Is my kid getting worse? : Stages in Play Therapy

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I totally empathize. You noticed a while ago that your kid has been really struggling with some things, so you decided to start therapy for them. You met with the therapist, brought in your kid, dropped them off a few times. You started out feeling hopeful and excited for your kid to get better. But now it's been a few weeks, and things are… worse? How is this possible? 

Don't panic! Believe it or not, the feeling that things are getting worse before they get better is actually a natural part of the therapeutic process for all folks (especially kids!). This is because we all go through stages in therapy. Let's walk through what these stages might look like for your kids:

Intake Stage

This is the very beginning of treatment and often actively involves parents or guardians in the process. You will have to sign a ton of paperwork (I'm sorry!), and you may be asked a bunch of questions about your child, their history, their behaviors, their favorite toys… it feels like it goes on forever! This part of the process is essential in giving your child's therapist the necessary information for them to identify goals and to plan how to work towards those goals. 

Introduction Stage

Then it's time for the first session with your kid. This part is certainly nerve-wracking because you are sending your child into a therapy session without you. What will they say? Will they be well-behaved? How do I know what they're even doing? 

This phase is essential to the process working and cannot be rushed. Understandably, it is hard to stay patient during this time because the "work" hasn't jump-started yet. However, stick to it! The Introduction Stage is where your child's therapist gets to know your kid and assesses their needs in session. Although you've known your kid for their whole life, we are just meeting them!

The other half of this equation is your child. Your child is going to be uncomfortable and nervous about coming to therapy, and it will take some time for them to feel comfortable with their therapist, the room, and the situation. Often kids will not talk about negative things at all during these first few sessions, as they are trying to figure out how their therapist will react to things. This part will be more difficult for kids who are anxious or shy to begin with. You can help us move through this phase by being super encouraging and normalizing this experience for your kid.

Acceptance Stage

This is the easy part. Once your kid feels comfortable, they will be excited about coming to therapy and will probably talk all about the toys and activities they get to do during sessions. Your kid is still not sharing about the hard stuff yet, so play therapy sounds a lot like playtime. But never fear! Your therapist is starting to ask questions and to challenge things little by little at a pace your child is comfortable with. Work is starting to happen!

Challenge Stage

Of course, what goes up must come down. As the child starts to be challenged and to start making changes, they will start to struggle. Change is not ever easy for anyone, especially for kids who are learning entirely new ways to think about or to do things. Imagine yourself: remember that time you recognized that you needed to work on something, but it wasn't as easy as you thought to change? In fact, you got pretty angry during that part. Yeah, we're there with your kid too.

The Challenge Stage (also known as the Negative Reaction Stage) is challenging because your kid is stepping out of their comfort zone to try new ways of thinking or doing things. Sometimes they will succeed, and sometimes they will revert back to old, comfortable (albeit difficult) habits. There is a battle going on in your little one, and I promise they are trying their best! You can help us during this part by supporting your child and letting them know that you trust them and the process. Talk with them about how hard it is to change, and how proud you are of the changes they are working on making. A kid who feels unsupported during this stage can get stuck, and it's difficult to get unstuck.

Growing Stage

The Growing Stage is where your child has started to see success in change, so they buy-in. They're open to talking about their problems, and they try their best to work through things outside of session. Sometimes kids soar during this phase, and sometimes they resemble a bit of a rollercoaster with ups and downs. This is usually the longest part of the therapy process.

The Growing Stage is also one of the most difficult parts for parents because you will probably feel disengaged and confused. That's normal. It will be easy for you to fall into frustration and to want to see quicker progress or graphs that prove that things are working. Trust the process and trust your kid. They're working at their pace. (And we promise, we always have a plan!) You can help us during this time by showing your kid that you trust what they're doing and by celebrating their wins with them.

Termination Stage

The Termination Stage is the final stage in therapy before you, well, terminate sessions. Your kid still isn't perfect (no one is), but their behaviors have stabilized to a point where they, their therapist, and you feel confident that your child is ready to maintain their progress without regular sessions. They're ready to spread their wings and continue learning on their own.

This part can be REALLY HARD for kids. They have formed a tight, trusting bond with their therapist, and it is very hard for them to say goodbye. Some kids might bring up some of their old issues as they feel that they are being abandoned just when things are getting better. Your therapist will do their part in transitioning and saying goodbye in a way that feels comfortable for your kid. You can help us during this time by talking about their feelings with them and normalizing if they feel sad or angry. Congratulate them for all of the progress they have made and encourage them that you will be there for them if they need help (because they will still need help). After all, you are the most important adult in their life. You can take it from here! 

The Final Word

So, if your kid feels like they're getting worse at the moment, think about what stage of therapy they are in. Some kids bulldoze right through these stages and are able to resolve some of their struggles quickly, while other kids may need more time to feel comfortable as they progress through the stages due to shyness, anger, fear, etc. Both are completely normal, and both lead to great results in therapy as long as the family sticks it out. You may also find that your kid was heading towards termination until a new issue popped up, which slid them back into the Challenge Stage. That’s normal too. The therapeutic process is long and frustrating at times for all involved, but your child will see progress. After all, the most rewarding journeys always take a little time! 

If you have any questions or are interested in starting the therapeutic process, check out the rest of our website for more information. We have several therapists at Amy Wine Counseling Center who specialize in working with children of all ages (even children at heart)!

For more information, check out these sources:

O'Connor, K. (n.d.). What to expect in a play therapy session. www.a4pt.org. Retrieved December 8, 2021, from https://www.a4pt.org/?page=ParentsStagesofThera.

Sepp, J. (2020, August 17). Stages of play therapy. Ensemble Therapy. Retrieved December 8, 2021, from https://www.ensembletherapy.com/blog/stages-in-play-therapy.  

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Ally Kennedy, LPC, MS

Ally Kennedy, LPC works primarily with kids through adults with neurodevelopmental differences (such as ADHD, Autism, learning differences, etc.). She also enjoys working with adolescents and adults struggling with anxiety.

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