In psychodynamic child therapy, the focus is on uncovering the unconscious factors that may contribute to the child's challenging emotions and behaviors, which have led them to seek psychological support. The aim is to help the child bring to the surface the conflicted emotions, thoughts, and desires that have been repressed into the unconscious in an effort to maintain psychological equilibrium. Through therapeutic play, the child is encouraged to recognize and express these connections, and to develop more mature defense mechanisms to cope with them more effectively.
According to the psychodynamic approach, there is a constant connection between the child’s external reactions and behaviors and their internal world. Therefore, the child is considered as a whole, including both their adaptive and maladaptive behaviors, as well as the internal processes of positive and negative emotions, thoughts, and desires. It is believed that the challenging emotions and/or maladaptive behaviors requiring psychological support stem from unconscious factors that need to be uncovered and resolved, as well as defense mechanisms that require maturation. Although symptoms may appear similar, the underlying reasons for a child's challenging emotions and behaviors are unique to their personal history.
Psychodynamic Play Therapy
In psychodynamic play therapy, as in all therapeutic processes with children, understanding the child’s language of play and meeting them in their play world is of critical importance. The therapist provides a safe relational space that allows the child to express all their thoughts and feelings—both positive and negative. This is achieved by containing, holding, and, when necessary, setting boundaries to maintain a secure relationship with the child, encompassing all the emotional material they present, whether good or bad.
This inclusive approach allows the child to find a secure therapeutic space where they can express the challenging aspects of their internal world that they may otherwise fear confronting. Within this space, the child can use their unique ways to explore their inner world and resolve emotional conflicts. For instance, a child might avoid engaging deeply in a play scenario by simply scattering toys or repeatedly acting out the same scene. The therapist carefully observes the child's play and responses, joining them in their play, making necessary interpretations, and helping the child to recognize, make sense of, and transform what they reveal through their play.
Pre-Therapy Assessment Process
Before beginning psychodynamic play therapy, assessment sessions are conducted with the child and their parents to gather the family history and the child’s developmental background. During this phase, the emotions that challenge the child, the coping strategies they use, family dynamics, intergenerational transmissions, and unresolved unconscious conflicts are evaluated through projective assessments and play observation. This helps to identify the child's current level of psychological development and their specific needs.
Psychodynamic play therapy requires a certain level of emotional and cognitive development and is not suitable for every child. The therapist evaluates whether the child’s age and developmental level are appropriate for this approach. If deemed necessary, and with parental consent, the therapist may also communicate with the child's teachers during the therapy process.
Duration of Psychodynamic Play Therapy
Psychodynamic play therapy is typically planned as a long-term, open-ended process. This is because the trust-based relationship between the therapist and the child forms the backbone of the therapy. Establishing this relationship, allowing the child to experience it, and bringing to light and resolving challenging psychological material requires time. Therefore, sessions should be held regularly, typically once or twice a week, and should continue for an average of 6 months to a year. Depending on the child’s needs, this process may be extended or shortened. The frequency and duration of the therapy sessions are determined based on the results of the initial assessment and the child’s psychological needs.
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