CLINICAL EDITOR’S COMMENTS: The author’s use of Adlerian play therapy
helped a child create safety and move toward healing after witnessing domestic violence.
M
any children who come to live in a domestic violence shelter have witnessed unimaginable abuse and have experienced intense fear and trauma. Billy (pseudonym), a middle-elementary school-aged boy,
was no exception. In fact, Billy had lived most of his life watching his mother experience violence and abuse in a series of unhealthy relationships. The latest episode of violence resulted in Billy calling 911 after he watched his mother’s head get smashed through a window. Domestic violence is noted as one of the most severe adverse events during childhood and leaves many children feeling a lack of protection or safety (Gil, 2010).
Adlerian play therapy emphasizes that the therapeutic relationship serves as the foundation for everything that occurs in the therapeutic process and stresses the importance of fostering the development of children’s connectedness to others (Kottman & Meany-Walen, 2018). Herman (2015) cited reconnection as a major goal in and stage of trauma therapy. The “Crucial Cs” of Adlerian theory – feeling connected, feeling capable, feeling as though they count, and developing courage – are positive goals for children that are explored and enhanced through Adlerian play therapy (Kottman, 2011).
Kottmann and Meany-Walen (2018) described the four phases of Adlerian therapy as building the therapist-client relationship, exploring clients’ lifestyles, helping clients gain insight, and helping them make changes in thinking, feeling, and behaving. Adlerian play therapy encourages strategic and systemic use of a variety of directive and nondirective skills and techniques as a means to provide support and aid for making these necessary changes (Kottman & Meany-Walen, 2018). The four phases of Adlerian therapy, as well as Billy’s development of the Crucial Cs can be observed throughout his progress in therapy.
Using Adlerian Theory to Connect to Billy introduced to the therapist and the therapy process. The therapist sat on the floor with Billy to explain that he may choose what he plays with and
how he plays with it in the playroom. Likewise, the therapist explained that sometimes she may have an idea about what activity or play is done in the playroom. The therapist tracked Billy’s play, reflected and validated feelings, taught and modeled self-regulation, as needed, and provided structure and consistency. The therapist and Billy practiced deep breathing and calming strategies through therapeutic games and blowing bubbles. Billy engaged in breathing and calming strategies as he began his play, and when he ended play and was ready to leave the playroom. Providing structure and consistency included informing Billy about when his play therapy would occur, how long it would last, and what to expect in the playroom. All of these strategies helped Billy to begin to build trust in the relationship.
The introduction to therapy and subsequent sessions were used to build rapport, and increase Billy’s sense of safety, control, and capability, which set the stage for developing a collaborative partnership in which he and the therapist would share power and responsibility (Kottman & Meany-Walen, 2018). The beginning sessions of therapy allowed Billy to develop a connection with the therapist and feel as though he counted in the relationship. These sessions also provided opportunities for the therapist to continually foster the development of the Crucial Cs of connection and of feeling as though he counts throughout therapy.
Common emotional responses to trauma include intense fear, helplessness, or horror resulting from the trauma itself…
When Billy started therapy at the shelter, he displayed moody and irritable emotions; dissociative symptoms, such as giving blank stares, “checking out,” and not speaking; and he demonstrated aggressive
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