can be helpful in ongoing monitoring and intervention of safety. Interpersonal problems were found to be precipitating factors in both improving external support systems, such as the youth’s interpersonal skills with family and friends and the ability for child and family to access help, can build protective factors toward prevention of suicide (Bilson et information, to include and collaborate as a team in the child’s life. The care team can create safe spaces, reinforce the safety plan, and help the child regulate. This process can help build new experiences in different settings to reinforce safety to connect suicide prevention to the child’s world outside the playroom.
Prevention Play therapists can work with caregivers and children to promote resilience as children grow throughout their lifetime. Characteristics that make an individual less likely to have suicidal thoughts, attempt suicide, or die by suicide are protective factors (Suicide Prevention Resource Centers, 2019). Resilience is a result of a combination of protective factors that include individual characteristics and social environments (Center on the Developing Child, 2021). It is important to recognize resiliency skills are established before a suicide crisis arises, before warning signs of suicide, or are done in conjunction with professional help if there is concern for safety.
Enhancing a stable environment for children includes improving their caregiver’s ability to regulate themselves and learn the impact of their regulated state on their child. Co-regulation established early in life between child and primary caregivers influence social relationships regulation builds the capacity for children “to develop relations with others and to deal with state regulation challenges and disruptions or caregiver, youth develop an understanding that some feelings in our bodies are associated with vulnerability and that behavioral adjustments can calm our bodies so they can seek connection from social engagement
Some strategies to building resilience in children and youth include teaching caregivers to model labeling emotions (Hurley, 2020) to promote a wide range of emotional vocabulary and decrease black-and-white thinking or all-or-nothing thinking. With emotions labeled, the caregiver can help their child identify a sensation in their body associated with the emotion. Then, they can demonstrate using healthy coping and calming strategies, such as long deep breaths to calm the sympathetic nervous system, so children can learn flexibility and broaden window of emotional feeling overwhelmed by emotions and sensations can restore a sense of
Caregivers build problem-solving and conflict management skills (Hurley, 2020) by refraining from stepping in or lecturing children and instead actively listening (summarizing, reflecting feelings, and withholding
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judgement and advice) and asking questions. Caregivers can allow time for structured and unstructured play and help children learn to take healthy risks (Hurley, 2020) by allowing youth to join a sports group or other activity group in which they may experience successes and failures and learn adaptations to stress and adversity. It is also helpful to involve children in a variety of social groups to reduce isolation.
Educate and model how to set healthy limits and boundaries with family, friends, technology, and time. Build in individual and family time where the caregiver and/or family is actively engaged with the child to increase interpersonal skills, prosocial behaviors, connection to culture and traditions, and a valuable time to learn about and address concerns (Hurley, K.2020). And build time for the child practice and learn comfort in self-soothing and a time for reflection. Finally, suggest caregivers promote healthy stress management such as exercise, healthy eating, healthy routines, and sleep habits (Hurley, 2020).
Treatment Planning It is imperative when treating suicide in play therapy that play therapists use an evidence-based approach, stay up-to-date on education and research, practice within their skillset and training, and contact other professionals for consultation or supervision. Treatment plans need to reflect how the play therapist directly addresses suicide and not just the may include assisting the client in increasing internal protective factors, skills, and a broadening window of tolerance for emotions, as well as increasing external protective factors, such as interpersonal skills and support systems. Other goals include reducing the child’s risk factors, such as isolation, access to care, and access to lethal means.
When developing a treatment plan, play therapists recognize children chronological age, development level, previous experiences with death, spiritual beliefs, and cognitive development. Play therapists need to consider these stages and thought processes and include the child’s support systems to help maximize the potential for resilience and building protective factors to prevent suicide.
Conclusion Suicide in children is a serious concern for play therapists; however, (Goldstein Grumet et al., 2019). Play therapists can directly assess and address suicidal ideations in play therapy settings. Increasing an individual’s ability to regulate plays a key role in the prevention and treatment of suicidality by strengthening the capacity of individuals to adapt to adversity. Using play therapy as a treatment modality has the power to build resilience and protective factors aimed at reducing suicide vulnerability in children and youth.
References Frontiers in Psychiatry, 9,
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