School-based violence, community violence associated with gang activity, natural and human-made disasters, terrorism, and other forms of acute or chronic trauma affect a significant number of children every year (Green, 2012). Exposure to traumatic events during childhood often leads to maladjustment that disrupts the typical maturation process. These children display iterations of trauma-related symptoms including dysphoria, hyperarousal, extreme sensitivity, interpersonal discord, and ostensible changes in healthy eating and/or sleeping habits. Play therapy is a potentially beneficial mental health treatment modality for traumatized children that is (a) developmentally-sensitive; (b) facilitates emotional safety by utilizing less threatening forms of communication than the standard “talking cure,” (c) engenders positive self-worth through creative self-expression, (d) fosters self-efficacy in collaborative problem solving; and (e) derives healing from the nonjudgmental, therapeutic relationship.
For some children and adolescents, writing about aberrant thoughts and feelings surrounding a potentially traumatic experience and then depicting them symbolically through play-based media like sandplay and abstract artwork is less threatening than expressing the information verbally and may assist with integration. Prominent trauma researchers van der Kolk and d’Andrea (2010) state that simply talking about traumatic experiences does not necessarily assist the mind and brain to integrate the dissociated images and cognitions into a cohesive whole so healing may activate. Through creative play-based therapy sessions, like those that incorporate the coloring of mandalas, children and clinicians may engage in co-participating activities that further the child’s trust in others and increase the opportunities for post-traumatic integration to occur.
A play-based integration materializes when clinicians incorporate play media to assist children in focusing attention on their internal experience while introducing cognitive, affective, and sensorimotor elements of their trauma. Play-based media, combined with tenets espoused and articulated through evidence-based approaches in Cognitive Bevahioral Therapy, may assist children in paying closer attention to their internal sensations and perceptions. Some of these integrative interventions may include (a) a sand tray and sand miniatures where children create pictures in the sand and share glimpses of their internal state symbolically, (b) the use of acrylic art with canvasses on an easel to produce abstract imagery; and (c) individually constructed multi-colored sand mandalas or coloring pre-drawn mandalas on paper using pencils and markers. Play therapists may facilitate family sandplay, an expressive art therapy intervention involving families co-constructing sand pictures in silence with sand miniatures. Afterward, the caretakers along with their children/adolescent(s) create a unified narrative from the symbols depicted in the sand story. The therapeutic relationship remains the most salient curative factor throughout the treatment process because it allows the play therapist to model trust, empathy, and unconditional acceptance.
The Johns Hopkins 3rd Annual Play Therapy Institute (July 12-13, 2013) seeks to address interventions related to recent outbursts of school-based violence and aggression affecting children’s mental health, including the mass shooting at Sandy Hook Elementary in Newtown, Connecticut. Play Therapy integrated with Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) will be covered through the series of goal-oriented trauma phases, while maintaining a focus on child safety, environmental and systemic contexts, and shoring up protective processes. Day 2 of the event will provide the overview of Jungian Sandplay Therapy, including advanced interventions specific to children and families affected by violence in schools.
Green, E. J. (2012). Facilitating resiliency in traumatized adolescents: Integrating play therapy with evidence-based interventions. Play Therapy, 6(3), 10-15.
van der Kolk, B., & d’Andrea, W. (2010).Towards a developmental trauma disorder diagnosis for childhood interpersonal trauma. In R. A. Lanius, E. Vermetten, & C. Pain, (Eds.), Impact of early life trauma on health and disease (pp.57-68). Cambridge: Cambridge University Press.
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