56-3 Themes, Symbols and Healing of Play Therapy: The Clinical Case of a Physically Abused Child

Dong-Yann Wu  Tsung-Chain Huang
National Changhua University of Education National Changhua University of Education


 
Recent studies have call for an increased attention to use play therapy as a crucial method for the treatment of physically abused children. While much work has been undertaken to examine the relationships between play therapy and treatment efficacy, few studies have addressed the symbolic and healing perspectives of children's play themes. In addition, the dynamic process of the therapeutic relationship has long been neglected. The researchers argued that not only the play behaviors between the sessions, but also the contextual and sequential meanings behind the play themes should be examined. Thus, the present study was aimed to synthesize the existing literature into a more process-oriented model that explains why and how play therapy works for the clients.
    Based on the approach of Thematic Analysis, the present study explored the repeated play themes from a physically abused child's 15 play sessions. Home-Room teacher, school counselor as well as the client's grandmother's reports were collected to increase data validation. Inter-Rater reliability between two researchers was carefully examined. Researchers read each play sessions' transcriptions and classified concepts based on conditions, contexts, action strategies and results. Researchers also conducted a re-inspection to verify the theoretical structure obtained in the above-mentioned analysis. Attention was placed on whether there was evidence pointing away from the theories obtained. Researchers also conducted continuous modifications and supplementary works based on discussions with scholars in related fields.
    Five major themes were identified from the data analysis: (1) captivity and escape; (2) go beyond or maintaining boundaries; (3) hide and seek; (4) death and replacement; (5) dialectical relationship between opposites. The researchers not only extracted meaningful themes of the child's play, but also draw attention to why the play behaviors were activated and presented. In addition, the interactions between play themes and the therapeutic relationship were investigated. The symbolic meaning of the play themes was also explored.
    As the therapeutic process continued, client was more able to contain his inner and outer experiences and allow them to flow. He was less against his teachers or school norms, in addition, he was more able to follow the rules and take responsibility for school assignments. Client's grandmother indicated that he was less provocative and had more positive interactions with her.
    The results also showed that, when the therapist can work on the client's projective identification, then the client was more likely to move his "bad me" identification to a more positive self image, that is, he became more realized that "bad" and "good" can both exist within himself. He was more able to set up a boundary and forgive the person who abused him. As to the content of his ego development, the client's abilities of competence, integration, interpersonal relationship and the devotion of libido were also improved. The present study adds to the existing literature on the etiology and underlying healing process of play therapy to a Taiwanese physically abused child. This has been done in an effort to increase understanding in Taiwanese families and to test previous conceptualizations and findings based on the available literature, which has typically observed or measured from White, middle-class families in America. This study highlights the importance of incorporating theoretical and methodological advances in the mainstream literature into research with culturally diverse population, while remaining sensitive to the culture-specific issues of Taiwanese - an obvious requirement that has not been met in much of the previous research. Influential reflections as well as practical applications were discussed.

Keywords
Physically abused child, play themes, play therapy, symbol.

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