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Play Therapy

Feeding Your Child’s Brain from the Bottom Up

Last week Theresa, Amy, and I were lucky enough to attend a training with Dr. Bruce Perry. In short, Dr. Perry is a brilliant guy who has spent years researching how the brain works and takes in information, and how therapists, teachers, and all of the systems that work with children in our country can use this information to better support children and their families. If you are interested, here is Dr. Perry’s bio:

The brain is amazing and complicated, and there is still so much we don’t know about how it works. Dr. Perry identified one idea as being the most important he would share with us at the training (if he had to pick one “most important thing”) and I wanted to pass it along. Please note these ideas are all Dr. Perry’s with a few thoughts from me of how I have seen them play out in my own experience.






Our brains process information from the “bottom up.” So first, our brains have to be Regulated. This means our physical basic needs have been met- we are not hungry, thirsty, or tired. And we have to feel safe both physically and emotionally. What children (and adults) need to stay regulated is individual for every person, and depends on their temperament and the experiences they’ve had in their lives, both positive and negative. Here is a video in which Dr. Perry talks more about the need for regulation and ways children can regulate themselves (and we can help them):

After regulation comes Relationship. Our brains are hard wired to make connections with other people, and how strong the relationship we have with the person is will impact our ability to use our upper level brain and retain information. More thoughts from Dr. Perry about the importance of relationship:

Finally comes Reasoning. This is what we expect our children to do all day long when they are in school. This is what we expect when our child misbehaves and we say “why did you do that?” And according to Dr. Perry, it is extremely difficult if not impossible for us to use this part of our brain without regulation and relationship.


So, in short, talking to a child, teen, or even adult who is not regulated about a reasoning task is pointless. They can’t process information with the top part of their brain until the parts underneath it are taken care of. In fact, trying to reason or use a behavior modification program with a child who is not regulated or whom you do not have a relationship with will often escalate their behavior. Have you ever tried to “reason” with a child in the middle of a tantrum? Have YOU ever had a conversation with someone when you were really hungry and realized later you didn’t have a clue what they said to you? What teachers did you learn the most from when you were in school? For me, it was the ones I felt like I had a stronger relationship with. And do you want to talk and reason through difficult or personal things with someone you don’t have a strong relationship with?

According to Dr. Perry, once basic physical needs are taken care of the best ways to regulate ourselves are through rhythmic activities that give us some sensory input- listening to music, walking, running, rocking back and forth, drawing, even chewing gum. This will not be the same for every person, and you are probably thinking right now of what you choose for yourself or what your child prefers to “regulate” themselves. So many of the children and even youth I work with walk into my office and head straight for my sandbox just to put their hands in it and rhythmically pour and fill their hands with sand. Some walk or jump around my office during our entire session. They know when they need a little bit of regulation! Try building these into your day- right after school before homework time, or during times of the day that can be particularly challenging for your child. Don’t forget to build some regulation in for yourself, too! When I feel my level of stress start to build and I am having a hard time focusing, going for a run is what helps me get regulated again.


Once regulation is taken care of, don’t forget to focus on relationship. I often talk to the parents of the children I work with about the importance of building a positive relationship with your child. A strong relationship carries you both through the times that are difficult. Do activities with your child (looking at Facebook or texting while they are playing video games in the same room doesn’t count- play a game, get on the floor with the Barbies or cars, read a book together; whatever your child enjoys that lets the two of you interact), give them positive attention when they are working hard or making a good choice, and show them through your actions that you love them unconditionally and will be there consistently for them even when they make a mistake.

Only when these first two things are taken care of can your child have a chance of reasoning through situations. And even then, our upper “reasoning” parts of our brain don’t fully develop until we are well into adulthood. So when you ask your child why they acted a certain way and they say “I don’t know,” they truly may not know. And by the way, we therapists have to go through this process when we first start working with clients and sometimes during every session.  Our job is to create a space where children (and adults) can feel safe, where they have access to things that allow them to regulate themselves, to build a caring, trusting relationship, and then do some “reasoning” through the issues they are dealing with.

This blog just summarizes the tip of the iceberg of Dr. Perry’s Neurosequential Model. If you are interested in reading more about it, visit

Back to School Part Two- Separation Anxiety and Young Children


In Part 1 of our back to school series, we offered some suggestions for helping your child/teen transition back to school if they are anxious.  Many of the ideas we discussed can also help young children, but here are some additional suggestions to help your young child if he/she is having a difficult time separating from you:

  • Read books about going to school and separation anxiety ahead of time, and talk with your child about how the characters are feeling and how they cope with their worry. Some of my favorites that are good for preschool and kindergarten aged children are The Kissing Hand by Audrey Penn and Wemberly Worried by Kevin Henkes.
  • When you attend back to school night with your child, take pictures of your child’s teachers, the playground, the classroom, etc. so they can look through them ahead of time again.
  • Young children sometimes find it helpful to bring a security object from home when they are anxious about separating from their parents/caregivers. This can be a favorite toy, family picture, etc., and often children feel better just having it in their backpack with them at school so they can get it when they feel like they need it.
  • When it’s time to say goodbye, don’t linger, but don’t sneak out of the door either. Say goodbye to your child, assure them you will come back, and then leave the classroom even if they are upset. Continuing to stay often makes children more upset in the long run, and teachers who work with young children have lots of practice in comforting them. Often creating a special ritual for saying goodbye can help with this transition- a special handshake, giving 2 hugs and a kiss, or whatever you and your child create together.

Overall, what is going to help your child (and your) anxiety the most is seeing that they can stay at school without you, you will always come back to get them, and they can have fun while they are there!

Look for part three of our back to school blog series next week- tips for helping your child be assertive and deal with bullying from Jessi Johnson, LPC.


Back to School Part One- Help Your Child Cope with School Anxiety




Over the next few weeks, we will be bringing you a blog series with some back to school tips for a great start to the school year!


Back to school time can be an exciting time for children and their parents, but if your child/teen struggles with anxiety it can be a stressful time as well. Here are some tips for helping your child start off the school year on a positive note:

  • Talk with your child ahead of time about what specifically they are worried about. Often knowing more about what to expect reduces anxiety, so help your child/teen write a list of questions they have about the upcoming school year (“what will my schedule be?,” “what do I do if I get lost in the hallway?”, etc.). Then help them find the answers to those questions. If your child is older or a teenager, help them figure out how they will find the answers to those questions- doing this on their own will help them feel empowered.
  • Attend open house/ back to school night with your child so they can meet their teachers and see their classroom ahead of time. Encourage your child to use this night to find the answers to some of the questions they have about school.
  • If your child is worrying about a specific situation happening (“what if someone teases me?” “what if my teacher is mean?”), help them problem solve what they would do in these situations. Focus on helping your child figure out how to handle problems themselves- NOT you doing it for them.
  • Encourage your child to use positive self-talk when they are worrying, like saying to themselves “I can do this,” or “Everyone makes mistakes; I will try again.”
  • Avoid giving your child “mental health days” or letting them stay home from school because they are anxious about going. They will enjoy the day they get to stay home, but that will not help their anxiety in the long run, it just teaches them to avoid situations that make them anxious. Going to school, seeing that it can be fun, and dealing with challenging situations are what will ultimately help your child worry less.


Coming next week- additional tips for supporting young children as they get ready to start school or daycare.


What is Play Therapy?

Play is an essential part of development in childhood.

As children grow, they use play to practice new skills, communicate with others, and relieve stress.

Play therapy uses what we know about how children use play to help clients process trauma, express their feelings, and practice coping skills. Play therapy lets children be active and engaged in the therapy process in a safe and accepting environment. When children are not able to express how they feel through words, they can use puppets, art, toys, and sand tray.

Play therapy also helps children begin to develop the words to tell us how they are feeling. Research suggests that play therapy is effective in helping a variety of issues (see Association for Play Therapy for more information).

Registered Play Therapists are mental health professionals who have completed additional training and supervision in play therapy and how to use play to help clients meet their therapy goals.

Vicki Knipmeyer and Amy Dobson at The Center for Counseling and Training both have specialized training in play therapy.