I: Creative Play Therapy and Core Needs
Creative Play Therapy is an adaptation of play therapy for older clients. With children, the therapist provides a playroom with carefully selected toys to facilitate nurturing, aggressive, real life and creative expression (Landreth, 2012), but with Creative Play Therapy, the therapist expands the creative category of “toys” (perhaps with a more professional grade of materials) to provide expressive arts tools for all forms of expression from an adult perspective. The creative expression is supplemented with talk therapy, not the other way around. Then, the therapist facilitates the stages of Creative Play Therapy while uncovering core needs, considering those needs within the context of development, taking into account any trauma during development along with current developmental stages.
This section will set the context for Creative Play Therapy, explain seven kinds of expressive arts and the basic materials needed, discuss how to use traditional talk therapy to supplement creative work, describe core needs and how to identify them, and review developmental models. These are the five areas of knowledge that inform the Creative Play Therapy: play therapy, expressive arts, talk therapy, core needs and development. See Figure 0.1.
Figure 0.1 Knowledge Blocks That Inform Creative Play Therapy
Landreth, G. L. (2012). Play therapy: The art of the relationship (3rd ed.) New York: Routledge.
What Is Creative Play Therapy?
People of all ages benefit from safe, accepting environments to risk expressing thoughts, feelings, and behaviors (Breen & Daigneault, 1998). Although play therapy has traditionally been a treatment for children, it can also be effective with adolescents and adults. In Creative Play Therapy, we use expressive arts instead of toys, add prompts strategically during some stages of the process, and focus the therapeutic work on core needs. While still grounded in client- centered theory, it is, at times, more directive. This chapter will provide an overview.
Play Therapy with Adolescents and Adults
Play therapy works with adolescents, especially when expressive arts replace more juvenile toys. For adolescents who may have limited experiences of empathy or disrupted early relationships, play therapy provides an opportunity to experience a secure, close relationship through a therapeutic alliance characterized by empathy, not being judged and permissiveness (Green et al., 2013). Adolescents naturally gravitate toward expressive arts seeking self-expression, turning to arts-based methods of coping, such as reaching for a journal, playing a musical instrument, or painting (Perryman et al., 2015). Like child play therapy, play therapy with adolescents incorporates natural forms of expression that are developmentally appropriate.
Adolescents internalize safety and security through the psychologically safe therapeutic relationship as they express raw, honest emotions directly or symbolically without judgment or being asked to change parts of themselves that others may see as unacceptable or undesirable (Green et al., 2013). They respond well to play therapy as they develop self-awareness and individual identity, but adolescent play is based more in reality than fantasy and is characterized by logic, rules, and structure (Breen & Daigneault, 1998). Understanding this desire for logic, rules and structure, Creative Play Therapy incorporates prompts to help build trust and safety.
Play therapy can be an effective treatment for adults who experienced early childhood trauma by addressing fundamental core developmental deficits (Olson-Morrison, 2017). It also has been used to work with child alter personalities, in clients with multiple personality disorder, now known as Dissociative Identity Disorder (Klein & Landreth, 1993), and adults with developmental disabilities (Demanchick et ah, 2003). But play therapy can also be used with the general adult population. Greenwald (1967) even advocated for play therapy for clients over 21 more than 50 years ago.
While rigorous research studies provide evidence of large beneficial effects from a variety of psychotherapies that work with children, adults and older adults (APA, 2012), not all who seek services are finding these benefits. Among adults who received some type of mental health service in the previous year, 5.9 million (nearly 20%) reported an unmet need for mental health care according to the American Counseling Association (АСА, 2011). That means that millions of people who are accessing services are not finding relief. They need something more; something that goes deeper; something that heals.
The cost of not helping those with mental illness is staggering. In the United States alone, the estimated cost is $63 billion in lost productivity, $12 billion in mortality costs, and $4 billion in in productivity costs for those who are incarcerated and those who provide family care - for a grand total cost of a whopping $79 billion per year (АСА, 2011). Traditional talk therapy has helped many people, but only using a verbal approach misses the opportunity to provide treatment using both hemispheres of the brain, one that physiologically facilitates healing and generates new neuron growth.