Children can't always tell you when something is wrong or if they're troubled by something. While a psychiatrist might help to an extent, play and expressive therapy would also help.

Sapet (The Selangor Association of Play and Expressive Therapy) was founded in response to the growing interest in PET as a tool to alleviate emotional problems.

“It is also a tool as a very strong counselling technique for children and adults,” explains Nalini Swaminathan, Sapet president.

Play and expressive therapy uses a range of techniques from different fields. It incorporates the use of various modalities like Art, Music, Expressive Writing, Creative Visualisation, Symbol Work, Clay, Sandplay, Bio Energetics, Role Play, Self Awareness Exercises, Personal Narratives, Relaxation, and Meditation.

Dr Linda E. Homeyer, a professor in the Professional Counselling Programme at Texas State University, who is in Malaysia to help Sapet with its programmes, says:

“In play therapy, the therapist is trying to look at and interpret that play and be able to see what the child cannot say because developmentally children like a five-year-old child cannot sit down and say 'You know I've been having a difficult time with my parents because my father is an alcoholic so I'll need a bit of intervention to help me deal with that stress.'

“Of course that's silly because developmentally children can't do that. When children develop from 0 to three years, the right brain develops first so images and stories of their life are stored there and through play therapy they can just naturally act out those images either in sandtrays or in a large play therapy room.

“There's a long history of using play with children to help them work out their emotional and psychological problems. If we can intervene with young children then they don't have to carry that trauma with them until they become adults because many people who do counselling as adults know that a lot of their problems go back to some childhood trauma.”

Dr Homeyer demonstrating how play is used in therapy.

Dr Homeyer explains that in order to ascertain whether the child is really troubled or just has an overactive imagination takes time.

In the United States the number of session per child would vary between 10 and 15 sessions, but it would depend on the child and the family. Some children might resolve their problems earlier than that and some with severe trauma might take longer.

“Sometimes we do have to look at it – is it really what's happening in the child's world or is it what they wish would happen or think will happen. So that's why we see them for several sessions and we get a lot of information from the parents so that we're working together with the parents. Even if a child makes up a story there's usually some meaning in that story that's important to them.

“That's why it's important for a group like Sapet to have training for play therapists so that people who are doing play therapy with children have a lot of training and supervision so that the public can be confident that what's happening in the play room is real therapy and not someone jumping to a conclusion,” she says.

What are some of the signs that parents can look out for that something is bothering their child emotionally or psychologically?

Big changes in behaviour, if all of a sudden their grades start declining, if the child stops eating or eats more now, if the child stops sleeping or wants to sleep all the time, becoming very isolated and withdrawn, or acting out and becoming very aggressive, regressive behaviour like bedwetting, thumb-sucking, acting like a much younger child.

It could also manifest in their drawings – with the use of darker, gloomier colours, drawing like a much younger child, storming pictures ….

“But again, we would never take just one drawing. It has to be a collection over a period of time before we can tell,” says Dr Homeyer.

She explains that some children may need a psychiatrist because they may benefit from some kind of medication such as very depressed children, obsessive compulsive children, ADHD children. Many children benefit from the medication. But in addition they should also have the play therapy because that helps them work out their emotional response to their being ADHD or their emotional response to how they've been affected by whatever reason they're taking the medication.

“We always like to do both. The medication helps but it doesn't resolve all of their behavioural problems,” she says.

Sapet conducts workshops in Selangor as well as in other states. The association was formed to conduct training,workshops and to maintain standards of practice and ethics of the practioners.This ensures all members of Sapet have credibility and proper certification.

To find out more about Sapet's workshops, send an email to sapet588@yahoo.com.