Why attachment

matters in play

Roberta Manners, Associate Theraplay® therapistSheila Lavery, Theraplay® trained facilitator

2014

Objectives for the day Learn the principles of Theraplay®

Explore the role of play in building trust

Demonstrate and practise Theraplay® activities

Consider how to employ Theraplay® in your own practice.

2014Why attachment matters in play

What is Theraplay®?

Theraplay® is adult-child playtherapy, based on the natural patterns of healthy interaction between parent and baby.

It is used to establish or re-establish connection between parents and children following loss, trauma or separation.

2014Why attachment matters in play

Theraplay® and child development

Early interactions between parent and child, create the foundation of the child’s being – their sense of self and how they relate to others and the world.

Fostered and adopted children have experienced a range of negative interpersonal interactions.

Foster and adoptive parents generally have more positive

experiences of relationships.

2014Why attachment matters in play

“…Because it focuses on attachment and relationship development Theraplay® has been used successfully for many years with foster and adoptive families”.

(Introductory Theraplay and MIM training)

2014Why attachment matters in play

What difficulties respond to Theraplay®?

Withdrawn, depressed, fearful, shy

children

Acting out, angry, non-compliant children

Attachment/relationship problems

Trauma history

Regulatory problems/ADHD

Autistic Spectrum Disorders

Developmental delays

2014Why attachment matters in play

What makes it Theraplay®? Responsive, attuned, interactive play

Modelled on “good enough” parenting

Focus on here and now

It is fun!

Adults direct the play

Focus is the relationship

Nurturing touch is integral

Geared to child’s emotional (not chronological) age.

2014Why attachment matters in play

Benefits for the child Feels safe and comforted

Experiences good touch

Learns to trust

Learns regulation

Improves self-image

Experiences fun with parents.

2014Why attachment matters in play

Putting back the missing pieces

Theraplay® provides an opportunity for

foster and adoptive parents to create

positive inter-subjective experiences

which their

children missed

or didn’t get

enough of.

soothing physical contact

dyadic

preverbal

right brain to right brain

intensive

2014Why attachment matters in play

These developmental building blocks

challenge the child’s negative internal

working model of themselves

and others, so they can

accept what foster and

adoptive parents have

to offer.

2014Why attachment matters in play

All children with an insecure attachment

history need heaps of nurture. Yet

parenting is often less intimate and

playful with older children.

Theraplay® enables

child and parent to

accept the need

for regression.

Why attachment matters in play

Theraplay with traumatised children

Relational trauma with attachment figure is more traumatic than external threats.

Trauma is non verbal – adaptive responses Traumatised children may resist

conventional therapy They see the world as threatening and

overwhelming Problems with relationships Primed for stress – fight, flight or freeze

2014Why attachment matters in play

Key concepts for trauma Work at a slower pace

Respect and work with the child’s coping mechanisms

Combines with other trauma work such as life story work

Avoid working with dangerous, acting out or actively psychotic children or recently traumatised children

2014Why attachment matters in play

Apply Theraplay® to the everyday

2014Why attachment matters in play

The 4 dimensions of Theraplay®

Scottish Attachment in Action 2014

The purpose of engagement

“To establish and maintain a

connection with the child, to focus

on the child in an intense way and

to surprise and entice the child

into enjoying new

experiences.”

Let’s try Peekaboo

Scottish Attachment in Action 2014

The purpose of nurture

“To re-enforce the message that the

child is worthy of care and that

adults will provide care without the

child having to ask.”

Let’s try caring for hurts

Scottish Attachment in Action 2014

The purpose of structure

“To relieve the child of the burden of

maintaining control of interactions. The

adult sets limits, defines body boundaries,

keeps the child safe and helps

complete the sequence

of activities” Let’s try hand stacking

Scottish Attachment in Action 2014

The purpose of challenge

“To help the child feel more

competent and confident by

encouraging the child to take a slight

risk and accomplish an

activity with adult help” Let’s try thumb wrestling

Scottish Attachment in Action 2014

The three rules of Theraplay

1. No hurts

2. The adult is in charge

3. We have

Scottish Attachment in Action 2014

The PLACE attitude

Playful

Liking

Acceptance

Curiosity

Empathy

Dan and Colwyn demonstrate shared meaning

Scottish Attachment in Action 2014

Theraplay programme Full history/presenting difficulties

Marschak Interaction Model (MIM) assessment Parent preparation

Sessions are planned - possibly up to 20 weekly/fortnightly 45-minute sessions with regular reviews

Sessions are usually filmed.

Scottish Attachment in Action 2014

Final things to think about

Find a safe, comfortable space

Adult sets structure (e.g. ready, steady, go!)

Flow of activities

Stay calm and focused on the child

Don’t say “don’t” (except with hurts)

Attunement and empathy

“We’re going to...” not, “ Would you like to...”

Be aware of resistance and trauma triggers

Stay playful and engaged.

Scottish Attachment in Action 2014

Further reading Theraplay – Helping parents and

Children Build Better Relationships Through Attachment- Based Play by A Jernberg and P Booth (Jossey-Bass)

I Love You Rituals by Becky A Bailey (HarperCollins)

Fun to Grow On by Virginia Morin (Magnolia Street Pub.)

Scottish Attachment in Action 2014