Back to Summer 2021 Newsletter

Luncheon Presentation Review by Tim Baima, PhD, LMFT

SCV-CAMFT graciously invited me to give a luncheon presentation on family play therapy on Friday May 21st. I was happy to provide 90-minute training. This was also my first time joining a SCV-CAMFT event, and I was delighted to connect with such a friendly community.

My presentation briefly reviewed several of the benefits of family play therapy. The majority of the presentation focused on case examples I hoped would illuminate these benefits. For this newsletter, I will review the rationale for incorporating play and family therapy. I will also provide guidelines for a few family play activities.

The Perfect Pair – (They just don’t know it yet)
Before I started graduate school to become an MFT, I spent approximately seven years working as a support counselor for highly marginalized and traumatized children and adolescents at group homes and foster care agencies. Through these experiences I grew to appreciate the healing potential in play, art, and other recreational activities. I learned that a good activity could break through the defenses of even the most highly guarded adolescent. I also witnessed how much more powerful an experience of something can be than a conversation about something.

Therefore, when I started graduate school to become a family therapist, I simply assumed that most family therapists incorporated play and art in their work. I was surprised to learn that this is often not the case. With the exception of Virginia Satir, family therapists have traditionally relied heavily on talk-based interventions. Talk-based therapy often sidelines family members who are not willing to talk, or those who have not yet developed the linguistic abilities to adequately express themselves with words (Gil, 2015). Furthermore, therapy may not be conducted in the primary language of one or more family members. Regardless of fluency in the language used to conduct therapy, one or more family members may not be speaking the language of their heart. Furthermore, talk is often used as a defense mechanism, keeping vulnerable content in a cerebral space. Incorporating play into family therapy can help overcome these limitations of talk-based therapy.

Given the significance of the family system for children and adolescents, one might also assume that play therapists would be drawn to work with families. However, the vast majority of play therapists are reluctant to engage families in treatment, often citing a lack of family therapy training, and personal fears as their primary reasons for not doing so (Gil, 2015). Treatment that does not include families often misses opportunities to facilitate second order change in a child’s family context. Carr’s (2018) research indicates that family treatment can be more effective and have longer lasting results than individual psychotherapy.

The Benefits of Family Play Therapy
There are numerous benefits to weaving play and family therapy together. I summarized several of these benefits during the training, and list them again below. (Gil, 2015 is a reference for the following points unless otherwise noted.)

• Play allows families to engage with each other, even about difficult topics, in fun and disarming ways.
• Play is the language of children. Therefore, it allows family members at each developmental stage to contribute meaningfully to a session.
• Play can provide a layer of distance from intense, painful, and/or taboo topics. This layer of distance supports families to engage around challenging issues in ways that are often more comfortable than direct dialogue.
• Play may contain a cathartic component, allowing for a discharge of emotion.
• Play is rich in symbol and metaphor. Evan Imber-Black, Janine Roberts, and Richard Whiting’s  (2003) groundbreaking work on rituals points out that symbols are invaluable in family therapy as they can:
• 1. mean different things to different people at the same time
  2. hold complex, even seemingly contradictory meaning
  3. hold meaning that evolves over time
• Because of the complex and fluid nature of symbols, play in family therapy can be used to shift and expand family member’s rigid views of one another.
• Play can provide family members with various ways to encounter their problems and experiences. For example, larger-than-life distress is miniaturized and manipulated in a sand tray, or family members embody and act out “small” disowned parts of themselves.
• Finally, many clients will describe a family play session as the most fun their family has had together in a long time. I believe that the significance of providing a family with a way to enjoy being together cannot be overstated.

OK! I’m Convinced. So, what are some family play activities I can try?

Symbol Scavenger Hunts: I opened the luncheon training with an activity that can be modified for use with a couple or family. I asked each participant to take a few minutes to hunt around for something that symbolized a family member who has had a significant impact on who they are as a therapist today. Once these objects were found, participants gathered in breakout rooms to say as much or as little as they liked about what they selected. I started using these “scavenger hunts” with families when COVID forced everything to go online. I might ask family members to find objects that say something about each family member, or to find symbols for events, such as a happy memory, a difficult event, a family strength, a wish, etc. I like the idea of recognizing the symbolism in objects that are in our everyday environment, and infusing those objects with meaning associated with experiences in therapy sessions.   

Family Play Genograms:  Family play genograms were created by Monica McGoldrick and Eliana Gil (2015). First, a family genogram is created on a large sheet of paper. Each family member then selects figurines to represent each family member. Next, they take turns sharing as much or as little as they’d like about what they selected. Lines can then be drawn between family members on the genogram to represent relationships. Next, family members select figurines to represent something about each relationship, and share about what they have selected.

Modified Family Play Genogram: Traditional family play genograms have the benefit of showing how everyone in a family is connected. While I sometimes use this approach, I have developed a modified version that incorporates symbol, art, storytelling, and drama. In my modified version, I ask the family to create space on a large piece of paper for each family member. Some families draw simple shapes, while others will draw images to represent their area on the paper. The process of simply selecting an area on the paper, deciding what to draw, where each person’s space is in relation to others, etc. can all be very revealing. Next, family members are asked to choose figurines that say something about each family member, including themselves. Selected figurines are placed in the area made to represent that person (i.e. all figurines chosen for Dad are placed in Dad’s area). After this, family members each share as much or as little as they’d like about what the selected. Finally, I like to ask family members to create stories with the figurines that have been selected. At times I draw upon Gil’s (2015) family puppet interview and ask family members to use the selected figurines to create a story with a beginning, middle, and end. Families are instructed to act out the story instead of narrating it (Gil, 2015). Another version is to ask each family member to enact a series of 30 second stories. In this variation, family members are given a prompt, and then act out a quick story using two or more figurines. For example, I might ask a family member to enact a story between two figurines that would love to meet each other, would be afraid of each other, could help each other, etc.

Unity Poster: The unity poster is a wonderful intervention to highlight intersections of autonomy and connection in a family. To prepare for the unity poster activity, the therapist follows these steps before the family arrives:

1. Draw a circle about the size of a dinner plate in the center of a large piece of heavy poster paper. Make sure the circle is bold and easily visible.
2. Use jigsaw puzzle style lines to cut the poster into equal parts – one part for each family member.
3. Now you will have jigsaw puzzle pieces with a bold line in the corner of one side.

At the start of the activity, give each family member one corner of the poster. Tell the family that you will give them a few prompts and invite them to decorate their small poster in response to these prompts. Prompts can be anything you wish for them to respond to. I am personally fond of prompts such as: An important event in your life, something you’re proud of, something you feel strongly about, and a secret dream. Ask them to leave the area past the line on their poster blank, but to draw, write, or make collage to respond to these prompts on the rest of the paper.
After each family member is finished decorating their individual posters, they take turns describing what they created. After everyone has had a turn, the therapist reveals that each of their pieces will fit together to create one whole poster. Ask them to figure out how their pieces fit together, and provide them with tape so they can bind the pieces together. The family will now see that the lines form a circle in the middle of the poster. Explain to them that this is the unity area, and invite them to work together to decorate it however they’d like. When they are done decorating the unity area, the therapist can end the activity by asking the family to title their poster and decide what they would like to do with it.

Conclusion
  I hope these ideas and activities will inspire many of you to try some play activities with families. I want to acknowledge Dr. Eliana Gil as the person from whom I have learned nearly everything I know about family play therapy.

Her books are informative, inspirational, and highly enjoyable to read. If you would like to read more about family play therapy, I suggest the following:

Play in Family Therapy Second Edition (2015) Guilford.
Posttraumatic Play in Children: What Clinicians Need to Know (2017) Guilford

Helping Abused and Traumatized Children: Integrating Directive and Nondirective Approaches (2006) Guilford.

References
Carr, A. (2019). Family therapy and systemic interventions for child‐focused problems: The
current evidence base. Journal of Family Therapy, 41(2), 153–213. https://doi-org.paloaltou.idm.oclc.org/10.1111/1467-6427.12226

Gil, E. (2015). Play in family therapy. Second edition. Guilford.
Imber-Black, E., Roberts, J. E., & Whiting, R. A. (2002). Rituals in families and family therapy.
Revised edition. W.W. Norton & Co.

Timothy Baima, Ph.D. is an Associate Professor in the MA Counseling Program at Palo Alto University where he serves as the coordinator for the Marriage, Family, and Child Counseling emphasis area. He is also a licensed Marriage and Family Therapist with a private practice in San Mateo, California where he specializes in family therapy with adolescents, and couple therapy. He is an AAMFT Approved Supervisor, training three MFT associates in his private practice. He has served on the Board of Directors for the American Family Therapy Academy since 2017. He has long held an interest in play therapy and has been receiving consultation from Dr. Eliana Gil for the past 5 years. His current research interests center on whiteness, and training the “self” of the therapist. He has published in The Expanded Family Life Cycle 5th Edition, The Journal of Marital and Family Therapy, and the Journal of Family Psychotherapy.   

Back to Summer 2021 Newsletter