cognitive self-control and becoming a problem solver. This parallels power of play for increasing personal strengths. In addition, a parent education component to treatment is necessary. Therapists can provide caregivers with psychoeducation about separation anxiety
Play therapy has also been beneficial with children with separation therapy was effective in the reduction of separation anxiety disorder (2011) found group play therapy resulted in statistically significant reduction of separation anxiety in children. The current author practices child-centered play therapy with children who present with separation anxiety symptoms. Child-parent relationship therapy (CPRT), where play therapists teach caregivers play therapy skills to utilize with their children during a weekly playtime, is also a valuable intervention (Bratton & Landreth, 2019).
In addition, the author
meets with parents or caregivers regularly to provide education, teach skills, and assess progress. Several tips are listed below that have been helpful when working with caregivers of children who exhibit separation anxiety symptoms.
Taking a walk around the block or a quick trip to the local
convenience store can provide children with successful separations that
will likely combat their feelings of helplessness and anxiety.
Intervention Strategies
Self-care is essential for caregivers. Individual therapy for a parent may help ease a parent’s anxiety and, subsequently, help a child feel more stable and calmer. In addition to working on the relationship through CPRT, the play therapist can coach parents to intervene outside of
Patrice Karst and The Kissing Hand by Audrey Penn. In addition, social stories are valuable with many anxiety-provoking situations and add a level of exposure. Parents may utilize a character the child enjoys and describe the character in a setting where a separation will occur. Walk the child through the separation, showing how the character is safe with other adults while utilizing coping skills and feels accomplished and proud when reuniting with the caregiver.
Structured doll play is another tool that may be used to support structured doll play as playfully creating a story utilizing props and dolls or stuffed animals to prepare a child for a change or to explore a stressor. The caregiver acts out a scenario where a toy with the child’s name separates from the caregiver and then returns safely. Thus, the child is further exposed to the stressor of separation while maintaining a safe emotional distance.
A more direct form of exposure is to practice brief separations. Taking a walk around the block or a quick trip to the local convenience store can provide children with successful separations that will likely combat their feelings of helplessness and anxiety. Once the caregiver has engaged the child in playful exposures as outlined above, they verbally prepare the child for the separation. Children should understand when the separation will occur and when they will be reunited with the caregiver. Specifically, providing the child with transition times may help prepare them for the separation.
If the child is returning to school, visiting the school together may be beneficial, if possible. In addition, create a goodbye ritual prior to the separation. This can involve a special handshake, hug, or kiss that helps the child feel safe. Keep the ritual and the goodbye brief and somewhat structured (Schaefer & DiGeronimo, 2000). Further, the caregiver will need to gently yet firmly set limits. Providing a child with limits, choices, and consistency will offer a level of comfort and safety for the child. If the child is attending school, designate a safe place at school, such as the nurse’s office, and allow the child to contact his or her parents to help the child feel safe as well. Avoid excessive discussion of
the separation and special playtimes. Simply having consistent daily
routines can help a child feel safe and secure. Further, songs, such as “Grownups Come Back” from the television show Daniel Tiger, are a helpful tool for children to add to their coping skills to feel calm and safe.
Exposure to Separation Children with separation anxiety will likely benefit from various forms of exposure to take power away from the separation, normalize the experience, and help a child feel successful. Bibliotherapy is a helpful intervention for exposing a child to the idea of separation, using separation-focused books, such as The Invisible String by
12 | PLAYTHERAPY | September 2021 |
www.a4pt.org
consider the child’s development, because younger children will need less time for preparation. Allow the child to ask questions about the separation. The main focus is to reassure the child that he or she is safe. Therefore, utilizing language to help the child feel safe is of the upmost importance.
During the Separation It is important for the parent to remember to remain calm when transitioning to and maintaining the separation. If the parent becomes anxious,
this will only fuel the child’s anxiety. It is
imperative for caregivers to not dismiss their child’s feelings yet reflect their child’s emotions. Balance the brevity of a goodbye ritual with allowing the child to feel heard and understood. Moreover, encouraging language, such as, “You know just how to help yourself feel safe/calm while I’m gone,” can help empower the child to separate from the parent and ease their anxiety.
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