Congruence in Nondirective Play and Filial Therapy: Response to Ryan and Courtney

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1 Congruence in Nondirective Play and Filial Therapy: Response to Ryan and Courtney Barry G. Ginsberg The Center of Relationship Enhancement Differences in the training of nondirective play therapists between University of York (U.K.) approach and the Guerney and Landreth approaches (U.S.) has been raised by Ryan and Courtney (2009). York-trained therapists are encouraged to initiate expression of their own feelings at selective times to assure that therapists are congruent in their relationship with children in nondirective play-therapy. Congruence, an important component of the necessary and sufficient conditions for therapeutic personality change (Rogers, 1957), is based on the importance of therapist genuineness to maintain a trustful and safe therapeutic relationship. This article compliments Ryan and Courtney (2009) for introducing the importance of congruence in play therapy. The assumptions of nondirective play therapy in the Guerney approach was influenced significantly by their development of filial therapy and to the training of parents and therapists, This article asserts that congruence, in the Guerney approach, is incorporated by therapists expressing their own feelings only when this is initiated overtly or covertly by the child. Responding to a child in this way is dependent on the empathic attunement to a child s emotional motivation by a skillful parent or therapist. This raises questions about whether a nondirective stance is maintained in the York approach. Keywords: nondirective play therapy, child-centered play therapy, filial therapy, congruence, child maltreatment Ryan and Courtney (2009) have made a significant contribution by acknowledging the importance of congruence in the practice of play therapy, particularly child-centered play therapy and filial therapy. Child-centered play therapy (originally entitled nondirective play therapy) is based on the work of Carl Rogers (1951) and his associates, particularly Virginia Axline (1969). Filial therapy incorporates child-centered play therapy in its approach to working with parents and children. As such, filial therapy is considered a play therapy approach. In developing filial therapy, Bernard G. Guerney, Jr. (Shannon & Guerney, 1973) was influenced by the interpersonal theory of Harry Stack Sullivan (1953) and the importance of reciprocal cycles of interaction in relationships. Barry G. Ginsberg, The Center of Relationship Enhancement. The author acknowledges appreciation for the extensive discussion with Virginia Ryan and Ann Courtney, Louise Guerney and Rise VanFleet in preparation of this article. Correspondence concerning this article should be addressed to Barry G. Ginsberg, The Center of Relationship Enhancement, 70 West Oakland, Suite 205, Doylestown, PA barry@ relationshipenhancement.com 109 International Journal of Play Therapy 2011 Association for Play Therapy 2011, Vol. 20, No. 3, /11/$12.00 DOI: /a

2 110 Ginsberg Playing with children in a therapeutic role should help parents relate more positively and appropriately to their children and visa versa by disrupting the cycle of perception and misconception of the parent s feelings or behaviors toward him [the child] (Guerney, 1964, p. 306). CONGRUENCE AND NONDIRECTIVE PRACTICE In their article, Ryan and Courtney (2009) make distinctions between York University (U.K.) trained nondirective play therapists and those trained by Louise Guerney and Gary Landreth, major figures in the training of nondirective play therapists in the United States. They state: Guerney and Landreth do not advocate practitioners using themselves within play sessions by expressing their congruent feelings within therapeutic relationships to the extent that York practitioners do. Landreth (2002), for example, suggested that therapists should be genuine and answer children s direct questions when asked about themselves where required (e.g., when a child asks his or her therapist, Are you a daddy? ). Guerney (personal communication, June, 2002) commented that adults I statements (e.g., I am sad to say goodbye to you ) should be used very sparsely in child-centered practice, arguing that if adults use these statements regularly, they interfere with maintaining children as the focus for play therapy sessions. Therefore, although there does seem to be a place for therapists to express congruent feelings within Landreth s and Guerney s practice, it is not considered to be a core therapeutic skill, as it is in the York model (Ryan & Courtney, 2009, p. 115). Ryan and Courtney (2009) clearly are making a distinction about being directive and being nondirective. In the York child-centered play therapy training, when therapists express their congruent feelings within the therapeutic relationship it is considered a core skill. Congruence, defined as an inner state on the part of therapists in which outward expressions of feelings consistently match therapists inner feelings, is seen by Rogers as an essential component of accurate empathy with clients. All three models of nondirective play therapy mentioned earlier agree with these statements. The York model differs from Landreth s and Guerney s and advocates that congruent feelings should be actively encouraged as verbal expressions to children by therapists and parents during play sessions (p. 116). This certainly is different from the Guerney and Landreth models, and this difference is the motivation for the present article. Rogers (1957) hypothesized congruence as one of three necessary and sufficient conditions for therapeutic personality change: (a) the therapist is able to convey a high level of accurate empathy; (b) unconditional positive regard (Acceptance and nonjudgment) is essential to being empathic in the moment-tomoment experience with the client, and (c) the therapist is genuine or self-congruent in his relationship with the client. Rogers et al. (1967) believed congruence to be the most basic because without it, the other two could hardly exist in the relationship. Congruence is best understood in the context of the other two necessary and sufficient conditions. The therapist is genuine or self-congruent in his or her relationship with the client when incorporating a high level of accurate empathy and unconditional positive regard (acceptance and nonjudgment). So the objective for therapists and parents, in play therapy, is to be skillful in being genuine is this way rather than letting children know when the therapist is concerned about his or her genuineness.

3 Congruence in Nondirective Play and Filial Therapy 111 Of the three necessary and sufficient conditions for the therapist (congruence/ genuineness, unconditional positive regard/acceptance, and empathic understanding), congruence has been the most difficult to define. Rogers (1967) states: certainly the aim is not for the therapist to express or talk out his own feelings, but primarily that he should not be deceiving the client as to himself. At times he may need to talk out some of his own feelings (either to the client, or to a colleague or supervisor) if they are standing in the way of the two following conditions (p. 76). Those conditions were unconditional positive regard and empathic understanding. So, the objective is for the therapist to be congruent (genuine), in order to establish trust, so that he or she can convey unconditional positive regard and empathic understanding. Unconditional positive regard and empathic understanding by the therapist are the elements that assist healing and therapeutic change in the client. Virginia Axline, a student of Rogers, has had a significant influence on nondirective, child centered, and most other approaches to play therapy. Several of Axline s eight principles may pertain to congruence and genuineness: the therapist accepts the child exactly as he is; the therapist maintains a deep respect for the child s ability to resolve his own problems if given an opportunity to do so; the responsibility to make choices and to institute changes is the child s; the therapist does not attempt to direct the child s actions or conversation in any manner; the child leads the way; the therapist follows; the therapist does not attempt to hurry the therapy along; it is a gradual process and is recognized as such by the therapist; and the therapist establishes only those limitations that are necessary to anchor the therapy to the world of reality and to make the child aware of his responsibility in the relationship (Axline, 1969, pp ). Axline (1969) pays a lot of attention to acceptance, permissiveness, and the importance of letting the child lead the way. Axline said, There should be no attempt made to guide the actions or conversation of the child (p. 94) and It s important that the therapist not get ahead of the child, also that she not read into the situation something that isn t there at all (p. 95). On page 120, Axline (1969) says, The therapist keeps her feelings, her guidance out of the therapy hour. These remarks suggest that congruence is different when working with children who, developmentally, are not on an equivalent level with an adult. Does a young child have the maturity to respond safely? It s seems likely that a therapist, out of her own concern, might express her incongruent feelings. Is the child safe, and what is the expectation of the therapist in sharing these feelings? The child may be safer if the therapist deals with this in supervision. Louise F. and Bernard G. Guerney, Jr. were trained at Penn State by students of Rogers in the 1950s and so were influenced by Rogers. The play therapy approach that the Guerney s developed, as part of filial therapy, was heavily influenced by Axline s (1947) eight principles. VanFleet, Sywulak, and Sniscak (2010) noted that Virginia Axline did not describe methodologies in great detail in her writings. Subsequent practitioners have had to translate her work into the methodologies that have since emerged for CCPT (p. 42). The Guerney s also were influenced by Dorfman (1951) and Moustakas (1953). The Guerney s reference congruence, defining it as genuineness, however their primary emphasis is on acceptance and empathic responding. Although Dorfman (1951) does not refer to congruence directly, she discusses several important distinctions between therapy with adults and children. Children

4 112 Ginsberg rarely refer themselves and are unlikely to be there because of a conscious awareness of being in neither difficulty nor desire for self-exploration. Typically, children are referred by a worried adult who can decide to discontinue therapy. This distinction raises concern about the power differential in working with children and the ability of children to face the expression of the therapist s incongruent feelings toward them. However, should a child request the therapist s feelings in a play session, it seems incumbent on the therapist to be genuine. What links the connection from Rogers to Axline to the Guerney s is their value of the importance of genuine acceptance (unconditional positive regard) and empathic responding (acknowledging the underlying feeling motivations) in a play session with a child. This is what heals and acts in a transformative self-actualizing way with children. The idea that a therapist spontaneously discloses his or her own feelings because of the therapist s concern for the therapist s incongruent feelings puts a burden on the child for which the child is not developmentally prepared. A discussion of limits and its relevance to congruence is important here. It is the author s belief that only those limits which secure a therapist s ability to respond empathically with unconditional positive regard, nonjudgment, and acceptance are necessary in a play session. When these conditions are met, a therapist can be congruent. Because the author of the present article was trained by Louise Guerney, the point of view expressed will be identified as the Guerney model. The Guerney model means here that therapists are focused on the child s emotional experience with acknowledgment, acceptance, and nonjudgment (a nondirective stance), not their own emotion. Congruence in the Guerney model is understood from this perspective. Note that Ryan and Courtney (2009) identify that in the U.K., the British Association for Play Therapy (BAPT) uses the term child-centered for all approaches to play therapy. In the United States, child-centered usually is considered nondirective. For the purposes of this article, the term child-centered and nondirective will be used interchangeably. EMPATHIC ATTUNEMENT AND CONGRUENCE Research on the mirror neuron system (Iacoboni, 2008) has given strong support to the notion that empathy is the result of reproducing feelings in our bodies that we observe in others. This certainly must be a component of how play therapists recognize feelings in their clients. However, an empathic therapist could feel bad recognizing the emotional distress of the child and act to relieve the distress. The therapist would be acting in a directive fashion initiated by the therapist s motivation not the child s. The primary ingredient in child-centered (nondirective) play therapy is when a therapist puts aside his or her inner feelings (feeling bad) so that the therapist s outer expression accurately acknowledges (empathically attunes to) the child s inner emotional experience. The objective is not to inform the child when the therapist s own feelings prevent outward expression of the child s inner state. It is incumbent on the therapist to develop sufficient skill in acceptance and nonjudgment so that the therapist can be congruent in his outward expression (acknowledgment) of the inner feelings of the child.

5 Congruence in Nondirective Play and Filial Therapy 113 To create the safety and security of the child-centered play therapy context, it is important that the therapist be genuinely accepting and nonjudgmental of the child. If the therapist s own feelings make this difficult, it is important that the therapist process this in supervision. This is preferable to the therapist sharing these feelings, possibly causing the child (in his or her immaturity) to take responsibility for the therapist s feelings and away from his or her own feelings. CONGRUENCE AND ATTACHMENT Ryan and Courtney (2009) justify the importance of training play therapists to express their congruent feelings on attachment theory. An important justification for York therapists expressing their congruence directly to children during play sessions in a timely way is based on child development, particularly attachmentrelated theory, and research. A key assumption in child development is that all self-growth by children occurs within a social context. Moreover, in attachment relationships, which are commonly viewed as having important shared features with therapeutic relationships (Ryan & Wilson, 1995), the relationship itself is central. Each person s responses influence the others responses, with children and their therapists involved in a dance in which therapists take the lead in attuning themselves to the needs of their clients and children take the lead in exploring and developing their own interests, confident that therapists will be able to help them, once a therapeutic relationship is established. Therapists, then, attempt to work alongside children, setting necessary limits when needed and fostering a climate in which children are able to express themselves more freely, without everyday hindrances (p. 116). It s very likely that every human encounter changes both parties. A therapeutic relationship, however, is not a relationship of equals but a hierarchical one, where therapists attune to the child s emotional experience not their own. The therapeutic relationship is established on the client being helped to change, not the therapist. Therefore, the attachment relationship in child-centered (nondirective) play therapy, in the Guerney model, is made more secure by creating a context in which the therapist accurately attunes to the child s experience. Congruence in the Guerney and Landreth models is when therapists can acknowledge children s feelings with acceptance and nonjudgment of the child s experience and actions. When they cannot, appropriate limits set clear boundaries that help therapists to maintain this stance. A context of acknowledgment, acceptance, and nonjudgment is created that helps children improve their confidence in themselves and in the therapist. This has the potential to improve attachment security in their relationship with the therapist and in their everyday lives. FILIAL THERAPY This model of congruence is particularly important in filial therapy. In filial therapy, the client is the parent child relationship. Bernard G. Guerney, Jr. has described the evolution of filial therapy.

6 114 Ginsberg The procedure that evolved was to train and supervise parents, sometimes individually, but usually in groups, in much the same manner (albeit without the formal theory and research) as I trained my graduate students in Clinical Psychology. But unlike the case with graduate students, the parents emotions, their personal problems as revealed by their interactions with their children in their play sessions, their verbal reports of the home play sessions, and their interactions with other parents in the group supervision sessions also were dealt with therapeutically. Because the parent child relationship was central to this approach to child treatment, we named it Filial Therapy. (I have also referred to it as Child Relationship Enhancement Family Therapy and Filial Family Therapy, but Filial Therapy is the name in most common usage.) (Guerney, B. G., 2003, p. ix). These comments by Guerney clearly establish that parents incongruent feelings motivated by their own problems are treated therapeutically in the group supervision so that parents could create a safe secure context of acceptance and nonjudgment in the weekly home play sessions. This distinction is particularly important in the discussion of congruence initiated by Ryan and Courtney (2009). It should be noted that, in the York model described by Ryan and Courtney (2009), therapists undergo personal therapy in addition to individual and group supervision to raise their awareness of unconscious feelings and thoughts to a conscious level. This is to help therapists distinguish between personal feelings and feelings arising within a therapeutic relationship with a child. This seems to be close to the attitude of Dr. Guerney (above) that therapists learn to monitor their feelings in their personal and group therapy. Yet the Guerney model would suggest that therapists and parents learn how to do this so that they don t express their own feelings in play therapy with children. With the client being the parent child relationship in filial therapy, the outcome focuses in on changes in this relationship to achieve an improvement in attachment security, emotional regulation, responsibility, and self concept in the child. An equivalent improvement occurs in parents when they become more child-centered (empathically taking into account and acknowledging the child s emotional motivations with acceptance and nonjudgment before their own). Parents become more accurate in their response to the child, more accepting, able to set realistic expectations and limits, and improve their confidence in themselves as parents. The child-centered skills parents learn are drawn from child-centered play therapy. However, there is a distinction that is important in filial therapy. The parent child relationship is already an attached relationship no matter how secure the child feels. The skills, which child and parent are learning together through the weekly nondirective play therapy sessions, can only improve the quality of this relationship and potentially family relationships. Louise Guerney reinforces this value in filial therapy, It is generally accepted that if a subsystem of the family, for example, parent and child, participates in a program designed to bring about change it can affect the family system as a whole. (Guerney, L., 2003, p. 2) The Training Manual for Parents in Filial Therapy (Ginsberg, 1997, adapted from Guerney, Stover & Guerney, 1972, 1976) states: The parent has to have an open mind and be willing to follow the child s lead, whatever form it takes (including ending the play session). Therefore, it is important that the parent engage in: NO criticism; NO praise approval, encouragement, or reassurance; NO questions, leads or invitations; NO suggestions, advice, or persuasion; NO interruptions or interference; NO information given, unless directly requested by

7 Congruence in Nondirective Play and Filial Therapy 115 the child [emphasis added]; NO teaching, preaching, or moralizing; NO initiating a new activity. In short, it is important for the parent to establish a setting in which the child and the child alone, sets the values and judgments. If the child wants you to participate in the play, it is the child s job to ask you [emphasis added] (p. 247). Helping parents adhere to these guidelines is essential to bring about change in the child, parent, and family system. In the York model of congruence, therapists are taught to express their own incongruent feelings (nonacceptance?) in play therapy sessions with children. In the Guerney model, any expression of the therapist s own feelings, not expressly requested by the child, would be discouraged because it would be initiated by the parent s own concern not the child s. This is a significant difference between the two models and raises the question of what is nondirective and what is not. It is essential (in the Guerney model) that a therapist or parent learn to be congruent in their relationship with children within the play therapy context. It means that the therapist or parent is genuine in empathy, acceptance, and nonjudgment of the child and the child s experience; accept the value, in the play session that the child is the initiator and therapist or parent initiate only for time and safety (limits); take responsibility for time, limits, and the structured way limits are conveyed to children; and trust in the child s capacity to be responsible for his own mastery and emotional regulation. The Guerney approach to child-centered nondirective play therapy has been influenced greatly by the years of practice and research in filial therapy. Ginsberg (1976, 1989, 1997, 2003) has suggested in a number of publications that in nondirective play therapy and filial therapy, a context is created that fosters constructive and positive change in individuals and their relationships. A context that is congruent adheres to these child-centered principles, allowing the opportunity for change. In the Guerney model, congruence is not determined by the therapist assessing whether his or her internal, conscious, or nonconscious emotions remain consistent with his or her overt behavior and the expressions to the child (seems like a directive stance); rather, the therapist genuinely experiences and provides acceptance and nonjudgment of the child during play therapy sessions (nondirective). The therapist is helped to be congruent by being true to the principles and boundaries or rules guided by these principles that define the play therapy context [see the Filial Therapy Parents Manual (Ginsberg, 1997)]. Though nondirective play therapy is focused on the child s emotional experience, its therapeutic power is derived from an emphasis on the transformative power of emotional experience in a relationship. The therapist focuses on acknowledgment and acceptance of the child s emotional experience in the relational context with the therapist. This reproduces the early attachment relationship which is so instrumental in the child s self development and relationship with others. Siegel (1999) is eloquent in his description of this attachment process, supporting the value of empathic attunement (accurately acknowledging the child s emotional experience with acceptance and nonjudgment as in nondirective play and filial therapy).

8 116 Ginsberg From a developmental perspective, the most utilitarian of these benefits is that parents can sense the inner needs of their children and therefore maximize the potential of their offspring s survival. Another benefit of empathic attunement is that it creates an attachment bond between parent and child, which provides a source of increasingly complex layers of external and then internal security for the growing child in the increasingly challenging world encountered as he develops. The experience of being understood develops a mental model or inner expectation that needs are important and goals are achievable. Also, the child s system requires the parent s attunement to help organize the child s own mind. Positive emotional states are amplified and negative ones modulated within these attuned communications. As the child grows, these repeated alignments of mental states allow him to develop a self-organizational capacity for autonomous state regulation. (Siegel, 1999, p. 141) So empathic attunement is the change agent and the structure and security of the play session context is the means by which therapists and parents attune empathically with the child. Any consideration by the therapist about the congruence of his own feelings during the play therapy session distracts the therapist s attention away from the child s feeling and undermines the empathic attunement and nondirectiveness of the session. Therapists are helped to be congruent by establishing rules (limits) that reduce significantly the need to express their own feelings. By establishing appropriate limits, applying them consistently according to the rules, and not expressing their own feelings unless specifically requested by the child, therapists and parents can respond with empathy and unconditional positive regard and remain congruent. Ginsberg (1997) believes that therapists and parents learn, through practice (weekly home play sessions), to implicitly incorporate what they have learned in to their relationship with the child. Once they become skillful in doing this, they are being congruent in their relationship with the child. Ginsberg (1997) also suggests that, in filial therapy, parents internalize what they have learned. As a result, in real life, they become skillful in responding with empathy and unconditional positive regard of the child s emotional experience before expressing their own emotional experience (child-centered parenting). Being child-centered is recognizing and acknowledging the child s emotional motivations before one s own. In that way, parents become more accurate in response to their children, facilitating a reciprocal security in their (attachment) relationship. Ryan and Courtney (2009) raise valid concerns about the difficulty of gaining the trust of abused children in play therapy. One factor that seems common to abused children is the inconsistency of their lives. Consistent adherence to the structure and rules of the nondirective play session model in the Guerney filial therapy approach is seen as the most effective way to foster the abused child s trust in the play therapy context and in the therapist or parent. Ryan and Courtney (2009) make some reference to influence in U.S. culture (and play therapy models) on the emphasis on autonomy in emotional development, that feelings are subjective internal states, whereas York-trained therapists use both autonomous and relational methods. In the Guerney model, therapists emphasize autonomy within a relational context. According to Siegel (1999) quoted above, autonomy and relationship are reciprocal and are not independent of each other. Therefore, the therapists genuine feelings are expressed only when the child requests it. This emphasis on child initiative recognizes the inherent power differ-

9 Congruence in Nondirective Play and Filial Therapy 117 ential in the adult-child relationship and is an effort to make the relationship more equivalent and emotionally attuned. The present article raises questions about many of the assumptions of the article by Ryan and Courtney (2009), particularly that therapists initiate expressing their congruent feelings in nondirective play therapy with children. Commentary on examples from the article will help to exemplify these concerns. EXAMPLES OF CONGRUENCE FROM RYAN AND COURTNEY AND COMMENTARY Jake Therapists instead are actively trained to express their feelings in therapeutic ways. An example of this is 7-year-old Jake, who had very low self-esteem. He was playing a board game with his therapist and desperately trying to win, but his therapist began to win instead. When this reversal of fortunes was seen and commented on with disgust by Jake, his therapist empathically reflected Jake s disappointment and desperation. Jake remained desperate to win, and his therapist decided to share her own feeling of wishing Jake was winning instead. It s so hard for you to lose. I wish you were winning too. (An incongruent response, on the other hand, would be the therapist pretending to lose and disguising this from Jake.) (Ryan & Courtney, 2009, pp ). This is a good example of a therapist spontaneously initiating an expression of her own feeling without being asked by the child. From the quotation above by Ryan and Courtney (2009), it would seem that this action of the therapist could be motivated by the therapist s concern for Jake s disappointment and desperation. This certainly was not requested by Jake and would seem to be an attempt to reassure him, a directive response. In the Guerney model, a therapist would say, it s so hard for you to lose and wait for the child s response before responding further. Marie Another example of expressing congruence is with a fearful, highly anxious child, Marie. She threw herself into playing in the sand for the very first time during a play therapy session, happily using her hands. She looked up, smiling with deep pleasure, appearing to want to share that moment with her therapist. The therapist, experiencing the child s pleasure herself, decided to express her own pleasure in Marie s enjoyment. I like it, seeing you so happy! (Ryan & Courtney, 2009, p. 119). In this vignette, the expression by the therapist shifts the focus from the child s pleasure to the therapist s happiness. The consequence of responding this way is that the opportunity for empathic and emotional attunement may be lost in place of attention to the attachment relationship. An alternative therapist response might be, you re really enjoying that. This response acknowledges the child s identity and the attachment relationship with the empathic attunement between child and therapist. In the Guerney model, the child would have to ask the therapist about the therapist s feeling for the therapist to say, I like it seeing you so happy. Often, acknowledgment of the feeling is enough and the child continues to pursue the activity. Children at younger ages tend to be egocentric and less attentive to the

10 118 Ginsberg adult s experience, especially in nondirective (child-centered) play sessions where the adult doesn t initiate except for time and safety. Diane In discussing the use of congruence in role play interactions, Ryan and Courtney (2009) state the following: Ryan and Wilson (2000) described play therapy with Diane, a 9-year-old girl who had been emotionally and physically abused. When asked to participate in Diane s intense role-plays, her therapist took directions from her about how to play out their roles. However, the authors argued there that her therapist also needed to use her own judgment of how to use her own feelings congruently in an emotionally healthy way. Role-plays, it was argued, become fully therapeutic in this way and can be used as a symbolic, imaginative means of restoring relationships that in reality may not be able to be retrieved. (p. 121) If the intention of the therapist is to use her own feelings congruently in an emotionally healthy way, then the therapist is leading, not the child. However, role play interactions in child-centered (nondirective) play therapy are difficult. It s hard to play a role without taking the lead from a child. Here, the intention is to introduce something based on the judgment of how to use her feelings in a healthy way rather than play the role spontaneously. In this example, Diane played out discovering her mother s wickedness and feeling deeply betrayed by her. The therapist, who had been placed in the mother s role, realized in role that she was feeling terribly guilty and ashamed of herself. Diane (with anguish): You tricked me. How could you trick me? Therapist (in a loud voice): I didn t think you d ever find out. You were just a little girl, I thought, and I could do what I wanted (p. 121). In the Guerney model, the therapist as role-played parent might respond, You re mad at me. It s hard to see how I could do that. This would provide an opportunity for the child to respond cueing the therapist s subsequent response. The objective here would not be to try to reproduce the real life experience of the child with her mother but rather heal the emotional hurt of this relationship through empathic attunement with the therapist. The congruence of the therapist is established by playing the role of the mother while retaining her own personhood as therapist and remaining true to her posture of empathy, acceptance, and nonjudgment as therapist. Of course, the therapist follows the lead of the child to develop the mother s character. Role-play interactions are emotionally complex and subtle. A skillful therapist fully engages in role-play with a child while being sensitive to the child s shifting from fantasy to reality. To do this the therapist remains in her role while being ready to acknowledge the child s feeling when the child s attention shifts away from the role-play. With Teenagers In a section entitled Expressing Feelings Congruently within Conversations, Ryan and Courtney (2009) state: Toward the end of their sessions together, Patricia confided that she had not told her therapist earlier about several of the

11 Congruence in Nondirective Play and Filial Therapy 119 dangerous games she had been playing with peers because she had enjoyed having secrets from her therapist. Besides, she was certain that her therapist would have told her social worker or the police. Her therapist reflected Patricia s feelings [empathically], that it was fun to feel more powerful early on by having secrets from adults who were trying to know just about everything about you. Her therapist also congruently acknowledged that Patricia was right. As an adult with some responsibility for Patricia, her therapist would have tried to prevent Patricia from seriously harming herself and others, and may have had to tell others (Ryan, 2007, p. 427, emphasis added). This example of expressing feelings congruently when working with a young teenager is similar to many examples in the client-centered literature of expressing genuine feelings congruently within adult relationships (p. 122). Ryan and Courtney (2009) are pointing to the importance of congruence when working with adolescents who are developmentally emerging into adulthood. The therapeutic relationship shifts to a more equivalent, adult-like, interaction. This puts more pressure for the therapist to be genuine, initiating the expression of his or her congruent feelings. In this vignette, rather than expressing congruent feelings, the therapist is setting a limit which does protect Patricia from harming herself or others. A therapist in the Guerney model might say: You enjoyed keeping that secret from me. Patricia: I m certain you d tell my teacher or the police. Would you? Therapist: You re worried about that. Patricia: Yes, would you? Therapist: You re really concerned and it s my responsibility to let parents and the police know when you are in danger. Patricia s revealing of this information might be a request for a limit in response to her own anxiety and guilt. If so, the therapist s response might have relieved Patricia, making her feel more secure and safe. Play therapy with adolescents is different than with younger children because of the increasing independence demanded by the adolescent s development. This increasing equivalence might require therapists to initiate expression of their own feelings. This shift in therapist stance requires a safe context in which adolescents and therapists (parents) can learn how to respond with greater acceptance and nonjudgment of each others feelings. This helps adolescents assert their feeling motivations rather than acting defensively. Ginsberg (1977, 1997) has developed an approach [The Parent-Adolescent Relationship Development (PARD) program] based on the filial therapy model to address the importance of the developing equivalence in adolescent-parent relationship. In child-centered (nondirective) play therapy with an adolescent, the therapist would be guided by how much the adolescent initiated this more mature way of relating. Limit Setting The example below reflects the importance of limit setting as part of the congruent role of the therapist, which is part of the Guerney approach too. With young children in play therapy, limit setting is expressed to the child as a rule in the play therapy context ( in here, the rule is ) in order not to confound it as an expression of the feelings of the therapist. As a result, the therapist can remain congruent in the role of therapist in this context. Of course, play therapists in the Guerney model would be encouraged to set limits appropriate only for safety and time, not the therapist s incongruent feelings.

12 120 Ginsberg Ryan and Courtney (2009) in discussing nondirective play therapy with abused children, refer to a previous article as an example: Often younger children who have been repeatedly sexually abused have inadequate personal boundaries between themselves and adults or other children and do not know what appropriate physical contact is. It is important for therapists to reflect back to children uncritically their own feelings, for example, that doesn t feel comfortable to me, because only through a genuine setting of boundaries can children learn to identify their own feelings [as distinct from others feelings in close relationships], and to distinguish between different kinds of physical and emotional expression of feelings. (Wilson & Ryan, 2005, p. 206). An example is with Claire, age 5 1/2. She made a large sausage shape out of play dough and thrust the object with both hands toward her therapist s mouth. Claire: It s nice. Therapist: You want me to like it, but I don t like it. Claire (becoming insistent): You want it. Therapist: You re telling me that I want it, but I don t want it. It s not nice for me. (Wilson & Ryan, 2005, p. 257) (p. 123). Therapists using the Guerney model would agree consistent limit setting is necessary with these children. However, they would not express their own feelings unless the child requested it. For example with Claire above, you d like me to put that in my mouth but the rule is that nothing can be put in my mouth. Claire insists. The therapist says, You really want me to put that in my mouth. You don t like that rule. Claire says, Yes, how come? The therapist says, You d like to know why. Claire, yes. Therapist, You d like to know why that s the rule. I don t like to put it in my mouth. The rule is that nothing is put in my mouth. You re unhappy about that. In this example, the therapists acknowledges and accepts Claire s feelings, while at Claire s initiative is making the boundary clear. It may be easier for the child to take responsibility for her emotions and actions when a limit is stated in this way and less likely to elicit conflicting feelings including shame and guilt in the child. Filial Therapy Ryan and Courtney (2009) make an important point: Indeed, congruence may have particular importance in filial therapy. Therapeutic relationships, as argued earlier, share important features with attachment relationships. In filial therapy, the therapeutic change agent is the attachment figure. This magnifies the impact of any therapeutic changes, which do not have to be generalized from a therapist to a primary attachment relationship. Children immediately can accommodate the new, more sensitive, and more attuned parenting experiences that they share with their attachment figure during play sessions, gradually adjusting their internal working model of relationships to become more flexible and accurate (p. 125). This process is reciprocal as parents, too, gradually adjust their internal working model of their relationship with the child and become more flexible and accurate. Parent and child together become more emotionally and empathically attuned and develop a more secure attachment relationship. It is particularly important in filial therapy for parents to avoid initiating their congruent feelings in play sessions with their children. The parent child relationship is already a natural hierarchical relationship. It is easy for parents to be directive out of concern and

13 Congruence in Nondirective Play and Filial Therapy 121 responsibility for their children. Filial therapy helps parents learn to suspend this directive stance to become more empathically attuned and child-centered with their children significantly improving their attachment. In Adoption and Foster Care According to Ryan and Courtney (2009), York therapists are less likely to encourage parents to express their own congruent feelings during the 30-min play sessions with their own children. However, in their work with adoptive and longterm foster parents, they do see some benefit in helping these parents use congruence. Adoption and foster care are complex processes which are affected by dynamic social forces, politics, and funding. In this article on congruence, it would be difficult to adequately address this subject; perhaps the chapter by Ginsberg (1989) may be helpful to clarify congruent behavior in nondirective play therapy with children in adoptive and foster families. It would be hard to differ in the following vignette from a section in the article by Ryan and Courtney (2009) entitled Expressing Feelings Congruently Within Role Plays. The parent seems to be spontaneously responding in the role play not trying to achieve an outcome. Amy (playing with play dough): I m going to make some pizza, do you want some? Mother: Oh, I d love some pizza. Amy: Sorry, I ve sold out, ask someone else. Mother: I ll go to McDonald s. Amy: No, sorry, ask next door. Mother: Have you got one? Amy: Yes, just a very little one. Mother (congruently): I really didn t think I was going to get anything nice, I was really worried, but maybe I will. Similar scenes were repeated, and Amy s mother congruently commented within the role play that sometimes she felt she wasn t going to be looked after, or that she felt sad, and a bit angry too (p. 125). In another vignette, they state: Another parent, working with four-year-old Hannah, was placed in the role of mother, as Hannah enacted a baby going to bed. She repeatedly called out to her mother, kicked the blankets off, and asked for things. Hannah s adoptive mother accepted all these demands week after week. In discussion with the play therapist, Hannah s mother found that she was wearying of some of these demands, although she was willing to continue because she recognized Hannah s feelings and insatiable need for reassurance. As a result, Hannah s mother was able to say within the role play, This baby is really hard work, and I am a bit tired, but I am going to carry on, while she needs me to. (Ryan & Courtney, 2009, pp ) The vignette above might be typical in adoptive families. However, a filial therapist would consider this directive, motivated by the parent s own interest in informing the child of the parent s feelings. A filial therapist would take a lot of time to empathize with the parent s concern, help the parent understand his or her own motivations, and explore ways to address how weary she was more effectively in real life not during the play session. A therapist in the Guerney model might try to help Hannah s parent understand that the repetition of behavior is a way for the child to soften and reconcile rigidly held emotions from past traumatic experiences. With accep-

14 122 Ginsberg tance, nonjudgment, and patience, Hannah may very well show signs of reducing the frequency of her demands in subsequent play sessions. The mother s acceptance of Hannah s demands in nondirective play therapy is critical to the therapeutic outcome. PRACTICE AND RESEARCH IMPLICATIONS WITH EXPRESSED CONGRUENCE Ryan and Courtney (2009) believe that, when working with maltreated children and teenagers who may form inaccurate attachment relationships in their current placements, it s especially important to have the option of using their own feelings congruently when they arise in play therapy sessions with these children. However, they raise the question of whether therapists and parents remain good enough without the skill of expressed congruence. They also wonder whether children with no apparent histories of maltreatment could benefit from expressed congruence within therapeutic relationships. They believe that more research is needed to answer these questions. Maltreated children and those in foster care represent especially difficult populations. Given the disruption and trauma in their lives, they may very well form inaccurate and insecure internal working models of attachment. Helping them to improve their ability to form secure attachment relationships is difficult. More research is needed to identify effective methods with these children including those indicated in this article. CONCLUSION Ryan and Courtney (2009) hope that their article will stimulate more conversation and research into the importance of congruence in nondirective play therapy. This author agrees about the importance of congruence. This article has been an attempt to convey how congruence is understood in a different way (Guerney model) than expressed in the article by Ryan and Courtney (2009). The primary concern regarding the expression of congruence by York-trained therapists has to do with whether their approach remains nondirective. This article suggests that expressing congruence in the York model changes the therapist s stance to a more directive one. By contrast, in the Guerney model, the therapist remains congruent in his role as therapist by adhering to the principles, structure, and boundaries of nondirective play therapy. Ryan and Courtney (2009) agree with the Guerney approach that in filial therapy, which uses the primary attachment relationship (parent child), training parents to initiate their own feelings in nondirective play therapy is more complicated. One of the variables that may contribute to child problems is this very issue of parent-directed (parent-centered) versus child-directed (child-centered) responses in the parent child relationship. Perhaps the most important intervention in the Guerney approach is helping a parent learn to be nondirective in play sessions as a means to improve the parent s skill in being child-centered in the parent s everyday life with the child. This

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