Suitcase Termination Activity

Suitcase Termination Activity: At termination, your client is finally ready to continue their journey on their own.  Even though they will be leaving you behind, they can pack up everything that they have learned during their time with you to take with them.  This metaphor is easy for most people to identify with and it is a fun activity. 

Supplies: Plastic or cardboard suitcase (see tutorial here); Blank sticker labels; Paper luggage tag (real ones are cheap, but you could also just use the template); String; Cards; Travel stickers (optional)

Goals: Process termination; Provide transitional object; Help prevent regression; Identify accomplishments, goals, coping tools, etc.

Directions:

1. Have your client make and/or decorate their suitcase. 
2. Then they write something they will “take with them” from their time in therapy on each card provided (I print cards with travel clip-art on the back).  This can be things they have learned, coping skills, supports, resources etc. 
3. You can also integrate this with the after-care kit I posted.
4. On the labels they write or draw goals they have accomplished.  (Like the old suitcases in movies that are covered with stickers of past travels).  I also provide additional travel stickers.
5. On the luggage tag they write where they are going next.  This could be a new life stage (ex. my 8th graders usually write “high school”) or a goal they would like to accomplish that the contents of the box will help them achieve on their own.
6. Process feelings about termination throughout the activity.

Careers in Social Work

I got an ask about what you can do with an MSW besides being a therapist.  It is a very broad degree and this is a list of common areas social workers work in.  

Treasure Chest Termination Activity

Supplies: Treasure box (Michaels has wooden “treasure” boxes that are cheap and easy to decorate.  Directions on how to make a paper one can be found here; Stick-on plastic jewels (found at crafts stores, oriental trading co., etc.); Small note cards (cut to fit the box); Pen.

Directions: First, have your client decorate a treasure chest.  Then stick a jewel to each card as your client writes down the “task” that is assigned to that specific color (see below).  On the back of the card they include a specific example of how what they identified has helped them in the past and/or how it will help them in the future.  Below are examples of possible color codes, but you should change them to meet your client’s specific age and needs.  In the end the chest will be full with a stack of jeweled cards.

• Blue: Strengths (Identified by both the client and therapist)
• Red: Coping skills
• Green: Supportive people in their life
• Orange: Resources from therapist (ex. hotline numbers, therapist referrals or directions for reenrolling in services.)
• Purple: Self-care activities
• Pink: Inspiration (future goals, motivational quotes, etc.)
• Yellow: Things they have learned in therapy

You’ve Got Mail: Group Termination Activity

Directions: First, have your clients create their own paper mailbox (click here for a tutorial).  Then, each person, including the therapist, writes a short note to every other member of the group.  You can instruct them to write something that they have gained by knowing that person, a strength they can identify, a motivating message, etc.  The notes are then placed in the mailboxes for the group members to take home.

Travel Play Therapy Ideas

Travel Play Therapy Ideas: Lots of clinicians work at multiple sites and must take their office with them.  Here are some portable ideas.

1. Travel Play Therapy Kit: This rolling case is perfect for a travel kit.  This link also has a list of important toys to include.
2. Portable Art Studio: This is easy to grab and can fit a lot of supplies.
3. Play Therapy Cart: I worked  as a school therapist and would sometimes get kicked out of my office during standard testing, etc.  One of these carts made the move much easier.
4. DVD Art Box: Easily pack up your colored pencils/markers with paper.
5. Portable Dollhouse: This is easy to make and when you are ready to put it away it turns into a box for you to store your dolls.  Here is a similar dollhouse that collapses flat.
6. Game Supplies: A good way to organize game supplies without losing small pieces.
7. Lego Box: Just glue a lego board onto your storage box.
8. Snapwear Sand Tray: You can put sand in the top and then keep your miniatures in the bottom portion.
9. Rainbow Rice Tray: Sand is ideal, but if you are going somewhere that you can’t risk sand spillage then fill a tub with colored rice for east clean up.

DIY Sensory Substances

DIY Sensory Substances (My social skills groups for young Autistic children love these activities)

1. Slime (Glue/liquid starch)
2. Glow in the Dark Slime (Borax/glue/glow paint)
3. Cloud Dough (Flour/oil)
4. Silly Putty (Clear glue/liquid starch)
5. Moon Sand (Sand/corn starch)
6. Goop (Cornstarch/water)
7. Flubber (White glue/borax)
8. GAK (Clear glue/borax)
9. Floam (Borax/Glue/styrofoam)

Click here for more DIY sensory substances

Separation Anxiety Pocket Hearts

Separation Anxiety Pocket Hearts: Young children often have trouble separating from their caregivers.  It sometimes helps for them to carry transitional objects (ex. a photo) with them to help manage their anxiety during time apart.

1. The caregiver can make these hearts for their child on their own, or the dyad can create them together (Click here for a tutorial).  The hearts can be substituted by any other handmade or personal items the family desires. 
2. Just before each separation the caregiver gives the child a heart representing their love and assures the child that they will be reunited.  The hearts are not a substitute for taking time with the child to process their anxiety (do not “sneak out” of the house).  They can tell the child that if they begin to miss them then they can take out their heart and know that their caregiver loves them, is thinking of them, will come back, etc.  Sometimes it might help for the parent to carry around a heart as well representing that their child is always in their thoughts and they are connected (kids like this).
3. If possible, take baby steps.  Initially, a child might use a heart for a brief separation when the parent is in another room, and then move on to short outings that get progressively longer as the jar gets fuller.
4. Each time they are reunited they place their heart in a jar.  Children may have trouble recalling all the times their caregivers returned and this provides a nice visual.  Looking at their jar will help to assure them that their caregivers always come back.
5. Ideally, separations will become easier and they will look to the heart for support less and less until they no longer need it.  At this point just thinking about their jar back at home should become enough to assuage any remaining anxiety.
6. These hearts are a supplemental intervention.  It is more effective when caregivers commit to building trust, following through with what they say will do, and continue to talk to their children about separation and encourage self-expression.
7. I have also known children who used a calm bottle to help self-regulate after their caregivers leave (click here)
8. More suggestions for dealing with separation anxiety and promoting independence can be found here.

Free PTSD Books

Message or E-mail me (uclasocialworker@gmail.com) if you want me to send you PDF versions of any of these books.

Trauma Mask-Making

This activity that creates a visual representation of a person's trauma and its impact can be highly therapeutic aid in self-expression and processing. Click here for a DIY suggestion. Above are masks created by Veterans suffering from PTSD.  You can read the full article here. Below are descriptions of the masks above (numbered left to right, top to bottom)

1. This mask from an army medic features the quote "I have destroyed my life and myself so that others may live'
2. This Marine depicts a 'split sense of self' in his mask
3. 'The Shock of Death' shows the traumatic memory of seeing an Iraqi killed after a gunshot wound to the head
4. 'Emotional Hostage' is the name of this mask
5. This mask shows the soldier's need to camouflage to try and acclimate back into society
6. This mask dually examines the significance of death and the surviving spirit that exist once a person is killed.
7. Fingerprints on the nose and chin represent resuscitation efforts by this commanding Marine for troops he lost.
8. The three stitches represent the healing process the soldier feels at Walter Reed
9. The soldier who created this mask wanted to show his trouble with opening up to his emotions

DIY Dollhouse Furniture

Click the links below to view directions on how to create each of the furniture pictured (numbered from left to right, top to bottom).

1. Matchbox Drawers
2. Yarn Rug
3. Wire Chair
4. IPhone Box Fridge
5. Cardboard Bed
6. Block Kitchen
7. Plastic Toilet
8. Bottle Cap Stools
9. Cardboard Sink

Yet another FREE book.  

I have a PDF of School-Based Play Therapy by Drewes and Schaefer.  It has a lot of information and is 526 pages long.

Just E-mail me if you want me to send a copy over to you (uclasocialworker@gmail.com)

Therapeutic Games

Therapeutic games are great but usually pretty expensive.  Children and teens disclose and express a lot more during games than if I were to just ask them questions.  One way I keep the cost down is by buying low cost regular games and give them a therapeutic twist (see jenga and feelings tic-tac-toe posts).  

Bare Books has really cheap blank game boards, books, puzzles, etc.  A professional looking blank board game is just $3.95.  They have flat rate shipping so I suggest getting together with a couple people to place your orders.  Click here to check it out.

Free Play in Child Development and Psychotherapy PDF

Here is another FREE book.  This one is Play in Child Development and Psychotherapy by Sandra Russ.  Send me an E-mail if you would like me to send you a PDF version (uclasocialworker@gmail.com)

Sand Tray Themes

I created this chart in Pages.  You just check off what themes you see in each sand tray your client does.  This chart helps you to create a great visual of your client’s progress in therapy.  Initially, check-marks are usually all clustered on the left, but as time goes one more and more drift over to the right.  It is great to see.

Themes That Suggest Wounding

• Chaotic: Haphazard, fragmented, or formless arrangement; e.g., objects’ flung into the tray; boundaries of outer reality disregarded; items carefully placed but overall appearance is jumbled or disconnected.
• Empty: Reticence to use figures or lifeless feeling with lack of energy and curiosity; e.g., a nearly empty tray with only a dead tree placed in a corner.
• Split: Parts of tray appear separated or detached; e.g., river, fence, or elephants placed from bottom to top of tray seem to divide tray
• Confined: Figure or groups normally free are entrapped or caged; e.g. an agonized figure is placed in a cage; a sand wall is built around an old woman.
• Neglected: Figure is isolated from possible support; e.g., a baby in a high chair while mother is sleeping in the nextroom.
• Hidden: Figures buried or hidden from view; e.g., a gun hidden behind a house; a witch buried in the sand under a tree.
• Prone: Figures normally upright are intentionally placed in a reclining, fallen position; e.g., a standing pregnant woman placed face down in the sand.
• Injured: Figures with injuries or in the process of being injured; e.g., a bandaged man lying on a stretcher; a cowboy placed in the mouth of a dinosaur.
• Threatened: Menacing or frightening events and the inability of the endangered figure(s) to escape the experience; e.g., aggressive animals surrounding small child.
• Hindered: Possibility of new growth and development is impeded or hindered; e.g. a boat moving into new waters, while under siege by an army.

Themes That Suggest Movement Towards Healing, Wholeness, and Transformation.

• Bridging: Connection between elements, joining of opposites; e.g., a ladder joins earth and tall trees; a bridge links an angel and devil.
• Journeying: Movement along a path or around a center; e.g., a knight follows a trail, someone paddles a canoe down a stream.
• Energy: Alive, vital, intense energy is visible; e.g., organic growth present, construction machines work on a task, airplanes take off from a runway.
• Going Deeper: Discovery of a deeper dimension; e.g, a clearing is made, a treasure unearthed, a well dug, a lake explored.
• Birthing: Emergence of new development; e.g., a baby is born, a flower opens, a bird lays eggs.         
• Nurturing: Nourishment or help are provided to support growth and development; e.g, a mother feeding babies, supportive family groups, nurse helps a patient, presence of food.
• Changed: Sand and/or objects are creatively changed or used; e.g., sand is contoured to build a land bridge; sand is moved/stacked as an essential part of a lunar compound; a house is built from twigs picked up on walk to school.
• Spiritual: Religious & spiritual symbols present, such as supernatural beings, worshiping figures or numinous items; e.g., Buddha overlooking a couple.
• Centered: In center of tray, elements are aesthetically balanced or a union of opposites occurs; e.g., a man and woman married; mandala centered in the tray.
• Integrated: Congruent organized idea encompasses entire tray; unity of expression; e.g., day at the zoo, baseball game, abstract construction unifying whole tray.j

Suggested Sand Tray Activities

• "Create your own world" or “Tell me a story in this tray"
• Client constructs representation of real-life experience, interaction or problem situation.
• Can provide reassuring distancing for client by keeping in third person.  For example, suggest a scene about "a girl who feels betrayed by her best friend"instead of the client.
• Client builds tray portraying particular issue requiring solution.  Client then selects miniature to act as a Helper or Wise One to answer questions or aid in needed actions.
• Client builds tray illustrating particular feeling and circumstances (or miniatures) that evoke that feeling.
• Client constructs a scene representing own family.
• Therapist selects clinically significant group of miniatures (to focus upon particular situation) and then asks client to create a world for the miniatures.
• Client may play out situation in tray
• Client and therapist do a Joint Tray (similar to Oaklander’s joint picture technique).
• Therapist and client create story in tray together where client selects miniature and supplies first sentence. Therapist follows suit for next sentence and miniature, etc.
• Therapist suggests that client build an Amplification Tray for certain part of constructed world that is confusing or difficult to experience.
• Miniatures involved are moved to second empty tray where they dialogue or play out situation.
• Client adopts physical stance of particular figure in constructed tray, (Therapist may mirror client’s stance.) Client focuses on feelings/thoughts the stance evokes.
• For small group: Members construct individual trays, then select figures symbolizing their own journey to form a group tray.

Sand Tray 101

1.  Direct a child to create a scene (can be general or specific)

• Allow client to work unhindered in tray until they tell you they are finished.
• Pay attention to what the child picks, discards, does with the sand, etc.
• Take not of themes and the energy in the tray that may occur to you as you think about this client’s, particular presenting problem, early years, family situation, etc

2.  Look for themes and comment on what you see (relating to the selection and placement of figures).

• I notice that…. (ex. this one is all alone in the corner)

3.  Make gentle interpretations, but do not share them.

4.  Invite the child to describe their scene (examples below)

• Tell me about your world

• Does your tray have a name?

• Does it have a story to go with it? Will you tell me the story?


5.  Ask relevant questions (examples below)

• What was difficult about doing this?  What was easy?

• What do you dislike about the scene? What do you like?

• Is there anything you would like to change?  (Have them change it) How did that feel?

• I’m wondering about _____________
• If you had to choose one of these figures to be you, which one would it be?
 (Don’t go farther than this and ask them to tell you what each figure represents, the probably wouldn’t even be able to tell you)
• Does this world remind you of anything in your own life?

7.  Invite parts of the scene to talk to each other

• Does anyone (referring to the figures) have anything to say?

Free Mental Health Powerpoint Presentations

Many School-Based Mental Health practitioners do presentations or in-service trainings for teachers and parents surrounding mental health issues.  This website provides free powerpoint presentations that may be helpful.  Many topics apply to practitioners working in non-school settings as well.

Subjects include adolescent development, anxiety disorders, disruptive behaviors, the IEP process, depression, anger management, and more.

Click here

Click here to access collection of 17 free, online series and over 150 on-demand presentations related to child and adolescent trauma. 

The topics covered include: Assesment and treatment of complex trauma, culture and trauma, theory and research findings of about trauma, creating trauma-informed child-serving systems, the impact of terrorism and disaster on children, child traumatic grief, and child sexual abuse. 

Each 1.5 hour presentation is worth 1.5 CEUs.

FREE Cognitive Behavioral Therapy Books

FREE Cognitive Behavioral Therapy books.

Just send me an e-mail at uclasocialworker@gmail.com if you want Pdf versions of any of these.

Therapeutic Toys

Here is a list of therapeutic toys that are used in play therapy.

1. Nurturing/Family Toys

• Purpose: Build and explore relationships
• Dolls, baby bottles, blankets, diapers, doll house (furniture and doll family), puppet family (people and/or animals), miniatures, kitchen set (food, dishes, etc.), doctor’s kit.

2.  Fantasy/Pretend Toys

• Purpose: Express feelings, and play out roles/scenarios
• Dress-up clothes/hats, costume jewelry, puppets, miniatures, mirror, masks, play money, magic wand, vehicles (cars, trucks, rescue vehicles, planes), doctor’s kit, communication toys (phone, microphone, mailbox, etc.)

3.  Expressive and Construction Toys

• Purpose: Express feelings, mastery, problem solving and creativity
• Arts supplies (markers, crayons, paint, paper, etc.), craft supplies (stickers, pipe cleaners, beads, popsicle sticks, tape), water, play dough, clay, building blocks, legos, cardboard bricks.

4.  Acting Out/Aggressive Release Toys

• Purpose: Expression, processing and mastery of fear and anger; Control
• Monsters and villains, heroes, plastic soldiers, dinosaurs, spiders, snakes, aggressive looking puppets and miniatures (ex. dragons, animals with teeth showing, etc.), rope, handcuffs, bop bag, toy guns/knives, dart gun.

5. Movement and Motion Toys

• Purpose: Mastery, emotional outlet, and self-regulation.
• Balls, basketball/hoop, bubbles, ring toss, bean bags, target games, jump rope, hula hoop, music.

Van Fleet et. al (2012). Child Centered Play Therapy.