OK, 4myson, I respectfully disagree with you.
Some children do not have other problems as a result of ADHD. They don't have anxiety or emotional issues or depression or anger or lack of self-respect or think that their feelings are unacceptable, etc. They simply have ADHD, a neurological condition, and nothing else. Play therapy is not going to reduce their hyperactivity level, get them to focus in class, or give them better impulse control.
When when a five year old ADHD child hits another child at school on the playground, it does not mean that he is not aware that he has a responsibility to control his feelings, or that he is failing to assume responsibility for himself, or that he is not resourseful in confonting problems, or that he lacks self contol -- it most often means that he has a neurological condition resulting in poor impulse control. He doesn't have enough neurotransmitters in the frontal lope where impulse control is located. His dopamine level is too low. Therapy is not going to help him gain impulse control.
Play therapy helps children with co-morbid conditions like low self-esteem, anxiety, depression, anger, etc. But in my opinion, it does nothing for dealing with the neurological condition when no other problems are present.
My son sees his therapist every other week. One hour sessions, half hour with the family and a half hour by himself. Thats what normally goes on but if my son needs more of her attention and things are going ok she spend the whole hour. Or if things are going rough we all spend that hour. She does play games with my son but he's 6 and that's how she grabs his attention.
Best of Luck!
NoTellin: Again....play therapy is a tool.... and it can and does help in many situations (including ad/hd) if the individual is willing to work at it, and if the child's parents support and believe in play therapy it can and will work.
No one is saying that play therapy will "take away the ad/hd." Those of us that believe in the approach of play therapy with ad/hd children (including play therapists) just feel it is tool to help these children. We are very aware that ad/hd is a neurological condition. We are very aware that play therapy is a tool to help.
4myson39341.3048958333To Gentle readers who have not heard of Play Therapy:
This is relates to Child Centered Play Therapy and speaks for no other. I hope it may be of some use.
In Play Therapy, the therapist helps children to learn:
Self control and responsible freedom of expression.
To respect themselves.
Their feelings are acceptable.
To responsibly control their feelings.
To assume responsibility for self.
To be creative and resourceful in confronting problems.
Self control and self direction.
Gradually, at a feeling level, to accept themselves.
To make choices and be responsible for their choices.
To help them discover these things inside themselves, the Play Therapist's focus is on:
The person rather than the problem
The present rather than the past
Feelings rather than thoughts or acts
Understanding rather than explaining
Accepting rather than correcting
The child's direction rather than therapist's instruction
The child's wisdom rather than therapist's knowledge
All of this is based on the principle that all people including children must find their individual ways of dealing successfully with life. Therapists cannot give solutions for they do not have the wisdom but instead work with children to guide them in a journey of self discovery and development of internal strength and resilience. The therapist follows rather than leads. The therapist does this by being with children on their level, communicating with children as they think, and feeling with children as they feel.
This is why Play Therapy is such a wonderful therapy for ADHD children. Again, it can do nothing about ADHD itself. It can do what it does however and that is it's strength.
If you have not heard of Play Therapy then I may have given you a tool of value.
Dizfriz
The above is based on a lot of cribbing from Virginia Axline and Gary Landreth and some of my own material.
[QUOTE=Dizfriz]
In Play Therapy, the therapist helps children to learn:
Self control and responsible freedom of expression.
To respect themselves.
Their feelings are acceptable.
To responsibly control their feelings.
To assume responsibility for self.
To be creative and resourceful in confronting problems.
Self control and self direction.
Gradually, at a feeling level, to accept themselves.
To make choices and be responsible for their choices.
I've seen evidence of the above mentioned in my own child and of children I've taught in school.
To help them discover these things inside themselves, the Play Therapist's focus is on:
The person rather than the problem
The present rather than the past
Feelings rather than thoughts or acts
Understanding rather than explaining
Accepting rather than correcting
The child's direction rather than therapist's instruction
The child's wisdom rather than therapist's knowledge
The above statements are just some of the reasons I so believe in the use of play therapy.
All of this is based on the principle that all people including children must find their individual ways of dealing successfully with life. /I totally agree with this statement
Therapists cannot give solutions for they do not have the wisdom but instead work with children to guide them in a journey of self discovery and development of internal strength and resilience. The therapist follows rather than leads. The therapist does this by being with children on their level, communicating with children as they think, and feeling with children as they feel. /elogantly stated in my opinion.
This is why Play Therapy is such a wonderful therapy for ADHD children./thank you for stating this so beautifully. Again, it can do nothing about ADHD itself. It can do what it does however and that is it's strength.
If you have not heard of Play Therapy then I may have given you a tool of value.
Dizfriz
The above is based on a lot of cribbing from Virginia Axline and Gary Landreth and some of my own material.
Be aware that Play Therapy can do nothing for ADHD itself. It is a neurological, mostly genetic developmental issue, not an emotional one. Play Therapy can do nothing about your height either. What it can do is work with the emotional issues that so often go along with ADHD. That is where it is effective.
[/QUOTE]
I think this is precisely what I am getting at. If there are no comorbids -- like depression, anxiety, or emotional issues -- play therapy does not help. I think that my son did not benefit from therapy because he has run of the mill ADHD (meaning, having nothing else that goes along with it). Therapy of course is not going to help a neurological condition.
NoTellin39340.6841666667Diz Friz thanks for your explanation of play therapy. It was well stated in my opinion.
I do think though, that play therapy can help a child with ad/hd. I feel it helps that child learn to express himself/herself and provides some life long strategies. I and many others have seen it work for our children.
NoTelling
The choice for therapy is a parental decision. Some kids do well on medication alone and have no emotional issues at least enough to warrant the cost and effort of therapy. This is a legitimate viewpoint. Others feel that the stresses and strains of ADHD over time are such that competent therapy would almost always be helpful. This is also legitimate. Again this is a parental decision. It is a judgment call. Both can be right to a point.
Related, while the child in the example above has an impulse issue does not mean the child is not responsible for their behavior decisions.The child does not lack self control but instead has a deficit in this area. The 30% rule puts one in the ball park of what should be expected of the child. Not holding the child responsible in a developmental appropriate manner is not helping the child and can be, in my opinion, very damaging to emotional growth.
Behavior Management is very effective in dealing with this. Using behavior management (combined with Play Therapy or not) has allowed many children, especially the milder cases, to operate without medication. It is a truism that in working with ADHD kids that they need more consequences not less (more structure if you would). They have difficulty connecting their behaviors with the consequences and need help with with this. The key here is the speed of the consequence not the severity. Light consequences but often and inevitable.
I am not in the main disagreeing with you as many of your points are valid. However Play Therapy especially when accompanied by Behavior Management training can be helpful to almost any ADHD child. The question is are the behaviors problematic enough to justify the time and effort. That is again the parent's decision as it should be. Remember even on medication, the child is still ADHD.
Yours
Dizfriz
The 30% rule of thumb: On the average children who are diagnosable as ADHD and not on medication are roughly 30% behind their peers in the areas involved with ADHD (not intelligence nor achievement). In other words a 10 year old ADHD child is operating with the self control, self regulation of a 7 year old. If you expect the child to self regulate like a 10 year old it is the your problem. If you expect the child to operate like a 7 year old and hold him responsible on that level then you are roughly where you need to be. Be aware that medication can change this but even then it is a good starting place.
Play therapy is a way for children to express themself through play. It is not an overnight result. My son has done play therapy for over a year and 1/2 and I have to say I've seen a great deal of success come from it.
Play therapy is for all types of situations...run of the mill ad/hd, etc.
Play therapist are trained specifically to work with children and are very much aware of cognitive behavior therapy ect.
Play therapy provides tools for children that are life long.
If you find a play therapist that is qualified and on top of things play therapy can benefit a great deal.
Just like therapy for adults... play therapy takes time for a child.
My son's doctor recommended that we use play therapy in conjunction with his meds. He believes that the two work hand in hand. I believe the same.
We got down to once a month but I think we will go back to 2 times a month since we are in a new year at school. Then monitor and go back to once a month.
Play therapy can and will work if you allow it to work.
Play Therapy
We as adults use words to work with our feelings and life. If we can put it to words we can deal with it. Children below age nine really do not have that ability. They use toys and play to work through their feelings and their world. This is simply an issue of neurological development. Play Therapy is the only thing we know that will work with younger children. Cognitive and talk therapy is simply not all that effective at these ages. Above age nine the choices begin to become somewhat greater. Some 10-13 year old kids continue to respond best in the play format. Some prefer and respond best to talk. Many do a combination moving back and forth between them. There are times and situations where even adults can find healing in a play room setting.
One of the reasons to play games with a somewhat older child is to take their mind off of focusing on the therapist's feelings. When the child is busy doing something like checkers they seem to be better able to put feelings into words and deal with them. Playing a game with children while they talk, especially the older ones, is a time tested technique and works well. With some exceptions, most kids under 12 or 13 cannot sit in a chair and talk for 30 to 50 minutes. It simply is not productive for most children this age. Now be aware that there are always exceptions. I am talking about most not all.
The progress seen in Play Therapy is usually slow with the course of therapy lasting from 12 to 26 weeks depending on the child, the therapist, and the presenting issues. Some finish sooner, some go longer. Many play therapists tell the parents to began to expect to see some changes around 6 weeks (again some earlier, some later).
Be aware that Play Therapy can do nothing for ADHD itself. It is a neurological, mostly genetic developmental issue, not an emotional one. Play Therapy can do nothing about your height either. What it can do is work with the emotional issues that so often go along with ADHD. That is where it is effective.
One issue of importance. Many say they "do" play therapy but have only gone to a couple of workshops. That is not enough. Look for someone who is a "Registered Play Therapist". You can find a directory at http://www.a4pt.org/directory.cfm.
This does not mean that those without this cannot do good play therapy, they can and do. Looking into a Registered Play Therapist simply increases your chances of getting a trained one. One very good question to ask a prospective Play Therapist concerns who they trained under. Extensive training and supervision are, in my opinion, key factors in competency in this field.
Sorry to be so lengthy but I felt that this is a subject worthy of some discussion.
I am a parent of a grown ADHD son. I have managed over the years to gather a fair knowledge base on ADHD and Play Therapy. I try to share to help others who are going through what I did. Knowledge is the key to helping these kids. It is a tough task but well worth it.
Dizfriz
Thanks for responding. At least it's nice to know that some kids are benefiting from this type of therapy.
My son is 13 years old. His father and I divorced when he was only 9 months old. I have been with my current husband since my DS was 18 months old, so he has been around for almost all of his life. His father remarried when he was 3 and then divorced a few years later. Now he's got another live in girlfriend who is very nice. However, she has enforced rules and chores, which he's not used to at his dad's house. Fortunately for me, they're the same rules he's had to follow at my house. My son is resenting the new girlfriend for making all these changes and is being more difficult when he's with his dad. I only have the anger issues first thing in the am or when he hasn't had his meds.
Our pediatrician has scheduled him an appt in 2 weeks, so we can talk about things with her then. I'm still letting him go to the therapist, however even my DS doesn't feel like it's doing anything at all.
Forensicmom
There are a lot of therapists with different theoretical orientations and styles. The trick with a 13 year is the find the right one.
First the therapist must click with the kid. Sometimes this takes 6 weeks or longer to just break through the barriers. If your son likes the therapist it might be worth while to let them work for a while to see what happens. The changes often come slow.
Second (and this is just a personal opinion) therapy for this age is much more successful if the caregiver(s) are involved. The concept of the therapist/kid/parent(s) working as a team to solve problems can be quite successful and I know many therapists who will work no other way with this age. The point here is that it is not seen as just the kid's problem but a family one and all need to be part of the solution. If the kid is seen as "the' problem then it probably will not work unless the child also sees it this way. Not many 13 year old kids see it as "their" problem. They more often see it as everyone else's problem but definitely not theirs. They are 13 after all.
If you are not satisfied with this therapist then by all means find another. Check around, it is very likely that other parents have been through this and some will have had good experiences and can give you the names.
Take care and keep plugging. It is worth it.
Diz
my daughter also started seing a counselor in the spring. She also plays games, but I've not figured out anything she's doing to help with her anxiety. Every time I've met with her she has mentioned how difficult and lazy my daughter is and how that must be for me. OK so I get the fact she may be trying to figure out our dynamic and see if I'm taking care of my own stress, but she's called her lazy to me 3 or 4 times, what is up with that?
Sorry I didnt answer your question, I am commiserating with you.
I've personally never been to one before, except to meet with one 3 years ago when my DS was diagnosed with ADHD. They seemed nice, but never really taught him anything. They played games and talked. My son got NOTHING out of it, so we stopped and after many struggles, opted for meds. They worked immediately and things changed for the better.
Now, he's having a little more difficulties with anger when he's not on his meds. I just spoke with the pediatrician, who believes that his dosage might need to be changed. However we started with a new counselor who is doing the same thing, playing games with him. We've never had a session with all of us together, which is what I think should happen.
What exactly is counseling supposed to do? Because so far, I dont' see it doing anything.
I took my son to one for seven months at the suggestion of my advocate. It was play therapy. It did nothing. My son thought it was cool. The therapist basically monitored the progress that he was making due to other interventions in place at school, social skills class, etc. The therapist himself appeared to make no contribution, which is really no surprise since he was doing play therapy and not cognitive behavior therapy. IMHO therapists don't help young children unless there's a comorbid that they can address -- like depression or anxiety. If the child just has run of the mill ADHD, I'm not sure what they can do. I understand that an adult or older child with ADHD can benefit from cognitive behavioral therapy -- to get tools to manage their symptoms. How old is your son? Sometimes they talk through games so the child can talk freely without having to make eye contact. It is supposed to comfort and make the child feel comfortable. Generally counseling is stating the issues of concern and they basically listen and help lead you to make your own decisions. They also teach you things about yourself and ways to cope and decision making. I have been in counseling myself and being a Social Worker I do the same thing on my job and I work with kids all the time.