Many years ago, while working towards my Bachelor of Social Work degree, I learned to NOT volunteer for public role play exercises.  “Why?”, you ask.  Well, inevitably it would turn in a direction that I really was not prepared for.  I was caught off guard and, therefore, I missed the opportunity to carefully consider my responses—feeling vulnerable and exposed.   As I became a more seasoned clinician, a ready response came more easily AND I continued in my established pattern of self-preservation. 

            Fast forward 25+ years. In 2019, I became a Registered Play Therapist.  In March 2020, I was introduced to and began a deep dive into incorporating digital tools in my play therapy practice.  In fact, it has become a passion! Through this journey of professional growth, I have also been exposed to an unexpected personal growth.  There may be more, but I attribute this shift to two primary factors: 1) healing properties of play and 2) felt safety among colleagues and friends.

Notice the picture above—one side is very tidy, while the other is very messy with a plethora of items on the floor.  These past several months I have had the opportunity to receive training in the therapeutic use of Virtual Reality.  Each training has given me a different, yet equally powerful take-away message.  In the most recent training, we utilized and discussed two games from the perspective of multi-sequential tasks and learning:  Job Simulator and Vacation Simulator.  Clinician hat on and learning brain activated—check. Well, until it wasn’t.  almost immediately my clinician hat and learning brain were replaced; instead, I was a person fully immersed in an unfamiliar setting, attempting to navigate surroundings.  I quickly became frustrated.  I could hear the tantalizing sound of the coffee pot; yet, after multiple attempts, I could not figure out how to dispense the coffee.  The more I looked around, the more things deeply resonated.  Finally, I gave up!  In fact, I became somewhat defiant—throwing things on the floor, putting my head in the copy machine to see if it would actually work (IT DID!!), randomly pushing all the buttons—trying to make sense of SOMETHING.  I quit….again—abandoning the job for a vacation.

Just a game, right? How is it possible that all of my senses could feel like I stumbled into the virtual version of my life??  On the surface, play seems like ‘just play.’ However, when considering the Therapeutic Powers of Play, it is so much deeper than that! For years, play therapists have been advocating for the profession; declaring “WE NEED MORE PLAY!  PLAY HEALS!”  So much so that, at times, I am baffled by the dichotomy.  We have fought so ardently for play therapy to be a recognized and respected modality and, yet, the acceptance of digital play can seem elusive.  In terms of traditional and digital play therapy, one does not replace the other—it is a both-and.  The goal is not for every play therapist to utilize every modality of play, including digital.  Instead, the hope is that we, as a play therapy community, will at least widely entertain the potential and acknowledge the benefits of Digital Play Therapy^TM. We owe it to ourselves, our clients, and our profession to be interested enough in the client’s world, and all it entails, to give consideration —even if it means making referrals.

Fiona Hill is a Licensed Professional Counselor-Supervisor and a Registered Play Therapist in the state of Missouri. She currently works in a group practice as a children-family therapist specializing in working with childhood trauma, attachment disruption, as well as families impacted by varying developmental needs within the family system. In addition, she has a sub-specialty of incorporating digital tools into therapeutic practice. Find more information about Ms. Hill here: https://fionahilllpc.com/

The post Stumbling Into My Life: first appeared on Jessica Stone, PhD, RPT-S.

An interview with Richard Hill of the Science of Psychotherapy https://www.thescienceofpsychotherapy.com/dr-jessica-stone-talks-about-virtual-therapy-tools/?fbclid=IwAR3g1q0a4rZoXeINXDrNHgrBUW0ERqH8uWt1e-Iup0djs2n6dOopZ1jWIfM

Check out their site – it is chock full of information! https://www.thescienceofpsychotherapy.com

The post Virtual Therapy Tools first appeared on Jessica Stone, PhD, RPT-S.

Check it out here: https://www.psychotherapy.net/interview/jessica-stone-on-play-therapy!

The post Play Therapy in the Digital Age first appeared on Jessica Stone, PhD, RPT-S.

By Fiona Hill, LPC, RPT

The Story

Feeling or being ‘stuck’ is difficult. ‘Stuckness’ can look and feel differently, depending on who you are talking to.  Personally, a common theme has been that I want to run away.  Seemingly, life starts to close in around me and breathing can become very difficult.  Then, my focus is how to get out of the situation as quickly as possible. 

Lately, I’ve been working to improve my Minecraft skills…not to perfection, but to the point I’m not bogged down by the mechanics.  At first, practicing Minecraft wasn’t really something I wanted to do.  Honestly, I would often find the game so frustrating and overwhelming that I clearly avoided playing.  However, I really felt drawn to the game for a couple of reasons: 1) In hearing other clinicians talk about it, I knew that there can be lots of therapeutic value 2) many of my clients talk about, play it, and are very drawn to the game and 3) I really do like a challenge—the best way to get me to do something is to tell me I can’t.  So, I started slowly:  googling how to work various mechanics; watching YouTube videos; informally playing with colleagues and friends; then, as I became more comfortable I began to play more on my own and ‘try things out.’  For me, a turning point away from avoidance of direct play was in playing with a colleague who had graciously volunteered to give me a Minecraft ‘lesson.’  It was described as a ‘sandbox game.’  You mention anything sand related and there is an automatic connection for me.  However, that wasn’t even really the most impactful.  I was getting a tour of the amazing realm, and we were about to cross over some very high planks.  Even though we were playing ‘just a game,’ my fear of heights kicked in and I was immobilized-stuck.  My chest became tight and I’m pretty sure I stopped breathing in that moment.  My colleague’s avatar graciously carried my avatar across the planks.  Immediately, I felt relief.  I felt safe. Now, I was ready to more deeply explore Minecraft, both as a game and as a therapeutic tool.

A few days ago I was playing Minecraft, and found myself stuck underground. It was dark. There was a tightness in my chest because I couldn’t see my way out. I literally turned my avatar in circles and all I could see was pitch black. I wanted out; so, I turned the game off.  Went back another day…same thing. The next day…same thing. Today was different, though. I went into my ‘world’ and I was stuck. My avoidance had served me well—I had forgotten about my situation.  I was more than slightly irritated.  I mentioned to friends that I was stuck in Minecraft and my exact words were ‘I just turned on my Minecraft world and remembered I’m STUCK and haven’t been able to get out…so I just keep turning it back off……#Iwillgetout.’ As I’m turning looking for a way out, I remember ‘OH! I can use a lantern for light!’ Within a matter of a minute or so I was back out into the daylight. I could see the house I had built, and the tightness in my chest was gone.

Clinical Application

What I shared above is a personal experience.  If I were to sum up my experiences in two words, they would be co-regulation and resilience.  Looking at my personal experience through a clinical lens, there are many opportunities for therapeutic work.  The same can be said for many, if not all, of our clients with whom play therapy is our mode of treatment.  Play therapy is more than ‘just play,’ whether it is traditional or digital.  How powerful it can be to immersively partner with clients in providing co-regulation and building resilience through the use of digital tools—and these are only a small glimpse into the therapeutic possibilities! 

Fiona Hill is a Licensed Professional Counselor-Supervisor and a Registered Play Therapist in the state of Missouri.  She currently works in a group practice as a children-family therapist specializing in working with childhood trauma, attachment disruption, as well as families impacted by varying developmental needs within the family system.  In addition, she has a sub-specialty of incorporating digital tools into therapeutic practice.

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By Lesley Simpson-Gray

I’ve found that creativity often comes when I’m looking for ways to solve a problem or bridge a gap.  The issue for me this year is that I’m super-excited about the future applications for the Virtual Sandtray®© (VSA) and virtual reality (VR), but I’m yet to put together a plan (and a budget) for the hardware that would make this happen.  Sadly for me, COVID-19 marked the start of my journey into telehealth and online therapy and I was yet to discover VSA when I purchased a new iMac this year.  My current hardware easily supports my passion for creating digital art, however I doubt it will enable me to have a full-scale adventure into the world of VR and gaming.  However, the benefit of this dilemma is that I can empathise with the therapists I support, who also need to find effective and inexpensive ways to bring creative, online interventions into their practice. 

Therapists who come to my training days often struggle to visualize what it means to combine VSA, VR, and ‘getting into your own sandtray’.  It has become more important than ever to help them understand how VSA promotes ‘cultural competence’ (Stone, J. 2020) and how they can use to an online sandtray to develop deeper, more immersive experiences through digital play therapy. 

I’ve been really inspired by the way that therapists can interact with their online clients through the background images they create on a green-screen.  By allowing myself to be curious and playful, I began to wonder what it would be like to download a video of a VSA sandtray as a background, and interact with the image.  Fortunately, the large, animated dragon in the video was very obliging and sat perfectly still while I looked back and forth in amazement between the image and my screen! 

I love using the camera in VSA to create different perspectives, but a life-size dragon immediately transported me to a place where I could focus on the experience of interacting with it, instead of controlling the camera.  It became far easier to imagine what it would be like to ‘meet’ an actual dragon whilst sitting way too close to a landscape of hot lava.  

I love how I’m suddenly more aware of my fear and excitement.  I’m looking forwards to helping my clients to create sandtrays using camera positions and dimensions which allow us to further explore their images as backgrounds on a green-screen.

I’m happy that I can apply some new skills and flexibility to find a fun and an exciting way to support other therapists on their journey towards achieving competence, cultural awareness, and comfort in their online practices (Stone, J. 2020).  However, I’m also left with my original dilemma – I’m more excited than ever to pursue my interest in bringing VR technology into my practice and bridge the gap between my current hardware and the technology I’ll need.  I’ll just have to imagine (for now) about the creative VSA interventions I’ll discover once I invest in a VR-ready pc and headset! 

For more information about digital play and Digital Play Therapy, see Stone (2020). 

References:

Stone, J. (2020). Digital play therapy: A clinician’s guide to comfort and competence. Routledge.

Lesley Simpson-Gray is based in the UK and has worked in private practice for nearly 4 years, since qualifying with a Postgraduate Diploma in the Therapeutic Application of the Arts and an MA in Integrative Child Psychotherapy.  She is commissioned to provide therapeutic life-story work and psychotherapy for her local authority post-adoption teams and accepts referrals from private clients and primary and secondary schools across 3 counties.  

Lesley has worked exclusively online since March 2020 and enjoys the challenge to find new and creative ways to use digital interventions and images in her practice.  She has recently launched her Cyber-Creative Confidence Challenge, a 6-week programme to support creative arts counsellors and psychotherapists to develop confidence using online interventions and feel comfortable engaging with their clients.  

LinkedIn: https://www.linkedin.com/in/lesleysimpsongray/

Facebook: https://www.facebook.com/Cybercreativetherapy

Website:  https://www.lesleysimpson-gray.com

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By Jessica Stone, Ph.D., RPT-S

            Storytelling has a rich, vast history. Passed down from generation to generation, stories have informed, taught, warned, expressed, and so much more. Utilizing storytelling in therapy has been highlighted in everything from narrative therapies to play therapy to bibliotherapy. When integrating storytelling into therapy it is important to have a variety of ways for the client to express themselves.  People are different, their stories are different, and how they tell their stories should respect and reflect such differences.

“Each individual owns their own story, and any effective helper knows this” (Lyons, 2019, para 4).

Storytelling 

Storytelling describes the social and cultural activity of sharing stories, sometimes with improvisation, theatrics or embellishment. Every culture has its own stories or narratives, which are shared as a means of entertainment, education, cultural preservation or instilling moral values  (Wikipedia, 2020, para 1).

Storytelling predates writing. The earliest forms of storytelling were usually oral combined with gestures and expressions. In addition to being part of religious rituals, some archaeologists believe rock art may have served as a form of storytelling for many ancient cultures.^[2] The Australian aboriginal people painted symbols from stories on cave walls as a means of helping the storyteller remember the story. The story was then told using a combination of oral narrative, music, rock art and dance, which bring understanding and meaning of human existence through remembrance and enactment of stories.^[3] People have used the carved trunks of living trees and ephemeral media (such as sand and leaves) to record stories in pictures or with writing. Complex forms of tattooing may also represent stories, with information about genealogy, affiliation and social status.^[4]

With the advent of writing and the use of stable, portable media, stories were recorded, transcribed and shared over wide regions of the world. Stories have been carved, scratched, painted, printed or inked onto wood or bamboo, ivory and other bones, pottery, clay tablets, stone, palm-leaf books, skins (parchment), bark cloth, paper, silk, canvas and other textiles, recorded on film and stored electronically in digital form. Oral stories continue to be created, improvisationally by impromptu storytellers, as well as committed to memory and passed from generation to generation, despite the increasing popularity of written and televised media in much of the world.

 (Wikipedia, 2020, para 3-4)

Sand Storytelling

            Telling stories in safe, non-threatening, projective, creative, even non-verbal ways can be important parts of mental health treatment.  Sand therapies (tray and play) can allow clients to express both conscious and sub-conscious experiences, concerns, self-and other- perceptions and so much more.  Many sand therapists utilize their sand tools to allow the space and environment for people to express such stories.  Some have even formalized the process, such as Lara Kazsa and her SandStory Therapy® technique. “SandStory Therapy® is a gentle and safe way of working therapeutically with sand and symbols within a contained sandtray that offers clients the opportunity to tell their ‘story in the sand’.” (Kazsa, 2020, para 5).

Virtual Sandtray Storytelling

            The Virtual Sandtray allows clients to access the powerful process of sand therapies both in person and via telehealth.  This tool expands the traditional sand therapies to include digital native’s culture, interests, and knowledge, while also expanding the ways one’s world can be depicted.  Want to have a dragon who can fly?  A house that is levitated/floating? A forboding sky or lava under the surface?  You can do all of this and more in the Virtual Sandtray.

            One technique – Virtual Sandtray Storytelling – can be used in person and via telehealth in the remote feature.  Starting with an empty tray of sand, the person chosen to go first (either the client or therapist in individual therapy or different members of a group or family) chooses 5  models (miniature/item/symbol, etc.) and buries them in the sand.  The other person looks away.  When all 5 are buried, the other person re-engages and looks for the items by digging in the sand.  Once all 5 items are found, the person then tells a story about the items.  This is then repeated by the next person and so forth.  The number of items can be altered, especially for younger children, as needed and appropriate per the client’s needs. Advanced VSA Storytelling includes changing the liquid layer and/or skybox to add an additional mood element for the person to incorporate into the story. 

Have fun!

References

Kasza, L. (2020). What is Sandstory therapy? https://www.larakasza.com/sandstory-therapy

Lyons, J. (2019, July). One person, one story, one CANS/ANSA. https://tcomconversations.org/2019/07/17/one-person-one-story-one-cans-ansa/

Wikipedia (2020, December). Storytelling.  https://en.wikipedia.org/wiki/Storytelling

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Escape for a moment to your island oasis, your own magical, connecting space for solace and replenishment. Animal Crossing is a Nintendo game available on the Switch console. While the game has been around since 2001, the latest edition, New Horizons, surfaced at the start of social distancing and quarantine orders during the coronavirus pandemic in March 2020. The game grew rapidly in popularity, as it provided many with entertainment and connection during a time of isolation, uncertainty, and panic. The purpose of the game is to design and build your own island. Various daily tasks help your island slowly advance, while you spend time enjoying quiet life with your adorable animal residents that populate your island. Friends can also visit your island from afar, allowing you to spend quality time in this virtual space together. 

I began playing the game in May 2020. It grew to become one of my primary self-care spaces through the coronavirus pandemic. Several other dear play therapist friends and colleagues also chose to spend quality self-care time in this game, which afforded us the opportunity to regularly connect, play, and both escape and process the mental and emotional toll that the pandemic had on us as mental health providers. 

As a Registered Play Therapist – Supervisor, I recognize the power behind play and creation. Play is our first language; we are able to process and express what we see, think and feel through nonverbal, play interactions. The play space is a comfortable place to explore, understand, release, and heal. It makes sense that this Animal Crossing virtual play space is as popular as it is during a global pandemic. Connecting with ourselves and others during a time of forced separation and isolation is incredibly beneficial. Play, and more specifically for the present era, digital play, is a preferential method for coping and communicating. 

Animal Crossing has similarities to Winnie the Pooh, which also gained popularity during a trying time in history. The author, “Milne had served in World War I, and the idyllic setting of the [Hundred] Acre Wood was a welcome sanctuary from the horrors of the Western Front that remained fresh in his mind and those of many readers in the 1920s” (Klein, 2018, p. 2). Winnie the Pooh has a strong connection to psychology. Williams (2000) even wrote a book analyzing how Pooh is seemingly a psychotherapist for his friends and ultimately the catalyst for their mental and emotional healing. A. A. Milne provided a magical, protected play place to assist children and adults in learning how to cope with the effects of collective trauma. 

Animal Crossing and Winnie the Pooh are both spaces for creative imagination and cathartic release during monumentally devastating and anxiety-provoking times in history. They have resemblances with animal characters being a central focus, each with their own distinct traits and personality. And, they both provide a playful approach to coping with psychological overwhelm. 

For more information about play therapy, visit https://www.a4pt.org. 

For more information about digital play and Digital Play Therapy, see Stone (2020). 

References

Klein, C. (2018, August 22). The true story of the real-life winnie-the-pooh. History.  https://www.history.com/news/the-true-story-of-the-real-life-winnie-the-pooh

Stone, J. (2020). Digital play therapy: A clinician’s guide to comfort and competence. Routledge.

Williams, J. T. (2020). Pooh and the psychologists. Dutton Children’s Books.

Dr. Rachel Altvater is a Licensed Psychologist in Maryland, Washington, D.C., and Virginia, Registered Play Therapist–Supervisor, and Certified Clinical Trauma Professional. She is the owner of Creative Psychological Health Services, an affiliate faculty member at Loyola University Maryland, and the President of the Maryland/DC Association for Play Therapy. Dr. Altvater published two articles in the International Journal of Play Therapy on her research of technology use in play therapy and is a contributing author in Integrating Technology in Modern Therapies: A Clinician’s Guide to Developments and Interventions, Digital Play Therapy: A Clinician’s Guide to Comfort and Competence, and Cultural Issues in Play Therapy (in press). She is the recipient of the 2019 Emerging Leader Service Award from the Association for Play Therapy, the 2018 Outstanding Play Therapy Research Award from the Maryland/DC Association for Play Therapy, and the 2018 Distinguished Alumna of the Year from The Chicago School of Professional Psychology, Washington, D.C. Campus.

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            One of the powerful benefits of using the Virtual Sandtray App (VSA) is the ability for multi-level, multi-dimensional depiction of one’s world. As we know, sand therapy was created by Dr. Margaret Lowenfeld to provide “a way to allow children to share their inner worlds” (Homeyer, 2020).  The World Technique was born, and with it, Projective Play Therapy formed (Lowenfeld, 2007; Homeyer, 2020). Numerous adaptations followed and this creative, expressive, projective technique used to work with clients of all ages is a mainstay for therapists many different theoretical foundations and approaches. 

            The Virtual Sandtray App allows the client to customize a number of components within the tray to allow for a greater level of expression and creation.  Sandtray is not merely about putting items in the sand or having a representation of an item placed on a sand-like field; sandtray is a series of processes which culminate in a mind-body connection and expression of one’s inner world, experiences, and how one sees themselves within multiple layers of being. To create a tray, the process must be intentional and immersive. Miniatures, items, figurines, symbols, models…  whatever you call them, must be selected ~ a process by which the mind and body feels a connection to the  depiction and how it will assist the person in expressing what is needed. A mindful process of scrolling through items, placing them one by one with one’s fingers, customizing the item individually to be “just right”, moving the sand with one’s fingers; these are all part of the process of intentional, immersive, projective creation ~ as intended by what we know from Dr. Lowenfeld’s writings and teachings. All of these critical features have been incorporated into the Virtual Sandtray.

            Additionally, when one ponders the components of intentional, immersive, creative projections (IICP), it would be natural to wonder what new mediums and platforms can provide.  Given the absence of many limitations in the traditional sandtray process, what might expand this IICP process? Here at Virtual Sandtray we believe the ability for multi-level, multi-dimensional depiction is a key portion of this process. Therefore, we developed features such as a liquid layer, skybox, and the ability to have 3 different layers to one’s world:  the base tray world, the sky world, and the VSA Underworld^TM.

            The VSA Underworld is created by removing sand from the tray, placing items in the liquid layer (think of a layer similar to the classic blue-bottom tray), changing the liquid layer to the desired color and texture, and then burying the items under the sand. Then, when the tray is tilted downward and the user zooms in, a world beneath the sand is revealed.  When the tray is tilted back to a level position, the Underworld disappears, tilt back down and it reappears.  A common use is to have the sand level be what the client shows to their world – what their friends, partners, families, peers, co-workers, etc. see and are allowed to know, while the Underworld is that which energy is expelled to hide. It could also be two visible but distinct portions of oneself or one’s world.  The possibilities are virtually endless!

            To learn more about this technique – play around with the Virtual Sandtray! Bury items, tilt all the way down, and zoooooooooooom in.  Keep zooming until you achieve the desired amount of the Underworld being shown.  Rotate around in the tray to reveal different items and portions of the depiction.  Take photos and videos of each and all. These IICP depictions allow for such ownership and investment in the creation; the meaning to the person, the process, the therapy, and the movement toward the therapeutic goals is priceless.  Enjoy!

Lowenfeld, M. (2007). Understanding children’s sandplay: Lowenfeld’s World Technique. Sussex Academic Press.

Homeyer, L. (2020). History of sand therapy. https://worldsandtherapy.org/history-of-sand-therapy

To learn more about the VSA Underworld technique (and more), please take the Level III VSA course, offered in 2021 through this website (under trainings).

To learn more about Dr. Lowenfeld, please read her books and visit The Lowenfeld Trust website: http://lowenfeld.org/

For more information about the Virtual Sandtray®© App, please visit: https://sandtrayplay.com/newsite/

Dr. Jessica Stone, PhD is a psychologist, international speaker, sought after clinical supervisor, and renowned play therapist.  She is the co-creator of The Virtual Sandtray®©, a best-selling author, and developer of Digital Play Therapy. Dr. Stone has been featured for her work throughout the virtual world as an innovator, ambassador of play, and stalwart advocate for the use of digital technology in the field of psychology.

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Sometimes caring for yourself seems like a daunting all day-everyday task that’s unmanageable.  We are a sum of all our parts and when it seems all parts are needing care at the same time, it can become overwhelming.  As mental health professionals, we know caring for ourselves is important, and yet, it is extremely easy to feel so obligated to help others that we unknowingly neglect ourselves.  After all, it’s why we went to school, right?? We want to help people—and that’s good.  However, especially during this time of pandemic, the question remains—at what cost and whose expense? 

“We need balance in all aspects of life. Humans do not function well when unbalanced whether that be regarding food, work school, sleeping, running, or anything else.  Internal balance is achieved when the activities and interests of a person do not cause other aspects of life to become under-or overinflated”(Stone, 2020).

During my undergraduate studies I had a full course load of 18 credits, worked full time AND worked 15-20 hours at my internship site.  It does not take a rocket scientist to figure out that this was not the healthiest decision, but never-mind health.  I had a goal, and I was intent on working towards that goal regardless of the future consequences.  In fact, future consequences were not even a thought in my mind.   During this time a dear friend said these words to me that have stuck with me all these years: “If you don’t take care of your body where will you live?”.

In order to hold the heavy, hard things for our clients we MUST have space to hold it.   How do we have the space?  We take care of ourselves to create space not only for our clients but for ourselves.  Often times we create an either/or scenario when really it is more helpful to have a both/and.  “I take care of myself AND I help others.”  Over the last several days I’ve found myself being curious about the word ‘permission.’  As a child, especially in my adolescent years, I wanted to be an adult so I did not have to ask permission to do things I wanted.  I find it curious that, like so many other adults, there are times I still need permission in order to take time to care of myself the way I need and deserve.  So….for those of you who need permission to say ‘Yes’ to yourself, you now have it.  You have permission to take care of yourself the way you need AND you deserve—whether it’s for 15 min, 30 min, a day, a weekend, or every day!  Take care of yourself so you can be the best you can be for yourself AND others.

Reference

Stone, J. (2020) Digital Play Therapy: A Clinician’s Guide to Comfort and Competence, Routledge, pp. 14.

Fiona Hill, MTS, MA, LPC

Fiona Hill is a Licensed Professional Counselor in the state of Missouri.  She currently works in a group practice as a children and family therapist.  She specializes in working with those who have experienced childhood trauma, as well as, families impacted by developmental disabilities.  Fiona utilizes primarily EMDR and Play Therapy in her practice; she is currently working towards both her Registered Play Therapist credential and EMDR certification.

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