The value and use of interpretation in play therapy.

Abstract

“My client has been coming to therapy for weeks and has yet to engage in any play even vaguely related to the presenting problem. Whenever I try to bring up anything even minimally related to the trauma, the child either freezes or gets angry. Managed care may only give me a few more sessions. The parent is worried that therapy isn’t progressing and, frankly, so am I. What now?” Does this sound familiar? If so, you are not alone. Many child therapists find it very difficult to keep sessions problem-focused without feeling that they are either violating fundamental tenets of their theoretical orientation or risking overwhelming the child. In addition, even when progress is being made in session, many children seem to have a great deal of difficulty generalizing those changes to their lives outside of the therapy. The systematic use of language in general and interpretation in particular is one way to make a significant dent in both of these problems. Although this article focuses on the use of interpretation within play therapy sessions, it is important to note that interpretation is only one part of the overall treatment process. Maximum treatment effectiveness depends on a multi- or ecosystemic approach. Within such an approach, the therapist works with the child, the family, and other systems impinging on the child’s development and well-being. These other systems might include the peer social system; the school, medical, legal, social service, community, and cultural systems; as well as any other system in which the child is embedded. Usually therapists approach assisting child clients from two directions. One is to help the child learn to function well within these various systems as they currently exist. The other is to change the systems so that it is easier for the child to function well. The knowledge gained by the child and therapist through the interpretive process usually impacts both, as better understanding helps children make necessary changes and may be used by the therapist to guide systemic changes. Whether the emphasis of the play therapy is on changing the child or the systems in which he or she operates depends on the age of the child and the capacity of all those involved to make meaningful changes. In any case, the use of language in play therapy is likely to facilitate the change process. The remainder of this article is divided into three sections. The first describes the importance of language in children’s mental health and presents a systematic strategy for formulating and delivering interpretations that brings language to the fore in play therapy sessions. The second part briefly reviews the therapeutic processes identified by Shirk and Russell (1996). The third and last section reframes much of the play therapy process under the general rubric of “problem solving” while describing how systematic interpretation and the use of various therapeutic processes can be used to support such problem solving.