Originally published in the The Theraplay® Institute Newsletter of Fall, 1999

Group Theraplay with Children Impacted by HIV

Candace L. Chambers, Ph.D.

Chicago, Illinois

The Chicago Women's AIDS Project offers support groups for children who are infected and affected by the HIV virus. The three to eleven year old children in these groups have received a great deal of education about not infecting anyone else, and about not becoming ill themselves, prompting one of the children to say, "I feel like a green man." During the past year Group Theraplay activities have been used with these support groups. Initially, the leaders chose very general and non threatening group tasks because they were not always fully aware of the childrens' backgrounds regarding abuse or neglect or the child's role in the family. As we all became more familiar with one another, the group Theraplay tasks became more specific and helpful to the children. The infected and affected groups were worked with separately first, allowing time and attention to their specific issues; the groups were gradually merged into one large group.

Several group activities were used successfully to break the ice for those children who were new to the group, such as, changing places in the circle with the person whose eyes met yours or passing a funny sound or hand squeeze around the circle. Other tasks were used to help the infected children feel more comfortable with their body image, their HIV status and with the other children. A number of the children had breathing problems; their triumph in using a straw to blow a cotton ball across the table to a teammate was visible. They also enjoyed hiding their shoes under a blanket and finding the owner of the shoe they pulled out, or figuring out how to get out of a tangle created by their group mates' crisscrossed arms. Running under a parachute made by a blanket held by their group mates and jumping or hopping while in the center allowed the children to discharge aggressive feelings. Feeding activities were found to be very important as quieting, soothing and care giving especially were needed. The children's responses to the group also were helpful in determining those who needed individual therapy.

The environment in which the support groups were offered for these children was not ideal by any means. Attendance was sporadic due to the mother's or child's fluctuating health status. Some mothers expressed concerns about an infected child "playing games" (Theraplay activities) with their uninfected child; this was in spite of the fact that the mother was infected with the virus and was aware of the modes of transmission. Some mothers whose children were referred for follow-up individual therapy resented the referral. Despite these issues, we felt that the Theraplay experience was very positive and we plan to continue the groups.

Additionally, I have used specific Group Theraplay games for an AIDS caregivers group and a bereavement group that I ran during this past year. To my surprise, the participants who enjoyed and benefited the most from Theraplay were those in the bereavement group. One individual expressed to me that it felt good to laugh again. Theraplay appeared to lift their spirits for a time.