Psychotherapy with a 3-Year-Old Child: The Role of Play in the Unfolding Process

Abstract

Few studies have investigated the outcomes and process of psychodynamic psychotherapies with children. Among the limited number of studies, some only paid attention to play and verbal production, as they are fundamental aspects in assessing the psychotherapy process. This paper focuses on an empirical investigation of a 3-year, once-a-week psychodynamic psychotherapy carried out with a 3-year-old girl. A process-outcome design was implemented to evaluate play and verbal discourse in in the initial, middle, and final parts of 30 psychotherapy sessions. Repeated measurements of standardized play categories (the Play Category System and the Affect in Play Scale—Preschool version) and verbal discourse (Verbal Production) were analyzed. To increase the clinical validity of the study, data from the assessment phase and vignettes from the sessions were reported to deepen the patient’s picture during the unfolding therapy process. Parent reports before and after the therapy were also included. Empirically measured changes in play and verbal production were fundamental in evaluating the young patient’s psychotherapy process. Verbal production and discourse ability progressively increased and took the place of play, which instead became more symbolic. Developmental issues as well as psychotherapy’s influence on the patient’s change, were discussed in relation to the role of play in enhancing the development of verbal dialog and the expression of the child’s emotions, needs, and desires.

O brincar na psicoterapia psicodinâmica de uma criança com sintomas externalizantes: um estudo de caso

“…O foco na externalização comportamental, em especial, faz-se necessário, considerando a alta prevalência e os desafios que crianças com esse quadro impõem à clínica. Diversos estudos internacionais investigaram o brincar em psicoterapia de crianças com diferentes diagnósticos e também, no intuito de compreender a ação __________________________________________________________________________________________ terapêutica (Chazan, 2000;Chazan e Wolf, 2002;De Felice et al, 2015;Halfon, 2017;Halfon et al, 2016;Halfon et al, 2017;Hoffmann e Russ, 2012;Salcuni et al, 2016). No entanto, ainda existe uma lacuna no cenário brasileiro a respeito dessa temática.…”

General Review on Cognitive Behavior Play Therapy on Childrens’ Psychology Development

“…Thus, service offered to these children has to match with their development stage because children are generally having less autonomy compared to adults. Their limited development has caused their expression through thoughts and words are limited (Salcuni et al, 2017). This has results in inability of the adults to understand and respond effectively to children's feeling.…”

Pre-K children’s play: different forms of imitation and exploration behaviours

“…However, this definition essentially excludes all those playing situations characterized by problem solving that require the subject to change (or at least adjust) his/her mental structures. In other words, if playing is considered merely in terms of assimilation, there is a risk of denying its important cognitive development function, in the sense that it allows children to explore several alternatives for establishing a relationship with reality (Lillard et al, 2013;Salcuni, Di Riso, Mabilia, & Lis, 2017;Sutton-Smith, 1966;Wertsh & Tulviste, 1990).…”