It’s a new year, and like always February comes faster than we can possibly think! I am so happy to return to Alongside You after a year away. It’s wonderful when you can return and rejoin the work of walking alongside others.
This is truly a joy for me.
Yet, rest and recovery are important. Have you ever been sidelined? Taken a hit out of the blue? What do you do? Worry? Pray? Meditate? Call all your best friends and chat? Eat? Drink?
Think about it for a moment with me.
More times than I can recall, I move towards worry. Other times, I am quick to pray. Even other times I reach out, call someone – anyone who will listen. How does this scenario play out for you?
When we are sidelined, or unable to make decisions, it is okay to reach out. It is okay to talk to someone. It is okay to get centred and understand what your priorities are, and will be.
Taking time to rest, ponder; consider choices and opportunities, even when you are sidelined or surprised is okay. Out of rest something magical – dare I say miraculous – happens. Creativity flows, clarity happens, and you may just get in touch with your “Knower.” You know, that deep place inside of you, where you are at peace, you understand with clarity what you want, and where you want to go.
If you struggle with quieting your mind or resting in the busy, and you keep putting off decisions to move forward in your life, call someone, call us, and call me. I’m here to listen and understand.
In the meantime, know you are not alone. Rest, and let’s look together at what can be birthed in this new season.
A Note from our Director
We’re very happy to have Kezia back working with us after her time away! Kezia works with evidence-based treatments such as CBT, EMDR, DBT Skills, Mindfulness, and Creative interventions. As a part of her return to work, she will be providing all of her counselling services through our online counselling platform.
Why would you want to do counselling online? There are many reasons, and you can read a bit about them here. Some of the many benefits include scheduling, lack of travel to an office, or if you’re having to travel for business, you can still have your counselling session.
Sometimes people wonder if online counselling is secure. We use a HIPAA/PIPA/PIPEDA compliant platform to provide counselling that meets all of the privacy laws in BC. It is encrypted end-to-end which means it is secure from whatever device you use, to whatever device we use.
If you’d like to try it out, give us a call and book a session with Kezia. As Kezia says, she looks forward to, “Working together face to face, online, so you can pause in your busy to mentally strengthen your day!”
Here we are again – that time of year that gets us all excited about lights, smells, food, and relatives. Oh, and friends, cookies, the Stanley Park train, and…
Wait. Why are we excited again? Is anyone else stressed? What is this peace that people keep talking about? What’s the secret, and who actually experiences peace this time of year? I’m like everyone else. I can let the stress get to me too. So, what I’ve done is some thinking and some research that will hopefully help all of us figure out how to get some peace this year. I don’t know about you, but I think we could use it. Here are three practical ways to experience peace this Christmas, I hope they’re helpful to you!
Say “yes” to what matters most to you, and practice presence when you are there.
“It’s crazy. I can’t believe how much I have to do!”
We nod our heads and empathize, “Yes, I know. Me too. It’s just too busy!”
I am guilty of making these kinds of “Christmas complaints.” I am also aware that these rote responses make us feel that we’re “all in this together.” What a shame it is to forget that we often have a choice in the matter and that much of what we’re begrudgingly doing may, in fact, be worth enjoying.
Christmas parties, school performances, family dinners, and year-end activities – everything can be meaningful and life-giving. If you find yourself excited about a particular activity, and you think it is a worthwhile investment of your time and energy, show up with your Ugly Christmas sweater and your party hat on! What a gift it is to be alive!
One of the keys to connecting with the activities in a positive way is to be mindful. The best way to practice mindful presence at your chosen festivity is to set your intention, going in with the knowledge that this event is not imposed upon you, but gratefully chosen by you. Allow yourself to enjoy the people you speak with, the food you choose to eat, the melody and rhythm of the music you hear, and the décor creatively displayed for your aesthetic enjoyment. Breathe deeply, attune to your five senses – sight, smell, touch, sound, taste – and pay attention to what is right in front of you in that moment.1,2
Say “No,” to what is not a priority, and learn to be okay with disappointing people.
If it is true that we can choose to be gratefully present at an event, it is also (usually) true that we can gratefully decline to attend. In fact, it can be very liberating to do so. When we choose to simplify our schedules and scale back our commitments, we are giving our enthusiastic ‘yes’ to what we do show up at. We may also disappoint a few people along the way.
It can be very difficult to let someone down; it is even more difficult, long-term, to live with blurry boundaries and residual resentment. We may think that we have to jump when our friends and family say “jump,” and perhaps we’ve done it our entire lives. Perhaps it’s instinctual, and to do otherwise would create tension. Part of our work as humans who work toward self-identity and emotional health is to know what is not for us at this time. It does not mean that we cannot change our minds in the future and show up meaningfully then, but that in this season, at this time, we cannot take it on.3
There is a way to communicate boundaries in a respectful, effective manner. It takes practice, but with new learning and perhaps some help from a counsellor, it is possible to become skilled at lovingly communicating our intentions and expectations to others.
Say nothing at all, and take time for solitude.
For some, it will be a challenge to take a break from the busyness, to be alone and recharge. It may feel selfish to have time away from your partner, children, parents, or co-workers, to collect your thoughts in quiet. You may literally be thinking that you will make time for yourself next year. While it is possible to push through and strong-arm this season, we remember that if we feel coerced or obligated to be somewhere (in this case, to be with people), we may find it difficult to remain present with them. One of the best gifts we can give ourselves, and those we love is to take some time alone.
It is also true that for some of us, this season will feel lonely, even when we are in a crowded room of people.4 Or perhaps we will actually be alone more than we’d like, and the idea of choosing to turn down holiday activities out of sheer busyness seems like a happy person’s privilege. There can be peace in this season for you, too. Take very good care of yourself and reach out to one person who makes you feel known.5
Wherever you find yourself this Christmas, and with whomever, you choose to spend your time, try to be intentional about when you say “yes,” what you say “no,” and when to say nothing at all.
If you struggle with some of the decisions and boundaries I’ve talked about here, give us a call. We all struggle with these things at times and sometimes an outside perspective, listening ear, and some validation can go a long way in getting us from stress to health; or, as the young people say, from the FOMO (fear of missing out) to the JOMO (joy of missing out). Ok, it’s not that simple, but boundaries don’t have to be complicated. We can help.
Goldin, P. R., & Gross, J. J. (2010). Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion, 10(1), 83–91.org/10.1037/a0018441
de Vibe M, Bjørndal A, Tipton E, Hammerstrøm KT, Kowalski K. Mindfulness-based stress reduction (MBSR) for improving health, quality of life and social functioning in adults. Campbell Systematic Reviews 2012:3 doi: 10.4073/csr.2012.3
Wuest, J. (1998). Setting boundaries: A strategy for precarious ordering of women’s caring demands. Research in nursing & health, 21(1), 39-49.
Kar-Purkayastha, I. (2010). An epidemic of loneliness. The Lancet, 376(9758), 2114-2115.
Research shows that client engagement in the counselling process strongly predicts the success of treatment.1 In other words, when you arrive, you are not coming to be fixed by a counsellor, but instead to work in partnership with them. There are several ways that you can prepare yourself for a successful experience in counselling, but ultimately your only job is to show up, and however, you do so is commendable and brave.
Know Your Preferences and Needs
Here are some things you might consider before coming to see a counsellor at Alongside You. First, think about what kind of counsellor you believe would be a good fit for you. Your preference may vary depending on your phase of life, and unique circumstance, and that’s okay. Some people prefer a female or male counsellor (for reasons of comfortability or life experience), someone within a certain age demographic, or someone who works within a specific therapeutic model. You may also have a need for someone very soft and gentle, or you may need someone who is willing to challenge you directly. If you can come up with ideas on these preferences, we can help to guide you in picking a counsellor.
It’s also helpful to know what it is you’d like help with. You may feel like your list of concerns are long and complex. That’s ok, you’re not alone. Although it can feel overwhelming to narrow it down, it is often helpful to come to your appointment with one or two issues that are, at present, the most problematic for you. It doesn’t mean this can’t change over time because it often does, it just means there’s some focus to start out the work. That said, sometimes we don’t know what’s wrong, we just know that something is not right and we need help figuring out what’s going on. That’s okay too!
Openness in Counselling
When you arrive for your first appointment, try to be as open as you can to establish a relationship with your counsellor. Research indicates that the therapeutic alliance (the relationship between the counsellor and client) strongly determines the effectiveness of therapy.2 The therapeutic alliance will go the distance when you work through difficult things together and so we (as counsellors and as clients) cannot overlook the significance of trust, empathy, and connection. We understand that it’s a big ask! As part of our professional practice, counsellors do clinical supervision, and many also have their own personal counsellors that they see. You may find it helpful to know that it’s not easy for us either when we’re the ones “on the couch.”
Honesty & Feedback
If part of what makes counselling effective is the therapeutic alliance, the relationship between the counsellor and the client should be strong enough to handle honesty. As counsellors, we value when clients provide honest feedback. This can occur at the moment (“I don’t think you have a clear understanding of what I meant by that”), or after working together for some time (“I find that I feel frustrated when we start our sessions a few minutes late, and I wanted to let you know”). Counsellors want to hear if something is, or is not, working for you. When you don’t agree, or don’t feel your counsellor is fully understanding you, your counsellor prefers that you speak up. Statistically, when a client offers feedback, it usually serves to strengthen the therapeutic relationship, not weaken it.3
Furthermore, be honest about what you believe you need from counselling, whether it be guidance, problem-solving, empathic response, acceptance, non-judgement, or practical insight. It is okay to communicate this. Although each counsellor and client will naturally create a dynamic (or a certain way of being with one another), your counsellor will be better equipped to work with you if they have a clear understanding of your needs. It helps your counsellor to know your objectives for therapy, but also, it can provide insight as to who you are as a person.
As you participate in counselling, aim to implement some of the homework (sometimes called “between-session interventions”) agreed upon in counselling. Counselling homework usually consists of experimenting with new behaviours, making cognitive shifts, acknowledging feelings in specific moments, or keeping track of a combination of all three during the time you are not with us. Homework, at its best, enables integration between the counselling hour and the client’s regular life. Ultimately, homework can be a meaningful way of facilitating healing and growth outside of the time spent with your counsellor.4 As my supervisor, Andrew Neufeld, sometimes illustrates – if you go to see a physiotherapist for your knee and the only work you do is with the physio in session, your knee will likely eventually get better but it will be a long, drawn-out process; whereas, if you do exercises in between sessions your recovery will likely proceed exponentially faster. The same is true for counselling – the work you do between sessions will significantly influence the speed at which you recover and heal.
Last, and perhaps most significant, try to practice self-compassion as you enter and proceed with therapy.5 Counselling can be exhausting, and emotional, and it always requires bravery. Your counsellor knows this and appreciates this about you. Try to be especially gentle with yourself during the process, and treat yourself with tenderness, care, and grace.
Shaw, S., & Murray, K. (2014). Monitoring Alliance and Outcome with Client Feedback Measures. Journal of Mental Health Counseling, 36(1), 43–57. https://doi.org/10.17744/mehc.36.1.n5g64t3014231862
Duff, C. T., & Bedi, R. P. (2010). Counsellor behaviours that predict therapeutic alliance: From the client’s perspective. Counselling Psychology Quarterly, 23(1), 91–110. https://doi.org/10.1080/09515071003688165
Murphy, K. P., Rashleigh, C. M., & Timulak, L. (2012). The relationship between progress feedback and therapeutic outcome in student counselling: A randomised control trial. Counselling Psychology Quarterly, 25(1), 1–18. https://doi.org/10.1080/09515070.2012.662349
Cronin, T. J., Lawrence, K. A., Taylor, K., Norton, P. J., & Kazantzis, N. (2015). Integrating Between-Session Interventions (Homework) in Therapy: The Importance of the Therapeutic Relationship and Cognitive Case Conceptualization: Therapeutic Relationship and Homework. Journal of Clinical Psychology, 71(5), 439–450. https://doi.org/10.1002/jclp.22180
Galili-Weinstock, L., Chen, R., Atzil-Slonim, D., Bar-Kalifa, E., Peri, T., & Rafaeli, E. (2018). The association between self-compassion and treatment outcomes: Session-level and treatment-level effects. Journal of Clinical Psychology, 74(6), 849–866. https://doi.org/10.1002/jclp.22569
Winter is coming, and so too are shorter days and longer periods of darkness. For a sizable percentage of people (~3% of the Canadian population1), this change to our environment can bring about a seasonal form of depression called Seasonal Affective Disorder, SAD. Those who experience SAD experience an onset of clinical depression in the fall season, which spontaneously improves in the summer, a cycle that usually repeats for at least two calendar years in succession. Interestingly, the symptoms of SAD are not typical of non-seasonal depression.2 Depressed mood, loss of interest in activities, and withdrawal from social interaction is common to both, but where typical depression usually includes insomnia, anxiety and reduced food intake, SAD is characterized by hypersomnia, carbohydrate craving and increased body weight. The symptoms look superficially like seasonal rhythms in animals as they prepare to hibernate.
In fact, many of the same biological mechanisms which prompt the onset of hibernation in animals like bears are similar to the processes which give rise to SAD in humans. This is because most organisms have internal body clocks which track daily and annual cycles in the external world. Our body clocks, for example, are capable of tracking how long the sun is present each day. While we don’t yet fully understand why this process affects mood, we know that SAD is associated with day length because data from different American states reveal that the incidence of SAD are higher in more northern states.3 This is also true of the ‘winter blues’, or sub-clinical SAD. We also know that the issue is in terms of day length and not the amount of sunshine a location gets because Calgary (~51° N) has much more winter sunshine than Vancouver (~49° N) but similar daylengths and population rates of SAD. This is particularly important information for us Canadians who live north of the 49th parallel. We may get plenty of sun, but we still experience shorter days.
So, as we get less daytime during these seasons, is it possible to trick our body clocks into thinking the days are longer?
Remarkably, one of the most effective remedies for SAD is bright light treatment. Introducing bright light in the Fall and Winter can prevent or reverse SAD, with roughly 2/3rd of SAD patients responding to the treatment4. The research indicates that it is as effective an antidepressant as any pharmaceutical used to treat SAD and when used correctly is accompanied by relatively few possible side effects. Importantly, however, bright light therapy may trigger mania in individuals with bipolar disorder5, so please consult with your doctor before considering the treatment. The minimum effective dose is approximately 2500 lux, which is about the intensity of sunrise outdoors.6 Bright light treatments, however, will often exceed 10,000 lux. Indoor, room lighting typically emits 500 lux and is thus an ineffective treatment. Those susceptible to SAD can purchase bright light-emitting visors or, alternatively, there are bright light lamps which allow one to sit or work in an environment containing ambient day-time levels of light. These devices can also be used strategically to ease certain sleep disorders and help realign one’s body clocks during jet lag.7
Because many of the symptoms of Major Depression and SAD are shared and the two disorders are often comorbid, traditional psychotherapy is also a highly effective treatment for seasonal depression.2 Research using group-based cognitive-behavioural therapy (CBT), for example, has demonstrated antidepressant effects which nearly mimic 30 minutes of 10,000 lux bright light treatment.8 Health professionals who utilize CBT teach skills to those suffering from various forms of depression which help to change their perceptions of the world.9 Cultivating emotional regulation, developing personal coping strategies, and learning to disrupt patterns of negative thoughts and actions are key constructs of CBT. Bright light treatment and psychotherapies like CBT may be used alongside one another, as well as in conjunction with other therapies like medication or mindfulness practices. Research also suggests that people whose depressive symptoms look more like the ‘winter blues’ than seasonal depression should improve their diets by limiting starches and sugars, exercise frequently, manage stress (especially around the holidays), increase social contact and connection, and spend more time outdoors.10
Finally, vitamin D, an essential building block for our bones and muscles, is in short supply in the Canadian Fall and Winter months. A deficiency of vitamin D has been associated with depressive symptoms and some research suggests that taking vitamin D before winter darkness sets in may help prevent symptoms of SAD.11 During the winter months, those living roughly 33 degrees north or 30 degrees south of the equator synthesize very little, if any, vitamin D.12 People beyond these latitudes rely primarily on eating fish and egg yolk or taking nutritional supplements to get the vitamin D needed.13 It is important that most of us, and perhaps especially people experiencing SAD, ensure that we have sufficient levels of vitamin D during these darker months. Thankfully, the Canadian government acknowledges this problem and mandatorily requires that products like cow’s milk, margarine, and calcium-fortified beverages have vitamin D added to them.14 Planning a mid-winter vacation may be valuable for its increased light exposure and onset of vitamin D synthesis, and who doesn’t like taking a vacation as a form of treatment?15
Thankfully, there are multiple options for Seasonal Affective Disorder which allow for more personalized treatment plans. If you’re feeling blue this Fall and Winter, Alongside You offers an abundance of counselling and well-being services that can help you if you identify with any of the discussion above regarding SAD.
If we can be of help to you, please don’t hesitate to ask. This is why Alongside You exists – because we believe that everyone is worth it. Feel free to contact us to see how we can help!
Adam Manz recently graduated from Simon Fraser University with a Bachelor of Arts majoring in Psychology. He is currently pursuing a master’s degree in clinical psychology while maintaining a love for meditation, podcasts, and hiking. Adam is volunteering with us here at Alongside You and we’re glad to have him on board!
1Body and Health Canada. (2019). Seasonal affective disorder. Retrieved from https://bodyandhealth.canada.com/healthfeature/gethealthfeature/seasonal-affective-disorder.
7Burgess, H. J., Crowley, S. J., Gazda, C. J., Fogg, L. F., & Eastman, C. I. (2003). Preflight adjustment to eastward travel: 3 days of advancing sleep with and without morning bright light. Journal of Biological Rhythms, 18(4), 318–328. doi: 10.1177/0748730403253585
9Canadian Mental Health Association. (2013). Seasonal affective disorder. Retrieved from https://cmha.bc.ca/documents/seasonal-affective-disorder-2/.
5Chan, P. K., Lam, R. W., Perry, K. F. (1994). Mania precipitated by light therapy for patients with SAD (letter). Journal of Clinical Psychiatry 55:454
4Golden, R. N., Gaynes, B. N., Ekstrom, R. D., Hamer, R. M., Jacobsen, F. M., Suppes, T., … Nemeroff, C. B. (2005). The efficacy of light therapy in the treatment of mood disorders: A review and meta-analysis of the evidence. American Journal of Psychiatry, 162(4), 656–662. doi: 10.1176/appi.ajp.162.4.656
13Health Link BC. (2019). Food sources of calcium and vitamin D. Retrieved from https://www.healthlinkbc.ca/healthlinkbc-files/sources-calcium-vitamin-d.
3Horowitz, S. (2008). Shedding light on seasonal affective disorder. Alternative and Complementary Therapies, 14(6), 282–287. doi: 10.1089/act.2008.14608
14Janz, T., & Pearson, C. (2015). Health at a glance: Vitamin D blood levels of Canadians. Retrieved from https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/11727-eng.htm#n2.
11Kerr, D. C., Zava, D. T., Piper, W. T., Saturn, S. R., Frei, B., & Gombart, A. F. (2015). Associations between vitamin D levels and depressive symptoms in healthy young adult women. Psychiatry Research, 227(1), 46–51. doi: 10.1016/j.psychres.2015.02.016
10National Health Services. (2018). Treatment of seasonal affective disorder (SAD). Retrieved from https://www.nhs.uk/conditions/seasonal-affective-disorder-sad/treatment/.
8Rohan, K. J., Mahon, J. N., Evans, M., Ho, S.-Y., Meyerhoff, J., Postolache, T. T., & Vacek, P. M. (2015). Randomized trial of cognitive-behavioral therapy versus light therapy for seasonal affective disorder: Acute outcomes. American Journal of Psychiatry, 172(9), 862–869. doi: 10.1176/appi.ajp.2015.14101293
12Stewart, A. E., Roecklein, K. A., Tanner, S., & Kimlin, M. G. (2014). Possible contributions of skin pigmentation and vitamin D in a polyfactorial model of seasonal affective disorder. Medical Hypotheses, 83(5), 517–525. doi: 10.1016/j.mehy.2014.09.010
6Tam, E. M., Lam, R. W., & Levitt, A. J. (1995). Treatment of seasonal affective disorder: A review. The Canadian Journal of Psychiatry, 40(8), 457–466. doi:10.1177/070674379504000806
15Targum, S. D., & Rosenthal, N. (2008). Seasonal affective disorder. Psychiatry (Edgmont), 5(5), 31–33.
2The National Institute of Mental Health. (2016). Seasonal Affective Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml.
It can be difficult for a parent to watch their child struggle with big worries. As parents, we want to be able to fix our child’s problems – preferably this would happen quickly and easily. If we can’t fix what concerns them (which we often cannot), we are left to support the child through their anxiety. This may sound simplistic, but I assure you, it’s not. Parental support is vitally significant for the child, and often, empowering for the parent. As the saying goes — a good parent prepares the child for the path, not the path for the child. Approached with gentleness and kindness, encouraging support can be a great gift to their developing identity and self-confidence.
Practical Ways Parents Can Support Their Anxious Child’s Wellbeing
Children require consistent, predictable routines in order to flourish1. These don’t have to be rigid or excessive, but a general structure for the course of a day allows a child to predict what comes next, and to prepare for it. For example, create a rhythm to the bedtime routine that becomes so predictable and soothing that it lulls the child to sleep (figuratively speaking). When a child knows what time they go to bed, and the events that lead up to it, they can begin to gear down and relax, knowing that the adult in charge will be helping this process the same way every night. Avoid screen time two hours prior to bedtime as the emitted blue light inhibits the release of melatonin (the hormone responsible for sleep cycles and circadian rhythm).2 Instead, read books together, discuss a moment of gratitude, ask questions about their day, or speak words of affirmation to your child.
During daytime hours, a child’s pace of life should be slow and sustainable. Children need plenty of time for play and quiet exploration.3 Children who are expected to run at a pace that is beyond their capacity may experience an increase in anxiety. As an adult, you may have a clear perspective on what is manageable for your child. They may be excited to join five different sports teams this fall, but you are the one with the foresight to understand that, within a short time, this may lead to them feeling overwhelmed. This, of course, evolves as children get older, and every child is truly unique in what they can tolerate – much like their adults!
Lastly, create space in your day (or week) to connect with your child. Follow your child’s innate interests and spend one-on-one time enjoying what they do.
Some ideas to get you started:
If they’re interested in food, bake cookies
If they love sports, kick a soccer ball around, just for fun
If they enjoy physical activity, go on a bike ride or for a walk
If they’re into music, listen to a new song they’re excited about and show them what you know on the guitar or piano
If they’re interested in mechanics, have them help you change the oil, or open the hood of the car to look around together
Intentional investment of time spent with your child will pay dividends when it comes to their behaviour, but more importantly, to their sense of belonging and connection. The attachment that is formed from these positive connections bolster a child’s confidence to face the world, and increases resilience to stress.4,5,6
Ways Parents Can Emotionally Support Their Anxious Child’s Wellbeing
Emotional support is an extension of practical support. A parent may become overwhelmed by their own feelings (of guilt, or frustration, or panic) when they see their child in the throes of anxiety. It may be important to take a moment to check in with yourself before running to the aide of your child. First, accept that your child is feeling anxious, and notice your own feelings about this. Give yourself some time to regulate your own emotions. When you feel ready, approach your child to validate their feelings, and to name what you see happening for them. For example, “I see that your fists are clenched and your eyes are wide. These must be big worries for you.” Sit with them as they feel the weight of their worry without trying to rush them, or brush it off. Once the child has walked through the experience of their big feelings of worry, re-direct them to calming activities.
Some ideas to get you started:
run a warm bath
go for a walk together
somatic breathing exercises
progressive muscle relaxation
Lastly, show your child that you, their hero, can make mistakes, do hard things, go on to survive the experience, and thrive. It can be very helpful to practice self-compassion in a way that is visible to the child.7 For example, if you find yourself running late at the school drop-off, model taking a few deep breaths, smile, and acknowledge, “Wow, we sure are running late today! I can’t get it right every day though, and that’s okay! Today we might be late, but maybe tomorrow will be different.”
It can be soothing for a child to observe their parents set boundaries that guard their own time and self-care in fact, it reinforces that it is acceptable for the child to do the same.
If you or your child would like to come in to discuss their big worries, or yours, please contact us and we would be happy to help! I’d love to work with you while I complete my internship. We also have a whole roster of Registered Clinical Counsellors available to work with you as well.
Spagnola, M., & Fiese, B. H. (2007). Family Routines and Rituals: A Context for Development in the Lives of Young Children. Infants & Young Children, 20(4), 284–299. org/10.1097/01.IYC.0000290352.32170.5a
Fletcher, F. E., Conduit, R., Foster-Owens, M. D., Rinehart, N. J., Rajaratnam, S. M. W., & Cornish, K. M. (2018). The Association Between Anxiety Symptoms and Sleep in School-Aged Children: A Combined Insight From the Children’s Sleep Habits Questionnaire and Actigraphy. Behavioral Sleep Medicine, 16(2), 169–184. https://doi.org/10.1080/15402002.2016.1180522
Mrnjaus, C. (2013). The Child’s Right to Play?! Croatian Journal of Education, 16(1), 217-233.
Neufeld, G., & Maté, G. (2004). Hold on to your kids: Why parents matter.
Priest, J. B. (2013a). Anxiety disorders and the quality of relationships with friends, relatives, and romantic partners: Anxiety disorders and relationship quality. Journal of Clinical Psychology, 69(1), 78–88. https://doi.org/10.1002/jclp.21925
Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York, NY: Basic Books
Neff, K. (2013). Self compassion. London: Hodder & Stoughton.
Last week, Andrew wrote a blog about the logistics of getting counselling for your child, I would like to provide some insight into what happens inside the counselling room. I absolutely love working with children. I find it challenging, inspiring, rewarding and unique. Often folks ask me “So, does the child just sit on a couch and tell you how they are feeling, does that even work with kids?” I chuckle and assure them that counselling with children is going to look very different than counselling with adults.
Enter PLAY therapy.
What Is Play Therapy?
I believe that play therapy is the most developmentally appropriate therapeutic approach for children. I feel that it is doing children a disservice if we ask them to communicate their inner world the same way we ask adults, which happens primarily through talk therapy. Children do not have the same cognitive ability as adults, therefore, play therapy bridges the gap between concrete experience and abstract thought.1 Play therapy provides the opportunity for children to express their feelings and thoughts in a way that is familiar to them because typically children love to play.
To this, some might question, “Are you just playing then?” The answer is unequivocal, “No, quite the opposite.” There is much meaning in play; Froebel says, “children’s play is not a mere sport. It is full of meaning and import.”2 Play is the natural language of children. Play is the way children communicate. Garry Landreth says, “toys are used like words by children, and play is their language.”3 While engaging in play therapy, the child uses the toys in the room to communicate thoughts, experiences, situations and feelings.
My Approach To Play Therapy
Each counsellor who works with children has a different way of engaging with the child through play therapy. For myself, I adopt a posture of curiosity; I want to see the child’s world through their eyes. Typically, the first session is about establishing trust and rapport, just like a session with an adult client. Personally, I find sitting on the floor and meeting the child at their level is helpful. I have a box of fidget toys that I have available on the floor or table, these are for the child to squish and fiddle with as we talk and play. Often if a parent is in the initial session, I will encourage the parent to use a toy too.
In order to help facilitate the sometimes awkward first meeting jitters, we play Getting to Know You Jenga. This is a tower building game with a twist – each block has a question. The child is encouraged to answer the question and this helps establish a rapport and points of connection. One of the things that never ceases to amaze me is the child’s ability to direct the conversation to the areas that are needed to be focused on. This is modelled in the way that child answers the questions and, in turn, ask me questions. When I have my initial meeting with the parent, I often share that my trust needs to be earned. Often a child might share a small piece to “test the waters” and see if I am paying attention. Like playing pass with a ball, I need to catch what they have shared with me and convey to the child that I have heard them.
What Is A Play Therapy Session Like?
Each play therapy session can look different. For me, I am all about the feelings. It is vital for children to grow up with a greater understanding of their feelings and learn healthy ways to express their emotions. I try to incorporate as many different modalities as I can. Sometimes it might be colouring pictures of feelings and emotions, other times it is outlining their body and drawing where they feel that emotion. Other times it is playing in the dollhouse and sharing about their family. There are incredible books that provide wonderful language for children as they process their feelings. One of my favourites is In My Heart, which beautifully describes some of the many emotions that are found in our hearts. For the more active children, we can play catch and answer questions back and forth. I really try to tailor the activities to the likes of each child.
One of my favourite ways to work with children is through the use of the sand tray. Picture a mini sandbox complete with figurines to play with. The child is encouraged to use the sand tray to create a scene. The child can build a magical world or perhaps create a scene that is more realistic. The beauty of the sand tray is that often it is a way to visibly show what a child might be feeling internally. As the child creates, depending on the preference of the child, I am asking questions and gaining insight or silently attending to what they are sharing with me.
How Can Play Therapy Help My Child?
Just the same as adult counselling, when I am in the room with a child, it is my desire to provide empathy, congruence and unconditional positive regard, as these are the core conditions that help to facilitate change.5 I truly believe it is the relationship with the therapist that helps to promote growth and healing. However, that does not negate the important role the parent plays in the relationship. When a child has shared something significant or created something powerful, I encourage the child to invite the parent into the room to see and learn together. As I remind the child, we only see each other during sessions, but you see your parent more. I want the parent to be well equipped to take the themes and language that was spoken during the session and translate that to home. I want to thank you, parents, for trusting me with the most precious gift: your child. I want to work with you in order for a child to learn, grow and develop into a confident and healthy person.
Although the mediums used in play therapy are often very fun, many times, the work that is done in play therapy is difficult – children work hard at expressing and understanding their big feelings. It is my role to help facilitate these discoveries through conversation and play. Play therapy can be a powerful experience where great changes can happen for our kids – changes that may not happen without the freedom and safety of the play therapy sessions. Play therapy is a place where children get to be who they are at their core and have that be ok and celebrated. A place where they can explore difficulties in life in a safe, supported way.
Working with children is a privilege and one I do not take lightly. If you are interested in learning more about play therapy or setting up an appointment for your child, please do not hesitate to contact me through our website.
Bratton, S. & Ray, D. (2000). What the research shows about play therapy. International Journal of Play therapy, 9, 47-88.
Froebel, F. (1903). The education of man. New York: D. Appleton.
Landreth, G. L. (2012). Play Therapy: The art of the relationship. Third Edition. New York: Brunner-Routledge.
Piaget, J. (1962). Play, dreams, and imitation in childhood. New York: Norton.
Rogers, C. (1951). Client-centered therapy, Its current practice, implications, and theory. Boston: Houghton Mifflin Company.