Play Therapy
The use of play in therapy was first elucidated by the pioneers of child psychotherapy. Anna Freud (1928, 1946, and 1964), Margaret Lowenfeld (1935, 1970) and Melanie Klein (1961) postulated the theoretical premise for the use of play. Klein stipulated that a child’s spontaneous play was a substitute for the free association used within adult psychoanalysis. By 1935, Lowenfeld published her theoretical ideas on play entitled, “Play in Childhood,” still considered a classic text on the subject. Lowenfeld saw in her unique therapy technique that play is a cognitive process which gives the therapist access to the ways in which children think.
Axline (1969, 1971) devised a clear and succinct Play Therapy theory and method. Her account of how she worked with a young boy called Dibs is well known (Axline, 1964). Axline described in great detail how she worked with Dibs and how he was able to heal himself over a period of time. She said, “No one ever knows as much about a human being’s inner world as the individual himself. Responsible freedom grows and develops from inside the person” (Ray, Bratton, Rhine, and Jones, 2001, p.85).
Her eight principles of the therapeutic relationship inform the work of many Play Therapists (Ray, D., Bratton, S., Rhine, T., and Jones, L., 2001).
2. The therapist accepts the child exactly as she is.
3. The therapist establishes a feeling of permissiveness in the relationship so that the child feels free to express feelings completely.
4. The therapist is alert to recognize the feelings the child is expressing and reflects those feelings back in a manner that gives the child an insight into her behavior.
5. The therapist maintains a deep respect for the child's ability to solve problems if given the opportunity. The responsibility to make changes and institute change is the child's.
6. The therapist does not attempt to direct the child's actions or conversations in any manner: the child leads the way; the therapist follows.
7. The therapist does not attempt to hurry the therapy along. It is a gradual process, recognized as such by the therapist.
8. The therapist establishes only those limitations necessary to anchor the therapy to the world of reality and to make the child aware of her responsibility in the relationship (p.85-102).
In spite of the different ages of subjects, these guidelines became a good source to use with dementia patients for this study. Using these points, the AMSS study could investigate the relationship between the clinical art therapist, as a researcher, and the patients who feel vulnerable when facing their diseases.
According to the Play Therapy Organization, (www.playtherapy.org, rev. 2000) Play Therapy emphasizes an environment of trust with the patient. Play Therapy is based upon three critical theoretical principles:
Actualization - Humans are motivated by an innate tendency to develop constructive and healthy capacities. This tendency is to actualize each person’s inner potentials, including aspects of creativity, curiosity and the desire to become more effective and autonomous.
The Need for Positive Regard - All people require warmth, respect and acceptance from others, especially from ‘significant others.’ As children grow and develop, this need for positive regard transforms into a secondary, learned need for positive self regard.
Play as Communication - Children use play as their primary medium of communication. Play is a format for transmitting children’s emotions, thoughts, values and perceptions. It is a medium that is primarily creative (www.playtherapy.org, 2007).
For over 50 years, Play Therapy was led by many Play Therapists, including Moustakas’ Children in Play Therapy (1953, 1974) and Schaefer (1976, 1986, 1993), who have further developed Axline’s original formulations and devised differing models integrating elements of systemic family therapy, narrative therapy, solution focused therapy and cognitive behavioral therapy.
