Lying and Stealing: Whose Problem Is It?

(See link at end of article for printable .PDF with photographs.)

When children present in play therapy with developmentally age-appropriate problems, parents' reactions can sometimes exacerbate the problems. While children need good therapeutic care, and their behaviors may need attention and limit-setting, it is also essential to help parents grasp the larger context of their children's states. Parents' understanding can reduce their reactivity and help prevent scapegoating of children. Furthermore, attention to root-level problems helps parents to gain insight into how their own life issues are stirring up, and how their growing awareness will benefit the child. Daniel Siegel referred to such holistic mindfulness on the part of parents as "mindful parenting" (Siegel & Hartzell, 2003). The following case study demonstrates how Mindfulness Based Play-Family Therapy (MBPFT) integrates play therapy, family therapy, mindful parenting, and child development theory (Higgins-Klein, 2013).

Case Study - The Child and His Family

Nathan, now eight years old, had been coming to therapy for the past three months because of his anxiety. Though both parents dated Nathan's anxiety back to his infancy, they had not reached out for help until his dishonest behaviors emerged at age eight. His school referred him after he stole candy from another child's backpack. Prior to this event, his parents had been afraid to get help for Nathan because they worried that having therapy might label him. During the initial four-session evaluation with the parents, I learned background information. Nathan was biting his nails, pulling out his eyebrows, and having difficulty expressing feelings. Nathan's mother, Sarah, had suffered anxiety all of her life and also bit her nails, while his father, Alex, was more laid back at home, despite his high-pressured job. They conceived Nathan after a year of medical interventions to assist conception. As the only child in the family, he received a lot of caring attention from his parents. I learned from the developmental history that he had seemed anxious even as an infant, when he would not sleep during the day and wanted to be held most of the time. His mother had intended to return to work when he was six months old, but believed that no one would be willing to give such a fussy baby the care that she gave him. She postponed her career until he was three years old. During that time, she found that she was happy staying home.

An Excerpt from Mindfulness-Based Play-Family Therapy: Theory & Practice, by Dottie Higgins-Klein (Norton, 2013)[Click here to read more excerpts and reviews on Amazon.]

Talk Time is a 15- to 20-minute meeting prior to each play therapy session. Together with the therapist, the parent and child address what is going well for the child and the family as well as one or two of the specific symptoms or behaviors motivating the therapy. It can be conducted using any of various clinical approaches, such as family therapy, behavior therapy, or cognitive therapy. It may include role playing, advocating for the child, or reframing negative behaviors. Sibling sessions or parenting support in context may also play a part...

One goal of every Talk Time meeting is to help children and parents increase their competence in intersubjective relating; this emerges through intentional efforts at honest verbal expression of feelings and thoughts.The parent acts as a model in constructive communication by using empathic "I" messages and avoiding judgmental "you" messages. The child learns to express herself in an authentic way and gains the benefit of feeling understood by her parents. Of most importance, this experience focuses not only on the child's problems but also on the parent's behaviors and responses. The mindful parenting approach means that the parents discuss with their child insights about how they are sometimes disappointed with their own parenting actions.Such efforts at communication by both children and parents make the intersubjective experience reciprocal. As parents and children use these skills more regularly, a major change may occur within the parent-child relationship.Daniel Stern (2004) points out that recounting past events or anticipating future ones can have all the benefits of a "present moment" experience. "If the present moment is not well anchored in the past and future it would float off as a meaningless speck" (p. 28). "Even the telling of something that happened is actually happening now. Telling is a now experience, even though it refers to a present moment that occurred in the past. We also have anticipations about the future, but these too are being experienced now. (p. 23)

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Mindfulness-Based Play-Family Therapy: Theory and Practice "is about helping children to heal from emotional suffering and to change the behavioral problems that accompany that suffering. It is also about the collateral healing that can occur in the family system of the child in treatment. These healing events arise from techniques derived from the rich fields of early child development theory, play therapy, family therapy, and interpersonal neurobiology, all combined within a framework grounded in mindfulness. This framework is what we call Mindfulness-Based Play-Family Therapy (MBPFT)."

An Excerpt from Mindfulness-Based Play-Family Therapy: Theory & Practice, by Dottie Higgins-Klein (Norton, 2013)[Click here to read more excerpts and reviews on Amazon.]

"Key to Mindfulness-Based Play-Family Therapy is the therapist's attunement with the child, which is based on establishing a space of unconditional presence where the emotional and somatic conditions of the child are free to unfold from their confinement and be transformed. Ideally, this joint experience nurtures the growth of trust, allowing the child to feel, 'I am okay for being me, as I am in my core self.' There is an appreciation of the crucial value of allowing silence to be interspersed with mindful speech, as well as an awareness of nonverbal body cues."

"An essential principle of MBPFT philosophy is that - as much as clinically possible -- the playroom is preserved as a 'pretend' space during play therapy time... The therapist often engages in subtle reflection of the child's words and experiences. This sensitive skill is a crucial element in the practice. The play-family therapist also allows for natural moments of silence, knowing that profound healing can occur in the meditative gaps within the play."

"Talk Time is a fifteen- or twenty-minute meeting prior to each play therapy session to develop inter-subjective communication. During this time, parent and child together address both what is going well for the child and family, and one or two of the specific symptoms or behaviors that are motivating the therapy... MBPFT does not focus solely on the child's problems but also attends directly to the family relationships."

Mindfulness-Based Play-Family Therapy: Theory and Practice "is about helping children to heal from emotional suffering and to change the behavioral problems that accompany that suffering. It is also about the collateral healing that can occur in the family system of the child in treatment. These healing events arise from techniques derived from the rich fields of early child development theory, play therapy, family therapy, and interpersonal neurobiology, all combined within a framework grounded in mindfulness. This framework is what we call Mindfulness-Based Play-Family Therapy (MBPFT)."

An Excerpt from Mindfulness-Based Play-Family Therapy: Theory & Practice, by Dottie Higgins-Klein (Norton, 2013)
[Click here to read more excerpts and reviews on Amazon.]

"Each individual starts and develops and becomes mature; there is not adult maturity apart from the previous development. This development is extremely complex, and it is continuous from birth or earlier right up to and through adulthood to old age. We cannot afford to leave anything out, not even the happenings of infancy, not even those of very early infancy." -- D. W. Winnicott, 1965

"When a child comes for therapy, his current situation is the product of his experience of life to that point. His development has been influenced by the reverberations between his changing developmental needs at each stage and the assets and deficits of his caregivers' responses, all evolving within the long-established emotional climate of the family. Because treatment starts with exploring the causes of the child's current problems, we begin our elucidation of MBPFT with an overview of early childhood development." (p. 1-2)

"When therapists have an adequate grasp of theory, they sense where, in the child's past, the necessary stages of growth were complicated by neglect, abuse, medical trauma, genetics, ignorance, or untimely family circumstances, resulting in the child's emotional or behavioral problems. The therapist forms a treatment plan based on an understanding of how essential needs that were unmet earlier may be revisited and satisfied well enough to reestablish true developmental balance. It is equally important to acknowledge how family members have nurtured healthy development in their children. An additional goal for the therapist is to give parents explicit information that will help them understand the connections between a child's early history, past family pain and traumas, and the present situation." (p. 2)

An Excerpt from Mindfulness-Based Play-Family Therapy: Theory & Practice, by Dottie Higgins-Klein (Norton, 2013)[Click here to read more excerpts and reviews on Amazon.]"Mindfulness-Based Play-Family Therapy (MBPFT) has developed from the experience and insights of mindfulness meditation. The pivotal element of MBPFT is what happens in the "Deeper Awareness" stage of play therapy,  when the child is offered a space to enjoy predominantly right brain function and relax her "busy mind." As her experience reaches a state comparable to mindfulness meditation, profound healing can occur. This book describes what happens in the therapist-child relationship and how to maximize the healing potential of this process." (p. xix)

"There is abundant research on the efficacy of mindfulness, including work led by Kabat-Zinn at the Stress Reduction Clinic at the University of Massachusetts Medical School. His writing has disseminated information about this ancient Buddhist method of meditation to a wide spectrum of people, who are learning to use it to reduce stress in everyday life. Mindfulness allows for healthier living in body, mind, and relationships. It is accessible to everyone, not just to those who think of themselves as spiritual...In the presence of a mindful therapist, a child can achieve this state in play therapy." (p. xix-xx)

"Healing occurs when the therapist and child together descend into their respective places of inner stillness. Sometimes the child's play looks somewhat mad, foolish, angry, or desperate; but this, too, can arise from the sacred stillness. The child's feelings may reflect the source of the powerlessness at the root of her trauma. The therapist learns just the right moment -- not too soon and not too late -- to mirror those powerless feelings. The only way out is through." (p. xxii)

"The therapy model described in this book has been practiced and taught since 1995 at the Family and Play Therapy Center, in Philadelphia. We provide therapy to clients of all ages. Our summertime week-long courses and year-long monthly certificate courses offer extensive training for graduate and post-graduate level therapists in Mindfulness-Based Play-Family Therapy, Contextual Family Therapy, and Sandtray Training. We also host Advanced Seminars presented by authors in these fields. Students earn professional credentials, and can also fulfill their requirements for education credits. Participants in the courses include therapists at the start of their careers as well as those who have a lifetime of experience." (p. xxiii)

"The breadth of this community makes the class dialogues richly rewarding. This community is further enriched by the national and international makeup of the group. The Center's IT department has designed our own state-of-the-art online system,called iLOC - "interactive, live on line classroom" -- that connects the classroom in Philadelphia with therapists anywhere in the world. Participants see and hear the live presentation, and are able to join into the class dialogue as it is happening. Our classes have included participants from across the United States - including Alaska and Hawaii -and from around the world- including Mexico, Ireland, the U.K., the Netherlands, Russia, India, Japan, Australia, and New Zealand. In order to foster this multi-cultural element, and wanting to extend economic fairness to all, we have a directory of geographical discounts that range from 20% to 75%, depending on the full-time residence of the student whose professional credentials meet the requirements of his or her country." (p. xxiii)

An Excerpt from Mindfulness-Based Play-Family Therapy: Theory & Practice, by Dottie Higgins-Klein (Norton, 2013)[Click here to read more excerpts and reviews on Amazon.]"At a time when so many families are deeply challenged, Dottie Higgins-Klein offers a wise, robust, and beautiful way of healing for all family members in Mindfulness-Based Play-Family Therapy: Theory and Practice. This way of being present to families developed slowly during her 30 years of clinical practice and clinician training at her Family and Play Therapy Center in Philadelphia. For the last 12 years, she has devoted much attention to this manuscript - building, refining and deepening as she continued her work with children, teens, parents and others close to the family. At the same time she was offering trainings to over 2000 clinicians in the art and science of family healing, raising her children, and engaging in her own healing process as well. These four viewpoints - clinician, mentor, parent, and developing human being - inform every page of this powerful book." (p. xi)Referring to David Brooks (NYTimes, op-ed) column 2012 concerning the ACE study with 17,000 participants, Bonnie notes: "As Brooks concludes, perhaps it is time for all areas of society to realize that we need to focus our efforts on healing the injuries that have already happened and move toward preventing additional wounding if we want to set our feet on a healthy course. Higgins-Klein offers well grounded, clear, and deeply caring steps along this way." (p. xii)"It is a particular joy to enter the playroom with Higgins-Klein and a young one. Throughout the book, she draws a parallel between imaginary play and meditation, both of them right-centric experiences of being in the moment with what is. She says, 'When a child is ready for the inner freedom that comes with letting the busy mind turn off, he will lead himself to the heart of the matter that needs reworking or healing.' And the therapist will be right there, mindfully and with wisdom, accompanying him or her along this healing inward arc." (p. xii)