Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-18T18:38:24.226Z Has data issue: false hasContentIssue false

Using ‘Expressive Therapies’ to Treat Developmental Trauma and Attachment Problems in Preschool-Aged Children

Published online by Cambridge University Press:  11 April 2016

Jenni Southwell*
Affiliation:
Strategy & Research, yourtown, GPO Box 2469, Brisbane QLD 4001, Brisbane, Australia
*
address for correspondence: Ms. Jenni Southwell, Senior Research Officer at yourtown, Strategy & Research, GPO Box 2469, Brisbane QLD 4001, Brisbane, Australia. Phone: +61403 754 993. E-mails: jsouthwell@yourtown.com.au

Abstract

yourtown's Expressive Therapies Intervention (YETI) is a trauma and attachment informed creative arts and play therapy intervention developed for young children with emotional and behavioural problems stemming from traumatic exposure. YETI aims to improve participants’ emotional and social wellbeing; behavioural adjustment; quality of attachment relationships and self-concept. The intervention is integrated within holistic family support programmes, chiefly a domestic and family violence refuge and a young parents programme. This paper describes YETI's therapeutic model and presents findings of a two-year outcome evaluation. The findings suggest that the intervention can achieve significant positive outcomes for preschool-aged children associated with healing from developmental trauma and attachment difficulties. Analysis of pre/post assessments of participants’ social, emotional and behavioural functioning using the Child Behaviour Checklist revealed significant improvements from intake to exit in children's internalising, externalising and total problems. There were also marked decreases in the proportion of children with symptoms in the clinical or borderline clinical ranges. Thematic analyses of parent/carer surveys and therapists’ end-of-therapy reports similarly indicate widespread improvements in social, emotional and behavioural functioning as well as improvements in children's self-confidence and self-esteem, and in the quality of the parent–child attachment relationship.

Type
Articles
Copyright
Copyright © The Author(s) 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms & profiles. Burlington, VT: University of Vermont, Research Centre for Children, Youth, & Families.Google Scholar
Ainsworth, M. D. S. (1978). Patterns of attachment: Assessed in the strange situation and at home. Hillsdale, NJ: Erlbaum.Google Scholar
Axline, V. M. (1974). Play therapy. New York: Ballantine Books.Google Scholar
Baggerly, J. N., Ray, D. C., & Bratton, S. C. (Eds.) (2010). Child-centred play therapy research: The evidence base for effective practice. New Jersey: John Wiley & Sons.CrossRefGoogle Scholar
Blaustein, M., & Kinniburgh, K. (2010). Treating traumatic stress in children and adolescents: How to foster resilience through attachment, self-regulation and competency. New York: Guilford Press.Google Scholar
Bowlby, J. (1969). Attachment and loss: Vol. 1 Attachment (2nd ed.). New York: Basic Books.Google Scholar
Bratton, S. C., & Landreth, G. L. (2010). Child-parent relationship therapy: A review of controlled-outcome research. In Baggerly, J. N., Ray, D. C., & Bratton, S. C. (Eds.), Child-centred play therapy research: The evidence base for effective practice (pp. 267293). New Jersey: John Wiley & Sons.Google Scholar
Bretherton, I., & Munholland, K. A. (2008). Internal working models in attachment relationships: Elaborating a central construct in attachment theory. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment: Theory, research, and clinical applications (2nd ed., pp. 102127). New York: The Guildford Press.Google Scholar
Cairns, K. (2002). Attachment, Trauma and resilience: Therapeutic caring for children. London: British Association for Adoption and Fostering.Google Scholar
Carey, L. (Ed.) (2006). Expressive and creative arts methods for trauma survivors. London: Jessica Kingsley Publishers.Google Scholar
Cloitre, M., Stolbach, B., Herman, J. L., van der Kolk, B., Pynoos, R., Wang, J., & Petkova, E. (2009). A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress, 22 (5), 309488.CrossRefGoogle ScholarPubMed
Cook, A., Spinazzola, J., Forde, J., Lanktree, C., Blaustein, M., Cloitre, M., . . . van der Kolk, B. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 25 (5), 390398.CrossRefGoogle Scholar
Crenshaw, D. A. (2014). Play therapy approaches to attachment issues. In Malchiodi, C. A. & Crenshaw, D. A. (Eds.), Creative arts and play therapy for attachment problems (pp. 1932). New York: Guilford Press.Google Scholar
D'Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., & van der Kolk, B. (2012). Understanding interpersonal trauma in children: Why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82 (2), 187200.CrossRefGoogle Scholar
Devereaux, C. (2014). Moving with the space between us: The dance of attachment security. In Malchiodi, C. A. & Crenshaw, D. A. (Eds.), Creative arts and play therapy for attachment problems (pp. 8499). New York: Guilford Press.Google Scholar
Edwards, K. (2007). Emotional fitness for children: A parent's program for children. Parents Notes. Version 6.0. Communities for Children, Australian Government Department of Families, Community Services and Indigenous Affairs.Google Scholar
Fall, M. (2010). Increased self-efficacy: One reason for play therapy success. In Baggerly, J. N., Ray, D. C., & Bratton, S. C. (Eds.), Child-centred play therapy research: The evidence base for effective practice (pp. 3750). New Jersey: John Wiley & Sons.Google Scholar
Field, A. (2009). Discovering statistics using IBM SPSS statistics (4th ed.). London: Sage Publications.Google Scholar
Foderaro, J. F., & Ryan, R. A. (2000). SAGE: Mapping the course of recovery. Therapeutic Community: The International Journal for Therapeutic and Supportive Organisations, 21 (2), 93104.Google Scholar
Gaskill, R. L., & Perry, B. D. (2014). The neurobiological power of play: Using the neurosequential model of therapeutics to guide play in the healing process. In Malchiodi, C. A. & Crenshaw, D. A. (Eds.), Creative arts and play therapy for attachment problems (pp. 178194). New York: Guilford Press.Google Scholar
Guerney, B. G. (1964). Filial therapy: Description and rationale. Journal of Consulting Psychology, 28 (4), 303310.CrossRefGoogle ScholarPubMed
Guerney, L., & Ryan, V. (2013). Group filial therapy: The complete guide to teaching parents to play therapeutically with their children. London: Jessica Kingsley Publishers.Google Scholar
Hammer, S. E (1996). The effects of guided imagery through music on state and trait anxiety. Journal of Music Therapy, 33 (1), 4770. CrossRefGoogle Scholar
Herman, J. (1992). Trauma and recovery: The aftermath of violence – from domestic abuse to political terror. New York: Basic Books.Google Scholar
Hernandez-Ruiz, E. (2005) Effect of music therapy on the anxiety levels and sleep patterns of abused women in shelter. Journal of Music Therapy, 42 (2), 140158.CrossRefGoogle Scholar
Hughes, D. A., (2006). Building the bonds of attachment: Awakening love in deeply troubled children (2nd revised ed.). Northvale NJ: Jason Aronson.Google Scholar
James, B. (1994). Handbook for treatment of attachment-trauma problems in children. New York: The Free Press.Google Scholar
Jenkins, S. (2004). Developing a residential program for children in response to trauma-related behaviours. Children Australia, 29 (3), 2229.CrossRefGoogle Scholar
Kalff, D. M. (1980). Sandplay: A psychotherapeutic approach to the psyche. California: Sigo Press.Google Scholar
Kalff, D. M. (1991). Introduction to sandplay therapy. Journal of Sandplay Therapy, 1 (1), 715.Google Scholar
Klorer, P. G. (2004). Expressive therapy with troubled children. Maryland: Rowman & Littlefield Publishers.Google Scholar
Landreth, G. L. (2002). Play therapy: The art of the relationship (2nd ed.). New York: Brunner-Routledge.Google Scholar
Landreth, G. L., & Bratton, S. C. (2006). Child-parent relationship therapy (CPRT): A 10-session filial therapy model. New York: Taylor & Francis Group.Google Scholar
Lowenfeld, M. (1939). The world pictures of children: A method of recording and studying them. British Journal of Medical Psychology, 18 (1), 65101.CrossRefGoogle Scholar
Malchiodi, C. A. (2005). Expressive therapies. History, theory and practice. In Malchiodi, C. A. (Ed.), Expressive therapies (pp. 115). New York: Guilford Press.Google Scholar
Malchiodi, C. A. (Ed.) (2008a). Creative interventions with traumatised children. New York: Guilford Press.Google Scholar
Malchiodi, C. A. (2008b). Creative interventions and childhood trauma. In Malchiodi, C. A. (Ed.), Creative interventions with traumatised children (pp. 321). New York: Guilford Press.Google Scholar
Malchiodi, C. A. (2014). Creative arts therapy approaches to attachment issues. In Malchiodi, C. A. & , D. A. Crenshaw, (Eds.), Creative arts and play therapy for attachment problems (pp. 318). New York: Guilford Press.Google Scholar
Malchiodi, C. A., & Crenshaw, D. A. (Eds.) (2014). Creative arts and play therapy for attachment Problems. New York: Guilford Press.Google Scholar
Pearson, M., & Nolan, P. (2004). Emotional release for children: Repairing the past, preparing the future. London: Jessica Kingsley Publishers.Google Scholar
Pearson, M. (2004). Emotional healing and self-esteem: Inner-life skills of relaxation, visualisation, and mediation for children and adolescents. London: Jessica Kingsley Publishers.Google Scholar
Pearson, M., & Wilson, H. (2008). Using expressive counselling tools to enhance emotional literacy, positive emotional functioning and resilience: Improving therapeutic outcomes with expressive therapies. Counselling, Psychotherapy and Health, 4 (1), 119.Google Scholar
Pearson, M., & Wilson, H. (2009). Using expressive arts to work with mind, body and emotions: Theory and practice. London: Jessica Kingsley Publishers.Google Scholar
Pelletier, C. L. (2004). The effect of music on decreasing arousal due to stress: A meta-analysis. Journal of Music Therapy, 41 (3), 192214.CrossRefGoogle ScholarPubMed
Perry, B. D. (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatised children: The neurosequential model of therapeutics. In Webb, N. B. (Ed.), Working with traumatised youth in child welfare (pp. 2752). New York: Guilford Press.Google Scholar
Perry, B. D. (2009). Examining child maltreatment through a neurodevelopmental lens: Clinical applications of the neurosequential model of therapeutics. Journal of Loss and Trauma, 14 (4), 240255.CrossRefGoogle Scholar
Perry, B. D., & Pollard, R. (1998). Homeostasis, stress, trauma, and adaptation: A neurodevelopmental view of childhood trauma. Child and Adolescent Psychiatric Clinics of North America, 7 (1), 3351.CrossRefGoogle ScholarPubMed
Perry, B. D., & Szalavitz, M. (2006). The boy who was raised as a dog: What traumatised children can teach us about loss, love, and healing. New York: Basic Books.Google Scholar
Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation, and ‘use-dependent’ development of the brain: How ‘states’ become ‘traits’. Infant Mental Health Journal, 16 (4), 271291.3.0.CO;2-B>CrossRefGoogle Scholar
Ray, D. C., & Bratton, S. C. (2010). What the research shows about play therapy: Twenty-first century update. In Baggerly, J. N., Ray, D. C., & Bratton, S. C. (Eds.), Child-centred play therapy research: The evidence base for effective practice (pp. 334). New Jersey: John Wiley & Sons.Google Scholar
Rolfe, S. (2004). Rethinking attachment for early childhood practice: Promoting security, autonomy and resilience in young children. Sydney: Allen & Unwin.Google Scholar
Schofield, G., & Beek, M. (2006). Attachment handbook for foster care andaAdoption. London: British Association for Adoption and Fostering.Google Scholar
Schore, A. N. (1996). The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology. Development and Psychopathology, 8 (1), 5987.CrossRefGoogle Scholar
Schore, A. N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22 (1–2), 201269.3.0.CO;2-9>CrossRefGoogle Scholar
Schore, A. N. (2015). Plenary address, Australian childhood foundation conference childhood trauma: Understanding the basis of change and recovery early right brain regulation and the relational origins of emotional wellbeing. Children Australia, 40 (2), 103113.CrossRefGoogle Scholar
Sroufe, L. A. (1988). The role of infant-caregiver attachment in development. In Belsky, J. & Nezworski, T. (Eds.), Clinical implications of attachment (pp. 1838). Hillsdale, NJ: Erlbaum.Google Scholar
Stewart, A., Whelan, W. F., & Pendleton, C. (2014). Attachment theory as a road map for play therapists. In Malchiodi, C. A. & Crenshaw, D. A. (Eds.), Creative arts and play therapy for attachment problems (pp. 3551). New York: Guilford Press.Google Scholar
Stien, P. T., & Kendall, J. (2004). Psychological trauma and the developing brain: Neurologically based interventions for troubled children. New York: Haworth Maltreatment and Trauma Press.Google Scholar
Streeck-Fischer, A., & van der Kolk, B. (2000). Down will come baby, cradle and all: Diagnostic and therapeutic implications of chronic trauma on child development. Australian and New Zealand Journal of Psychiatry, 34 (6), 903918.CrossRefGoogle ScholarPubMed
Teague, C. M. (2013). Developmental trauma disorder: A provisional diagnosis. Journal of Aggression, Maltreatment & Trauma, 22 (6), 611625.CrossRefGoogle Scholar
van der Kolk, B. (2005). Developmental trauma disorder: Towards a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 22 (5), 401408.CrossRefGoogle Scholar
van der Kolk, B. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. New York: Viking.Google Scholar
Van Fleet, R. (2002). A parent's handbook of filial play. Boiling Springs, USA: Play Therapy Press.Google Scholar