Childhood Trauma and Play Therapy Intervention for Traumatized Children
Ogawa, Yumiko, Journal of Professional Counseling, Practice, Theory, & Research
Play therapy is examined as an intervention for traumatized children. Difficulties in assessing Post-Traumatic Stress Disorder (PTSD) in children according to the existing criteria are described, and the aspects of play therapy that facilitate the curative potential in children are analyzed. Release Play Therapy and Child-Centered Play Therapy are discussed as possible approaches in the treatment of traumatized children.
War, terrorism, earthquakes, hurricanes, airplane crushes, and school shootings are catastrophes that are all too common in the world today. In addition, on a daily basis, people are exposed Ut the risk of personal trauma, such as car accidents, medical surgery, or abuse. According to Vogel and Verriberg (1993). the earliest study of children's reactions to disaster was the research done by Perry in 1956 on children who were sitting in a theater in Vicksburg, Mississippi, when it was struck by a tornado. Tt wasn't until the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) (American Psychiatric Association, 1980) was published that research on traumatized children began in earnest (Fletcher, 1996).
The milestone work in the field of traumatized children was that of Terr (1979), who studied kidnapped children in Chowchilla, California, As a result offace-to-face interviews with the victimized children, Terr described the children's unique traumatic responses, including their tendencies Io relive their trauma through reenactments of significant parts of the experiences by either talking about the incident or though trauma-inspired play. Terr's findings revealed the limitations of applying adult assessment and treatment, methods to children and reestablished the importance of play and play therapy.
Similarly, Shelby and Tredinnick (1995), in their study of the survivors of the 1993 Hurricane Andrew in Florida, discussed symptomology oi'these traumatized children, as well as the importance of play as a means of expression and resolution of children's terrifying experiences.
Although play has been observed to be an effective treatment for traumatized children, the paucity of research on its therapeutic utilization with this population has prevented it from gaining recognition as an effective approach by mental health professionals. However, the terrorist activities of September 11, 2001, resulted in metre attention to play-therapy as a means of helping children cope with the trauma they witnessed and experienced. By using the child's universal language, play, play therapists, the author included, observed the effective and powerful use of play therapy in the lives of children at a New York City shelter for the victims of the World Trade Center terrorist attack.
Definition of Trauma and its Difficulty in Assessing Children
Terr (1991) defined psychological trauma in children as "'the mental result of one sudden, external blow or a series of blows rendering the young person temporarily helpless and breaking past ordinary coping and defensive operations'" (p. 11). According to the nature of the event Terr (1991) divided childhood trauma into two categories: Type I, which involves a single, sudden, unexpected, relatively timelimited, and public (i.e., affecting children from more than a single family) stresser, such as a natural disaster or school shooting; and Type II trauma, which refers to a stresser resiilung from a long-standing ordeal, such as repealed abuse.
The criteria for PTSD in the Diagnostic and Statistical Manual of Mental Disorders (4th Ed., Text Revision) (DSM-IV-TR) (American Psychiatric Association, 2000) is cfuite broad and includes direct experiencing of the event, witnessing the event, or learning about the sudden death, serious harm, or threat of death experienced by a family member or another close person. However, it is important to remember that the nature of the experience will affect the healing process. …