Trauma and Play Therapy

What is trauma?

When we talk about ‘trauma’ we are referring to Adverse Childhood Experiences or ACEs. ACEs are well researched to show that the more of these experiences that you have, the more likely your health and wellbeing is impacted into adulthood. Read more about ACEs research here and here.

ACEs include:

  • experiencing violence, abuse, or neglect

  • witnessing violence in the home or community

  • having a family member attempt or die by suicide

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding, such as growing up in a household with:

  • substance use problems

  • mental health problems

  • instability due to parental separation or household members being in jail or prison 

Additional ACEs can also have a significant impact on children and families. They include:

  • loss of a parent or caregiver due to death, or separation due to deportation or immigration

  • living in out-of-home-care, such as foster care or kinship care

  • experiencing harassment, bullying, racism, prejudice or other forms of discrimination

  • having a serious medical procedure or life threatening illness; and/or

  • community violence.

                                                                                              Source: cdc.gov

How does trauma present in children's behaviour?

We use the window of tolerance to help get a quick and easy picture of how trauma can present in children - here is a picture: 

 

NICABM-InfoG-window-of-tolerance.jpeg

As you can see, trauma will reduce a child's window of tolerance and can send them into hyperarousal or hypoarousal very easily. This is also known as the flight, fight, freeze and fawn response.

The hyper or hypo response can be from a smell, a sound, conflict, pressure or even kindness. A child's triggers, response and the way to get them back into their window is individual to that child and can rarely be predicted or planned.

To support a child presenting with trauma, your emotional resilience will need to be high and your presence calm.

Playing with Dreidel

How does trauma present in Play Therapy?

We see so many different themes, play scenes and roles played out in the playroom and it's often difficult to determine what is coming from real life experience, what is imaginary and what is from tv or video games. However, we do know that everything a child says, plays and shares in session is important so we meet the child where they are in the moment and don't worry about any analysis/themes/notes until later.

Some of the presentations we may see could be:

  • a child playing out specific scenes that they have witnessed ie. they may use the playmobil people as characters, and one hurts the other over and over

  • putting the babies to bed and then waking them up constantly

  • locking the therapist up and throwing away the key

  • yelling, stomping and punching the bop-bag

  • sitting on the couch, curled up

  • creating a barricade and exclaiming 'this is just for me you have to stay out there'.

Basically, children will play out their ACEs in many different and varied ways! 

How can Play Therapy help?

In Child-Centered Play Therapy (CCPT) we don't treat any diagnosis/presentation or symptom differently. We accept the child as they are in the moment and provide a safe and secure space for them to express themselves. 

By providing a safe and secure space, the child is able to slowly build a therapeutic relationship with the therapist which in turn creates more trust and security. Once the child feels that the playroom is a safe space they will likely start to play out their traumatic experiences symbolically. The therapist then use their skills to create meaning, encourage processing and integration. 

This is not a quick and easy fix! Most kids that have had one or more ACEs will need between 20 and 30 sessions and an involved parent to trust the process and learn some new ways of responding to their child at home.

There is so much more to be discussed around trauma and how Play Therapy can help! If you want to ask any questions or discuss it further email us: hello@playtherapysa.com.au
Play Therapy SA