Thousands of children are adopted both domestically and internationally every year. Many of these children come from institutional or foster care and may have repeatedly experienced trauma, abuse and neglect, which negatively affect their transition and attachment with their adoptive families (Van Der Kolk, 2005). If left untreated, these effects can last into adulthood, impairing a person’s ability to form secure relationships throughout their lives (White, 2014). 

Using the lens of attachment, the purpose of this research is to explore the use of virtual play—especially play therapy—to help adopted children in Pennsylvania work through these past traumas so they can form healthy attachments with their adoptive families. Treating complex trauma in these children requires treatment that addresses the whole child: 1) safety, 2) relationships and 3) self-regulation and management (Purvis, 2013). 

Many interventions are behavioral-based and revolve around the caregiver and family, such as attachment parenting and Trust-Based Relational Intervention (TBRI) training (Chobhthaigh, 2019). There have also been a variety of research studies on adoption and/or foster care, as well as the use of play therapy to help children with trauma. However, few studies focus on adopted children and their use of play, and no studies have been published that revolve around the use of virtual play to treat adopted children with trauma.

Research Question

How might we utilize play to help adopted children in Pennsylvania work through past traumas so that they can form healthy attachments with their adoptive families?

Video Presentation

Design Solution: Mythos

In the form of a video game, adopted children and children with trauma role-play as a stuffed bear who’s lost their home and finds themselves on a journey of self-discovery. The game will be partnered with therapy and a physical stuffed bear. At the end of each session, the therapist will ask the child questions about their experience. 

Target audience: Adopted children, ages 5-12

Ultimate learning/treatment goal: Termination of self-defeating acting out behaviors and acceptance of self as loved and loveable within an adopted family

Prototype: http://www.inkkspot.com/2016/images/mythos.html

References

Ackerman, Courtney (2018, April 27). Attachment Theory in Children and Adults: Bowlby & Ainsworth’s 4 Types, Positive Psychology Program. Retrived from https://positivepsychologyprogram.com/attachment-theory/ on 05 October 2019.

Arrow, Jessica (2019). How to Use Play for Learning, Edutopia. Retrieved from https://www.edutopia.org/article/how-use-play-learning on 04 October 2020.

Association for Play Therapy (2020). Play Therapy Credentials, Association for Play Therapy. Retrieved from https://www.a4pt.org/page/CredentialsHomepage on 16 September 2020.

Association for Play Therapy (2020). Stages of Play Therapy, Association for Play Therapy. Retrieved from https://www.a4pt.org/page/ParentsStagesofThera on 05 October 2020.

Axline, Virginia M. (1964). Dibs in Search of Self.

Bergen, Doris and Fromberg, Doris P. (2015). Play and Socialization in Middle Childhood, Play from Birth to Twelve: Contexts, Perspectives, and Meanings, Third Edition, 31-34.

Bodrova, Elena, et al (2015). Vygotskian and Post-Vygotskian Views on Children’s Play, The American Journal of Play. Retrieved from https://files.eric.ed.gov/fulltext/EJ1070266.pdf on 02 October 2020.

Bowlby, John (1982). Attachment and Loss, Attachment, Volume 1, Basic Books. Retrieved from https://www.abebe.org.br/files/John-Bowlby-Attachment-Second-Edition-Attachment-and-Loss-Series-Vol-1-1983.pdf on 16 November 2019.

Boys & Girls Aid (2020). Preventing the Movement of Children in Foster Care, Boys & Girls Aid. Retrieved from https://www.boysandgirlsaid.org/stories/2017/7/25/how-we-are-stopping-the-movement-of-children-in-foster-care#:~:text=A%20child%20entering%20foster%20care,having%20to%20make%20new%20friends on 16 September 2020.

Bray, Bethany (2018, August 24). The Therapy Behind Play Therapy, Counseling Today. Retrieved from https://ct.counseling.org/2018/08/the-therapy-behind-play-therapy/ on 04 October 2020.

Bretherton, Inge (1992). The Origins of Attachment Theory: John Bowlby and Mary Ainsworth, Developmental Psychology. Retrieved from http://www.psychology.sunysb.edu/attachment/online/inge_origins.pdf 11 September 2020.

Brown, Frasier (2014, December 1). The Healing Power of Play: Therapeutic Work with Chronically Neglected and Abused Children,   Retrieved from https://www.researchgate.net/publication/307675730_The_Healing_Power_of_Play_Therapeutic_Work_with_Chronically_Neglected_and_Abused_Children/fulltext/57d9b27408ae601b39b15feb/The-Healing-Power-of-Play-Therapeutic-Work-with-Chronically-Neglected-and-Abused-Children.pdf on 03 October 2020.

Brown, Stuart, M.D. (2010). Play: How It Shapes the Brain, Opens the Imagination, and Invigorates the Soul, 65-73.

Cherry, Kendra (2018, September 20). The Story of Bowlby, Ainsworth, and Attachment Theory, Very Well Mind. Retrieved from https://www.verywellmind.com/what-is-attachment-theory-2795337 on 05 October 2019.

Cherry, Kendra (2018, November 6). The Different Types of Attachment Styles, Very Well Mind. Retrieved from https://www.verywellmind.com/attachment-styles-2795344  on 22 November 2018.

Cherry, Kendra (2019, November 26). Sociocultural Theory of Cognitive Development, Very Well Mind. Retrieved from https://www.verywellmind.com/what-is-sociocultural-theory-2795088 on 04 October 2020.

Cherry, Kendra (2020, June 3). The 5 Levels of Maslow’s Hierarchy of Needs, Very Well Mind. Retrieved from https://www.verywellmind.com/what-is-maslows-hierarchy-of-needs-4136760 on 04 October 2020.

Children’s Rights (2020). Foster Care, Children’s Rights. Retrieved from https://www.childrensrights.org/newsroom/fact-sheets/foster-care/ on 16 September 2020.

Chobhthaigh, Sorcha Ni, et al (2019). The Effectiveness Of Psychological Interventions With Adoptive Parents On Adopted Children And Adolescents’ Outcomes: A Systematic Review, Clinical Child Psychology and Psychiatry. Retrieved from https://journals.sagepub.com/doi/pdf/10.1177/1359104518786339 on 11 September 2020.

Cook, Alexandria, et al (2005, May). Complex Trauma in Children and Adolescents, Psychiatric Annals. Retrieved from https://www.researchgate.net/profile/Joseph_Spinazzola/publication/264230758_Complex_Trauma_in_Children_and_Adolescents/links/579a1d4a08ae425e4918339e/Complex-Trauma-in-Children-and-Adolescents.pdf on 03 October 2020.

Cranny, Katelin M. (2016, May). The Effectiveness of Play Therapy and Reactive Attachment Disorder: A Systematic Literature Review, St. Catherine University. Retrieved from https://sophia.stkate.edu/cgi/viewcontent.cgi?article=1573&context=msw_papers on 16 September 2020.

Craft, Carrie (2020, June 13). Reasons Why Children Enter the Foster Care System, Very Well Family. Retrieved from https://www.verywellfamily.com/top-reasons-children-enter-foster-care-27123 on 16 September 2020.

DivorceCare4Kids (2008). Lesson Plans, DivorceCare4Kids. Retrieved from https://s3.amazonaws.com/leaderzone/leaderzone/downloads/resources/dc4k/LessonPlansBook.pdf on 21 March 2021.

Ebert, Daniel David, et al (2015, March 18). Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Youth: A Meta-Analysis of Randomized Controlled Outcome Trials, PLoS One. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364968/ on 12 September 2020.

Firestone, Lisa, PhD (2013, June 19). Disorganized Attachment: How Disorganized Attachments Form & How They Can Be Healed, PsychAlive. Retrieved from https://www.psychalive.org/disorganized-attachment/#:~:text=Studies%20have%20shown%20that%2020,disorganized%20attachment%20to%20their%20parent on 16 September 2020.

Ginsburg, Kenneth, M.D., MSEd (2007). The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bonds, American Academy of Pediatrics. Retrieved from https://pediatrics.aappublications.org/content/pediatrics/119/1/182.full.pdf on 02 October 2020.

Google (2020). Chrome Music Lab, Google. Retrieved from https://musiclab.chromeexperiments.com/Experiments on 05 October 2020.

Gray, Peter, PhD (2013). The Evolutionary Importance of Self-directed Play, The Genius of Play. Retrieved from https://thegeniusofplay.org/genius/expert-advice/articles/the-evolutionary-importance-of-self-directed-play.aspx#.YFjx5K9KiUm on 21 March 2021.

Hafetz, Robert Allan (2015). Creating a Secure Attachment in the Adopted Child, The Attached Family. Retrieved from http://theattachedfamily.com/membersonly/?article=creating-a-secure-attachment-in-the-adopted-child  on 05 October 2019.

Healthline (2018, September 14). It’s Not Me, It’s You: Projection Explained in Human Terms, Healthline. Retrieved from https://www.healthline.com/health/projection-psychology on 21 March 2021.

Henry, Darla (2014, February 1). The 3-5-7 Model—Helping Children Work Through Grief, North American Council on Adoptable Children (NACAC). Retrieved from https://www.nacac.org/resource/3-5-7-model-work-through-grief/ on 01 March 2021

Hinman, Jack, PsyD (2016, November 16). The Adoption Cluster: Abandonment, Attachment and Trauma and Teens, New Haven Residential Treatment Center. Retrieved from https://www.newhavenrtc.com/attachment-disorder-treatment/the-adoption-cluster-abandonment-attachment-and-trauma-in-teens/ on 16 September 2020.

Hodges, Jill, et al (1989). Social And Family Relationships Of Ex-institutional Adolescents, Journal of Child Psychology and Psychiatry. Retrieved from http://www.holah.karoo.net/hodgesstudy.htm on 16 September 2020.

Hudson, Lucy, et al (2009).  Healthy Beginnings, Healthy Futures: A Judge’s Guide, ABA Center on Children and the Law, National Council of Juvenile and Family Court Judges and Zero to Three National Policy Center. Retrieved from https://www.americanbar.org/content/dam/aba/administrative/child_law/healthy_beginnings.authcheckdam.pdf on 16 November 2019.

Huebner, Grechen (2020, July 20). 4 Tips to Create a Virtual Makerspace from Shannon Miller, Kodable Blog. Retrieved from https://www.kodable.com/learn/virtual-makerspace-tips/ 05 October 2020.

Indiana University School of Medicine (2010). Helping Your Child in Foster Care Handle Transitions, Indiana University School of Medicine. Retrieved from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/healthy-foster-care-america/Documents/IU-Transitions.pdf on 16 November 2019.

Itzkowitz, Mari, LCSW (2020). Too Many Losses Too Soon: Loss and Grief in Children Who Are Adopted and in Foster Care, Center for Adoption Support and Education. Retrieved from https://www.fairfaxcounty.gov/healthymindsfairfax/sites/healthymindsfairfax/files/assets/documents/csa-symposium/2019/pm-loss-and-grief-ncfa.pdf on 01 March 2021.

Julian, Megan, et al (2015, September 12). Social Skills in Children Adopted from Socially-Emotionally Depriving Institutions, US National Library of Medicine and National Institutes of Health. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830636/ on 21 March 2021.

Juster, Anna Housley, PhD (2015). The Amazing Benefits of Self-directed Play, Pop-Up Adventure Play’s P.L.A.Y. Guide. Retrieved from http://www.beactivekids.org/assets/pdf/MorganLeichterSaxby.pdf on 21 March 2021.

Kittlitz, Wendy (2010). Attachment: What Adoptive Families Need to Know, Focus on the Family. Retrieved from https://www.focusonthefamily.ca/content/attachment-what-adoptive-families-need-to-know on 27 October 2019.

Karen Purvis Institute of Child Development (2013). TRBI Connecting Principles Participant Workbook, Trust-Based Relational Intervention (TRBI) Caregiver Training, 4-8.

Landreth, Garry, EdD, LPC, RPT-S (2020). A Message from Garry Landreth, Association of Play Therapy. Retrieved from https://www.youtube.com/watch?v=AtXhBcEgnHI on 05 October 2020.

Laney, David F (2007). Accounting For Variability In Mother-child Play, American Anthropologist. Retrieved from https://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=1616&context=sswa_facpubs on 21 March 2021.

Mayo Clinic (2020). Fetal Alcohol Syndrome, Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/fetal-alcohol-syndrome/symptoms-causes/syc-20352901 on 21 March 2021.

Makerspace for Education (2020). Why Makerspace? Makerspace for Education. Retrieved from http://www.makerspaceforeducation.com/why-makerspace.html on 05 October 2020.

Montgomery. Megan (2013). What to Expect #4: Developmental vs Chronological Age, Adoption Star. Retrieved from https://adoptionstar.com/what-to-expect-4-developmental-vs-chronological-age/ on 27 October 2019

Mindes, Gail (2015). Can I Play Too? Reflections on the Issues for Children with Disabilities, Play from Birth to Twelve: Contexts, Perspectives, and Meanings, Third Edition, 55-62.

Nicolopoulou, Ageliki, et al (2009, December 23). Using the Transformative Power of Play to Educate Hearts and Minds: From Vygotsky to Vivian Paley and Beyond, Taylor & Francis. Retrieved from https://psychology.cas.lehigh.edu/sites/psychology.cas2.lehigh.edu/files/transformative_power_of_play.pdf on 02 October 2020.

Nicolson, Julie (2019). The Power of Play for Addressing Trauma in the Early Years, Early Childhood Funders. Retrieved from https://acei.org/wp-content/uploads/2020/05/TraumaPowerPlayBrief.pdf on 21 March 2021.

Night ZooKeeper (2020). Night ZooKeeper. Retrieved from https://www.nightzookeeper.com/ on 05 October 2020.

Oldham, Charlene (2019, June 7). The Magic House @ MADE now open on Delmar, St. Louis Magazine. Retrieved from https://www.stlmag.com/family/magic-house-made-maker-space-delmar-loop/ on 12 October 2020.

Office of Child Development, University of Pittsburgh (November 2012). Developments newsletter. Retrieved from http://www.ocd.pitt.edu/Files/PDF/dev11-2012.pdf on 27 October 2018.

Perry, Bruce D., M.D., PhD and Szalavitz, Maria (2017). The Boy who was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us about Loss, Love and Healing.

Pramana, Gede, et al (2018, May). Using Mobile Health Gamification to Facilitate Cognitive Behavioral Therapy Skills Practice in Child Anxiety Treatment: Open Clinical Trial, University of Pittsburgh. Retrieved from https://www.researchgate.net/profile/Gede_Pramana/publication/325073594_Using_Mobile_Health_Gamification_to_Facilitate_Cognitive_Behavioral_Therapy_Skills_Practice_in_Child_Anxiety_Treatment_Open_Clinical_Trial/links/5bd882294585150b2b91e748/Using-Mobile-Health-Gamification-to-Facilitate-Cognitive-Behavioral-Therapy-Skills-Practice-in-Child-Anxiety-Treatment-Open-Clinical-Trial.pdf on 12 September 2020.

Purvis, Karen, PhD (2013, July 1). The Healing Power of “Giving Voice,” Adoption Advocate. Retrieved from https://www.adoptioncouncil.org/publications/2013/07/adoption-advocate-no-61 on 24 August 2020

Purvis, Karen, PhD (2013, December 17). Trust-Based Relational Intervention (TBRI): A Systemic Approach to Complex Developmental Trauma, Taylor & Francis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877861/ on 04 October 2020.

Saldaña, J. (2015). The Coding Manual For Qualitative Researchers (3rd ed.), SAGE Publications.

Selva, Joaquín, Bc.S. (2020, January 9). 50 Play Therapy Techniques, Toys and Certification Opportunities, PositivePsychology.com. Retrieved from https://positivepsychology.com/play-therapy/ on 12 September 2020.

Scully, Simone (2020, May 21). Remote Learning Got You Down? Here Are The Best Educational Sites For Kids, Mashable. Retrieved from https://mashable.com/roundup/best-online-learning-platforms-for-kids/ on 05 October 2020.

Smith, Abbie, LCSW (2012, August 12). Emotional Regulation — “Felt-Safety:” A New Take on an Old Term, Post Adoption Services eNews Blog for Adoptive Parents. Retrieved from https://www.holtinternational.org/pas/newsletter/2012/08/12/emotional-regulation-felt-safety-a-new-take-on-an-old-term/ on 24 August 2020.

Suomi, S.; Harlow, H. (1971) Monkeys Without Play. In Play: Its Role in Development and Evolution, 493.

Tang, Eileen, et al (2018, July 10). Making Sense of Adopted Children’s Internal Reality Using Narrative Story Stem Techniques: A Mixed-Methods Synthesis, Frontiers in Psychology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6048414/ on 11 September 2020.

Teheri, Karen Marie Swanson (2015, May 15). How Play Therapists Integrate Knowledge of Attachment Theory Into Clinical Practice: A Grounded Theory, University of New Orleans. Retrieved from https://scholarworks.uno.edu/cgi/viewcontent.cgi?article=3072&context=td on 12 September 2020.

Toy Theater (2020). Toy Theater. Retrieved from https://toytheater.com/ on 05 October 2020.

Van Der Kolk, Bessel A, M.D. (2005). Development Trauma Disorder: A New, Rational Diagnosis for Children with Complex Trauma Histories, CME. Retrieved from https://traumaticstressinstitute.org/wp-content/files_mf/1276541701VanderKolkDvptTraumaDis.pdf on 03 October 2020.

Van Der Kolk, Bessel A, M.D. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.

Van Meter Community School (2020). Virtual Makerspace. Retrieved from https://docs.google.com/presentation/d/e/2PACX-1vSHipyygeVpJD0uFpRqFjMC5QMS3uI09TZVOiD9tWADKVygmFZkYIEUOuNjgritnKO4zylPMI9UcGd2/pub?start=false&loop=false&delayms=3000&slide=id.g8b9033a6e9_0_60 on 05 October 2020.

Vogel, Michelle (2017, December 12). What is Play-Based Learning? Wonderschool. Retrieved from https://www.wonderschool.com/p/parent-resources/what-is-play-based-learning/ 04 October 2020.

Webster, Andrew (2020, August 21). Minecraft Education Is Perfectly Suited For This Surreal Back-to-school Moment, The Verge. Retrieved from https://www.theverge.com/21377192/minecraft-education-edition-back-to-school-pandemic on 04 October 2020.

White, Andrea S. (2014). The Benefits Of Child-centered Play Therapy And Filial Therapy For Pre-school-aged Children With Reactive Attachment Disorder And Their Families, Smith College. Retrieved from https://scholarworks.smith.edu/cgi/viewcontent.cgi?article=1923&context=theses on 12 September 2020.

Weinberg, Elizabeth (2006, March). Mentalization, Affect Regulation, and Development of the Self, Journal of the American Psychoanalytic Association. Retrieved from https://www.researchgate.net/profile/Elizabeth_Weinberg/publication/254077851_Mentalization_Affect_Regulation_and_Development_of_the_Self/links/58fa53364585152edecec63d/Mentalization-Affect-Regulation-and-Development-of-the-Self.pdf on 11 September 2020.

Wolfberg, Pamela (2015). Play’s Role and Meaning in the Lives of Children with Autism, Play from Birth to Twelve: Contexts, Perspectives, and Meanings, Third Edition, 63-71.

Ziegler, Dave, PhD. (2008). Childlike Play is Affected by Traumatic Experience, Jasper Mountain. Retrieved from https://www.jaspermountain.org/Article_childlike_play_traumatic_experience.pdf on 02 October 2020.

Ziegler, Dave, PhD (2011). Traumatic Experience and the Brain: A Handbook for Understanding and Treating Those Traumatized as Children, Second Edition.

Full Thesis Document

OhioLINK Access

xdMFA Candidates must disseminate their research online in the Ohio Library and Information Network (OhioLINK) Electronic Theses and Dissertations repository. This thesis may be accessed at
http://rave.ohiolink.edu/etdc/view?acc_num=miami1619193153362829