What do you see as the most important considerations in treatment related to childhood traumatic grief?

2.Reflecting on the needs grieving children and their families bring to therapy research techniques and interventions that you can use in play therapy.
3.highlighting the connection between the presenting problems and the evidence-based interventions that are best suited for these problems.
Researchers have come to understand that childhood mourning is a normal
process and does not necessarily result in psychopathology and developmental
dysfunction (Oltjenbruns 2001). The experience of loss and exposure
to trauma can affect the childs development in either a positive or a negative
way. Children are resilient and may not have any adverse reactions or
negative behavior changes or the loss may result in psychological distress and
behavioral change.
Understanding the impact of loss in a childs life and developing effective
interventions is the focus of this chapter. In this chapter I present filial therapy
as an empirically validated intervention for the grieving preschool child.
Taking an ecological perspective I focus on the individual within the environment.
Interpersonal relationships community resources and conditions and
the various systems within which the person functions all affect the way in
which he or she copes and problem solves (Collins & Collins 2005). The
childs functioning is then related to the others reactions and the support available
to the child and the family. I begin the chapter with a discussion of developmental
issues and play followed by a discussion of childrens grief. Play
interventions and filial therapy are presented with supporting research and illustrated
by a case study. The chapter ends with suggestions for future directions.
Play Therapy for Preschool Children edited by C. E. Schaefer
Copyright 2010 American Psychological Association. All rights reserved.
Copyright American Psychological Association. Not for further distribution.
Play is an important part ofthe childs life. All children use play therapeutically
as a way of dealing with stress (Elkind 2007) and processing events
in their lives. In a therapeutic playroom the therapist provides a safe place
for the child to play and process life events. The relationship that develops
between the child and the therapist is a critical piece of that process. The
therapist provides the context in which expression occurs. The communication
in the playroom is bidirectional with both the child and the therapist
responding to the interaction.
The child has to depend on the adult to see the need for therapy and
to make the arrangements. However when one is working with grieving or
traumatized families it is difficult to separate the adults experience and
response from those of the child. Some adults in my experience see the
childs response as the same as their own and are unable to differentiate
between the two. Helping the adult to differentiate becomes one ofthe goals
of therapy.
When conceptualizing the interventions for a particular child
there are a number of questions that should be raised. These include the
What is the presenting issue?
How does the family system affect the presenting problem?
What are this childs needs?
Who is going to have the greatest impact on the child?
Which intervention will have the greatest potential to facilitate
Changes in behavior are often the presenting reason. All of a sudden a
child cries easily is clingy shows regressive behaviors or acts out in ways
that are new to this child and are disturbing at home and preschool. For the
preschool child the answers to the second and third questions are determined
through interaction with the family and child and understanding
what brought them to therapy. The answer to the fourth question is often
the parent rathet than the thetapist and one intervention that should be
considered in treatment planning with the preschool child is filial therapy.
Filial therapy provides the opportunity for the parent to become the childs
primary therapist under the guidance of the play therapist. Although still
child centered the intervention uses the attachment bond between parent
and child to facilitate change and provide the context for processing.
The playroom becomes a place where the parent and child will have something
Copyright American Psychological Association. Not for further distribution.
Filial therapy or child-parent relationship training is a theoretically
integrative approach combining elements of psychodynamic humanistic
behavioral cognitive social learning attachment and family systems theories.
However the primary theoretical basis is client-centered play therapy.
Moustakas (1959) in describing relationship therapy saw therapy as a unique
growth expetience created by one person who needs help and another person
who accepts the responsibility of offering it. The parallel in filial therapy is
that it is based on the parent-child bond and the assumption that the parent
has more emotional significance to the child than does the therapist. The parent
and child are developmentally linked and the playroom becomes a place
where they learn and grow together. In his experience Moustakas (1959)
found that parents recognize the significance of their own participation and
are eager to explore their relationship with the child to express their interests
and concerns and to discover new ways of approaching him (p. 169).
My theoretical basedeveloped while studying under Garry Landreth at the
University of North Texas and then in working with Louise Guemeyis
client centered with a psychoeducational group therapy model.
Relational-cultural therapy is related theoretically to filial therapy in that
many of the guiding or core principles are similar. Relational-cultural therapy
is based on a set of core principles that include the following:
people grow through and toward relationships throughout the life