THERAPEUTIC LIMIT SETTING

Basic guidelines in limit settingo “Limits provide structure for the development of the

therapeutic relationship and help to make the experience a real-life relationship. Without limits a relationship would have little value” (p. 257).

o “Therapy cannot occur without limits” (p. 257).o What do limits provide children?

• Opportunity to learn self-control• Fact that they have choices• Experience of what making choices feels like• How responsibility feels

o Therapist should believe that the child will choose positive cooperative behavior

o Limits should be minimal and enforceable

Basic guidelines in limit setting (cont.)

The establishment of total limits rather than conditional limits is more effective

Focus and emphasis are always on the child to convey where responsibility lies

Children should be allowed to be separate (no plural pronouns)

THERAPEUTIC LIMIT SETTING (CONT.)

When to present limitso Present a limit only when it is neededo Self-control is learned only when the opportunity occurs

Rationale for therapeutic limitso Limits facilitate the attainment of accepted

psychological principles of growtho The child’s desire to break the limit has greater

therapeutic significance than the exhibited behavioro All feelings, desires, and wishes are accepted, but not all

behaviors are accepted

Rationale for therapeutic limits (cont)

Seven principles of limit settingo Limits provide physical and emotional security and safety

for childreno Limits protect the physical well-being of the therapist and

facilitate acceptance of the childo Limits facilitate the development of decision-making, self-

control, and self-responsibility of childreno Limits anchor the session to reality and emphasize the

here and nowo Limits promote consistency in the playroom environment,

which in turn promotes• Predictability• Security

o Limits preserve the professional, ethical, and socially acceptable relationship

o Limits protect the play therapy materials and room

THERAPEUTIC LIMIT SETTING (CONT.)

Procedures in the therapeutic settingo Objective – to facilitate the expression of the motivating

feeling, want, or need in a more acceptable manner, not to stop the behavior

o Steps in the therapeutic limit-setting process• Acknowledge the child’s feelings, wishes, and wants (A)• Communicate the limit (C)• Target acceptable alternatives (T)

o Example:• A: “I know you want to paint on the wall, but”• C: “The wall is not for painting on.”• T: “The easel paper or the block of wood is for painting on.”

THERAPEUTIC LIMIT SETTING (CONT.)

When limits are brokeno The child needs understanding and acceptanceo Repeat ACT at least three times – patience, calmness,

and firmnesso State the final choice – last resort

• “If you choose to do X, you choose not to play with X for the rest of our time in the playroom today.”

• “If you choose to do X, you choose to leave the playroom for the rest of our time together.”

THERAPEUTIC LIMIT SETTING (CONT.)

Situational limitso Taking toys or materials from the playroom – not allowed

• Emphasis is on emotional sharing, not material sharing• Budgetary limits• Taking other children’s words and depriving them of

freedom of expression• Retrieval of borrowed toy

o Leaving the playroom• Children need to learn not to run away from responsibility• Limit trips outside playroom

o Time limits• 5 minutes, then 1 minute• Stand up to give visual cue• Gradually step toward door

Situational limits (cont.)

Limiting noise – necessary in clinics and schools Personal items are not for playing Limiting water in the sandbox

o Takes a lot of time to draino Ruins experience for subsequent children

Urinating in the playroom

Typical Problems in Play Therapy and What To Do If…

The child is silento Respond verbally to what the child is doing in the

momento Therapist needs to feel comfortable with the child’s

silenceo Don’t comment on every little thing

The child wants to bring toys or food into the playroomo Child’s desire to take a special toy to the playroom

should be recognized and accepted unless• Electronic toys• Favorite books

o Snacks should be prohibited because of the distraction

Typical Problems in Play Therapy and What To Do If…

The child is overly dependento Return responsibility to the childo Facilitate self-reliance

The child persists in seeking praiseo Harmful consequences of praise

• Directs behavior• Restricts freedom• Creates dependency• Fosters external motivation

o “What is important is what you think about your picture.”

o “You worked hard on that.”o “It can be whatever you want it to be.”

Typical Problems in Play Therapy and What To Do If…

The child says, “You talk weird”o Parroting can be irritatingo Goal is to convey understanding, not simply reportingo “I sound different than other people to you.”o “You don’t like the way I talk.”

The child wants the therapist to play a guessing gameo Child can guess for therapisto “You have something in mind.”o “You can tell me.”

The child asks for expressions of affectiono Children develop strong emotional bonds with therapistso “You are special to me, and this is a special time

together.”

Typical Problems in Play Therapy and What To Do If…

The child wants to hug or sit in the therapist’s lapo Has this child been sexually abused?o Has this child been taught to connect liking with

seductive behavior?o Is this child merely expressing an unconscious desire to

re-experience being a baby?o Is the child simply being spontaneous or free?

The child tries to steal a toyo Be straightforward, understanding, and firmo Follow ACT

Typical Problems in Play Therapy and What To Do If…

The child refuses to leave the playroomo Therapist must manage a process that allows the child

to take themselves out of the playroom o Through this process, the child is developing enough

self-control to stop, to say no to desires The therapist unexpectedly cannot keep an

appointmento Tell child at beginning and end of sessiono Child will be able to return in two weekso Reason can also be given to prevent child from thinking

he or she has pushed you away