Theraplay is a dyadic (parent/child) treatment modality for supporting children and families that focuses on harnessing the power of the relationship between the child and their caregiver as path toward change and healing.
Theraplay places a priority on strengthening the parent/child relationship as the way to create change for a child or within a family- even in diagnoses or symptoms that don’t seem obviously related to the parent/child relationship, such as ADHD or Autism. Theraplay believes that strengthening the parent/child relationship will always contribute positively to a child’s mental health, regardless of the specific symptoms or mental health diagnosis.
My guest today on today’s podcast episode is Mandy Jones, Program Director of The Theraplay Institute in Chicago, IL. Mandy is a Theraplay trainer, practitioner, and supervisor, a Registered Play Therapist, and an attorney. In addition to her administrative and training responsibilities at The Theraplay Institute, Mandy also provides therapy to children and families.
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Four Theraplay Dimensions
Theraplay is based on four, equally important dimensions: Structure, Engagement, Nurture, and Challenge.
Structure
Humans– both children and adults– do better when we have some structure in our lives and we know what is happening next. We feel safer and more secure, both in ourselves and in our environment. Theraplay provides more structure for the therapy hour than many other child therapy modalities, such as child-centered play therapy. This structure is viewed by Theraplay as a crucial element in creating felt-safety for children, especially ones who have had a history of unpredictability, trauma, or toxic stress.
Theraplay is a therapist-led yet extremely child-centered modality. It is an advanced skill for a therapist to be able to balance the level of structure in Theraplay while maintaining the level attunement necessary for healing.
It can be a common misperception that Theraplay is not child-centered! Child-Centered Play Therapy is a very specific modality of play therapy that is different than Theraplay, but that does not mean Theraplay is not child or client-centered. As a Theraplay practitioner myself, I find the high-level of presence and attunement needed to stay so child-centered while being therapist led to be one of the most powerful- and challenging- elements of the model. I have always considered Theraplay to be an advanced modality for therapists to learn and effectively integrate into their practice.
Engagement
Attunement, as mentioned above, is a core element of Theraplay. This level of attunement intended to create an experience where the child feels as though they are the center of the adult’s world. The therapist, and ultimately the parent, are focused on reading the child’s non-verbal cues to stay in attunement- does the child like this activity? Or not? Are they becoming more regulated? Or less?
Theraplay therapists use very few toys and the therapy experience is largely focused on the experience between the child and the therapist, and ultimately the child and their caregiver while the therapist provides support.
Nurture
Nurture is all the things we do to keep babies alive! They’re fed, rocked, swayed, and soothed. Nurturing activities and experiences are a central aspect of Theraplay treatment. Theraplay therapists usually have oodles of band-aids in their office and the therapist and caregivers pay a lot of attention to caring for kids’ hurts.
Touch is also a big piece of Theraplay. Theraplay practitioners are trained on the ethical use of touch and to lean into touch as an important component of healing of our regulatory circuits. It’s not uncommon for Theraplay therapists to have to re-work their ideas about touch in the therapy room. If this makes you feel a little uneasy, it might help to remember that the child’s parents or caregivers are heavily involved in the therapy.
Challenge
The challenge dimension of Theraplay recognizes that parents and caregivers are the first to lay the foundation for the child’s sense of self and competency. Some of this comes from engagement but some of this comes with challenge!
In the interview, Mandy gave them example of tummy time. Parents and caregivers can find playful ways to challenge children right at the edge of their window of tolerance. When challenge is too much, it becomes overwhelmingly frustrating and erodes connection. When challenge is too low, our children don’t grow and discover their capabilities.
The challenge dimension supports the parent to attune to their child, in the moment, and set the bar for their child just high enough. When the caregiver sets that bar at the right height, the child feels a sense of competency and “I’m good!” When the caregiver sets the bar too high or too low, it’s simply a rupture! Ruptures in relationship mean they have the opportunity to repair- to try again. This persistent pursuit of “I want to know you and get it right” is healing and strengthening in the parent/child relationship.
Parenting the Theraplay Way
Theraplay happens in the office (or in the home with a Theraplay therapist) but one of the more important elements of Theraplay treatment is that the therapist helps parents and caregivers take the concepts they are learning in the Theraplay therapy into their everyday life. There are so many ways that the concepts of Structure, Engagement, Nurture, and Challenge can be woven into moments of parent/child relationship in their home and life outside the therapy room. Theraplay places a priority on supporting the caregiver’s relationship with the child so ultimately the child can experience these moments of healing and attunement far beyond therapy.
Theraplay activities are almost all grounded in rhythmic, repetitive, relational, somatosensory experiences (and at this point in the series, we all know that those are experiences that strengthen the foundation of the brain!). I’ve spent many sessions blowing cotton balls and feathers back and forth with children (and grown-ups- yes, pre COVID when we got a little more cautious about blowing spit around the office)!
But more than the specific activities, Theraplay is all about discovering a fluid dance of serve-and-return between a caregiver and a child.
I do this and you do that.
This back-and-forth continual attunement becomes moments of rhythmic, repetitive, relational, and somatosensory experiences.
Caring for Parents
Theraplay therapists hold at their core that if parents aren’t OK, kids aren’t OK. Theraplay therapists wrap the parents up in their care and work to empower the parent to really own that they are their child’s expert. When I work with families, I want parents to know that they are who their child needs, and that I will help them feel confident in that role.
This is one of my favorite aspects of Theraplay and unfortunately, it’s a unique aspect of children’s mental health treatment.
Therapists can – and should! – take concepts from how Theraplay prioritizes the parent/child relationship and weave those tenets into other modalities.
Moments of Healing
Dr. Bruce Perry speaks so emphatically about the important of creating moments of healing for kids. Theraplay is the perfect modality for supporting the parent/child relationship during the therapy appointment while also providing the caregiver with new ways to provide their child with moments of healing throughout the week.
Brains (and relationships!) don’t heal in one hour a week. But the one hour a week (or less) of Theraplay can provide a great touchstone for the moments of healing that can emerge throughout the rest of the week.
Theraplay is Exhausting
And so is parenting the Theraplay way.
Parenting with this level of attunement, structure, challenge, nurture, and engagement is exhausting.
It’s a challenging way to do therapy and it’s a challenging way to parent.
Mandy considers the possibility that one of the reasons why parenting the Theraplay way is so exhausting- and doing therapy that way!- is because it’s a new way of being in relationship. As a parent (or therapist), your brain has a lot of new neural connections to make in order to parent with this level of attunement. Changing brains is hard work!
The level of intimacy in Theraplay requires that parents (and therapists) do a lot of internal work and self-exploration. To show up in a relationship with that level of depth and resonance can be hard and, yup, exhausting.
You Need Support!
It’s so important to find the level of support and self-care needed to keep showing up for yourself in this way.
Which, for so many parents and families, is almost impossible to find.
There aren’t enough resources or time. The supports simply don’t exist.
Where can parents find the connection and co-regulation they need in order to give to their children what they need?
This is one of the reasons I love Theraplay because yes, it’s exhausting, but a great Theraplay therapist is pouring in to the parents and caregivers as much (or even more) than they are pouring into the child.
The Club
This is also why I created The Club. Parenting kids with special needs, especially behavioral special needs and then on top of that, kids who struggle to be in close, connected relationships is exhausting and can be traumatic.
It’s lonely.
It’s confusing.
Finding ways to be seen and known and not judged can make a tremendous impact in growing resilience and decreasing burn-out, hopelessness, and overwhelm.
This is challenging even in a community that is bursting with resources (where is that community? I need to know!).
Feeling less alone is the most common piece of feedback I get from Club members. And not only are they less alone but they are surprised at how much it matters to feel less alone.
Find Theraplay
Head to the Theraplay website to discover all their resources and training opportunities. If you live in the greater Chicago area, The Theraplay Institute offers therapy services for kids and families. If you don’t live in the greater Chicago area, you can contact The Theraplay Institute to see if traveling to Chicago for an intensive therapy experience could be a good option for your family.