For most of the young people that come into our office, at the core of what we do is emotional regulation work – regulating tantrums, tearful episodes, painful feelings associated with low self esteem, anger and irritability, panic attacks, fear of separating, frequent worries - you know the drill. As a Cognitive Behavioral Play Therapist I am always curious about what thought patterns are leading to feelings and how that combination relates to every day choices – in short the cognitive triangle.
I am always excited to find new ways to teach and explore the cognitive triangle. Let’s be honest – playing feelings UNO (although it is one of my favorites) can get pretty stale for you and the child on the 100th round. AND if you are bored in the play room the child will feel it, and it will impact their play. Staying present is SO important. This is why I am so excited about this feeling face check in. Check out these FREE printable play dough faces and bodies here!
Kate, a former preschool teacher, created faces and body outlines – all with four different skin tones. Pro tip – if you use two different printers you actually can get a slightly different shade of skin tones for each printable increasing the different skin tone shades available to young people. After you print out these amazing profiles you can laminate them.
Don’t have a laminator? Most office supply stores sell self laminating packets – these ones at Target are $6.99 for 10. This is the laminator I have here for $21.99 at Target and after 5 years it is still going strong! The pouches are also $21.99 but come in 100 packs. Do you have an IDEA how much lamination can go on with that budget? So. Much. Laminating.
I seriously LOVE my laminator – I laminate getting to know you cards, feelings match, feeling identification cards, and self-regulation cards for kids. I also laminate “cheat sheets” for things like maladaptive cognitions list or my emotion coaster. I have laminated negative cognition and positive cognition cards for work with EMDR as well as SUDS scales. The AWESOME thing about lamination sheets is that you can write on them with dry erase markers, erase, and then use the whole sheet again. #notanad BUT it has been such a valuable and unexpected tool in my play room. Can you tell I'm slightly obsessed? If you are not on a lamination kick yet - this will definitely not be the last freebie I share that can be laminated. I might just convert you!
So back to these adorable little faces – why laminate? WELL you can make an amazing face on it with play dough or draw faces with dry erase markers and re-use them. I will do a check in with young people of the high and low of the week using the feeling faces. You can even add thought and speech bubbles. It creates hemisphere integration accessing both the right brain (which holds our pictures) and left brain (which holds our verbal processing). It taps into visual, auditory, and tactile and kinesthetic learning. Also, it is just so much more FUN than just asking "how was your week"?
For the whole body outlines you can do body mapping with what feelings they were feeling in different areas of their bodies with color coding. If your client is processing a conflict, the feeling faces can be used to explore thoughts and feelings AND you can use them with bibliotherapy (I talk about bibliotherapy more here) to track the feelings of the characters. They are amazing to use to help young people who may be on the Autism Spectrum to identify social cues such as what they eyebrows and mouth are doing and how that relates to what someone might be thinking or feeling. Thought and speech bubbles can be used to process mental filter and what thoughts should stay in our heads vs. come out of our mouths. These little sheets have been SO wonderful for a wide variety of clinical difficulties as well as culturally inclusive - which is a must! Oh and the fact that they are absolutely FREE definitely helps when your playroom is on a budget.
What are your favorite emotional regulation strategies with young people? How do you incorporate art and creativity?
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My son has exactly 5,873 books. Ok, maybe that is an overstatement BUT he does have a ton of books – like baskets upon baskets and shelves upon shelves. The first thing I went out and bought when we found out we were pregnant was an amazon cart of books. To say I am book obsessed is an understatement, and this love of books has been growing ever since I was little and had 5,873 books.
I have been using bibliotherapy in my practice with children and young people nearly since day one. I cannot describe how amazing it feels when a child feels seen and heard through bibliotherapy. Some children feel like they are the only ones to have gone through something or know what it feels like to have the feelings they have. BUT children get so much comfort in the fact that if someone actually wrote a book about something AND a publishing company felt it was so important to actually make the book – then they are not alone. That look of relief that washes over their face and the shame melting away is an amazing experience both as a therapist and for the young people we work with.
Bibliotherapy is the use of literature to help children cope with and process emotional and behavioral difficulties and big life changes. It is one of my favorite things to present on and I only combined my last presentation Books, Games, and Media Oh My: Broadening Your Play Therapy Toolbox because I didn’t know how many other book nerds were out there and would be interested in a whole 6 hours of bibliotherapy. Drop a comment below if you are also a fellow book nerd with your favorite book to use in the playroom!
Books are SO magical because they engage and capture the three portals of learning – visual, auditory, and tactile and kinesthetic. The last portal is especially engaged when bibliotherapy is combined with other directive play therapy techniques and research actually shows that bibliotherapy increases with effectiveness when paired with another directive technique.
The amazing thing about bibliotherapy is it can fit into most theories of play therapy depending on how you are using it. For those that practice Child Centered Play Therapy it fits into a play therapy session when a child spontaneously takes a book from the shelf and begins to explore. Some may read as a mother character or when playing the role of teacher. For more directive approaches liked Cognitive Behavioral Play Therapy the therapist can introduce the book and the directive activity based on the child’s goals – maybe for emotional identification, shifts in maladaptive cognitions, or identifying adaptive behaviors or coping skills.
Being a mom and a play therapist is an incredibly interesting season as sometimes the play I do in office with clients spills over an informs the play I do at home. I mean, I have all categories of Dr. Gary Landreth’s toys present in my son's toy collection AND a sand tray in my living room. However, I am finding more and more that my play at home is informing my therapy practice. There are new toys, books, and games that I finding that I just NEED to by a second one for the office. The book Last Stop on Market Street by Matt de la Pena is one of those times.
To say this book is amazing is an understatement. It is beautifully and vibrantly illustrated, has a wonderful message on gratitude, and has won a slew of awards. One the first page we meet CJ, a curious young boy who is wanting what others have. As he and his grandmother catch the bus across town after church to volunteer at the soup kitchen CJ is wondering – why doesn’t he have a car? How come he doesn’t have headphones like the teenage boys? How come he has to go volunteer? His grandmother shows kindness and gratitude on every page. She is able to find the little miracles in the every day.
After the 500th time of reading this book (because that’s what kids like to do) I had a lightbulb moment that this was ABSOLUTELY a therapy book. The ways to help young people see the miracles and magic in the everyday is endless. This book is wonderful for those that struggle to see the good or positive, are often angry or irritated, have a sad or down mood, or are just chronic complainers! Research shows us that gratitude, the act of showing thanks and appreciation, is linked to improvement in mood, can actually change your brain, and releases the feel good chemicals of dopamine and serotonin!
The book on its own is amazing and for some who practice reactive bibliotherapy that is where this activity ends. I am a huge fan of interactive bibliotherapy where you pair the book with some sort of creative activity – and let me tell you – the sky is the limit. You could go together (with all the necessary permissions of course) on a gratitude walk during the session, naming things on the way you are grateful for. Even in your office think about all the wonderful things you could see on the way from your office to the waiting room – electricity, heat (especially important to Minnesotans with subzero temperatures), art, the internet, indoor plumbing, the ability to be mobile, and the list could go on!
You could assign the child homework to do a gratitude walk alone or with parents OR one of my favorite assignments for families is developing a ritual of sharing of gratitude on a daily basis before bed, at dinner, or in a gratitude journal. Sometimes I bring this technique into the therapy session because I find parents are often times so busy putting out fires that in a moment of peace they just want to relax and take a breath! For some young people I end my parent check in portion with the parent looking at the child and telling them all the things they are grateful for their child over the week. It can be anything from loving the child’s sense of humor, when a sibling instigated the child and he/she walked away, or enjoying an activity done together. I call these “ushy-gushy” moments because it is so darn COOL to see this outpouring of love that often times we don’t stop to do.
The book creates a nice springing off point to talk about WHO in the child’s life they are grateful for and HOW they could show that person/people they appreciate them. This could mean drawing a picture or making a collage of what they are grateful for. You could focus on the toughest part of their day and find the good parts to pull out. I also often have children in my office that want to make a card/art for a parent, teacher, sibling or friend. Other times it can be a thank you card – sent or kept private – that the child writes to someone special in their life OR to someone they struggle to find the good in.
Questions I found helpful to process this book:
Now lastly, I want to share one of my favorite bibliotherapy secrets – almost all books you can find on YouTube! I prefer having book in hand reading in real time, HOWEVER if you don’t have the budget, don’t know if a book will fit will into your practice, or dang it you forgot to put it in your amazon cart and the client you want to do this with is on your schedule today – watching a video of the book together can be wonderful.
What are your favorite ways to cultivate gratitude in session with clients? I would love to hear what goes on in your play room!
Want more training on how to use Bibliotherapy in your Play Therapy practice? Check out this training HERE!
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Yearly Practice Evaluator
Woo hoo! We made it – one more year down! For some 2019 held the best year ever and for others you were ready to say goodbye. Now that we’ve settled in a bit and come out of our holiday comas it’s time to get down to business and dream of what this new year holds.
For most of us new years resolutions last approximately 2.5 weeks until old habits creep in and we are back where we started. Do you want that same fate for your therapy practice? Not today! Let’s dive in to ALL the areas of a therapy practice so you can get curious of where 2020 will take you so you can develop goals that stick. There is nothing more disheartening than blowing the dust off of your resolutions and goals from last year and realizing you are one millimeter away from where you started, or worse, that you are going backwards.
So as we jump into the new year it’s time to dream big! In your dream practice what will be happening in your life in the next year? What are the problems in your practice that you finally want a solution for? How will you make that happen?
Some of you might think – but why set goals I am happy just as I am? To that I would quote Steve Siebold – “You’re either growing or dying. Stagnation does not exist in the universe”. Now, I’m not saying that you shouldn’t have gratefulness, gratitude, and contentment for where you are now, however it doesn’t mean that you can’t continue to grow. AND the well-seasoned and wise therapists I know are always striving to learn something new and reach for something more. If they won’t stop growing – neither should you! Now I know some of you are saying – but I’m so overwhelmed! I can’t possibly take on one more thing! Well…that might be a goal in itself.
Goals give you clarity and a benchmark for what you want to have happen. I mean we do this with our client’s multiple times a week in adherence with insurance standards! Maybe insurance companies are on to something more than just busy work? You will never achieve your goal unless you call your shot – a specific, measurable, and achievable shot.
So now that I (hopefully) have convinced you that goal setting is something you need in your life, practice goals can be broken down into the following categories. For some you may dive deep and target just 2-3 areas for your yearly goals. Others may want at least one goal from each area. The great news is because they are your goals you get to make them what you want! Consider your strengths and weaknesses in each of the categories below.
This is really the heart and soul of a therapy practice. This is the time you spend face to face with a client in the therapy space and during this time how you show up and serve your clients. Taking a good look at your strengths and areas that you would like to continue to grow is an absolute necessity and can help you avoid burnout. Areas for growth may include increasing your ability to be present with clients. It may have to do with getting the balance right between meeting clients where they are at and encouraging growth. Maybe you want to be more structured with the beginning of your sessions or work towards ending sessions on time. This area could hold one of a million things AND just because you have areas where you want to grow, doesn’t mean in any way you are not already providing great quality care for your clients.
Self care goes beyond getting a massage one time or getting regular doctor’s check ups. You should really do those things AND self care is so much more than that. Self care is the holy grail of work life balance and the intentional practice of taking care of our emotional, mental, and physical health. This area of evaluation of your practice could include hobbies you have, practices that you incorporate into your daily practice to relieve stress like taking a couple laps around your office or a mantra between sessions.
Training and Education
This area of your practice has to do with how you are going to improve your knowledge and skills over the next year. If you are licensed then there is a required amount of Continuing Education Units (or some other similarly worded concept) you will need for each licensure cycle. However, I am not just talking about putting in a token effort or just going through the motions of continuing education. Setting goals in this area could be a credential or certification you are striving for like in Play Therapy or EMDR. It could be identifying your strengths and weaknesses in practice and developing goals to improve in the areas that you need it most and your client’s need you to be at your best.
I would also encourage you to widen your lens of what “training and education” means beyond traditional CEs. What books do you want to read? Are there any authors you keep hearing about in your circles that you feel you need to dive deeper into? Do you want to learn more through checking out more blog posts or tuning into more podcasts? What about those Play Therapy Journals you get a couple of times per year – maybe your goal looks like diving in and checking out the research when it arrives at your door.
The organizational task list for therapists is typically the most despised part of the job, except for very special therapists who are paperwork and organizational geeks. For them this is what gets them going! This area includes timelines of paperwork, as in do you have your notes, treatment plans, and diagnostic assessments due in a timely manner? And by timely manner the insurance companies usually like this to be within 48 hours. AND for most of us who accept insurance there are many other forms we need to complete to be in compliance such as CASII forms, SDQs, PHQ9, WHODAS, and the list could go on. How are you pulling all of this together to make sure that it all gets done? Do you feel like you are constantly in a place of playing catch up? Goals in this area might be more checklists, spreadsheets, or electronic checks and balances so you don’t have to work so hard to make sure everything is in line.
This area typically encompasses the outside of session work we do for clients. It could mean assessing how often and frequently you are touching base with those you have releases of information for and that it is necessary you coordinate with. For some this may mean setting firmer boundaries of how much time you can take to connect outside of session with clients themselves or third parties.
We should all be very familiar with the requirements of consultation and supervision for the path toward licensure or in our graduate programs! If you are an employee there is a good chance your employer has requirements for consults and/or supervision beyond licensure. If you are in private practice you may or may not be on your own to figure out how to meet your consultation and supervision needs. Goals in this area might look at assessing whether you are getting enough supervision/consultation? Do you want to see out support with a group of professionals that have clients that are a bit more similar to your caseload? Do you want to go out and seek out specialized consultation on an area of specialty like EMDR, Play Therapy, or DBT or a special population such as pica, high conflict co-parenting, gifted and talented children, or Tourette’s?
The business area of a practice can mean completely different things if you are an independent contractor, practice owner, or an employee. I would argue that for all three there is a “business side” of the practice. This includes how you manage and track the financial side of your business, budget for supplies and trainings, manage receipts, pay taxes, etc. It could also encompass advertising, online profiles, your webpage, intake paperwork and processes. I am admittedly terrible with receipts and they usually end up jammed behind my phone case until they can get distributed into a file. For sure one of my goals for 2020 is to be a responsible receipt saver!
This one is my personal favorite! This is exploring all the ways you might want to grow outside of your role as a therapist. This could be getting involved in your state board or organization, working towards providing continuing education and presentations for other professionals, developing your own programs, becoming a supervisor, engaging in community advocacy, blogging or podcasting, and SO MUCH more.
So here is where you dream big! Grab the FREE yearly practice evaluator to identify the top areas of stress and struggle in your practice in 2019 and what your 10 concrete results you want to achieve over the next year. When you are thinking of this ask yourself if you were the best version of yourself as a therapist what would an ideal session look like? What kind of things would you be thinking or saying? What would an ideal day look like for you to feel your best? How would you be thinking during this time? What would you know then that you don’t know now? How would you go about getting training?
Once you are done you can file away the evaluation sheet and bring it out with a glass of champagne as you celebrate 2021! Just kidding. Make a date on your calendar three months from now to take 15 minutes to assess your progress. Come 2021 you will be glad you did.
Comment below with the goals you are working on this year! What areas of practice goal setting did I miss?
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The new year is a time of such excitement of what the next 12 months will hold for you, your business, and therapy practice. It's also a time to look back and review your accomplishments and learning moments of the past year. What went well? What did you wish went differently? What do you want to set your sites on for professional growth for the new year?
I am SUCH a huge believer in being intentional in your practice of how you want to show up for your clients, as a team member for the professionals in your life, and as a business owner in your practice. Each year I set not only a word of the year but also a picture of the year.
For my word I select a word that will help me focus on how I need to show up, what strengths I need or what my journey will be like. I also select a picture to help me visualize this in practice and ground me in where I am going. I keep this at the forefront of my practice by setting it as my lock screen on my phone as a reminder multiple times in my day of what my focus is.
Last year my word was LEAP and this above was my picture. LEAP was my word as I was making the leap to move across the state and leave a practice I loved for a life closer to family. Where was I going to leap? Right into this kayak where I was likely going to battle some wicked rapids, but at the end would come out in a calm and beautiful space....here.
Over the next couple of days I am going to dig deep and set my new word and picture. If you set a word or picture of the year I would LOVE to hear about it! I would also love to hear about any other yearly practices you have going on for reflection and setting intention - drop a comment below!
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I'm Ann Meehan, an LPCC,