Play Therapy: A Psychodynamic Primer for the Treatment of Young Children

486 Pages·2018·2.411 MB·English

by  Pamela Meersand, Karen J. Gilmore

Play Therapy

A Psychodynamic Primer for the

Treatment of Young Children

Pamela Meersand, Ph.D.
Karen J. Gilmore, M.D.
PLAY THERAPY

A Psychodynamic Primer

for the Treatment of

Young Children

PLAY THERAPY

A Psychodynamic Primer

for the Treatment of

Young Children

Pamela Meersand, Ph.D.
Karen J. Gilmore, M.D.
Note: The authors have worked to ensure that all information in this book is
accurate at the time of publication and consistent with general psychiatric
and medical standards, and that information concerning drug dosages,
schedules, and routes of administration is accurate at the time of publication
and consistent with standards set by the U.S. Food and Drug Administration
and the general medical community. As medical research and practice con­
tinue to advance, however, therapeutic standards may change. Moreover,
specific situations may require a specific therapeutic response not included
in this book. For these reasons and because human and mechanical errors
sometimes occur, we recommend that readers follow the advice of physi­
cians directly involved in their care or the care of a member of their family.
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Library of Congress Cataloging-in-Publication Data
Names: Meersand, Pamela, author. | Gilmore, Karen J., author. | American Psychiat­
ric Association Publishing, issuing body.
Title: Play therapy : a psychodynamic primer for the treatment of young
children / Pamela Meersand, Karen J. Gilmore.
Description: Arlington, Virginia : American Psychiatric Association
Publishing, [2018] | Includes bibliographical references and index.
Identifiers: LCCN 2017028373 (print) | LCCN 2017029477 (ebook) | ISBN
9781615371440 (ebook) | ISBN 9781615370436 (paperback : alk. paper)
Subjects: | MESH: Play Therapy | Child | Psychotherapy, Psychodynamic |
Child Development | Case Reports
Classification: LCC RJ505.P6 (ebook) | LCC RJ505.P6 (print) | NLM
WS 350.4 | DDC 618.92/891653—dc23
LC record available at https://lccn.loc.gov/2017028373
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Contents
About the Authors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix

Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv

PART I

Theory of Play and Play Therapy

1
Why Play Therapy? Introduction to the Psychodynamic
Treatment of Young Children. . . . . . . . . . . . . . . . . . . . . . . . . . . 3

2
Play, Playfulness, and the Sequence of Play Forms

in Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

3
Pretend Play. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

4
Play in the Digital Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

5
Basic Psychodynamic Concepts and Their Use in

Play Therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

6
Therapeutic Action and the Multiple Functions of

Play Therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
7
Play and Developmental Psychopathology, Deprivation, or

Disability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171

PART II

Technique of Play Therapy

8
The Logistics: Planning a Practice and Arranging for

Office Space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217

9
Getting Started, Creating an Alliance, and Facilitating Play . . 251

10
Working With Parents Over the Course of Treatment . . . . . . 277

11
Deepening Play Therapy: Verbalizing Inner States,

Expanding Narratives, and Working With Transference

and Defense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319

12
Ending Play Therapy and the Process of Termination . . . . . . 345

13
Play Therapy, Variations in Child Development, and

Serious Psychopathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407

Appendix A. Selected Assessment Measures for Play Therapy . . .413

Appendix B. Development Form. . . . . . . . . . . . . . . . . . . . . . . . . . 421

Appendix C. Narrative School Reports. . . . . . . . . . . . . . . . . . . . . . 439

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447
About the Authors

Pamela Meersand, Ph.D., is Associate Professor of Psychology in the
Department of Psychiatry at Columbia University College of Physicians
and Surgeons, and Director of the Child Division at the Columbia Uni­
versity Center for Psychoanalytic Training and Research. She is in pri­
vate practice in Manhattan.
Karen J. Gilmore, M.D., is Clinical Professor of Psychiatry at Columbia
University College of Physicians and Surgeons, and Senior Consultant
to the Columbia University Center for Psychoanalytic Training and Re­
search. She is in private practice in Manhattan.
vii

Preface

Psychodynamic play therapy is the premier medium for the treatment
of young children. As a therapeutic modality, it comprises elements of
both science and art: the practitioner is guided by a set of theoretical
principles and informed by a vast reserve of developmental research,
while the playing state between child and adult is fueled by their unique
subjectivities, affective reciprocity, and creative potential. Indeed, the si­
multaneous cognitive and emotional challenges of play therapy—engag­
ing fully in the spontaneous, rapidly unfolding imaginary action while
retaining the capacity to evaluate and reflect—require the clinician’s sub­
stantial knowledge, preparation, and personal resourcefulness. Despite
this, contemporary training programs for child clinicians in all disci­
plines rarely provide in-depth education in the theory and practice of
play therapy; fellowships and internships are far more likely to empha­
size brief, evidence-based modalities with highly specific methods for
eliciting and guiding children’s participation in treatment. During our
many years as teachers and supervisors of aspiring child practitioners, we
have experienced first-hand the frustration of young trainees who feel ill­
equipped to approach play from a more exploratory, less directive stance
even as they recognize its function as the most natural and revealing and
potentially the most growth-promoting form of self-expression for
young patients.
Ideas for the current book developed during our interactions with
students as they began to immerse themselves in working and playing
with children; along with our trainees, we grappled with theoretical
questions (How do we conceptualize major psychodynamic ideas, such
as transference and resistance, in work with young children? What is
the role of play in the mental development of the child?), questions of
technique (What are effective ways to work with parents while maintain­
ix