Flexibly Sequential Play

Therapy (FSPT): A New

Model of Trauma Treatment

Paris Goodyear-Brown, LCSW, RPT-S

615-397-9480

www.parisandme.com

paris@parisandme.com

Type II trauma conceptualizations

Complex trauma

Complicated PTSD

Disorders of Extreme Stress NOS

Developmental trauma disorder

Key concepts for treating traumatized

children

Psychosomatic symptomsAmygdala alarm

Decreased reactivity to physical injury

The portals for therapeutic learning

Follow the child’s need

Kinesthetic involvement

The dyadic dance: towards and away from the trauma content

Identifying and handling post-traumatic play

Commonalities in current trauma

treatments

Safety

Stabilization

Affect regulation

Addressing cognitive distortions

Some form of exposure

COMPONENTS OF FSPTFlexibly Sequential Play Therapy for Trauma

Treatment

EnhancingSafety

and Security

Assessmentand Augmentation

of Coping

Relaxationand

StressManagement

Parentsas

SoothingPartners

Soothingthe

Physiology

IncreasingEmotionalLiteracy

Continuumof

Disclosure

ExperientialMastery

Play

TraumaNarrative

Play-Based

GradualExposure

Addressingthe

Thought Life

Making PositiveMeaning of

the Post-TraumaSelf

Flexibly Sequential Play Therapy (FSPT)A components model for play-based trauma treatment

Treatment Goal/ Interventions

Containment of Perpetrators(Helping clients empowerment experiences

through manipulation of perpetrator symbols )

Learning to Bear It(transitional object)

Safe Place Productions(Creating an external image that can become

an internalized resource)

Therapist as Megaphone(Amplify safety messages)

(Align self with client)

Assist the client in re-establishing asense of safety and security

Treatment Goal/ Interventions

Coping Umbrella

Crowning Community

Coping Tree

Coping Bubble Wrap

Family Play Genogram

Copecakes(Detailing components of

healthy coping)

Assessment of coping and augmentationof positive coping strategies

Physiological systems

The hypothalamic-pituitary-adrenocortical (HPA)

axis is an integral part of how the body responds

to stress.

The autonomic nervous system (regulating heart

rate, respiration, the galvanic skin response)

The neuroimmune system which regulates the

body’s response to sickness and disease

Psychosomatic symptoms

“…the extreme nature of the

external threat is often matched by

an extreme and persisting internal

activation of the

neurophysiological systems

mediating the stress response and

their associated functions”

-Bruce Perry, 1999

Treatment Goal/ Interventions

Chum Chants(CBT skill rehearsal)

The Bubble Fall(Gives clients concrete visual images

that induce relaxation)

The Balancing Act(Encourages relaxation through

focused attention)

Pinwheels(Providing an external focal point

for deep breathingexercise)

The Big One(Encourages Deep Breathing)

Five Count Breathing(Encourages relaxation through targeted

deep breathing process)

Assist client in managing anger, anxietyand stress reactions through relaxation

and guided imagery

Treatment Goal/ Interventions

Filial Therapy

"You're a Star" Board

PCIT

SOOTHE Strategies

Child Parent Relationship Therapy

Sweet Dreams Lotion Potion

Good Behavior Book

Theraplay

Assist protective parents to enhancetheir protective, supportive function

Treatment Goal/ Interventions

Take Your Temp

Color My Heart

Assist client in completing full spectrumfeelings identification and verbalization

Treatment Goal/ Interventions

Fruit Loops FeelingsNecklace

(Allows for assessment of events/situationsthat trigger various feelings)

Butterflies in MyStomach

(Targets fear and anxiety)

Clearing It Up(Demonstrates that a multiplicity of feelings

can exist simultaneously)(Empowers clients to face their feelings)

The Sands of Time(Allows for uncovering layers of feelings)

(Is process based)

Assist client in completing full spectrumfeelings identification and verbalization

“Anyone can be angry, that is

easy. But to be angry with the

right person, to the right

degree, at the right time, for

the right purpose and in the

right way-this is not easy.”-Aristotle

Treatment Goal/ Interventions

Anger Buttons

Volcanos

Blow It Up, Blow It Out

Anger Thermometers

Assist the client in identifying the nuancesof anger escalation

Continuum of

Disclosure

The glimpses that children

show us: making sense of

the snapshots

Treatment Goal/ Interventions

Finding Your Voice(Sends a message that the

child will eventually find the strengthto tell the story of the trauma)

Zip It(Implants message that secrets can

be shared in the playroom)

Gabby the Gecko(Uses a therapeutic metaphor to give the

child powerful permission to tellthe secret)

The Creep and theCreepy Crawly

(Invites clients to pinpoint body partsthat have been made to feel uncomfortable)

Inviting Disclosure

Experiential Mastery

Play

A form of gradual exposure

Create a trauma

narrative

Help client re-create the facts of the

trauma, followed by thoughts,

feelings and body sensations

Key Structures in Memory

Brainstem

Amygdala

Hippocampus

Corpus collosum

Prefrontal cortex

(includes the

Orbitofrontal cortex)

Memory

Implicit Explicit Integrated

Nonverbal

memory present at

birth, generates

emotions and

perception

Semantic or

factual memory-

begins at one and a

half years of age

Requires the

transfer of info

across the corpus

collosum

Behavioral

responses, bodily

sensations, and

mental models

Autobiographical

(episodic)

memory, develops

after 2nd birthday

More difficult to

impact change in

emotional

responses

The Right Hemisphere

Dominant during the first three years

holistic, parallel, visual spatial

Self-soothing

Non-verbal aspects of language (tone, gestures)

Encodes facial expressions

The Left Hemisphere

Linear

Logical

Linguistic

Sequencing of events using words

Coherent Narratives

“To have a coherent story, the drive of the

left to tell a logical story must draw on the

information from the right. If there is a

blockage, as occurs in PTSD, then the

narrative may be incoherent.”

-Siegel, p.15, (2003). An Interpersonal

Neurobiology of Pschotherapy. In Healing

Trauma: attachment, mind, body, and brain

Anchoring Activities

Name five objects in the room

Draw two objects in the room

Name two sound you hear

Count the number of holes in

your tennis shoes

Sing a simple song together

Play “I Spy”

Provide a grounding touch, if

appropriate and pre-arranged

Work in the sand or with clay

Treatment Goal/ Intervention

Memory Books

Sandtray Stories

Timelines

The Toddler Book

Puppet Plays

"I Remember When"

Build coherent narratives for the child

Treatment Goal/ Interventions

Google Eyes

Monster Ears

Putting the Pieces Together

See No Evil, Hear No Evil

Assist clients in processing somatosensorymemories related to the trauma

Treatment Goal/ Interventions

Erase the Place

Repairing Self-Esteem

The Why Wheel

Thinking Caps

Punching Holes in that Theory

Put a Positive Spin on It

Identifying and challenging traumarelated cognitive distortions

Extinguish trauma induced

avoidance symptoms

Help client successfully overcome

anxiety induced avoidance patterns

Graduated Exposures-Building

Stepladders by Scenario Help the client make a

hierarchy of fear inducing

stimuli

Help the client rank these in

order of difficulty

Begin with the easiest task

first

Make the tasks small enough

that the client experiences

many initial successes

-as adapted from Wolpe as described by Shapiro, 1989

Making Positive

Meaning of the Post

Trauma Self

While encouraging a

meaningful goodbye

Before, During and After

Helping the client make meaning of

the trauma that includes a positive

sense of self

Flexibly Sequential Play

Therapy (FSPT): A New

Model of Trauma Treatment

Paris Goodyear-Brown, LCSW, RPT-S

615-397-9480

www.parisandme.com

paris@parisandme.com

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Creative Child Therapy Resources

Resources by Paris Goodyear-Brown (www.parisandme.com)1) Play Therapy with Traumatized Children: A Prescriptive

Approach2) The Worry Wars: An Anxiety Workbook for Kids and Their

Helpful Adults3) Digging for Buried Treasure: 52 Prop-Based Play Therapy

Interventions for Treating the Problems of Childhood4) Digging for Buried Treasure 2: 52 More Prop-Based Play

Therapy Interventions for Treating the Problems of Childhood5) 10 PEAS in a Pod (DVD)6) Gabby the Gecko

Creative Child Therapy Resources

Resources By Liana Lowenstein (www.lianalowenstein.com)1) Creative Interventions for Troubled Children & Youth2) More Creative Interventions for Troubled Children & Youth3) Creative Interventions for Bereaved Children4) Creative Interventions for Children of Divorce5) Paper Dolls & Paper Airplanes: Therapeutic Exercises for Sexually

Traumatized Children6) Assessment & Treatment Activities for Children, Adolescents, and

Families: Practitioners Share Their Most Effective Techniques

Resources by Sueann Kenney-Noziska (www.playtherapycorner.com)

1) Techniques-Techniques-Techniques: Play-Based Activities for Children, Adolescents, & Families