I feel very strongly that mental health care in the U.S. has been subsumed by our capitalistic values. Therapy is seen as something that has to have an end result in order to be effective, yet often individuals feel no better than before they started therapy. Perhaps we have the wrong approach. Instead, I believe that therapy should be a place of exploration, healing, and connection that has no specific timeline or goal.
I do not “fix” children. I firmly believe that therapy with children should be child-centered and child-led. I allow the child to decide what their own goals and needs are for therapy, and what they feel they need during each session. Children are given the choice to attend therapy and I never see children who do not want to be in therapy. Children are also given the choice of what they want to discuss or not discuss, what activities they want to do, and how they want to spend their time. I do not believe in a type of goal-oriented, linear therapy where the child is magically "cured." I do not believe in trying to modify or change children's behavior, as all behavior is communication. What children need the most is for adults to listen to them and to be given a space where they can feel that they matter, are cared for, and are seen.
Most of the therapy I do with children is play therapy or expressive arts therapy. Other work can be helpful at times, but I do not subscribe to behaviorist techniques. Children are not given assignments to complete, they are never rewarded or punished during therapy. They are not required to do something in order to then get the “reward” of playing. I recognize that this may be considered a more radical approach to therapy and that it runs counter to many therapies with children in our society. In my experience, this is the most effective approach to therapy with children, and, more importantly, the most humane approach.
Therapeutic Approaches
Liberatory therapy is a therapeutic approach that focuses on addressing systemic oppression and promoting social justice within the therapeutic relationship. It acknowledges that mental health is deeply intertwined with social and political contexts, and seeks to empower individuals and communities to challenge and overcome the negative impacts of power imbalances and marginalization. Liberation therapy seeks to challenge dominant power structures and empower marginalized communities. It emphasizes the importance of understanding the social and historical context in which individuals live, recognizing that personal struggles are often deeply intertwined with larger systems of oppression such as racism, sexism, colonialism, and economic exploitation. It is guided by values that emphasize social justice, equity, and human dignity. Unlike traditional therapy, which often focuses solely on individual pathology, liberation therapy recognizes the systemic nature of oppression and allows individuals to confront and transform oppressive conditions in their lives. Central to this approach is the idea that we are shaped by our social world and relationships. It acknowledges the positional power held by the therapist and the power dynamic that is present in therapy. This therapy also acknowledges that “unbiased” therapy is a myth and that therapy in itself is inherently political. It recognizes that the mental health field has been harmful, particularly to those with minoritized identities, and seeks to actively dismantle the harmful structures that are in place in therapy. Focus on Social Context:
Play therapy recognizes that play is the language of children. Play allows for self-expression, self-knowledge, and self-actualization. It offers therapeutic relief for the child during and after the play, and allows them to take control of their environment and gives them a sense of agency. Play therapy utilizes play to help children express their thoughts and feelings when they do not have the verbal language to express them. In play therapy, toys are the child’s word and play is the child’s language. It understands that the relationship between therapist and child is the most important element in the healing process. The strong and positive relationship between the therapist and child can offer a corrective emotional experience necessary for their healing. It allows the child to experience undivided attention and an adult who will directly engage in their play with no rules or right or wrong choices. It recognizes that children are wise and innately know what they need to heal. It involves the therapist being directly involved in the child’s play and allowing them to direct the play. Play therapy is highly beneficial for children who have experienced or are continuing to experience trauma, children who have difficulty communicating verbally, and children who have experienced abuse.
I am trained in several models of child therapy, including Child-Centered Play Therapy, created by Dr. Garry Landreth, Gestalt Play Therapy, created by Dr. Violet Oaklander, Experiential Play Therapy, created by Dr. Bryon Norton and Dr. Carol Norton, Synergetic Play Therapy, created by Lisa Dion, and Play Therapy with Traumatized Children, created by Dr. Eliana Gil.
I am a certified AutPlay Therapy Provider through Dr. Robert Jason Grant’s AutPlay program. AutPlay is a neurodiversity-affirming framework for implementing play therapy with neurodivergent children and youth. It is a unique approach that incorporates traditional play therapy with knowledge of the specific needs of neurodivergent individuals. It is a strength-based approach that helps create affirming identity understanding and teaches advocacy. It is informed by the neurodiversity paradigm and focuses on assisting youth with mental health needs that are either a result of their stigmatization in society, or co-occurring with their neurodivergence. It believes in the therapeutic power of play to help with emotional regulation needs, sensory challenges, identity appreciation, trauma, anxiety, depression, low self-worth, inclusion needs, autonomy and advocacy, and parent/child relationship challenges.
Expressive arts therapy is the purposeful application and integration of art, music, dance, movement, dramatic enactment, creative writing, and imaginative play. It is an action-oriented and sensory-based approach. It recognizes and respects that everyone has their own unique form of expression and offers an opportunity to choose to express feelings and thoughts in a creative way. Expressive arts therapy can provide another body-based approach for regulation and healing, and is often helpful for those who have experienced trauma, anxiety, depression, grief, and chronic health and pain challenges. It is also particularly effective for children and adolescents and offers a safer option for expressing emotions nonverbally.
Neuro-affirming care is about providing support that embraces and respects the diversity of neurotypes. It involves helping individuals claim or reclaim their neurodivergent identity and unlearn deficit perspectives of their identity. It supports neurodivergent individuals in navigating a world that is built for neurotypicals and advocating for themselves. Neurodiversity-affirming practice presumes competency, promotes autonomy, respects all communication styles, honors neurodivergent culture, tailors support to individual needs, takes a strength-based approach, and is informed by neurodivergent voices. It challenges stigma and stereotypes, helps empower individuals, and gives agency back to the person.
Somatic therapy explores how the body expresses deeply painful experiences, using mind-body healing. It posits that our body holds and expresses experiences and emotions and these can become trapped inside the body. In somatic therapy, the body is the starting point for healing. It cultivates an awareness of bodily sensations and teaches people to feel safe in their bodies while exploring thoughts, emotions, and memories. As opposed to behavioral therapies that focus on desensitizing people to uncomfortable sensations, somatic therapy focuses on relieving the tension. This work allows individuals to release damaging, pent-up emotions in their body using various mind-body techniques.
Trauma-focused treatment is a therapeutic approach designed to help individuals process and recover from traumatic experiences. It addresses the psychological, emotional, and sometimes physical effects of trauma, aiming to reduce symptoms of PTSD, anxiety, and depression. This is a specific approach to therapy that recognizes and emphasizes understanding how the traumatic experience impacts an individual’s mental, behavioral, emotional, physical, and spiritual well-being. This type of therapy is rooted in understanding the connection between the trauma experience and the person’s emotional and behavioral responses. The purpose of trauma-focused therapy is to offer skills and strategies to assist the individual in better understanding, coping with, and processing emotions and memories tied to traumatic experiences. Trauma-focused therapy provides a space for individuals to learn about responses to trauma and the impact of the traumatic event. This type of discovery and learning helps people to digest why certain thoughts, feelings, and behaviors might occur, gives names and explanations to experiences, and reminds the person that they are not alone in their experience.
With its roots in Buddhist philosophy and practice, mindfulness emphasizes present-moment awareness & acceptance. Mindfulness work in therapy is a process that leads to a mental state characterized by nonjudgmental awareness of the present moment experience, including one’s sensations, thoughts, bodily states, consciousness, and the environment, while encouraging openness, curiosity, and acceptance. The overarching theoretical premise of mindfulness work is that, by practicing mindfulness (through sitting meditation, yoga, or other mindfulness exercises), individuals will become less reactive to unpleasant internal phenomena but more reflective. Mindfulness is both a skill and a practice; the practice of mindfulness begets the skill of staying mindful. The stronger one’s ability to adopt a mindful state throughout the perpetual ups and downs of life, the less suffering one will experience.
Compassion-focused therapy helps individuals cultivate the skill of self-compassion and move toward self-acceptance and feelings of safety. It is particularly effective for those who struggle with low self-worth, high levels of internalized shame and self-criticism, and perfectionism. This therapy uses a definition of compassion grounded in Buddhist tradition, which defines compassion as “a sensitivity to suffering in self and others, with a commitment to try to alleviate and prevent it” (the Dalai Lama). Compassion regulates negative affect through caring behaviours and expressing and communicating feelings of warmth and safeness. It helps individuals develop a more compassionate inner voice. Using a compassion-based therapy involves enabling individuals to develop self-compassion, compassion to others, and openness to compassion from others, in particular in response to adversity or threatening situations. It consists of guided exercises, including role-playing, visualization, meditation, and activities intended to foster appreciation for daily life that aim to help the client recognize what compassion feels like and become better at practicing it, both toward themselves and toward others.
Sometimes referred to as “parts work,” internal family systems is a non-pathologizing form of psychotherapy that helps individuals understand. It hinges on the idea that each of us has multiple parts and getting to know all of our parts intimately, understanding them, and treating them with compassion can help us to be more accepting of ourselves. This model recognizes that our minds are not one-dimensional and that we all have multiple perspectives within, such as an inner critic, worrier, or striver. Some parts tend to dominate our lives, while others are more hidden, and this therapy teaches a process to embrace all of our parts, bring them into balance, and find a sense of wholeness. Internal family systems allows individuals to embrace all of the parts of them rather than try to fight against them or get rid of them. It offers a path for better understanding ourselves and being more compassionate.
Gestalt therapy emphasizes a holistic approach to mental health, focusing on the present moment and the interconnectedness of thoughts, feelings, and actions. It encourages individuals to become more aware of their experiences, to understand what is actually happening in their lives at this moment and how it makes them feel, and integrate different aspects of themselves into a unified whole. The term “gestalt” is derived from a German word that means “whole” or “put together.” The gestalt philosophy rejects the notion that any one particular trait, episode, or diagnosis could define a person. Instead, a person’s whole self must be explored, discovered, and confronted. As they encounter and gain awareness of other parts of themselves, individuals can take greater responsibility for themselves and hopefully gain a greater sense of what they can do for themselves and others.
