ADLERIAN PLAY THERAPY

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1 International Journal of Play Therapy, 10(2), pp Copyright 2001, APT, Inc. ADLERIAN PLAY THERAPY Terry Kottman, PhD, RPT-S, NCC, LMHC The Encouragement Zone Abstract: The author describes Adlerian play therapy, with an emphasis on the basic tenets of the approach, the view of the child and his or her capacity to change, the role of the therapist, the goals of therapy, and the unique characteristics of the approach. Adlerian parent consultation is also described. Because most children under the age of 10 do not have the abstract reasoning and language skills to verbally process their thoughts, feelings, reactions, and attitudes (Bettelheim, 1987; Piaget, 1962), many professionals who work therapeutically with children use toys, art, and play as a vehicle for communicating with young children. In play therapy, the play can be a means for (a) establishing rapport with children; (b) helping adults understand children and their interactions and relationships; (c) helping children reveal feelings, thoughts, reactions, and attitudes that they have not been able to verbalize; (d) constructively acting out feelings of anxiety, tension, or hostility; (e) teaching children social skills; (f) providing a way for children to explore their desires and goals; (g) creating a relationship in which children can test limits, explore their perceptions of themselves, others, and the world; and (h) providing an atmosphere in which children can gain insight about their own behavior and motivation, explore alternatives, and learn about consequences (Kottman, 1995, 1999b, 2001; Landreth, 1991; Thompson & Rudolph, 2000). Play therapy allows children to communicate through their natural ways of expressing themselves Terry Kottman, Ph.D., NCC, LMHC, RPT-S, is the director of The Encouragement Zone, a training center for play therapists, school counselors, and other professionals who work with children, adolescents, and their families. At The Encouragement Zone, she also does personal and professional coaching and "playshops" for women who want to lead more fun, balanced, and fulfilling lives.

2 2 Kottman playing, telling stories, making puppet shows, constructing creatures out of clay, drawing pictures, painting, singing, and so forth without requiring that they be able to conduct adult conversations or articulate their feelings, thoughts, and concerns using sophisticated language skills. In Adlerian play therapy (Kottman, 1994, 1995, 1999a, 1999b, 1999c, 2001, 2002; Kottman & Ashby, 1999; Kottman & Stiles, 1990), play therapists use the concepts of Alfred Adler's Individual Psychology to conceptualize children and their parents while using toys, art, and play material to communicate with child clients. Adlerian play therapists believe that the therapeutic powers of play will facilitate the process of working with children by creating a bond between the therapist and the client based on shared fun. The play will also allow play therapists to communicate (mostly through metaphor, but sometimes through direct verbal interaction) in a way that will facilitate the exploration of the child's (a) beliefs about self, others, and the world; (b) methods for attaining a sense of belonging in the family; and (c) the behaviors that stem from the child "acting as if" his or her beliefs about himself/herself, others, and the world are true. Play, art, and storytelling are excellent vehicles for sharing therapists' understanding of these factors with the child in order to help the child gain insight into his or her thoughts, feelings, attitudes, perceptions, relationships, behaviors, and ways of gaining significance. Adlerian play therapists also use various playful interventions to help the child learn to makes changes in thoughts, feelings, and behaviors. BASIC TENETS OF ADLERIAN PLAY THERAPY The Adlerian play therapist bases his or her work on the belief that all people are socially embedded, goal-directed, creative beings (Adler, 1956; Dinkmeyer, Dinkmeyer, & Sperry, 1987; Kottman, 1995, 1999b). Socially embedded means that people have a need to belong in their families, in their classrooms, in their neighborhoods, in other collections of people. One of the primary functions of the therapist is to investigate how the child fits into these relationships. The play therapist must work to understand how the child makes connections with others, by watching the child play out scenarios about people or animals

3 Adlerian Play Therapy 3 building relationships with others, by watching how the child builds relationships in the play room, and by talking to the parents and teachers about the ways the child interacts with others outside the play room. One of the basic tenets of Individual Psychology related to social embeddedness is the concept of "social interest" (Adler, 1937,1956,1958; Ansbacher, 1991), the sense of being connected to other people. All human beings are born with an innate ability and desire to connect with others, but they must learn how to make those connections in positive rather than negative ways. In many instances, a child referred to play therapy has a lower level of social interest as compared to that of other children. The play therapist must assess each child's level of social interest and try to work with the child to increase his or her social interest by modeling the desire to connect with others and the skills necessary to build and maintain relationships and fostering this ability in the child. Initially this process occurs in the therapeutic relationship in the play room. Over time, the play therapist works with the child to broaden the sense of positive connection by teaching and encouraging the application of social skills in other relationships in the family and in other settings such as school and the neighborhood. The play therapist also uses the parent consultation sessions to teach parents how to make positive connections with the child and how to encourage social interest in the family. Another important tenet in Adlerian play therapy is that all behavior has a purpose. Dreikurs and Soltz (1964) posited four basic goals for children's misbehavior: attention, power, revenge, and proving inadequacy. The play therapist learns to recognize the child's goal or goals by (a) observing the child's behavior in the play room and listening to parents and teachers describe behaviors that are upsetting to them; (b) using questions, observation, and self-examination to explore the emotional reactions of adults (including the therapist) when confronted with the child's inappropriate behavior; and (c) asking questions about and observing the child's reaction to correction or discipline. Once the Adlerian play therapist uncovers the goal of the child's misbehavior, he or she can use play, art, and storytelling to help the child learn to strive for more positive, constructive goals, such as those described by Lew and Bettner (1996, 1998)~the "Crucial Cs" of feeling connected, feeling

4 4 Kottman capable, believing that they count, and demonstrating courage. The therapist can use many play strategies to help the child move toward enhancing the Crucial Cs (Kottman, 1999c). Another central concept in Adlerian theory is lifestyle-the person's unique, creative approach to life and belonging (Adler, 1956, 1958; Kottman, 1995, 1999b, 2001). The child usually evolves his or her lifestyle before the age of 8. By observing others and their reactions to other people and to various situations in life, the child develops conclusions about self, others, and the world. The child's behavior organically grows from his or her perceptions and the conclusions based on these perceptions because the child "acts as if" these perceptions and conclusions are true and real. Some of these perceptions and the conclusions about how life and relationships work are inevitably faulty. While children possess keen observation skills, they lack the sophistication and experience to be able to accurately evaluate and interpret situations and relationships. In Adlerian play therapy, the therapist uses play techniques to gather information about the child's lifestyle. With perceptions and conclusions that are self-defeating ("faulty" or "mistaken"), the therapist helps the child examine the ways in which these convictions are undermining the child's ability to maintain attitudes and behavior that will sustain a positive self-image, successful interaction patterns, and socially-appropriate behavior. The play therapist tries help the child reevaluate these mistaken beliefs; draw more constructive conclusions about self, others, and the world; and formulate revised methods for resolving difficulties and building relationships. VIEW OF THE CHILD AND HIS OR HER CAPACITY TO CHANGE Adlerian play therapists have a positive and pro-active view of the child and his or her capacity for change (Kottman, 1995). Since Adlerians believe that a person's lifestyle is not really formed until the age of 8, play therapy is the perfect vehicle to bring about change and growth. In Adlerian play therapy, the therapist works to optimize the relationship, which can provide much positive and corrective feedback to the child about him or herself, others, and the world. One of the primary tools for accomplishing this task is encouragement, an Adlerian

5 Adlerian Play Therapy 5 technique in which the therapist acknowledges the assets and the efforts and progress of the child, returns responsibility to the child to build his or her sense of competence, and demonstrates the courage to be imperfect to reinforces the child's willingness to take risks and try new behaviors. There are four phases in Adlerian play therapy: (a) building an egalitarian relationship with the child, (b) exploring the child's lifestyle, (c) helping the child gain insight into his or her lifestyle, and (d) providing reorientation and reeducation for the child when necessary (Kottman, 1994, 1995, 2001). Parent consultation follows the same phases, with the emphasis on the parent and his or her lifestyle and the interaction between the lifestyles of the parents and the child. The specific expectations for the evolution of the child and his or her parents will be different, depending on the phase of the play therapy/ parent consultation process. During the first phase, the play therapist builds an egalitarian partnership with the child. In this phase, the child may change very little, except in his or her willingness to make a connection to an adult. The therapist also works to build a relationship with the child's parents, with little expectation for them to begin change their parenting strategies, though sometimes simply having another adult listen to them talk about their child brings about changes in the parent/child relationship. In the second phase, the therapist explores the child's lifestylegathering information from the child and the parents. The therapist also works to understand the parents' lifestyles in relationship to their parenting practices. During this phase, the therapist has the expectation that the child will answer questions and play out the various aspects of his or her lifestyle and that the parents will answer questions about the child, the parents' family-of-origin, the marital relationship, family values, parenting methods, and so forth. There is little pressure from the play therapist for change on the part of the child or the parents, although sometimes they gain insight simply from the exploration process, which may lead to change. In the third phase, there is a major shift in the Adlerian play therapist's expectations for change both with the child and with the parents. The play therapist will attempt to help the child gain a better

6 6 Kottman understanding of his or her lifestyle and make some decisions about whether or not to begin making changes in parts of it. Simultaneously, the play therapist works with the parents on gaining a better understanding of their child and of their own lifestyle issues that might be interfering with their ability to be the best parents they can be. The Adlerian play therapist expects that the child and his or her parents will gain insight into their own lifestyles and begin making major shifts in their attitudes toward themselves, one another, other people, and the world in preparation for the fourth phase, reorientation/ reeducation. During the fourth phase, the therapist's has the highest expectations for change. The child and his or her parents are learning new skills and attitudes, putting these attitudes into place in their relationships with other and their outlooks on the world, and practicing these new skills with the play therapist so that they can use them in interactions and experiences outside the play room. The play therapist uses teaching techniques (such as brainstorming, modeling, sharing metaphors, role-playing, and playing games) and encouraging skills focused on the improvement and effort of the child and the parents. ROLE OF THE THERAPIST The role of the Adlerian play therapist changes depending on the phase of counseling (Kottman, 1995, 1999b, 2001). As the play therapist builds the relationship during the first phase of the process, the role of the therapist is that of partner and encourager. In this phase, the therapist is almost always relatively nondirective, making sure that the child leads the action the majority of the time. It is important to share power in sessions with the child so that he or she begins to trust the play therapist, creating a sense of teamwork and cooperation in the play room. The therapist uses tracking, restatement of content, reflection of feelings, returning responsibility to the child, encouragement, limiting, answering questions, asking questions, and cleaning the room together to build a egalitarian and collaborative relationship. Using drawing techniques, questioning strategies, investigating goals of behavior, Crucial Cs, family constellation, and family atmosphere, observing play patterns, and soliciting early recollections in the second phase, the therapist is an active, directive explorer. He or

7 Adlerian Play Therapy 7 she must get information about the child's attitudes, perceptions, thinking processes, feelings, and so forth. Since the intervention strategies in the two later phases spring from the therapist's conceptualization of the lifestyles of the child and the parents, being actively involved in gathering the essential information is critical during this phase. In the third phase, the Adlerian play therapist is relatively directive, using metacommunication, metaphors, "spitting in the soup" (a technique in which the therapist points out situations in which the child is acting as if self-defeating beliefs about self, others, and the world are true), and drawing techniques to convey essential information about lifestyles, mistaken beliefs, goals of misbehavior, Crucial Cs, assets, and so forth to the child and to the parents. The role of the therapist during this phase is rather dichotomous. Sometimes, the play therapist is nondirective and empathically supportive, especially when trying to gently move the child (or the parents) to a new understanding of situations and relationships. Other times, the therapist will be extremely directive and confrontive challenging long-held self-defeating beliefs about self, others, and the world and pointing out discrepancies between what is said and what is done, between the verbal and nonverbal communication, and so forth. In the fourth phase (reorientation/reeducation), the Adlerian play therapist is an active, occasionally intrusive teacher and encourager. The therapist uses an assortment of teaching techniques grounded in play to help the child adopt more positive attitudes and perceptions and learn and practice new skills. The "curriculum" during this phase involves the provision of training and experience in assertiveness skills, negotiation skills, social skills, and other methods of positively interacting with others and coping with difficult situations and relationships. The therapist may also teach parents parenting skills (such as setting consequences, providing encouragement, recognizing goals of misbehavior) or work with parents on any issues that might be getting in the way of their application of parenting skills.

8 8 Kottman GOALS OF THERAPY The goals of Adlerian play therapy are inseparable from the phases of the process. The initial goal (which corresponds to the first phase) is for the therapist to develop relationships with the child and his or her parents (if possible) in which the two parties can share power and work together as a team (Kottman, 1995, 1997, 1999b, 2001). Tracking the second phase of play therapy, the second goal is for the play therapist to acquire enough information about the child's lifestyle (and the parents' lifestyles) to be able to formulate a comprehensive set of hypotheses about views on self, others, and the world and the connection between these beliefs and the child's behavior. The primary goal in the third phase of Adlerian play therapy is for the therapist to help the child begin to understand his or her lifestyle and mistaken beliefs. Conjointly, the therapist works to help the parents gain a different perspective on their child's behavior and motivations and learn more about the possibility that their own lifestyle convictions might be interfering in their interactions with their child. As a segue to the fourth phase of play therapy, the therapist guides the child and/or his or her parents to make decisions about whether to actuate emotional, attitudinal, and behavioral changes. In the fourth phase, the goal of the Adlerian play therapy process is teach the child skills necessary to effect these changes outside the play room. The therapist attempts to shift the child from destructive goals and misbehavior toward constructive goals; enhance attainment of the Crucial Cs; increase the child's social interest; adjust self-defeating perceptions in his or her beliefs about self, others, and the world; reduce discouragement; and help the child to understand and "own" his or her personal assets (Kottman, 1995, 2001). With parents, the primary goals are to teach Adlerian parenting strategies, using resources such as Systematic Training for Effective Parenting (STEP) (Dinkmeyer & McKay, 1989), Raising Kids Who Can (Bettner & Lew, 1996), A Parent's Guide for Understanding and Motivating Children (Lew & Bettner, 1998), and Positive Discipline (Nelson, 1996), and to help parents make enough shifts in the behavior connected to their own issues that they can apply the parenting methods they are learning.

9 Adlerian Play Therapy 9 UNIQUE CHARACTERISTICS OF THE ADLERIAN APPROACH Adlerians do several things that are different from other approaches to play therapy, including (a) the phases of the play therapy process, (b) limitsetting, (c) picking up toys and other play materials, (d) the focus on encouragement, (e) the type of information gathered, (f) the technique "spitting in the soup," (f) the use of metacommunication as an interpretation tool, and (g) the emphasis on collaboration with the parents. The four phases of therapy are unique: Although other approaches to play therapy may have steps in the process, the phases of Adlerian play therapy range from being highly directive to being nondirective at times. The sequence of the phases incorporates the deliberate emphasis on three elements of the therapeutic process: (a) the relationship between the client and the therapist; (b) insight into intrapersonal and interpersonal dynamics and the working of the family system; and (c) cognitive, emotional, and behavioral change. The emphasis on all three of these elements is a distinctive feature of Adlerian play therapy. In most approaches to play therapy, the primary focus is on one or two of these elements, but not on all three. Adlerian play therapists set limits in a unique manner. Limit-setting is a four-step process in which, rather than redirecting the child's misbehavior, the therapist sets the limit, makes a guess about the child's feeling and/or the purpose of the misbehavior, engages the child in redirecting his or her own behavior, and negotiates logical consequences for continued violation of the limit (Kottman, 1995, 2001). The hypotheses about the goals of behavior, the emphasis on self-redirection, and the collaborative negotiation of logical consequences are peculiar to Adlerian play therapy. The Adlerian process of forming a team with the child to pick up materials in the play room seems to be unique in the play therapy literature. Although other play therapists ask children to pick up toys and materials, the Adlerian approach is very structured and specific, with the child in charge of who picks up what and how the picking-up time proceeds. This method of clean-up was designed to promote cooperation and an egalitarian relationship by engaging the child in a cooperative partnership with the therapist (Kottman, 1995,2001). The focus on techniques designed to encourage the child and her or her parents also seems to be a distinctive feature of Adlerian play therapy (Kottman, 1995, 2001). The Adlerian play therapist emphasizes the assets,

10 10 Kottman efforts, and improvements of the child and the parents to enhance their sense of self-efficacy and reduce any discouragement they might be feeling. The type of information gathered during the second phase is unique to Adlerian play therapy (Kottman, 2001). The therapist wants information about family constellation (birth order), family atmosphere, goals of misbehavior, assets, Crucial Cs, early memories, and personality priorities (Kottman, 1999c, 2001; Kottman & Ashby, 1999). The Adlerian play therapist uses this special combination of data to devise a comprehensive conceptualization of the child's lifestyle, and in many cases, the parents' lifestyles as well. Spitting in the soup and metacommunication are both uniquely Adlerian techniques. Spitting in the soup is a strategy in which the therapist points out situations in which the child (or parent) is interfering with his or her own functioning-usually because of mistaken beliefs or striving toward goals of misbehavior. In Adlerian play therapy, the therapist uses metacommunication to make guesses about elements of the child's lifestyle based on his or her observation of the child's nonverbal reactions, responses to therapist comments, patterns and themes across sessions, and patterns and themes related to the child's lifestyle. In parent consultation, the therapist makes guesses about patterns in relationships, behaviors, feelings, and thought processes. The purpose of this technique is to help the child and the parents gain awareness and understanding of their motivations, goals, and beliefs. The strong interconnectedness of the play therapy process and the parent consultation and the structure of the consultation with parents is also a distinctively Adlerian phenomenon. Although there are other play therapy approaches that work with parents, the emphasis in those relationships is usually solely on the child and his or her behavior. In Adlerian parent consultation, the therapist combines consultation with teaching and counseling techniques so that parents are able to better understand their own roles in the maintenance of the child's self-defeating behaviors and attitudes. As part of this process, parents also develop the knowledge and skills to make concrete changes in parenting strategies and any other aspects of the relationships within the family in order to support positive shifts in the child.

11 Adlerian Play Therapy 11 REFERENCES Adler, A. (1937). Psychiatric aspects regarding individual and social disorganization. American Journal of Sociology, 42, Adler, A. (1956). The Individual Psychology of Alfred Adler. (H. Ansbacher & R. Ansbacher, Eds.). New York: Basic Books. Adler, A. (1958). What life should mean to you. New York: Putnam. Ansbacher, H. (1991). The concept of social interest. Individual Psychology, 47, Bettelheim, B. (1987, March). The importance of play. The Atlantic MonthlyL Dinkmeyer, D., Dinkmeyer, D., & Sperry, L. (1987). Adlerian counseling and psychotherapy (2nd ed.). Columbus, OH: Merrill. Dinkmeyer, D., & McKay, G. (1989). The parent's handbook: Systematic training for effective parenting (STEP) (3rd ed.). Circle Pines, MN: American Guidance Service. Dreikurs, R., & Soltz, V. (1964). Children: The challenge. New York: Hawthorn/ Dutton. Kottman, T. (1994). Adlerian play therapy. In K. O'Connor & C. Schaefer (Eds.), Handbook of play therapy, vol. 2 (pp. 3-26). New York: John Wiley & Sons. Kottman, T. (1995). Partners in play: An Adlerian approach to play therapy. Alexandria, VA: American Counseling Association Kottman, T. (1997). Adlerian play therapy. In K. O'Connor & L. Braverman (Eds.), Play therapy theory and practice: A comparative presentation (pp ). New York: Wiley. Kottman, T. (1999a). Group applications of Adlerian play therapy. In D. Sweeney & L. Homeyer (Eds.), Group play therapy (pp ). Springfield, IL: Charles C Thomas. Kottman, T. (1999b). Play therapy. In R. Watts & J. Carlson (Eds.), Interventions and strategies in counseling and psychotherapy (pp ). Philadelphia: Accelerated Development. Kottman, T. (1999c). Using the Crucial Cs in Adlerian play therapy. Individual Psychology, 55, Kottman, T. (2000). Adlerian case consultation with a teacher. In M. Dougherty (Ed.), Psychological consultation and collaboration (3rd ed.) (pp ). Pacific Grove, CA: Brooks/Cole.

12 12 Kottman Kottman, T. (2001). Play therapy: Basics and beyond. Alexandria, VA: American Counseling Association. Kottman, T. (2002). Billy, the teddy bear boy. In L. Golden (Ed.), Case studies in child and adolescent counseling (3rd ed.) (pp. 8-20). Columbus, OH: Merrill Prentice Hall. Kottman, T., & Ashby, J. (1999). Using Adlerian personality priorities to custom-design consultation with parents of play therapy clients. International Journal of Play Therapy, 8(2), Kottman, T., & Stiles, K. (1990). The mutual storytelling technique: An Adlerian application in child therapy. Journal of Individual Psychology, 46, Landreth, G. (1991). Play therapy: The art of the relationship. Muncie, IN: Accelerated Development. Lew, A., & Bettner, B.L. (1996). A parenvs guide to motivating children. Newton Center, MA: Connexions. Lew, A., & Bettner, B.L. (1998). Responsibility in the classroom: A teacher's guide to understanding and motivating students (rev ed.). Newton Center, MA: Connexions. Nelson, J. (1996). Positive discipline (rev ed.). New York: Ballantine. Piaget, J. (1962). Play, dreams and imitation in childhood. New York: Rutledge. Thompson, C, & Rudolph, L. (2000). Counseling children (5th ed.). Pacific Grove, CA: Brooks/Cole.

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