Working with Young Children

It is important that children are able to express and understand how they are feeling. Some children feel uncomfortable talking about their feelings, therefore combining discussion with an external activity will often help them open up about their feelings. It is important when working with children to remember to apply the strategies and techniques that work best with the child. For example, a toddler may be able to express their feelings using a finger puppet or a stuffed animal whereas pre-school aged children like to express their feelings through creative imagery, drawings, and feeling charts.

Sessions with children tend to be short and brief. When identifying the issue, keep the idea simple and at the level the child can identify with, e.g. a little boy called Tim wanted to get rid of his fears of vampires and monsters. In the session Tim indicated that he liked chocolate, therefore he was asked by the counsellor to make all the monsters into chocolate and place them in the sun and make them melt. This gave Tim control over the monsters as he could watch them melt away (Baumgardner, 1989).

Some children may be fearful about coming to counselling and may not want to participate in the session. One way of overcoming this barrier is to give the child the counsellor role. Children feel very excited to be in the driver’s seat.

An example of this technique would be:

James is six and his mother brings him to counselling because he has behaviour problems. James’s behaviour became worse after his mum and dad separated. The counsellor, who was the client for the session, began to talk and draw pictures of her duck (Queenie) and about all the things as a little girl they did together. The counsellor (client) then discussed about how sad she felt when Queenie died because she was her only support when her mummy went to work.

She went on to say “that when her mummy went to work she was very fearful that she would not come home”. James listening to this, said “yes me too”. “I am so scared when my Mummy goes to work that she will leave me and never come home”. He then began to draw pictures of his guinea pigs and express how he felt when they died. The session concluded with James happy to come back and play the role of the counsellor. This is a useful technique and can be very helpful when there are barriers blocking children from expressing their feelings.

Below we explore many techniques available for helping young children.

Five Feelings Cards

One simple technique is the five feelings technique. There are five important feelings that children are likely to have: SAD, MAD, HAPPY, SCARED and LONELY. These feelings are written on five cards and whilst holding up the cards and proceeding through the five of them, the counsellor could ask the child to pick the card that matches how they feel (Jarratt, 1982).

The Feeling Chart

The feeling chart can also be used where children pick how they are feeling and put it in the middle of the chart. Then the child can draw the face to go with the feeling. Sometimes other emotions may need to be added to the basic list such as silly, angry, sleepy, sick, surprised, embarrassed feelings and helpless feelings.

Five Faces Technique

(Jarratt, 1982)

Another effective way for counsellors to work with children about their feelings is to use an activity that combines seeing, hearing and doing and alternates feelings with other activities – for example, putting a face to how they are feeling.

Feeling faces cards are a good way to begin talking about some of the things that might be troubling children. Spreading the cards on the table the counsellor might ask the child which of these feelings they had when their mum didn’t live with their dad anymore; or indirectly ask the child what they might say to someone about how kids might feel when they don’t live with one of their parents anymore. The child can then use the cards to explore and explain the feelings about the same event.

The counsellor could start by telling the child that she knows of at least five feelings that kids are likely to have. Then ask the child if they would know what some of them might be. The dialogue would go like this.

Dialogue

Counsellor: I know at least five feelings that children might have. Do you know what some of them might be?

Child: I don’t know. Happy, I guess.

Counsellor: Sure, happy is one. Let’s write that on the bottom of this card, and then we’ll see what a happy face might look like. Do you want to draw it, or shall I?

Child: You do it.

Counsellor: OK what colour shall I use? (the idea is to proceed with the activity and invite the child to make as many verbal choices and inputs as you can. Many times the child will just take the activity over)

Child: I don’t know blue I guess.

Counsellor: Sounds good. OK, there’s a happy face. We’ll write each feeling you can think of on one of these cards, and then we’ll draw the faces to match… Let’s see, you also thought of angry and scared. Do you have a guess about what some of the other feelings might be (the child can’t or won’t answer). Can you write the words for other feelings on these cards if I tell you what they are?

Child: Ok (as the counsellor recites the feelings, the child writes SAD, MAD, HAPPY, SCARED, AND LONELY across each card).

Counsellor: Good. Now we need to make faces to go with the words. Do you sometimes use your face to tell people how you are feeling?

Child: I don’t know.

Counsellor: Show me how your face would look if I told you that we were going to do something that you didn’t want to do. Your mouth would go straight across with your teeth showing and your eyes would look like they were frowning, like on this mad card. Let’s pick another one. You picked happy. Will you draw it or will I?

Child: I will (the child draws a face).

Counsellor: Great. Is that how you look when you are feeling happy? Now we will do another face.

When using the cards counsellor’s need to be aware that children at times may substitute words when they are thinking of a feeling; e.g. using the word boring as a substitute for ‘lonely’ or ‘painful’.

After each session tell the child that their homework is to notice which feelings they have during the coming week. Then start the next sessions by looking at the “feeling faces” going through them in random order.

The “five feelings” and “five faces” techniques can be used at home to help continue the work that has been done throughout the counselling sessions. When children start to feel that they can talk about their feelings, they begin to relax and feel confident that someone is finally listening to them without judgement.

Visualisation

(Stokes & Whiteside, 1996)

Children love to use their imagination. The basic procedure for using this technique with children is:

1. To see someone doing the activity.
2. To see themselves doing the activity.
3. To feel themselves doing the activity.

An Example

A five year old is brought to counselling by her mum. She has been defiant and has been displaying bad behaviour.

Dialogue

Counsellor: How do you feel about starting school?

Child: Very scared!!!

Counsellor: Do you know anyone who has started school for the first time?

Child: Yes, my sister.

Counsellor: I want you to imagine in your head your sister going to school for the first time. Did she do it well?

Child: Yes, she was very excited and happy to go there

Counsellor: Now imagine yourself going to school for the first time as happy as your sister did. Are you doing as well as your sister?

Child: No, it is too hard for me, I feel very scared.

Counsellor: Take your time and keep imagining yourself going through the gate. Now how are you doing?

Child: Okay.

Counsellor: Now is the time to really imagine yourself meeting the teacher and making new friends and being happy just like your sister.

Child: The teacher is really nice. I am making some friends and they are very friendly. I am having a great day.

Counsellor: Now imagine you have an animal who is going to be with you when you go to school for the first time. He is your power animal and he is going to help you.

Child: Yes, I have a bear with me to keep me safe.

Counsellor: Now, each night before you go to sleep, imagine in your mind that you are going to school as happy as your sister and that your bear is keeping you safe at all times.

At the beginning of the school year the child was back to see the counsellor feeling very proud about going to school without any tears or frustration.

This same technique can be used to reduce anxiety and to take the stress of any given situation such as riding a bicycle for the first time, taking tests, or learning a sport.

Creative imagery can also be used to help six and seven year olds make each day a new beginning. The counsellor would ask them to think in their minds about what they have planned for tomorrow. What does the day look like? Would they be going to school? If so, what is happening in the morning, in the afternoon, and after school? Now see beautiful light shining on the day. How would they like tomorrow to look? Create the day as they would like it to turn out. What happens in their version of tomorrow? They feel relaxed, creative, happy and safe. When they have painted in all the detail of their ideal tomorrow, they can then come back slowly and open their eyes.

Framing the Picture Using Creative Imagery

(Stokes & Whiteside, 1996)

Implementing this technique has great power because it allows the child to start making choices about what they experience. With every choice made, they are freeing themselves from the hold negative emotions can have on them.

This technique could be used when inviting children to see how they view themselves. The child is asked to think of a picture frame (in their head) and tell the counsellor what it is like. It can be wooden, metal, shiny, or anything that they would like to have. They are then asked to put a picture of themselves in this frame in as much detail as possible e.g. what they are wearing, what their hair is like, are they smiling, or sad, would they be in a park or at the beach, is there anyone else in the picture (family).

Once the picture is complete and they are happy with it they are then asked to change the frame to something else that they would like better. Changing the frame changes the way they see and feel about themselves. They could then be asked what they would like to do with the frame such as put it on a wall or carry it with them.

Children can also draw the frame. They can also use it to put all the things that are making them feel sad, mad, confused or stressed. They can then throw that frame away crushing it up into little pieces. Once that is done they can then create a new frame with all the things that make them happy. This overrides the negative emotions they are feeling.

Drawings

(Malchiodi, 1998)

Most children love to draw, therefore to deny that children express emotions through art would ignore a significant part of who they are and how they perceive themselves and the world around them. Art is a powerful tool for their emotional lives and is an important aspect of understanding children.

At the age of two or three, it has been observed that children feel comfortable with drawing through scribbling as a way of expressing their feelings.

At the age of three to four children start to want to tell stories about their scribbles and will often name them, then change the name of their scribble the next day. It is normal behaviour for children of this age to change visual symbols in their drawing development, e.g. a three year old little girl by the name of Kelly had come in for counselling, soon after her grandmother had told her off for spilling her milk. She was not in a good mood. Kelly was asked to draw something so she made a scribble drawing with felt pens.

When the counsellor asked Kelly what her drawing was, she said, “the black bug monster who yells at me for doing bad things”. It is clear that the “black bug monster” is a reference to what happened with her grandmother moments before her counselling session and perhaps a reference to other times when she had been punished. When Kelly came for her next session she noticed her drawing and decided to call it “Kelly’s music”. Kelly had absolutely no memory of the “black bug monster” that she was so consumed with in the last session.

Although many people who work with children offer thick, round tipped crayons for drawings, this particular type of crayon may be frustrating for some children. As children begin to make figures and add detail to their drawings, small crayons will give them a less frustrating way to draw teeth, fingers, toes, and facial features. While the smaller crayons do break more easily than the large ones, they encourage and allow children to make more distinction and details in their drawings.

Play Therapy

(Oaklander, 1988 pp. 76-77)

Five-year-old Roger squirmed restlessly in his chair as his mother described his behavior at home and at school. He was, she said, hitting, kicking, grabbing, punching, jumping on other children so much that other parents were complaining about him. Roger appeared sullen and hostile with me, made no bones about his dislike of me, my office, and this waste of his time. But he examined all the toys carefully when we were finally alone together. I stood by quietly as he did this.

At the next session, he immediately took down the doctor set and ordered me to lie down. We spent the whole session playing doctor; I was the patient and he was the doctor. His whole manner changed when he played the doctor: he was kind and gentle to me, solemn, and he spoke quietly with great sympathy over my illness. I asked him if I would have to go to the hospital. He told me gravely that I was very sick and would have to go. He asked me if I had children. I said that I had one little boy and I was very worried about who would take care of him if I went to the hospital.

I spoke about my concern over his welfare at home and at school, and the fact that he was so young he wouldn’t understand and would worry too much about me. Roger listened intently. Finally, in the gentlest, kindest voice I have ever heard, he said, “Don’t worry. I’ll talk to him and explain that you’ll get better. And I’ll even take care of him for you when you’re in the hospital.” He patted my arm and smiled at me, and I thanked him for these wonderful things he would do for me.

Roger and I played doctor at least five sessions in a row, and each time, the drama became more elaborate and extensive under his direction. “Pretend you’re at home and all of a sudden you feel sick and you call me.”

Roger’s gentle, sensitive manner carried over into school and at home following these sessions. At the first parent-child session, I had learned that the mother was quite ill at one time and had been in the hospital three times for extended periods. She was well now, however, and indicated that she did not believe that this past period of sickness could be a factor behind Roger’s hostile behavior. His great interest in the doctor play, however, told me that his feelings about his mother’s hospitalizations apparently needed expression in a way that had been difficult for him to do at home.

Play is the young child’s form of improvisational dramatics. It is also more than that. Playing is how the child tries out his world and learns about his world, and it is therefore essential to his healthy development. For the child, play is serious, purposeful business through which he develops mentally, physically, and socially. Play is the child’s form of self-therapy, through which confusions, anxieties, and conflicts are often worked through. Whereas Roger allowed himself to be gentle and thoughtful, other children play tough and aggressive. Through the safety of play every child can try out his own new ways of being. Play performs a vital function for the child. It is far more than just the frivolous, lighthearted, pleasurable activity that adults usually make of it.

Play also serves as a language for the child—a symbolism that substitutes for words. The child experiences much in life he cannot as yet express in language, and so he uses play to formulate and assimilate what he experiences.

Four-year-old Carly painstakingly placed the doll furniture in the various rooms of the dollhouse, moving and straightening pieces until she was satisfied. Then she placed the mother doll and the father doll in the bed in one room and a child doll in bed in another room. “It’s nighttime,” she told me, as I looked on, she manipulated the parent doll figures in a lovemaking scenario. Next she placed all the figures around the table in the kitchen and said to me, “It’s morning.”

I use play in therapy in much the same way I might use a story, a drawing, a sand tray scene, a puppet show, or an improvised play. An outline of how I pace the technique follows, along with some comments on the play therapy process.

I observe the process of the child as she plays. How does she play, how does she approach the materials, what does she choose, what does she avoid? What is her general style? Is there difficulty in shifting from one thing to another? Is she disorganized or well organized? What is her play pattern? How she plays tells a lot about how she is in her life.

I watch the content of the play itself. Does she play out themes of loneliness? Aggression? Nurturance? Are there lots of accidents and crashes with planes and cars? I watch for the child’s contact skills. Do I feel contact with her as she plays? Is she so absorbed in her play that I see she makes good contact with her play and herself as she plays? Is she continually at the edge of contact, unable to commit herself to anything?

What is the contact like within the play itself? Does she allow for contact between the objects of play? Do people or animals or cars contact each other, see each other, talk to each other? I may take the opportunity to direct the child’s awareness to her process and contact during the play. I may say, “You like to do that slowly.” “You don’t seem to like to use the animals—I notice you never touch them.” “You get tired of things fast.” “No one seems to like each other.” “This plane is all alone.”

I may choose to wait and direct the child’s awareness to these things after the play. If the pattern repeats itself in the play, I direct my questions to her life. I may say, “Do you like things orderly at home?” “Do people mess up your room?” (One answer to this was a vehement “Yes!! My bratty sister!”—from a child who rarely spoke.)

I may simply direct the child’s awareness to what she is doing: “You are burying the soldiers.”

I may ask the child to stop at any point and repeat, emphasize, or exaggerate his action. For example, I noticed that a 10-year-old boy used a fire engine often in an elaborate situation he set up with cars, houses and buildings—all done on the floor rather than in the sand tray. The fire engine came to the rescue in a variety of situations. I commented that I noticed that his fire engine did a lot of rescuing and asked him to do it once more for me to see. He did so and I asked him if it reminded him of anything in his life. His answer, “My mother expects me to help her with everything. Since my Dad’s been away (in the Navy) she wants me to do everything!”

I may direct the child’s awareness to emotions suggested through his play or the play’s content. “You sound angry!” Or, “That father doll sure sounds mad at the boy.” I watch his body, face, and gestures. I listen to his voice, cues, remarks. I may ask him to repeat something he says.

I may ask the child to identify with any of the people, animals, objects. “You be that fire engine. What does it say? Describe what it does in your story as if it were you.” Or, “What might that snake say about itself?” “How is it to be that shark in the water?” Or, “Which one are you?”

I may ask the child to conduct an open dialogue between objects or people. “What would the fire engine say to this truck if he could talk?” I bring the situation back to the child and his own life. “Do you ever feel like that monkey?” “Do you ever get in a fight like those two army men?” “Do you ever feel crowded?”

I am careful not to interrupt the flow, waiting for a pause before asking a question or commenting. When I stay very involved with what the child is doing, I know when it is the right time to speak or ask the child to do something. Often the child talks to me as he plays, and sometimes as a natural part of this contact with me I can direct his awareness in some way.

I never ask the child to identify, own, or discuss any of the play, process, or content if it does not feel right and appropriate to me, or if the child is reluctant. Very young children, especially, do not want to, or need to, verbalize their discoveries and awareness, or “own” what is expressed through the play. Just by bringing those feelings, situations, and anxieties into the open, a degree of integration occurs. Integration occurs both through the open expressions, even though it may be symbolic rather than direct, and also through the child’s experiencing the play situation in a safe, accepting atmosphere. Many parents report that the child leaves a session showing a sense of peacefulness and serenity.

Sometimes I set up a structured situation with the toys for the child to play out. I may select various items to fit some circumstances in the child’s life or some mythical problem-solving dilemma, as in the role-playing process. For example, I may select several dollhouse figures and ask the child to enact a scene with them. Or I might say (as I manipulate the dolls), “This girl in the bedroom trying to go to sleep but she can hear her mother and father having a fight in the kitchen. What happens next?” Or, “Here is a family sitting around the table eating. The phone rings. It is the police saying that the son is at the police station because he was caught stealing. What happens?”

A 9-year-old girl was terrified of airplanes and did not want her parents to go on a trip they were planning. I set up a play airport, airplane, and doll figures representing herself and her parents. I asked her to play out her feelings in this pretend situation. In her play she managed to keep her parents from getting on the plane. (We had spent previous sessions going into her feelings surrounding her fear of planes and the impending disaster she expected, her fear of being abandoned, etc.) I set up the situation again, had the parents get on the plane after kissing her good-bye, and asked her to be the doll left at the airport and to describe her feelings. Much more material relating to her paralyzing fears came out in this enactment than ever before.

Sometimes when I am working with very young children (ages 4 or 5) I will conduct a play session with the mother and child. I may suggest they pick any of the toys to play with, or I may select some toys. A great deal of helpful information about the interaction between the mother and the child comes out this way. I was motivated to do this after reading Are You Listening to Your Child? by Arthur Kraft. Kraft writes about his experiences in teaching a group of parents how to conduct their own play therapy sessions with their children

Brent, age 5, and his mother sat on the floor in my office with some blocks, some farm animals, a few cars, a dump truck, and puppets. I suggested that they spend some time playing with any of the toys that I had set out. The setting seemed artificial and strained to them at first, but soon the play began in earnest. Brent suggested that they each build a farm with the blocks and divide up the animals. He decided that he would be in charge of the animals and would put the ones he wanted to go to his mother in the truck and deliver them to her. She agreed to this. After a while Brent decided he needed more blocks and wanted to take some from the structure his mother built.

She would not go along with this, and Brent went through a sequence of arguing, whining, grabbing blocks, screaming, and then crying, huddled on the floor. His mother finally agreed to give him a few blocks. Suddenly Brent said he was tired of playing with the blocks and animals and announced he would do a puppet show for us. He looked each puppet over carefully and finally placed the alligator puppet in one hand and, with some difficulty, a lady puppet on his other hand. He then had the alligator puppet attack and gobble up the lady puppet as he shrieked with laughter and glee. I announced that it was time to stop, and we picked up the toys together.

I began a discussion with Brent and his mother about what happened during the play. Brent’s mother said that what happened in my office was exactly what happened in almost every aspect of their life together. As long as he directed things, she said, everything seemed fine. But he would become more and more demanding, and when at some point he didn’t get his way, he would have a tantrum. So she eventually gave him his way again, but when she did, everything was somehow spoiled and he wasn’t happy. From the very graphic example of the play situation in my office, we could now deal with the evident power struggle that existed between Brent and his mother, and with his actual need for her to take the initial role of the strong director. She came to realize that a 5-year-old typically becomes frustrated and rebellious when he is put in a position of setting too many of his own boundaries.

Older children also respond readily to play therapy. Jason, a 10-year-old boy, spent some time building with small blocks on the table. He described a structure as a jail to me as he built it. In the jail he placed a cowboy. As he played he told an elaborate story of the cowboy and his exploits. Finally he sat back and announced he was through. I asked a few questions about the various structures and people, and finally asked him to be the cowboy in the jail and describe what it was like to be there. I chose to do this because this is where I found my interest—a lone cowboy locked up in jail.

He willingly complied and finally I asked, “Do you ever feel as if you’re in jail like that cowboy?” This led Jason to share some very strong feelings about his life situation. Although there was not much we could do about his particular situation, it was still important for him to speak from his deepest places to me. Keeping these feelings inside only weakened him, and when the time came that the situation can be changed, feelings unspoken would have remained buried and stagnant, burdening him needlessly.

Other children, though they have more language at their command, nevertheless often find it safer and easier to express themselves through play. It feels much less threatening to express hostility by having toy animals attack each other, or by smashing clay, burying figures in the sand, and the like.

Sometimes I will ask a child to look around the room and pick out one specific toy. I will then ask him to imagine that he is this toy and to describe to me all the ways he is used, what he does, what he looks like, what he wants to do. Example: “I am a plane. I like to fly to new places. I feel free.” “I am an elephant. I am clumsy and people think I’m silly.” “I’m a rock. I have a very rough side. But this side of me is very smooth and nice.” In each sentence, the person could “own” the statement, and this ownership led the way to opening up new areas of feeling. This type of exercise is useful for any age. I sometimes ask questions to bring out further material. Then I will say, “Does any of what you said fit for you? Would you like to do any of those things? Does any of what you said have anything to do with your life?”

One 6-year-old girl chose a dump truck. She described herself picking up garbage, going around the streets. Soon she began to tell me that she had so much garbage to pick up she ran red lights all over the place. I asked her if she herself broke any rules. She grinned and nodded. We had an interesting discussion about this.

Although the child plays in an atmosphere of acceptance, this does not mean that limits are not set. In fact the limits become an important aspect of the therapy. Limits involve time (I generally see children in 45-minute sessions) and rules on abuse of equipment and the playroom, not removing equipment from the playroom, and no physical abuse to me or the child herself. The child needs to be given a little advance notice of the ending of the session: “We have only about five minutes left,” or “We’re going to have to stop soon,” Of course, the child’s desire to go beyond any of the limits needs to be accepted and acknowledged even though the limits are adhered to.

The playing done by children in the therapist’s office is useful for purposes other than the direct purpose of therapy. Play is fun for the child and helps promote the necessary rapport between the therapist and child. The initial fear and resistance on the part of the child is often dramatically reduced when he faces a roomful of attractive toys.

Play can be a diagnostic tool. Often when I am asked to “evaluate” a child I will spend some time allowing him to play. I can observe a great deal about his maturity, intelligence, imagination and creativity, cognitive organization, reality orientation, style, attention span, problem-solving abilities, contact skills, and so forth. Of course I will avoid making snap judgments.

I think it’s important to realize that a child can also use play to avoid expressing his feelings and thoughts. He may also get stuck in one kind of play, or resist getting significantly involved in any of the play. The therapist must recognize this obliqueness and deal with the situation directly and gently. Sometimes I will talk to parents and find it helpful to advise them on the kinds of play materials their children would benefit most from at home. It is not unusual for children to express great interest in some rather common materials that have not been available to them at home, such as clay or paints.

Conclusion

In conclusion, it is clear to see that children have much the same issues as adults. When working with young children, it is a good idea for counsellor’s to be flexible in their approach by helping them express their feelings in their own way and at their own time. Feeling Faces, Feeling Charts, Visualization and Framing Pictures are all very powerful techniques and can be used anytime throughout the session at the creativity of the counsellor. Other techniques that can also be very useful are Sand Play and the use of Puppets. Puppets are particularly useful in the case of a multiple loss.

References

1. Baumgardner, P.A. (1989). The abc’s of children. Burbank, CA: Three In One Concepts.
2. Jarratt, C.J. (1982). Helping children cope with separation and loss (Rev. ed.). Boston, MA: The Harvard Common Press.
3. Stokes, G., & Whiteside, D. (1996). Improve learning awareness. Burbank, CA: Three In One Concepts.
4. Malchiodi, C.A. (1998). Understanding children’s drawings. New York, NY: The Guilford Press.
5. Oaklander, V. (1988) Windows to our Children: A Gestalt Therapy Approach. The Gestalt Journal Press: Highland, NY.