Listen to thisA boy, alone, sits on a fence staring sadly, a tear wending its way down his face, at a group of children playing in a yard. This is the lonely isolate, hurting inside to be able to join in but so threatened by relationships with himself and others that he cannot. (DeNoon, 1965, p. 88).
All of us who have worked with disturbed children will recognize the plight of the “empty” child: the child who cannot make friends easily or who considers himself so “nothing” that nobody could want to be his friend. One of the most important components of any treatment plan for such a youngster would have to include his participation in carefully selected and supervised activity programs – where he could begin to learn new peer-relating skills and develop his own embryonic sense of self worth. Skilled clinicians have come to think of activity programs as not merely a pleasant adjunct to psychotherapy, but as a meaningful and necessary part of a child's treatment. Redl and Wineman speak of activity programs as a “full-fledged therapeutic tool"; they state quite emphatically that “Programming can play a specific role in the clinical task on its own, not only a “time-filling” substitute for psychiatric contacts during the rest of the day” (Redl and Wineman, 1957, p. 393).
Some theorists have shown that activities have a reality and a behavior influencing power in their own right (Gump and Sutton-Smith, 1965, p. 414), while others have pointed out that some specific developmental needs of children are met through activities: mastery of skills, release of aggression, mastery of relationships and the art of sublimation (Konopka, 1954, pp. 141-146). Play, as described by Bettelheim, (1950, p. 218), is that area where the child tests and develops his independence and where he learns to hold his own with his peers. Obviously, such an important part of the child's world, “play” should not be looked upon as a uniform event or as a totally random activity. Piaget has given us some insight into the complex normative structure governing what at first glance appears to be unplanned activity (1951). Erikson gives us some insight into the potentialities of child's play as a medium for learning:
Child's play is not the equivalent of adult play ... it is not recreation. The adult steps sidewards into another reality; the playing child advances forward to new stages of mastery (Erikson, 1950, p. 194-195).
Finally, Redl and others have noted the tremendous impact of the structure of games and activities on those participating in them (Redl, 1966, p. 87). What, then are we speaking of when we discuss this rather complex subject of activity programming? For our purpose here, we may think of “program” as any activity in which children are engaged either with other children or with adults. Clearly, this rather loose definition of program encompasses many things, but it is well to remember that the child's world is a world of play. With or without the intervention of helping adults, activities have benefit both for the individual child and for the group. Perhaps no other medium is better designed to allow individual children to acquire a sense of competency and mastery over their environment. Activities also provide opportunities to practice group participation, to experiment with new roles in a small group situation, and to try out newly acquired peer-relating skills.
Activities may also be used as diagnostic tools to assess not only individual children, but also group structure and decision-making processes. Most of the case records accompanying children to residential treatment centers have a surplus of intrapsychic evaluative data, but a dearth of material pertaining to how the child functions in a group situation. We are often quite aware of a child's learning deficiencies, but tend to overlook the fact that many children simply do not know how to have fun. The mastery of program activities provides them with at least one concrete and marketable peer skill. Finally, if we truly believe that activity programs are not merely a pleasant addition to psychotherapy, but function as “full-fledged therapeutic tools,” then activity programs must be a guaranteed commodity in the therapeutic milieu and not something held out solely as a reward for “good” behavior. This is not to suggest that we always present a wide range of activities to all children at all times. It would make little sense, for instance, to suggest a game of chess to a child wildly out of control. On the other hand, many of the presenting problems of the youngsters: poor peer relations, aggressive outbursts, and low self images can often be treated better in the context of an activity than a fifty-minute office interview. It is, therefore, important that we not limit the use of this “tool” to those times when children are in good psychological shape.
References
Bettelheim, B. (1950). Love is not enough. Glencoe, Ill.: Free Press
DeNoon, B. (1965). Horses, bait and chocolate cake. In Henry W. Maier (Ed.), Group work as part of residential treatment. New York: National Association of Social Work.
Erikson, E.H. (1950). Childhood and society. New York: W.W. Norton
Gump, P., & Sutton-Smith, B. (1965). “Therapeutic play techniques.” In Nicholas J. Long, William C.
Norse and Ruth G. Newman (Eds.), Conflict in the classroom. Belmont, California: Wadsworth
Konopka, G. (1954), Group work in the institution, New York: Association Press
Piaget, J. (1950). Play, dreams and imitation in childhood. New York: W.W. Norton
Redl, F., & Wineman, D. (1957). The aggressive child. Glencoe, Ill.: Free Press
Redl, F. (1966). When we deal with children. New York: Free Press
This feature: Whittaker, J.K. (1969) Program activities “their selection and use in a therapeutic milieu. In Trieschman, A.E., Whittaker, J.K., & Brendtro, L.K. (Eds.), The other 23 hours: child care work with emotionally disturbed children in a therapeutic milieu. New York: Aldine de Gruyter. pp.100-102
