Therapies

Toy Stories: Play Therapy for Children with ADHD

Play therapy — used to treat ADHD, trauma, or other childhood difficulties — allows kids to express themselves in a language all their own.

Mother and daughter outside

Play is the “language of childhood.” Watch a child play, and you’ll see her express a variety of emotions, acting out fanciful scenarios. You almost see her “trying on” different kinds of expression.

Play therapy taps into this intuitive childhood language, helping children develop greater self-esteem. It empowers them to cope with their problems — from ADHD challenges to traumatic events to damaged relationships. When parents play along, the parent-child bond improves.

For my seven-year-old daughter and me, play therapy healed our relationship. When she was three, she and I started butting heads, and it got worse over time. I couldn’t understand why this pint-sized individual drove me to madness. However, once she was diagnosed with ADHD, her behaviors — impulsivity, incessant arguing, temper tantrums — started to make sense. I understood why my firm approach to her misbehaviors made things worse.

Even with this new understanding, we needed something else to improve our relationship — and we found it in play therapy. When I met play therapist Pam Mitchell, LCSW, in Salt Lake City, I expected her to “fix” my child. Several sessions later, we had something more profound — a healed relationship and the tools to help us keep it that way.

The ABCs of Play Therapy

Play therapy is founded on the premise that play is a natural way for a child to express herself. If play is a child’s language, toys are her words. Research by the UK Society for Play and Creative Arts Therapies suggests that 74 to 83 percent of children who participate in play therapy show a positive change. Another study, a meta-analysis of 93 studies on play therapy, showed that the approach is an effective intervention for a range of children’s problems. What’s more, research indicates that children whose parents practice play therapy at home, in addition to working with a therapist, derive more benefits than those who “play” with a therapist alone.

An astute play therapist observes and interacts with a child as he plays, picking up on social cues and mirroring the child’s emotions. The therapist helps a child express himself when he doesn’t know how to articulate what’s troubling him. Play therapy does for children what a good, long talk with a therapist or trusted friend does for adults. A child uses his imagination to achieve the outcomes that we get through talking.

As we watch our children play, we have a front-row seat to their inner thoughts, struggles, motivations, and feelings. When we learn their “language,” we can relate to our children on a deeper, more empathetic level.

The therapist plays alongside the child in the play therapy room. She doesn’t guide the child, but follows him. This non-directed play allows a child to explore challenges or feelings at his own comfort level. It’s important to let the child define the play. If a child picks up a tiger and calls it an elephant, the therapist goes with that. It’s not about teaching; it’s about letting the child use the toys to express himself.

If a child or family member has recently experienced a traumatic illness or injury, the child may choose to play with doctor toys. The therapist knows that the child is playing as a way of relating to his experiences, but she won’t call attention to that right away.

“We won’t say to a child, ‘Oh, remember how you were hurt,'” Mitchell says. “There are many ways to mirror what the child is doing. One might say, ‘Oh, your baby has an ‘owie’ on her arm. Look how sweet you’re being with that baby. Look how you can heal. It might feel good if everything could get fixed.’ Or the therapist may take the perspective of the hurt doll, voicing baby’s feelings.” The play therapist makes educated guesses as to what the child is expressing, and the child will let the therapist know if she’s on the right track.

Play therapy works because it validates the child’s feelings. Through the therapist’s facial expressions and words, she mirrors the emotion she believes the child is expressing. This type of therapy is useful in boosting a child’s self-esteem by overcoming shame. Giving a child permission to express himself freely in a play therapy room, and having his feelings mirrored back, allows a child to gain confidence in who he is, ADHD diagnosis and all.

Taking It Home

I lost my ability to play when I was a teen, so I was skeptical about playing with my daughter at home. But I found it simple and not at all intimidating. In play therapy, I follow my daughter’s lead. She chooses which toy to play with and how, and I ask to be involved. Typically, she’ll hand me a toy and tell me what to do with it. If I don’t know what to do next, I ask. She tells me.

“As the parent follows the child’s lead,” says Mitchell, “it shows the child that her parent gets what she’s feeling, cares about it, and wants to understand.” In addition to playing, I now set aside time to tell stories with my daughter, a practice that play therapy reminded us that we both love.

After we stopped formal play therapy sessions, a new challenge arose in our relationship. Without the tools I learned from play therapy, we’d still be trying to resolve things. But I knew what to do. I set aside time each night to spend with my daughter. As I let her guide our play and storytelling, the challenge became smaller. It never went away, but it did shrink. She and I didn’t get angry with each other, and the situation didn’t get worse. In my parenting book, I would call that success.

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