Pretend play processes and anxiety: Considerations for the play therapist.

Abstract

This study investigated the effect of anxiety on play processes in 43 first-, second-, and third-grade children. Using a mood-induction procedure, this study compared processes in play among children randomized to an anxious or neutral mood-induction procedure. Children were assessed using the Affect in Play Scale pre- and post-mood-induction. In addition, this study examined relationships between pretend play processes and self-reported state and trait anxiety levels using the State Trait Anxiety Inventory for Children. Findings demonstrated a significant negative relationship between baseline state anxiety level and organization of the play narrative. Consistent with previous research, children in both conditions significantly improved on multiple play scores over time. Although pretend play processes were not significantly affected by condition assignment, further analysis with a more sensitive measure of affect in play revealed a significant interaction between state anxiety and condition assignment on the amount of positive affect expressed in play. Results indicate that play processes can improve with time and greater state anxiety may impact organization and affective processes in play. Implications for play therapy are discussed in terms of the potential impact anxiety has on play processes.

The Non-linear Trajectory of Change in Play Profiles of Three Children in Psychodynamic Play Therapy

“…The play themes are reflective of these concerns, and in Cluster 6, create significant inhibition and conflict. This is consistent with literature that shows that anxious children have been shown to play solitary, engage less readily in dyadic play and are more inhibited in play ( Christian et al, 2011 ). However, children in our study are oscillating between Inhibited (Cluster 6) and Adaptive Profiles (Cluster 2) in face of the emerging issues, which parallels prior findings by ( Chazan, 2002 ; for a review), who showed that children use the play scene to reenact certain problematic situations which can cause temporary stagnation, however, as long as the child continues to play symbolically, adaptive strategies are also used as part of an overall coping effort to master these problematic scenarios.…”

“…Our findings support and bring additional findings on the central role of play in psychodynamic treatment process. The initial findings having to do with the predominance of the Inhibited Profile is in line with literature that shows that anxious children have difficulty engaging readily in play ( Christian et al, 2011 ). They tend to remain centered upon themselves and bring solitary representations to the play field ( Barnett and Storm, 1981 ) which are all captured under the items loading toward Inhibited Profile.…”

Assessment of Pretend Play in Preschool-Aged Children: Validation and Factor Analysis of the Affect in Play Scale–Preschool Version

“…Future studies should examine whether specific play variables on the APS-P or APS-P-BR, including imagination, organization, and positive affect, relate differentially to indicators of cognitive or socioemotional development or whether an overall factor score is more appropriate. For example, Christian et al (2011) examined pretend play in first-, second-, and third-grade children divided into groups based on self-reported anxiety levels. Results were that children in the group that reported more anxiety displayed less organization in their pretend play stories.…”

“…Finally, children with mental health difficulties and developmental disorders often present with characteristic play patterns. For example, children have less organization in their play when they are anxious (Christian, Russ, & Short, 2011;Grossman-McKee, 1989), children with autism display a deficit in imagination or symbolic abilities (see Jarrold, 2003, for review), and children diagnosed with posttraumatic stress disorder often display constricted affect and repetitive play (Gil, 1991;Terr, 1990). In the future, play assessment might be helpful in determining whether a child's play skills match pre-established play profiles for a particular diagnosis.…”

Pretend Play in Italian Children: Validation of the Affect in Play Scale-Preschool Version

“…A large body of research related pretend play to a diverse set of measures of creativity (Fisher 1992;Russ and Schafer 2006;Singer and Singer 1990), the growing capacity to self-regulate (Berk et al 2006), coping ability (Christiano and Russ 1996;Goldstein andRuss 2000-2001), problem solving and adjustment (Russ 2004(Russ , 2006Singer and Singer 1990), perspective taking and emotional understanding (Fehr and Russ 2014;Fisher 1992;Seja and Russ 1999). Moreover, the ability to pretend and make believe represents the integration of cognitive, affective and interpersonal competencies for preschool children (Christian et al 2011;Russ 2004Russ , 2006Russ and Dillon 2011). Recent reviews pointed out that these different domains should be taken into account to assess preschoolers' development through play.…”