Theraplay Innovations and Integration by Rana Hong and A. Rand Coleman 
​
Theraplay is a tried and tested intervention for children with social, emotional and behavioural difficulties. It has earned its stripes in numerous quantitative and qualitative studies since its introduction to the Head Start program in Chicago over 50 years ago. I have been familiar with Theraplay since my own children were small and have seen people (wrongly) dismiss it as an intervention that is suitable only for very young children.


So, it was exciting to read Theraplay Innovations and Integration to learn how Theraplay practitioners are combining the approach with other therapeutic modalities to address specific issues and situations more effectively than they might with Theraplay alone. It also makes complete sense that practitioners are even using the approach to improve social connection in older adults, reaching out to the ever-present inner child to support the maintenance of attachment bonds throughout life.
 
The book begins with an overview of Theraplay and how this simple playful dyadic and group interaction has been instrumental in transforming the lives of unhappy and marginalised children, regardless of their diagnosis or lack of diagnosis. There is also a useful round-up of research in recent years and an introduction to its integration with other modalities. This is followed by a chapter on the neurobiology of Theraplay and each chapter after that then focuses on a specific example of integration, using detailed case studies and helpful examples.
 
Not surprisingly, there is a chapter on integrating Theraplay with DDP, a marriage with which many DDP practitioners will already be familiar.  In the beautifully and clearly written DDP chapter, attachment specialist Dafna Lender also incorporates an example of a gentle exploration of intergenerational trauma with a parent. It’s a wonderful snapshot of how to work pace-fully with parents in therapy. There is a chapter on Theraplay with sand tray therapy – a partnership that allows families to benefit from the attachment building and reduced anxiety that Theraplay offers combined with the explicit trauma processing that sand tray therapy can facilitate. There is a wonderful chapter on Theraplay and EMDR and how closely these two modalities map onto each other in their structure and thorough preparation. This chapter by Helen Rodwell was one of my favourite, not only because Theraplay took the lead in the treatment approach but also because of Rodwell’s in-depth knowledge of the work and her clarity and confidence in writing about it. Other topics explored include combining Theraplay with other play therapy approaches; using Bruce Perry’s Neuro-Sequequential Model of Therapeutics; music therapies and Theraplay and working with autistic and gifted children. There is an excellent chapter by Jay Vaughan on somatic experiencing with Theraplay within the Family Futures model of Neuro-Physiological Psychotherapy (NPP). This may be of particular interest to adopters who could identify with the emotive case study.  Vaughan repeats throughout the essential message that we must read the nonverbal cues of the child and track our own non-verbal communication, while ensuring we regulate our own nervous systems to facilitate regulation in the child.
 
The editors also managed to squeeze in information about group Theraplay with teens in SEN setting and with homeless families as well as a chapter on ways to engage men in the play. As expected with a post-Covid publication there is a chapter on Theraplay and telehealth, making this a dynamic and comprehensive collection of innovative Theraplay collaborations.
 
This is such a well-written, well structured, engaging, and accessible book, aimed at answering many of the questions, parents, funders and therapists would have around the use of Theraplay in various contemporary settings with traumatised children and others. It is easy to dip in and out of and has many practical suggestions on working with families with differing abilities, structures and cultural needs. It is a welcome addition to the Theraplay literature.

Sheila Lavery
art psychotherapist, trauma educator and therapeutic parenting coach

Play Is The Way: Child development, early years and the future of Scottish education. Edited Sue Palmer

This compact volume is a rich and engaging resource for educators, health professionals, policy makers and parents which sets out a comprehensive argument for establishing a relationship-centred and play-based education for Scotland’s under 7 year olds. Edited by Sue Palmer, who has gathered an impressive array of voices from education and health professions, the book summarises and expands the campaign of Upstart Scotland whose aims include establishing a statutory play-based ‘kindergarten stage’ for Scottish children and stressing the importance of play as a natural part of human development. 

Throughout the book, there is a thorough examination of existing Scottish guidance and legislation on early years education and care, and an overt frustration at the current mismatch between what is on paper and existing practice in nurseries and schools.
The reader will find the book divided into three sections.  The first considers ‘What we know about where we want to go’ and is a fascinating insight into the cultural and historical barriers in Scotland regarding the efficacy of play in early education.  The myth of early acceleration is skilfully outlined through examining the historical contexts that have brought about the persistent but unfounded belief that educating children as young as 4 or 5 years in the 3 Rs (Reading, wRiting and aRithmetic) is the most beneficial for later outcomes,  and that the stubborn suspicion of the validity of play is part of Scottish identity, proud of its early start to formal education. Psychological and neurobiological studies are set out to highlight how human brains are built from the bottom up ie gradually building connections on top of existing foundations of understanding so that incoming information has something to grasp onto.  Trying to accelerate this process by top-down pedagogy goes against the natural development of human brains yet the myth of starting early seems engrained not just in Scotland but throughout the UK.

Section two sets out to consider ‘How can we get to where we want to be?’ with real examples of existing projects leading the way and projected scenarios of what might be possible including harnessing the power of parents.  I was particularly drawn to the arguments for raising the status of the workforce in the early year’s arena and an emphasis on the relational experiences needed to build the foundations for literacy and numeracy before formal learning begins.  As a play therapist, I am delighted to read segments about the vital role of play for children’s social, physical and emotional development; that play is not just a fun way of learning cognitive concepts but is the fundamental language through which children first understand themselves and interact with the world.

The final section examines the wider context in which the authors’ arguments sit and the challenges ahead.  A prime block seems to be the persistence of the Scottish government to require formal assessment of P1 students (age 6 years) rather than moving towards more holistic assessments such as the Early Development Instrument (EDI) which considers social, emotional and physical developments in addition to cognitive and language developments. EDI is already used by other English-speaking countries such as Canada and Australia but has not (yet) found a place in UK education.

In the 2nd edition of this book (it had two reprints within a few months of being published in October 2020), there is a super additional chapter from Shaddai Tembo in which he challenges the often positive and idealised environment in early years settings which may be masking ongoing inequalities and not giving space for recognition of celebrating diversity in all its forms right from the start of a young child’s educational experience. Play, he argues, is a means by which young children can take flight into aspects of themselves that may be constrained in the culture of their setting.  A powerful read which comes from a standpoint of experience and compassion and is well worth a read on its own.
​
The excellent reference bank at the end demonstrates the robustness of the research related to the topic of play in early years education and in itself provides a rich source of further reading.  Whilst stemming from Scotland and referring to particular cultural and historical aspects of early education in that country, the book is of equal importance to those of us working elsewhere in the United Kingdom.  I smiled when reading that a copy was sent to every Member of the Scottish Parliament for Christmas!  Bravo to the whole team who put this gem of a compendium together during the pandemic lockdown and are keeping the momentum going for appropriate and life-enhancing early education and care. 
 
Julie McCann, London
Former primary school teacher, BAPT Play Therapist, Theraplay Practitioner, Visiting Lecturer Roehampton University

Theraplay® – Theory, Applications and Implementation edited by Rana Hong and Sandra Lindaman
​
When the latest Theraplay publication landed, I was excited to see the list of contributors. The Forward is written by Theraplay founder, Phyliss Booth, she provides the history of Theraplay. It’s followed by a Preface from Sandra Lindeman and Rana Hong, Editors. In these troubled times, it’s refreshing​ to know practitioners around the world are adapting the model to use in Covid safe ways (including virtually). Theraplay brings such joy and hope to many.

 
The body of the book is comprised of 12 chapters each focusing on a different application of Theraplay. They are well organised with introductions, key points, subsections, case studies, concluding comments, questions for reflection and references. Chapter 1 provides an overview of the Theraplay model with updated reference to Polyvagal theory, attachment theory and neuroscience.
 
I was drawn to Karen Doyle Buckwalter’s chapter 2, ‘Ghosts in the Theraplay Room – Exploring, Considering and Understanding the Impact of the Caregiver’s Own History on Theraplay Treatment’. I attended Karen ‘s training on applications of the Adult Attachment Interview last year and was fascinated to read applications of this, and other tools, in Theraplay. The chapter offers powerful insight and navigates an area my supervisees often bring to supervision.
 
I was also trained by Saara Salo and Hannah Lampi last year, authors of chapter 3, Prenatal and Infant Theraplay. The descriptions of Theraplay applied   in the prenatal phase are full of hope but also backed up by Saara et al’s own research (2019) which is outlined.
 
Chapter 4, Theraplay with Adolescents was written by my amazing supervisor, Fiona Peacock. I loved how Fiona highlighted the need to be conscious of our own cultural identity and how our attitudes and values may impact on our work and clients. Fiona brings her ideas to life through a description her own child gave growing up with a ‘Theraplay Mother’, case work about applications of Group Theraplay and using Theraplay to support a teen mother.
 
Kay Schieffer has contributed chapter 5, ‘Sunshine circles, Universal Best Practice for Young Children in Preschool Classrooms’. As well as giving a rationale for the approach, Kay provides a detailed case description showing how Sunshine Circles was used to form community and stimulate interaction.
 
Annie Kiermaier who inspired my Theraplay journey, writes about ‘Home-Based Theraplay’ in chapter 6. She highlights the thought process the family and practitioner need to consider around the possibilities of home-based Theraplay. Annie knits the realities of all of her experience into her chapter to give practitioners a true reflection of working in this way. She highlights the nuanced support the home-based practitioner may be able to offer.
 
Chapter 7 by Danielle H. Maxonight, ‘Theraplay Adaptatios for Anxiety Disorders’, focuses on the need to consider both children’s and caregiver’s anxiety as it can be intergenerational. Adaptations are described alongside a full case description (including intake).
 
Elizabeth Konrath and Eliana Gil contributed chapter 8, ‘Using Theraplay to Treat Clients of Child Sexual Abuse’. A rationale for Theraplay as an approach is provided alongside theoretical underpinnings and neuroscience related to trauma. The case description highlights the complexities of this work alongside adaptations.
 
Vivien Norris, in chapter 9, writes about ‘Using Theraplay to Help Children Who Are Moving Families’. Vivien describes how Theraplay can be used to support transitions. Vivien has developed her own training and resources (By Your Side, Norris 2019). This is discussed. Vivien outlines how the principles of her work are used within her case description.
 
Chapter 10 is written by Donna M. Gates, ‘Theraplay with families Affected by Domestic Violence’. Donna provides an overview of the impacts domestic violence can have and describes how to work with the non-offending caregiver before beginning dyadic work. A full case description is provided to illustrate Donna’s work.
 
Lauren C. Smithee writes  about ‘Adapting Theraplay for Affirmative Intervention with LGBTQ Families.’ The chapter begins with a focus on understanding the impact of minority stress and internalized stigma. There’s focus on use of terminology and a helpful glossary is provided. Lauren’s case description is of working with a 12 year old transgender girl. It highlights many different issues practitioners may encounter in this application of Theraplay.
 
The final chapter 12 is written by Alexis Greeves and Nicki Melby, “Theraplay with Children who are Deaf or Hard of Hearing’.  It outlines the need for the practitioner to understand how families identify themselves and their culture around hearing loss. Links are made again to Polyvagal theory and further work with caregivers, who may have unresolved grief around their child’s hearing loss is described. Alexis and Nicki describe specific adaptations to Theraplay for work in this context.
 
This edited collection is a fascinating read and the case illustrations bring the theory to life. It has enhanced my love for Theraplay and increased my understanding and sensitivity across a wide range of applications. I highly recommend to all practitioners and organisations with an interest in Theraplay.
 
Dr Amelia Taylor
Child and Educational Psychologist
Theraplay Practitioner and Trainer
Lifecycles Psychology

This is a book for anyone who has an interest in Theraplay, who is thinking about undertaking Theraplay  training, and most especially for those who have some years of experience in Theraplay.  It does, as they say ‘what it says on the tin’, in that it provides relevant theory, the various ways of applying practice/ theory to different ways of using Theraplay, and gives excellent examples of implementation, which I found particularly useful, as a I know my learning style is one of ‘learning by doing ‘ with an underpinning of theory that I can see/recognise as evidence.
 
Chapers are written by a number of people, which also gives a variety of voices to their contribution, with each contributor writing about how she uses Theraplay in her given specialism - and there are plenty of specialisms shared here - Prenatal and infant Theraplay, Children being prepared to transition from foster care to adoption, Sunshine Circles, Home based Theraplay, Theraplay with adolescents, Using Theraplay to treat clients who have experienced child sexual abuse, families affected by domestic violence, Theraplay adaptations for anxiety disorders, Adapting Theraplay for affirmative interventions with LGBTQ families, and Theraplay with  children who hearing impaired.
 
 I enjoyed reading this book, I found the content and the layout to be exceedingly helpful. The blend of theory and practice worked very well, as does the references to more recent experts such as Stephen Porges Polyvagal Theory, BasselVan Der Kolk’s work, as well as other known names like Fongay, Perry, Siegel and Shore.
 
The biggest message I have taken from this excellent book is the importance of getting the foundations right, i.e preparation / background work with the care giver. This being critical to effectively working with the child. As an adoption support worker, this rang true for me. My experience is often one of ‘listening and acknowledging’ a care givers own life experiences, and reflecting with them how and what is happening for them in their relationship/life regarding their child and presenting difficulties. I would strongly recommend this book as a valuable resource and practical support to practitioners using Theraplay in their work. 
 
Rita Grant
Adoption Support Manager
St. Andrew's Children's Society

Theraplay® The Practitioner's Guide by Vivienne Norris and Dafna Lender 
 
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I was really excited to read Theraplay The Practitioners Guide by Vivien Norris and Dafna Lender as I found and continue to find Parenting with Theraplay really useful and I wasn’t disappointed.

The book starts with a description of the Theraplay Guiding Principles and beautifully describes what makes it such a powerful intervention, the reader is taken through the underlying principles with great attention to detail and practical explanations linked to the theory underpinning them. 

I think the short paragraph describing the simple Mantra of Theraplay attitude  ‘NO hurts, stick together, have fun and the adult is in charge’ gives a simple and memorable framework that those at the beginning of their theraplay journey will find invaluable and for those further in their journey a helpful reminder of what theraplay is.

The dimensions are helpfully described and I love the inclusion of considering raising the need to think about cultural differences between ourselves and our families and the different way they can impact and the exploration of adaptations needed for older children, physical or cognitive limitations, gender etc.  Not every situation can be listed but it’s helpful to raise this need especially in the UK as my experience has been that adaptation of some description has invariably been needed in my work with families.

The table which constitutes the summary at the end of this chapter is a really helpful quick reminder of what the practitioner needs to hold in mind in different situations in sessions, the explanations illustrate key pointers for good practice clearly based on the theoretical principles underlying.  It will be an invaluable resource to dip into for a quick reminder both prior to sessions and afterwards when reviewing the video footage and I think will be invaluable in helping one think through where their practice can be improved.

I loved the chapter called Nuts and Bolts which takes you step by step through using Theraplay, as well as giving the ideal practice it helpful raises questions that help to identify where adaptations are needed and the examples used illustrate the points made clearly.  It was great to see how the importance of the therapist relationship with the parents is highlighted and the challenges that this can bring. Again there were great examples which really bring the theory to life such as the importance of a simple as a cup of tea in offering nurture and building relationship.

It really feels as though you have someone walking besides you as you read through the steps that lead to your first theraplay session.   Again the joy is in the detail of the writing and the thoughtful examples used that illustrate the work so well.  The careful consideration given to each step makes it seem so simple but the practicalities and the theory are written in such a way that they prompt both the new and experienced practitioner to be thoughtful about their practice and remind you how complex this intervention is when it is truly delivered.   The decisions made at each stage of the work from the parent feedback, the sessions themselves to the importance of working with parents and the challenges this can bring are worked though so that the reader gets a real sense of what’s needed from them.

The chapter titled Theraplay Outtakers and Bloopers – What No One Ever Told You is great encouragement to us all and illustrates how we all learn from practicing and how important it is to never stop looking at the detail when preparing our sessions or feedback or examining what we did.  That we all get it wrong sometimes but if we remember the Theraplay Mantra it will be okay.
The examples illustrate that there’s always learning, that the best plans need adaptation, that children can be unpredictable, the need for safety and the practicing with theraplay attitude are illustrated again and again and how using the theraplay guiding principles allows what can feel like failure to be turned round to positive experiences for parent and child. 

Part 3 looks at Becoming a Theraplay Practitioner and It is helpful to have such a detailed look at what it means to become a theraplay practitioner, what one needs to consider if one wants to takes one’s practice forward.  The challenges that one might face and how to think about them within the context of theraplay.

There’s a super chapter on the supervision process, the practicalities of supervision as well as what might come up personally and the process required to become certified is fully explained.

There are very helpful examples of supervision forms which will be invaluable to those considering whether qualification is the right path for them as well as invaluable for those that in the process of qualifying.

And finally a wonderful array of resources to further support those working with theraplay.  I was so pleased to see the inclusion of how to work with Sensory regulation and the adapations that might be needed.  And it is helpful to have a chapter addressing the need for reflective dialogue in some cases and to have examples of where it can and has been useful.

There is such strength in this book in that it clearly supports workers drawing on all the tools in their tool box to enhance their Theraplay Practice.  The illustrations of where its important and indeed vital to look at adaptations are well illustrated and I think will give workers confidence to ask the questions they need to ask and go looking for answers in how best to meet the needs of their families.

And just to finish - I loved this statement. ‘This does not mean that the relationship will be without its difficulties because therapeutic work is hard , but if we attend to the rupture and repair cycle that happens within relationships, this gives us a strong basis to move forward’

I often talk to parents about how rupture in relationship with their child is not the end of the world but can be seen as an opportunity to repair and deepen attachment.  And I love that theraplay is about relationship and if we can show parents how to rupture and repair successfully not only do we strengthen the trust and strength of their working relationship with us but we also see them  grow in capacity and stretch themselves further than they ever thought possible.

I would recommend this book to anyone wanting to develop their theraplay practice.  It will be invaluable to those at the beginning of their journey with Theraplay and also a lovely refresh for those of us that have been practicing for some time.  It is full of wisdom as well as a ton of practical tools to support practice.  I know that I will be re-visiting it again and again.


​I did my Level 1 Training in London at the beginning of 2010 and immediately loved it and started using it in my work. I used the games in  groups for new adoptive parents and in my direct work with families as part of my role as Children’s worker at Scottish Adoption. In 2013 I did my Level 2 and realised that I needed to start formalising the work I was doing, using MIMs and being more structured with my parent and Child work.  I started talking to Fiona Peacock at this point although it wasn’t until Feb 2016 that I started my Foundation Level.  Fiona is still my go to person for supervision and my Mid-term report for my Intermediate has been on hold since I took on the Practice Manager Role at Scottish Adoption in 2018 – my New Year’s resolution is to complete Intermediate this year. 
 
Fiona Peacock has been working with us an organisation since 2017 and has been invaluable in supporting the understanding and use of theraplay principles in our work.  All our Senior Practitioners are trained to Level 1.  Our adopters are introduced to Theraplay games in prep group, again after approval on our Practical skills for Attachment Training day and post placement in our group programme.  Additionally we use MIMs for all families looking for After Adoption support – its invaluable as an assessment tool and parents are very positive about the process. 
 
I love theraplay - for me it’s a great fit both with me personally and the other tools that I use in my work and through Fiona’s support my practice is growing.  I look forward to dipping into The Practitioners Guide by Vivien Norris and Dafna Lender as part of my Theraplay journey going forward – I can see that it will be invaluable.
 
Julie Connaway
Practice Manager
Scottish Adoption

Theraplay® The Practitioner's Guide by Vivienne Norris and Dafna Lender 
 
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​Anyone interested in Theraplay® will know how difficult it is to find Theraplay® Institute approved information and activities. It can also be a challenge for people who use Theraplay® within their wider practice to get appropriate supervision for the Theraplay aspects of their work. In both areas Norris and Lender’s book is an invaluable resource.

It is a book packed full of reflection, imagination, problem solving and trouble shooting. The case studies are particularly helpful; they feel real, with honest acknowledgement by the therapists of their own countertransference, defences and complex feelings. They also highlight without any blame or shame how difficult it is for some children and parents to adapt to news ways of relating.  
 
One of the complexities of Theraplay® is that it looks incredibly simple in theory but can be remarkably difficult to practice with efficacy. The authors have considered numerous challenges for the newly qualified and perhaps even the more experienced practitioner, from choosing sequences of activities that allow the therapist to stay relaxed while the child remains engaged, to working with complex parents and understanding and supporting children with deeply challenging forms of resistance, anxiety and control. In fact, in many ways, this is a treasure chest of support for anyone working with children and families, even those who are not Theraplay® trained. By that I mean the Theraplay® attitude and perspective provide a great model of engagement and relational connection that has a true attachment-in-action focus .
 
The book packs in a lot of reading, helpfully structured into five sections.
Part 1 covers the overarching principles of Theraplay® and places it firmly within the context of trauma and attachment theory, dyadic developmental psychotherapy, social engagement theory and neurobiological research.

Part 2 is entitled Nuts and Bolts. I found this “troubleshooting” section particularly valuable. It deals with the “lived experience of engaging in Theraplay®”, answering many questions that I’ve never seen addressed anywhere else. It illustrates the real complexities of using the apparently simple activities in depth with traumatised children and their parents. All too often we focus on challenging children and fail to prepare for the parent work. The authors consider the skills needed for parent work and the challenges of engaging complex parents who could (often unconsciously) sabotage work with the child. As it says on the tin – the nuts and bolts!

Part 3: Becoming a Theraplay® practitioner is a much shorter section, obviously of particular interest to anyone consider training in the approach, trainees and new therapists. Again, although clearly focused on Theraplay®, it also addresses many aspects of supervision that would be of interest to therapists of other creative disciplines who work with children and their parents.

Part 4: examples of completed supervision forms looks at the MIM-based assessment form and shows examples of completed supervision forms, plus a final evaluation supervision form, complete with feedback. It is a practical section that should leave you in no doubt about the meticulous detail required in the paperwork. This detail is made possible through the use of video recording sessions and playing them back so that therapist, parent and supervisor can view the detail of interactions, proving yet again the power of the most subtle relational exchanges in creating connection or disconnection.

Part 5 is the resources section. It includes session plans for different types of clients, a guide for parents, including handouts with checklists to help parents see what the four dimensions look like within the parent-child relationship.  It’s also great to see a section on sensory regulation and children’s tolerance of touch.  As you would expect there is an updated list of Theraplay® activities. I had mixed feelings about this section. It was good to see the guidance for different age groups, but I tend to find the description of Theraplay® activities brief and often vague. Also, no group activities are included. These are small quibbles in an otherwise super resource. I have no doubt that this will be the Theraplay® bible for years to come. 

​Sheila Lavery

​By Your Side Foster Carer and Adopter Guide: support for children moving families
by Vivien Norris (The Family Place 2019),
reviewed by Sheila Lavery
 
Transitions are understandably difficult for care-experienced children, not least because of the huge losses they involve or rekindle. Chief among these are the transitions from birth family to temporary foster care and from foster care to permanency.  

We expect a lot from children when we leave them to manage these moves without respecting their relational history and their ability to make sense of the conflicting and potentially overwhelming feelings such transitions involve.
 
So I was thrilled to read and review By Your Side, by Vivien Norris, Clinical Director of the Family Place. This genuinely trauma-informed guide for supporting both children and adults involved in the move to permanency joins the ranks of Norris’s other publications including Parenting with Theraplay (with Helen Rodwell) and Not Again Little Owl. This review is in respect of the foster carer and adopter guide, which forms part of a wider resource package including a practitioner guide and training programmes.
 
By Your Side acknowledges that starting well is crucial in adoption. It aims to do this by establishing a model of collaboration and containment. It employs DDP and Theraplay to provide consistency, playful connection, a coherent narrative, routines and rituals and a level of caring engagement so a child remains seen, heard and valued at a time when practicalities and planning often take precedence over emotional connection. The book aims to help the adults develop greater insight and empathy when moving a child. That means the adults must cooperate, manage their own feelings and model mind-mindedness and containment for the child.
 
It’s interesting that even though we know how attachments are built through rupture and repair we fail to use the huge rupture of transition as a critical attachment building opportunity and indeed, a key responsibility. Likewise, we may fail to recognise that the liminal space of transition between what was and what is yet to come is not a void but an opportunity for growth. Norris’s guide is hugely valuable in addressing this area.
 
 The manual begins by listing the seven core principles of the approach (see above) and defines the terms attachment and trauma, which helps to clarify the content that follows. The principles give a framework, goals and everyday examples of the By Your Side approach while providing the flexibility needed for every child and family’s unique experience.
 
By Your Side recognizes that the practical tasks of permanent placements and the excitement of a “forever” family means that adults often minimize or ignore the very real feelings of anxiety, grief, frustration, sadness, confusion etc., that a child may struggle to manage. In doing so we begin or continue a culture of, “if we don’t look at the tough stuff, it will go away” or we wait until a child is settled before addressing challenges. Norris addresses the reality of dealing with what comes up, as it comes up, in the here and now because that’s what being present for a child really means. She also asks us to consider our use of language and a child’s understanding of terms like “forever family”. It’s important to be curious about how those words fit with the child’s experience of family and the concept of forever, given the child’s current feeling state and developmental stage. For example, might we not distinguish between “first family”, “helping family” and “keeping family” rather than the usual fostering, adoption and care-order terminology.
 
What I liked most about this guide is that it puts attachment into action in this minute and every minute that we engage with a child, not somewhere down the line. It makes attachment the responsibility of each one of us involved in the child’s journey, not just the job of the “forever family”. Despite the abundance of attachment and trauma language on everyone’s lips, attachment is still not alive in the detail of care planning. There is still an expectation that a child will transfer attachment from one set of parents to another because it’s in their best interests. The system struggles to hold simultaneously the view of what is needed in the here and now with a long view of permanency. In reality minimising the pain of the transition undermines the chances of “permanency” or ‘forever” from the outset. When placements are not managed well subsequent transitions often become problematic and the adolescent transitions can become so difficult as to challenge the stability of everyone’s place in a “forever family”.
 
The sensitivity of the transfer of care from foster carer to permanent parent in the By Your Side approach means the adults can hold the child and the practitioners can hold the adult carers throughout the transitional process. For anyone familiar with DDP and Theraplay the detail of this approach will seem very familiar. I guess what is new is the packaging of those principles into a practical resource with a refreshing view of the space between temporary care and permanency as a bridge rather than a void.
 
As an adopter I questioned how some of the approach would work in practice. I was reassured that the midway review in the process could pick up on the fragility of some situations and the professionals could bolster any support needed for the child. Practitioners using the approach would need to be very skilled, hence the accompanying training, and the support system would need to be very robust. I’m also curious about what other supports might be available to help the adults in this vulnerable period. Still, it’s a great resource. Thinking as I often do these days about adoption disruption, the content of this guide is not only relevant to getting off to a good start in permanent placements, but together with the practitioner guide and training it would be a hugely valuable resource for repairing the hurt in families when the “forever” bubble is fit to burst and it provides a model of collaboration and support that gives adoption placements their best chance of success throughout the lifespan.

Parenting with Theraplay®
- Understanding Attachment and How to Nurture a Closer Relationship with Your Child by Vivien Norris and Helen Rodwell.

Forewords by Phyllis Booth and Dafna Lender, illustrated by Miranda Smith

​




I love this book for so many different reasons!  It unpicks Theraplay - a complex, but really useful tool that has been tried and tested in the professional arena.  We see Theraplay introduced for all families wanting to better their relationships, whatever their challenges. It makes it accessible to the key people in children’s lives – their parents, carers, grandparents etc.  It speaks directly to these adults that children need as the “bigger, stronger, wiser and kind” people they can feel safe and connected with.  The book provides just the right amounts of the Theraplay principles of structure, engagement, nurture and challenge in the text and illustrations. This makes the model something we can make our own in our families. 

The first part of the book explains the history, theoretical development and research that underpin Theraplay. It explains why it is needed in some families and how it works. It begins to show why “returning to early and simple ways of playing together is like building up the foundations of your relationship.” Key concepts such as attachment, safe base and emotional regulation are explained, if you want this level of knowledge; likewise, the importance of touch and creating “moments of meeting”. Theraplay is based on what happens in healthy interaction between carers and their infants/babies and the elements that make up these interactions - Structure, Engagement, Nurture and Challenge - are fully explored. Helpfully, each section and each chapter has the same format and is introduced, chunked into bite sized bits and then summarised, so that you can pick out what is useful to you right now. Every section is full of suggestions of what you can do to shift the way you interact with your children. There are scenarios and check lists to help you think about your internal life and that of your children and many ideas about what to do to support your relationships. There are loads of examples of things you can do in daily living situations and well as games for more specific play time. What I found particularly helpful is that while illustrating each relational element and aspect that makes up Theraplay there is as much support for parents – possible ways to practice, to find the way forward, to have their own needs met etc – as advice on how they can support their children.

The second part of the book looks at the stressors of daily living that our children often need help with, whatever their age. It also looks at some of the behaviours that are the outwards signs of our children’s response to these and more complex causes of overwhelming stress. Just how the principles and practice of Theraplay can help address these difficulties are discussed in a warm, empathetic conversational tone. You feel as though the authors are really alongside you and your children.

I think that this book successfully conveys the “being” and the “doing” nature of Theraplay. It gives so many ideas to work on, practice and adapt so that we can get to know so much more about ourselves and our children. It empowers us to find our way to safer, repairable , fun and joyful relationships.

Roberta Manners 
Mother, Adoptive Mother, Grandparent, Certified Theraplay Practioner and Trainer.
 
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FOR THOSE ATTENDING THE THERAPLAY TRAINING IN EDINBURGH AND THE THERAPLAY CONFERENCE IN LEICESTER IN SEPTEMBER 2017 - THIS BOOK WILL BE AVAILABLE AT A DISCOUNTED PRICE!!!

DON'T MISS 'MEET THE AUTHORS' BOOK SIGNING AT THE THERAPLAY CONFERENCE

There is no better guide to how children develop their rich emotional, relational, and creative lives than is the wisdom of Colwyn Trevarthen, Jaak Panksepp and Phyllis Booth.  In this book, all three make it clear that reciprocal play--play that involves joy and delight, magic and music, often rough and tumble, always engaging in the back and forth of spontaneous encounters and movements--is a central component in the full development of children.  
            
In the first chapter Trevarthen and Panksepp summarize clearly their view of human development:  “We are born with a moving body, ready to share its rhythms and melodies of joy or anguish.  Our vitality is by nature that of a dancer or musician, and this intelligence in movement gives us signals to be shared. (p. 39).”   In the Forward, Booth gives us a brief glimpse of how Winnicott saw play between the child and psychotherapist as being at the heart of the creative changes that such meetings attempted to foster.   Play too, is the central core of Theraplay, a treatment modality developed by Booth that moves play from the focus on the symbolic play of traditional therapies to the reciprocal, expressive, movements of delight and engagement that occurs within Theraplay between the child and therapist and the child and parent. 
            
Attachment theory and research stresses the importance of safety that is established in the infant-parent relationship within which the young child learns within joint activities with the parent to regulate their affective states and begin to make sense of the world.  The reciprocal, moment-to-moment engagement--often characterized by music and  rhythms that have been called “the dance of attunement”-- between infant and parent is the foundation for the child becoming safe to explore the larger world of relationships with peers and developing interests.  Through reciprocal play, the rich inner world into the minds and hearts of others--family and friends--becomes open to the child.
            
When children have had the misfortune of developing a troubled or disorganized attachment with their original caregivers, these children need to develop relationships with their new caregivers that feature the presence of comfort (for attachment) and joy (for companionship).  Repetitive nonverbal communications that express empathy, delight, interest, and wonder are central in these children learning that they are able to trust these caregivers.  Joint activities that involve music and dance, spontaneous intentional movements requiring a shared focus and cooperation are important ways to engage these children to develop their trust.  Similar activities with their peers are often crucial both in helping the child to both return to the past with joint activities that they had needed but did not receive, as well as moving into the future into groups of friends. 
            
Inclusion, Play, and Empathy offers a great variety of ways to become engaged with children who have had difficult beginnings while guiding them to participate in those spontaneous, joint activities of creative play that they desperately need.  Music and dance, but also all sorts of shared intentions and activities, are presented in this book as ways that will facilitate children’s neuroaffective development in group settings.  Therapists from many countries and all persuasions share their insights attained through their creative therapies that are likely to offer ideas for engaging children to both parents and professionals alike.
 
These programs cannot replace the child’s need to develop safe relationships with their primary caregivers characterized by comfort and joy.  However they may well complement such relationships and, in fact, the child’s participation in these crucial experiences of play with peers, maybe actually help them to become more open to exploring a closer relationship with their caregivers.  The therapies presented in this well-edited book are excellent examples of “therapies that enhance the deep creative and restorative powers of human nature (p.49).”

Dan Hughes PhD
​Founder of DDP

THIS MONTH'S REVIEW IS A LITTLE DIFFERENT -
A POSTER AND PRACTICE NOTES FROM THE FAMILY PLACE
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Using Theraplay to support transitions from fostering to adoption by Dr Vivien Norris and Sally Twigger.

Dr Norris begins the practice notes by stating “Although it is widely recognised that support over the transition from fostering to adoption is essential, many are uncertain how best to do this in practice”.

We recognise that transition is a complex process which carries with it many hopes and expectations for all involved.  It can be a tense and emotional time for the child the adopters, the foster carers and professionals.

Prospective adoptive parents will all have had their own particular journey to adoption, they will have attended preparation groups, have under taken an intensive home study , been to an approval panel and will have known the details of the child they have been matched with for a number of weeks, and will be desperate to meet and claim the child.  The adopters will want to begin to get to know the child to establish a relationship as soon as possible.  They may also feel nervous about being surrounded by other people who know the child well.  This can result in adopters feeling vulnerable and intimidated by an experienced foster carer who has effectively built up and managed a relationship with their child. 

The co-ordination process can be emotionally painful for foster carers who have cared for the child for a long time sometimes from birth.  Foster carers will have supported the child through some difficult experiences.  They will have integrated the child into their family and will have developed empathy for the child’s experience.  They will have supported the child to meet their developmental milestones and will have established rhythms’ and routines that the child will be familiar with.  Many foster carers can experience difficult feelings about the imminent separation from a child in their care.  This can be even more complicated and sensitive if the foster carers have previously expressed an interest in caring for the child on a permanent basis.

The workers have also known the child and supported the child through difficult and distressing times.  They will have contact with the birth family and will have facilitated family contact which is often fraught.  They will have been instrumental in removing birth parents parental rights and responsibilities and are invested in securing a good outcome for the child parents who will meet the child’s life long needs and offer the child an opportunity to heal, grow and develop.  In my experience everyone comes to co-ordination with hopes, dreams and high expectations, and it is possible to lose sight of the child’s needs when so many conflicting adult needs are at the forefront.

In her piece Dr Norris reminds us that children who are transitioning from one family to another, and who have a history of developmental trauma face complex difficulties.  They are likely to have a fragile sense of trust in adults and sensitivity to being triggered into a survival state, or to regress to earlier ways of relating which means they may move away from rather than towards their main attachment figure (the foster carer) at times of significant stress.  They are also likely to hide their fear and miscue; that is to give signals that they are fine and self-sufficient when they are feeling frightened.  In addition their capacity to think and make sense of what is happening to them is likely to be highly compromised and exacerbated by fear.  They may not be able to process and retain information or respond to logic and their sense of time may be distorted. Foster carers will often report that things have been explained clearly to a child but ‘they act as if they haven’t heard it’.  Alongside age related development and a child’s concept of time, children who are highly anxious may be able only to think in minutes or seconds and any discussion of the future beyond that may be meaningless.  This obviously presents challenges in terms of how to be of most help to children who are moving family.

The purpose of a transition is to move a child from their foster carers to their  adoptive parents.  This is usually achieved.  In my opinion that makes how we do the co-ordination even more important as we should be child focussed and protective of the child recognising their distress as described by Dr Norris.
The co-ordination plan focuses on practical arrangements but these arrangements should be put in place to support the child to transfer their sense of trust from his primary care giver to their adoptive parents. 
Dr Norris’s approach helps us to put the child in the centre and supports the child to make use of their main attachment figure.

With my colleagues I have put into practice Dr Norris’s approach to good effect. The use of theraplay in transition has made everyone more aware of the importance of transferring established loving ritual.  We are more conscious of need to know more about the child’s rhythms and to transfer these from the foster carer to the adopters. We are more conscious of putting in place a co-ordination plan aims minimise the trauma that the child will experience during the transition.  We want to know what soothes and what excites the child.  We pay greater attention to the continuity of the sensory environment and to the non verbal means of communication such as touch, play, music and transitional objects.

I have found the poster helpful, as it supports us to think about the impact of developmental trauma and the implication for the child when they are experiencing another move.  It is helpful to think about potential issues, the implications and goals that underpin the transition process.

This model recognises the foster carer as central in supporting the child throughout coordination and it is essential that they are well prepared for and well supported throughout this process.  Their social worker has a crucial role in relation to this and needs to be available to the foster carer during the co-ordination process.  Foster carers need to be enabled to undertake this piece of work and it is important that other departmental demands are kept to a minimum where possible (e.g. additional foster placements, LAC Reviews for the child).

As Dr Norris points out even children who are well prepared for moving placements can find the experience confusing and anxiety provoking.  This model recognises and accepts the child’s experience and helps us all to remain child focused throughout this difficult and challenging process.

I would recommend that all workers, foster carers and adopters read Dr Norris’s piece alongside her chapter in "Healing the Hidden Hurts".

Anne MacKenzie 
Senior Practitioner at City of Edinburgh Council