Saturday, November 17, 2012

Play Therapy and Asperger's Syndrome

A while back I wrote a post about "ludotherapy," or using videogames as a springboard for discussion in psychotherapy. Kevin Hull, who wrote the dissertation I discussed there, e-mailed me and mentioned he wrote a book related to his dissertation, and I asked him for a copy in exchange for writing about it. My bachelor's is in psychology, and I worked with children in high-conflict divorces for a brief time, which often included playing with them. This was my first time reading an entire book about play therapy, and it makes me want to read more.

The structure of Play Therapy and Asperger's Syndrome is highly organized with specific play therapies recommended for the problems children with Asperger's typically encounter. Hull's approach is anecdotal (with a few citations where needed), and he stresses the need to adapt techniques to each individual. There's no one chapter on videogames, but rather, the book is organized by problem type with videogames as a resource for addressing several different problems. I was struck by Hull's high level of respect for children and teens with Asperger's, which seems fitting of a child therapist. My own eye-rolling to the constant reference to "these remarkable young people," made me think I should stop being such a cynical reductionist about certain types of people.

So what is play therapy? It's more than a way for a child to feel comfortable talking with the strange adult who is their therapist. It's also a safe, nonverbal space for them to express their fears and insecurities. With videogames, it often becomes a way to teach children that they can transfer their skills of persistence and problem-solving to the real world.

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Reading about play therapy made me excited to see children and try out some of the techniques myself—things like telling a child what they're doing to let them know you're watching them, or with older children (and adults), talking about how the themes from a videogame can help us cope with our anxieties and other problems. With videogames specifically, the "game as metaphor" technique was the most common Hull mentioned. Here's an example:
The "clones" from Lego Star Wars that constantly try to attack the player and thwart progress can illustrate bullies. Challenges that have to be completed to get to the next level can be used as metaphors for conquering fears and getting through situations that the child diagnosed with AS views as unpleasant. When a metaphor presents itself, I push the pause button on the controller to stop the action to explain the metaphor.
Merely playing a videogame is usually not enough to be therapeutic. It's the discussion of the game and how it applies to real life that makes the experience meaningful to a child. Hitting the pause button and saying "there, right there, you were brave."

Hull has another technique where he has the child play Tetris on a very high level, with the intent of frustrating the child. The frustrating experience provides a setting to learn and apply principles of relaxation and controlling your emotions that is a real test of those skills! I find these examples of teaching and practicing coping skills to be an excellent example of what applied psychology/psychotherapy should do well. I wonder if teaching adolescents to think about game design (why a level was made the way it is) could help them think more about how other people think and feel.

As adults, we are in a similar situation with videogames. We can play them "just" for fun, though some games are positioned to teach specific lessons. But I would argue that for any game, discussing the experience will make it more meaningful and applicable to our daily lives. I think that's why I feel passionate about videogame criticism; it's not just that I love videogames, but that thinking about them makes my own life richer. It's a way for me to contemplate life while still focusing on an experience in itself (playing a game).

In short, play therapy sounds like an excellent way for children and teens (and I would argue, adults) to express themselves. If you are a parent, I would encourage you to take a little time to play with your children, even if it seems awkward or you don't have a lot of time (children are impressed when you play with them! Even once a week can make a difference). I highly recommend this book to any child psychologist who deals with clients with Asperger's, and also parents of children with Asperger's and anyone interested in play therapy. It's a little on the expensive side to read on a whim, but if you're in college you can probably get the book on ILL. Next time a child asks "can you play with me?" think of it as an opportunity to enter their imaginative world! :-)

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