Therapeutic Play with Children

by Deborah Hage, MSW

Dr, Ann Jernberg developed Theraplay techniques in the 1960’s. The Theraplay Institute in Chicago continues to train therapists and parents in creative and effective ways to incorporate play into the parent-child relationships in such a way that attachment is enhanced. The typical age range of children is from birth to 12 years, however, adaptations of the techniques can be used with older children.

Guidelines:

The parent is in charge and chooses the activities to meet the child’s needs
Theraplay involves emotionally attuned, interactive, physical play
Nurturing touch is part of each interaction
Activities geared to child’s emotional age, not chronological age
Fast, quick

According to the Theraplay Institute, “Psychopathology results when early and ongoing experiences lead to a negative or inadequate sense of self. In the absence of positive and responsive interactions, the child learns to view herself as unlovable and incompetent, to view others as uncaring and untrustworthy, and the world as unsafe and full of threat. Within an insecure attachment, the process of learning of learning about one’s self and the world becomes negative and hopeless. Many behavior problems of older children can be traced back to their beginnings in insecure attachment and in their negative views of themselves and the world. The Theraplay approach assumes both that change is possible and the essential ingredients for change lie in the creation of a more positive relationship between children and their parents. Because the roots of development of the self, of self esteem and trust lie in the early years, it is essential to return to the stage at which the child’s emotional development was derailed and provide experiences which can restart the healthy cycle of interaction.”

The activities are based on the playful interactions of parents with their young children, redoing the interactions that come naturally to parents. In fun ways the child learns to:

follow the parent’s lead
accept direction with joyful outcomes
engaging with the parent is enjoyable
trust the parent will not ask them to do something unsafe
relinquish control

Initially, when playing with an over reactive child, activities are best conducted within very narrow time limits, beginning with less then 30 seconds and building up to longer interactions as the child’s defenses come down. It is better to surprise a child with little bits of joy throughout the day than to overwhelm him with an unwelcome thrust of heavy relationship building. The goal is to get in and out of a child’s space before he flinches away.

<30 seconds
Stack of hands – hold out hand and child puts hand on top. Put 2nd hand on top of child’s hand, child puts their 2nd hand on top of parents. Parent pulls hand out from bottom and puts on top, child repeats, going faster and faster
Crawl race
Hand feeding – quickly put small treat in child’s mouth (Do not let child take treat and feed himself!)
Wake child up with a special treat or greeting
Quick hug
Blow kisses

30 seconds – 1 minute
Putting lotion on “owies”, caring for hurts, quick kiss on hurt spot, look all over child’s body for little scratches or hurts to put lotion on
Hand feeding with eye contact – get child’s attention and as soon as he looks at you put small treat in his mouth
Put love note and treat in lunch box
Straight faced tickle – parent tells child she is going to tickle him and he has to keep a straight face
Shoe & sock race – race child to get shoes and socks on

1 – 3 minutes
Cotton Ball Blow – Lay on stomach, facing each other, blow cotton ball between you
Patty Cake, Patty Cake
Mirroring – Face each other and take turns moving arms, legs, slowly while other person copies the movement. Take turns leading.
Pay attention to small hurts and soothe child with lotion or treat
Blow bubbles – Have child strong sit and then blow bubbles, telling them to jump up and pop them, repeat as long as child strong sits between
Pushing over – Sit on floor with legs spread apart, with child’s legs inside parent’s legs, grab hands and pull child on top of parent and then child pulls parent on top of him, go back and forth a few times, parent comments on how strong child is
Blowing over – Child “blows” over parent and parent makes a big commotion over it and then “blows” over child
Pick up with toes – drop something on the floor and take turns trying to pick it up with toes
Tell a “When you were a baby” or “When I first saw you” story
Touch noises – Have child touch nose and parent makes a funny sound (beep, honk, snort, etc). Parent touches child on ear and child makes a sound. Repeat
This little Piggy song
Call to meal time – Tell everyone to come to dinner waddling like a duck, or hopping like a bunny, or prancing like a dear or marching like a drummer, etc
Horse back ride
Jump – How far can you jump? This is how far I can jump.
Water gun fight
Draw letters on child’s back with finger and have child guess what letter it is
Stand on chair with small objects, see how many each can drop into a container

4 – 5 minutes
3 legged walk – Stand next to each other and tie inside legs together, grab around the waist and walk, faster and faster
Have child look at your while you feed him a bowl of ice cream or other treat

> 5 minutes
Toilet Paper Bust Out – Wrap child in toilet paper, asking them to stand very still under you are done, then counting down from 10, yelling “Bust out”
Lay child in lap and feed juice or chocolate mild from a bottle while he looks at your and you look at him
Make me a Pizza – Child lays on back on floor. Parent pretends to knead the child’s body as if it were dough, then rolls hands across body as if rolling out the pizza dough. Parent rubs pretend pizza sauce all over body and then pokes around on the child’s body as if she were putting on pepperoni and cheese. Parent scoops “pizza” up in arms and puts it in the oven (another spot on the floor). Pulls the “pizza” out and “gobbles” it up, kissing the child all over. Must be done with high energy and lots of laughing and giggling!
Face Painting
Do Chores/tasks together, sing while you work
Bake cookies – make sure child gets to lick the bowl to get the sugar
Read a bed time story while child snuggles or sits on lap
Stand in front of mirror – touch child’s hair and talk about how beautiful it is, he must have had a beautiful mother to have given him such wonderful hair, repeat with eyes, ears, nose, arms (how strong they are), etc
Give manicure and/or pedicure

Group Activities
Mother May I

Two adults –
Blanket swing – Have the child lay down in a blanket and the adults swing him
Child toss – gently toss child back and forth between parents