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This essay looks at the issue of symbolic play being therapeutic play for children. The essay looks at the theory of symbolic play, the use of symbolic play with children, the therapeutic value of symbolic play, using research to support the discussions. The essay discusses what is understood by symbolic play, then moves on to discuss the importance of symbolic play in children's development, looking at the various theories that have been put forward to explain the importance of play in children's development. The essay then moves on to look at various instances where therapeutic play has been used, and is considered useful, such as in children who are experiencing a chronic illness, who are hospitalized, who are awaiting surgery or who have experienced some form of trauma.
What is symbolic play? Symbolic play is, according to Piaget (1962) one of the main ways in which children learn to think in a representational manner, where representation is understood as a process through which children store information according to the perceptual analysis of their ingoing experiences (Leslie, 1987; Lyytinen et al., 1997). Play essentially allows children to understand the things they experience and to put these things in to perspective. As such, play is fundamentally important for children's development (Piaget, 1962). Play is one of the ways in which children understand the world, their interactions with others and the rules and regulations that govern their passage through the world. Play is, thus, a fundamental activity for children that allows them to form their personalities and to understand their place in the world, in relation to others.
Relevant of symbolic play in child development
Symbolic play, which arises around the age of 18 months, basically involves children substituting one item for another, and can constitute incorporating others in to their play, pretend play or sequencing. This can mean that children pretend to be mother (or father) or that they use household items to reproduce day-to-day activities they have seen their parents doing, amongst other common symbolic play activities. This symbolic allows children to experiment with different roles and different forms of being, which, as has been discussed, allows children to understand, and to contextualise, their experiences. As Piaget (1962) argues, such symbolic play allows children to understand the role of self and others, the use of objects and the sequences of actions and activities whilst playing. This allows children to understand objects, to learn about the properties of objects and to learn about consequences and causality (Piaget, 1962). Play thus allows children, amongst other things, to realize where their boundaries are, to understand why things work in the ways they do and to understand how to interact with others. Symbolic play is thus, as has been discussed, a fundamental developmental tool for children.
Watson and Zlotlow (1999) talk about symbolic play as, "an important characteristic of children's early play, through the enactment of activities that are very familiar to the child in contexts that are not typical for those activities". Enacting activities out of context allows the child to explore, and to understand, the role of agents in their lives, allowing them to understand how the world works and what their role is in this world. Symbolic play, therefore, has been argued to have three main features: the use of objects; the use of actions during the play; and individuals enacting the play (i.e., agents) (Watson and Zlotlow, 1999). The use of objects can be undertaken in many forms, either through substitution, in which the object is used to represent something else, through scenario-building, with the object being used to perform some task or in combination, with the object being used in various ways (Watson, 2008). The use of actions in play and the development of the agent in play follow certain patterns depending on the age of the child, as does the theme of children's symbolic play (Watson, 2008). The one thing that all symbolic play has in common, at whatever age or developmental stage the child is at, is that the child uses some representation of self in their play. At age four, for example, children will have progressed to fantasy play, but these fantasies will usually involve themselves in becoming their fantasy - a fireman or a prince, for example (Garvey, 1990). This allows them to explore different roles and responsibilities.
Symbolic play is, therefore, a natural phenomena, that children follow naturally, as part of their development through childhood. As Reed (2007) argues, symbolic play links all four areas of a child's development, namely cognitive, language, social/emotional and physical, and, as such, is a fundamental part of the development of children. Symbolic play allows the child to acquire knowledge and to express and represent their ideas, thoughts and feelings: as Vygotsky argues, in his sociocultural cognitive theory, symbolic play allows children to develop and to self-regulate and to work out any problems they might face (Reed, 2007). It is in this aspect, then, that the therapeutic value of symbolic play becomes clear. As children constantly experiment with their environment, their peers and the other agents they meet, and as the results of these experiments are constantly being fed back to lead to reinforce certain behaviours or to elicit different patterns of behaviours, the value of play as therapy is clear. Children who are passing through a difficult moment and who need help to understand this, to contextualise these difficulties in the framework of their existing knowledge, can, through engaging in therapeutic play, manage this. Therapeutic play allows them to experiment with the various outcomes and to contextualise the problems they face, allowing them an opportunity to work through these problems/problematic situations, through this working out their difficulties and coming to understand how to deal with them.
The use of symbolic play as therapy
In terms of the use of symbolic play as therapy with children, as Bettelheim states, "Play permits the child to resolve in symbolic form unresolved problems of the past and to cope directly or symbolically with present concerns. It is also his most significant tool for preparing himself for the future and its tasks" (Schaefer, 1995). Using play as a tool to help children through a difficult stage in their lives is, therefore, grounded in theory and makes sense in light of the fact that children learn through play. The research shows, for example, that therapeutic play can be helpful in aiding children through hospital stays (William, 2007) or through surgery, with this therapeutic play being shown to reduce anxiety and increase overall well-being (Bowmer, 2002). As Moore and Russ (2006) discuss, pretend play can act as a resource for children, relating, as it does, to many areas of adaptive functioning including creativity, coping and emotional regulation. As Moore and Russ (2006) show, pretend play in hospital settings can reduce anxiety and, through this, can reduce the likelihood of complications following surgery and can allow children to adapt better to the complications of chronic illness.
The therapeutic value of symbolic play
In terms of the therapeutic value of symbolic play, as Axline (1964) discusses, therapeutic play can be delivered through one of two major approaches, namely via non-directive play therapy and via directive play therapy (Oaklander, 1988). According to Axline (1964), play therapy should be governed by eight principles, namely that the therapist and child must be comfortable with each other; that the therapist accepts the child as he/she is; that the child can freely express their feelings; that the therapist is alert to the feelings the child expresses; that the therapist respects the child and their ability to resolve their own problems; that the therapist does not attempt to influence the child; that the therapy is carried out in its own time; and that the only limitations placed on the play therapy are those that anchor the therapy in the real world (Axline, 1964). If the therapeutic play is provided within this framework, the benefits of the therapeutic play can be many and varied, as discussed above, with the troubled child benefitting greatly from this intervention.
As Li and Lopez (2008) argue, therapeutic play can be valuable not only in helping children through a difficult stage in their lives but can be useful in helping to in prepare children for a stressful, or difficult, period that they might face. For example, children who are facing surgery or a chronic illness can be helped to come to terms with this through the use of therapeutic play. As Li and Lopez (2008) report, by reinforcing to nursing and medical staff that play is a very important part of the lives of young children, and be employing therapeutic play techniques, this can markedly improve the anxiety that these children experience and can allow these children to have a more positive outlook regarding their situation and the difficult things they will face, meaning that they are better equipped to face these situations. As Li and Lopez (2008) argue, therapeutic play can help to improve the resilience of children who face difficulties and, as such, it is an important tool to use in those children who need help to become more resilient.
Children who have faced some form of trauma, for example, can be aided through the fallout of this trauma through engaging in therapeutic play. By allowing the child the space to act out what they saw, or what they have experienced, for example, the child can come to terms with this traumatic experience. This therapeutic play could take the form of using puppets, or drawing, or role playing: anything that allows the child to re-enact the event(s) and, through this, come to terms with what happened. The use of therapeutic play in explaining the loss of someone close to them is known to be particularly valuable, for example, as this can allow them to imagine the person is still here and to resolve any outstanding issues they had with them, or to slowly come to terms with the fact that they are no longer alive and no longer able to be physically present with the child. The 'simple' act of playing can, therefore, allow the child to come to terms with many difficult emotions, allowing the child to slowly become more able to cope with the negative emotions that a traumatic event (such as witnessing a violent act or the unexpected death of a close family member), allowing them to deal with these negative emotions (Schaefer and O'Connor, 1994). As Schaefer and O'Connor (1994) argue, role playing in particular can help children to face the negative post-trauma reactions that children might face, with role-play allowing children to relive the trauma and to find various solutions to their negative experiences and emotions.
In summary, then, this essay has looked at the issue of symbolic play being therapeutic play for children. The essay has looked, in particular, at the theory of symbolic play, the use of symbolic play with children and the therapeutic value of symbolic play. In regards to the theory of symbolic play, it has been seen that various theories have been proposed to explain the importance of symbolic play in children's development, with all of these theories agreeing that play is a fundamental part of children's development and that this play allows them to contextualise their experiences and to understand how these experiences dictate how they should act and should behave in different situations.
It is this attribute of symbolic play that lends itself to being useful in helping children come to terms with difficult events in their lives: as has been discussed, play allows children to explore different scenarios (even difficult scenarios), with this play enabling them to overcome any negative emotions or feelings they might have had towards these scenarios. A child who is facing a difficult surgery, for example, might be scared, might be worried for themselves and for their families, but engaging in role play with this child (for example) allows them the opportunity to explore different possibilities and to release some of their anxieties and concerns. This has been shown, as discussed, to reduce the anxiety these children feel and to enable the child's health and well-being to be maintained, even under difficult circumstances. Similarly, a child who has experienced trauma can be helped through their post-traumatic period by engaging in some form of therapeutic play. This would normally consist of helping the child to act out their fears and their experiences, allowing the child to get rid of all of their negative emotions and feelings with regards to the even, allowing the child to expel these from their psyche and then to carry on without carrying this burden along with them.
In conclusion, then, the essay has shown that play is fundamental for children and that, given its experimental nature and its ability to contextualise events and interactions for children, play is, at its very essence, therapeutic. Using play with children who need therapeutic interventions, then, makes perfect sense to allow children to understand the negative events/emotions and to overcome their fears and anxieties regarding these negative events and emotions. Therapeutic play has been shown to be a useful intervention in many cases, including in hospitalized children and in children living with chronic illnesses, who can be helped through this difficult period by engaging in therapeutic play, which has been shown to reduce their anxiety levels. In conclusion, then, therapeutic play is an extension of the symbolic play that children engage in as a normal developmental process and can be useful in helping children through difficult periods in their life.