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Play Therapy to Address Trauma in Children & Adolescents

Trauma is a word that is often used but misunderstood. Trauma can be defined as any scary, dangerous and/or violent event or situation that disrupts a child's daily life. It's important to remember that everyone responds to trauma in different ways; so you may be working with siblings where one child is more aggressive while the other child has more crying behaviors.

There are different types of events that can be traumatic to a child including:

  • Bullying is a deliberate and unsolicited action that occurs with the intent of inflicting social, emotional, physical, and/or psychological harm to someone who often is perceived as being less powerful.

  • Community violence is exposure to intentional acts of interpersonal violence committed in public areas by individuals who are not intimately related to the victim.

  • Witnessing Intimate Partner Violence (IPV), also referred to as domestic violence. This occurs when an individual purposely causes harm or threatens the risk of harm to any past or current partner or spouse.

  • Experiencing a natural disaster such as a tornado, hurricane, or any other naturally occurring weather-based events

  • Pediatric medical traumatic stress refers to a set of psychological and physiological responses of children and their families to single or multiple medical events.

  • Physical abuse occurs when a parent or caregiver commits an act that results in physical injury to a child or adolescent.

  • Many refugees, especially children, have experienced trauma related to war or persecution (also known as refugee trauma) that may affect their mental and physical health long after the events have occurred.

  • Child sexual abuse is any interaction between a child and an adult (or another child) in which the child is used for the sexual stimulation of the perpetrator or an observer.

  • Child sex trafficking involves the giving or receiving of anything of value (money, shelter, food, clothing, drugs, etc.) to any person in exchange for a sex act with someone under the age of 18.

  • Terrorism and violence can affect families and children like mass violence, acts of terrorism, or community trauma in the form of shootings, bombings, or other types of attack

  • Racial trauma is the physical, emotional and psychological harm that results from individuals experiencing daily acts of racism, prejudice and microaggressions

And YES COVID was a traumatic event for people of all ages!!! That would definitely fall underneath medical trauma.

Trauma & Play

Children engage in post-traumatic play after experiencing a traumatic event. This is where play therapy can aid in addressing trauma in children. Individual, family and group play therapy provides a place for to children safely express themselves & make meaning of their experiences

Early intervention through play & expressive arts can shift long-term health outcomes in a positive direction. However, children of all ages experience traumatic events, and play can be used with children of all ages to process their traumatic experiences. Activating the therapeutic powers of play serves as a protective factor to buffer the effects of trauma in children and adolescents.

Signs of Trauma in the Playroom

There are several signs mental health professionals can look for when working with children who have experienced trauma. They include:

  • Using community helpers (e.g. fire fighters, doctors, police officers)

  • Regressive behaviors like crying and "baby talk" that is outside the child's normal development

  • Sexualized play with dolls or other toys

  • Difficulty understanding/respecting boundaries

  • Avoiding certain toys/areas of the playroom

  • Acting out scenes of predator vs prey or other power & control themes

Key Items in the Playroom to Support Children Experiencing Trauma

  • Costumes- Helpful for role play. Suggested costumes include doctors, fire fighters, police officers, army men/gear (e.g. helmets, armor), superheroes

  • Puppets- Also helpful for role play and trauma narratives if using TF-CBT. Recommended to have community helpers along with a variety of cultures represented

  • Doctor's kit- Play therapist note: try to have real items like band-aids, face masks, gauze but only put the amount needed for one child at a time to avoid setting additional limits in the room

  • Sand tray- This sensory-based intervention can be helpful for both directive and non-directive play to heal from trauma

  • Dolls and dollhouse- Very helpful for role play with children who have experienced sexual abuse. Again, attempt to have cultural diversity in your dolls

Additional Resources to Support Children Experiencing Trauma:

Looking for additional support and training in using play therapy to help traumatized children? Check out our APT approved trainings offered throughout the year!

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