What is Theraplay?

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Theraplay is a short-term, attachment-based intervention utilizing non-symbolic, interactional play to re-create experiences of secure attachment formation between parent and child. The interactive sequences are carefully structured by the therapist to make possible the pleasure of being together and shared enjoyment in the child´s mastery. These elements of shared positive emotions may be crucial in restructuring the attachment relationship towards greater organization and security. Theraplay’s Core Concepts consist of interaction, here and now experience, adult guidance, attunement, right brain language, multisensory experience, and playfulness as well as the Theraplay Dimensions of Structure, Engagement, Nurture and Challenge.

The Core Concepts of Theraplay

Core Concepts of Theraplay

Theraplay incorporates many well researched concepts from child development, mental health and therapeutic change. Key supporting research concepts and researchers are cited below; full descriptions are found in Theraplay, 3rd Edition, 2010; pages noted below.

Interactive & Relationship Based (pp. 42-47)

Theraplay recognizes that the drive toward relatedness is the primary motivating factor in human behavior (Bowlby, 1969). The Theraplay treatment process uses and reactivates innate attachment mechanisms of rhythm and synchrony (Trevarthen, 1989), resonance (Siegel, 2006) and imitation and mirror neuron function (Iacoboni, 2009).

Direct Here and Now Experience (pp. 48-51)

Theraplay believes that a direct reparative emotional experience will be the most effective way to change the child’s and parent’s internal working model. Aspects of this emotional experience are: primary intersubjectivity (Trevarthen & Aiken, 2001), now moments (Tronick, et.al, 1998), non-congruence (Hart, 2008), and the creation of new meaning together (Makela, 2003).

Guided by the Adult (pp.51-54)

Theraplay provides a safe, organized, well-regulated experience for the child and parents, similar to a “holding environment”(Winnicott, 1987) in which the true self of the child can emerge. Supporting research findings include: importance of adult guidance and structure (Sroufe, 2005), authoritative parenting (Baumrind, 1991), resiliency (Grotberg, 1997) and autonomy growing from attachment (Shahmoon-Shanok, 1997).

Responsive, Attuned & Empathic (pp. 54-62)

Theraplay treatment takes as its model the attuned, reflective, empathic and contingent responsiveness of good parenting that has been shown to lead to secure attachment and the development of a positive inner working model (Bowlby,1973). The Theraplay therapist responds in an attuned way to the parent and child and assists the parents with their skills in attunement to vitality affects (Stern, 1985), reflective function (Fonagy, et al, 2002, Slade, 2002) and mindfulness (Siegel, 2006).

Preverbal/Social/Right Brain Level (pp. 62-73)

In recognition that neurons are pruned via interactive experience with caregivers (Gerhardt, 2004), Theraplay seeks to provide experiences that can reorganize the brain, leading to affect regulation and changed patterns of interactions and expectations. Theraplay uses the nonverbal language of the right brain rather than the verbal of the left to change patterns in the same way they were laid down initially (Shore, 1994). Theraplay values the centrality of early dyadic regulation (Schore), the importance of the right hemisphere in emotional development, and the power of procedural memory (Shore & Shore, 2008).

Multi-sensory including Touch (pp. 73-78)

Theraplay treatment contains multiple opportunities for safe and appropriate therapist-child and parent-child physical contact and stimulation of all senses. The stimulation of body senses is involved in the sense of self and interaction ability (Williamson & Anzalone, 1997). Positive touch is implicated in survival and meaning (Brazelton, 1990), social development (Harlow, 1958), physiological & intellectual development of prematurely born infants (Field, 1995), management of stress (Tronick, 1995), the ability to overcome genetic propensity to anxiety and irritability in animal studies, and the development of body Image (Weiss, 1990).

Playful (pp. 79-83)

Theraplay employs the lively, joyful play of parent and young child that is critical to the formation of secure attachment. Early experiences of high levels of positive affect co-regulated with an attuned caregiver are related to the development of connectedness and empathy and to the ability to self-regulate high affect (Stern, 1974). Playfulness, joy, and rough and tumble play are implicated in buffering negative emotions (Panksepp, 2007), reducing social problems when adult (Brown, 2009), creating affective synchrony and enhancing brain development (Hart, 2008), and creating new neural connections and stress reduction ability (Sunderland, 2006).