Progress through the Early Stages of Assimilation in Play Therapy with a Traumatized Six-Year-Old Girl

ABSTRACT

We applied the assimilation of problematic experiences sequence (APES) to a six-year-old girl’s processing of traumatic experiences involving violence and death in play therapy. We analyzed the post-session notes from the first 34 sessions of a much longer treatment, during which the girl repeatedly enacted a drama we called the cottage play, involving characters assumed by the child and characters assigned to the therapist. We distinguished four phases based on changes in play themes. In phase 1, the girl expressed her need for safety in response to an overwhelming internal threat (APES stage 0, warded off/dissociated). In phase 2, she worked to escape and avoid the threat, referenced in the play as monsters and bad memories (APES 1, unwanted thoughts/avoidance). Phase 3 was a brief period of consolidation. In phase 4, she actively faced the trauma, referenced as murderers, soldiers, and death (APES 2, awareness/emergence). Our observations underlined the child–therapist collaboration and dyadic processing. The expressions of the problematic experiences suggested increasing but limited assimilation (stages 0 to 2 out of eight stages). The assimilation model usefully described symbolic processing in play therapy, and the results pointed to tentative elaborations in APES stage descriptions.

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No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Tuija Aro

Tuija Aro, Ph.D., is Senior Lecturer and Adjunct Professor at the University of Jyväskylä, Finland. She is a cognitive and integrative psychotherapist and clinical neuropsychologists working mainly among children and adolescents.

Kirsti-Liisa Kuusinen

Kirsti-Liisa Kuusinen, Ph.D., is Emeritus Senior Lecturer at the University of Jyväskylä, Finland. She is a psychotherapist, trainer and supervisor in cognitive and integrative psychotherapy, and has been working as a lecturer in psychotherapy training programs in years 1997- 2020.

William B. Stiles

William B. Stiles, Ph.D., is Professor Emeritus of Psychology, Miami University, Oxford, Ohio, USA, Adjunct Research Professor of Psychology at Appalachian State University, Boone, North Carolina, USA, and Senior Research Fellow at Metanoia Institute, London, UK. He has been President of the Society for Psychotherapy Research and of Division 29 of the American Psychological Association. He has served as Editor of Psychotherapy Research and Person-Centered and Experiential Psychotherapies.

Aarno Laitila

Aarno Laitila, Ph.D., is Senior lecturer at the University of Jyväskylä, Finland, and has been a Professor of Psychology at the University of Eastern Finland years 2012 to 2016. His academic career has mostly been connected to psychotherapy research and teaching. He is a psychotherapist and psychotherapy trainer in family therapy.