Recently I ordered a copy of Call Of Duty: Modern Warfare 3, which I plan to try this week. As I have mentioned in a previous post, I am not easily interested by first-person shooters, but as a gamer-affirmative therapist I can’t let my low interest get in the way of educating myself.
I once calculated that by a conservative estimate I had played approximately 27,000 games of Uno in my decade working in a public school as a clinical social worker. I drove around with a ton of board games and a sand tray as well. I had learned the value of play therapy at the first placement I ever had as an intern, from Winnicott’s squiggle game to the infamous Talking, Feeling, Doing Game. This is all a roundabout way of establishing my “street cred” for valuing play therapy.
Back then, I would go home from work, and many times play Legend of Zelda: Majora’s Mask on the Nintendo 64. My roommate at the time liked to hang out with me while I played and we chatted about life, education (he was a teacher) and politics. He also liked to imitate the fairy guide in the game, and would often cry out, “Listen!” and offer a couple of tips.
In all those years, it never occurred to me that I could have played those games at school if I’d had an office (and some years I did) or that there was a disconnect between what I was doing with the students (card playing) and what they were talking about (Nintendo, XBox, Playstation.) I could hold a conversation with them about these things because I played them in my spare time, but the idea of playing them with my students didn’t register as, well, therapeutic.
I am not alone in this. Many if not most play therapists are not inclined to play video games with their patients, and it is time to rethink this. When 97% of the boys and 94% of the girls we work with play video games, it is no longer an outlier. But there are a few fallacies which I think get in the way of play therapists integrating play therapy into the 21st century.
One I hear frequently is that video games don’t require imagination, or offer projections to explore. But I think this is contempt prior to investigation for the most part. The proliferation of video games is itself the best evidence that there is imagination going into each generation of games, which are produced by imaginative people who must have been able to develop their imagination in part through video games. And we don’t start each session making our children build their own dolls and dollhouse from scratch. We use available tools that do to an extent always structure and limit the imagination. For example, why does the dollhouse have a pointy roof and two floors? This is limiting, and in fact didn’t represent 90% of the urban population I worked with at all. And few play therapists would avoid using Elmo puppets on the grounds that it limits the imagination of the child, even though Elmo is clearly an icon of popular culture.
In fact, play has often had its inception in the popular culture of the time. We may take chess for granted now, but when it came into being it was a reflection of a medieval monarchy, with kings, queens, and bishops. Yet play therapists often fall prey to nostalgia, if not luddism, and maintain that there are certain games and play that are relational and therapeutic, and others, usually the modern ones, are not.
This brings me to what I suspect is another reason we resist using video games in play therapy, which is the therapist’s fear of being incompetent or failing at the unfamiliar. Years of training in a traditional educational model have taught us to silo down in our area of “expertise” as soon as we can. We “major” in psychology or social work, go to graduate school for advanced specialization, and basically get to a point where we can work in a routine and structured environment. For years we get in the habit of certain forms of play therapy: Candy Land, Chutes and Ladders, cards, chess, dollhouses and telephones. These are easy and portable, but more importantly perhaps, we know how to play them, so we can not be “distracted” by the game, or lose by design if we want to build the kids self-esteem, and otherwise feel in control of the play situation.
It’s time we work through this resistance. People can and do have conversations while they play video games, and video games are in themselves social media. There are plenty of metaphors to explore in and after video gameplay. Angry Birds is rife with themes of anger, different abilities, and protecting the innocent and defenseless. Call of Duty can give rise to expression of competition, drives, and the hunger for destruction or cooperation. And a recent (to me) favorite, Demon Souls, is a tone poem on isolation, yearning to connect, and persistence in the face of despair.
I’m sure I’ll get comments arguing that video games are inherently violent as well. To which I would respond, just like Battleship and the card game War are inherently violent. We have become insulated to the violence in them, and it may not have the graphic sophistication of video games. But the next time you play Battleship ask yourself what you think happened to all the people on the battleships that sunk? The game doesn’t come with little lifeboats, you’re drowning people. Play therapy does not avoid violence in its expression.
Virginia Axline, one of the founders of modern play therapy, had 8 guiding principles for play therapists:
- The therapist must develop a warm, friendly relationship with the child, in which good rapport is established as soon as possible.
- The therapist accepts the child exactly as he is.
- The therapist establishes a feeling of permissiveness in the relationship so that the child feels free to express his feelings completely.
- The therapist is alert to recognise the feelings the child is expressing and reflects those feelings back to him in such a manner that he gains insight into his behaviour.
- The therapist maintains a deep respect for the child’s ability to resolve his own problems if given an opportunity to do so. The responsibility to make choices and to institute changes is the child’s.
- The therapist does not attempt to direct the child’s actions or conversation in any manner. The child leads the way; the therapist follows.
- The therapist does not attempt to hurry the therapy along. It is a gradual process and is recognised as such by the therapist.
- The therapist establishes only those limitations that are necessary to anchor the therapy to the world of reality and to make the child aware of his responsibility in the relationship.
Nowhere in there does it say, the therapist sticks with the tried and true games s/he grew up with. To my colleagues who are ready to decry the death of the imagination and lesser play of video games, I think Axline said it best: “The child leads the way: the therapist follows.”
Following in the 21st century means having Gameboys and Playstations in our repertoire. If we don’t keep learning and using technology in our play therapy, we may find ourselves in a state of unplanned obsolesence. Am I saying we should stop playing Jenga and Uno? No. But if our patients are looking for video games amongst the chess sets and dollhouses, perhaps they are telling us something we need to pay attention to. Just because we don’t know how to play a game doesn’t exempt us from learning it. And what a gift it can be for an adolescent to experience themselves as more competent and talented by an adult! So many of them come to us having been labeled as “failed learners,” and we have the potential to help them experience themselves as successful teachers, of us.
Those of us working in agencies and schools need to resist the temptation whenever possible to use the excuse of needing to be mobile or budgetary constraints. Video games are now as portable as a Nintendo DS PSVita or Smartphone. And the price of a video game system is not so prohibitive as to be a given. The real reason we often don’t advocate for video games at the agency or school is our own bias that they are somehow less valuable as therapeutic play media.
I anticipate that this will meet with resounding criticisms from the “play-is-going-to-hell-in-a-hand-basket” crowd, but I’m really interested in hearing from colleagues who have managed to successfully integrate video games into their play therapy. What are your success stories? What have been some challenges you’ve had to overcome? Do you schedule online play sessions? How do you manage the noise in an office suite? I’m really interested in your experiences.
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Hi Mike,
Excellent points. We must stay relevant. The only population that I don’t want to spend the session on video games is the AS kids. They are very comfortable in a world of silence or not relating to human interactions. I encourage stare downs, describing my face with their eyes shut and making story cards so that they can describe/speak to someone when they are being bullied for example.
Otherwise gaming is an amazing way to help kids go from concrete to abstract thoughts.
Keep up the good work.
Debbie
Dear Mike, I have just read your article and what came to my mind were a couple of articles: that show what we can learn from videogames. They are very interesting. Hope this open our thoughts. (I’m a systemic family therapist and I’m in my 2nd year of the specialization in education and new technologies).
Jewitt, Carey (2005) Multimodalidad, “lectura” y “escritura” para el siglo XXI. Discourse: Studies in the Cultural Politics of Education, Vol. 26, N° 3, Septiembre de 2005.
ARMANDO http://campusvirtual.unex.es/cala/editio/
GEE, J. P. (2005) ámbitos semióticos: ¿es una “pérdida de tiempo” jugar con los videojuegos? En: Lo que nos enseñan los videojuegos sobre aprendizaje y alfabetismo. Málaga: Aljibe. (cap. 2)
Awesome article and brings up some questions for me on how new generations of social workers and therapists are adjusting/utilizing today’s technology in their practice. We don’t usually get the option of experiencing this integration in the classroom (I have professors that still don’t know how to operate a VCR/DVD or Smartboard!!!). Is this a disservice to newer generations of social workers and clients? How do we integrate video games into therapy, and what are the boundaries there as far as content and what type of games to play with clients?
Playing CoD as research is an excellent point to make. When we talk therapists talk about being culturally competent, it is accepted that there is no way we can learn everything about a particular culture. But when it comes to children and young clients, it bothers me that some clinicians are so hesitant to learn more about the things that influence children so much, specifically the TV shows they like and the games they play.
I once debated with a supervisor that it was a shame she did not learn more about Pokémon. Kids love that game and if a child progresses in it, I believe it says a lot about the child. If you know the game, you know what I’m talking about. I told co-workers that they don’t need to go out and buy a DS and a copy of the game but at the very least read up on it online. I once made great progress with a client by using Pokémon in sessions as a rapport builder (we shared our collections and battled), a behavior modifier (an incentive to behave), using its stories as metaphors (evolution, battles, rivals, progress, being a hero, capture), and by helping the client apply skills learned in the game in real life (inventory management, statistical analysis, collaboration, perseverance). I used a DS in therapy with the client although the program had a “no video games” rule.
I once worked with a group of at-risk children and the program had a Wii (purchased by the previous coordinator) but the current coordinator refused to use it. Obsolescence is a real concern. Why would these children be excited about playing Candyland at the program when they had an Xbox 360 at home. It is such a missed opportunity to not use what the children are familiar with and enjoy in different ways, and ways they can bring home. A child’s father might be more willing to play co-op Halo than Candyland or UNO.
I agree that therapists must embrace whatever clients are into. Not doing so is to be culturally incompetent and it is a disservice to our clients.
I can’t agree more. Much of what kept me grounded and semi-sane as a youth was video and computer gaming. What I could not understand at home or in the schoolyard in terms of control, fairness and propriety I could readily grasp in electronic media. I did not often win or even finish most games but I could refer to a manual, FAQ, strategy guide or expert opinions to find out what works best in accomplishing in-game goals. Now, as a parent and therapist, I continue to use board, role-playing and interactive media with others old and young to demonstrate how play is necessary for growth and development.
i have played flash based internet games in my office with clients, it was definitely fun for all and something that my young clients looked forward to, but not sure if it led to increased dialogue. I’ve had some older clients show me all the fun things they liked about their DS, and have watched them play games as well.
the potential for video games to be used in therapy sessions is there, i wonder if the games need to be collaborative like a 2 player game, or even sport games on the Wii.
perhaps we can compile a list of great video games that has worked well in sessions with X aged clients. looking fwd to all suggestions.
Nicely put, Michael. I’ve used electronic games of one sort or another in therapy for years. My favorite approaches include using an RTS (Command & Conquer-Tiberian Sun) to work with several children on impulse control and planning. Their typical initial approach to the game mirrored their approach to most things in life: Rush forward as soon as possible without considering subtle but important variables that are available for consideration and can significantly impact the outcome. Over time and with varying degrees of structure in their play (that I imposed) most began to recognize and inhibit the urges to do something rather than wait for a better time or circumstance. It was child’s play to relate their game behavior to salient issues at home and school and then to create metaphors and cognitive cues that the child could use in R/T.
Very interesting! I don’t use video games in my practice, but I can see your point. I think the reason that I don’t use them has a lot to do with my age! I’m just not familiar with them, though I certainly knew about the ones my son played when he was a teen 5-10 years ago. I have always been able to see the use of strategy in video games, just like in Stratego or chess. This offers food for thought. Perhaps I need to branch out into the 21rst century.
Hi Mike,
I enjoyed reading your thoughts regarding integrating video games into play therapy. As a RPT (registered play therapist) I am mindful of how to best integrate technology not just into the play therapy room but into all aspects of my practice.
You may be interested to know that the Association for Play Therapy http://www.a4pt.org/ recently put together a technology task force of which I am a member. We’re looking at the benefits of integrating technology into play therapy practice, playrooms, instruction and trainings, supervision, research, etc.
APT has put a link to your blog post on their web site and they’re encouraging members to read your comments. We recognize technology is changing the ways of the world and we want play therapists to be able to adapt to the future without feeling like we’re destroying our past.
Earlier this year I started working with elementary and middle school students in urban Springfield where, after first recapitulating my formal training for adults and using talk therapy, I began to branch out and engage students with the squiggle game and drawing. After a few months I acquired an indoor basketball set-up that really gets us out of our seats, which most of my male clients seemed to enjoy. However, the other day I let a 10-year old show me his favorite games on http://www.poptropica.com/, the first time I ever used a computer in a session with a client! I felt a mixture of emotions, including the clear sense of no longer being in control of the session and being more of an observer than a therapist, never mind even a facilitator. That being the case, I do think we need to meet our clients where they are, especially since nearly every one of my male clients reports using PS-3 and X-Box on a daily basis. I should add that I never had an interest in either video games or social networking, perhaps an indication of my generation. Nevertheless, I think it would be a lost opportunity if we didn’t try to engage young people in the game arena, even though there are question that we need to pay attention to, such as the real concern about the impact of gaming on the ability of young people to relate to people socially as they get older. Maybe, just maybe, I’ll let my wife talk me into opening a Facebook account!
I am a play therapist and always open to new ideas and using technology in therapy. I had not considered using the popular video games though so this has given me some new ideas to consider. Thanks.
Im a mother of 2. both of whom have neurological disorder needing therapy Now that they are 12, I find that too many psychiatrist want to stop using play therapy.. I am very sad about this. I am not a fan of them using board games. I prefer free play with toys or doll houses, and now that I read this Ii never thought of video game. I do think video game would be a big improvement on board games, mainly because like dolls or blocks many games allow you to build or use your imagination in a much fuller extent. I’m always disappointed when I hear they played a board game. not very imaginative.