Identifying therapeutic change processes in the treatment of complex trauma: the case of play therapist's perspectives. A qualitative study.

Parsons, Ruth Mary (2017) Identifying therapeutic change processes in the treatment of complex trauma: the case of play therapist's perspectives. A qualitative study. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Therapeutic interventions for children have been proven to be effective across all ages and stages of development. However, knowing that therapy works does not account for how or why it works. This question specifically asks, ‘what are the change processes within treatment’ has been raised historically and continues to be asked today. Knowing more about how and why therapy works with children can provide opportunity for the design and development of programming to meet the specialized needs of children in multiple areas of treatment. This dissertation utilized the naturalistic inquiry to identify therapeutic change processes within the context of treatment of complex trauma with children. Certified and experienced play therapists that practice in Ontario, Canada were interviewed to discover what therapeutic change processes were utilized in their interventions with children who have experienced complex trauma. The guiding questions for this study were: 1. What practices have play therapists found to be effective in assessment and treatment of children exposed to complex trauma? 2. What practices have play therapists found to be effective in reducing the long-term impacts of complex trauma? 3. What are play therapists’ understandings of therapeutic change processes in which they have confidence? In-depth qualitative interviews were conducted with a purposeful sample of nine certified play therapists, all with advanced training and/or experience in working with children who experienced complex trauma. All participants reside in the province of Ontario, Canada, and practice in both public and private services. Thematic analysis was utilized to analyze the data. Three themes emerged from this data: theme 1 – therapeutic tools; theme 2 – building the therapeutic foundation; and theme 3 – working through complex trauma. From within these three themes and their sub-themes, six therapeutic change processes emerged: fostering a renewed ability to attach, fostering a renewed ability to trust, instilling hope for the future, providing age appropriate time and pacing for processing, facing the trauma together, and promoting mental health and resilience. Additionally, this study’s findings show a comprehensive practice model for therapeutic intervention with children who have been exposed to complex trauma and their caregivers. It also highlights the need for creativity and skill in intervening with children.

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