Play Therapy Group Research Articles

Effect of short‐ and long‐term play therapy services on teacher–child relationship stress

AbstractThe purpose of the present study was to explore the effect of both short‐ and long term Child‐Centered Play Therapy on teacher–student relationship stress. Teachers identified 58 students exhibiting emotional and behavioral difficulties who were randomly assigned to one of two treatment groups. Students in the short‐term intensive play therapy group participated in 16 sessions of play therapy over 8 weeks, and students in the long‐term play therapy group participated in 16 sessions over 16 weeks. Results indicated that both intervention groups demonstrated significant improvement in teacher–student relationship stress from pre‐ to posttest. Post hoc analyses indicated that the short‐term intensive intervention demonstrated statistical significance and larger effect sizes in overall total stress, teacher characteristics, and student characteristics. © 2008 Wiley Periodicals, Inc.

A New Beginning – A Dramatherapy Group for Participants with Co-Occurring Mental Illness and Substance Abuse in a Mental Health Setting

Rehabilitation for people with dual diagnosis (co-existing mental illness and substance dependence) has existed in many forms over the past thirty years and has become more urgently needed over time. Treatment for this population inevitably requires a team effort (Schwartz & Lehman, 1998). These people are difficult to engage in treatment and it takes time to unravel the interacting effects of substance abuse and their mental illness. Social relationships may also be problematic, particularly once the person has decided to discontinue drug or alcohol abuse. Often such clients find it easier to communicate socially with people who have similar problems (Hatfield, 1993). Improvements in self-esteem and reduced intake of drugs and alcohol are rarely monitored in the one community psychiatric facility, as in this study. The method of treatment in this case was to run a small group for participants over an extended period with support from multidisciplinary teams, using a Dutch model for drug and alcohol rehabilitation. By targeting psychiatric relapse prevention and people's life stories, using a biographical developmental framework and dramatherapy interventions, the intention was to achieve outcomes of higher self esteem and reduced intake of recreational drugs. In fact the pre and post measures chosen did not show significant variance. For all participants, including those who were already abstinent, changes in lifestyle and achievement of life goals were sought. As a result, there was reported enjoyment of mutual support, sharing and understanding of individual life stories, together with strategies to increase resilience. Further research is needed to identify how best to measure outcomes. Hatfield, A. (1993) ‘Dual Diagnosis and Mental Illness’, Journal of National Alliance for the Mentally Ill, (Online), retrieved 11.1.08 Schwartz, R. & Lehman, A. (1995) in ‘Overview of Treatment Principles’ in Lehman, A. & Dixon, L. (eds.) Double Jeopardy, Harwood Academic Publishers, Chur, Switzerland, p.77

Voices of Pride

SUMMARY This paper demonstrates how drama therapy assists incarcerated women in freeing themselves from internalized oppressive beliefs. In the context of a drug and alcohol treatment program for incarcerated1 women, the authors assist the women in building three distinct bridges to healing: a new relationship to one's self, to other women, and to the community. Writing exercises, performance techniques, and group drama therapy empower women to express their diverse voices. As the women risk sharing their personal stories and journeys of recovery, they begin to actively envision a different future for themselves. The participants discover talents that offer them an opportunity to experience themselves in a different light, no longer bound by the stigma of being in prison

Randomized trial of treatment for children with sexual behavior problems: Ten-year follow-up.

This study prospectively follows 135 children 5-12 years of age with sexual behavior problems from a randomized trial comparing a 12-session group cognitive-behavioral therapy (CBT) with group play therapy and follows 156 general clinic children with nonsexual behavior problems. Ten-year follow-up data on future juvenile and adult arrests and child welfare perpetration reports were collected. The CBT group had significantly fewer future sex offenses than the play therapy group (2% vs. 10%) and did not differ from the general clinic comparison (3%), supporting the use of short-term CBT. There were no group differences in nonsexual offenses (21%). The findings do not support assumptions about persistent or difficult to modify risk and raise questions about policies and practices founded on this assumption.

Recreating masculinity: drama therapy with male survivors of sexual assault

The topic of adult male rape has only recently begun to receive attention by researchers and clinicians. Most of the scant research that has been done since the topic was first tentatively broached in the late 1970s (Scarce, 1997, p. 12) has focused on the demographic characteristics of victims and perpetrators (Groth & Burgess, 1980; King & Woollett, 1997; Lipscomb, Muram, Speck, & Mercer, 1992), the presenting symptomology of survivors (Goyer & Eddleman, 1984; Rogers, 1997), the attitudes and attributions of blame by friends and professionals (Mitchell, Hirschman, & Hall, 1999; Washington, 1999), and attempts to understand both the prevalence of the crime and the causes for underreporting (Pino, 1999). There have been a few activists and cultural researchers who have endeavored to make the stories of male rape survivors known on a sociological level (McMullens, 1990; Scarce, 1997). While all of this research represents a much needed effort by a few pioneers to understand the nature and effects of this brutal crime, there has not been much offered, to date, in terms of descriptions of treatment progressions for survivors. In this paper, I will offer a review of some of the literature that has emerged about male rape and narrate a first-hand account of a drama therapy group treatment of three male veterans who were sexually assaulted while in the military. This admittedly small group may not represent the treatment needs of a majority of male survivors of sexual assault. I offer the work of this small group as an initiation of discourse towards the creation of a model of clinical work with survivors of male rape.

Intensive filial therapy with child witnesses of domestic violence: A comparison with individual and sibling group play therapy.

The rationale for utilizing filial therapy as a treatment intervention with child witnesses of domestic violence while residing with their mothers in a shelter facility is explored and the effectiveness of an intensive 12-session filial therapy parent training group, conducted within 2-3 weeks, is described. Results of analysis of covariance revealed that child witnesses in the experimental group significantly reduced behavior problems prevalent in child witnesses and significantly increased their self-concept as compared to child witnesses in the non-treatment comparison group. In addition, t-test results showed that mothers who facilitated treatment of the experimental group scored significantly higher after training on both their attitudes of acceptance and their empathic behavior. Comparative analysis revealed that intensive filial therapy as facilitated by the children's mothers was as effective in reducing behavior problems as was intensive individual play therapy and intensive sibling group play therapy as facilitated by professionally trained therapists.

Group Play Therapy With Sexually Abused Preschool Children: Group Behaviors and Interventions

Group play therapy is a common treatment modality for children who have been sexually abused. Sexually abused preschoolers exhibit different group play therapy behaviors than do nonabused children. Group workers need to be aware of these differences and know the appropriate group interventions. This article describes group play therapy with sexually abused preschool children, how to establish a play therapy group for sexually abused preschoolers, common group play therapy behaviors observed among sexually abused preschoolers, and appropriate group therapy interventions.

Group Play Therapy for Young Children Exposed to Major Stressors: Comparison of Quantitative and Qualitative Evaluation Methods

Examined the outcome of a 16-week play group therapy intervention for six highly stressed preschool-aged children compared to a preschool-aged control group. The focus of the group was to help the children build social skills, learn to express emotions appropriately, increase understanding of stress events, and learn new coping skills. The results indicated a significant increase in anxious and externalizing behaviors during the course of the intervention for the treatment group subjects compared to controls. Furthermore, group treatment subjects also indicated a significant increase in social skills during the group intervention. However, there were no significant differences on the psycho-social measure from pre-test to post-test. Despite the lack of differences on quantitative measures of children's functioning, parent report on a qualitative measure indicated improvement in children's psycho-social functioning at the end of treatment. Implications of the play therapy group approach for children exposed to major stressors are discussed.

Rivalry, Competition and Transference in a Children's Group

The authors describe their drama therapy group for children in a North West London Child and Family Centre. They discuss the rationale for this treatment. An account is given of the group processes with special reference to rivalrous feelings as they emerged in the transference relationships. Issues concerning the dynamics of cotherapy are addressed.

Reactions to Hill End Adolescent Unit: interviews with 20 ex-patients

Recently discharged adolescents were interviewed, to explore their experience of the Unit; parents were interviewed briefly. Over half the sample described some benefit, most notably from drama therapy, family therapy and peer group support. Several areas of difficulty emerged, including, objections to video recording and one-way mirrors, dislike of being in the grounds of a psychiatric hospital, inadequate night-staffing levels and fear of an autistic adolescent. Preference was expressed for use of a Time Out Room, rather than sedation. Recall of pre-admission explanations of unit practice was poor. Certain changes have been made at the Unit since the study.

Helping Bereaved Children: A Hand-Book for Practitioners

Part I: Introduction: N.B. Webb, The Child and Death. N.B. Webb, Assessment of the Bereaved Child. N.B. Webb, Counseling and Therapy for the Bereaved Child. Part II: Death in the Family. N.B. Webb, Death of Grandparents Family Therapy to Assist Bereavement: Case of the Silver Family Siblings Ages 11, 9, and 5. J. LeVieux, Terminal Illness and Death of Father: Case of Celeste, Age 5 1/2. N.B. Webb, Complicated Grief Dual Loss of Godfather's Death and Parental Separation: Case of the Martini Family Sisters Ages 8 and 10. C.P. Kaplan, H. Joslin, Accidental Sibling Death: Case of Peter, Age 6. N.B. Webb, Suicidal Death of Mother. T. Bevin, Violent Deaths of Both Parents: Case of Marty, Age 2 1/2. D.C. Tait, JL. Depta, Play Therapy Group for Bereaved Children. Part III: Death in the School and Community. N.B. Webb, Traumatic Death of Friend/Peer: Case of Susan, Age 8. G. Doster, C.Q. McElroy, Sudden Death of a Teacher: Multilevel Intervention in an Elementary School. L.O. Hickey, Death of a Counselor: A Bereavement Group for Junior High School. M. Munsch, School-Based Intervention Following Violent Death in a Classmate's Family. Appendix: Training Programs/Certifications, Resources, References on Religious/Cultural/Ethnic Practices Related to Death. Index

Persona and performance: the meaning of role in drama, therapy, and everyday life

Preface. A journeyer to the spiritual mount. 1. The Origins of Role. Hamlet's soliloquy and the paradox of drama Role ambivalence The origins of role in drama/theatre The origin of role in the social sciences The origin of role in art and literature From role metaphor to role concept. 2. The Development of Role. The human being as role recipient The human being as role-taker The human being as role-player The role system. 3. The Drama Therapy Role Method. The invocation of the role The naming of the role The playing out/working through of the role Exploring alternative qualities in sub-role Reflecting upon role-play: discovering role qualities, functions and styles inherent in the role Relating the fictional role to everyday life Integrating roles to create a functional role system Social modeling. 4. The Case of Michael. The treatment: Beginnings The three bears The Lawyer Black rage The boy who learned to burn Fathers and sons The judge and the raincoat The mask of the actor The critic The blind girl An integration. 5. The Case of Michael Part II. The kiss The wooden clogs and the rubber boots The marriage proposal The glass heart Bugs More glass Me vida abajo (My life down there) The confused searcher The beat of black wings My father's body Mickey and Jake: you dream at your own risk Victor/victim The ring Postscript. 6. The Case of Hansel and Gretel: An Example of a Drama Therapy Group. Implications of the role method for diagnosis Evaluation. 7. Role in Everyday Life. Role type and archetype Somatic roles Cognitive roles Affective roles Social/cultural roles Spiritual roles Aesthetic roles. 8. A Taxonomy of Roles: Building a Theatrical Archetype System. The form of the taxonomy: The taxonomy of roles. 9. The Taxonomy: Cognitive and Affective Domains. Domain: cognitive Domain: affective. 10. The Taxonomy: Social Domain Domain: social. 11. The Taxonomy: Spiritual and Aesthetic Domains. Domain: spiritual Domain: aesthetic The use and significance of the taxonomy. 12. Conclusion. References. Appendix.

Video as an externalizing object in drama therapy

Drama therapy as a group process explores the many levels of metaphor that are a result of dramatic engagement among members of a group. To facilitate this process, drama therapists make use of a wide range of dramatic media (e.g., masks, puppets, photography, and video). Video in particular offers a number of possibilities, especially those that involve direct interaction between the patient and the video technology “in which the camera and monitor are themselves objects to be reckoned with” (Landy, 1986). This paper describes my work with Brian using video as an externalizing object, that is, as an inanimate object transformed by the patient into the role of a significant other so that a fictional relationship to real-life conflicts can be dramatically played out and explored. By directly engaging patients with the video through play, they can enact roles and transform the technology into objects from their real lives (e.g., the camera as mother who is always watching us, the microphone as the father who will not listen to us), their fantasy lives (e.g., the recorder who will remember us, the video-image of self that is gigantic or very small, or to erase what was bad and create something new), or as transitional object (e.g., the television set as babysitter). Through the process of “externalization” (Kernberg, 1970) or “projective identification” (Klein, 1932/1959), these internalized characters are played out in the external world using the video as a stand-in for the internalized object, not as belonging to the past, but as an object to play and interact with in the here-and-now. According to Winnicott (1953, 1965), the main thrust of therapeutic activity is for the therapist to be utilized as a transitional object, and to manage rather than interpret the transference so as to provide the patient with a sense of well-being, security, and cohesion. The therapist, by functioning as a transitional object, fills the deficit and enables an aborted maturational process to resume. For the drama therapist, video is similar to a transitional object introduced into the therapeutic setting. By using this inanimate object as a stand-in for objects from the patient’s inner psychic world and actual external world the drama therapist has a tool to examine and explore actual and desirable relationships. Here relationships that have become rigidified, stereotyped, and inflexible can be recast; a new balance in the expectations of others can be struck. This use of video as a stand-in for significant others from the patient’s life will be described here as an “externalizing object.” The following case history describes an experience in The Institute of Pennsylvania Hospital (IPH) Adolescent Treatment Unit for emotionally disturbed adolescents. The patient was part of a drama therapy group designed for 12-14 year-olds who were having difficulty functioning at an age-appropriate peer level. The group, co-led by a drama therapist and a movement therapist, met for 14 one-hour sessions over a period of eight weeks. The composition of the group included Brian and three females: D age 12, post-traumatic stress disorder; E age 13, bipolar disorder; and B age 14, oppositional/atypical disorder. In terms of the intervention, I hope to

Notes from a Dramatherapy Group

Notes from a Dramatherapy Group

Effects of psychological preparation on children hospitalized for dental operations

We studied the effect of preoperative preparation on stress reduction in children hospitalized for dental surgery under general anesthesia. Participants were 45 children, 3 and 4 years of age, with no previous hospital-surgery experience and no history of medical or psychological conditions requiring special care. Subjects were randomly assigned to one of three experimental groups: control, receiving no preoperative preparation; unrelated play therapy, receiving a preoperative play session unrelated to hospital or surgical procedures; and related play therapy, receiving a preoperative play session focusing on hospital and surgical procedures. Subjects' behavior was assessed using behavior observation scales for cooperation and upset at seven stress points: admission, nurse's examination, pediatric medical examination, blood test, preoperative injection, transfer to surgery, and induction. The related play therapy group was more cooperative and less upset than either the unrelated play therapy group or the control group across stress points. No significant heart rate differences were found among the three groups. The results suggest that play therapy related to hospital and surgical procedures can alleviate stress and anxiety in 3- and 4-year-old children.