Methods of corrective work with children:
play therapy
Play therapy is one of the varieties of art therapy, which is a psychotherapeutic method based on the use of role-playing as one of the most intensive methods of influencing personal development. The essence of this technique lies in the use of the therapeutic impact of the game to assist the client in overcoming social or psychological difficulties that create barriers to personal growth and psycho-emotional development. The technique of play therapy covers the implementation of a group of persons or an individual special exercises which suggest and stimulate verbal and non-verbal communication, living through the game of situational tasks.
Game therapy is aimed at providing a healing effect on people of different age categories who suffer from emotional disorders, fears, neuroses of various etiologies, etc. The methodology is based on the recognition of an important factor in the personal development of the game.
Game therapy methods
Play therapy refers to all psychotherapeutic areas that use the game and toys. It is often practiced when working with children. Since all other methods of therapy may simply not be suitable for working with babies. After all, even detecting a problem in babies, and even more so its cause, can be quite difficult, since most often it does not lie on the surface. Many experts recommend play therapy for working with children, due to the fact that the game reflects the way children think, how they interact with the environment and cope with emotions. The psychotherapist, controlling the child's play process, teaches him how to deal with difficult feelings or situations.
Play therapy methods allow you to gently and carefully diagnose the emotional and mental state of the baby, discover the cause of the problem, correct it, and provide the child with possible ways to overcome it.
Note that today there are many methods of psychotherapy, which include fairy tale therapy, sand therapy, etc.
Today, play therapy can be classified as: ego-analytic therapy, guided by the concepts of social learning, non-directive therapy.
Ego-analytical game therapy as a method of correction consists in helping the individual to comprehend and accept emotional conflicts that were previously repressed or rejected by him. Psychotherapy based on the theory of social learning is to teach collective interaction during the game, and not on the emotional component of games. Non-directive psychotherapy is an assistance to the client in the manifestation of his personality conflicts, while the therapist supports his reflection.
Among the methods of play therapy, there are active, passive, liberating, structured method and relationship therapy.
Active play therapy as a correction method consists in working with the client's symbolic imagination. The patient is offered several deliberately selected toys that can be symbolically associated with the problem situation. The therapist during the session participates in playing out emerging game situations. In the course of such game therapy, there is a rapid decrease in the level of anxiety. A kind of marker in understanding the client's relationship with other people is how he builds his relationship with the therapist.
The passive method is a game that is not limited or directed by the therapist, it is simply present with it. The specialist is gradually involved in play therapy. With this method, the role of the therapist is more of an observational one. He only occasionally interprets the patient's actions. The leading role in this method belongs to the client, who gets the opportunity to work in game form own anxiety, aggressiveness, or feelings of insecurity. The position of the therapist in this method should be one of acceptance.
"Releasing" therapy, developed by D. Levy and created on the basis of the belief that the game provides clients with opportunities for emotional response. The therapist during the session reconstructs the traumatic event while helping the client overcome the negative emotions that arose at the time of the traumatic situation, free himself from fear, express anger or other feelings generated by this event. It is in the game that the individual controls the situation, as a result of which he transforms from a victim into an actor, from a passive to an active role.
Structured Therapy is an offshoot of Liberation Therapy and is focused on solving specific problems.
Relationship therapy is not far from passive psychotherapy, but the focus is on what happens in the counselor's office rather than on the client's previous experience. In this case, the patient is given complete freedom of action in the presence of a therapist.
A specific feature of game therapy is its two-sidedness, the elements of which are preserved in any game of a collective nature. The first side is expressed in the performance by the player of a real activity, the implementation of which requires actions related to the resolution of specific, often non-standard tasks. The second side is related to the fact that some moments of such activity are conditional, which contributes to abstraction from the situation in reality with countless attendant circumstances and responsibilities.
The two-sidedness of the game predetermines its developmental effect. The psychocorrectional impact of gaming activities is achieved by establishing a positive emotional relationship with others. The game makes adjustments to suppressed negative emotions, fears, indecision, uncertainty, expands the ability to communicate.
The hallmarks of the development of play therapy are rapidly transforming situations in which the object finds itself after manipulations with it, and the same rapid adaptation of actions to new circumstances.
Play therapy as a method of correction has the following specific mechanisms:
modeling the system of social relationships in a visual-effective model in specific game circumstances, following them by the client and orientation in such relationships;
transformation of the individual's position towards overcoming personal and cognitive egocentrism and logical decentration, as a result of which there is a comprehension of one's own "I" in the game and the measure of social competence and inclination to solve problem situations grows;
development simultaneously with the game of real relationships on the basis of equality and partnership, cooperation and cooperation, providing the possibility of personal development;
organization of a gradual study in the game process of new, more appropriate methods of orienting an individual in conflict situations, their formation and assimilation;
organizing the orientation of the individual to highlight the emotional moods he feels and ensure their understanding with the help of verbalization, as a result of which there is an awareness of the meaning conflict situation, development of its new values;
development of the ability to arbitrarily regulate activities based on the subordination of actions to a system of rules governing the performance of the role and behavior in the process of game therapy sessions.
Play therapy in kindergarten
The role of play therapy for a small individual is enormous. It contributes to the development of the baby's abilities, overcoming conflicts and achieving psychological balance. The game process helps the child to learn easier and faster, to acquire skills that will be useful to him in later life.
Game therapy for preschoolers as a method of corrective impact on their psyche can be used for work, starting from the age of two. The child is offered a role-playing game to clarify his emotional state, fears and possible psychotraumas, which the child is not able to talk about. Experts in play therapy say that with the help of the game process, children can be taught to interact more freely with their environment, improve school performance, reduce their hyperactivity, aggressiveness and other behavioral disorders.
Play therapy in kindergarten today is considered one of the trends of modern times. Today, almost all kindergartens have a psychologist on staff who develops children using the method of play therapy. Usually in kindergartens, elements of play therapy are present in the daily routine.
The leading person in the course of using play therapy will always be a child. The task of the psychologist is to maintain friendly relations with children and between them, to help in asserting the “I” of the child for himself and among those around him. Game classes in kindergarten are recommended to start with games that are aimed at improving psychological well-being.
Play therapy for preschoolers provides emotional relaxation, relieves nervous tension, reduces fear of the dark, punishments, closed spaces, optimizes flexibility in actions, promotes the development of group norms of behavior, establishing contact between babies and their parents, develops coordination of movements and dexterity. Important in play therapy is respect for the wishes of the child, his active position in the game. The task of the psychologist is to make the gameplay bring joy to the baby. During the game, you should pay attention to the well-being of the child.
Game therapy examples of games focused on the correction of various fears are role-playing situations. So, for example, the game "Brave Mice", in which a cat and mice are selected. The mice run and squeak while the cat sleeps in her house. Then the cat wakes up and tries to catch up with mice that may hide in the house. Then the children switch roles.
Playing "daughter-mother" with dolls also has a therapeutic effect, reveals the potential and reveals inner world kids. In gaming processes, the child models the situation in accordance with the situation at home. That is, the child will project relationships in the family onto the game.
Therefore, the most important task of the psychotherapist in play therapy is careful observation of behavior. It is not recommended to regulate the rules of the game, speed up or slow down the game process. In the process of play therapy, the psychotherapist needs to understand the feelings of the baby, to become a kind of mirror for him, helping him to see himself. And the correction process in the game should occur automatically. The psychologist is required to express a sincere belief that the child can independently cope with the problems that have arisen.
Several monographs have been published on the theory and practice of play psychotherapy. So, for example, Panfilov's game therapy has become a real bestseller today. In his book, Panfilov offers an exemplary program of play psychotherapy with kids and their parents, describes play therapy and examples of therapeutic and educational games, introduces methods of parental interaction with children prone to anxiety, aggression, hyperactive kids.
Play therapy classes with kids allow you to bring the child closer to adults and has a beneficial effect on the personal development of the baby, helps him in the process of socialization and development of social norms.
Play therapy saves children from the influence of stress factors and traumatic life situations.
The game is one of the forms of manifestation of the activity of the individual. The essence of the game is in unproductive activity, the motive of which lies not in its results, but in the process itself, aimed at recreating and assimilating social experience, and in which behavior management is formed and improved. Children's play is a form of inclusion of a child in the world of human actions and relationships. The game contributes to the mental discharge of the personality, the removal stressful conditions. The game is that universal form of activity, within which, by definition, D.B. Elkonin, there are progressive changes in the psyche and personality of a preschool child; the game determines his relationship with the people around him, prepares him for the transition to the next age stage to new activities. The paramount importance of play for the natural development of the child is evidenced by the fact that the United Nations has declared play to be a universal and inalienable right of the child. In a number of studies, the game is defined as the work of the child (50, p. 5). Z. Freud wrote: “The most beloved and all-consuming activity of the child is the game. Perhaps we can say that in play every child is like a writer; he creates his inner world, or otherwise, he arranges this world the way he likes it best. It would be wrong to say that he does not take his world seriously, on the contrary, he takes the game very seriously and generously invests his emotions in it. L. Frank believed that a game for children is a way to learn what no one can teach them, a way to navigate in the real world, space and time, a way to explore objects and people. Involving in the process of play, children learn to live in modern world. J. Piaget believes that the game is a bridge between concrete experience and abstract thinking, the symbolic function of the game is especially important. T.I. Shulga, V. Slot, H. Spaniard distinguish five signs by which the game can be attributed to a therapeutic agent:
1. What the child does during the game symbolizes his emotions and fears.
2. Play is a natural setting for a child to express themselves.
3. Unconsciously, the child expresses with emotions in the game what he can then realize, he better understands his emotions and copes with them.
4. The game allows the psychologist to learn more about the history of the child's life.
5. The game is the key to building a good relationship between the child and the psychologist and his behavior will be spontaneous.
That is why play therapy is becoming increasingly important.
Play therapy is a relatively young branch of modern psychology, which focuses mainly on working with children. Appearing in the first half of the 20th century in the depths of psychoanalysis, play therapy gradually spread over a wide range of areas, finding a theoretical justification for the diversity of its methods (17, pp. 32-33).
A.A. Osipova offers the following definition: "Game therapy is a method of psychotherapeutic influence on children and adults using the game."
L.M. Kostina considers game therapy as a way to correct emotional and behavioral disorders in children, which is based on the game.
We will look at some of these areas.
1. Game therapy of reacting.
This direction in the development of play therapy arose in the 30s with the advent of the works of D. Levin (1938), which developed the idea of reaction therapy, structured play therapy for working with children who experienced some kind of traumatic event. He believed that the game occupies an important place in psychotherapeutic work with children, since it is a natural form for the child to overcome emotional difficulties.
The child is allowed to play freely so that he gets acquainted with the decor of the room and with the play therapist. Then the play therapist uses certain play materials to introduce a stressful situation into the child's play at the right time. Reenacting the traumatic event allows the child to release the pain and tension caused by the event. In this approach, the play therapist recreates the environment so that specially selected toys help the child recover the experience that triggered the anxiety response.
In the process of acting out previous experience, the child controls the game and thereby moves from the passive role of the victim to the active role of the actor.
Three forms of play activity are possible in the game room:
1. Release of aggressive behavior: the child throws objects, explodes Balloons or displays forms of infantile behavior.
2. Releasing the feelings of standardized situations: stimulates feelings of jealousy towards the sibling by placing the doll on the mother's breast.
3. Release of feelings by recreating in the game a specific stressful experience from the life of a child (32, p. 137 - 138).
2. Game therapy of building relationships.
With the appearance in the early 1930s of the studies of D. Taft (1933) and F. Allen (1934), called relationship therapy, such a direction as relationship building play therapy arose. The philosophical basis for it was the work of O. Rank (1936), who shifted the focus of research into the history of the child’s life and his unconscious to the development of relationships in the “therapist-client” system, focusing on what is happening “here and now” in the office.
Relationship play therapy focuses on the healing power of the emotional relationship between therapist and client.
Children are given the freedom to choose - to play or not to play and the opportunity to manage their own activities. The goal of relationship therapy is not to change the child, but to help him establish his "I", his sense of self-worth. A child, like any person, is unique, valuable in itself and has internal sources of self-development.
The main mechanism for achieving correctional goals is the establishment of relationships, connections between the play therapist and clients, with the help of which the play therapist demonstrates unchanging and complete acceptance of the child, his attitudes and values and expresses constant and sincere faith in the child and his abilities.
Limiting the goals of therapy to the tasks of personal self-determination, self-actualization and freedom of real self-expression determines the range of specific problems that must be corrected within the framework of this approach: impaired growth of the “I”; doubt and uncertainty about the possibility of one's own personal growth and the anxiety and hostility of the child to others caused by them (32, p. 138 - 139).
3. Game therapy in psychoanalysis.
The use of the game in correctional practice is historically connected with the theoretical traditions of psychoanalysis. The beginning of play therapy was laid in the 20s of the 20th century in the works of M. Klein (1922), A. Freud (1921), G. Goog - Helmut (1926).
The turn of psychoanalysis to the play of the child was, to a certain extent, forced. Thus, Melanie Klein believed that analysis could eliminate or at least have a beneficial effect on the violation mental development child.
However, attempts to directly transfer the techniques of psychoanalysis to work with children were unsuccessful due to a number of specific features of childhood.
The possibilities of such use of the game are associated with two of its characteristics:
The game of the child, according to M. Klein, is a symbolic activity in which unconscious impulses and drives, suppressed and limited by social control, find free expression. In the roles assumed by the child, in play actions with toys, there is a certain symbolic meaning.
The game is the only activity where the child is free from coercion and pressure from an environment hostile to him.
She believed that almost any child's play action has a certain symbolic meaning, expresses conflicts and repressed desires of the child.
In 1919, M. Klein began to use play technology as a means of analysis when working with children under 6 years of age. She believed that children's play and play therapy based on it allowed direct access to the child's unconscious. The term "play therapy" was coined by Melanie Klein.
In her works, for the first time, the necessary play material was singled out, which included simple toys: small wooden men and women, cars, carts on wheels, swings, trains, planes, animals, trees, cubes, a house, paper, scissors, pencils, crayons , paints, glue, balls, sets of balls, plasticine and rope. The small size of such toys, their considerable number and variety allows the child to express a wide range of his fantasies and experiences. It is important that the child can recreate situations from his experience with the help of these toys.
Working in a play situation, where the child is offered several specially selected toys, and the therapist participates in the reproduction of certain traumatic episodes by the child, has been called active play therapy. In active therapy, the goal put forward by M. Klein to quickly reduce the level of anxiety in children was successfully perceived. It was assumed that no other method could lead to similar results so quickly.
At the same time, A. Freud began to use the game to establish contact with the child. She found that play is an important factor in establishing emotional contact with the child and serves as the means that makes the child's self-expression free.
Along with the active type of play therapy, a passive type of play therapy developed in parallel, when the therapist does not limit the child's play, but instead is simply present with it, being in the same room with the child.
As the child discovers through various activities what he is allowed to do, the therapist gradually becomes involved in the child's play. In passive play therapy, it is generally accepted that the adoption of the child's ways of self-expression is important in overcoming emotional disorders. The child gets the opportunity to work out his anxiety, hostility in a playful way and at his own pace (32, pp. 130-132).
4. Client-centered play therapy.
The goal of such therapy is not to change or remake the child, not to teach him some special behavioral skills, but to give him the opportunity to be himself.
The development of the ideas of therapists in this direction has been studied and expanded by K. Rogers and W. Ecksline.
Child-centered play therapy is based on the idea of the spontaneity of the child's mental development, which has internal sources of self-development and the potential for self-solving problems of personal growth.
The main task of correction is to create or restore meaningful relationships between a child and an adult in order to optimize personal growth and development. The game as an activity free from coercion, submission, fear and dependence of the child on the world of adults, is, according to supporters of non-directive therapy, the only place where the child gets the opportunity for free, unhindered self-expression, exploration and study. own feelings and experiences (32, p.133 - 134).
V. Exline's research gave rise to a major trend in play therapy. She successfully applied the principles of non-directive therapy, such as naturalness, the desire of the individual to develop, the ability of the individual to control their own development in the game. corrective work with kids. At the same time, the process of personal realization, self-development can be disrupted or limited due to either adverse environmental conditions, or violations of interaction and communication with significant others, and primarily with parents and close adults. Relationships, communication with another person are a necessary condition for personal development.
The variety of possible procedures taking place in the playroom made V. Axline face the need to formulate a number of requirements that the psychologist must:
Sincerely respect the child and be interested in him as a whole person.
Relates with patience and understanding to the complexities of the inner world of the child.
Knowing yourself well enough to be able to maintain emotional stability and serve the interests of the child.
To have enough objectivity and intellectual freedom to put forward and experimentally test hypotheses and be able to flexibly adapt their thinking and responses to the child's deeper knowledge of himself.
Possess sensitivity, empathy, a sense of humor and ease of communication.
V. Axline for the first time noted the importance of restrictions for the sense of security and stability of the therapeutic relationship in the child, as well as for increasing the child's sense of responsibility for his own actions. She defined a list of restrictions and requirements for them (17, pp. 44-45).
5. Game therapy of parent-child relationships.
In the 1960s, through the efforts of L. Gurney and B. Gurney, play therapy of parent-child relationships was formed as a special direction, which was focused on solving the social, emotional and behavioral problems of children. L. Gurney noted that this direction combines two strategies: 1) play therapy with children and 2) teaching parents through their direct involvement in the process of ongoing changes. The parent-child relationship therapist trains parents in psychologically competent behavior with children and in conducting play sessions, while providing supervisory support and helping to use the experience gained by parents in conducting play sessions with children at home. Typically, parent-child relationship therapy is used with children from 3 to 12 years old, but filling the time devoted to the child by parents with play activities can also extend to communication with adolescents.
The fundamental basis for the parent-child relationship is the recognition of the importance of play in the development of the child and in the therapeutic relationship with him. Recognition of the ability of parents to master the ability to conduct play sessions with their children and, finally, the preference for a teaching model in relationships with parents and children, since, recognizing the presence of biologically determined problems, specialists in the field of parent-child relationship therapy “consider social, emotional and behavioral children's difficulties as socially conditioned problems arising mainly from a lack of knowledge and skills” (17, p. 45 - 46).
We see that in all directions one way or another, according to the functions of an adult in the game, non-directive game therapy and directive game therapy are distinguished.
Non-directive play therapy is a purposeful therapeutic system, the center of which is the child as an independent person capable of self-development.
The goal of non-directive play therapy in a general sense is consistent with the child's inner desire for self-actualization.
The child needs to be helped: 1) to become more responsible in his actions and deeds; 2) develop a more positive self-concept; 3) become more self-governing; 4) develop a greater capacity for self-acceptance; 5) master the feeling of control; 6) develop sensitivity to the process of overcoming difficulties; 7) develop an internal source of evaluation; 8) gain faith in yourself;
Directive play therapy is a form in which the psychotherapist acts as an organizer, leader of the psychotherapeutic process with the assumption of responsibility for achieving the goals of psychotherapy.
Directive play therapy involves the performance by the play therapist of the functions of interpreting and transmitting to the child the symbolic meaning of the child's game, the active participation of an adult in the child's game in order to actualize unconscious repressed tendencies in a symbolic play form and play them in the direction of socially acceptable standards and norms.
In directive play therapy, an adult assumes the functions of the organizer of the game, the interpretation of its symbolic meaning.
The advantages of directive play therapy include the fact that the psychotherapist can predict with a high probability the time and quality of therapeutic changes in the child, implement and control them in a more structured and systematic way, and also work with the child in a more intensive and short-term mode (17, p. 81 - 82).
Based on these two main types of play therapy, the method of mixed play therapy was created.
The use of mixed play therapy for the correction of the personal sphere in preschoolers becomes possible with a clear tracking of personality neoplasms and the so-called shifts in the child's behavior. The ability of a psychologist to respond in a timely manner to these changes in a timely manner to respond to these changes allows you to flexibly use game situations. various methods game therapy, which increases the effectiveness of the psychotherapeutic process and greatly simplifies its use (17, p. 19).
So, we have considered various approaches to play therapy, as well as its types. The variety of approaches once again confirms the relevance of using this method.
A.A. Osipova notes that the game has a significant impact on the development of the individual, and also relieves tension, fear of others and anxiety (32, p. 126).
G.A. Uruntaeva defines the game as a special kind of human activity. The game, in her opinion, affects all aspects of mental development.
A.V. Zaporozhets wrote: “Psychic changes occurring in the game are of particular importance. They consist in the formation of a mental plan in a child on the basis of external play activity, in the development of the ability to create systems of generalized, typical images, surrounding objects and phenomena. And then make their various mental transformations, similar to those that were actually made with material objects.
Playing for a child is joy and pleasure. The toy is the constant companion of the child from the first days of birth and the most important means of the mental development of the preschooler.
It is specially created by an adult for educational purposes in order to prepare the baby for entering into social relations (45, p. 64).
N.M. Nikolskaya and R.M. Granovskaya believe that with the help of the game, children develop a variety of qualities (30, p. 249).
Therefore, many methods psychological correction and psychotherapy in childhood are based on the game as a universal way of influencing the child's personality. One such method is play therapy.
Currently, play techniques for working with anxious children are very diverse. They take their origin not only from the theory of psychoanalysis, but are also developed by modern play therapists.
So, in the first chapter of our work, we examined the main aspects of the problem of anxiety. An analysis of literary sources showed that the problem of anxiety has its roots in antiquity and remains relevant at the present time. The causes that cause anxiety and affect the change in its level are diverse and can lie in all spheres of human life. There are various methods for correcting the level of anxiety (art therapy, fairy tale therapy, writing stories, etc.), one of them is the method of game therapy. This is a method based on the game. Play therapy appeared in the first half of the 20th century gradually and spread over a wide range of areas. We believe this method is the most optimal for working with anxious children. before school age, since the leading activity of this age is the game.
play therapy is based on the natural need for children to play, which is the most important condition for the correct, harmonious development of the child, including imagination, independence, skills of adapted interaction with people. Play therapy implies the organization of the game as a therapeutic process and requires the emotional involvement of the doctor, his flexibility and ability to transform into games.
Play therapy and suggestion are the basis of psychotherapy in children, its driving force. Play therapy finds its successful application as an independent method of psychotherapy, and in combination with other methods. We have already mentioned its possibilities as the final stage of family and drawing psychotherapy. With a combination of explanatory, playful and suggestive psychotherapy, the reception takes place in the following sequence: conversation - spontaneous game - directed game - suggestion. Spontaneous play as an informal part of the technique relieves the tension that arises during a conversation, increases interest in treatment and is a kind of warm-up before directed games. For preschoolers, the gaming component predominates at the reception, for younger students the time for conversation and play is approximately the same, in adolescence the share of discussions increases significantly.
The game is played in the doctor's office, where there is a rug and shelving with toys. The set of toys includes motionless dolls for children of the first years of life, for older children - parsley dolls worn on fingers or on the hand (puppet theater), masks, skittles, tambourines and a small drum, children's dishes, collapsible structures, etc. In the study there is a large horizontal mirror in which children can see themselves while playing. With the help of a small number of dolls, an almost unlimited number of game situations can be reproduced. Fairy tales, poems, stories, fictional stories, children's fantasies, dream content or real events are used as themes for the game.
The duration of the game session usually does not exceed 30 minutes. This time is enough to maintain interest in the game and satisfy the need for it. Less time causes a feeling of incompleteness and the desire of children to continue the game. In this case, its abrupt termination is unacceptable, since this negatively affects the emotional contact of the patient with the doctor. The long duration of the game can cause a decrease in interest in it and a feeling of satiety. The relatively constant duration of the gaming session is an organizing moment for the patient, an invisible prescription. The same applies to the prohibition of damage to toys and their cleaning after the end of the game. The frequency of gaming sessions depends on the tasks of psychotherapy and the capabilities of the doctor. In the acute period of neurosis, they are carried out 2-3 times, in the chronic course - 1 time per week. Accordingly, the duration of the course of play therapy is determined - from several days to several months.
Diagnostic, therapeutic and educational tasks of play psychotherapy are closely related. They are realized in a spontaneous game, conducted without a specific medical scenario, or in a directed game according to a predetermined plan. As a rule, the latter does not contain a strict prescription of roles and allows a significant amount of improvisation. The exceptions are skittles and kolobok games with a standardized diagnostic procedure.
In the skittles game, the patient throws the ball alternately with the doctor from one place, the loser collects the skittles. The doctor can “lose” or “win”, creating advantages for the patient or for himself, complicate or simplify the game task by placing pins at a greater or lesser distance from each other, etc. Such a game reveals the development of coordination, the level of claims, the desire for dominance, reaction to success and failure. An impression can also be made about the patient's suggestibility if, without hesitation, he repeats a series of doctor's actions, for example, deliberately emphasized missing the target or his irrational attempts to knock down a separate pin instead of several adjacent ones. With the help of skittles, you can increase tolerance to stress and correct unfavorable character traits.
In the game "Kolobok" based on the famous fairy tale, the role of Kolobok is played by a patient who runs away from home and meets various characters portrayed by a doctor. On its way, Gingerbread Man must overcome a number of obstacles, for example, find a way in the forest, hide from a thunderstorm, cross a river, protect himself from the threat of an attack, etc. Here, in addition to identifying fears, it also matters how far a child can go in his fantasy. In dependent and anxious children, Gingerbread Man shows more and more anxiety and a desire to return as he moves away from home. In children with a tendency to independence and protest reactions, Kolobok makes a more distant "escape".
The diagnostic function of the game is to reveal the experiences of the patient, the features of his character and relationships. The game as a natural experiment reveals some hidden symptoms and tendencies, defensive attitudes, conflicts and ways to resolve them.
The therapeutic function of spontaneous play is to provide the patient with an opportunity for emotional and motor self-expression, awareness and response to tensions, fears and fantasies. Through directed play, mental processes are strengthened and trained, frustration tolerance increases and more acceptable forms of mental response are created. Play therapy with its cheerful, optimistic mood activates the vitality of children, increases their tone.
The restructuring of patients' relationships, the correction of unfavorable character traits, along with the expansion of life horizons and the range of communication, the formation of adaptive interaction skills, allow us to talk about the educational function of play therapy. The game also contributes to the development of many mental functions, including sensory and motor components of behavior.
When playing, a number of rules are observed that contribute to a better organization of the psychotherapeutic process: 1) the game is used as a means of diagnosis, therapy and education; 2) the choice of game topics reflects their significance for the doctor and interest for the patient; 3) the management of the game is built in such a way as to promote the development of independence and initiative of children; 4) spontaneous and doctor-directed games represent two complementary phases of a single game process, in which the main thing is the possibility of improvisation; 5) the ratio of spontaneous and directed components of the game depends not so much on the age of children, but on clinical and personal characteristics. In acute neurotic reactions, the spontaneous component of the game predominates; in neurotic developments, emphasis is placed on the directed restoration of disturbed relationships. Neurotic states require an individually selected composition of the game; 6) the game is not commented on by the doctor; 7) the directed influence on the patient is carried out through the nature of the characters reproduced by him and the doctor and the psychotherapeutically simulated game situation.
Consider building a game session. The game is understood as a desirable but not mandatory activity. Initially, the child is given the opportunity for independent activities in the doctor's office or in a special playroom. In the latter case, it may initially be carried out together with one of the parents, especially in preschool children. Then, for some time, the child plays alone or in the presence of a “mindful” doctor. If it is difficult to start the game, the doctor suggests another activity, such as drawing, or introduces patients to toys and gradually involves them in the game. In the future, children act independently. The condition of continuity of the game is also not obligatory. It can be terminated on the patient's own initiative, but he must give an explanation for this. Usually, the termination of the game is associated with a loss of interest in it or fear of certain situations. The absence of a doctor's intervention does not mean that he has no effect. The child sees a doctor "mindful of his own business" but cannot predict his behavior. The emerging situation of uncertainty, understatement and suspense creates a certain psychological tension that the child must overcome and complete the task assigned to him - to act independently. As he begins to play by himself, he loses the feeling of alertness and stiffness. Being carried away, children begin to express their emotions more and more boldly, gesticulate violently, speak, etc. Usually, emotional revival is more pronounced in children of strict, limiting parents. Emotion response is not the only therapeutic mechanism for spontaneous play. The opportunity to express themselves in a safe play situation, where the child is in agreement with himself and his feelings, is also important. Acceptance by the doctor of his feelings and lack of judgment act soothingly, develop self-confidence and the ability to make a decision. Mutual understanding with the doctor represents the desired model of communication for the child, improves his well-being and perception of himself, thus fulfilling a positive regulatory role in the system of his value orientations.
Some children, especially preschoolers, accompany spontaneous play with replicas of game characters, which further helps to reduce emotional stress. The doctor's imperceptible (not included) observation of the behavior and remarks of the game characters provides valuable information about the characteristics of the temperament, character and relationships of children, including relationships in the family. So, in the game "daughters-mothers" girls in the role of mother can forcibly force the doll to eat, sleep, shout at her, punish and read morals. If children depict the world of animals, then an atmosphere of benevolence, understanding and calmness reigns in it, or dominant and aggressive tendencies appear. It is not difficult to see in this a reflection of the desires of children or a reproduction of real life conflicts. For example, a 6-year-old boy often portrayed Barmaley in the game, who attacked the animals with the words: “You need to crush it with your heel.” His aggressiveness was a response to the frequent physical punishments coming from his mother holding him tightly (squeezing) as he did so.
In a number of cases, the doctor also participates in spontaneous games in the role assigned by the children. Remaining within its boundaries, he is inferior in everything to the main character, showing negative tendencies in him (excessive resentment, alertness, fears, avoidance or dominance, aggressiveness). The exposure of these tendencies to the extent of the grotesque leads to the realization by the patients of their undesirable character. The possibilities of other playable characters make it possible to indirectly reproduce some traits of the character and behavior of the patient. This mirroring also aids awareness of inappropriate responses.
In doctor-directed games, an individual tempo is selected for each patient by means of a gradual increase in duration, different durations of game pauses, and alternation of game plots. The optimal pace eliminates the monotony of the game and the stamp. At the same time, frequent change of plots is inappropriate, since they require a certain amount of time to act out and obtain therapeutic results.
The creation of a direction in the game means not only the doctor's guidance on the part of the doctor, but also the acceptance by him of the patient's experiences as a condition for the joint game. It has the rules of game reality and game equality. The latter implies the division of responsibility for decision-making and the performance of the main and subordinate roles by both the doctor and the patient. Parity participation of the doctor increases the game initiative of children who are invited to choose any of the acting roles. The purpose of the game is not explained, and the nature of the role is determined by its generally accepted meaning in fairy tales, for example, the role of a wolf implies aggressiveness and greed, a hare - spontaneity and fear, foxes - cunning and deceit, a bear - strength and stupidity, a rooster - militancy, a cat - disinterested friendship etc.
In improvisational play, special stressful situations of fright, accusation, and argument are created, and the child is given the opportunity to resolve them independently. If he cannot do this in an acceptable way, he is prompted to resolve the conflict, but not directly, but through the appropriate behavior of the character portrayed by the doctor. Such behavior implies confidence, cooperation, role flexibility, lack of fear and aggressiveness. The reproduction of therapeutically oriented models by the doctor is perceived by the patient not as a special demonstration of the required behavior, but as the most acceptable way of playing communication and solving emerging difficulties. During the game, the patient is not told how to play, what exactly he should portray at any given moment, and what lines the game characters utter. The absence of strict directorial control and obligations to explain the behavior of the characters in the game allows us to preserve the principle of game reality and makes it easier to get used to the role. Otherwise, the child is obliged to control his game, which makes it difficult to reincarnate and improvise.
In addition to showing models for resolving conflict situations, some fears are eliminated in the directed game and unfavorable traits of the patient's character and behavior are corrected. First, let's consider a game technique for eliminating fears. Fears of real and fabulous animals (dog, bear, wolf, etc.) are usually eliminated during one session, consisting of three phases of game interaction. In the first phase, the nature of fear and the type of patient's response are established in the form of avoidance of a frightening object shown by the doctor. Essentially, this means reproducing a situation that causes fear. In the second phase, desensitization to fear is carried out through role reversal. The doctor, by the behavior of his character (for example, a hare), depicts the fear of the patient, the latter reproduces a threatening image (depicting, for example, a wolf). At the same time, children show aggressiveness, usually expressed to the same extent as they experience a feeling of fear. The therapeutic effect is due to the depth of getting used to the threatening image, its emotional response and desensitization in the mind of the patient. The third phase uses learning behaviors through repeated role reversal. The image of a threatening image by the doctor is no longer accompanied by reactions of fear in the patient.
Thus, the fear of animals is eliminated during the three phases of the game action: the actualization of fear, its response and consolidation of the results achieved.
At further appointments, children are given the roles of a fearless commander, pilot, sailor, firefighter, etc., developing self-confidence and the ability to make decisions.
A brief illustration of the game technique for eliminating fear can be the game therapy of a 2.5-year-old girl who developed stuttering and fear of the dark after a night fright, the cause of which she could not explain. The reception took place a few days after the nocturnal episode. In spontaneous play with dolls, avoidance of the "wolf" was noticeable. At the same time, the patient willingly played with other toys. We drew the attention of parents to this, who remembered that shortly before the disease they read the fairy tale "Little Red Riding Hood" to their daughter. There was an assumption about the reflection of a fairy tale in a nightmare. According to its plot, a game was held in which the mother was portrayed by means of a controlled puppet of a good wolf. At the same time, the girl no longer showed the former sharpness of fear, which was the result of combining a threatening image with an emotionally close face to her. In the future, the role of the wolf was played by the doctor, gradually endowing him with the appropriate attributes of behavior. As in the game with her mother, the girl showed only a minor response of fear. When changing roles, when the patient portrayed a wolf, putting a rag doll on her hand, she screamed and threatened Little Red Riding Hood, whose role was played by the doctor. When the roles were reversed, the girl had no fear reactions. She began to sleep better at home, her fears of the dark ceased, and her speech returned to normal within a week. There was no relapse, according to a ten-year follow-up.
The play therapy of fears in a 3-year-old boy with neurotic stuttering is also indicative. At the reception, he was afraid of the wolf, which, in his words, "beats everyone." I saw him in a dream, when talking about it, he stuttered a lot. The boy's tough and impulsive father was extremely inconsistent with his son and often punished him physically. In contrast to the father, the mother was soft in character, but limited her son's mobility. The boy was afraid not only of the wolf, but also partly of the fox: "She has sharp teeth." At the reception, he himself took the role of a wolf, putting a rag doll on his hand, and made his mother a fox. The wolf behaved aggressively and attacked the fox. Fear was removed and ceased to sound in the future. At the same time, stuttering was quickly stopped.
In other children, in the case of fear of the dark, due to the fear of loneliness, the game of “hide and seek” and “blind and seek” in a gradually darkened room, at first in the presence of parents and a doctor, then with the participation of only a doctor and a patient, has proven itself well. In sthenic children, the fear of the dark can also be eliminated with the help of the cat-and-mouse game. The doctor and the patient take turns hiding in a gradually darkened office. When emotionally involved in the game, children usually completely “outlive” their fear.
Often, fears of the dark are motivated by fear of an unexpected impact, an attack, which is reflected in nightmares. In this case, the following construction of a game session is therapeutically effective. At first, the patient hides in an office without light, and, wearing masks, his mother, father, doctor and unfamiliar adults are looking for him in turn, who accompany their actions with appropriate “aggressive” remarks, which, however, does not increase, but reduces the fear of children. Then the roles change, and adults take turns hiding in the office. The patient in a "terrible" mask finds them, while showing more interest and gambling passion than stiffness and fear. This method of eliminating fears usually does not require a reverse role reversal, provided that the fear is expressed emotionally. If the child, of his own free will, immediately portrays the object of his fear, this indicates his great determination to overcome this fear.
The fear of the dark, especially if it is of a specific nature, is one of the expressions of the fear of changing the "I", which complicates the adoption of new roles, the development of empathy and adequate social responsiveness. In the presence of a pronounced fear of change, usually correlated with general anxiety, play therapy is indicated to improve the process of accepting and playing roles. Such communicative training manages to eliminate the fear of changing the “I”, regardless of the specific form of its expression. Then the psychotherapeutic techniques for eliminating fears described above can act as its preliminary stage. At the next stage, simple stories composed by the sick at home are played together with the parents. The main things here are improvisation and the image not of oneself, but of others, that is, entering into their image. In itself, role-playing in the course of dramatizations is a desirable, but not a necessary condition for the game. No less significant is the portrayal of others on the basis of the “if only…” principle and the whole emotional mood of the game, its life-affirming, creative activity. In the future, the plots of some fairy tales are used, where magical transformations take place, for example: “Little Red Riding Hood”, “The Tale of Lost Time”, a fairy tale about “Vasilisa the Wise”, who can turn into birds and work miracles, making a person unusually strong, a fairy tale about “ The Frog Princess”, to whom everything is also obedient in the field of miraculous transformations. Playing out these fairy tales by a child, a doctor and a parent reduces the fear of changing the “I” with a gradual complication of plots, improvisation and alternation of roles, that is, changing the game, giving it elements of novelty each time. In the last classes, communication in extreme life situations is modeled. At the same time, the child depicts himself as confident in his abilities and capabilities, while the doctor and parents reinforce this with the image of others. As a result, role-playing flexibility of behavior is achieved, which implies painless and completely controlled entry into one or another image, playing it while maintaining the integrity of the “I” and self-confidence, that is, without fear of changing the “I”.
The participation of parents in play therapy and the restructuring of their relationships reinforce the results. If we are talking about the need to further change the relationship of the patient and his unfavorable character traits, then role-playing behavior correction is shown. In its rudimentary form, it consists of three game stages, carried out in one or more sessions. At the first stage, the patient is assigned roles that reflect the unfavorable traits of his character. Their brief description is given, for example, a whiny hedgehog, a capricious bear, a timid bunny, etc. The doctor depicts characters with opposite, positive character traits, thereby showing a model of acceptable behavior. In the second stage, the roles are reversed. The patient shows the desired model of behavior, while the doctor contrastly reflects the features of his behavior. At the third stage, both of them reproduce an adequate model of game interaction.
The described gaming technique is applicable not only to younger schoolchildren and older preschoolers, but also to children aged 2.5-4 years, for whom other methods of psychotherapy are practically impossible. In the latter case, there is no need to enter the game image, but the tendency to imitate, expressed at this age, is used, i.e., more emphasis is placed on the learning process through imitation and suggestion.
Role behavior correction can be illustrated by the example of a 5.5-year-old girl with neurotic stuttering. Being active, energetic and independent, she was in conditions of excessive guardianship, an excessively strict, principled attitude of her parents and a completely permissive relationship between two grandmothers. Therefore, she became more and more stubborn and at the same time emotionally unstable and capricious. To this should be added frequent punishments from the father-teacher for the manifestation of stubbornness and self-will in his daughter. Her younger brother focused all the attention of her parents on himself, which caused her feelings of resentment and intrusive questions addressed to her parents: “Do you love me?” These questions indicated the emergence of doubts about the sincerity of parental feelings and the associated anxiety. The girl's mental state improved after the parents, on the advice of a doctor, began to play with her at home in turn, allowing her to express fantasies, resentment and irritation in the game, including in relation to them. At the reception, the girl, having prepared at home, told the content of the tale and distributed the roles herself. In the future, the topics for the game were chosen alternately by the girl, the parents and the doctor. The game began in the clinic and continued at home. In her dramatizations, the patient was a brave hare who attacked the wolf, portrayed alternately by the parents and the doctor, and defeated him. Thus, in a symbolic form, discontent and resentment were reacted. When changing roles, the wolf was peaceful. Further improvement in the patient's condition, including her speech, occurred after the use of regressive game tactics. Parents were advised to treat their daughter as little child, like a one-year-old brother, put her on her knees, rock, sing songs, give her the opportunity to use a horn, a pacifier, etc. The girl delightedly accepted the softening of her parents' attitude, compensating for the lack of spiritual responsiveness and warmth on their part. In addition, she was thus equalized in rights with her brother, which eliminated her resentment towards her parents.
After some time, the girl and her parents became more aware of the extremes of their relationship, which contributed to their restructuring and made it unnecessary to continue the regressive game tactics.
The conflict between siblings, starting from the age of 5-6, can be eliminated not only by changing the relationship of the parents, but also by playing them together with the doctor. Children are encouraged to memorize or write down the conflict situations that arise between them in order to discuss and play together at the reception. When jealous of one of the parents, he is depicted in turn by each of the participants in the conflict, and the doctor represents the absent parent. A balanced relationship between siblings can also be achieved by playing fairy tales, where relationships between characters are dramatized.
Here are some more examples of role-based behavior correction. In the first case, it was a 3-year-old boy with neurotic stuttering that arose as a result of an overstrain of developmental opportunities (early intensive training) and blocking of emotional self-expression (hyperprotection combined with an overly strict and moralizing attitude of parents and two grandmothers). The need for emotional release in a sthenic by nature boy was so great that at times he himself involuntarily created reasons for crying, after which he noticeably calmed down, that is, crying was a means of discharging emotions. The boy was aware of speech difficulties and experienced them. After corrective conversations with parents, several game sessions were held. At the first session, the doctor was an elephant calf, who, bypassing all obstacles, made his way to Africa to see Dr. Aibolit, portrayed as sick, like the doctor, with an appropriate toy. Appearing before Aibolit, the baby elephant, stuttering, said that a splinter in his mouth prevented him from speaking, and if it was removed, he would be able to speak easily and clearly (indirect suggestion by the doctor). Aibolit agreed with this and removed the splinter - a small stick that the baby elephant (the doctor) held in his mouth. The baby elephant thanked the doctor and, saying (with inspiring accents) that now nothing prevents him from speaking, demonstrated his pure speech, constantly exclaiming how strong Dr. Aibolit is, he can do anything. Aibolit took all this very emotionally and began, joyfully gesticulating, shouting together with the baby elephant that now nothing prevents him from speaking, the words go by themselves, easily and freely. After the reception, the boy solemnly threw the "splinter" into the trash can. His speech improved greatly, but, as is often the case with neurotic stuttering, he became more excitable, moody, stubborn and aggressive, since stuttering, as a psychomotor form of discharge, to some extent prevented these reactions. On the advice of the doctor, the parents did not resist the boy's noisy games, in which, although he was overexcited, he actively expressed his feelings and mood. After a decrease in excitability, anxiety sharpened, i.e., the basal level of neurotic response was exposed. At the next session, the doctor, together with the patient, crawled around the playroom, imitating the danger and actively overcoming it with loud statements: “We are not afraid of grey Wolf Let's drive away all the bad." After the game, the boy became noticeably calmer. In subsequent gaming sessions, he, as before, acted as the all-powerful doctor Aibolit, who successfully treated all sorts of diseases in the animals represented by the doctor. The animals constantly emphasized the "doctor's" clear speech and his confidence as an example for them (suggestive consolidation of the achieved results in the boy). In the above case, we see a successful combination of the game with the indirect suggestion of the doctor and the restructuring of parental relationships.
In the second case, we observed a 4-year-old girl with neurotic tics that arose a few months ago in the south during a summer vacation. The girl hardly endured the change of scenery and did not eat as her parents wanted, despite force-feeding on their part. Even in the south, she became capricious and irritable, to which her parents reacted with a sharp increase in severity and punishment. In response, the girl became whiny, and soon she developed a variety of alternating tics. The main one was "yawning" - an involuntary opening of the mouth, which resembled a grimace of disgust. So the girl unconsciously protested against force-feeding. As the tics increased, her emotional tension decreased. This suggests that tics, as a psychomotor form of discharge, perform some kind of protective function for the body. At the same time, they point to the constitutional deficiency of the psychomotor sphere (the girl's father has an ocular tic). At the first appointment, the patient had difficulty making contact with the doctor, remaining emotionally tense and constrained. She preferred to destroy the buildings she made herself, reacting emotionally violently at the same time. At the second appointment, she stated that she wanted to feed all the little animals, but, unlike her mother, she was patient in doing this, did not persuade or force anyone. Fully connected with the doctor. At the third appointment, she asked her mother to leave the office and began to play with the doctor "on a visit." Having invited him to her place, she began to treat him, but without persuasion and pressure. Then she began to call the doctor on a toy phone. At the same time, the doctor spoke on behalf of the hedgehog (putting his hand into the rag doll), and the girl spoke on behalf of various little animals, which she, like the doctor, alternately held in her hands. The hedgehog was informed that the little animals do everything quickly, eat without persuasion, obey their parents and do not twitch. The hedgehog listened attentively to all this, rejoiced along with the girl and praised her, telling the news to all the dolls sitting nearby. The motive for such assurances was a positive emotional contact with the doctor and his authority in the eyes of the girl. She cherished this and tried to please the doctor, justifying his expectations regarding the change in her behavior. The next time, the mother was connected to the game, which the daughter, having changed roles with her, fed without persuasion and, most importantly, praised her. Together with the restructuring of the relationship of the parents, the girl's condition gradually returned to normal.
In the third case, a sthenic and father-like 6-year-old girl from an incomplete family was in conflict with a hypersocialized and hysterical mother, who experienced many of her own problems and lived in her own inner world, closed from her daughter. The mother punctually forced her daughter to learn poetry, brush her teeth twice a day, do exercises, made countless remarks to her, constantly taunting her and physically severely punishing her when she disobeyed. In the first years of the girl's life, her mother fought with her because of her poor, from her point of view, appetite and unwillingness to sleep during the day. As a result, the daughter, being stubborn and negative towards her mother, constantly "threw" tantrums and repeatedly wet herself during the day. At the first session, the mother and daughter could not establish contact in the game for a long time, while with the participation of the doctor in it, the girl was completely contact and non-capricious. She chose the role of a bunny, appointed a doctor for the role of a wolf, and made her mother a fox, which was quite consistent with her flatteringly insinuating voice. The wolf and the fox were chasing the hare and could not catch it, that is, the daughter wanted her mother not to overtake her at least in the game. Then the girl turned herself into a bear, and her mother into a roe deer, which the bear immediately killed. So in a symbolic form, she expressed reciprocal aggression towards her mother. Then the daughter became a hunter, and the mother again made a fox. The hunter immediately shot the aggressive wolf (doctor), but the fox hid and, when the hunter sat down to rest, quietly crept up behind and tried to grab the gun, but was immediately shot dead. With such an action, the girl, as it were, eliminated the traumatic image of “not a mother”, as a symbol of insincerity, deceit and deceit. After this dramatic episode, she wanted to play with her mother herself. The doctor left the office. The game went on without a hitch. The behavior of the girl was distinguished by softness and compliance. In the following days, the mother noted that her daughter was as calm as ever, without whims, tantrums and stubbornness. Daytime urinary incontinence stopped, the girl became more attentive and critical of herself. At the next appointment, the mother sat down on the mat for the first time and began to play face to face with her daughter. The girl who came to the doctor made her a dad, and herself a mom. She designated the doll as her daughter, saying about her that she is not only naughty, pissing, but also pooping. Having thus removed everything bad from herself, the girl in the role of mother and the doctor in the role of a rehabilitated father began to raise their daughter. The “mother” dominated the game, put the “daughter” in a corner, spanked, lectured on morals and claimed that she was incapable of anything, that she was bad, dirty, did not love anyone, etc. e. The mother did not directly participate in the game, but she saw and heard how her daughter, carried away by the game, portrayed her attitude. Finally, the girl in the role of mother took the "incorrigible daughter" to the hospital, where they were received by the doctor - the girl's mother. The doctor gave advice on education and prescribed various medicines. In contrast to the behavior at home, the mother, in the role of a doctor, already gave more adequate advice, including offering to play with her daughter. Then again mother and daughter played together without a doctor. Between appointments, the girl was calm. Mother and daughter began to understand each other better and cherish this. At the third appointment a week later, the girl again acted as a mother, and the mother as a daughter. Unlike the previous game, there was more flexibility and spontaneity in their interactions. The girl still had no cases of urinary incontinence. Subsequently, she adapted well at school.
It should also be said about a 5-year-old boy from an incomplete family who has an overprotective authoritarian grandmother and an emotionally unstable mother with hysterical character traits. The mother practically did not take care of her son, giving all her time to work. At the same time, she was emphatically strict and principled and did not allow him to meet with his father. The unsatisfied need for gender-appropriate identification turned into fears, whims, stubbornness and, at the same time, an anxious dependence on the mother, a protest against attending a kindergarten. At the first visit, the mother and child were left in the playroom with an offer to start the game. Returning, the doctor saw that the mother, instead of playing with the child, read morals to him. In her presence, the doctor started a game with the boy, indirectly reflecting his communication problems in kindergarten by the behavior of the characters. On the advice of a doctor, the mother quietly left so as not to hamper her son's play initiative. After playing together, the doctor invited the boy to play skittles and went out to his mother to comment on the game. At the second visit 10 days later, the mother noted the absence of crying and whims when visiting the kindergarten. Like the first time, she couldn't play with her son. He, on his own initiative, depicted various problem situations in kindergarten, saying that it did not refer to him, but to another boy. He secretly confessed to the doctor that he was a soldier, that is, he approved himself in the corresponding gender role. At the third visit, 10 days later, he told a poem he had invented: “The sky is blue, the sea is strong, father is strong, mother is beautiful.” In the figure, "family" included the father in the family. I went to kindergarten with a desire. Conflicts with the guys stopped, he began to participate in the game, and not stand, as before, on the sidelines. At home, after watching a TV movie on a military theme, for the first time I reproduced everything in faces. I was impatiently preparing for the holiday in kindergarten, I made the Cipollino costume myself. On this occasion, a conflict arose with the mother, who did not like the choice of her son. It was decided to play the emerging conflicts with the mother at the reception, after which they completely stopped at home, as the mother began to restrain herself. At the reception, the doctor and the boy without a mother reproduced scenes of various battles. They hid behind chairs, throwing "grenades" at each other and counting the number of hits. Then there was a duel on "sabers". Note that such games, which are often played by healthy children, naturally prevent the fear of touching and changing the "I" and can be successfully used in psychotherapeutic practice. At the same reception, a game of hide-and-seek was played in the corridor of the polyclinic. At first, the boy was hiding, and the doctor and mother were looking for him, then vice versa. The boy's dexterity and ingenuity, his endurance and patience were noted with praise. Sports badges were presented as a reward. At the fourth visit, 10 days later, the boy's condition was completely normalized. The conflicts with the mother, who stopped interfering with her son's play, stopped. The leading activity at the reception was a tour of the clinic with a visit to the offices of doctors who spoke favorably about the boy. After the reception, the mother took her son to the amusement town for the first time. This example shows how the timely satisfaction of the boy's age-related need for role-playing and the gender-appropriate need for identification helps him feel more confident and able to communicate with peers.
As can be seen from the examples, the main thing in play therapy is responding to emotional stress and role-playing various ways to solve communication problems in a joint creative search with the doctor and parents, the essence of which is the disclosure of unused development opportunities, strengthening the unity of the “I”, self-esteem and faith in yourself as a person. We have cited only relatively simple cases of play therapy as an integral part of the psychotherapeutic process. It is important to emphasize that no two game sessions are the same, no two patients are the same, and that game solutions to problem situations are based more on the doctor's creative improvisation than on the patient's fitting into a pre-designed and non-exclusive scenario. It is also important that play therapy, used according to indications, prevents excessively frequent use of psychopharmacological agents.
Play therapy (staging) is most successful at the age of 4-7 years, when there is an intensive process of role-playing personality development. It is advisable to use it both at a younger age (mobile, object games) and at an older age (dramatization). In adolescents, the game is played without dolls and toy props, in one or another imaginary setting. In joint replays with a doctor, it is essential to teach a teenager to make adequate decisions in stressful situations of communication, i.e., communicative training. For this, the mode of action of the doctor and his authority in the eyes of a teenager are of exceptional importance. Greater value compared with other age attached to the organization of discussions and discussions. The dramatizations are helped by masks of people with different character traits made by a teenager and dialogues in masks with a doctor. In general, role therapy in adolescents is more successful in a group that reflects their age-related need for communication.
Play is the main occupation of the child. However, not many realize what its role is in the life of the baby. After all, this is not just a way to dispel boredom, but a way to comprehend reality and one's own "I". The game is even used in psychiatry. Play therapy with anxious children is invaluable.
At the beginning of the 20th century, psychologists began to say that through the game it is possible not only to form certain skills, but also to eliminate internal problems, overcome physical difficulties, and get rid of delays in intellectual development. Representatives of science drew attention to the fact that with the help of the game it is easier to achieve the psychological stability of children, form and improve communication skills, and free them from fear and phobias. So we can talk about the healing effect of the game.
Game activity is of great importance for the mental development of the baby. In the course of the game, he learns to live: he receives various knowledge and skills, masters social rules. Also, seemingly ordinary fun can improve the well-being and mood of the child, help in overcoming mental trauma and difficult life situations.
This effect of gaming activity is due to the fact that the baby is relaxed and in a good mood. He is more open to communication with adults and does not perceive with distrust and rejection what he is offered to do.
Play therapy with anxious children performs the following functions:
- Diagnostics. Play therapy helps to concretize the properties of the child's personality, its relationship with the surrounding reality and people. Ordinary conversation will not help to determine the causes of the baby's problems as much as an informal setting in which he non-verbally expresses his feelings and emotions.
- Education. Play therapy in working with children gives them the opportunity in one or more lessons to master the ability to reconstruct relationships, broaden their horizons. The child easily readapts, acquires skills, without which a full-fledged life in society is impossible, learns the world around him.
- therapeutic function. The child does not care about the outcome of the game, he is more attracted to the process in which he loses his own emotions, fears, shyness, tries to resolve disagreements and problems. As a result, important mental processes are formed and consolidated in him, tolerance and the correct reaction to the phenomena of the surrounding reality are developed.
Solves a wide range of problems
Play therapy in action can help address a range of issues:
- Psychological problems of the child after the divorce of mom and dad.
- hostile behavior.
- Hair twitching.
- Fears and phobias.
- Anxiety and tension in a hospitalized child.
- Reading problems.
- Problems with study.
- Speech delay.
- Mental retardation.
- Stuttering.
- Disorders that are more associated with mental processes than with physiological ones.
Some believe that play therapy is required in extreme situations. This opinion is wrong. It is applicable in many areas: cognitive, sensual, volitional and others.
The specialist during the lesson takes part in playing out what is happening. The child loses the feeling of anxiety. The way he behaves with the therapist speaks volumes about his relationship with other members of society.
The passive method is a game in which the specialist is only present, without interfering with its course. He only sometimes interprets the actions of the child. The main place here is occupied by the baby, who, with the help of the game, learns his problems. The specialist, in turn, should treat him with understanding.
During "liberating" play therapy, the therapist recreates the event that caused the shock, helping the child cope with negative emotions, get rid of a phobia, throw out anger and other feelings caused by the event. So the baby from the victim turns into an active participant in the situation.
Relationship therapy is similar to the previous method, but there are significant differences. What is more important here is what happens in the specialist's office, and not the events of the past. In this case, the child can do whatever he wants.
Who plays and how
There are various classifications of play therapy. Based on the place in the adult's game, directive and non-directive game therapy are distinguished. The first is an activity in which an adult directs the child, giving him a choice of how to act in a given situation. While playing, the baby is aware of his inner feelings.
There are also structured and unstructured games. The former are used as part of "liberating" therapy. They can encourage them to show their aggression (a toy gun), show their desires (dolls) and more. The second refers to dynamic games, sport exercises, modeling from various materials that help the child to reveal his feelings and increase his self-confidence.
According to the form of the lesson, group and individual play therapy are distinguished. In choosing the first, the child's need for communication plays a role first of all. If not, then the second type is used.
Group therapy is often used in kindergarten. It allows the baby to understand that he is a person, to become more self-confident, to get rid of anxiety and guilt. It is important that none of the children in the group has advanced sexual development, hostility, tension, behavior that threatens others, jealousy.
Accept the child for who he is.
You can take a course of play therapy with a psychologist. He will choose an individual technique for the child, taking into account all factors. However, therapists themselves argue that games that involve parents, rather than strangers, are more effective.
Where does the game start? First, you need to accept the child as he is. That is, respect his wishes, do not force him to play, create an atmosphere of fun, monitor the state of the baby, do not emotionally overload him.
What's next? Many children like to draw. This is where you should start: to portray a family, a house. So you can find out the child's fears, worries, psychological trauma. This does not even require special education. Parents should ask who the kid drew, what kind of person he is, what he does, etc. - so they can get close to their child, relieve him of worries, dispel suspicions and anxiety with their attention and care.
It is necessary to involve the child in a variety of games. He will definitely like something new, and he will see your responsible and reverent attitude towards him.
For different purposes - different games
They will allow you to establish a trusting relationship between a child and an adult, relax, cheer up, overcome the fear of being alone, attacks, closed spaces, improve health, and develop physical skills. These games include blind man's buff, tag, hide and seek, obstacle course.
Here are some examples of games that help get rid of fears:
- Bold mice. The “cat” is dozing, and a “mouse” is running around him, making a squeak. Waking up, the first player must catch the second, who is trying to escape into the house.
- Ghost. A white cloth is thrown over the driver, and he must catch someone with frightening sounds.
- Owl and hare. When it is light, the first sleeps, and the second jumps. At nightfall, the "owl" tries to find the "hare", which should not move.
These simple games will allow children to have a good and useful time. The main thing is that parents try to create the most comfortable conditions for the child and surround him with their warmth. Without this, achieving the goal of psychotherapy is much more difficult. Author: Alexandra Pushkova
Psychotherapy and psychocorrection are becoming one of the most popular areas of modern medicine. More and more people are realizing the importance of preserving and maintaining the mental health of a person at any age, including preschool children and even infants. Today, there are many psychotherapeutic techniques that are used to work with children. different ages, but one of the most effective and popular is game therapy.
Play therapy is a psychotherapeutic method of influencing children of preschool and school age through the use of games, toys and other elements. Role-playing games, which form the basis of this therapy, help identify problems in the behavior, psyche or development of children, teach ways to solve these problems and help restore mental and emotional health.
Play therapy can be carried out in the most different conditions- independently, at home, in kindergartens and schools, in the office of a psychologist or psychotherapist. Many parents are somewhat wary of this method of treatment, they do not believe that play therapy for children is the most powerful way to influence the mind and feelings of a child of any age (excluding older students and adolescents, other methods of psychotherapy are used for them, although game techniques can also be effective). To understand why and how play therapy affects the baby, you need to understand its basic principles of action, as well as understand what "pitfalls" this technique has.
How does it work
The game is the main activity of the child, from birth to adolescence. With its help, he receives information about the world around him, about the ways of interaction between people, objects, and also thinking, fantasy, strong-willed and other qualities are formed in the game.
Numerous studies prove that learning through play is one of the most effective methods interaction with children, and of different ages, normotypical and with developmental features.
Involving the child in the game, the specialist gets the opportunity to "look" into the inner world of the child, who unconsciously transfers his feelings, experiences or fears to the characters of the game or "loses" the situations that concern him. This technique is well known to most modern parents, who, using this simple method, determine whether the child is comfortable in kindergarten, school, among new friends, and so on. To do this, it is enough to call him to play "in the kindergarten" or "school" and carefully observe his behavior, remarks and emotions.
The goal of play therapy- help the child cope with some traumatic events, even if he does not realize or perceive them. The specialist can assess the emotional and mental state of the child and help him cope with negative emotions, fears, anxiety, incomprehensible but disturbing situations, other feelings, or teach him acceptable ways to express his emotions, interact with others and perform certain everyday skills.
The basic rule of play therapy is its comfort for the child. He should feel confident and free, the only way to find out about his internal state and help him deal with his problems.
Who can help
This method is universal; there is also play therapy for adults who, with its help, also “live through” unpleasant emotions or get rid of stress. But if “home play therapy” can be carried out with any child, then professional therapy requires a visit to a specialist, who, as a rule, “works” with certain problems, since it is with their presence that play therapy is most effective. Thus, play therapy with anxious children has its own characteristics, as well as play therapy with children with developmental delays or psychological trauma.
These can be mental and behavioral disorders, manifested by:
- aggressiveness,
- fears
- Difficulty communicating with peers and adults
- Poor academic performance
- stuttering
- Enuresis
- other problems.
Such behavioral disorders and disorders are faced by many children who have experienced stress due to the divorce of their parents, loss loved one, moving, abuse, witnessing some kind of traumatic event, and so on.
Play therapy with anxious children helps not only to reduce the level of negative emotions, but to find their source, and this is sometimes much more important - in cases of family violence, child abuse in educational institutions and so on.
Play therapy is used as a method of correcting behavior and teaching new skills to children with developmental disabilities and impaired social adaptation. This method is used for all types, excluding deep autism and schizophrenia. With the help of play therapy, children with developmental disabilities are taught the most important everyday skills, how to interact with other people, and how to express their emotions. But the therapy of such children should be carried out only by a specialist with education and work skills. On their own, parents and persons involved in the development of the child can carry out elements of play therapy in the form of teaching household skills, but not corrective work.
Today, play therapy is recommended for use from 2 years of age. Play therapy in kindergarten helps to solve the problems of the child's adaptation, teaches children interaction and communication skills. It can be carried out by both a child psychologist and an educator who has received an appropriate education.
Types and features
Sigmund Freud is considered to be the founder of game therapy as a psycho-corrective method. He used it as an analysis of what is happening with the child, using the method of free associations, and this method was not widely used, unlike play therapy according to the method of M. Klein, and later Anna Freud, they considered it as an opportunity to influence the child's psyche, using toys for this , associative games and other techniques.
In the book of G.L. Landreth "Game therapy: the art of relationships" describes all the stages of the formation of this type of therapy, describes the principles of game therapy, methods and material for the game. It may be of interest to parents whose children are going to attend play therapy or are already attending it. And also for those who want to use this method on their own.
Today, play therapy is a popular and widely used method. She has several varieties, types and many independent techniques. According to the method of influence, they distinguish:
- Non-directive play therapy is spontaneous, client-centered. Using this type of therapy, the specialist does not try to somehow influence or change the behavior or emotions of the child. He is fully involved in the game, he can gently guide, but at the same time follows the child, creating the most favorable conditions for him.
- Directive - the specialist takes the leading role in the game. He guides the child, teaches him the basics of behavior, tells him how and what to do, and takes on the role of organizer and leader of the game.
Depending on the type of games and the material used, structured and unstructured game therapy are distinguished.
Structured - the game uses certain images: toys, puppet theater, images of people, models of animals, food, and so on. Playing with these objects, the child can express his attitude towards them, learn how to handle these objects or build his own game, taking into account the proposed elements.
Unstructured play involves physical activity and the use of materials such as sand, water, clay, plasticine, paints, and so on. Such games help with the child's refusal to cooperate, his unwillingness or inability to express his feelings, and also when it is impossible (for the child) to express feelings and emotions that overwhelm him, for example, anger at parents or resentment.
Depending on the number of children, individual and group play therapy is distinguished.
Individual is considered more effective, it is recommended to use it when working with the child's emotions, his behavior or attitude. Also, in order to treat an emotional or behavioral disorder, only individual sessions are used.
Group play therapy helps to improve relationships in a team, teach social skills, and can also be used to correct fears and anxiety.
Play Therapy: Specialist or Mom?
Should I take classes on my own or seek help from a specialist? Today, many parents face such a choice, classes with professional psychologists promise to be more effective, but for this it is necessary to allocate special time and money to attend classes. You can practice play therapy on your own at any time, with the whole family and completely free of charge. So what should you choose?
There is no unequivocal answer to this question, each parent decides it on his own, but if you are going to do play therapy with your child or several children, it is imperative to study at least the basics of this technique and follow the basic rules:
- The game should begin and be carried out only at the request of the child, any coercion to play is unacceptable. Parents can offer time, involve other family members in the game, but the main thing is the desire of the child and his positive attitude towards the game. Without this, there is no point in conducting classes.
- Compliance with the regime of games - depending on the age of the child, play therapy can last from 5 to 30 minutes. It is also important that play therapy be gradual and unobtrusive. There is no need to offer the child all the available games at once or after finishing one, immediately start another. It is best to devote several days to one game.
- Following the child in the game without forbidding or imposing is the most difficult skill for all parents. In play therapy, they should follow the child, not trying to forbid or react negatively to something. Even if the child in the game says obscene words, beats toys and promises to kill everyone - this is an occasion to carefully listen to his words and understand why he pronounces them. It is strictly forbidden to scold and punish a child for what and how he plays. During the game, the parent should gently explain why this behavior is unacceptable and show him other ways to interact.