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

Figures & data

Table 1. Assimilation of problematic experiences sequence

APES 0 Warded-off/dissociation	Content is unformed; client is unaware of the problem. Distress may be minimal, reflecting successful avoidance.
APES 1 Unwanted thoughts/avoidance	Content is distressing thoughts. Person prefers not to think about it; topics are raised by therapist or circumstances. Affect is more salient than the content and involves strong negative feelings (anxiety, anger, sadness).
APES 2 Awareness/emergence	Person acknowledges the problematic experience and describes distressing thoughts, but cannot formulate the problem clearly. Affect includes acute psychological pain associated with the problematic thoughts and experiences.
APES 3 Problem statement/clarification	Content includes a clear statement of a problem – something that can be worked on. Affect is negative, but manageable.
APES 4 Understanding/insight	The problematic experience is placed into a schema, formulated, and understood with clear connective links. Affect may be mixed, like unpleasant recognitions, but also with curiosity, even pleasant surprise.
APES 5 Application/working through	The understanding is used to work on a problem; there are specific problem-solving efforts. Person may describe considering alternatives or systematically selecting courses of action. Affective tone is positive and optimistic.
APES 6 Resource/problem solution	Person achieves a solution for a specific problem. Affect is positive, satisfied, proud. As the problem recedes, affect becomes more neutral.
APES 7 Integration/mastery	Person successfully uses solutions in new situations; this generalizing is largely automatic, not salient. Affect is neutral.