The primary theory of play therapy we utilize with children and their families is Mindfulness-Based Play Family Therapy (MBPFT) developed by Dottie Higgins-Klein at the Family and Play Therapy Center in Philadelphia, PA. MBPFT is based on the premise that a child’s current situation entering treatment is a result of his/her experience of life to the present time. A four-segment evaluation is included in MBPFT which allows the identification of where in a child’s developmental past growth and development may have been disrupted which relates to present problems and concerns. Treatment is based on “an understanding of how essential needs that were unmet earlier may be revisited and satisfied well enough to re-establish true developmental balance” (Higgins-Klein, 2013).

According to the MBPFT model, the four-segment evaluation consists of four sessions: the first with parents alone to complete the intake and gather a full developmental history on the child; the second with the child and all members of the household which includes a group play activity; the third with the child and one parent to include the first non-directive play therapy session; the fourth with parents alone to gather family history. The four-segment evaluation is modified for children with separated/divorced parents or in foster care to accommodate separate sessions for separate households. Following the four-segment evaluation, recommendations are made but generally, treatment continues on a schedule of four play therapy sessions followed by a session with parents/caregivers alone for feedback and dialogue on the child’s progress.

Each weekly play therapy session for children ages 3-12 consists of one parent or caregiver and child together for the first 15 minutes for talk time to discuss what went well and what was problematic about the week, followed by 30 minutes of the child and therapist together in non-directive play therapy kept in the realm of pretend; it is generally recommended that parents take turns bringing the child to therapy. Non-directive play therapy, where children lead the play, provides children the space to revisit and rework painful issues at the root level as play is expressed in the safe distance of the pretend realm in the presence of a trained play therapist. Directive play therapy may also be used and occurs with the child and parent together in a specific play activity designed to address/alleviate symptoms, strengthen the parent-child bond and promote secure attachment.

Boszormenyi-Nagy is best known for developing the Contextual approach to family therapy and individual psychotherapy. Contextual family therapy is a way of look at families through the family history.  Your therapist will work with you by using a tool called a “genogram” which is taking a look at who is in your current family and the generation or two above you, examining both sides of the family tree.  We will discover together how your family history may be impacting or informing your own parenting, your relationships, and ways that you feel or think about yourself.  We look at the different aspects of your family and the historical facts that have affected you and your family. In particular to many of your needs, loyalty to the present or absent family member will be explored. These examinations may enable you to work through symptoms and problems at a deeper level through the course of treatment.

The contextual family therapist will look at each side of the story starting with yours but including the perspective of the different family members, both now and in the past.  Through understanding and holding everyone’s story, your therapist will help you try and establish fairness and honesty in your relationships and to help unload burdens that may be keeping your or your family stuck in repeated, unhealthy patterns.  Trust and forgiveness are a fundamental part of working with families and couples.  Your therapist will try to help you work on truly becoming who you see yourself as, not necessarily as others may see you.

Sometimes in individual therapy, both with children, adolescents and adults, there is a part of therapy that may ask the individual or couple to think about the way they think. This is a cognitive intervention that has been shown to be helpful in the treatment of depression and anxiety. Every thing we think isn’t always true. Sometimes are thinking can become our worst enemy. We can explore how your think drives the way you feel and then will sometimes affect how you act. Looking at thoughts and how they are self-defeating can help some people by coming up with new ways to think.

In conjunction with this type of therapy, it is important to add to that awareness, the ability to calm down all those thoughts and to become calm. Relaxation and mindfulness may also be a way that the therapist will work with you, your partner or your child to help you find more peace and calm.

Trauma-focused Cognitive Behavior Therapy
This is a therapy for children and adolescents who have experienced some type of trauma in their lives. This can include medical interventions, sexual and physical abuse, domestic violence, or some type of natural disaster, to name a few. This therapy uses playful techniques to help children understand their experiences and their thoughts and feelings. This therapy can be more directive than other types of play therapy. It can be one part of the child’s treatment and may include other types of treatment approaches.

Sandtray therapy, originally developed Margaret Lowenfeld and Dora Kalff, may be used with children, families, adults and couples through the course of treatment.  Sandtray therapy allows people to work through problems held in the unconscious, or out of a person’s awareness, and from the part of memory which is held by body and out of a person’s ability to express through words.  This therapy involves using a dry or moist tray of sand to create a picture, scene or story from a wide selection of miniatures which represent many different things found in the world including people, animals, things, nature and other symbols.  When used with children and some adults, the therapist invites the child/adult to create any picture, scene or story they wish.  Other times a therapist may use the sandtray by inviting adults, families, or couples to create something in the sand based on a specific concern or problem.  Sandtray therapy promotes brain integration, a healing through the connection of body, feeling and thought, in the presence of a trained therapist.  This therapy allows people to express problems through metaphor and symbol, enabling a deeper way to revisit and rework current or past trauma, problems and issues.

Theraplay is an active and playful family therapy used to enhance a healthy relationship between parents/caregivers and their children. This therapy focuses on four qualities found in parent-child relationships: Structure, Engagement, Nurture, and Challenge. Theraplay sessions use those qualities to develop an individualized set of activities catered around the unique needs of the child and parent. Through the use of the fun and hands on activities, children will begin to see themselves in a more positive self-view and experience a richer more rewarding parental relationship.

Theraplay works with many different types of behavior issues. Theraplay believes that the most important and powerful relationship a child has is with his or her parent. Therefore, this treatment modality uses play to improve that relationship so that the child develops greater self esteem and the parent also learns to understand behavior and the needs of their child in a different light.
Theraplay is currently being used with children of all ages who:
• Are sad, depressed, or withdrawn
• Overactive or aggressive
• Afraid of attaching due to adoption
• Have experienced trauma
• Have experienced medical trauma or chronic illness
Prior to beginning Theraplay the therapist will conduct an assessment called the Marschack Interaction Method (MIM). This assessment consists of activities for the parent and child to complete together which helps to identify strengths and areas of potential growth between the parent/caregiver and child. Assessments are video taped and reviewed with the adult(s) at the following appointment.
Therefore, permission for video recording is required for this intervention. Further information will provided for the parent at parent sessions.

What to expect during therapy

Therapy will be different for each individual and based on the unique needs of the presenting problems or situations. Therapy may be short-term and solution-focused for acute needs. Individuals or families with more extensive needs will be invited to engage in more intensive sessions to better achieve their specific goals.