The Blog
What is Theraplay®?
Key Takeaways:
- Theraplay® is a structured attachment-focused therapy model that utilizes play for optimal learning
- Theraplay® can support families with a range of issues including but not limited to attachment concerns, acting out, neurodivergence, and anxiety.
- Theraplay® is a fun and easy way to boost your relationship and support your child with coping.
Peanutbutterrrrrrrr!!!” shouts a little girl, …… Jellllyyyyyyy chants the mom, trying to say it just the way her child did. They try again… “Pea-nut-butt-ah Jel-ll-ll-YY,” Their faces move closer together, and the child leans in and whispers in her funniest voice. “PEE-NUT Butt-AH”
The room erupts in laughter! She turns to her father and shouts, “PEanUT ButTER!!” in the funniest voice she can muster. The father smiles and says. “JE-el-lly.” Now the mother offers her “peanut butter” and the child follows her lead. This continues, with funny faces and funny voices until everyone is out of breath with laughter.
You might not believe it, but up until recently this family was experiencing daily tantrums from their daughter and a profound feeling of disconnection. Laughter felt like a distant memory and bedtime was a nightmare.
They started therapy completely exasperated and ready to try anything. As they told their story I noted that the family had been through loss and trauma, and medical difficulties when the child was an infant, and as she grew older, she became quick to anger. What I heard in the story is that the child’s sense of safety and attachment to her parents had been disrupted by necessary medical treatments in early life. The moments after a child is born are a critical time to connect with a child and provide a sense of felt safety. Children who experience medical issues or attachment disruptions at this stage may have a harder time regulating their nervous system as they get older.
I had a sense that this family could really benefit from Theraplay®- an attachment based family play intervention. Theraplay® founders note.”Our model for treatment is based on attachment research that demonstrates that sensitive, responsive caregiving and playful interaction nourish a child’s brain, form positive internal representations of self and others, and have a lifelong impact on behavior and feelings. “
Theraplay® is a structured therapeutic model that supports parents and their children with attachment and bonding. The model was developed by Ann Jernberg in 1967 as a way to bolster the mental health of at-risk kids in the Head Start program in Chicago. Jernberg utilized observations gleaned from healthy parent-infant interaction, and created play-based structured games in order to strengthen and repair early life interventions and trauma. Jernenburg understood that mental health is built upon a firm foundation of healthy attachment to parents.
So how did it help this family?
As I watch the family play together so joyfully, I am tracking beautiful moments of shared attention: the child is looking into her parents’ eyes and for the first time in a while, following the parents’ directions. We are using playfulness and fun to reduce the child’s stress, keep her engaged, and shift her brain into a receptive learning mode. We are using touch and nurturance to provide felt safety. Through a series of comforting and simple connecting activities, we are able to restore a sense of security that the child missed out on in early life due to medical trauma. She is reveling in the connection with and attention from her parents. Over the weeks that we have been doing these structured activities, the child has begun to relax and relinquish her need for control. The child feels safe enough in the parents’ care that she can trust the parents’ directions and relax. We are starting to shift the daughter’s entrenched patterns of anger and overwhelm and replacing them with a sense of deep connection and security.
The Four Dimensions of Therapy
As this family played, we chose prescriptive games that support parents with boosting the skills below. These are the building blocks of sound mental health for our children. Theraplay® identifies four dimensions of healthy parenting that set children up for success throughout their life. Using these four dimensions, Theraplay® assesses which dimensions need the most support and provides prescriptive play activities. The goal of Theraplay® is to transfer these skills in creating structured play sessions to parents so they can continue to provide support for their child in their home
Structure: The parent clearly communicates the boundaries and rules in a predictable manner and confidently enforces the rules. In this dimension, parents are firm but not overly authoritarian in their maintenance of structure. When this dimension is strengthened, children know what to expect from both parents and rules and boundaries feel predictable and safe.
Nurture: The parent provides warm, appropriate soothing touch, and assures the child that they are cared for. This dimension can be heavily impacted by medical trauma, adoption, separation and other difficult early life experiences. Strengthening nurture can improve the child’s felt sense of safety, priming them to be able to relax, follow rules, and learn new things. Nurture and appropriate physical touch is necessary for optimal development.
Engagement: The parent draws the child’s attention and gets them excited to relate to others. This is a building block of brain and social development.
Challenge: The parent provides an appropriate level of challenge- not too difficult, resulting in a lack of confidence, but also not too easy, sending the message that the child is not capable. The parent provides a level of challenge for growth and self-confidence.
What issues can Theraplay® support:
Because Theraplay® works on a brain level, from the bottom up, it can be helpful on a wide range of issues including:
Attachment Concerns
separation anxiety
Distant parent-child relationship
Adoption
Traumatic Experiences
Power Struggles
Adhd
Autism
Impulsivity
Rule Following
What to expect in Theraplay® Treatment?
Typical Theraplay treatment follows the example below:
Session 1: Intake- I meet with parents only to gather a detailed history and set goals for treatment
Session 2: I conduct a play-based assessment to determine current strengths and challenges
Session 3: I meet with parents only to discuss assessment and explain the tenets of Theraplay model.
Session 4: Demo session- Parents meet with me to experience a Theraplay session without the child present. This is an opportunity to understand the model in practice and ask questions.
Session 5-8
I lead activities with child, while parents observe
Session 9: I conduct a feedback session with parents
Session 10-12
I continue to lead the session with child and parents become participants in the play.
Session 13: Feedback session
Session 14-16
Parents Lead session with child while and I observe.
Session 17: Feedback session and preparing for Transition to home
Sessions 18 and Beyond- I meet with parents about home sessions and to troubleshoot issues at home. Therapist may review video and continue to support parents with any issues that arise. Once a parent has solid skills, they are able to conduct 30 minute play sessions independently at home once per week for each child in their home. It is recommended that parents continue these sessions for a significant period of time until symptoms begin to shift. The therapist will slowly step back support over time as the symptoms resolve and the parents gain more confidence. It is always recommended that even if you decide to shift away from the therapeutic play you learn in Theraplay® you continue to have one on one time with each child in your family.
How can I get started?
- Book a free phone consultation with me to learn more about family-play therapy options.
Resources
Parenting with Theraplay: Understanding Attachment and How to Nurture a Closer Relationship with Your Child Helen Rodwell and Vivien Norris
