By using play therapy, children are able to learn more helpful behaviours and understand their emotions in an environment that nurtures their feelings and mental health. NMT speaks to Sophia O’Neill, course director, postgraduate MA in Practice-Based Play Therapy about the next steps needed to bring play therapy to the mainstream.

Over the course of the pandemic, the state of children’s mental health has worsened. Many children will be left without vital mental health support unless the government goes further to invest fully in services such as Play Therapy, where they are most needed.

Moving it forward, what would you like to see from the UK government this year?

Well, what we had promised to us is that they are going to reform the mental health act that was last reformed in 1983 so it well overdue a rewrite. We have told that this will happen in the current session of parliament and 2022 has been brought up. So, we are now poised for this potentially life changing legislation to come through as long as it includes children.

We have had a helpful green paper from Theresa May’s government which included community-based help but the white paper that followed last January had removed all mention of children’s mental health needs and community based therapeutic support except for sections on young people in closed wards and clinical settings, not the early help we are promoting.

It is early intervention that is necessary, not waiting until a situation has become critical.

Absolutely, we need to be able to implement support during those early years to help prevent more serious cases going forward. Online there is a plethora of information to support the fact that therapeutic support for younger children is necessary so that things don’t escalate. This is not just to help decrease human suffering, which is cause enough, but it will be beneficial to our economy and political system.

At any stage, were you told why mentions of children were removed from the white paper?

Not that I’m aware, it was just published. The green paper was Theresa May’s government, but it was superseded by the white paper and there is no legislation to protect it. It’s terrifying that children don’t have the right to therapy and access to a trained therapist. There are lots of different types of people in the workforce who are there to support children and we appreciate as much help across communities as possible but now we want to see qualifications being supported by law and regulation.

We want to see the 6 principles put to action: childmentalhealthcharter.com

• Focus on the needs of children. Children’s voices must be heard and their dignity and human rights upheld. Within school, the curriculum must embed within it an understanding of emotional wellbeing, the principles of good mental health and the certainty of therapeutic help for those children who need it
• Protect children. Any individual who works therapeutically with children must be registered through an independent government-approved agency such as the Professional Authority’s Accredited Register programme or the Health and Care Professions Council. Children are currently insufficiently protected because too many unqualified and unsupervised people are practising
• Invest in a properly qualified workforce. Level 7 postgraduate training is essential and the main obstacle to a properly trained workforce is the lack of financial support. Accessible, high-quality and recovery-focused mental health services require personnel whose appropriate training is not solely dependent upon their own financial resources. All professionals (including teachers) who work with children must be trained in mental health awareness
• Ensure policy is informed by the best available and appropriate evidence and adequately funded. Practice-based evidence uses continuous measurements obtained from real life practice and should inform an ‘evidence base’ for working therapeutically with children
• Focus on the needs of parents and carers. There must be high quality support for parents and carers to help them to better understand and support their child with schools promoted as effective, familiar, accessible and empathetic service delivery channels
• Make policies work. ‘Joined up working’ would prioritise appropriate data–sharing between all agencies concerned with child welfare. The responsibility for children’s mental health would encompass all relevant departments in addition to the Department for Health and Social Care.

We will continue to lobby the government with the child mental health charter as there are simple steps that can be taken to put children at the centre of it.

What are some of the key findings in your data?

From a professional perspective, the consistency of our data. The level of efficacy has remained constant across the two measures. The first measure done in 2017 and then over the past five years we’ve done the same tests and the results came out within a percent, that from over 10,000 referrer and parent measures pre and post Play Therapy, results showed Play Therapy making a positive impact in 72- 73% of cases. A closer look shows that for the highest scoring referrals improvement increased to 79-86%.

There is a strong case for the stability of our work and research. It’s a large data set and it will continue to grow. Most useful presenting conditions that come through. Right at the top is anxiety and lack of self esteem followed by family relational difficulties. Then we move into different cases such as loss and abuse. The pandemic has definitely changed the landscape at least for now.

Why Play Therapy is more effective than other methods?

There is a lot of opinion that this is true because talking therapies are more easily accessed by young people and adults than by very young children.This is because adults are aware of what is troubling them or that they want to explore a feeling that they can’t understand. Young children either are worried about talking or they lack the words to do so. It might be that their vocabulary hasn’t got to the level to be able to express what they are feeling or that they don’t know yet how to tune in to their emotions. Play therapy uses very natural ways of communicating for children so that is why in the therapy room we use creative play.

Now in the room, it’s also important to note that we never interpret, it’s all about observing and being open to notice patterns. Always remembering not to force our own hypothesis on it, instead having open theories ready to collate information.

Are there countries leading the way and that we can learn from?

Two examples. We have a very good example from Indonesia. Our play therapists there have managed to come to an agreement with the Ministry of Justice whereby every child that moves through the court system is referred for Play Therapy which is absolutely fantastic. A very good example of joining up institutions and communities.

In Indonesia they have what they call the play bus which is a play therapy room on wheels, and they take it to homeless shelters and work with children there which is an extraordinary example of outreach. I looked at their figures and look specifically at the SDQ measures. They showed a 56% improvement in emotional difficulties pre and post therapy across the whole country.

There is also in Hong Kong, a university that trains teachers have put our postgraduate certificate in therapeutic play skills as part of the MA to become a teacher so everyone doing the course has embedded that first tier of training in Play Therapy.

This means their understanding of trauma and roots underneath behaviour is enhanced.

In the UK, our training organisation APAC has launched the Play Therapy apprenticeship training which is amazing, and it has taken a long time to get it up and running. It’s going to be that schools will have staff trained as Play Therapists for free.

We want the mental health act reformed and the child mental health charter is the way we can do that.

My hope is that this is a watershed moment and a change will happen in the law this year.

To find out more, visit PTUK https://playtherapy.org.uk/