The relationship you have with a child is the number one factor for client change. Really! Research shows the relationship is even more powerful than any technique or theory! (Don’t cringe too much - all the schooling, degree, and extra training you have is really important too!)
 
The therapeutic relationship is also described as the “most important ingredient in successful therapy” by Athena Drews and Charles Schafer when talking about the therapeutic powers of play. It is the relationship that opens the door to make the other powers of play possible. 

In short - if a client doesn’t trust you or think you are someone safe they can talk to, it doesn’t matter how skilled you are, how many trainings you have attended, or protocols you know. None of that will matter because the child won’t feel safe enough to engage. 
 
Okay, so now that we know that rapport and the relationship are not only important but essential - what next? Here are four of my biggest tips to build and foster relationships with young people! 
 
Get cued in to the child’s window of tolerance 
Having a good read on the child’s nervous system and looking for cues of hyperarousal (fight/flight) or hypoarousal (dorsal vagal collapse / shutdown) is essential, especially in the early stages of therapy.  If the child is going outside their window of tolerance it is your job as therapist to regulate your own nervous system and give the child safe and social cues to help them regulate. Paying attention the small cues of dysregulation can help you pull back from activities or topics before the client floods. 
 
When the relationship is stronger a child’s window of tolerance may be wider for certain techniques, types of therapy, or activities.  Pushing too far earlier on can be a significant detriment to the relationship and can damage rapport. Want more information on neuroscience and Play Therapy?  Check out my training HERE!
 
Have a collaborative relationship 
The child and family are experts in their reality and what it means to be living in their unique family system.  They are also coming to you as a therapist because they are struggling. 

Working together with the client and parent in collaboration as opposed to making goals or recommendations from the position of an expert can significantly increase buy in from both the child and the parent.  Ask the child what their strengths are, what areas are a struggle, how they see their symptoms, and what they want to be different in their lives.  AND hold their answers with care both in the way you set treatment plan goals and how you work towards those goals in therapy. 
 
Be open to feedback 
In my first session with families I let them know that the relationship is the number one factor for therapeutic change (see above).  I welcome them to give me feedback on my approach and style and have openness that there might be something about my approach that doesn’t fit well with them. 

As therapists we need to be sensitive and curious about whether approaches, techniques, theories, or models are not a good fit for the client, or if they are struggling for some other reason.  And sometimes….well, we find out that what we have to offer and our specific style of therapy is not a good match for the client. I mean we are human beings after all and one therapist is not the perfect fit for everyone! 

In this case we put on our referral hat and figure out what therapist might be a better fit. All in all when we can be open with families about this from the beginning they feel more confident to speak up, which increases retention and engagement! 
 
Repair Any Ruptures 
Working with children is complex and multilayered. You are not only working with the child as an individual but also with parents and caregivers.  In a climate where parents and children can often disagree about the symptoms that are the presenting concerns and factors impacting symptoms, your role as therapist to maintain rapport within the family system is difficult. 
 
Sometimes you are put in a place to make parenting recommendations that are in the best interest of the child, but don’t often feel good to the child.  Hopefully you can relate if you have ever made the recommendation that unrestricted media time and activities could have adverse effects on mental health! 
 
And sometimes, well...you just mess up.  You are human after all.  I think we all have those moments where we wish we could re-play the tape and say or do something differently in our sessions.  The best thing you can do for a therapeutic rupture in rapport is to repair it.  Take ownership, apologize, explore the impact on the client, and work to fix it.  And this process?  Well some research has shown that it actually makes the therapeutic relationship stronger! Wheew - we can all feel a little bit better now!
 
These are my favorite strategies for building and keeping rapport with clients along with Carl Roger’s core conditions of genuineness, empathy and unconditional positive regard. Children have excellent detectors for grown ups who are not congruent! 
 
Let me know your favorite ways to build rapport and relationship with the young people you see in the comments below! 
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Goal setting is one of my favorite things about the intake process.  No, really! 
 
When you can fully understand a client’s current level of symptoms when they start therapy, it is incredibly clear to see if they are improving in their mental wellness.  And although there are external life stressors that may make it difficult for a client to progress, most of the time when you update goals you can see changes, improvement, and progress! Woo Hoo! High five! 
 
This is also extremely helpful when you have parents or caregivers that don’t feel like their child has changed.  Well….the initial treatment plan says that your child was tearful 2x per day and now they are having 2 crying episodes per week! Amazing news! 
 
Sometimes parents (or children for that matter) don’t notice the micromovements of change that come during the therapy process and it might feel the same or normal to them but when you give them a clear picture to look back on it can make all the difference! It can allow them to give themselves credit and celebrate their successes! 
 
Now, I am a firm believer that goals should be done collaboratively with the client, not just you typing away alone at your computer to wrap up the paperwork. For younger clients this might be heavily guided by their parent.  However, for late elementary school students to teenagers they have the ability to think more about what they want from the therapy process. 
 
And at the same time articulating goals to insurance standards for young people can be, well...tough.  Does “I want to  feel better” count for a quantifiable goal?
 
To help engage middle to older adolescent clients I developed a FREE  interactive goal setting worksheet. Now updated with two font options!!! 

This worksheet is an adaptation of the Wheel of Life activity developed by Paul J. Meyer for coaches to use with adult coaching clients.  I adapted it to use with my middle school and teen clients to help them take personal responsibility and ownership for goal setting, which can be difficult at any age!

In this worksheet young people are encouraged to rate themselves on the 8 most common areas goals are typically set with young people and it also accesses the right brain visual centers which is a huge bonus! 

Grab your FREE interactive goal setting worksheet HERE! (now updated with two font options!)

 
This worksheet assesses the 8 most common areas where I see young people struggling and needing to set goals. The first step is to fill out the self assessment sheet of how satisfied they are with each area on a scale of 1-10.  Areas include things like peer and family relationships as well as self esteem.  
 
Once all of these areas are rated the client colors from 0 -10 in each category their level of satisfaction.  Any color that seems right!  At the end you process the circle.  
 
Sometimes I will use a wheel analogy and let young people know that in order for us to be operating as our best selves we want our wheel to be as full as realistically possible and a wheel that could roll down the street. Nobody will have all 10s, but sometimes it is difficult to live life as what I call a “whole happy person” if there are several areas where you are at a 1 or a 2.  That leads to a stuck wheel! 
 
Client goals in therapy should be targeted at helping increase client’s abilities to live their life in a way that feels good to them (and keep their wheel rolling)! By filling out the goal setting worksheet you can get clearer on what brought your client to therapy and what areas of their life they want to improve! 
 
Grab your copy to use in assessment sessions HERE!  Now updated with two font options!

So you’ve greeted the client, given a great informed consent, now it’s on to asking those millions of questions you need to in the diagnostic assessment session to get enough information to make a diagnosis.  
 
In Minnesota according to the Department of Human Services in order to have a comprehensive Diagnostic Assessment you need to include not only current and historical symptoms and mental health treatment but a comprehensive assessment of factors that may impact development and the presenting problem.  Factors that need to be assessed include (but are definitely not limited to) information about meeting developmental milestones, any difficulties with development, trauma or maltreatment history, health history, family health and mental health history, academic functioning, and social engagement and resources. 
 
If you take insurance, getting all the information for the Diagnostic Assessment write up can be daunting in a short amount of time.  Some pro tips include having families fill out intake forms beforehand answering questions about each area of assessment.  You can also meet alone with the parent for a portion of time if you need information quickly and are worried the child will be negatively impacted by this process. However, insurance does state that the client needs to be present in some capacity for the assessment - which makes a ton of sense!  We don’t want to diagnose children without getting their perspective of their difficulties.  I mean, it is their life right?
 
AND whether they agree or disagree with their caregiver about level of symptoms and impact on their life is full of rich clinical data!
 
I wanted to share with you some of my favorite go-to questions to ask young people during the assessment phase Diagnostic Assessment clinical interview: 

• What do you think made it important for mom/dad/caregiver to bring you to see me today?
• What did mom/dad/caregiver tell you about coming here today?
• When is the first time you remember [the problem] happening? 
• What is your biggest strength? 
• Have you seen anyone like me before?
  • What was your favorite thing about working with [therapist]?
  • What is one thing you would change about working with [therapist]?
• How do you get along with mom/dad/parent/sibling?
  • What is your favorite part about mom/dad/parent/sibling/your family?
  • What is something you wish you could change about mom/dad/parent/sibling/your family? 
• What is the most stressful thing that has happened to you in the last year? 
• Do you have anyone you would consider a good friend? 
• Do you see friends online, in school, or in person? How often?
• What do you like to do for fun?
• What is your favorite toy to play with?
• Are you a part of any clubs, sports, musical groups, or other activities?
• Have you been bullied before?
• How do you like school? 
• What is your favorite subject?
• What is your least favorite subject?
• Are there any subjects that are difficult for you or that you struggle in?
• Do you need extra support in class? 

 
As always the language in these questions can become simplified or more complex depending on the age of the client or situation.  If the child has parents who are divorced I add questions about divorce history, transition, and separate households. I also ask trauma questions and questions specific to symptoms the parent is identifying as the presenting problem.  
 
And lastly, if a client is uncomfortable with any of these questions - no problem! We skip it and move on! Although (if you take insurance) you need enough information for a diagnosis before beginning treatment, you always want to let the relationship lead the way. 
 
What about you?  What are your favorite questions to get young people talking in assessment sessions?  Drop your favorites below! 

How many people do you think actually read your informed consent? Like actually sit down and read all the information word for word? Nothing more exhilarating than reading about HIPAA, clients rights, insurance reimbursements, and privacy practices! Am I right? 
 
If your informed consent is anything like mine, clients head straight for the signature portion and move it right along to the other forms and paperwork they need to sign to get this therapy thing a movin! 
 
This is why I believe it is so important to go over a quick verbal informed consent at the start of our time working with children.  In the slim chance that parents are reading it, the child certainly isn’t getting in on the action. 
 
Ethically we want to make sure that parents and young people are aware of the therapy process, limitations, and policies even if they choose to pass on wading through all the technical jargon in the informed consent. We want to make sure they receive informed consent on things such as confidentiality and what were to happen if you would see them in public. 
 
And, it’s not only ethical, but I believe that a strong informed consent significantly increases client retention and engagement in the therapy process.  If clients (or parents) know how long therapy might take, what types of activities clients and parents might expect, and what the expectations are for parent involvement we manage expectations for what the process will be, thus increasing engagement and communication. 
 
Since I am not a superhuman and do not have the entire informed consent memorized I developed an informed consent checklist that I still have with me every intake session, even though I have been doing this work for over 13 years! It is so easy to forget the little things so this checklist makes it a breeze! 
 
One of the most important things on the checklist is client confidentiality and what you will do if you see a client in public.  Even when I lived in a busy metro area I would bump into clients occasionally, but in a more rural area it seems like every trip to Target is a high likelihood that you will see a past or current client. 
 
Without fully explaining confidentiality to a child you are at risk for damaging the relationship should you see them out. If you don’t say hi first they might think you are ignoring them, upset with them, or don’t like them.  
 
Also, while maintaining confidentiality in public is super important, the reality is that most young people see us as just another helper.  Like a coach, teacher, or mentor.  This is the script I developed to explain confidentiality to children. 
 
“Now, what we do in this office is confidential.  That means that I don’t tell anyone outside of here what we do or say in this office like your sister, bus driver, or best friend.  However, there are some important people in your life that do need to know what we talk about.  Who might that be? (usually they eventually get to naming a parent or guardian).  Yes! Your mom/dad/guardian does need to know some of the things we talk about.  If there are other people outside of mom/dad/guardian that need to know what we do in here, like a school counselor or doctor I will tell you beforehand and let you know I will be speaking with them and we have to sign some paperwork that lets me talk with them - it is all very official and not a secret or private thing.  Now, because what we do in here is confidential, if I were to see you out in public I wouldn’t acknowledge you or say hi first.  I want it to be up to you, I want you to decide.  You can choose to say hi or wave OR you can choose to pretend you don’t know me and we have never met before - either one is okay! My feelings won’t be hurt.  The thing I am most concerned about is that you feel comfortable.  Some young people are with friends or someone else and don’t want to explain who I am or that they are in counseling and other young people are excited to say hi and wave.  Again, either one is fine - you have the power to choose!”
 
After that I go into limits to confidentiality and head right on down the checklist.  Some things I speak mostly to the parents about (i.e. HIPAA) and other times I am dialoguing with the client about what they were told about coming to therapy and what their expectations are. 
 
Now, how long does the whole verbal informed consent last?  Usually for me it takes about 15 minutes.  But, because it primes expectations for future sessions and increases client retention, it is likely one of the most important 15 minutes I get with a client. 

Want to know everything that is on my list?  Grab the free download for your next intake HERE!
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The first session with a client sets the stage for the entire therapeutic process. Sure, we all have those sessions that hit the fan, the correct paperwork didn’t go out, a child shows up without a parent, or even an all out client tantrum.  For most of these hiccups we can course correct and get into the therapeutic work seamlessly.
 
BUT did you know that clients (and their parents) will judge you and make up their mind about your character in 1/10 of a second? No pressure right?
 
The factors that clients will judge us on include likeability, competence, trustworthiness, and aggressiveness.  All of this is pretty darn important seeing that one of the most important factors that determine client growth and healing is the therapeutic relationship. 

In about one blink of an eye a client will decide if you are someone they can have a relationship with.  Parents will decide if you are someone they can entrust the care of their child with.  Children will decide if we are someone they can play with and share with.  
 
So, because of this it is my theory that an excellent first session (i.e. the start to great therapeutic work) starts in the lobby.  Before you even have the chance to say Hello. I wanted to give you four of my tips for a great first impression from the moment you meet the client in the lobby to when they have a seat in your office to settle into the intake! 
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• Do your homework - this may be a given, but before entering the lobby know both the child and parent’s name.  Nothing creates doubt or feelings of unease more than when you greet Jayden by saying “you must be Ayden”.  Kids and parents might doubt that you know anything at all about them if you don’t even know their name. 
• Send cues of safety - I do a deep dive on this topic HERE, but some of the intentional ways you can communicate trustworthiness to a young person is a smile, soft eye contact, a slight head tilt, getting below their level when you speak to them, and vocal prosody.  Remember - we have 1/10 of a second and these are all intentional (mostly nonverbal) ways to communicate safety and trustworthiness.  
• Greet the child first - I mean it is their appointment after all! I love greeting children by saying “Hi! Are you Jayden?” (hey we got it right!), then move into introducing myself to the child.  I might say something like “I’m Ann, nice to meet you!”  before addressing and greeting the parent by first name. 
• Orient them to structure - let clients know what the next steps are.  Are they all supposed to come back to the office? What about their brother or sister? Where exactly is your office? Where should they sit?  These are all ways that I make the unknown known with clients as they are coming back to my office. 

 
All of these little things can help clients feel comfortable and safe enough to begin talking about (and playing out!) the tough stuff that brought them into therapy. 
 
What are your favorite tips for an excellent first meeting with clients?  How do you make the most of the 1/10 of a second?  Comment below! 
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And just like that...I’m back in the Playroom. In person! 
 
Well...it wasn’t exactly that seamless. It was more like 5,234 trips up the elevator with all of my toys I took home at the beginning of the pandemic, setting up a new desk and file cabinet, shifting toys around my playroom, adding new toys, assessing my COVID-19 in office policies, procedures, and paperwork, notifying my clients, juggling who was in person and who wanted to still stay virtual, re-activating my parking, and notifying the office of my return. 
 
Wheew! 
 
Oh yeah, and reconfiguring my computer to the new wifi and printer. Ugh. Tech is the worst. 
 
I wanted to share with you 6 things I noticed about coming back into the office after being back for a couple of weeks.  If you are already back in person I hope this makes you feel seen and that you can relate!  If you are thinking about going back here are some things that might help you a bit to see what is to come! 
 
You might forget what floor you are on 
Or you try to enter the wrong building after you get your morning coffee. True story.  To my credit, I hadn't had my morning coffee so classic mistake. Some things about coming back were a bit fuzzy and after sitting in the elevator for a minute trying to figure out what button to push you realize that this is old, but this is new too. 
 
You’ve done it thousands of times before, but it has been a loooong time since you have been in this routine.  Give yourself some grace. For me, it had been a year and a half since being in person at the office.  And for this one - don’t worry - your neural networks for your office routine will blow the dust right off and it will be like you never left in no time!  
 
My timing is off 
See the former on the whole “this is old, but it is new too” thing.  I didn’t have to get up off my chair to close down my sessions.  I didn’t have to get up to greet people.  The clean up from the session was timed differently.  All of this has resulted in getting done a little after I wanted to, or maybe a little too early.  Mostly for me, it was not ending with enough time to wrap down the session, walk my client to the waiting room, come back, take a breath, and finish my note.  
 
This was also complicated by the fact that a portion of my caseload is also virtual. SO my timing for getting my computer setup ready (on my coffee table, which has the best light), make sure the cord and camera are attached, and login after having a session where my computer was over on my desk was also off too! All of this led to me playing catch up on paperwork my first week and a half.  Again, you get back into the hang of it and your flow comes back! 
 
My memory and information retrieval was hazy 
I’m not going to lie - the first week was rough.  I chalk it up to state dependent learning. Not only was I in a completely different space the last time I met clients (ie my house) we were also having sessions over a computer.  AND even though I had notes from the past session it was hard for me to recall with clarity (as much as I typically have) the content of the session.  
 
Also it was harder to retrieve more complex words or internal scrips I had for explaining concepts like polyvagal theory.  It just felt...stuck.  It was also hard for my brain to process that my clients were...different.  I mean, they didn’t change BUT my brain was used to seeing them on a computer screen and getting their audio into my earbuds and now in person my brain was working hard to make sense of these changes.  After about 2 days things were well on their way to back to typical - wheew! 
 
I needed to re-orient clients to the play space 
Clients had been playing for over a year and a half in a virtual way.  A way where kids played with play kits, in a space in their home, with a different setup and structure.  Some kids played virtually where we entered a game together or with screen sharing.  And from what we know (see above) it is hard for adults to transition back to in person sessions, it’s also different, new, and sometimes difficult for young people too.  
 
Acknowledging the shift significantly helped as well as re-orienting to the Playroom and the toys.  For some young people they had been in the Playroom before and knew what it looked like and where they could find the toys and at the same time they were also taking in a slightly new office set up and some new friends in the Playroom.  For others that I started seeing during the pandemic, the Playroom was completely new.  I conceptualized the first session or two of coming back to be like clients coming into your play space for the first time - looking at the new things, re-orienting to the things they knew, and trying all the things out! 
 
Clients know what to do 
This is one of my most favorite things I learned about coming back into the office.  It is about the resilience of children. For kids to pick up right where they left off.  For some clients, this meant literally picking up where they left off during the last office session.  You hear them say “do you remember when we played with the horses - we’re going to play that game again”.  And just like that they get into their play and themes. They are doing the work. 
 
I’m excited and emotional at the sight of sand on my floor 
Ackk! I never thought I would be so in LOVE with the sight of messy sand all over my floor, (ask me in three months I may feel differently) let alone have it bring me to gushy tears. Seeing the toys around the office floor.  Feeling the energy of clients with you playing in person, where you can actually reach out and grab something from them. All of that has helped re-energize me as to why we do the work that we do. Why we are Play Therapists. 
 
I still hold gratitude for Tele-Play and what it has allowed us to do, and although I don’t think it is going anywhere, I am dang ecstatic to be back in the Playroom! 
 
What about you?  If you are back in office comment below with what you have noticed! 

Oh! And if you are looking for resources to help support young people get back in the groove of things check out Transitioning to Life After the Pandemic by Dr. Karen Fried and Dr. Melissa Mullin or The World Made a Rainbow by Michelle Robinson!
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When I was young it felt like I lived at the library.  
 
Story time. The anticipation of what might be available to check out.  The agony of being put on a wait list for a book you REALLY wanted. 
 
Ahh… such sweet memories.  And that shouldn’t surprise you seeing as bibliotherapy is one of my favorite ways to engage in therapy with young people.  
 
So, what does my childhood love for the library have to do with being a Play Therapist?  
 
Well...the library is actually one of the BEST resources for new and seasoned Play Therapists! With a library card you have access to all the free books you could dream of!  Well...technically with my library you can check out up to 100 at a time for four weeks.  
 
The last load of books I got there were 4 out of 10 books that I would be interested in using in my Play Therapy practice - and that was without even trying!  These books ranged in topics of appropriate social behavior (ahhh hem - The Bear Who Stared), gender fluidity, emotional expression, and generational trauma. Yup - all kids picture books. 
 
The library is a great resource for checking out books to see if they would be worth investing in for your practice and testing out how kids respond to them.
 
It’s also easy to plan to use the intervention and specific book and activity with all children (where it fits their goals and treatment plan) over the span of several weeks as the book is checked out.  If it’s a hit you can consider adding it to your collection OR checking it out from time to time for new young people who can benefit - which is completely free and a great resource for new Play Therapists. 
 
I also love that there are books that I had never heard of and never came up in my searches that are excellent for Play Therapy.  And when I say this, I don’t mean it lightly.  I spend hours on hours on hours looking for, purchasing, reading, and training on bibliotherapy with children. 
 
Lastly, there is also wisdom in librarians.  If you are looking for a specific topic they likely will have one or seventeen books that could fit your need!  
 
Looking for inspiration?  Check out these bibliotherapy interventions HERE, HERE, HERE, and HERE from Cognitive Behavioral Play Therapy, shifting thoughts, gratitude, and self esteem.  You can also get inspired by my list of 70 Books for Emotional Regulation HERE! 
 
Want more?  Check out my Bibliotherapy and Play Therapy training HERE! 
 
AND are you a Play Therapists that goes to the library?  What books have you found that you use in your Play Therapy practice?  Drop a comment and resource below! 

If you work with kids, you also work with parents.  
 
I truly believe that parents are the most important people, supports, and structures in their child’s life.  
 
Even though the child may come into the therapy office or Playroom once per week - their parents are the ones that are in the thick of it, every day, with their children.  They hold the attachment relationship with their child, which is a powerful means for helping children regulate, develop, and grow. 

And ...research shows that parent engagement in therapy actually leads to improved outcomes. 
 
Inevitably we do some sort of parenting work with the families that we see.  I would say that when I work with parents it is a combination of Dr. Daniel Siegel and Dr. Tina Payne Bryson with books like No Drama Discipline along with Cognitive Behavioral Therapy paired with a heavy dose of Polyvagal Theory. 
 
Now, one of the things that comes up often is the importance of consistency and how follow through or lack thereof can significantly impact the way children may act in the future.  
 
Let me pause for a moment.  When talking about boundaries, limits, and consequences vs. threats I am talking about engagement with the child who still has access to their prefrontal cortex, reason, logic and decision making - not the child who is in their sympathetic nervous system (or fight/flight response).  That is a whole different type of parenting technique.  If you want to learn more about the differences and how parenting strategies are different depending on what area of the brain is functioning check out this training HERE. 
 
Okay - now back to the child that is struggling with limits, maybe whining, glaring - but they are still with you.  They can still hear you and can still communicate. 
 
Parents often will struggle with not wanting to threaten their children, wanting to make a boundary with impact, and aren’t quite sure how to put it all together. 
 
Sometimes I hear things like Halloween has been taken away, a child is grounded for the summer, or isn’t allowed to play in the big game or dance in the big show.  Most often the parent ...well...reconsiders or just doesn’t follow through with the big thing in the end. 
 
I get it - parents are stressed and want to say something impactful so their child will listen, comply, and regulate.  At the same time they still care for their child and want them to have fun and enjoy the things that make childhood great.   

One of the things I highlight with the families that I work with is that if you are going to put something out of the table it must be something you are willing to follow through with. Period. 
 
If parents aren’t willing to follow through with the thing they are telling their child is going to happen one of two things happen, usually both.  Thing one is that the child learns that the parent isn’t really serious with the structure they are attempting to put into place.  In the future children retrieve this data and may make a decision to continue to engage in a behavior (which I like to call “jackpotting”)  because they don’t think the parent is likely to follow through with what they are saying because they haven’t in the past.  This is most frustrating for everyone involved. 
 
Thing two is there is a high level of likelihood that there will be damage to the relationship.  The parent escalates and may say or do things that they may regret later.  If the limit is actually put into place then the child can feel like it was unfair because that wasn’t how “the rules” worked before. The parent feels disrespected and the child feels blindsided. Lose lose. 
 
This is where threats vs. boundaries and limits come into play.  A threat is something that a person is highly unlikely to act upon and is intended to make the child act in a certain way. Usually a threat has a high level of stake (ie see above with no Halloween, activities, or intense groundings) meant to engage in behavior change through the child’s fear. In short the intent is that they listen because they are scared. 
 
On the other hand boundaries, limits, and consequences are a statement of what the expected behaviors are and what the parent will do in response to a child breaking a rule or limit.  
 
All of these are meant to engage in teaching a child with the relationship and attachment at the forefront.  Limits and boundaries come into play to help the child understand what the expected behavior is and the structure around behavior and privileges. It might sound like: 

• You can absolutely have candy after you eat some of your dinner. 
• Kids who clean their room are kids who get to go out and play. 
• Video game time ends at 8pm. 

 
Consequences come into play after a limit or boundary has been broken.  We know what this looks like. The child who sneaks technology at night, shoves the mess in their room under the bed, or continues to use disrespectful language.  Consequences then sound like:

• Ohh I know video games are so important to you and you really want to beat the next level.  That's so frustrating. Until I can trust you won’t play them at night I will be taking the controllers when I go to bed. I love you. 
• I get that you are overwhelmed with school and tests and that’s why you are behind.  School can be really stressful.  As soon as your late homework is in you can go to the sleepover.  What do you need from me to help you get this done? 

 
Always with a good dose of empathy, connection, naming feelings before we deliver what the consequence will be.  Consequences in a natural logical way are meant to keep the attachment relationship intact along with developing an internal locus of control and ethical compass about what appropriate behaviors and choices are. The child decides to follow rules because they know that's "what's right" for both themselves and the world around them. 

What are your go to phrases to help parents set limits, consequences, and boundaries?  Let me know in the comments below! 

​We all do it.
 
There is that one toy, resource, or item that just NEEDS to enter your playroom. Okay - maybe more than one.  You click add to cart or take it off that garage sale table and it’s yours! Off to the Playroom it goes! 
 
I wanted to land on this topic that has come up several times recently in supervision and consultation. That is, the topic of how we integrate new items into our play space.
 
Maybe you’re thinking - but Ann…. you just unpackage it and put it on your shelf, right? How complicated can it be?
 
Well...I wanted to make the case for intentionality when introducing new items to your playroom or taking old items out. 

Every new toy in your Playroom can significantly affect the neuroception of safety in your office and can spark anything from curiosity, sorrow, intense distraction, or all out giddiness. 
 
This can actually interrupt the flow of play or play theme that may have been building up over weeks.  Sometimes it might be exactly what the child needs.  Other times a distraction. 
 
And sometimes kids can start to feel like your office isn’t safe or stable and might start asking you (even every week) “What’s new?” if the toys rotate too frequently.
 
Wait. Does this mean I should never get new toys?
 
Of course not! New toys are essential to our practice as we are replacing things that are broken or used (yes Play Dough I’m looking at you) or when we want to add to the collection of materials available for children.  
 
At the same time we want to make sure that as we are bringing new things we evaluate what might need to make an exit out of the Playroom.  Maybe that toy that never gets used and you need the precious space for something else, or just something that is on its last leg. 
 
For the toys that have seen their last session, for some children it can be a sense of loss and grief or create an uneasy or unstable feeling. 
 
So….what do we do about it?  I put together my three phase method of making changes in the Playroom that might be useful as you evaluate your own Playroom! 
 
Evaluate Your Toys 
I think it is a great practice to occasionally evaluate your toys.  Take a mental stock of what is being used and what hasn’t been touched...like ever.  For the toys in the latter category I like to take a deep evaluation of is the toy not used because it is not appealing or useful to play OR is the storage and placement something that is a barrier to use.  Does it need to be shifted in placement or taken out?
 
I also like to go back to my foundational Child Centered Play Therapy text books HERE and HERE and see how my categories and availability of toys is comparing to the suggested lists.  If I am thinking about taking things out of the Playroom is that category represented in another way?   If I am thinking about adding toys into the Playroom what do I already have in that category?  Can children use the existing toys for play or does this new object amplify what can be done? 
 
Identify the Changes 
Now it is time to identify what specific changes you would like to make.  Shift up the placement of objects, take out some old toys that aren’t terribly effective for Play Therapy themes, or the creation of a new list of items you would like to add. Maybe a new desk or coffee table? New storage for toys? Yup.  All of that counts as a shift and a change. 
 
In all of this we again keep the theory at the forefront of what purpose each toy serves.  Even though you or your child might LOVE one of the newest toy crazes - how it fits into your theory will determine whether it is invited into your Playroom! 
 
All At Once 
I am a huge fan of selecting certain times a couple of times a year or less (sometimes only one) to make changes into your Playroom.  For me one of these times is usually around the holiday season only because I can usually find some good deals on new toys. 
 
If we are using the “All At Once” method, then several times per year the young people we see will have some opportunities to process through healthy changes in a therapeutic space BUT won’t get so distracted like if new toys are coming into our office every other week.  
 
When I decide to make a shift (like I am now as I go back to in person) I save up some of the toys that I have been gathering or furniture I want to paint and all at once make the shift.  Then as time goes on and I collect things here and there I just continue to make a pile or a stash until it gets big enough to rearrange and put into the playroom. 
 
The one exception 
In all of this there is definitely one exception, which is if a toy is significantly broken or dangerous it needs to be removed immediately.  We can empathize with clients and identify feelings as they process through the loss of a favorite toy, but we definitely don’t want to keep something dangerous lingering around.  
 
Want to know more about setting up your Play Therapy space?  Check out this training HERE! 
 
What about you?  Comment below with how you like to assess and shift toys in your Playroom!