Contributions and Challenges of Psychodynamic Play Therapy- With Foster Children and Their Many Parents

Abstract

Dr. Shimrit Prins-Engelsman, Dr. Noga Levine Keini and Dr. Karin Keydar Cohen

This article describes the important contributions provided by the psychodynamic approach to the psychotherapy and treatment of children in foster care. It was written in consideration of the dearth of literature about foster care of children in Israel. Foster care comprises transient substitute parenting, whose aim is to provide a family experience with benevolent parental figures to foster children whose parents were unable to raise them, and to provide for these children have experienced extensive cumulative trauma during their childhood. Removing a child from their home inevitably adds an additional traumatic experience, and their adjustment to foster care is dependent on their past and particularly, their past history of attachments. Internal models of attachment figures who were experienced as neglectful or abusive, impede the attachment of children to new benevolent attachment figures. The characteristics of the therapeutic encounter with foster children are illustrated by means of a clinical case. Difficulty in establishing a trusting relationship, absence of playfulness, deep deprivation of primary needs, traumatic reenactments and an interal world sated with destruction and loss, manifested in the play and in the therapeutic relationship. Reflective observation of the transference processes and those of the countertransferences and projective identifications opened an avenue to explore and rehabilitate the internalized representations of the childr treated and contributed to the expansion of the emotional capacities of the therapist to contain the difficult experiences. The therapeutic sessions with children in foster care challenge therapists with their intense emergent emotions. Consequently, it is important to provide parallel accompanying supervision to therapists as this enhances the containment of their internal worlds and supports their capacities to consider therapeutic interventions and to contain the relationships that develop. In the parallel process the therapists who facilitate the expression of the needs and feelings of the child in the process, provide essential support to the child in connecting to themselves to their latent hopefulness and their inner resources. By means of the benevolent therapeutic presence and encounter that is experienced, a corrective internalization may be acquired by the child, in contrast to the experiences of arbitrariness, instability and loss that were experienced in their pasts.

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