Week 8: Interventions With Children

When working with children, it is essential to be aware of their developmental stage. Their language capability may be limited, so the use of alternative forms of therapy is sometimes needed. Play therapy, including art, dolls, and sandtray work, is regularly utilized with young children to help them begin to tell their stories. Children often use these tools to reenact their experiences and express their emotions. Many times these therapeutic play times are ritualistic in nature, a process that helps the child achieve a sense of mastery and control over the situation (Gil, 1991).

Learning Objectives

Students will:

• Analyze play therapy strategies with children
• Analyze the effects of transference and countertransference on working with children

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Chiesa, C. (2012). Scripts in the sand: Sandplay in transactional analysis psychotherapy with children. Transactional Analysis Journal, 42(4), 285–293.

Malawista, K. L. (2004). Rescue fantasies in child therapy: countertransference/transference enactments. Child & Adolescent Social Work Journal, 21(4), 373–386. 

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Working with Children and Adolescents: The Case of Claudia (pp. 15–17)

Note: Depending on your concentration, you may not receive a case study book until a later term. Therefore, if you did not receive a copy of Social Work Case Studies: Concentration Year in your previous course, use the linked PDF provided here. If you did receive the book referenced above, you may find the cases there or use the PDF.

Ruffolo, M. C., & Allen-Meares, P. (2013). Intervention with children. In M. J. Holosko, C. N. Dulmus, & K. M. Sowers (Eds.), Social work practice with individuals and families: Evidence-informed assessments and interventions (pp. 41–69). Hoboken, NJ: Wiley.

Taylor, E. R. (2009). Sandtray and solution-focused therapy. International Journal of Play Therapy, 18(1), 56–68.

Christogiorgos, S., & Giannakopoulos, G. (2015). Parental presence and countertransference phenomena in psychoanalytic psychotherapy of children and adolescents. Psychoanalytic Social Work, 22(1), 1-11.

Optional Resources

Gil, E. (1991). The healing power of play: Working with abused children. New York, NY: Guilford Press:

Chapter 2, “The Child Therapies: Application in Work With Abused Children (pp. 26–36) (PDF)

Chapter 3, “The Treatment of Abused Children” (pp. 37–82) (PDF)

van der Kolk, B. A. (2003). The neurobiology of childhood trauma and abuse. Child and Adolescent Psychiatric Clinics, 12, 293–317. Retrieved from http://www.traumacenter.org/products/pdf_files/neurobiology_childhood_trauma_abuse.pdf

van der Kolk, B. A. (2005a). Child abuse & victimization. Psychiatric Annals, 35(5),374–378. Retrieved from http://www.traumacenter.org/products/pdf_files/neurobiology_childhood_trauma_abuse.pdf

van der Kolk, B. A. (2005b). Developmental trauma disorder. Psychiatric Annals, 35(5), 401–408.

Use this link to access the MSW home page, which provides resources for your social work program.

Discussion 1: Play Therapy

Children who have been abused or traumatized in some way may benefit from working with a therapist. Children often reenact trauma through repetitious play in order to establish mastery over their emotions and integrate experiences into their history on their own terms. Through the use of toys and props, children may naturally share their emotions and past experiences without feeling the pressure they might encounter with traditional talk therapy.

For this Discussion, review the course-specific case study for Claudia and the Chiesa (2012) and Taylor (2009) articles.

By Day 3

Post an explanation of ways play therapy might be beneficial for Claudia. Using the insights gained from the articles, describe ways you might have worked with Claudia to address her fears and anxiety related to the mugging she witnessed.

Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

By Day 5

Respond to at least two colleagues by expanding on evidence in support of play therapy.

Support your responses with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

Response 1

 Britney Fallen RE: Discussion 1 – Week 8COLLAPSE

According to the International Journal of Play Therapy, Sandtray Solution Focused Theory demonstrates a blending of two therapies including exploring and processing as well as problem-solving (2009). Often times when working with children they don’t know how to express their emotions appropriately or they can’t even identify the emotion they are feeling. In the Social Work Case Studies Claudia is introduced and has been struggling with regulating her emotions and going to school (Plummer, Makris, & Brocksen, 2014). Claudia observed a mugging and since the occurrence it has affected the way she perceives most situations in her life. She is afraid of the security guards at her school and perceives them as bad people. Play therapy would be beneficial for Claudia as it is interactive and fun to a child. Not only could she communicate nonverbally with the therapist but she could explore her emotions and feelings.

To begin as stated in the Social Work Studies Case on Claudia, over a series of sessions using play sand therapy Claudia would be able to identify good figures and place them in the sand surrounded by protective barriers from bad figures (Plummer et al., 2014). This was shown by good figures looking welcoming and warm while the perceived bad figures were cops and people wearing darker colored clothing. Eventually through exploration, processing, and problem-solving Claudia was able to place good figures beside bad figures and recognize some people make bad choices. I think the social worker completing this intervention was wise and I would use this technique as well. It is important to create a welcoming childlike environment for Claudia so she feels as though she is safe. The social worker would be building rapport and trust while learning about Claudia’s perceptions in the sand. Another way I would address Claudia’s fears could be introducing puppets to her. I would also encourage Claudia to demonstrate different feelings and emotions as stated on flash cards I would show her. Furthermore, I would ask her to show me a time that was stressful for her or produced fear or anxiety such as the mugging incident. This would allow Claudia to demonstrate what happened as she perceived it. We could then process these emotions and feelings and begin to problem-solve through the experience. Claudia could learn coping skills and ways to react in stressful situations she may face in life.

References:

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014b). Social work case studies. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Taylor, E. R. (2009). Sandtray and Solution-Focused Therapy. International Journal of Play Therapy, 18(1), 56–68. https://doi-org.ezp.waldenulibrary.org/10.1037/a0014441

Response 2

 Sara Hale RE: Discussion 1 – Week 8COLLAPSE

From my understanding, a client such as a younger age child, can benefit a lot from the concept of the play theory. Claudia, a 6-year-old, does not understand some of the terminology that the social worker might use. If a child uses paper and crayons to draw what they think the answer is when asked a question it will be so much easier to them. If you ask Claudia to build or demonstrate something she would feel more comfortable with interacting with some type of toy. Play therapy will help a child develop skills that allow them to accomplish their own behaviors. The plasticity of sand gives three- dimensional expressivity to children through involvement on a kinesthetic level (touch and movement) land the use of the visual channel (Chiesa, 2012). “The use of sand and objects takes place in a container that defines, by means of its borders, a horizontal space, inside of which the child is free to play and create what he or she wants (Chiesa, 2012).”  Sand can easily be change and manipulated. This activity will give Claudia a chance to use her own imagination and show her that she can achieve something without another person assistance. 

I would provide her with different toys and each toy would be a representation of something dealing with the mugging incident. Claudia witnessed a very traumatic event that probably would affect the rest of her childhood. Due to that incident, Claudia has been dealing with anxiety and because of her age this is very overwhelming to her. I will give Claudia a chance to play in the sandbox and then I would ask her “build your world.” As Claudia initially constructs the world in the sand tray, the words that I might say should be carefully considered. According to (Taylor, 2009), as the client constructs the sand tray, the therapist listens and attends more through body language and less through words. The sand play activity will give Claudia a chance to have a little fun while expressing how she feels. I would eventually have a discussion with Claudia, so she will describe to me what she made and the reasoning behind it.

References:

Chiesa, C. (2012). Scripts in the sand: Sandplay in transactional analysis psychotherapy with children. Transactional Analysis Journal, 42(4), 285–293.   Note: Retrieved from Walden Library databases.

Submission and Grading Information

Grading Criteria

To access your rubric:
Week 8 Discussion 1 Rubric

Post by Day 3 and Respond by Day 5

To participate in this Discussion:
Week 8 Discussion 1

Discussion 2: Transference and Countertransference

Specific skills and knowledge are essential for a social worker working with children. Understanding transference and countertransference is crucial to a healthy therapeutic relationship. Both transference and countertransference can be evident in any client–therapist relationship, but are especially important in working with children because of a common instinct among adults to protect and nurture the young. The projection or relocation of one’s feelings about one person onto another, otherwise known as transference, is a common response by children (Gil, 1991). Countertransference, a practitioner’s own emotional response to a child, is also common.

For this Discussion, review the Malawista (2004) article.

By Day 4

Post your explanation why transference and countertransference are so common when working with children. Then, identify some strategies you might use to address both transference and countertransference in your work with children.

Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

By Day 6

Respond to at least two colleagues who identified strategies different from your own by proposing alternative strategies.

Response 1

 Nakesha Morgan RE: Discussion 2 – Week 8COLLAPSE

As it relates to transference a client is projecting their feelings onto another person as if they would to another person in their life.  A client may be unaware that they are doing transference to someone else.  The feelings may be positive or negative.  Clients display anger towards you when they may be discussing an abusive person for example.  Discussing this person at that time can make the client speak in an aggressive tone towards others that may be trying to help them.  Countertransference is when a clinician transfer their feelings onto a client.  The client that the clinician may be working with may remind them of someone from the past in their life of a previous client.  The clinician may offer advice rather than listening actively to their client.    During this time of countertransference a client may disclose inappropriate personal experiences or information (Andersonson, 1998). 

For workers to better counteract negative interactions with clients they must have awareness of their actions.  With a worker being aware of the transference and countertransference it may have better outcomes for advancing themselves as clinician.  With workers having ongoing trainings and being knowledgeable of things that may help prevent them from harming their client.  Worker should make supervisor aware of their difficulties in that area.  When workers are working with children they should try to recognize these things to ensure that the services being given to the children are in order.  As a social worker we must be aware of the code of ethnics when working with a vulnerable population, providing reactions or emotions towards a child will be against the code of ethnics.  Being able to provide adequate services is most important.

Anderson, S. M. & Berk, M. (1998). The Social-Cognitive Model of Transference: Experiencing Past Relationship in the Present. Current Directions in Psychological Science, 7(4), 109-115

Response 2

 larry harris RE: Discussion 2 – Week 8COLLAPSE

Transference and countertransference are necessary in the client and therapist relationship.  Transference is when the client transferring their emotion on the client and countertransference is when the therapists transfer their emotions on to the client.  With children it is easy for transference to occur because we naturally want to protect them.  Often the therapist becomes the protector from the bad object (Malawista, 2004).   

To counteract transference and countertransference is to be aware of our own emotions and how we relate to certain situations with children.  We must know our vulnerabilities and not transfer that onto the child.  I would also identify other figures in the child’s life and their connections and have those individuals attend sessions so that the child identifies safety with other individuals. “ Chused (1988) states ‘‘The real dependency needs of all children…, their potential for growth, their tremendous vulnerability to external forces, and the wish to have them grow successfully with minimum suffering, are all powerful seductive forces which lead to countertransference interferences with the development of a transference neurosis’(Malawista,2004, p.376)”.  As a therapist we need to look at the greater need for the child and figure out ways to better the relationship with the parent and child. 

References

Malawista, K. L. (2004). Rescue Fantasies in Child Therapy: Countertransference/Transference enactments. Child & Adolescent Social Work Journal, 21(4), 373–386. https://doi-org.ezp.waldenulibrary.org/10.1023/B:CASW.0000035222.16367.32