Theories of Development

Play and Play Therapy

Play & Biology

Play evolved with mammals – biological drive

Play circuits – midbrain; mammalian brain
Three forms of play

1) Solitary Locomotor rotational play.

2) Object play

3) Social play

‘A little nonsense now and then is

cherished by the
wisest men’ Roald Dahl.
Solitary Locomotor-rotational (Movement) play refers to the vigourous bodily motor acts
that are typically performed alone. Such actions often mimic but exaggerate normal
movements and motor activities. This is considered the earliest form of play as there is no
intended goal that the activity is aiming towards. Rather it is done so for its own sake. In
infants this form of play is witnessed early on in how they move the parts of their body,
make facial expressions, smiles and so on. This play that is common to most animals and
instrumental in developing the coordination required for more sophisticated motor
activities.

Object Play refers to the playful manipulation of inanimate objects. This play is also
common to many animals e.g. a dog playing with a bone, a cat chasing a ball of string or a
killer whale tossing a seal in the air. In predatory animals this is an essential aspect of
early behaviour. In childhood, play with objects provides the opportunity for hand-eye
coordination control etc and signals the childs ability to physically manipulate the
environment for the purposes of their own enjoyment.

Social Play refers to play that involves two or more individuals. In the animal kingdom this
generally revolves around rough and tumble play that provide the participants with the
opportunity to practice survival behaviour. For children social play is an essential
component to learning basic response patterns and visual & verbal cues in peer relations.
The development of play

Piaget’s sequences of play:

A) Practice Play
B) Symbolic Play
C) Play with rules

“Each time one prematurely teaches a child something he could have discovered
himself, that child is kept from inventing it and consequently from understanding it
completely.”
Jean Piaget
A) Practice play refers to early sensori-motor play in infants. This can occur well beyond the period
of infancy. Rough and tumble play can count as practice play unless it has some symbolic elements
or rules guiding it. Such play often begins with rhythmical stereotypes followed by bodily
movements and exercise play leading on to rough and tumble play.
B) Symbolic play is thought to occur in or around the ages of 12-15months..
Pretend play tends to involve children directing activities towards themselves in the beginning
before involving others in the game. This is referred to by Piaget as decentration. This occurs when
the child incorporates another into the activity which was originally independent of others. In the
early stages the play is heavily dependent upon real objects such as cups or combs etc. Adults are
required to model the pretend behaviour in order to include objects that are further removed from
the thing they are representing. By 3rs of age symbolic play using arbitrary objects occurs much
more spontaneously. This decontextualised pretence is built up over time. Jackson 1973 found that
when 3-4yr olds were asked to pretend to brush their teeth that they would use some substitute
body part such as a finger, 6-7yr old however would imagined the brush in their hand.

C) Play with rules is often observable in in preschool children e.g doctor-patient play. Some
constraints exist on what each person is supposed to do. However these rules are largely arbitrary
and dependent on the two participants playing the game. It is generally not until the child reaches
their 6th year that rule-governed play becomes the preference. Up until this point children remain
largely ignorant of the rules governing more sophisticated games.
 Piaget on play cont’d

Piaget saw adaptation as depending on the two processes accommodation and

assimilation.

Play as assimilation: Play utilises existing cognitive schemas . A process reflective of

emerging symbolic development but contributing little to it. Piaget believed children
are acting through the play what they already know.

Play as adaptation: Play can (1) consolidate existing skills by repeated execution of
known schemas (2) Provide the child with a sense of ego continuity through mastery.

‘Nel, after throwing a stone onto a sloping bank watching the stone rolling said, 'Look
at the stone. It's afraid of the grass”

Jean Piaget
 Piaget on play cont’d

Piaget defined play as assimilation, or the child's efforts to make environmental stimuli
match his or her own concepts. Piagetian theory holds that play, in and of itself, does not
necessarily result in the formation of new cognitive structures. Piaget claimed that play
was just for pleasure, and while it allowed children to practice things they had previously
learned, it did not necessarily result in the learning of new things. In other words, play
reflects what the child has already learned but does necessarily teach the child anything
new. In this view, play is seen as a "process reflective of emerging symbolic
development, but contributing little to it“.

For Piaget play related more to accommodation to reality. For Piaget the functions of
play are two fold: play can consolidate existing skills by repeated execution of known
schemas, with minor variations. It can give a child a sense of ‘ego continuity’ that is the
confidence and a sense of mastery.

Developmentally speaking Piaget understands play as the organisms response to

libidinal energy which is sublimated. As the child grows the manner in which play
unfolds changes according to the stages of development they occupy.
https://www.youtube.com/watch?v=TRF27F2bn-A
 Vygotsky

Zone of Proximal Development & Play : Make believe play requires the assistance
of partners for whom this skill already exists. Older siblings provide younger siblings
with the necessary resource to learn more sophisticated ways to play.

Scaffolding and Play: The most effective learning happens when the new skills
being taught are right on the edge of emergence. These new skills which occur in
language play or word games provide the child with the opportunity not only to
learn new skills but progress in his or her development ‘learning leads
development’

“A child’s greatest achievements are possible in play, achievements that tomorrow

will become her basic level of real action”.
Vygotsky
 Vygotsky cont’d

Imaginative play, according to Vygotsky is a crucial component of a child's

normal development. What may seem to be a simple and uncomplicated way
for children to entertain themselves is actually a complex process that affects
all aspects of a child's life. Play shapes how children make sense of their
worlds, how they learn thinking skills, and how they acquire language. In
contrast to Piaget, Vygotskian theory states that play actually facilitates
cognitive development. Children not only practice what they already know-
they also learn new things. In discussing Vygotsky's theory, Vandenberg
(1986) remarks that "play not so much reflects thought (as Piaget suggests) as
it creates thought" (p. 21).

So how does imaginative play boost a child's brain development? How can it
affect cognition? There are a multitude of ways in which unstructured, child-
centered play builds healthy minds.
https://www.youtube.com/watch?v=bulTeiHu8ME
Conclusively….
Observations of children at play yield examples to support both
Piagetian and Vygotskian theories of play. A child who puts on a
raincoat and a firefighter's hat and rushes to rescue his teddy bear
from the pretend flames in his play house is practicing what he
has previously learned about fire fighters. This supports Piaget's
theory. On the other hand, a child playing who announces to her
teacher, "Look! When I put these two square blocks together, I get
a rectangle!" has constructed new knowledge through her play.
This supports Vygotsky's theory. Whether children are practicing
what they have learned in other settings or are constructing new
knowledge, it is clear that play has a valuable role in the early
childhood classroom.
Contributions to the theory of Play

G.Stanley Hall: Play provided children with the means for working out primitive
atavisms reflecting our evolutionary past. The rough and tumble play was meant to
gratify predatory instincts. The primary function of play is cathartic. RECAPITULATION
THEORY - ontogeny recapitulates phylogeny i.e., the development of the animal
embryo and young traces the evolutionary development of the species.

Maria Montessori: Play allows for self-initiated activity under adult/expert guidance.
Play had the primary function of learning and the presence of the appropriate
materials best facilitated this experience. Did not value pretend play, rather,
encouraged real-life activities like serving meals and cleaning up etc. “real pretend”

Susan Isaacs: Advocated the emotional and cognitive benefits of play. ‘Play is indeed
a child’s work and a means whereby he grows and develops’. Isaacs contends that
active play was a sign of mental health, its absence indicated some inborn defect or
mental illness.
Play as communication

Non-verbal communication in infancy:

Mirroring
Intonation
Holding

Infants pick up on the pitch and patterns of the voice and respond to such intonations with basic skills of
communication. Imitation play in infancy helps accustom the baby to internal states. This is referred to as
mirroring. The caregiver provides the infant with responses to their internal states by facial expressions and
variations in the tone of the voice. This form of mirroring allows the infant to build a secure bond with the
caregiver while providing some meaning to the various experiences they are encountering.
Non verbal communication teaches them to pick up on danger, affection, sadness and so on. Basic emotional
states are communicated in this non verbal way often in play. Parents are the first playmates that children
acquire this skill from. Facial expressions such as happiness or anger acquire a meaning that at this point is
preverbal. Peek-a-boo games allow the child to build up a range of facial expressions that have different
associative meanings.
Play as Communication Cont’d

Semiotics:
How we make meaning out of symbols.
Semiotics is the study of signs and symbols of communicative behaviour. It is the study of how
meaning is created. In childhood the basic components of meaning are pieced together on the
basis of experience. Play allows the child to gradually piece together meaning using signs that
represent different things. Semiotics is used to analyse text and similarly the practice can be
applied to the interpretation of play where objects are used as props in a narrative. Colours in
pictures, scale and form etc all are used to communicate some underlying meaning.

Umberto Eco proposes that every cultural phenomenon may be studied as

communication.

Play forms the basis of our earliest meaning making experiences.

Story telling

“Humanity has advanced, when it has advanced, not because it has been sober,
responsible, and cautious, but because it has been playful, rebellious, and
immature.”
Tom Robbins
 Play across cultures

Common across cultures:

Problem solving
Skill
Memory & Attention
Gender variations in play

Culturally specific:
Socio-economic factors in play
Individualism V Collectivism in play

“How come we play war and not peace?"

"Too few role models.”
Bill Watterson
Play across cultures – research

The international council on health and physical education and recreation listed more than 65 games and 39
dances from 58 countries. These plays included a)games of imitation which are considered to prepare the
child for adult life, b)games of physical skill, c) play as a projective or an expressive activity and d) play as a
past-time. Games of problem solving include - hide and seek help the child develop the skills involved in
perception.

Gender plays a significant role in how children play - boys tending to play in an exploratory mode, girls on the
other hand use more symbolism in play. These factors are consistent across cultures.

Griffing (1974) found that play involving socio-dramatic play was linked to socio-economic status.
Socio-dramatic play is where children act out imaginary situations and stories, become different characters,
and pretend they are in different locations and times. While children reached the requisite cognitive capacity
to engage in socio-dramatic play at the same age children from higher socio-economic back grounds tended
to play more at socio-dramatic games. Gottfried (1986) contends that children coming from higher SES
backgrounds are more likely to be provided with the materials to engage in more sophisticated forms of play.

Western culture tends towards an individualistic ideology. Games most commonly played by children reflect
this ideology. This is in contrast to children from native American and eastern backgrounds where there is
greater degrees of collective and cooperative aspects to play. A lesser degree of competitiveness is evident in
the play of these native American and eastern studies. (Rettig, 2002).
 Gender Differences

Parents tend to have different attitudes to the play of their

male and female children.

Social Learning theory (Bandura) suggests that children learn

to engage in particular activities because they are rewarded
for doing so e.g. girls + dolls = smiles and positive remarks,
boys + dolls = frowns and negative remarks.

Fathers appear more attentive to gender stereotyped play

(Endendijk 2014).
 Play during Adolescence

What is the purpose of play in adolescence?

Transition stage which involves a shift in emphasis from family to peers

We don’t call it “play” ….
Play is predominantly social
Freedom to choose how they engage
Mimicry of adult life
Reflection of social values
Sports
The role of play in therapy

Key Theorists

Anna Freud
Melanie Klein
D.W. Winnicott
Virginia Axline
 Anna Freud (1895 – 1982)
Publications:

The ego and its mechanisms of defence (1936)

Indications for Child Analysis and Other Papers (1945–1956)

Normality and Pathology in Childhood: Assessments of Development (1965)

Infants Without Families Reports on the

Hampstead Nurseries (1973)

Papa continually emphasizes how much

remains unexplained. With the other
psychoanalytic writers, everything is always so
known and fixed.
 Anna Freud (II)
Background in teaching

Expanded on Freud’s concept of ego defenses – methods that the unconscious mind uses to protect
from anxiety (repression, identification with the aggressor)

Founder of psychoanalytic child psychology – child analysis should be distinct from adult
psychoanalysis

Emphasized strong alliance – earning childs attention and trust before commencing therapeutic
work (after age 6; off the couch)

Studying unconscious mind, memories, desires and thoughts that influence childrens behaviours
could be determined, despite their lack of awareness

Therapist as the second mother

Using psychosexual stages of development to create a timeline for healthy growth and development,
and observe what is lagging

Anna Freud viewed play as adaptation to reality; children could speak most freely and truthfully
while playing (encouraged drawing)

Influenced todays child psychotherapy

 Melanie Klein (1882-1960)

Publications:

The Psychoanalysis of Children (1932)

Mourning and its relation to manic depressive states (1940)

Notes on some schizoid mechanisms (1946)

Envy and gratitude (1957)

‘In the unconscious children are by no means so fundamentally

different from adults but as their ego has not yet attained
full development they are very much more under the sway of
their unconscious’ Klein (1927)
Melanie Klein (II)
Object relations theory – controversial at the time, as it veered of Freudian thought

Drew on her theories from the analysis of child’s play to formulate concepts such as
paranoid schizoid position and depressive position

Work on concepts of Oedipus complex, projective identification, superego, envy, internal

objects, reparation, pathological organizations, phantasy, symbol formation etc.

Klein noticed that children’s play and toys they used always carried important symbolic
meaning for them – a pathway into the unconscious, same as dreams

Unlike Anna Freud, treated child analysis same as adult analysis; focused on fears and
anxieties expressed in the play, and defences used against them

Infant is born with the capacity and drive to relate to others; thus infant has to be
prepared to deal with all types of relationships – death instinct and aggressive energy are
every bit important as life instinct and libidinal energy (love and hate)
Paranoid-schizoid position

According to Klein, the child’s first object is the infant’s mother. Klein believed that
object relations are present at birth, and the first object is the mother’s breast (Klein,
1946/1986). Due, in part, to the trauma of birth, the child’s destructive impulses are
directed toward the mother’s breast from the beginning of life. As the child fantasizes
about attacking and destroying its mother, it begins to fear retaliation. This leads to the
paranoid position.

Because of this fear, and in order to protect itself, the child begins the process of
splitting the mother’s breast and itself into good and bad parts (the schizoid position).
The child then relies on two principle defense mechanisms in order to reduce this
anxiety: introjection leads the child to incorporate the good parts of the object into
itself, and projection involves focusing the bad parts of the object and the child onto
the external object. This introjection and projection then provide the basis for the
development of the ego and the superego (Klein, 1946/1986; Mitchell, 1986).
Depressive position

As the child continues to develop, it becomes intellectually capable of

considering the mother, or any other object, as a whole. In other words, the
mother can be both good and bad. With this realization, the child begins to feel
guilt and sadness over the earlier fantasized destruction of the mother. This
results in the depressive position, and it represents an advancement of the
child’s maturity (Jarvis, 2004; Kernberg, 2004; Klein, 1946/1986; Mitchell, 1986).

These two positions are not abandoned in adulthood – we move through them
as we go through life
Example of Klein’s work
It is her 12th session with Richard, and he has made a drawing including one
of a series of ‘starfishes’. She interprets the picture as follows:
Mrs K. … interpreted that the hungry starfish, the
baby, was himself; the plant, Mummy’s breast which
he wished to feed from. When he felt like a greedy
baby, who wanted his mother all to himself and
could not have her, he became angry and jealous and
felt he attacked both parents. This was represented
by the U-boat, which would ‘probably’ attack the
ship. He was also very jealous of John because, as Mrs
K.’s patient, he received time and attention from her.
The analysis stood now for being fed. He had said
that everything which went on under water had
nothing to do with the upper part. This meant that
greed, jealousy, and aggression were not known to
one part of his mind, they were kept unconscious. In
the top part of the drawing, divided off from the
lower half, he expressed his wish to unite his parents
and to have them happily together. These feelings, of
which he was quite aware, were experienced in what
he felt to be the upper part of his mind.”
 D.W. Winnicott (1896-1971)

Publications

The Child and the Family (1957)

The Child and the Outside World (1957)
Through Paediatrics to Psychoanalysis (1958)
The Child the Family and the Outside World (1964)
The Family and Individual Development ( 1965)
Playing and Reality (1971)
Key Concepts (I)
Rejection of the drive theory; postulated along with Bowlby that healthy development is based on the quality of
the early maternal care and the environment – there is no baby without a mother

Holding environment - “the basis for what gradually becomes a self-experiencing being”; infant journeys from
‘absolute dependence’, through
‘relative dependence’, to ‘towards independence’ – holding environment provides the arena for these processes;
total independence is not the goal – interdepence is

Primary maternal occupation - where the mother is innately, highly attuned to the infant and its needs from
pregnancy through childhood
Primary maternal occupation helps create a ‘holding’ environment for the infant which does not simply
constitute physical holding but also emotion regulation, a “total environmental provision…all that a mother is
and does”
Key concepts (II)

Good enough mother – the ordinary devoted mother who makes mistakes and reparations;
allows for adaptation to reality – disillusionment is necessary; paradoxical nature of the
mother’s ability to be wholly available to her child whilst simultaneously being humanly
unreliable
The imperfection of human nature provides the perfect environment for the child’s move
‘towards independence

The Transitional object - lessening the separation anxiety and helping the child to adapt to
change; achievement in development – mother is viewed separate; objects have a “not me”
quality – in possession of the child but not wholly separate; the transitional object is
adopted by the infant to allow him tolerate the mother’s failures as her adaptation lessens
in accordance with his growing maturity

False self and True self – in absence of good enough parenting, parents wishes are imposed
on the child, that gives up on their spontaneity and adopts a false self based on compliance
 A belief in….

Winnicott had faith in the individuals unconscious belief in finding help.

Symptoms were signs of hope. Therapy allows the child to relive the
past deprivation in order to integrate the experience.

What then is play?

To get to the idea of playing it is helpful to think of the preoccupation

that characterises the playing of young children. The content does not
matter. What matters is the near-withdrawal state, akin to the
concentration of older children and adults. The playing child inhabits an
area that cannot be easily left, nor can it easily admit intruders.

This area of playing is not inner psychic reality. It is outside the

individual, but it is not the external world.
Playing implies trust belongs to the potential space between (what was
at first) baby and mother-figure, with the baby in a state of near-
absolute dependence, and the mother-figure’s adaptive function taken
for granted by the baby.

Playing involves the body:

i) because of the manipulation of objects.
ii) because certain types of intense interest are
associated with certain aspects of bodily excitement

Winnicott saw playing as the gateway to the unconscious…

“ the repressed unconscious must be kept hidden, but the rest of the
unconscious is something that each individual wants to know, and play,
like dreams, serves the function of self-revelation”
For Winnicott, Psychotherapy involves two people playing together
– two people able to use potential space…

“ Psychotherapy takes place in the overlap of the two areas of

playing, that of the patient and that of the therapist.
Psychotherapy has to do with two people playing together. The
corollary of this is that where playing is not possible then work
done by the therapist is directed towards bringing the patient from
a state of not being able to play into a state of being able to play”

Winnicott indicates to the child therapist that the play-space is

more important than the interpretation, precisely because it allows
for the child’s creativity rather than the analysts cleverness in
making the interpretation.
 Winnicott’s Squiggle Game

A therapeutic diagnostic tool. Winnicott initiated this game in his first

assessment interviews with children. It involved drawing a squiggle and asking
the child to add to it. Over the course of the interview the child and Winnicott
took it in turns to add to what the other had drawn. Squiggles sometimes
turned into pictures.
The squiggle game invited the child into a sequence of play that enabled a form
of communication.
It is a diagnostic tool and psychotherapeutic for the child.
It is based on the childs hope and trust that help can be found.
It is initiated and held but must never be dominated by the therapist.
The technique is straightforward: the aim is to facilitate play and surprise.
The results of the interaction on the paper can be likened to dreams as
representations of the unconscious.
 Viginia Axline (1911-1988)

Unstructured play therapy is client led and non intrusive.

Virginia Axline adapted the Rogerian person-centred
approach to approach to play therapy with
children.

Play Therapy ‘The inner dynamics of childhood’ (1947)

‘In Search of Self’ (1964)
 -Maintains a deep respect for the child’s ability to solve his/her
problems and gives the child the opportunity to do so. The
responsibility to make choices and to institute change is the child’s.

-Does not attempt to direct the child’s actions or conversations in

any manner. The child leads the way, the therapist follows.

-Does not hurry the therapy along. It is a gradual process and must
be recognised as such by the therapist.

-Only establishes those limitations necessary to anchor the

therapy to the world of reality and to make the child aware of
his/her responsibility in the relationship.
 Examples of non directive play therapy

Sand Play (Margaret Lowenfield & Dora Klaff) .

Combining Jungs collective unconscious with Lowenfeld's World Technique Klaff
constructed the technique in which the child is provided with a number of
figurines and encouraged to play in the contained space of the sandtray.

Klaff contends that if the child is given the chance to speak and play freely
under optimal therapeutic conditions, he/she will be able to resolve their own
problems and work toward their own solutions. This can facilitate a healing
process as the unconscious expresses itself in the sand and influences the sand
player. When a client creates in the sandtray, little instruction is provided and
the therapist offers little or no talk during the process. This protocol emphasises
the importance of holding what Klaff referred to as the "free and protected
space" to allow the unconscious to express itself in symbolic, non-verbal play.
Cognitive Behavioural Play Therapy
KEY PRINCIPLES
>CBT requires a good client-therapist relationship.
>CBT emphasizes collaboration and active participation.
>CBT identifies and modifies maladapative thoughts
>CBT is goal-oriented and problem focused.
>CBT initially emphasizes the present.
>CBT is educative; it aims to teach the client to be his/her own therapist,
and emphasizes relapse prevention.
>CBT aims to be time limited.
>CBT sessions are structured.
>CBT teaches patients to identify, evaluate, and respond to their
dysfunctional thoughts and beliefs.
>CBT uses a variety of techniques to change thinking, mood, and
behaviour.
 Settings & Materials
CBPT is usually conducted in a play room with a wide variety of
materials available e.g. toys, arts materials, puppets, dolls etc.
Some materials may be tailored to the child’s specific needs and
presenting problems. Sessions may need to be conducted in vivo
(phobias).

Treatment Stages
- Introduction/orientation stage
- Assessment stage
- Middle stage
-Termination stage
 Treatment Interventions
Systematic desensitisation: replacing maladaptive responses with adaptive ones.
Breaking down the negative associations that connect the stimulus with and the
fear response that it elicits. The object (stimulus) is presented but the anxiety is
controlled (distraction techniques/role play/games/laughter). Hierarchical fears
and in vivo settings.

Emotive Imagery
The therapist evokes images of self assertion, pride and other anxiety-inhibiting
responses through the use of super-hero characters. Positive affect is
encouraged as the negative stimulus is slowly introduced into the fantasy
scenario.

Stimulus Fading
Children may possess some of the skills for a behaviour but only exhibit the
behaviour in certain circumstances or with certain people. Translating the skills
across settings may involve some parental involvement.

Modelling
Allowing the child to see non-fearful behaviour in the anxiety provoking
situation. Look, learn and apply involves generating new adaptive skills.
 Cognitive Techniques
Look at the evidence-explore the alternatives-examine the
consequences.

Positive Self-Statements
Constructing adaptive coping self statements (I am brave=I am
doing a good job) need to be modelled by therapist and parents.
Positive reinforcement by the parent once the behaviour changes.
Active control (I can do this) and reality testing (there aren’t really
monsters under my bed).

Bibliotherapy
Serves as an adjunct to CBT. Self-help literature, creating a semi-
fictional narrative piece (co-constructed) novels with particular
narratives that educate the reader.
 Other Examples of Play Techniques

Stress Inoculation Play

For example, the therapist might have the client play out a future stress-causing situation, such
as an upcoming class presentation. The client can use toys to work out what might happen
during the presentation, and the client might realize that the situation is not as scary as it first
seemed. The therapist can also offer coping strategies for the client based on the client’s fears
about the presentation.

Reenactment Play
For example, the therapist might recreate a stressful event for the client, such as a car accident,
using toys in the playroom. The client can then freely play with the toys in a non-directed
manner to gain a sense of control over the situation and start losing some of those lingering
feelings of trauma and fear. These recreations often need to happen multiple times over
multiple sessions for optimal results.

Feeling Faces
For example, the therapist might decorate their playroom walls with “feeling faces”, or faces
that demonstrate different feelings such as happiness or anger. The therapist can then start off
the therapy session by asking the client to point to a face that they identify with at the time,
which can give the therapy session some direction. They can also be helpful for clients to show
how they are feeling throughout the session without having to use words.
 Mask Play
For example, the therapist might ask the client to make two collages (masks) out
of magazines. One mask (the “outside mask”) is how they think the world sees
them, and one mask (the “inside mask”) is how they see themselves. This can
reveal a lot about how the client thinks of themselves and the world.

Puppet Play
For example similar to the concrete play metaphors example, the therapist
might present the client and the client’s family with dozens of puppets, then ask
the client and the client’s family to each choose a puppet to represent them.
The client and the client’s family then tell a story using the puppets, and the
therapist interviews each family member about the story, then discusses the
story with the whole group. This can reveal certain family dynamics that the
client is unable or unwilling to directly discuss with the therapist.