Theraplay®...

Theraplay® is a treatment approach which fosters engagement with others, a sense of belonging, trust in others, self-awareness, and self-esteem. It is based on the natural patterns of healthy interaction between the parent and infant and, therefore, is personal, physical, and playful.

The play activities chosen are those which are fun, spontaneous, interactive, and require physical contact. They involve intervention in the four basic dimensions of:

1. structure -- demonstrating that there are limits/boundaries/expectations/inner and outer control/order so that the child may develop feelings of security and trust, and, eventually, autonomy;
2. challenge -- requiring the child to take risks in growing and learning which promotes feelings of competence and confidence;
3. stimulation/engagement -- promoting attention to the environment via new experiences, constant change, variety, and surprises; and
4. nurture -- demonstrating that the world is a caring, safe, secure, warm and predictable place, that adults provide comfort and stability, and that the child is valued (accepted, wanted) and loveable (unconditional acceptance).

This approach may be used with children with emotional needs (aggressive, withdrawn, reactive, compulsive, insecure, fearful, despondent, controlling, disruptive, oppositional, demanding, defiant), children with social needs (adjustment, security, trust, belonging, relating), and children with learning needs (language, cognition).

Theraplay® may be provided as a short, intensive treatment approach for families or as a group, social interactive approach with peers. However, both approaches reflect the needs of the children and have as a basic underlying tenet that change is possible and that change occurs via the development of positive relationships.

For children with hyperlexia, both approaches may be used effectively, however, the goals may be slightly different. With the family, the focus would be based on the child's individual needs, in relation to family interactions and would address the use of positive and responsive interactions which would have the child view himself/herself as accepted, loveable and competent, to view others as caring and trustworthy, and view the world around him/her as safe and secure. With a peer group, the focus would be extended to include the development of a sense of self separate from others, recognition of others, and the development of trust in others via establishing comfortable interactions within a social context using physical contact, eye-to-eye contact, turn-taking, imitation, and communication.

Group Theraplay® creates a sense of connectedness in the child through attention, recognition, appreciation, and nurturing. The children appear to deal with personal issues and feelings that are demonstrated via their behaviours, develop greater awareness and understanding of themselves and others, learn to socialize in a positive manner with others and support one another, and learn to advocate for themselves.

Group Theraplay® is proactive in that it is not in reaction to misbehaviour but meets the needs of the child at his/her developmental level, is task-oriented with the emphasis on "action" and "feeling" rather than "talk", and is adult-directed, which assists the child in recognizing that he/she is safe and secure and can trust others.

The three basic rules of Group Theraplay® are:

1. No Hurts, which allows for nurturing and disallows pain or anxiety;
2. Stick Together, which indicates inclusion for all, caring for one another, and involvement;
3. Have Fun, which is exciting, positive, and allows for the development of relationships.

Each session begins with an introduction and greeting, followed by an inventory of personal body parts and traits, then active games interspersed with quiet activities involving the four dimensions, and, lastly, a closing activity. Few material objects are used so that the focus is on person-to-person interaction.

At the completion of each session, observations are noted so that the next session can be structured with the types of activities that would be appropriate to meet individual needs. Behaviours observed include: facial expressions, eye contact, body postures, body positions, verbal responses, vocal responses, focus issues, nurturing responses, attentional responses, transition/change responses, communication, autonomy, and power/control issues.

Based on personal experiences, I have found that Theraplay® has had an immediate and dramatic impact on overall development. Not only do the children become more communicative and social, but they appear to be happier, more confident, and more self-aware.

Theraplay® is a registered service mark of The Theraplay Institute, Wilmette, IL, USA.