Emerging Minds webinar: Parent–child play:  A mental health promotion strategy for all children

Emerging Minds webinar: Parent–child play: A mental health promotion strategy for all children

Good afternoon everyone and welcome to today’s
webinar, Parent-child Play: A mental health promotion strategy for all children, produced
by Child Family Community Australia and Emerging Minds. Hi there, my name is Chris Dolman, I am a
senior workforce development officer here at Emerging Minds, the National Workforce
Centre for Child Mental Health and I’m really delighted to be a part of this presentation
today. In this presentation we will be discussing
an approach to playtime known as child-led play and how parents can participate in this
type of play in a way that encourages the parent to follow the child’s choices and leads
and prompts during play time without teaching the child and without correcting the child. And how this can be used as a mental health
promotion strategy in a variety of settings. I’m just going to briefly look at the learning
objectives now so you sort of know what’s ahead in the next hour and yes so during this
webinar we’ll be speaking about themes and topics that will assist practitioners to interact
with families in universal health and education and community services including early childhood,
education and care settings. We’ll be describing how practitioners can
play an important role in promoting child-led play as a mental health promotion strategy
for all children, be outlining how practitioners can support parents to use play with their
child to gain insights into their relationship with their child and their child’s strengths
and what’s important to children and their vulnerabilities. We’ll be talking a bit about how play can
be a mechanism for practitioners to begin conversations about the hopes that parents
have for their relationships with their children, and you know, increase parents’ agency in
making positive changes in their family life. And also you know we’ll be providing some
strategies that develop the resilience of children and can have positive effects, positive
impacts on their long term social and emotional wellbeing. But as we proceed I’d like to – well both
Emerging Minds and CFCA wish to recognise and pay respect to Aboriginal and Torres Strait
Islander peoples and their ancestors and the Elders past, present and future from the different
First Nations right across this country. We acknowledge the importance of connection
to land and culture, spirituality, ancestry, family and community for the wellbeing of
all Aboriginal and Torres Strait Islander children and their families as well. This webinar today is the third in a series
of six focused on infant and child mental health. It’s being facilitated in partnership between
CFCA and Emerging Minds over 2019 and 2020. The next couple are focused around child focused
supervision, working with Aboriginal children and families in mainstream services, and also
cultural considerations when working with children and families. The first of those is coming up in February
and we’ll be letting you know of the dates of the others as we proceed. Before I proceed as well just so there’s a
few kind of housekeeping things to mention. I guess you know one of the core functions
of the CFCA information exchange is to share knowledge of course, so I’d really like to
invite everyone to submit questions via the chat box on your screen at any time during
the webinar and we hope to respond to your questions at the end of this presentation. Of course if we don’t get to any of those
questions they may be published along with your first name on the CFCA website and there
will be a response provided by our presenters today to those as well. So please let us know if you don’t want your
question or your first name published on our website. And we’d also like to really invite you to
continue the conversation we begin here today so to make this happen we’ve set up a forum
on the CFCA website where you can discuss some of the ideas and issues raised or submit
other questions for our presenters, and also access some links to related resources as
well. We’ll send you a link to this forum at the
end of today’s presentation. And of course you know as you leave this webinar
there will be a short survey that will open in a new window, we’d love if you could provide
some feedback, that helps us get better at what we do. So please remember that this webinar is being
recorded and the audio and transcript and slides, they’ll all be made available on the
CFCA website and the CFCA YouTube channel soon. So that’s quite an introduction but it’s my
pleasure to do some other introductions and that’s to introduce our presenters today,
Sarah Seekamp and Ben Rogers. Sarah and Ben are both occupational therapists
and with a keen interest in this theme and I thought I’d invite them to speak a bit to
that interest and yes Sarah, so I was wondering for you, and I’ll ask you this question as
well Ben, but perhaps starting with you Sarah. What is that’s captured your interest in terms
of this particular area of practice? Sure, thanks Chris. I guess for me you know with the knowledge
that we’re seeing more and more childhood anxiety and depression presenting, I think
that we really need to increasingly look at our investments in mental health promotion
for children. And I think that child-led play and parental
participation in this play, what I really love about that is it does present us with
a mental health promotion tool but it’s a tool that is really accessible for families,
and also it’s very child centred. You know the strategies are completely around
working within the child’s realm of strength. Right. So both accessible and child centred really
struck a chord with you. Yes. Yeah terrific. Is there something in what Sarah said Ben
that kind of draws you as well or other things? Yeah. As an OT working closely with kids it became
really clear early in my career that play was a primary occupation for kids, it’s how
they make sense of the world around them. And as a practitioner when I could step back
and observe this with fresh eyes, you begin to see the child for who they are and their
strengths, their values, their interests, you know even their vulnerabilities in that. So as Sarah mentioned, adding the parent into
this and you know supporting the parent to be with those play experiences really does
strengthen the parent-child relationship and the child’s overall social and emotional wellbeing. Right. Yeah well I look forward to hearing what you’ve
both got to say shortly. So yeah if everyone listening in participating
in this webinar, if you could join me in really welcoming Sarah and Ben. So yeah I’ll hand it over to you now Sarah. Thanks Chris. All right, so it’s unlikely to be new information
to many of you that children who have a consistently responsive and nurturing relationship with
their parent, typically go on to experience better mental health and are more resilient. And also experience better outcomes in school
and later life. So for these children it’s those nurturing
and caring child-parent interactions that provide those necessary environments to optimise
development and wellbeing for the children and then go on to equip those children to
manage the negative effects of stress and adversity in life more effectively. So really for us we see that supporting parents
to have a responsive relationship with their children is ultimately a powerful investment
in child mental health. And perhaps before Ben and I get any further
into the presentation we also just want to clarify that when we talk about parent throughout
this presentation that we’re really talking about any primary care giver. Okay so just I guess to really spell that
out schematically. We just will be looking at how when we have
a child engaging in child-led play and we bring a responsive parent into that play,
the outcome can be a strengthened relationship and it’s this relationship once it strengthens
that enhances that mental health protective factor for the child and that’s really what
we’re going to unpack for you today. Yeah thanks Sarah. So this leads us to your role as a practitioner
in relation to child-led play and as Chris mentioned, this webinar is aimed at practitioners
who interact with families in universal services. So that’s health, education and community
services. So it’s quite a broad range of practitioners
out there so hello to everyone. . And we acknowledge that there’s a high level
of diversity and experience and understanding in this approach. Today we’ll emphasise the importance of child-led
play as a universal mental health promotion strategy. So it’s an evidence informed approach that
can be promoted by any practitioner. So the webinar today will be focusing on defining
child-led play and its benefits. We’ll look at how parents can participate
in child-led play, we’ll explore behaviour change theory and how this can support the
way we work with families. And then the I guess the big part of this
the first part is building awareness and knowledge for you as the practitioner. But we really want you to come away with some
practical ways in which you can support parents in implementing child-led play. So in translating some of this knowledge into
practice, we’ve developed two resources that you can use following the webinar. One of them is a practice resource for you
to understand some background around child-led play and the other is a conversation guide
which helps you starting those conversations with parents. So we’ll go into that in more detail at the
end of today’s webinar and we’ve embedded some of the learnings from these resources
into what we’re talking about today. Thanks Ben. So many of you will be familiar with the evidence
based practice lens which represents our commitment and ambition to bring together the best research
evidence in the field that we’re working and what we’ve learnt from our clinical experience. And also then obviously filtering that with
the clients values whom we’re working with at the time. And today Ben and I will share with you some
research regarding the benefits of child-led play and responsive child-parent relationships
and we’re going to draw on our clinical experience and share stores that reflect the value of
some of the clients who we’ve worked with. But what we also really hope to do is provide
opportunities for you to draw on your own expertise and reflect on some of the clients
from your own experience and then contemplate how you might be able to apply some of the
learning that we might present to you today. So we’ll begin by ensuring we all have a shared
and consistent understanding of what child-led play is as there’s a broad range of terms
that can be used to describe this concept. So what we’re really talking about is play
where the child is free to direct their own play where they are the decision maker moving
at their own pace and discovering their own areas of interests and ultimately engaging
in those things that reflect their passions. So further, I guess this play can look different
depending on which child is engaging in the play because ultimately it will look differently
depending on the age of the child, the child’s developmental stage, their interests, values,
cultural background. Even perhaps their sensory motor preferences
from an OT perspective. And this play can absolutely involve playing
with others so long as those key ingredients of child-led play aren’t overly disrupted. So the child still needs to be able to feel
that they are able to lead the play and make lots of decisions around what the activity
looks like and the direction of the play as it moves forward. So shortly we will move into the parents’
involvement in child-led play but what we really wanted to do was first acknowledge
the vast array of benefits that child-led play provides for children in its own right. So children’s freedom to express themselves
through play is fundamental to their cognitive, physical, social and emotional development
and wellbeing. This type of play allows them to explore the
world in a world that they can master and as they begin go master those challenges they
set themselves, they develop those new competencies and that leads to growth in their confidence
and their resiliency and that better equips them to face challenges in their futures. And finally and perhaps most relevant to this
presentation today, children whose parents regularly join their child’s play are less
likely to develop mental health difficulties such as anxiety, depression, aggression and
sleep problems. So Ben is now going to have a bit of a closer
look at how parents can participate in this play. Yeah thanks Sarah. It’s great to reflect on the benefits of child-led
play and how children are innately driven to play and when they’re given those opportunities
to freely play it has a lot of benefits. What we are particularly interested in in
terms of supporting the mental health of children, is using child-led play to strengthen the
relationship between parent and child. So the question we ask ourselves is how do
we introduce a responsive parent into this play. So child-led play is an ideal way for parents
to engage with their kids. It requires the parent to tune into what their
child’s communicating, what are they thinking, what are they feeling, without distraction. And when parents observe or join their kids
in this way, they’re given this unique opportunity to start seeing the world through their eyes
a little bit. The parents are encouraged to notice what
are they thinking, what are they feeling, what are they doing, what do they want me
to do. And we’ve talked about this term responsiveness. So the parents role is to be responsive in
this way and when Sarah and I were talking about this, those qualities of love and delight
are really a way of showing a child that they’re responsive to them. Showing that they’re interested in them, showing
that they’re validating their activities that they’re engaging in. And these qualities of love and delight can
look many different ways for parents, it can be smiling, it could be being curious, it
could be noticing. It’s that reciprocity between parent and child. I like the notion of encourage parents to
be with the child in their play experiences, sending messages that I care or I hear or
I understand. We really can’t dismiss the primary drive
that parents have to ensure that their children are safe. In order for child-led play to be effective
for the parent, it’s important that they’re relaxed and fully engaged. So it’s important the parent takes the time
to create an environment which is safe and one where it’s free for the child to explore
without redirection. And I think that’s really important, the idea
of the parents’ redirection. There’s a few things for them to think about
avoiding during this play. For instance not using child-led play as a
reward, it’s important the parent is fully focused on the play without interruptions
or multitasking. And that final point there I think is important
and challenging for a lot of parents, is ways of them engaging without needing to teach
or correct in any way. So when we’re thinking about the benefits
for the parent, parents often report that child-led play allows them to get to know
their child as their own person. As we’ve mentioned a couple of times, you
know a child with their own interests and values. They start to see their child from a different
perspective, and one that’s based on a better understanding of their strengths and overall
vulnerabilities as well. So children and parents are in a constant
flow of interaction and in this busy life that we’re all living, parents can often miss
or even misread some of those cues that are coming from a child to the parent. And this type of play gives the parent a deeper
level of understanding of those needs. Parents begin to look under the surface, to
look beyond the behaviour that they might be seeing and think about hey what’s this
child trying to communicate with me. I think this is an important perspective shift,
it allows parents to start attuning to the child’s needs more effectively. I’m sure you’re starting to think about parents
that this might be beneficial for and we’ll talk about that a little bit later on. But it’s really, it is useful to some parents
where there is a narrative around some negative experience in their interactions with kids. The next point there is also around it gives
parents a focus, a sense of agency in being able to support their child’s overall social
and emotional wellbeing. Parents can often self-blame or feel guilty
for not being available for their children. When putting this together I thought of an
example of a mum that I worked with who had five children and her eldest son was referred
to our service for mental health related difficulties. And this mum held a lot of guilt and shame
in her words. She felt like she’d neglected the needs of
her son. So child-led play was that perfect opportunity
for her to take some action. For short periods each day she would follow
his lead and give her full attention, her full love towards him. And it’s this process that supported yes their
connection but it also helped to minimise some of that negative self-talk that she had
about herself. And finally those parents where there are
levels of adversity happening in their life, child-led play can be a type of refuge for
them, a time where they can anchor their attention fully in the present moment of their child’s
exploration. And there’s a strong therapeutic process in
this because opposed to focusing attention on the outside negative experience, they begin
to step into their child’s shoes and anchor their attention in a nonjudgmental way on
their child’s needs. And when Sarah and I were talking, we’ve often
had parents say to us that that this was their favourite part of the day or week, a time
that they set aside where they could truly see their child in a new positive light. And I think that word ‘positive’ is really
important for us because child-led play opens that door for pleasant experiences, for joy,
happiness and excitement. So let’s just take a moment to stop and reflect
on some of the learning so far. We’ve learnt that child-led play allows children
to explore their environment freely without restriction. We learnt that play is a fundamental aspect
to a child’s cognitive physical and emotional wellbeing. And part of this process is having a responsive
parent where they’re full present, sharing in the love and delight of their child’s experiences. And finally this idea of the parental perspective
shift more towards the strengths and interests of the child overall. Yeah thanks Ben. So we, as Ben alluded to, are now going to
shift our focus a little bit towards practitioner strategies and tools that can enable our families
who we’re working with to take the next steps around child-led play. So I guess just to get you thinking, you know,
who out of the people you’re working with might this approach suit. And so Ben and I have put some suggestions
down here and we’ve listed that parents and children who may benefit from strengthening
their relationship, this would be an opportunity for them. Or definitely as Ben said before, perhaps
it might be that you have a family and the child might be exhibiting some challenging
behaviours and those behaviours become the dominant story in that family. And so this strategy provides an opportunity
to lift up a different story around that child and to see some of the strengths and joy that
the child can bring and participate in. Similarly, perhaps you might be working with
parents who have incredible adversities in their own lives and therefore find it very
difficult to put any priority on their child’s needs and this can be a way that they can
be enabled to do that. Or perhaps you might have families who as
a whole are living through stressful times and like Ben said, I love that word ‘refuge’. This might be able to provide a small regular
window of refuge for the children and the parents that can help fill up their emotional
cup to keep them moving through those stressful times. And then finally as this is a universal mental
health promotion strategy, obviously we believe that this is actually something that will
benefit everyone. Okay so as we mentioned at the beginning of
the presentation we’d really like to provide you the opportunity to think about how parental
involvement in child-led play might fit into your practice, and so drawing on your knowledge
and expertise as a practitioner and the values of your clients who you’re familiar with and
who you’re working with on a day to day basis. So what we’d really like you to do is take
a moment to think of a family who you’re familiar with from your work and bring them to mind
so that you can have them in mind as we move through the rest of the presentation. Okay, so we suspect that it’s very likely
that many of you are working with families who are living with multiple adversities and
have quite complex lives. We believe that the iceberg model can sometimes
be a helpful tool to make sense of this complexity. So I will just quickly introduce this to you. So above the water is what we see and measure. So that might be how well someone is or isn’t,
rates of childhood anxiety or perhaps a score on a mental health assessment. And then just below the water are the lifestyle
behaviours that contribute to those measurable outcomes. Things like eating, drinking, sleeping, exercising,
our interpersonal relationships, how we deal with stress and so on. And this is often the level at which our interventions
target but sometimes that’s without a good understanding of the factors that are at the
very bottom of the iceberg, and this is the hardest part to see but the biggest part. And what’s at the bottom of the iceberg is
actually often what’s led the person to be engaging in the very behaviours that we may
be seeking to change and influence. And so trying to change those behaviours without
understanding these other pressures that are driving those behaviours can be really hard
work for both us and our clients. I was reflecting also as I was putting this
presentation together and was reminded recently of the importance of understanding what’s
at the bottom of the icebergs for one of my clients. A colleague and I were referred a little boy
who’s probably about 18 months I think, for support, as he hadn’t been meeting a range
of milestones. But in particular there were concerns around
his social and emotional milestones. So this mum and her son attended most of our
sessions across a ten week small group play based intervention but we just didn’t see
the progress for this little guy that we anticipated we might. And we were also really struggling to get
a connection that we were happy with with either him or his mum. So we went back to have a bit further look
at the context of the family rather than honing in on his development. And what we learnt at that time was that mum
was living with mental illness and also that she had a violent partner who she was in the
process of trying to leave. So these were really big factors at the bottom
of the iceberg for this little guy and his mum. And certainly once we became aware of this,
that gave us a much more appropriate understanding of his developmental presentation, and also
some of the struggles that his mum was experiencing in terms of trying to develop her responsive
parenting. And it’s likely that it may have taken many
of these weeks for this mum to feel able to share this information with us, but it does
remind me well of the importance of continually seeking to understand a family’s context so
that I can be more attuned as I move forward in working with families. So I just encourage you at the minute to take
a moment to recall the family you brought to mind earlier in the presentation and just
think about how much you know about what might be going on at the bottom of their iceberg
and how this may influence their capacity to follow through on any of the recommendations
that you might be making. Okay we’re just going to shift focus a little
bit now. The other model that we would like to share
with you today is around the stages of behaviour change presented by Prochaska. So as some of you might be aware, behaviour
change theory can be really helpful to guide our practice when we’re ultimately looking
to change behaviour. So I’m just going to briefly talk you through
this model now. So if someone was at the very bottom of this
model in the precontemplation stage, they’re really not considering changing anything. And so our role is about creating a curiosity
as to how things could be different if some change may be possible, just to dip their
thought into the water so to speak. And then they move into that contemplation
stage, and people in this stage are starting to feel a sense of discontentment with their
current situation but they’re not really sure about what they need to do or what a goal
might look like or where they want to be going. They’re just knowing that something might
need to be different. And so this is where our work can come in
to help them create that vision and then move them into that preparation stage. And that preparation stage is really about
narrowing down a focus on what they would like to be different and how they might get
there and what might be some of the strengths and enablers that they could draw upon, and
similarly being mindful of what might be some of the challenges and barriers to achieving
their goal. And then naturally the action phase is about
implementing that plan that you’ve worked together to develop and maintenance is about
sustaining it. But I think it’s also really important that
we as practitioners are mindful, but also enlighten our clients that it is almost inevitable
that always to some degree clients are going to relapse and we’re going to need to return
to those earlier stages to work with them again to get them back up to that action and
maintenance phase. So the earlier stages of this model are really
around building the client’s motivation for action and the later stages are really around
building their confidence and their sense of self efficacy in relation to achieving
those changes. So thanks Sarah. So again let’s stop and reflect on some of
the key learnings from that section. Sarah shared with us that child-led play is
an approach that’s beneficial for all families. We talked about the importance of understanding
the factors that can impact behaviour change by looking at the iceberg and what’s underneath
the surface. And then we explored what’s important in terms
of understanding the stage of readiness for change, looking at a behaviour change theory. And then you’ve started to translate some
of this learning into reflecting on clients that you’re currently working with at the
moment. We’ve actually had a question from someone
who has been reflecting on people they work with at the moment and they have a question
about grandparents and I know you, when you both spoke earlier, you took a broad view
of the definition of a parent. The question relates, you know, do you think
that grandparents have a role to play given that they aren’t the primary caregiver. And perhaps sometimes can more readily enter
into play with a child because of the stresses and demands on parents. Is that something that you’ve come across
in your practice and yeah, your thoughts around that? Yeah, actually that’s a really opportune question
for us to lift that up Christ thank you. Because I guess what the research tells us
is that children just need someone, they just need one consistent responsive person in their
life. And sometimes unfortunately that can’t be
their parent for whatever reason. And so if there is an available grandparent,
and there’s many grandparents out there who desperately want to help, then this is – and
an accessible way for them to do that, then they are a very appropriate person to pursue
that with, yeah. I guess why stop at grandparents really, I
guess there might be other people in the broader family that have particular caregiving responsibilities
at particular times for the child. Absolutely. Or neighbours, other people that are close
to the family yeah. Yeah. So you’re advocating for that as well, yeah,
great. Yeah I think so. I think one of the challenges as we look broader
is we still need to do and Ben is about to launch into some talking about building knowledge
– – – Okay.
– – – so people are really mindful about what child-led play looks like because that’s the
key ingredient, the child needs to be the leader of the play. But really the more people in a child’s life
that are able to engage in child-led play with them just further validates the child’s
joy in the activities that are meaningful to them. And that you know instantly fills up their
emotional cup. Great thank you. Yes there are some other questions but we’ll
leave those to later perhaps, so yeah, thank you for that. So yeah thanks Chris and Sarah. This – this kind of final section of our
presentation today is looking at really practical ways that you as the practitioner can promote
child-led play with families. So we’ll look at you know how do you connect
with families and strengthen their capacity, looking at making a plan and then the idea
of action and reflection as part of that process. So the first step in this process and in many
processes that we take when a family comes into our service, is about connecting with
them. So it’s really important that the family members
feel safe and supported, so they can openly express their feelings, their fears, their
hopes. And I know firsthand that this can be difficult
for practitioners when we’re limited by time. But it’s important for us to stop and reflect
that this is the most important step for us initially with a family and we often do come
back to this at different stages as well. And so just as we described following the
child’s lead in play, connecting is an opportunity for you as the practitioner to meet the parent
where they are right in this moment. And it’s, you know I think the first stage
really acknowledges that every family has a unique history and circumstances. What Sarah touched on a bit earlier around
context is really important here. And the way we work with family really needs
to reflect their context overall. So an understanding of the family’s cultural,
social relational context is key to helping integrate this approach into their daily lives
as a family. So how do we go about doing this, you know
what is this connection and how does it look. I’m sure you’re already kind of reflecting
on the ways that you build connection with families but some of those qualities are listening,
remaining curious, working collaboratively in a partnership with a family. And it’s by doing this that we build that
understanding of previous experiences and we start to understand the strengths and vulnerabilities
of the families. And so let’s take an opportunity now for you
to reflect on the way that you connect with families. How do you go about understanding their context
and what core qualities do you draw on to support this process. So this next section is about strengthening
capacity for child-led play for that parent and with behaviour change, in the early stages
our role is about building the client’s motivation for action. Building knowledge can really provide the
drive for this motivation. And we know that parents are highly unlikely
to do what we tell them just because we say so, especially when it comes to changing behaviour. And I think back to myself earlier in my career,
I remember you know doing that, connecting with families, doing my assessment and giving
that feedback and recommendations at the end of that process. And in there often I would put a recommendation
about child-led play without discussing it with the family and when they returned to
the service I would talk about the things that were going well. But often parents would say, ‘Oh sorry I didn’t
have time for that’ or ‘I forgot to do that strategy, sorry about that’. And this is a really key example of how I
was missing the opportunity to build knowledge for that family. Because the reality is that many parents,
you know they may not have heard of child-led play before as an approach, so the first step
following connecting with the family is to build that knowledge. What is child-led play? Talk to them about the role of the child,
their role in child-led play and talk about the benefits of child-led play with them. That next point there is around drawing on
their knowledge of previous play experiences and I wouldn’t mind us splitting this into
two ways of looking at this. I think the first way is that parents come
with their own level of insight already around play and we really want to draw on their strengths
in this. So meeting them in the conversation, meeting
where they are right now around this. They might say you know reflect on a previous
experience where they had a lot of joy in playing with their child. So they’re opportunities to really tag and
build on that knowledge. The other part of this is looking for those
times perhaps when things aren’t going as well, that can provide the bridge into almost
tagging some meaningful information about child-led play. You know a parent might reflect on how their
child doesn’t want to play with them anymore or they’re not feeling as connected with their
child. And as a practitioner we can name that and
say, ‘It sounds like you really want to spend more time connecting with your child, there’s
this thing called child-led play which might be supportive for you’. So by tagging that it makes it a little bit
more meaningful for that parent in the context of their life. And overall it’s just about providing information
for that parent so they can make the decision about whether they use this or not. And this next section is around strengthening
the capacity for child-led play. It says knowledge there but this is really
about confidence. For some parents this may be the first time
that they’re contemplating this approach and it can be vastly different from how they were
brought up or even how they’ve ever acted. And I think you know, our role as a practitioner
is really important here because a parent can be feeling quite vulnerable with this. So we need to ask ourselves what does the
parent need support with. It might be around emotional support, whether
that’s listening or providing empathy, you know it’s quite important for us to normalise
a parent’s unfamiliarity with child-led play, talking about and also acknowledging that
many parents can feel unsure about how to play with their children. And within that there’s some practical things
that we can support families with as well in building their confidence. Some parents find it useful to label or comment
on their child’s play, that really helps them to stay engaged in the process because it
can be difficult for sustaining attention for extended periods of time for some parents. And also you know how do we prepare the environment
as well and providing information to support them with that. Really what we’re doing is looking at focusing
on building the strengths of the parent and as a practitioner what that means is we need
to at times model these skills for parents. And what that means is that we also need to
feel vulnerable with that. So what does that involve? It involves us getting on the floor, it involves
us taking off our practitioner hats and it involves us following that child’s lead in
play. And I’ve got an example here when I was putting
this slide together. I was working closely with a dad who I was
introducing child-led play with. And the dad was in that contemplation stage. Now we’d built the connection, we’d built
some knowledge and he’s really interested in finding ways of strengthening his relationship
with his son at home. And in the discussion he said, ‘Look Ben,
I wouldn’t mind if you’d just show me a little bit about how to do this, you know it’s different
to the way I’ve engaged with him before’. So we’re in the room and I’m following the
child’s lead and the dad is next to me and the son you know crawls through a Lycra tunnel
across the room. And for those that don’t know what a Lycra
tunnel is, I don’t know Sarah, do you have any way of describing what a Lycra tunnel
is? I think well you could probably liken it to
going down the leg of an oversized pair of leggings perhaps. That’s a very good way of describing it. So you know the boy’s gone through and here’s
me at the end and I’m like all right I’ve got to do this. So I’m crawling through all the way to the
other side. And the boy was smiling when I got to the
other side but he looked over at his dad and he’s like come on dad, what are you doing. And so the dad you know crawled across, went
through the tunnel and I’m smiling thinking about this because really when that dad got
to the end, the laughter, the joy that they shared is what it was all about, that connection. And although you know I was modelling that
for the dad to build his confidence, it was actually the child that built his confidence
in the end. So that’s an example of how we need to be
vulnerable in this space and at times children can build the confidence of their parents
as well. I was just wondering, there was a question
that came through just before you began speaking about that point actually, you know a question
about in circumstances where the parent has fairly limited or no experience of play themselves
because of the circumstances around which they grew up in I guess. And just about how to respond to that, and
so you’ve mentioned kind of modelling that play as a key response to that kind of circumstance. I’m just wondering yeah, were there other
things around that that can also sort of yeah support those parents that perhaps can’t draw
so readily on their own experience? Yeah I think a really important thing is the
steps that we’ve touched on here. Yes. You know it sounds like for some parents really
for them the confidence is a big piece. And we can reflect on the information I just
shared. In some of that I think really building on
the strengths of the parents can be a good example of that. And even just breaking down the idea of what
it is, you know demystifying what child-led play is because although it is you know unfamiliar
to a lot of parents, what it involves is them just sharing and delighting in their child’s
play experiences, which they would’ve done in other circumstances. And you can always relate to that through
their own experiences. Right. You know, when you – and it could be anything. An example of watching them play football
and when you’re cheering or when they’re eating or you know in the bath time. Whatever it is, building on the strengths
and where they can relate to that as well. Yeah hopefully that kind of answers that question. Sure, yeah, no thank you. You know an important question so thanks for
that. Okay, and I think probably I’m about to get
to something which might help that listener as well Chris – – –
Okay great. – – – to see how we can scaffold some of the
plans up and down a little bit. All right so Ben has just given us a lovely
insight into how we can build the family’s knowledge and capacity relating to child-led
play. And so hopefully in an ideal world after we’ve
spent some time in that space with families they’ll be ready to move into that preparation
stage and so our role then becomes about creating a vision for change and a plan for that. So as I’ve just alluded to, this phase is
really about becoming very clear about what the parents is hoping to achieve and then
working with them to find out what are the steps to get them there. And having the parent articulate what they
want to achieve and what they hope might be the outcomes if they’re able to achieve that
goal is really important because it allows the families to identify what feels manageable
for them. So similarly to what that listener was just
talking about as well. For some families their capacity is small
so the goal needs to be small, it needs to be realistic and achievable for them so we
need to scale that right back initially and then we can grow it in time as their skills
and confidence grow. And then as they also set this goal then it
conveys to us and to them, you know what are they intending to do and what are the motivations
for their actions. And that information can be really powerful
for us as a practitioner to be aware of because as perhaps a parent’s motivation towards finding
the time and energy to engage in this process with their child might wane on and off, then
we can lift up to them and remind them you know what is it that really made them want
to engage in is in the beginning. So with that family with the five children
you know that mum was feeling shame and guilt around not being able to show her love to
her oldest child. And so that sort of insight is really powerful
for us to help support that person to maintain their motivation moving forward. I think the other thing that we as practitioners
really need to be mindful of is sitting with parents as they refine their goal takes time
and is usually quite hard work. And I think certainly myself as a practitioner
I can often see what I think would be a really nice fitting goal for someone and I really
almost have to bite my tongue to hold onto that so that the parent can get there themselves
and come to their own goal and their own plan. And certainly the literature really clearly
tells us that when we do allow the parent time to come up with this goal themselves
then the likelihood of them actually committing to this and achieving it is actually significantly
higher. So our role really becomes one of facilitator,
someone who can share information as Ben was saying, and ask questions that can help positon
the client to be able to work towards identifying their own goal. So for example it might be if a parent is
trying to work out how much time they’re going to spend with their child in this goal, it
might be that we might clarify for them well five minutes in pure play time with your child
three times a week is actually a much stronger investment in your child’s mental health than
one hour every week or so because that predictability and that consistency is what really will make
a difference for that child. So then the parent can go on and go okay so
I don’t have to make this a really big long thing, what I’ve got to do is make sure that
I feel like I can actually stick to this regularly. And similarly perhaps finding the right time
and space. So for our chaotic families I think that can
be one of the biggest challenges where they can actually look into their already busy
lives and think my goodness, where am I going to fit one more thing. And certainly that mum who I talked about
earlier with the little boy who was about 18 months old, you know her life, and his
life was really tough. And when we were looking for a window to strengthen
their relationship and invest in his mental health, what we ended up finding was bath
time. She was regularly bathing him most days of
the week and she would stay present to ensure he was safe. And so what we did is we just scaffolded that
time up a little bit by she would offer him some toys in the bath and then sit close to
him and then look for that shared attention and give him a warm face with a smile. And then we had it such that she was just
aiming to you know notice and name some of the things he was doing and demonstrating
her delight and validation in him that way. So I’ve just included a couple of other examples
which kind of also relate back to that other listener which will show you how you can kind
of start small or bigger depending on where your parent might be at. So the first one there is this week I’ll play
with Joe on two days after school for 15 minutes. So you know that’s probably a middle of the
road type of goal for someone to try and achieve. And then the next one, three times a week
when Isaac plays outside, I’ll ask if he’d like me to play with him and follow his lead
if he wants me to join in and then play for at least 15 minutes. So you can see in that middle goal the parents
really has to have a more sophisticated understanding of what following Isaac’s lead is going to
look like because that’s going to be what’s going to determine the success of that goal. And then lastly scaled right down again, a
little bit like the bath goal, we had a parent who regularly just plops the child on the
floor and floor time is important, but we were looking to lift the connection. And so what we moved towards is when I put
Emily on the floor I’ll provide her with a range of toys and the mum was going to sit
with her for five minutes. Just five minutes before she moved off, and
in that time she was going to notice which toys Emily sought out and seemed to enjoy. And try just describing, ‘Oh you’re banging
the block’, what are some of the things that Emily might have been doing with some of those
toys. Actually Sarah, I think those goals again
link to a question we’ve had from a listener around as mental health practitioners, how
do you advise a parent who’s had a long day at work, come home feeling quite exhausted
from that of course. How do we advise them to be involved in child-led
play, to enter into that or not. It’s a very real circumstance of families
I guess. It is and as a parent Chris, I think that
once I had kids I had a way better insight into what we’re asking of families. Okay. And you know my life is not a chaotic life
by many standards. Right. So I think it’s really important that we’re
mindful of that and hence the importance of spending that time working with the parent
for them to set the goal and for you to kind of amplify that what we’re looking for is
consistency. It doesn’t have to be a huge chunk, you know
five minutes regularly is a place to start. And I think the other really big thing which
probably relates to Ben and I having an OT background, you know looking at the occupations
that that family are already engaging in, like bath time, meal time, you know driving
in the car to school. Okay. What opportunities are there in some of the
things that they’re already doing just tweak a little bit and then doing it that way. Thank you. Okay. So once the parent’s created that vision,
however small that might be as a starting point, what we really need to do is then have
a look at what are the steps that are going to increase the likelihood of them being able
to sustain this change and achieve their goal. And for some families this conversation might
be quite brief and informal because they might have reasonable capacity to problem solve
and make plans and their lifestyle might be quite routine. But I suspect for many of the families who
we’re all working with, this process is almost vital to ensuring that the family can move
from wanting to achieve their goal and actually being able to achieve their goal. So this provides a really great opportunity
to build the parent’s capacity in planning and problem solving and for the parent to
become much more mindful of their own supports and barriers as they move forward. So what I’ve done here is I’ve just lifted
out of our practice paper that Ben alluded to a little bit earlier some of the prompting
questions that can support this process. So some of the things that you might want
to unpack with the client as you’re working through the plan is what things might get
in the way of this playtime happening. And so what might the parents see could be
done to overcome some of those challenges. Or perhaps as we alluded to before, you know
what’s going to keep me motivated. Like life is tough and full as that last listener’s
question kind of really lifts up for us. So how am I going to stay motivated towards
achieving this goal that I’ve set around shared playtime. Or also for some families and most of us I
think, if we’re trying to embed a new routine into our lives, just remembering to do something
that is new and that we’re wanting to do regularly can sometimes be a barrier. So actually unpacking well how am I going
to remember to do this if I’ve scheduled to do it after school two days a week, how am
I going to remember. You know is it a note on the fridge, is it
a reminder on my phone, what does that family member, that parent think might work for them. And then finally what are some of the things
or the people, what are the strengths and resources available to help make this plan
possible. They might be physical things like a backyard
or toys or a local playground or they might be a supportive partner or parent that we
can draw upon. Okay so we’re nearly at the end. So finally we’ve got the action and reflection
stages. So as I alluded to really the action stage
is obviously about the client implementing their plan. But as a practitioner there’s a few things
that we can do that makes all the difference to the likelihood of success for the client. So making it clear to the client that we’re
interested and we’re with them and want to see how they’re going to go with achieving
this goal is a really important thing to demonstrate. And we can most usually demonstrate this by
either a follow up appointment or a phone call, and ideally we don’t want this to be
more than two weeks past setting the goal because we want to try and get them on the
right track early. And this follow up has two really key purposes. On the one hand it enables you to continue
to collaborate with the client in working towards maintaining their goal that they’ve
set towards and conveying your genuine interest in how they go with that. But secondly, and importantly, it sets up
an accountability in relation to their goal. And what the research really tells us is that
if some – if people know that someone is going to follow up with them and see how they
went with something, they’re way more likely to actually follow through on that action. So again is another strategy to really lift
the likelihood of success for your client. And finally this follow up provides the practitioner
with the opportunity to facilitate reflection by the parent and unsurprisingly this is a
really important part of the process. It provides the opportunity for the practitioner
to enable the client to unpack how they went with working towards their goal and look at
what went well and even if we have to find the smallest things there, it’s really important
to be able to lift up some progress and some success. But also importantly we can lift up what didn’t
go so well and validate the challenges that got in the way of the parent’s success this
time. But then return to some of those preparation
stage type conversations around acknowledging that as a barrier and then trying to problem
solve around that so you can move past that in the future. So this process can be really important for
parents with lower self-efficacy because it can be presented as an acknowledgement that
things don’t go right all the time and in fact when we’re trying something new it often
might not go right. But if we as practitioners can lift up what
did go well and then support the client to problem solve around those things that didn’t
go well, then again we’re able to build the capacity of the parent to self-reflect and
persist in moving forward. So finally just take a minute to think about
that family you brought to mind earlier and I wonder what sort of opportunities there
might be for this type of accountability and follow up to provide some support for your
clients to achieve some of the goals they’re working towards. Thanks Sarah. So we’ve got four key messages for you to
take from today and I think there’s lots more you can take but really reflecting on child-led
play as an important health promotion strategy for all families. And we focused on the strengthening of the
parent-child relationship in child-led play, and we touched on behaviour change theory
and how this can be helpful in enabling families to act on implementing this strategy. And then we talked about practitioner needs
around supporting and tailoring this to the family’s context. Now one of those things following a webinar
is that you’ve got all this information, what do I do with it now, that’s been really great,
but where to go next. And these two resources really can help guide
you in that process. You’ve got one resource which is a practitioner
specific resource and one that’s a conversation guide which can help you with having conversations. So they’re linked into our website but also
embedded into some of the webinar material that you currently have. Great, thank you Sarah and Ben for that. And thank you to those that have – many
people actually that have been submitting questions around a variety of things. We have got a little bit of time to address
some of those. There has been some questions around adolescent
play but I think we’ll hold those for the forum to respond to those given they’re a
fraction outside of the scope of what we’re talking about today. But there’s been a number of other questions
to around that theme of practitioners who don’t have – sorry parents who don’t have
the capacity, capacity or are time poor. And so I know you’ve mentioned a number of
things particularly again towards the end of the presentation Sarah in response to that,
but are there other things you’d like to say in terms of what your recommendations might
be for practitioners who are working with parents who just don’t have that kind of capacity
for this type of approach with a child? Look I think there’s probably two – there’s
a key decision a practitioner has to kind of make when they’re faced with that challenge. Okay. They have to kind of look at does this parent
have some capacity and you know where it might be literally five minutes in a small window,
or does this parent have no capacity. And so the answer to that question will then
turn the practitioner either to you know talking with that parent about acknowledging the adversities
they’re facing at the minute but also lifting up their child’s needs and saying something
that would be really important for the child is a responsive person spending some time
in play can be a way that can be fostered are there other people who could perhaps you
know play this role for your child and look to identify those people and then perhaps
follow this process with them and see how they might go. Or otherwise as Ben said, you know, we need
to spend that time scaffolding that skill and knowledge development but then setting
a very small achievable goal to start with. And are there – is there a particular age
range you have in mind of children when you’re speaking or are we looking you know up to
12 years of age broadly or? I – even it was interesting with that question
in relation to adolescents. I think all children, well and the research
will tell us all children will benefit from having that responsive consistent person in
their life. And when you follow the child’s lead, what
you’re doing is just going to look different depending on the age of that child. So what you do with the adolescent, you know,
is going to be different because it’s going to be what their interests are versus what
you do with an 18 month old child. But I think that you know ultimately we can
apply this type of model right across the age spectrum. Great. And there’s been some questions too about
fathers as well which I know have been very present in our conversation as we’ve spoken. But are there sort of – what are some ways,
because I know you gave an example Ben of working with a father, but what are some ways
that you’ve both found around the best ways of supporting fathers as you do this work? Yeah so when supporting dads, I guess thinking
of when that dad comes into the room, you know what’s been their exposure to the process
of getting there. And often if a parent is – a dad is in the
room that’s a really good sign, that’s the first starting place to be able to work with
them. And the focus is on a lot of the things we’ve
already talked about, it’s about building trust and connection. But what I find with dads is that they really
do love this practical approach to getting on the floor with their kids and once you’ve
built that trust, when you’ve listened to their experiences. And I find using the same language that the
dad uses with me really helps them to connect with the overall approach. I know obviously being a male at paediatric
OT I worked a lot with dads, but I think that really does go for any practitioner working
with dads is building that trust and connection over time as well and using language. And I think reflecting on how the service
really shapes the way that a dad comes into that room, what’s their perspective when they
step in the doors, is it one of collaboration and partnership. Because that’s really what we want to foster
here. Yeah, so and you know we spoke about grandparents,
even siblings I’ve worked with are really engaged in child-led play as well. Any support network really is beneficial for
the child. Great. I know you’ve mentioned as part of your presentation
that one of the things that could get in the way of parents participating in child-led
play is actually quite a fixed and diminished view of their child, you know a negative view
of their child. And there’s been a question around that in
terms of okay so, and you would notice this as you’re speaking to the child. How do you respond to that, you know with
a view to sort of inviting them into child-led play. Yeah we both kind of went to go on that one. Yeah. But do you want to go first? Yeah sure. I think one of the things as I’m listening
to the question that seems to be coming to mind by Chris is I’m wondering whether the
child is present or not. Okay. Because I think there’s a strategy I learnt
from a colleague that works particularly well if the child is present because what you sometimes
see is parents talking about this horror story of this child that’s doing this, that and
the other, and we’ve tried this and nothing is working rah, rah, rah, while the child
is there which is really unideal for that child. And so the strategy of bringing that child
straight into that conversation as a way of you demonstrating their presence. So oh my goodness, you know say the little
boy is called Tim, say, ‘Gee Tim that sounds like you’ve had a really hard time and you’ve
tried lots of different things and you’re still feeling like things aren’t going very
well, that must be incredibly challenging for you’. And it’s a – – –
Bring their voice in, yeah. Yeah bring their voice in, and then I think
that you then can begin that very obvious collaboration with the parent and the child
right from the beginning then. And you can talk about one of the things that
can be really helpful in this situation when times have been really tough, is for us to
find some time doing something that actually brings us joy and closer together outside
of those challenges that’ll still be here and need to be addressed but this can give
you both a break from those really tough times and then you introduce it as a strategy. Ben do you have something you want to add? Yeah I think you covered a lot there Sarah
and I think for me working with families, I get really curious with the parent often
and say, ‘Has this always been the case?’ or ‘Can we just go back to a time where you
can remember spending that time connecting in play’. And I was thinking of a scenario when you
were just talking then of a parent that I worked with who we’d built up to the point
where she was actually engaging in child-led play with her daughter and had those you know
quite fixed views, you know every time we talked with the child not present she would
talk in negative ways about that child. But then in the session I noticed that she
was sharing and delighting, she was smiling, and you know in that moment as a practitioner
it’s really important we can draw the parent into that and say, ‘I can notice there’s some
emotion here, it looks like you’re feeling is it happiness’ or just drawing that in. For that parent when I did that it was kind
of a felt experience, which in a way can help to shift how they view their child overall. And I know there’s many ways you can go about
this but as Sarah reflected, the fundamental is connecting with the parent, understanding
their own experiences and when we start to do that we can really work with the families
really effectively. What if – and again another question, about
the – and gosh we haven’t got much time so it might have to be a fairly shorter answer
we’ll answer more fully perhaps on the forum. But what about you know sometimes, you know
children that perhaps become aggressive during this playtime and you know some of the dilemmas
that brings I guess parents, and practitioners I guess as you hear about it. You go yep. Okay I guess I’m wondering whether they’re
envisaging that this is occurring in a clinic setting where you might have been practising
some play or this is a parent reporting back from home. Right, not sure. But I think I’d really want to understand
you know like we do any time we try to manage challenging behaviour is what went on before. Because if a child is just happily engaging
in what we described earlier in the presentation as that free child-led play, they don’t typically
get too aggressive unless perhaps they became frustrated with something that didn’t go quite
right. But what you do often see aggression coming
in is if someone comes in and intrudes on that play in a way that then makes them feel
judged or non-validated or a failure. So I’d be really interested to learn about
well what went on before that happened and what might have been some of those (indistinct). Yes and what the parent’s response is I guess
to that as well. Just very quickly – – –
Sure. I’d reflect on what it is they’re observing. You know is it the child hitting the teddy
with a hammer and that’s perceived as an adult as aggression. So we really need to look at this with fresh
eyes. Okay. And I think when we do that as a parent we
can see things a little bit more differently to whether it is actually aggression or is
it this child making sense of something. I think that’s an important thing we can take
out of this as well. There’s lots more questions, there’s lots
to explore and thank you again for those that have submitted them, we will be responding
to them in the forum. Thank you so much Sarah, thank you Ben for
your contributions today, yeah thank you to all the participants out there. Thanks to the folks at CFCA behind the scenes
for making this webinar happen as well. And so yeah, please follow the link on your
screen to the website and continue this conversation. Thanks very much everyone.



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