Abstract
ABSTRACT We applied the assimilation of problematic experiences sequence (APES) to a six-year-old girl’s processing of traumatic experiences involving violence and death in play therapy. We analyzed the post-session notes from the first 34 sessions of a much longer treatment, during which the girl repeatedly enacted a drama we called the cottage play, involving characters assumed by the child and characters assigned to the therapist. We distinguished four phases based on changes in play themes. In phase 1, the girl expressed her need for safety in response to an overwhelming internal threat (APES stage 0, warded off/dissociated). In phase 2, she worked to escape and avoid the threat, referenced in the play as monsters and bad memories (APES 1, unwanted thoughts/avoidance). Phase 3 was a brief period of consolidation. In phase 4, she actively faced the trauma, referenced as murderers, soldiers, and death (APES 2, awareness/emergence). Our observations underlined the child–therapist collaboration and dyadic processing. The expressions of the problematic experiences suggested increasing but limited assimilation (stages 0 to 2 out of eight stages). The assimilation model usefully described symbolic processing in play therapy, and the results pointed to tentative elaborations in APES stage descriptions.
Highlights
In this qualitative theory-building case study, we examined the process of assimilation in a year-long episode in the play therapy of a traumatized six-year-old girl
After the summary of each phase, we present our interpretation of the events, the identified voices and problematic experiences, and the predominant assimilation of problematic experiences sequence (APES) stage of Lisa’s central problematic voices in that phase
The child-directed drama we called the cottage play evolved across sessions through four phases distinguished by changes in the play events, the character assumed by Lisa, and the character assigned to the therapist
Summary
In this qualitative theory-building case study, we examined the process of assimilation in a year-long episode in the play therapy of a traumatized six-year-old girl. Qualitative theory-building case studies do not test isolated hypotheses, effectiveness of a treatment, or restrict attention to a few selected variables. Instead, they compare many aspects of a theory to correspondingly many aspects of case observations (Campbell, 1979). We do not aim at testing the effectiveness of the treatment, the use of the APES as an outcome measure has been supported in nomothetic studies (e.g., Basto et al, 2018; Detert et al, 2006) and in case studies (e.g., Honos-Webb et al, 1998; Mendes et al, 2016)
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