Family Therapy

Theraplay is a dyadic child and family therapy that has been recognized by the Association for Play Therapy as one of seven seminal psychotherapies for children. Theraplay was developed for any professional working to support healthy child/caregiver attachment by increasing positive connection and emotional felt safety in the relationship. Strong and secure attachment between children and the important adults in their life has long been recognized as basis of lifelong mental health as well as the mainstay of resilience in the face of adversity. Modern brain research and the field of neuroscience have shown that healthy and secure attachment is the vehicle by which children come to understand, trust, and thrive in their world.

In treatment, the Theraplay Practitioner guides the parent and child through playful, fun activities, developmentally challenging activities, and tender, nurturing and engaging activities. The very act of engaging each other in this attuned and playful way helps the parent regulate the child's behavior and communicate love, joy, value and emotional felt safety to the child. It helps the child feel secure, cared for, connected, and worthy.

Theraplay uses practitioner guidance to create playful and caring child-adult interactions that foster joyful shared positive experiences. These activities build attunement and understanding of each other – replicating early relationship experiences that are proven to lead to secure attachment. The interactions are relational, physical and fun – a naturally playful way for everyone to experience the healing power of being together.

Theraplay interactions focus on four essential qualities found in healthy parent-child relationships, and the main Theraplay therapy goals include the following four dimensions:

Structure: The adult as the leader and "container" in the relationship, creates organization both externally in the environment and internally for the child's experience in their body and emotions, and the adults structured leadership brings predictability and consistency for the child in order to communicate safety. Adults start in charge, and remain in charge in a bigger, stronger and wiser manner.
Engagement: The adult is present in an attuned manner so that the child experiences being seen, heard, feeling emotionally "felt", and fully accepted. The child is focused on in an intensive, personal way in order to make an attuned connection between the adult and child. Engaging activities offer pleasant stimulation, variety, and a fresh view of life, allowing a child to understand that surprises can be fun and new experiences enjoyable.
Nurture: The adult provides caring that can calm and soothe the child in a manner that makes them feel good physically and emotionally regulated. Soothing, calming, quieting, caretaking activities that make the world feel safe, predictable, warm and secure, and reassures the child that the adult provides comfort and stability. Meets the child's unfulfilled younger needs; helps the child to be able to relax and allow herself/himself to be taken care of; builds the inner representation that the child is lovable and valued.
Challenge: The adult supports the child in the acquisition and mastery of new skills, enhancing the child’s sense of competence and confidence. Adults help the child take a mild, age appropriate risk, and promote feelings of competence and confidence, so that the child experiences agency and empowerment.

With the support of the Theraplay Practitioner, parents learn to play with their child in a way that establishes felt safety, increases social engagement, expands arousal regulation, and supports the development of positive self-esteem for both the child and the parent.

Click here to visit the official Emotionally Focused Family Therapy website to read more!

Emotionally Focused Family Therapy (EFFT) extends the gold standard principles of Emotionally Focused Therapy (EFT) to mend, repair, and fortify familial bonds. The core objective is to cultivate safe and secure family patterns, where attuned and comforting caregiving responses are expressed by the parent first reaching towards their child, and then the child is able to receive and take in their parents care and comfort in return. When new and corrective emotional experiences are experienced and felt in positive and healing ways between a parent and child, safe and secure attachment can be established and emotional bonds are transformed. EFFT centralizes on stabilizing negative interaction patterns within the family system, restructuring parent-child interactions, and consolidating the felt security through new patterns of connection. Following the science of attachment, it guides families to experience swift progress as members become more responsive and engaged towards each other, uncovering and addressing previously unrecognized attachment-related emotions and needs, thus fostering individual growth and intergenerational relationship enhancement.

The main therapy goals of EFFT include:

Accessing and expanding awareness of unacknowledged and unresolved feelings that are associated with the family’s negative interaction cycle and pattern that is keeping everyone stuck. The EFFT therapist tracks and de-scalates the negative interaction cycle and pattern between family members.
Reframing family distress, family stuck points, and child problems by understanding that "relational blocks" are what is reinforcing this family distress and stuck points. Thus parent blocks and child blocks are identified and reframed in terms of attachment significance and unresolved emotional needs of the child.
Promoting awareness and helping support parents to regulate and dismantle their own parental blocks first, and then healing the parents own disowned attachment-related needs. So that the parents can access and become bigger, wiser, and stronger change agents for their child by providing kinder caregiving responses and parental intentions of care towards their child.
Accessing the child's vulnerability so that the child's blocks are fully understood by means of attachment protection, and then helping to soften the child's block(s) so that the child is able to take in and receive their parents positive intentions and corrective emotional experiences of care and comfort.
EFFT goes beyond providing better communication skills to family members, and only providing or facilitating problem solving measures. EFFT facilitates restructuring attachment bonds by providing new corrective emotional experiences between family members so that the long term benefits outweigh crisis management skills.

Click here to visit the official Parent-Child Interaction Therapy website to read more!

Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment for children ages two to seven and their parents or caregivers that focuses on decreasing externalizing child behavior problems (e.g., defiance, opposition, aggression), increasing child social skills and cooperation, and improving the parent-child attachment relationship. It teaches parents traditional play-therapy skills to use as social reinforcers of positive child behavior and traditional behavior management skills to decrease negative child behavior. Parents are taught and practice these skills with their child in a playroom while coached by a trained play therapist. The coaching provides parents with immediate feedback on their use of these new parenting skills, called the PRIDE skills and more, which enables the parents to apply these skills correctly and master them rapidly.

PCIT is done across two treatment phases. The first phase of treatment focuses on establishing warmth in your relationship with your child through learning and applying skills, called the PRIDE skills, proven to help children feel calm and secure in their relationships with their parents, and to feel good about themselves. Desired outcomes of the first phase of treatment in PCIT include: increased attachment, more positive interactions, increased attention span, increased pro-social behaviors, decreased frequency, severity, and/or duration of tantrums, decreased activity levels and decreased impulsivity, decreased negative attention-seeking behaviors (such as whining and bossiness), decreased parental frustration, increased feelings of security, safety, and attachment to the primary caregiver, increased attention span, increased self-esteem, and increased pro-social behaviors (such as sharing and taking turns, and positive reciprocal play behaviors).

The second phase of treatment will equip you to manage the most challenging of your child's behaviors while remaining confident, calm, and consistent in your approach to discipline. In this phase, you will learn proven strategies to help your child accept your limits, comply with your directions, respect house rules, and demonstrate appropriate behavior in public. Desired outcomes of the second phase of treatment in PCIT include: effective limit setting with warnings and choices provided to the child, increased compliance by the child with adult commands, decreased frequency, severity, and/or duration of aggressive behavior, decreased frequency of destructive behavior, decreased defiance, increased respect for house rules, improved behavior in public, and increased parental calmness and confidence during discipline.

How do we know which family therapy modality will be most effective with our family?

Great question! And the good news is, you do not have to figure this part out! Your therapist will outline the appropriate modality and the rationale for its implementation based off of thorough assessment that was done at the beginning of treatment, as well as introducing the modality's goals, expected length of treatment, typical outcomes, and any other questions you may need answered.

What are Theraplay therapy sessions like?

Theraplay is a highly structured modality that will incorporate relational assessments, parent-child family sessions, parent-only feedback sessions, and even the use of video recording! Our office is equipped with high quality recording equipment to facilitate the use of both the therapist, as well as the therapist with parents, reviewing sessions for growth as well as growing edges to continue developing. Many parents exclaim "I had no idea" regarding things like their tone of voice, facial features, body posturing, and other facets of their presentation during parent-child interactions. Come see how the use of video work can accelerate your growth as a parent and the quality of attachment and shared connection with your child or children.

What are Emotionally Focused Family Therapy sessions like?

EFFT most often consists of multiple family members together in session. This is true "family therapy" in the relationship between parents and their children is the focus. This is not one therapist doing individual therapy with the child while the parent watches...that is wholly ineffective. EFFT provides a proven way to strengthen attachment bonds, identify and remove parental blocks to care, and increase accessibility, responsiveness, and engagement across all family members. There are times when parent-only collateral sessions are also utilized to advance the family towards expressed goals, but most often sessions will consist of family members together with your therapist skillfully navigating the various challenges presented to draw people closer together.

What are Parent-Child Interaction Therapy sessions like?

Outside of the two "teaching parent orientation sessions", one before each half of PCIT, the remainder of the sessions involve the parent(s) and child together with the therapist in play. These sessions occur in-office with a curated selection of creative and collaborative toys recommended by PCIT International for use in session. Parents will engage in assessment (known as "coding" at the start of each session, so you can track exactly how far you as the parent have developed each of the five CDI skills (Child Directed Interaction, also known as the PRIDE skills) in the first half of PCIT. Feedback is provided on the coding, with coaching to follow to advance the various CDI skills as needed until "mastery" is reached, a measurable threshold that indicates readiness for the second half of PCIT- which the second half of PCIT treatment is Parent Directed Interaction (PDI skills). Sessions are informative, lively, fun and joyfully play-based.

Do you offer family therapy online via Telehealth?

There are some therapy modalities that comport themselves well to telehealth therapy online, and others that may be more challenging. We will communicate this information directly. Generally speaking, children and adolescents benefit most from in-person services, particularly when they can take advantage of areas like our dedicated play space, sand tray, and variety of assessments on hand that we can administer as needed.

Can you work with families where the "child" is older than 18?

Absolutely! The responsibilities of parents to their children does not end at their 18th birthday. Research has clearly shown that parents can continue impacting their children across the lifespan. "Adult" children and their parent(s) will be well-served with Emotionally Focused Family Therapy (EFFT work). Relationships are often the vehicle by which difficulties enter a child's life; accordingly, repairing and restoring those same relationships is the vehicle for healing.

Why do you also work with families, and not just children?

The parent-child relationship is the first and most important relationship in a child's life, eclipsed only by marriage and children of one's own. Again, here in our practice we see parents as the primary change agents of growth and healing for their child! We have found that many other therapists find that true family therapy, where the relationships between family members are targeted, to be daunting, imposing, or just too difficult. Accordingly, recommendations are made for children to find a new therapist, try a new modality, or the parents get their own individual work. These may all be very helpful, but ultimately, it takes a skilled systemic and attachment-based therapist to actually effect change in a family system. We have that skill here at Connections Counseling!

Do you offer events, retreats, or seminars for families?

No, not at this time. If you have recommendations for desired trainings, events, or topics, feel free to email us and let us know!