The American Psychiatric Association (2013) defines ASD as “a neurodevelopmental disorder characterized by restricted interests, repetitive behaviors, critical impairments of communication, and social relationships – more specifically, a typical development of reciprocal interactions with others.” However, ASD has such a large variance of symptoms within the three areas (communication, socialization, and interests) to look for in each person diagnosed, so treatment can be incredibly challenging because there is no “one size fits all” magic fix.
Every 1 out of 68 kids under the age of eight in America is diagnosed with Autism Spectrum Disorder (ASD) . Both children and adults with ASD are at a higher risk of being victimized because of their challenges with communication, low levels of social intelligence, and high levels of naivety. Because 63% of children with ASD have a harder time telling others about emotional experiences or hardships, they are less protected against and tend to have higher rates of physical or sexual abuse and trauma, because those who commit crimes against them get away with it fairly easily. For example, (Mendell et al. , 2005) found that not only had 18.5% of 156 children with ASD in a community been physically abused, but 16.6% of those 156 kids had also been sexually abused. Those children with ASD who were physically and sexually abused were six times more likely to make one or more suicide attempt(s). In another study, Mehtar and Mukaddes (2011) observed that 26% of children with ASD had some sort of history with trauma. The definition of trauma is one or more events that change a person’s life so much that their functioning becomes affected in a negative manner. (Guest, 2018)
Neurologically speaking, kids with ASD literally see things in a different way. For example, the level of trauma they experience from social stimulation is much higher than what people who are not on the spectrum experience. This substantial difference in perception combined with “mental rigidity, impaired emotional insight, and poor cognitive coping skills” contributes to the higher amounts of trauma people with ASD experience on a daily basis. (Guest, 2018)
The two types of play therapy that are most commonly utilized today are Non-Directive Play Therapy and Directive Play Therapy. The non-directive approach is essentially when the counselor uses reflective and encouraging language but stays out of the child’s business for the most part. For example, if a child was having a temper tantrum, the counselor would allow he or she work it out by themselves as long as no threat of harm to the client, counselor, or environment was present. It tends to take a much more relaxed and uninvolved stance in order to let the child really take control of their own play and behavior. The directive approach is when the counselor is more involved in the process of change and, in turn, may not allow the child to be as independent and active in the decision-making process as they could be. For example, if the child was dealing with something making him or her angry, the counselor would set up a conflict between two toys in order to aid in the resolving of the anger. This could have harmful effects in the future if the child becomes too dependent on the counselor to make their decisions. (“Types of Play Therapy”, 2013)
Throughout the course of play therapy, the counselor has many different options when it comes to deciding what type of play would be most advantageous for the client’s overall progression. The six types of plays that currently exist are the following: assessment, expensive arts, bibliotherapy, filial therapy, sand tray therapy, and imaginary play. (“Types of Play Therapy”, 2013) The approach and type of therapy that a majority of this paper will be dedicated to is a non-directive methodology called child-centered play therapy with imaginary play as the type of treatment.
The central idea of Child-Centered Play Therapy (CCPT) is that children have an instinctual and irrepressible capacity to deal with challenges by themselves. It is established on concepts in Carl Rogers’ person-centered theory from 1942. Landreth formally defined CCPT in 2012 as “a comprehensive therapeutic system grounded on the belief in children’s resiliency and innate tendency to grow and develop in a self-guiding or self-directed manner.” (Guest, 2018). Because children are so open and receptive to communicating through play, CCPT tends to be one of the most efficient and helpful treatment available to their population. The underlying models of CCPT are trust, safety, and a strong therapeutic relationship; however, how a child feels about themselves and those surrounding them is the primary catalyst in the process of behavior change. The positive, negative, or just off-balanced state of the therapeutic relationship plays a truly vital role in determining how the child feels about play therapy. This can, in turn, have a huge effect on whether play therapy is going to be beneficial or harmful to the child’s growth. Because of this, it is obvious that the counselor needs to exhibit several characteristics for the children in order to maximize the productivity of the play therapy. The counselor should stay in a genuine, consistent, nonjudging, and loving (unconditionally) state of mind so that the child can experience an area of freedom of expression and play. When kids are not being shown these attitudes and expressions, they are much less likely to be engaged in play therapy or motivated to make positive change. Growth is the purpose of play therapy. (Guest, 2018)
CCPT can be highly effective for children who have suffered from abuse, trauma, or learning disabilities. However, it is also quite advantageous for kids who have been diagnosed with autism spectrum disorder or any combination of the aforementioned conditions. The benefits that children in these categories can gain from completing play therapy are as follows: regulating issues regarding emotion, aggression, and attention, improving the self-concept, decreasing unfavorable social habits, and diminishing difficulties with internalizing and externalizing. (Guest, 2018)
The four stages that were created for CCPT are the following: warm-up stage, aggressive stage, regressive stage, and mastery stage. First, The warm-up stage is a time when the counselor and client attempt to get to know each other and to get through all the initial awkwardness. If completed correctly, it is a time where the client discovers that they are going to be safe and secure in this new setting and will be able to express themselves freely without judgment. Essentially, it is the building of good rapport and the launching of a solid therapeutic relationship. Second, the aggressive stage is when the child gets slightly power hungry and wants to be the one with the higher power at all times in the therapeutic relationship. Third, the regressive stage occurs when the child starts to transform back into an infant-like state and desires higher levels of nurturing or mothering type behaviors from the counselor or even people at home that have never been shown those behaviors from the child. Fourth, the mastery stage occurs when the child starts to take concepts or habits from previous lessons and integrate them into the current stage and into everyday life. (Guest, 2018)