Play and recovery in mental deficiency

Starting from the hypothesis that in mental deficiency an individual has lost mental function, recovery involves the intervention to train the unaltered functions to take over the activity of the damaged or lost ones. In its full meaning, recovery implies the restoration or reconstitution of lost human functions, but in the case of mental deficiency this is not possible.

The objective of recovery, which can be of a psychological (psychotherapy and occupational therapy), pedagogical or medical nature, is that through the formation of certain skills and behaviors, the deficient can integrate as well as possible into social and professional life.

 Some of the psychotherapy options include:

• suggestive psychotherapy

• relaxation psychotherapy

• play and recovery therapy or playful therapy through which individuals acquire personal autonomy both in everyday life (manual dexterity and motor skills for basic needs, sense of self-control, oral and written communication, relationships, social integration) and in the training of specific work skills (jobs)

• occupational therapy uses various forms: play therapy, art therapy, dance therapy, ergotherapy. They all emphasize compensation and stimulation of normal, unaltered sensory and mental functions.           

The objective of play therapy is to reduce emotional and behavioural difficulties faced by a child with mental disabilities and which otherwise interfere with his normal functioning, as well as to improve communication and understanding between the child and parents. Secondary goals can include improving verbal expression, impulse control, better communication, coping with frustration and anxiety.

This form of therapy facilitates the expression of experiences and feelings, as well as finding solutions to problems through play. The specialist structures and protects the environment, whilst observing the behavior, affectivity and language of the child. The therapist tries to understand the thoughts, feelings, fantasies and where he discovers conflicts, he/she then helps the child to understand and overcome them.

Play and recovery therapy uses the child’s innate ability to play, filling in and recovering developmental “gaps” through play techniques. Its a non-invasive and pleasant way to develop language, communication, as well as personal care behaviours. Equally it works for assimilation of social knowledge, or the management of emotional distress.       

Play and recovery therapy techniques:

Sessions usually last between 30 minutes and an hour and can take place approximately once a week. The number of sessions depends on the child and how well they respond to this type of therapy. Therapy can take place individually or in a group.

Play therapy can be directive or non-directive. In the directive approach, the therapist will specify what toys or games to use in the session. The therapist will guide the piece with a specific goal in mind.

The non-directive approach is less structured. The child is able to choose the toys and games as he sees fit. They are free to play in their own way with little instruction or interruption. The therapist will observe closely and participate as appropriate.

Sessions should take place in an environment where the child feels safe and where there are few limitations. The therapist may use techniques that involve:

• storytelling
• creative visualization
• role play
• toy phones
• dolls, stuffed animals and masks
• dolls, action figures
• Arts and Crafts
• water and sand play
• building blocks and toys
• dance and creative movement
• musical game

In a study published by the American Psychological Association, play therapy was effective in the case of imbecile children. It measured increases in IQ after playful interventions for a period of 9-13 months.

Studies show that Group Play Therapy can be effective for children with post-nursery mental retardation, where other therapeutic techniques have failed. 8 boys between the ages of 4 years 6 months and 9 years 6 months, all with behavioural problems, received the Vineland Scale and the WISC before and after the experimental program of approximately 90 hours of group play therapy in just over a month. The authors report that “there is good evidence that the experience activated some of the intellectual potential that could not be tapped before the experiment.”

Criticism of this intervention made another study, “The effectiveness of play therapy: Responding to the critics”, to show not only the effectiveness of the method, but also the fact that positive and greater effects are obtained when parents are engaged in treatment and an optimal number of sessions is offered. Positive results came in behavioural adaptation, social skills, emotional adaptation, intelligence and anxiety/fear.

Bibliography:

Canadian association for Play therapy https://cacpt.com/

Therapy with physically and mentally handicapped children in a mental deficiency hospital https://psycnet.apa.org/record/1958-05605-001  

The effectiveness of play therapy: Responding to the critics. https://psycnet.apa.org/record/2001-05142-004

Group play therapy with a group of post-nursery male retardates.

https://psycnet.apa.org/record/1960-01515-001