Child-Centered Play Therapy - PowerPoint by iPv3vS9

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									Stopping Child Abuse ... One Child At A Time.
Understand the effects trauma has
on the brain.
Identify how creativity helps the
therapeutic process.
Discover a thinking pattern to
develop your own creative ideas.
Leave with creative interventions
that can be utilized in the future.
Pre-frontal Cortex




                     Hypothalamus
Located in the front portion of the brain.

Is referred to as our “thinking brain”.

Responsible for executive functioning including
forethought, judgment, impulse control,
planning, attention, and organization.

Is the last part of the brain to develop.
Lies beneath the prefrontal cortex and is part of the
“primitive brain”.

The “primitive brain” controls basic instinct and
functions necessary for survival.

Is the center of memory and emotion and therefore
referred to as “emotional brain”.

Involved in instinctive behaviors, basic impulses, and
deep-seated emotions related to survival.
Emotions are predominantly unconscious physical
reactions to threat or opportunity.

Consists of:
  Hippocampus
  Amygdala
  Hypothalamus
  Thalamus
A switchboard for sensory data

It screens, sorts, and pre-processes the incoming
sensory information and relays it to the amygdala
and cortex.
Is responsible for emotional regulation.

Considered our main “sensor” for emotions.

Is the brain’s alarm system which is activated by
any threats, then tags it as “fear” and transmits
information to other brain systems.

Detects an emotional stimuli related to fear and
takes over as the “safety autopilot”.
Located beneath the thalamus.

It’s most important function is to maintain
homeostasis.

Controls autonomic functions to include: release
of hormones, regulation of food and water intake,
and regulation of sleep–wake cycle.
Is the memory indexer.

Controls how memories are stored, organized,
and retrieved.

Connects memories to emotions and senses.
          Thalamus    (receives sensory data)
 All
clear


        Amygdala   (tags fear)

                                 Hypothalamus           (cortisol
                                                 & serotonin)

 Hippocampus        (memory indexer)



        Pre-frontal Cortex       (evaluates experience)
There are two parts:
   Sympathetic- regulates the arousal response and
   increases activity as needed during times of stress. It
   prepares us to meet the actual or perceived threat.

   Parasympathetic- induces relaxation and helps the
   body become balanced after periods of high arousal. It
   provides a feeling of contentment and pleasure and is
   activated when we are relaxed, quiet, or asleep.

The Parasympathetic and Sympathetic Nervous Systems
are designed to function in a way that maintains a balanced
state of being.
Sympathetic=Reactive=Stress=
        Diminished Functioning=Limited Choice

If a person is functioning in Sympathetic Dominance there is:
   Fight or flight response
   Chronic muscle tension
   Increased threat perception or hypervigilance
   Diminished brain function
   Loss of language and speech
   Intimacy intolerance
   Similar mistakes are repeated
   Incongruent emotional reactions
Parasympathetic=Intentional=Comfort=
   Optimal Functioning=Choice

If a person is functioning in parasympathetic dominance
there is:
   Muscle relaxation and comfort
   Problems are seen as challenges
   Mobility in decision-making capacity
   Optimal motor and cognitive skills
   Intentionality or internal locus of control
   Emotional and behavioral self-regulation
   Intimacy tolerance
   Creative problem solving
“Successfully stored” traumatic memory
          Thalamus    (receives sensory data)
 All
clear


        Amygdala   (tags fear)

                                 Hypothalamus           (cortisol
                                                 & serotonin)

 Hippocampus        (memory indexer)



        Pre-frontal Cortex       (evaluates experience)
Sometimes the transition of a traumatic experience
into the memory is disrupted among people suffering
from PTSD symptoms.

As a result the event is repeatedly experienced as if it
is occurring in the present.

The memory is not stored as a verbal memory that
occurred in the past.
When your brain is in sympathetic dominance a false
alarm is happening, the prefrontal cortex is skipped
and the memories of the event become foggy and are
stored erratically in the hippocampus.

Sympathetic Dominance

http://www.youtube.com/watch?v=HnbNcQlzV-4
Thalamus   (receives sensory data)
Explicit-
   Involve the conscious recollection of facts, memories, events,
   and ideas.
   Language allows for the verbal communication of these
   memories
Implicit-
   Memories are generally unconscious.
   Stored as senses, sensations, emotions, moods, images,
   pictures, metaphors, and actions.
   Traumatic experiences are initially implicit.
   A trauma memory is mainly sensory with limited language.


Trauma is what we experience, not what we know,
understand, or can comprehend.
          Thalamus    (receives sensory data)
 All
clear


        Amygdala   (tags fear)

                                 Hypothalamus           (cortisol
                                                 & serotonin)

 Hippocampus        (memory indexer)



        Pre-frontal Cortex       (evaluates experience)
Repeated exposure to trauma leads to a change in
overall brain structure, function, and chemistry.
When people remain in Sympathetic Dominance the
following have been shown to occur:
  A volume reduction of the hippocampus
  The hippocampus has difficulty in storing and recalling
  information
  The hippocampus has difficulty forming new memories.
  The pre-frontal cortex is skipped and executive functioning is
  suddenly rendered functionless, then the primitive brain rises
  in activity.
  The amygdala enlarges and becomes hyperactive
  The hypothalamus repeatedly excretes stress hormones which
  makes it difficult to distinguish between danger and safety.
The combination of the disturbances in the functioning of the
amygdala, hippocampus, and prefrontal cortex explain the reason
as to why the memory is continually experienced for years and
easily aroused by triggers and emotions that are difficult to
describe in words.

The perception of the threat and the actual threat is what puts a
person in Sympathetic Dominance.

Perception is influenced or changed by the brain structure and
chemistry.

The stress reaction can be seen as a conscious reaction; however
it is an automatic survival response.
Trauma affects you cognitively,
behaviorally, socially, and emotionally.



These reactions are survival reflexes.
Behavioral             Social                    Emotional             Cognitive
Aggression or Overly   Difficulty making and     Irritability          Difficulty recalling
Submmissive            keeping friends                                 information
Impulsive acts         Difficulty following      Hopelessness          Not completing tasks
                       rules                                           assigned
Defiance               Difficulty adjusting to   Shame                 Flighty thoughts or
                       social interactions                             disorganized thought
                                                                       patterns
Lying, stealing,       Difficulty trusting       Guilt                 Struggle to accept
cheating               others                                          responsibility for
                                                                       process triggering
                                                                       event
Hyperactivity or low   Become isolated due       Extreme worry         Indecisive
energy                 to constant intense
                       emotions
Increase or decrease   Isolates themselves       Fearful               Intrusive memories
in appetite or         to gain control of                              and flashbacks
restricted eating      their internal state
Poor sleeping          Vulnerable to re-         Emotionally numb
patterns               victimization
Promiscuity                                      Dissociation

Self-injury                                      Mood swings
Poor hygiene                                     Incongruent
                                                 emotional reactions
Creativity- the ability to approach an object or situation
from an alternative perspective.

Creative Counseling- counseling that incorporates the
expressive arts in order to help access, give form to, and
understand experiences, memories, and emotions.

Types of Expressive Arts:
   Art (paint, draw, sculpt)
   Dance or movement (yoga)
   Music
   Poetry/Journaling
   Drama
   Photography
   Guided Imagery
An adult’s pre-frontal cortex is better developed
which can hinder creative thinking.

A child’s underdeveloped pre-frontal cortex
makes them less likely to have rigid thinking
patterns thus allows for a more natural creative
expression.

This limitation can be used as a strength to
promote creativity.
Creative interventions must influence the limbic system in
order to access sensory experiences (implicit memories)
that then can be converted to explicit memories by
providing understanding and verbal language to the
experience.

Having both an implicit and explicit memory of the
experience allows for an integrated connection between
senses, images, behaviors, affect, and meaning.

In this process the memory is now stored successfully
because it was given language and now can be accessed as
a past experience and a resource for future challenges.
Children’s ability to process experiences at a
sensory level helps facilitate the shift from
Sympathetic Dominance to Parasympathetic
Dominance.

Through creative interventions children are better
able to self-regulate and self-soothe.
Using creative interventions is a powerful tool which
provides benefits including:
  Helps capture and maintain interest and motivation in the
  counseling experience.
  Allows for an accepting, respectful, and safe environment
  Helps gain mastery through senses
  Allows the processing of the traumatic experience to be
  contained and not become overwhelming
  Inspires creative problem solving
  Promotes feeling identification
  Makes the unconscious conscious
  Supports emotional and behavioral self-regulation
  Promotes arousal reduction
  Appears less threatening or intimidating with special
  populations.
Potential obstacles to utilizing creative interventions
include:
  Cost of materials and supplies
  Not perceiving self as creative/artistic
  Self-conscious or a fear of judgment on abilities
  Hesitation of going outside of the box of traditional talk
  therapy
  Concern about having less control of the session in regards to
  the unpredictability of the results
  Time for the prep and cleanup
  Reluctant clients
Ways to overcome obstacles of creativity:
  Pay attention to the client interests
  Create a predictable and safe environment for the child
  Be enthusiastic for the creative intervention
  Pace the session based on the child’s developmental level,
  engagement in therapy, and ability to manage arousal
  response
  Allow for spontaneity and flexibility
  Outline instructions of the intervention clearly
  Recycle or reuse generic materials
  Practice interventions and participate in supervision
  Trust the creative process!
Don’t limit yourself by negative thinking. “I’m not a good artist”
Do invite clients of any age to exercise their creativity
Do seek supervision, research, and consult on the
appropriateness and effectiveness of the method
Do ask clients to try only those activities for experiences that you
feel comfortable with experiencing
Do be aware of the depth that the creative process may lead to
the client to experience
Do tie creative interventions to evidence-based practice
Do seek out resources
Don’t judge or assess clients work
Don’t force the client to create if they are not ready to or are
invested
Don’t underestimate your own creativity and ability to develop
creative interventions
                                                      (Shallcross, 2011)
 For additional information
about topics discussed today,
please feel free to utilize the
 reference list and Creative
   Interventions Catalog.
The body as a resource. (2010, August). Retrieved from
    http://www.tlcinstituteonline.org/courses/mod/resource/view.php?id=203.
Bowirrat, A., Chen, T., Blum, K., Madigan, M., Baily, B., & Lih Chuan Chen, A….
    (2010). Neuro-psychopharmacogentics and neurological antecedents of
    posttraumatic stress disorder: Unlocking the mysteries of resilience and
    vulnerability. Current Neuropharmacology, 8, 335-358.
The biology of trauma. (2012). Retrieved from http://www.natal.org.il
Campbell, J. (2012, April). Trauma and the brain. Healing Magazine.
Conger, K. (2007, July). Severe trauma affects kids’ brain function,
    sayStanford/Packard researchers. Retrieved from
    http://mednews.stanford.edu.
Corbett, H.C., (2009, March). Project (E)motion. Fitness Magazine.
Gantt, L., & Tinnin, L.W. (2009). Support for a neurobiological view of trauma with
    implications for art therapy. The Arts in Psychotherapy, 36, 148-153.
Interventions. (2010, August). Retrieved from
    http://www.tlcinstituteonline.org/courses/mod/resource/view.php?id=219.
Kendall, J. (2002, September). How child abuse and neglect damage the brain.
    The Boston Globe.
Lowenstein, L. (2010). Creative interventions for children, youth, and families.
   Retrieved from
   http://www.insswa.org/Newsletter/Creative_Interventions_for_Children_and_Fa
   milies.pdf
Lowenstein, L. (2010). Favorite therapeutic activities for children, adolescents, and
   families: Practioners share their most effective interventions. Retrieved from
   http://www.lianalowenstein.com/e-booklet.pdf
Korlin, D., Nyback, H., & Goldberg, F. S. (2000). Creative arts groups in psychiatric
   care: Development and evaluation of a therapeutic alternative. Nord J
   Psychiatry, 54(5), 333-340.
Pretorius, G., & Pfeifer, N. (2010). Group art therapy with sexually abused girls.
   South African Journal of Psychology, 40(1), 63-73.
Raider, M.C., Steele, W., Delillo-Storey, M., Jacobs, J., & Kuban, C. (2010).
   Structured sensory therapy (SITCAP-ART) for traumatized adjudicated
   adolescents in residential treatment. Retrieved from http://www.tlc.org.
The roots of trauma. (2008, August). Retrieved from
   http://www.tlcinstituteonline.org/courses/mod/resource/view.php?id=201.
Schimmel, C.J., & Jacobs, E. (2011). Ten creative counseling techniques for
    helping clients deal with anger. Retrieved from
    http://counselingoutfitters.com/vistas/vistas11/Article_53.pdf
Shallcross, L. (2011, February). Working outside the box. Retrieved from
    http://counseling.org
Shen, Y., & Armstrong, S. A. (2008). Impact of group sandtray therapy on the self-
    esteem of young girls. The Journal for Specialists in Group Work, 33(2), 118-
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Shonkoff, J.P., & Garner, A.S. (2012). The lifelong effects of early childhood
    adversity and toxic stress. The American Academy of Pediatrics, 129(1), 233-
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Talwar, S. (2007). Accessing traumatic memory through art: An art therapy
    trauma protocol (ATTP). The Arts in Psychotherapy, 34, 22-35.
Trauma as an experience. (2010, August). Retrieved from
    http://www.tlcinstituteonline.org/courses/mod/resource/view.php?id=213.
Van Der Kolk, B. (2006). Clinical implications of neuroscience research in PTSD.
    New York Academy of Sciences, 13(1),1-17.

								
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