Theraplay® Treatment Protocol

Marschack Interaction Method (MIM)

Group Theraplay®

Statement about the Use of Touch in Theraplay® *(.pdf)

How Theraplay® Differs from Non-Directive, or Child-Centered, Play Therapy

In 1967, Ann Jernberg, Ph.D., became the Director of Psychological Services for the new Chicago Head Start program. She brought in Phyllis Booth as one of her assistants. She and her team were to identify children in need of psychological services and refer them to existing treatment centers. However, there were very few resources for childrens' mental health at the time, and the existing ones could not possibly handle the hundreds of children identified as needing help.

Jernberg set out out to create her own program that would treat children at the Head Start centers, rather than at outlying clinics, and could use paraprofessionals supervised by mental health professionals to do the actual work.  The result was a model based upon healthy parent-infant interaction which borrowed elements from the work of Austin Des Lauriers and Viola Brody.  From Des Laurier she took the idea of actively engaging the child in an intimate environment that focused on the here and now.  From Brody, she adopted the nurturing relationship between child and therapist, including touch, rocking and singing.  Ernestine Thomas, a talented early therapist, contributed the focus on being strongly affirmative and hopeful about the child's health, potential and strength.

The Jernberg team took the model and recruited people with a lively, playful ability to engage children.  They trained and supervised them to go into the schools to work individually and intensively with the children who needed help.  When they ran into resistance to this unorthodox method, they produced films to demonstrate its effectiveness (Here I Am is still available from The Theraplay Institute).

The Theraplay Institute was formed in 1971, and people familiar with the Head Start work began referring children for treatment.  In 1976, Theraplay was registered as a service mark to protect the integrity of Theraplay treatment and training around the world.  In 1979, Jernberg published Theraplay: A New Treatment Using Structured Play for Problem Children and Their Families.

In the 1980's the focus became increasingly on training others to use Theraplay.  The Theraplay Institute reached out beyond the Chicago area to train mental health professionals in other areas of the United States and Canada.  Today, there are chartered Theraplay Assocations in Germany and Finland, and people from over 10 other countries have been trained in Theraplay.  Theraplay therapists are working with Aids orphans in Botswana, Russian orphans, Bosnian war trauma sufferers, victims of the 2004 tsunami and 2005 Hurrican Katrina.

Phyllis Booth published the second edition of the Theraplay book in 1999, and in 2010 the third edition of Theraplay: Helping Parents and Children Build Better Relationships Through Attachment-Based Play.  Theraplay has evolved since its Head Start roots to focus on the child-caregiver relationship, which has led to an increased emphasis on secure attachment and affect attunement (D.N. Stern, A.N. Schore, M. Ainsworth).

To learn more about the history of Theraplay's Head Start origins click here.

From the beginning the Theraplay® approach shared many assumptions with interactional theories of development, particularly those of Self Psychology and Object Relations theory.  Over the thirty years of its clinical practice, an increasing body of research in the fields of early brain development and attachment theory has given further support to many of Theraplay's tenets.

The Theraplay approach assumes that the primary motivating force in human behavior is a drive toward relatedness.  Personality development is essentially interpersonal.  The early interaction between parent and child is the crucible in which the self and personality develop.

The playful, joyful, empathic, attuned responsiveness of caregivers is essential to the development of a strong sense of self, feelings of self worth, and secure attachment. The capacity to soothe and nurture oneself in later life depends on early experiences of being soothed and nurtured.

When things go well in the relationship, the infant develops an inner representation of himself as lovable, special, and competent, and able to make an impact on the world; of others as being loving, caring, responsive and trustworthy; and of the world as a safe, exciting place to explore.  In other words, he begins a process of learning about himself and the world which is positive and hopeful and which will have a powerful influence throughout his life.

Psychopathology results when early and ongoing experiences lead to a negative or inadequate sense of self.  In the absence of positive and responsive interactions, the child learns to view herself as unlovable and incompetent, to view others as uncaring and untrustworthy, and the world as unsafe and full of threat.  In other words, within an insecure attachment, the process of learning about one's self and the world becomes negative and hopeless.  Many behavior problems of older children can be traced back to their beginnings in insecure attachment and in the concomitant negative views of themselves and the world.

The Theraplay approach assumes both that change is possible and that the essential ingredients of change lie in the creation of a more positive relationship between a child and her parents.  Because the roots of development of the self, of self esteem and trust lie in the early years, it is essential to return to the stage at which the child's emotional development was derailed and provide the experience which can restart the healthy cycle of interaction.  Activities are geared to the child's current emotional level rather than to chronological age.  Parents are encouraged to respond empathically to their child's needs.  The goal of treatment is to change the inner representation of the self and others from a negative to a more positive one.


Please select link to read article:
"What Makes Theraplay Effective: Insights from Developmental Sciences"

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