Progress through the Early Stages of Assimilation in Play Therapy with a Traumatized Six-Year-Old Girl

Abstract

We applied the assimilation of problematic experiences sequence (APES) to a six-year-old girl’s processing of traumatic experiences involving violence and death in play therapy. We analyzed the post-session notes from the first 34 sessions of a much longer treatment, during which the girl repeatedly enacted a drama we called the cottage play, involving characters assumed by the child and characters assigned to the therapist. We distinguished four phases based on changes in play themes. In phase 1, the girl expressed her need for safety in response to an overwhelming internal threat (APES stage 0, warded off/dissociated). In phase 2, she worked to escape and avoid the threat, referenced in the play as monsters and bad memories (APES 1, unwanted thoughts/avoidance). Phase 3 was a brief period of consolidation. In phase 4, she actively faced the trauma, referenced as murderers, soldiers, and death (APES 2, awareness/emergence). Our observations underlined the child–therapist collaboration and dyadic processing. The expressions of the problematic experiences suggested increasing but limited assimilation (stages 0 to 2 out of eight stages). The assimilation model usefully described symbolic processing in play therapy, and the results pointed to tentative elaborations in APES stage descriptions.