A Handbook of Play Therapy with Aggressive Children

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Jason Aronson, 2005 - Medical - 337 pages
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Written by two authors with a combined experience of more than fifty years in the residential treatment of severely aggressive-and often traumatized-children, this book has proven invaluable to new as well as seasoned child practitioners. The chapters cover the nuts and bolts of play therapy with this extremely challenging clinical population, including the therapeutic alliance, aims of play therapy with aggressive children, setting limits on destructive and obtrusive behaviors, typical play themes of aggressive children, and developing distancing and displacement through playful action and through teaching, modeling, and structuring action play. Other chapters cover such topics as: how to create more mature defenses and calming strategies; the role of interpretation; the use of spontaneous drawings as a bridge to fantasy play; specific drawing techniques to create access to the inner world of children; how to teach and model pro-social skills and the language of feeling; and how to facilitate affect expression and modulation, contained reenactment of trauma, and children's ability to mourn tangible as well as intangible, unacknowledged and invisible losses. Later chapters cover the therapeutic process and techniques to facilitate termination. The authors introduce the Play Therapy Decision Grid, which is intended to guide the therapist into the levels of therapy best suited for the child at any given point based on the child's resources and the anxiety engendered by the therapy.
 

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Contents

Play Therapy the Childs Expectations and Psychodynamics and the Therapeutic Alliance
1
PLAY THERAPY
2
THE CONTRIBUTION OF PLAY THERAPY
4
EFFORTS TO FACILITATE VERBALIZATION IN PLAY THERAPY
5
THE PSYCHODYNAMICS OF GORILLASUIT WEARERS
6
THE THERAPEUTIC ALLIANCE
10
CHILDREN IN GORILLA SUITS
12
THREE EFFORTS THAT AID IN THE FORMATION OF THE ALLIANCE
13
WORDING THE INTERPRETATION
152
CONCLUSION
155
Making Interpretations Advanced Concepts
156
Interpretation and Response
157
Working Through
158
Insight
159
GENERALIZATION EXTERNALIZATION AND PROTECTIVE IDENTIFICATION
160
TRANSFERENCE INTERPRETATIONS
163

Convey Profound Respect
15
SIGNS OF A DEVELOPING ALLIANCE
16
A CASE EXAMPLE
18
Aims of Play Therapy with Fawns in Gorilla Suits
21
INCREASED CAPACITY FOR SOUND JUDGMENT MAKING
22
CLARIFYING INTENTION AND MOTIVATION
26
REDUCTION OF EXCESSIVE AND UNREALISTIC SELFPREOCCUPATION AND INCREASED UNDERSTANDING OF SELF
27
DEVELOPING NEW PERSPECTIVES
30
INCREASED UNDERSTANDING OF THE WORLD OF FEELINGS
31
INCREASED UNDERSTANDING OF CHOICES AND CONSEQUENCES
32
FORTIFICATION OF WEAK DEFENSES AND EASING OF RIGID DEFENSES
33
FACILITATING A VISION OF A MORE HOPEFUL FUTURE
34
Setting Limits on Destructive and Controlling Behaviors
36
LIMIT DESTRUCTIVE BEHAVIORS
37
LIMIT CONTROLLING BEHAVIORS
42
LIMIT PHYSICAL INVOLVEMENT
45
WHAT LIMITS ACHIEVE
48
Setting Limits on Other Obtrusive Behavior
49
LIMIT SEDUCTIVENESS
50
LIMIT PROJECTIONS
51
LIMIT DILUTION OF THE THERAPY RELATIONSHIP
52
LIMIT UNDISCIPLINED BEHAVIOR OUTSIDE THERAPY
53
LIMIT COMPARISONS WITH OTHER THERAPISTS
55
LIMITING PERSEVERATION
56
LIMITING INSTITUTIONAL PRACTICES THAT DISTRACT FROM THE TOTAL TREATMENT PROGRAM
57
LIMITS ARE NOT FOREVER
58
LIMITS SET IN LATER PHASES OF THERAPY
59
Limit Adoption Fantasies
60
A Decision Grid for Play Therapy
62
THE INVITATIONAL APPROACH
65
THE COPING APPROACH
70
DIFFERENTIAL DECISION MAKING
75
THERAPEUTIC EXPECTATIONS
77
ORIENTATION TO A POSITIVE FUTURE
78
Typical Play Themes of Fawns in Gorilla Suits
79
THREAT
81
ABANDONMENT AND REJECTION
82
SEPARATION AND LOSS
84
THE NEED FOR PUNISHMENT
85
DEPRIVATION
86
NEED FOR NURTURANCE
88
CARING FOR THE WOUNDED AND FIXING BROKEN THINGS
89
Developing Distancing and Displacement through Playful Actions
91
CLAY
93
HARMLESS DESTRUCTION
94
REAMING THEM OUT
95
THE MAD GAME
96
HAVING A FIELD DAY WITH MAGIC MARKERS
97
DRAWING STRATEGIES
98
Volcano Pictures
99
Storm Pictures
103
Anger Thermometer
105
ENCOURAGING COMMUNICATION OF VIOLENT FANTASIES
107
CONCLUSION
109
Developing Displacement and Distancing by Teaching Modeling and Structuring Action Play
111
GETTING AT PREVERBAL CONCEPTS
115
DEVELOPMENT OF DISPLACEMENT AND DISTANCING
117
PLAYROOM TOYS
121
The Fair Trial
123
Rage toward Others and toward Victims
124
Creating More Mature Defenses and Calming Strategies
126
DEVELOPING AND SUPPORTING DEFENSES
127
Splitting
128
Binding and Compartmentalization
129
Dissociation
131
DEVELOPMENT OF THE MORE MATURE DEFENSES
132
ENCOURAGING SUBLIMATION AND REACTION FORMATION
134
CALMING ACTIVITIES
135
REWARDING MATURE DEFENSES
138
WHEN TO BEGIN TO INTERPRET DEFENSES
139
The Role of Interpretation Elementary Concepts
141
EMPATHETIC INTERPRETATIONS
143
DYNAMIC INTERPRETATIONS
144
PREPARATION
145
Reductive Statements
146
Situational Statements
147
INTERPRETATION OF DEFENSES
148
STEPBYSTEP PROGRESSION
150
INTERPRETATION WITHIN THE METAPHOR
151
INTERPRETATION OF WISHES
166
CONCLUSION
168
Windows into the Inner World Spontaneous Drawings as a Bridge to Fantasy Play
169
Windows into the Inner World Specific Drawing Techniques
176
BOAT IN THE STORM
177
I
181
II
185
A SAFE PLACE
187
III
191
IV
194
YOUR PLACE
196
DRAW THE PROBLEM
198
V
202
VI
203
BECOMING MORE LIKABLE
205
VII
209
VIII
213
EMPATHY FOR THE HEALER
215
IX
216
X
219
GINGERBREAD PERSONFEELINGS MAP
221
XI
227
XII
228
FEELINGS CHARADES
229
EMPOWERMENT PLAY
231
XIII
232
A CAUTIONARY NOTE ABOUT TIMING AND PACING
234
XIV
235
Facilitating Contained Reenactment of Trauma
236
WHY UNDERTAKE TRAUMA WORK?
237
THE MEANING GIVEN TO THE EXPERIENCE
238
THE SILENT BOND
239
XV
243
XVI
244
XVII
250
ENACTMENT OF TRAUMA AS A RESULT OF UNPREDICTABLE TRIGGERING
252
XVIII
253
DYNAMIC FLEXIBILITY AND TITRATING THE APPROACH
254
Helping Children to Mourn Tangible Losses
255
CHILDREN GRIEVE IN STEPS
256
XIX
259
XX
260
DRAMATIC PLAY AND TANGIBLE LOSSES
261
STRUCTURED ACTIVITIES TO HELP EXPRESS TANGIBLE LOSSES
262
Poems Songs and Journal Writing
263
Family Therapy Sessions
265
XXI
268
Conflicted Relationships and Loss
270
XXII
271
Divorce and Loss
273
Finding New Meaning and Shaping a Narrative Memory
275
XXIII
276
XXIV
279
XXV
280
Selected Video Clips
281
CONCLUSION
282
The Process
283
ANXIETY MANAGEMENT
284
Sessions 2 and 3
285
Violent Play and Identification with the Aggressor
287
XXVI
288
XXVII
291
XXVIII
294
XXIX
295
The Reemergence of Anger and Chaos
296
The Struggle with Confusing Parental Ties
297
XXX
300
XXXI
301
THE PROCESS OF ENDING THERAPY
302
PRIOR LOSSES REVISITED
303
REHEARSALS FOR ENDING
304
SPECIFIC TECHNIQUES FOR PREPARING THE CHILD FOR TERMINATION
305
The Talk Show Interview
306
Jose and Pete on the Mountain
307
THE COUNTDOWN TO TERMINATION
308
XXXII
313
XXXIII
325
XXXIV
335
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About the author (2005)

David A. Crenshaw, Ph.D. ABPP, is the Founding Director of Rhinebeck Child and Family Center, LLC in Rhinebeck, New York. He is Board Certified in Clinical Psychology and a Registered Play Therapist Supervisor. He is the author of Bereavement (now in its third printing), A Guidebook for Engaging Resistant Children in Therapy: A Projective Drawing and Storytelling Series, Evocative Strategies in Child and Adolescent Psychotherapy and a forthcoming book, Healing Paths to a Child's Soul. John B. Mordock, Ph.D., ABPP, was employed by the Astor Home for Children for 28 years. In his last position, he directed the agencyOs community mental health programs, helping to develop a full continuum of services for emotionally disturbed children and their families. He is the author of twelve books, including a textbook on exceptional children.