Aaron Ruehle, Ed.S., L.P.C., L.M.F.T

Centra Health

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Aaron Ruehle, Ed.S., L.P.C., L.M.F.T

Family Therapist

Contact Information: 
Bridges Treatment Center
693 Leesville Road
Lynchburg, VA 24502
Phone: 434.200.5700
Fax: 434.947.5708

Education & Training

Education & Training
Education & Training
  • BA, Olivet College, Michigan
  • MA, Counselor Education, University of Virginia
  • Ed. S, University of Virginia

Play therapy helps children relieve emotional distress

By Aaron Ruehle, Ed.S., L.P.C., L.M.F.T., Family Therapist Bridges Treatment Center

Play is to children what talking is to adults. Often unable to articulate their thoughts and feelings through words, children communicate through play. When a child suffers from unidentified fears and concerns, play therapy provides a developmentally appropriate means of expression and communication. Play—undefined by age—is healthy for everyone. However, the difference between play and play therapy is great. Play therapy is an evidence-based approach in which specific techniques are used to elicit information from children to help them work through their conflicts and concerns and relieve emotional distress. It also offers an effective means of developing rapport and trust in the therapeutic relationship.

The goal of play therapy is two-fold:

■ To deal with clinical symptoms

■ To improve skills and problem-solving abilities

Play therapy helps children verbalize feelings. For example, a child who might not respond to the question, “What are you worried about?” can build a model with clay or play dough and tell a story about the object. The story serves as a metaphor for the child’s perception of a real-life conflict, concern or anxiety. The play session offers the therapist and child a non-threatening forum whereby they can resolve the conflicts and decrease anxieties. It is not uncommon for children to deal with unconscious fears through play. They can work out their fears in a healthy way that allows them to distance themselves from their fears while simultaneously keeping their emotions intact. Play therapy also helps a child develop new methods to cope with their conflicts and concerns.

Individual play therapy

Individual play therapy enables children to move from parallel play (in which the therapist sits next to the child performing a separate activity) to cooperative play (in which the child shares the materials with the therapist). The ability to share, engage in collaborative experiences and use appropriate relationship skills are central to developing friendships and maturation. Lessons learned are then recreated in the classroom, on the playground and in future life situations. Play therapy is not completely permissive. Children do best within boundaries and are not allowed to do anything they want to do. Limits provide emotional security which enables children to explore and express feelings that may have remained hidden. At the same time, limits help the child learn responsibility and self-control. Children feel safe in play therapy. Here they have an opportunity to express outwardly in play what they are feeling inside. For mental health professionals, play therapy opens a window into how the child perceives the world and interacts within that world.


Play therapy methodology

Mental health professionals use a wide range of play therapy techniques, including:

■ Doll and dollhouse play. Children frequently act out what happens in the context of their environment, including families, schools and neighborhoods, when playing with family dolls. Dollhouses enable the therapist to see the children’s view of how things function in their world.

■ Story-telling. The child tells a story, depicting different relationship scenarios (best friends, peer conflicts, parent/child relationships, etc.). The objects used to tell the story can range from dolls to stuffed animals. Some children use neutral objects as innocuous as wooden blocks, “blockman,” to describe their story of a bullying incident.

■ Clay or play dough. The child builds something and then explains the object, tells a story about the object or tells a feeling that the object may have, etc.

■ Puppetry. Family and animal puppets help younger children express their feelings, by dialoging their story through the medium of a puppet.

■ Art. Verbal exchange is opened effectively when a child draws a picture and explains it. Children who find difficulty articulating their thoughts can keep a daily picture journal.

■ Books. Children are often responsive to having stories read to them and reading to the therapist. The therapist can learn a great deal from what children hear in the story. At times, they perceive negative thoughts and deeds in relatively neutral reading material, depicting underlying fears.

■ Games. Playing games is a low-key way in which children can develop an understanding of how and why they make decisions. The therapist and the child discuss how the child goes about making decisions, and children learn the value of patience and sequencing.

■ Sand tray. Children have the opportunity to literally create their world through the act of placing figures of people, animals, buildings, etc., in a world that is confined to the tray of sand. The children can demonstrate their perception of how the world interacts through this modality.