859 --> 00:09:54,380 So she says, 294 00:09:54,500 --> 00:09:54,580 no, 295 00:09:54,700 --> 00:09:55,250 never mind, 296 00:09:55,380 --> 00:09:56,409 I don't want to come anymore. 297 00:09:58,469 --> 00:09:58,700 Child, 298 00:09:58,710 --> 00:09:59,619 you mentioned at the end, 299 00:09:59,830 --> 00:10:02,070 he doesn't want to come to thera therapy anymore either. 300 00:10:02,229 --> 00:10:04,219 He's been doing lots of process and play. 301 00:10:04,549 --> 00:10:05,679 It's resistance. 302 00:10:06,070 --> 00:10:07,780 He feels scared and look, 303 00:10:07,869 --> 00:10:09,619 many kids will avoid. 304 00:10:10,109 --> 00:10:12,739 Avoidant behavior is very consistent with resistance. 305 00:10:13,669 --> 00:10:14,669 If I just don't come anymore, 306 00:10:14,710 --> 00:10:15,700 I don't have to deal with this. 307 00:10:16,869 --> 00:10:17,239 So, 308 00:10:17,250 --> 00:10:17,450 Orla, 309 00:10:17,530 --> 00:10:18,849 let me go back to your question. 310 00:10:18,890 --> 00:10:20,799 Do we trust the child's sense of when they're done? 311 00:10:20,929 --> 00:10:21,400 No. 312 00:10:22,130 --> 00:10:24,530 Because often a child is going to say that they don't 313 00:10:24,530 --> 00:10:26,559 want to come right when they need to come the most. 314 00:10:27,400 --> 00:10:27,760 Now, 315 00:10:27,950 --> 00:10:29,159 toward the end of treatment, 316 00:10:29,210 --> 00:10:32,169 when a child has actually done the work that they need to do and 317 00:10:32,169 --> 00:10:35,280 they have processed most of all of the stuff that they came in for, 318 00:10:35,489 --> 00:10:38,119 they'll start to not really know what they're supposed to be doing. 319 00:10:38,289 --> 00:10:39,359 They'll say things like, 320 00:10:39,489 --> 00:10:40,669 I don't know what to do. 321 00:10:41,010 --> 00:10:42,090 It's kind of boring. 322 00:10:42,130 --> 00:10:42,880 I don't really know. 323 00:10:42,950 --> 00:10:43,270 I'm, 324 00:10:43,409 --> 00:10:44,210 I'm kind of bored. 325 00:10:44,250 --> 00:10:45,880 I don't know what I'm supposed to do today. 326 00:10:46,289 --> 00:10:48,559 You can tell they don't have pressing work. 327 00:10:48,849 --> 00:10:50,000 So at that point, 328 00:10:50,250 --> 00:10:52,559 we could trust their assessment that they don't really know 329 00:10:52,559 --> 00:10:54,809 that they have anything that they're supposed to be addressing. 330 00:10:55,669 --> 00:10:57,419 We would listen at that stage, 331 00:10:57,789 --> 00:10:59,349 but 6 sessions in, 332 00:10:59,359 --> 00:11:00,580 12 sessions in, 333 00:11:00,789 --> 00:11:03,020 it's highly unlikely that kids are done, 334 00:11:03,030 --> 00:11:05,460 and that tracks with the resistance phase 335 00:11:05,909 --> 00:11:07,820 and the avoidance and the hesitancy 336 00:11:08,109 --> 00:11:10,659 more than it does the child has actually worked through everything. 337 00:11:11,270 --> 00:11:14,659 So then what do you do to advise parents? 338 00:11:15,429 --> 00:11:18,260 You have to set expectation that the average is 30 to 40 weeks, 339 00:11:18,270 --> 00:11:18,929 first of all. 340 00:11:19,309 --> 00:11:19,830 Second of all, 341 00:11:19,909 --> 00:11:23,179 you have to set the expectation that you're going to commit to 5 at a time. 342 00:11:23,909 --> 00:11:26,080 So they're not committing to 30 or 40, 343 00:11:26,140 --> 00:11:29,369 they're committing to 5 at a time because every 5 sessions with the child, 344 00:11:29,419 --> 00:11:30,780 you're going to meet with the parents 345 00:11:31,059 --> 00:11:32,549 for their 5-week consult. 346 00:11:33,140 --> 00:11:34,409 And at that 5 week, 347 00:11:34,539 --> 00:11:36,010 if they're really pleased, 348 00:11:36,489 --> 00:11:38,130 we chalk that up as a win, 349 00:11:38,260 --> 00:11:42,049 but then we share all the meaningful work that's happening in the playroom 350 00:11:42,049 --> 00:11:44,929 and therefore we know that we're not ready to wrap up yet. 351 00:11:45,380 --> 00:11:48,270 I'm celebrating with you and I'm so thrilled to hear 352 00:11:48,419 --> 00:11:49,539 that things have gotten better. 353 00:11:49,619 --> 00:11:51,059 That's always what we're hoping for, 354 00:11:51,099 --> 00:11:52,450 that you will see the progress. 355 00:11:52,700 --> 00:11:53,539 And they are right. 356 00:11:53,695 --> 00:11:54,744 In the middle of deep work, 357 00:11:54,835 --> 00:11:57,625 so we're obviously going to need to do another round of 5, 358 00:11:57,994 --> 00:12:00,224 and then we'll re-evaluate in 5 weeks 359 00:12:00,474 --> 00:12:03,465 if we need to do 5 more or if we're ready to wrap up. 360 00:12:03,674 --> 00:12:06,025 If you can chunk it into sets of 5, 361 00:12:06,354 --> 00:12:11,065 it seems more manageable for parents and it seems like there's a constraint of time. 362 00:12:11,594 --> 00:12:14,905 So I'm committing to 5 and then we will reassess. 363 00:12:15,450 --> 00:12:18,280 So that's a really helpful way to handle that and keep in mind, 364 00:12:18,320 --> 00:12:20,400 I've talked about this in earlier podcast episodes, 365 00:12:20,479 --> 00:12:22,349 but I know there's always new listeners. 366 00:12:22,640 --> 00:12:23,320 So if you're new, 367 00:12:23,359 --> 00:12:23,700 welcome, 368 00:12:23,719 --> 00:12:24,859 I'm really glad you're here. 369 00:12:25,520 --> 00:12:28,200 There are 4 questions that we ask ourselves to determine 370 00:12:28,200 --> 00:12:31,429 whether or not a child is ready to terminate, 371 00:12:31,719 --> 00:12:32,429 and that is, 372 00:12:32,599 --> 00:12:37,119 have all of the presenting concerns and issues either reduced or resolved? 373 00:12:37,609 --> 00:12:40,390 Is the child regulated across all environments? 374 00:12:40,919 --> 00:12:42,880 Are no new themes emerging in play? 375 00:12:43,340 --> 00:12:45,400 And are any persistent themes, 376 00:12:45,650 --> 00:12:47,690 there's no changes within those themes. 377 00:12:48,580 --> 00:12:49,330 And so Orla, 378 00:12:49,409 --> 00:12:50,380 based on the 379 00:12:50,690 --> 00:12:52,119 cases that you described, 380 00:12:52,690 --> 00:12:55,010 they did not meet criteria for termination. 381 00:12:55,090 --> 00:12:57,080 So that's another thing you can share with parents, 382 00:12:57,330 --> 00:12:57,760 that 383 00:12:58,049 --> 00:13:02,210 you have a set of questions that you are able to implement 384 00:13:02,570 --> 00:13:04,609 in your consideration of termination. 385 00:13:05,280 --> 00:13:05,559 There's, 386 00:13:05,650 --> 00:13:08,700 there's no like magic thing where it's just like we just 387 00:13:09,119 --> 00:13:11,250 see pixie dust fly through the air and we're like, 388 00:13:11,320 --> 00:13:11,559 OK, 389 00:13:11,679 --> 00:13:12,469 child's done. 390 00:13:12,760 --> 00:13:14,469 There's something that we're measuring. 391 00:13:14,840 --> 00:13:17,989 We're obviously going to see evidence of the four universal outcomes. 392 00:13:18,119 --> 00:13:20,750 We're obviously going to see evidence of 393 00:13:21,039 --> 00:13:23,039 changes over the course of time, 394 00:13:23,320 --> 00:13:26,239 but there are 4 actual termination criteria. 395 00:13:26,799 --> 00:13:28,919 So unless all 4 of those are met, 396 00:13:29,179 --> 00:13:31,289 we have clinical justification 397 00:13:31,539 --> 00:13:32,940 for continuing with a child, 398 00:13:32,979 --> 00:13:35,549 even if the child says they don't want to come anymore. 399 00:13:36,520 --> 00:13:39,349 So you also have to reassure parents that it's very normal 400 00:13:40,000 --> 00:13:40,929 that a child says they don't, 401 00:13:40,940 --> 00:13:41,719 they don't want to come. 402 00:13:42,479 --> 00:13:44,830 It's very normal that a child will resist. 403 00:13:45,049 --> 00:13:48,039 It's very normal that a child will try to avoid 404 00:13:48,289 --> 00:13:50,130 the work because it's hard. 405 00:13:50,450 --> 00:13:51,679 So we normalize that, 406 00:13:51,750 --> 00:13:52,849 we reassure them. 407 00:13:53,640 --> 00:13:56,400 And we help them to know that if they stop, 408 00:13:56,890 --> 00:13:58,070 that it's actually 409 00:13:58,609 --> 00:14:00,799 potentially damaging and dangerous for the child, 410 00:14:00,830 --> 00:14:03,039 because when they are right in the throes of work, 411 00:14:03,450 --> 00:14:05,650 and then their therapeutic alliance and the 412 00:14:05,659 --> 00:14:08,429 therapeutic environment and relationship are pulled away, 413 00:14:09,229 --> 00:14:10,419 They have nowhere 414 00:14:10,750 --> 00:14:12,020 and no one. 415 00:14:12,950 --> 00:14:15,020 With whom to process 416 00:14:15,349 --> 00:14:17,099 what they're trying to work through. 417 00:14:17,349 --> 00:14:21,429 So we also have to help parents understand the importance of remaining in 418 00:14:21,429 --> 00:14:24,179 therapy even if a child says that they don't want to come. 419 00:14:24,429 --> 00:14:27,380 And the most simple response for a parent is, 420 00:14:27,710 --> 00:14:27,840 well, 421 00:14:27,869 --> 00:14:30,419 you know that you get to choose what you do when we go. 422 00:14:30,710 --> 00:14:32,659 So we have an appointment with Orla 423 00:14:32,909 --> 00:14:34,219 on Wednesdays at 2. 424 00:14:34,969 --> 00:14:37,909 And we're gonna go to the appointment because we've committed that 425 00:14:37,909 --> 00:14:40,090 we're going to go see her every Wednesday at 2, 426 00:14:40,469 --> 00:14:42,260 but you know you're in charge once you're there, 427 00:14:42,309 --> 00:14:44,150 so you can choose to play or not to play. 428 00:14:45,359 --> 00:14:47,289 And so child still has control, 429 00:14:47,469 --> 00:14:49,299 child still has a measure of power, 430 00:14:49,630 --> 00:14:52,070 but the expectation is that they are going to go to 431 00:14:52,070 --> 00:14:54,979 the appointment and then they decide what that looks like. 432 00:14:55,510 --> 00:14:59,590 So there is a little bit of responsibility and power being returned to the child 433 00:14:59,830 --> 00:15:02,229 even when they're in resistance or avoidance. 434 00:15:03,159 --> 00:15:03,400 All right, 435 00:15:03,479 --> 00:15:03,799 Orla, 436 00:15:03,840 --> 00:15:05,030 thank you so much for the question. 437 00:15:05,080 --> 00:15:07,479 I hope that that is helpful for all of you because 438 00:15:07,770 --> 00:15:10,229 you know one of our challenges is definitely 439 00:15:10,520 --> 00:15:13,159 helping parents understand what's happening 440 00:15:13,440 --> 00:15:15,030 to normalize and reassure, 441 00:15:15,280 --> 00:15:17,150 and then also to 442 00:15:17,520 --> 00:15:19,190 make clinical decisions 443 00:15:19,440 --> 00:15:21,229 and they have to default to us. 444 00:15:21,400 --> 00:15:24,059 We have to be able to articulate and communicate 445 00:15:24,440 --> 00:15:27,119 the justification for the things that we're doing and the 446 00:15:27,119 --> 00:15:29,479 time frame and the phases and all of that. 447 00:15:29,760 --> 00:15:32,330 And so that's something that's really important to discuss and 448 00:15:32,330 --> 00:15:33,929 I'm really glad we were able to process that. 449 00:15:34,900 --> 00:15:37,690 Keep in mind that you can also use CPRT 450 00:15:38,219 --> 00:15:38,609 content 451 00:15:38,859 --> 00:15:41,450 for your psychoeducation when you meet with parents as well. 452 00:15:41,780 --> 00:15:45,219 So CPRT content becomes really valuable for your 453 00:15:45,219 --> 00:15:48,380 five week consults because you're able to educate parents 454 00:15:48,659 --> 00:15:50,369 with some of the CCPT skills. 455 00:15:50,659 --> 00:15:52,900 That's something else that you want to do as you're meeting with parents. 456 00:15:52,929 --> 00:15:54,780 It's not just to give them updates, 457 00:15:54,820 --> 00:15:56,799 it's also to provide them with resources, 458 00:15:56,900 --> 00:15:57,539 tips, 459 00:15:57,580 --> 00:15:58,409 strategies, 460 00:15:58,700 --> 00:15:59,340 skills, 461 00:15:59,460 --> 00:15:59,859 etc. 462 00:16:00,059 --> 00:16:01,090 and many of that 463 00:16:01,340 --> 00:16:03,820 can come from the CPRT curriculum. 464 00:16:04,429 --> 00:16:05,000 So just, 465 00:16:05,109 --> 00:16:05,280 you know, 466 00:16:05,429 --> 00:16:08,460 an FYI if you're on the fence about the CPRT program. 467 00:16:08,669 --> 00:16:08,869 Y'all, 468 00:16:08,989 --> 00:16:09,229 it's, 469 00:16:09,309 --> 00:16:11,630 it's so fantastic and it's not my curriculum, 470 00:16:11,669 --> 00:16:13,109 so I'm not taking credit for it. 471 00:16:13,210 --> 00:16:13,950 I didn't write it. 472 00:16:14,020 --> 00:16:14,390 Obviously, 473 00:16:14,469 --> 00:16:14,750 you know, 474 00:16:14,869 --> 00:16:16,419 Landreth and Bratton wrote it. 475 00:16:16,669 --> 00:16:17,500 It's just, 476 00:16:17,619 --> 00:16:18,190 it's 477 00:16:18,590 --> 00:16:22,309 going to make you so confident in your ability to work with parents. 478 00:16:22,659 --> 00:16:27,169 I've been doing this for 20 years and I have loved every single CPRT group 479 00:16:27,390 --> 00:16:29,140 or individual I have ever 480 00:16:29,460 --> 00:16:29,820 done. 481 00:16:29,989 --> 00:16:31,750 I've loved every second of it. 482 00:16:32,219 --> 00:16:34,130 If you like supporting parents, 483 00:16:34,219 --> 00:16:35,770 if you like working with parents, 484 00:16:35,900 --> 00:16:37,849 if you want a more comprehensive approach, 485 00:16:38,099 --> 00:16:39,119 CPRT is it. 486 00:16:39,179 --> 00:16:40,929 If you're all in on child-centered, 487 00:16:41,260 --> 00:16:43,460 CPRT is wholly aligned 488 00:16:43,700 --> 00:16:46,460 and it gives you everything you need to not only train parents 489 00:16:46,460 --> 00:16:49,210 but also psychoeducate them if you're working with their children. 490 00:16:49,900 --> 00:16:50,380 So 491 00:16:50,659 --> 00:16:51,750 not because of me, 492 00:16:51,820 --> 00:16:52,460 it's awesome. 493 00:16:52,539 --> 00:16:55,380 This curriculum is well worth your time and investment. 494 00:16:55,500 --> 00:16:56,059 It truly is, 495 00:16:56,140 --> 00:16:57,299 and you get CEUs. 496 00:16:57,500 --> 00:16:59,599 So often CPRT training 497 00:16:59,859 --> 00:17:00,539 is just that, 498 00:17:00,580 --> 00:17:01,289 it's training. 499 00:17:01,419 --> 00:17:03,250 You're gonna get hours for this as well. 500 00:17:03,380 --> 00:17:03,729 So 501 00:17:04,300 --> 00:17:05,209 if you're interested, 502 00:17:05,380 --> 00:17:10,280 please make sure you save the money "CPRT100" until the 17th of July. 503 00:17:10,540 --> 00:17:10,900 All right y'all, 504 00:17:11,030 --> 00:17:11,510 I love you. 505 00:17:11,618 --> 00:17:12,219 Have a great week. 506 00:17:12,459 --> 00:17:12,660 Bye. 507 00:17:13,689 --> 00:17:16,550 Thank you for listening to the Play Therapy Podcast with Dr. 508 00:17:16,709 --> 00:17:17,630 Brenna Hicks. 509 00:17:17,790 --> 00:17:19,750 For more episodes and resources, 510 00:17:19,868 --> 00:17:24,630 please go to www.playtherapypodcast.com.