“Psychological trauma in children
is “the mental result of one sudden, external blow or a series of blows
rendering the young person temporarily helpless and breaking past ordinary
coping and defensive operations.” (Ogawa,
20) When looking at kids that have
been traumatized there seems to be a Type I child and a Type II child. “A
Type I trauma is a single, sudden, unexpected, relatively time limited, and
public stressor such as a natural disaster or school shooting; and Type II
trauma refers to a stressor resulting from a long standing ordeal, such as
repeated abuse.” (Ogawa, 20) Often times these children go unnoticed
because the people in their lives aren’t aware of the struggles they are facing
because children don’t verbalize them. However there is help for these
children, one way of helping these children is through interacting with and by
observing their play.
Play is very
important in children’s everyday lives and is a child’s most natural form of
communication. It is even more important for a child who has been involved
in a traumatic event for them to work through what they are thinking and
feeling through play. Children are not able to express
themselves verbally as well as adults do, they tend to express their emotions,
feelings, and ideas through their actions. Play helps children make meaning of the
events in their lives and can help them cope. Play can also help children deal with stress when it is done
in a therapeutic way. Play
provides a way for adults to connect with kids and to bridge the space that may
be standing between a child and an adult.
Play helps to reveal what children are struggling with especially with
children who have been through traumatic events in their lives.
Children can work through these events with toys such as dolls, puppets,
board games, blocks, sand play, and many more.
Play can help
these children who have experienced trauma in many ways. It can help the
children to develop coping skills and build confidence. Play gives children a feeling of power and control and allows
them to work through their problems in their play in their own way.
Children that would benefit from Play Therapy are children that have
experienced a death of a family member, pet, or friend; Abuse (verbal, physical
or sexual); a loss such as a friend moving away; Divorce, or a natural or human
disaster. In each individual case the nature of the experience will
affect the healing process differently for each child. For example when
my father died my sister was five and she stayed at the hospital until he died.
If you were to compare her to my brothers who went home before he died,
it is evident that she is the one that was effected greater by it because she
was actually there when he died which was more traumatic than just being told
that he died. Through a child’s play we can learn a lot about the internal
struggles a child is experiencing. “The horrific images that are shown
through the child’s play, drawings or sand tray creations have a profound
affect.” (Drewes, 10) The
child’s play can piece together the story of the event. Sometimes the
story the child is putting together is completely different from what actually
happened. However when this happens it is because the child is
confused by some aspect of the event and is trying to make meaning of it in
their own way so that they can understand the situation. At this point in
time in a therapy session a therapist or parent could step in and try to help
the child grasp a better understanding of the actual events.
I feel that it is important for the children to know the true facts
regarding the traumatic event because this can sometimes make it less scary and
the child can make meaning out of the situation. Our goal as adults is to do whatever we
can to alleviate the stress the children may be experiencing after these
traumatic situations that life deals them.
There are many different types of
therapy that children can participate in, one is play therapy and another is
filial therapy. Play therapy is a way for children to express their
experiences and feelings through a natural, self-guided, self-healing process.
In play therapy children don’t have to sit and explain anything to the
therapist, everything the therapist needs to know about the child is determined
through play. “In play therapy the therapist plays with the child in
sessions and the parent is not normally present unless the child won’t separate
from the parent. The sessions typically last about an
hour. The therapist discusses the child’s progress with the
parents in review meetings around 5-6 weeks from the start.
Parents do not know exactly what the child does or says in therapy
because the therapist has a “privacy contract” with the child.”
(Rye, 180)
Filial Therapy is an extension of
play therapy that emphasizes a structured training program for parents in which
they learn how to implement child-centered play sessions in the home.
In Filial Therapy it can have an effect on the whole family.
“Filial Therapy can help parents or caregivers help children who have experienced
difficulties such as trauma and abuse, or who for other reasons have problems
with behavior, relationships and mental health.”
(Rye, 179) Parents can use filial
therapy for as long as they want some use it for months others use it for years.
Compared to Play Therapy, Filial Therapy tends to differ slightly.
“In Filial Therapy the therapist does not play with the child in
sessions but observes as unobtrusively as possible and parents have sole
responsibility for the therapeutic play sessions. The play session usually last about a
half hour. The therapist then discusses the child’s progress with the
parent’s after every play session. Parents know exactly what happens in
play sessions and the therapist gives the parents feedback on how to enhance
the filial play in the next session.” (Rye,
180) This type of play allows the
therapist and parent to work together, interpret the play together and come up
with ideas on how to help the child. This can sometimes be a more effective
approach especially for a very family orientated family because it allows the
parent which is a very trusted person in the child’s life to help them.
It allows the child to be comfortable in their play and it will take
less time for the child to break down those barriers of trust that may have
been needed with a therapist. “Children aged 3-12 years who have
experienced difficulties such as trauma, abuse or who for other reasons have
problems with attachment, peer relationships, behavior and mental health
problems can all benefit.” (Rye, 181)
The effects of trauma on children
can play significant roles in their lives and drastically change a child. “Four
common responses of child victims of catastrophes are Flashbacks, Repetitive
Behavior, Trauma-Specific Fear, and limited future perspectives and
expectations.” (Ogawa, 21-22) Children dealing with a traumatic
experience can also demonstrate outbursts of anger, regression, excessive
anxiety, poor self esteem, a negative attitude and many fears.
Children who have experienced trauma often have relationship problems with
peers and family members, act out, and have problems with school performance.
There are also many psychiatric disorders that are commonly found in
children and adolescents such as depression, substance abuse, as well as
anxiety disorders such as separation anxiety, panic disorder, and generalized
anxiety. There are also externalizing disorders such as ADHD,
oppositional defiant disorder and conduct disorder that a traumatized child may
develop. Every person is born with fear, adding a traumatic event to
a child’s life just magnifies that built in fear that lies within each and
every human being.
Children will also sometimes
experience Post Traumatic Stress Disorder after experiencing a traumatic event. “There
are three factors that have been shown to increase the likelihood that children
will develop PTSD. These factors include the severity of
the traumatic event, the parental reaction to the traumatic event, and the
physical proximity to the traumatic event.”
(Hamblen, 2) Young children will
show little symptoms of PTSD but can still experience in ways such as
generalized fears, stranger or separation anxiety, avoidance of situations,
sleep disturbances, and preoccupation on words or symbols related to the trauma.
They may also regress and lose an acquired developmental skill such as
being potty trained or speech. With school age children they
experience “time skew” and “omen formation”. “Time skew refers to a child
missequencing trauma related events when recalling memory. Omen
formation is a belief that there were warning signs that predicted the trauma
and children believe that if they are alert enough they will recognize warning
signs and therefore avoid future traumas.”
(Hamblen, 2) School age children
seemed to be the ones that benefit the most from play because they reenact the
trauma in their play, drawings, or verbalizations. “Posttraumatic play is different from
reenactment in that posttraumatic play is a literal representation of the
trauma, involving compulsively repeating some aspect of the trauma and does not
tend to relieve anxiety.” (Hamblen,
3) In this case a therapist may
have to do more than play therapy with a child in order to help relieve that
anxiety. However in most cases Play Therapy will be helpful to a
child with Post Traumatic Stress Disorder.
Play has been
proven to be a positive intervention of therapy for children experiencing
traumatic events. Play allows a child to begin to break
down those walls and barriers that they have put up after the traumatic event they
have experienced and begin to work through them by themselves or with a trusted
adult. Through therapeutic relationships in play therapy children
may be able to reveal feelings that they may not be able to verbally state to
someone in their life. “The outcome of posttraumatic play
depends on several factors: (a) the amount of security and freedom a child
possesses in order to express inhibited feelings, (b) the degree of control a
child perceives, (c) how well cognitively reworking or the event is facilitated,
and (d) the child’s satisfaction with the ending of the play.
If these conditions are not met satisfactorily, the child may be
retraumatized or fixed on the trauma.”
(Ogawa, 24) As long as the therapy
is done in the correct way and is developmentally appropriate then children
will benefit from the therapy. The first step to helping children who
have been traumatized lies within the parents. The parents are the ones who need to
take the first step in recognizing that their children need help and then get
it for them. Many parents don’t want to bring up the subject of the
traumatic event because they fear they will upset them or they don’t think the
child understands. In most cases though, children want to
talk about the traumatic event that they have experienced and have many
questions, concerns and thoughts about the situation. As adults we need
to stop and consider the needs of the children in these traumatic situations
and put aside our own personal feelings about seeking help in order to best
serve the child’s needs. Despite our best efforts to protect and
minimize children’s exposure to trauma, it is something that is a reality of
our world that we must face and prepare ourselves and children for.
These findings will be used
further in my professional practice in many ways. As a teacher in the early childhood
field I am sure I will have at least one if not more children affected by
trauma. With the research that has been done on play therapy I would
be very willing to refer a parent or family to a play therapist.
This information will help me to further explain to a family that may be
looking for additional help that this is a great option for children.
Play therapy provides that outlet that kids need to express their
feelings about the traumatic event they have encountered. It also allows
them to get a firm grasp on the event and understand it with a trusted adult to
support them through the process. I will also be using these findings as
I begin to volunteer at a Bereavement Camp, Comfort Zone Camp, next summer.
After all the research I have done I know that when I step into that
camp next summer that I am truly making a positive impact in a child’s life in
just one weekend. At this particular camp they provide
kids the opportunity to play, share their experiences and to build trust and
friendships. I feel that
this research will even be able to help me with this experience at the
bereavement camp because I will be able to apply my knowledge of play therapy
with these children who have experienced the trauma of losing a parent,
caregiver or sibling.
It is important to remember that
often times the children aren’t the only ones that have experienced the
traumatic event. Most of the time the trauma is affecting
the whole family. If we can alleviate the stress of the
child it helps that family take one step closer to healing.
Play therapy can help these children and families heal and move on with
their lives. Play Therapy will help the children understand the event and
help to develop coping strategies to move on. No child should have to deal with a
traumatic event, and no child should have to go through it alone.
Play therapy can give children and families hope that they can move on
after such tragedy has shattered their world. I wish that I had known about this play
therapy when I lost my Dad in order to help my sister who struggled so much
after the loss of my dad. These play therapy sessions not only
help the children but the families as well, many parents say things such as “my
child hasn’t been the same since _______” or that “my child was changed from
their experiences with a play therapist”. Most importantly most parents feel that
play therapy can “give them back” their child. It is clear that these methods of play
therapy are working for children and their families. We should continue to promote this play
therapy and offer them to children who need them. Without play therapy many children may
not have the support system to deal with the traumatic events that they have
experienced. Many children may also fall into the statistics that
indicate children who have experienced a traumatic event are at a much greater
risk for depression, suicide, poverty and substance abuse.
If we can save a child from being a statistic by allowing them the
opportunity to work through their trauma using the power of play then it is
clear that play therapy is successful. Healing after a traumatic event is a
tough journey but children have to keep moving forward and ask for help, ask
for answers, and open up to people in their lives that are willing to help.
By doing so children are able to address their trauma and this will
lessen the complications they may have as they get older.
Bibliography
Articles & Pamphlets-
1.
Rye, N. (Oct
2008). Filial therapy for
enhancing relationships in families: Nina Rye
explains how filial therapy enables parents to play
therapeutically with children who have experienced trauma or other problems. Journal of Family Healthcare, 18, 5. p.179 (3). Retrieved November 09, 2009, from Academic
OneFile via Gale: http://find.galegroup.com/gtx/start.do?prodId=AONE&userGroupName=mlin_s_abingpl
2. Ogawa,
Y. (2004).
Childhood Trauma and Play Therapy Intervention for
Traumatized Children. Journal of Professional Counseling:
Practice, Theory & Research, 32(1), 19-29. Retrieved from Academic Search Premier Database.
3. Hamblen,
J., PH.D. (2003, May).
PTSD in Children and Adolescents [Pamphlet].
4. Drewes,
A.
“Clinical Lessons Learned from Trauma Survivors and Their Traumatic
Play.”
On-line at: www.a4pt.org/download.cfm?ID=22578
Books-
5. Brazelton,
T. B.,
M.D.,
Trozzi, M., & Massimini, K4. (1999).
Talking with Children
About Loss. New York, NY: The Berkley Publishing Group.
6. Alexander,
D. W.,
Ph.D.
(1999). Children Changed by Trauma. Oakland, CA: New
Harbinger Publications, Inc.
7. Monahon,
C. (1997).
Children and Trauma: A Guide for Parents and Professionals.
San Francisco: Jossey-Bass
Publishers. (Original work published
1993)
Video used in Presentation-
