The Use of Poetry in Play Therapy: a Logical Integration

One of the greatest challenges that face child psychotherapists is to find an effective way of working with the many pre-adolescent children who come for treatment. Young children arrive at mental health settings with a tremendous array of emotional and behavioral problems, and the clinician must learn to help these children as well as their typically frustrated and perplexed adult caretakers. A traditional solution has been to place the children in psychodynamicallyoriented play therapy. In this type of treatment the patients are typically seen on an individual basis once or twice a week. The parents are then seen periodically for child guidance work or are referred to another therapist for assistance (Weisz & Benoit, 1989). From the beginning, psychotherapists who have practiced this type of treatment have recognized the need to connect on a deep level with the children’s experience and inner world. For this reason, the legendary Anna Freud often conducted her therapeutic consultations in the child’s home (Young-Bruehl, 1988) and Erik Erikson (1950) liked to begin treatment by joining the child and his or her family for dinner. These therapists realized that unless they literally went into the children’s daily milieu, they were unlikely to understand the children’s experience in a profound manner. Psychodynamically-oriented child clinicians were also generally advised to begin treatment by obtaining a detailed developmental history from the children’s parents (Friedman, 1966; Smirnoff, 1966/1971) in the hope that this information would also further the clinician’s understanding of each child’s particular plight. An early diagnostic understanding of the children’s condition was considered particularly important as this information could then foster the interpretation of a transference neurosis (Weiss, 1964). Ornstein (1976) has pointed out, however, that this traditional approach to treatment was designed only to deal with internalized psychoneuroses rather than with children who suffer from character pathology or developmental deficits. In other words, an emphasis upon transference interpretation assumed that the children’s history had created structuralized problems, which would then come to life with purportedly neutral therapists. The clinician’s job was to take the child’s history and interpret their transferential reactions in light of this background information so that the child could be freed of what had become a fixed and pathological way of relating to others. Ornstein (1976) emphasized, however, that this approach often failed to work with a large number of children. Ornstein believed that children with severe behavior disorders typically suffer not from internalized conflicts, but from their failure to accomplish basic developmental tasks. This is particularly true for children who have grown up in chaotic, abusive or neglectful families. Given their pathogenic environment, these children have often been unable to develop basic trust, a healthy sense of initiative or adequate control over their more primitive impulses. For such children, therapy must consist not of interpreting conflicts, but of creating an empathic and supportive enough environment for the children so that they can move forward developmentally. As the social support network for families has disintegrated in recent years, creative arts therapists are faced with an ever-growing