Play Therapy and the Brain

I was fascinated recently when I read an article in the International Journal of Play Therapy by Hong and Mason entitled “Becoming a Neurobiologically-Informed Play Therapist” (Hong & Mason, 2016). Over the past years a new subspecialty of play therapy has been developing which some are calling “Neuro-biologically Informed Play Therapy”. As past president of the Arizona Play Therapy Association and a trainer in the Neuro-sequential model of therapeutics, I have a unique perspective on these tested modalities of therapy for children.

What is Play Therapy?

For children, play is one of the most natural modes of learning and relating to others. It is through play that children often express their feelings, explore their relationships, and attempt to understand their experiences. Brain research has shown that experience (such as play) influences neuronal function and brain structure (Siegel, 2012) and that the core therapeutic methods that change brain structure are experience and relationships (Siegel & Bryson, 2011).
The goal of play therapy is “to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development” (Association for Play Therapy website). Play therapy emphasizes the establishment of accepting, supportive therapeutic relationships which are consistent with neurobiological research. This therapy recognizes the importance of being understood and being relational with an adult which enhances the regulation of a child’s developing brain. Neurobiological research has also shown that play, in and of itself, is regulating. The use of toys in play therapy allows hands on, sensory experience that provides an opportunity for a child to process his or her experiences.
Here are a few of the principles of neurobiology and there applications to play therapy:

Brain develops from brainstem up

• The brain develops and Is organized from the brainstem up to the higher cortical areas – when children have difficulty sleeping and show significant separation and school anxiety, a neuro-biologically informed play therapist might consider the possibility that these symptoms are in part caused by dysregulation in the brainstem and limbic systems. The therapist would include interventions targeting those areas. Play therapy that focused on rhythmic sensory integration would likely help calm the brainstem and allow the child to be focused and present during the rest of the session.

Trauma can cause damage

• The brain has mechanisms for assessing and responding to threat, and chronic threat may cause permanent brain changes – When the stress response system of the brain is activated by a traumatic experience, the brain makes an association between the traumatic experience and the accompanying sensory stimuli (sights, sounds, etc.). This offers clinical applications for play therapists in their work with children who have trauma and anxiety disorders. Traumatized children may respond with a response to sensory stimuli they associate with traumatic memories, even when there is no specific threat. An acute fear response is often accompanied by emotional and behavioral dysregulation. The body remembers a threat that children once experienced. The utilization of sensory-based play therapy interventions to alter trauma associations in the brain to will certainly aid in treating dysregulation caused by traumatic experience.

Different brains – different treatments

• The best way to work with a child depends on which areas of the brain that are dominant at any time – a child who is responding primarily from the limbic system will benefit most from relationally driven interventions such as child-centered play therapy. A child reacting from the brainstem needs safety, space, and movement to be able to regulate and access higher areas of the brain (Perry, 2006)

Putting it all together

Neuro-biologically informed play therapy is a valuable tool for accessing the needs of a child and explaining the treatment plan to the supportive adults in his/her life. As more play therapists become neuro-biologically trained we will find that our work with children is more effective and more rewarding.

Perry, B. D. (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children: The neurosequential model of therapeutics. In N. B. Webb (Ed.), Working with traumatized youth in child welfare. New York, NY: Guilford Press.
Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are (2nd ed.). New York, NY: Guilford Press
Siegel, D. J., & Bryson, T. (2011). The whole brain child: 12 revolutionary strategies to nurture your child’s developing mind. New York, NY: Bantam Books.
Hong & Mason (2016). Becoming a Neurobiologically-Informed Play Therapist. International Journal of Play Therapy, Vol. 25, No. 1, 35– 44.

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