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Jurnal Csa 10 Luar
Jurnal Csa 10 Luar
To cite this article: Craig I. Springer, Giselle Colorado & Justin R. Misurell (2015) Structured
Therapeutic Games for Nonoffending Caregivers of Children Who Have Experienced Sexual Abuse,
Journal of Child Sexual Abuse, 24:4, 412-428, DOI: 10.1080/10538712.2015.1022295
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Journal of Child Sexual Abuse, 24:412–428, 2015
Copyright © Taylor & Francis Group, LLC
ISSN: 1053-8712 print/1547-0679 online
DOI: 10.1080/10538712.2015.1022295
CRAIG I. SPRINGER
Newark Beth Israel Medical Center, Newark, New Jersey, USA
GISELLE COLORADO
Yeshiva University, New York, New York, USA
JUSTIN R. MISURELL
The Child Study Center at NYU Langone Medical Center, New York, New York, USA
412
Structured Therapeutic Games 413
been found to be efficacious for motivating and helping children with symp-
toms of attention-deficit/hyperactivity disorder, social skills deficits, conduct
problems, and anxiety disorders (Cavett & Drewes, 2012; Goodyear-Brown,
Fath, & Myers, 2012; Lowenstein & Hertlein, 2012). Lowenstein and Hertlein
(2012) describe several play therapy techniques helpful in engaging fami-
lies in the therapeutic process by allowing the families to further discuss
important family aspects and psychological issues with games aimed at
recalling positive attributes and strengths of the family. Similarly, Goodyear-
Brown and colleagues (2012) developed the flexibly sequential play therapy
approach for children with posttraumatic symptoms that utilize play tech-
niques and prop-based games to provide trauma-specific psychoeducation,
moderate some of the discomfort related to trauma content, and help the
children create a more cohesive narrative of their abuse. Cavett and Drewes
(2012) discuss the benefits of integrating play therapy with trauma-focused
cognitive-behavior therapy skills because it supports children’s feelings of
control, joy, and mastery. Games have been discussed as particularly useful
in the treatment of trauma since they seemingly make it easier to deal with
the high level of discomfort and avoidance that often accompanies such
experiences (Goodyear-Brown et al., 2012). Furthermore, games and play
have been described as allowing the traumatized brain to cool down, act,
and think more effectively, contributing to decreased arousal and a sense of
calm (Schaefer, 2003).
The utility of therapeutic games for enhancing motivation and interest
has been discussed in the treatment literature for children and adolescents.
However, while it would seem that these treatment methods would bene-
fit adults in similar ways, there has been very limited discussion of using
games with adults. Schaefer (2003) contends that the paucity of research and
literature on adult play therapy is due to societal views that depict play as
unproductive and infantilizing for adults. In his edited book, Schaefer (2003)
argues that play can be used effectively to help adults process and heal from
distressing life experiences as well as to address emotional, physical, and
social deficits caused by a traumatic childhood. More specifically, he explains
that games appear to allow adults to gain emotional control, stimulate intel-
lectualism, enhance social skill development, and facilitate generalizability
Structured Therapeutic Games 415
The session structure for the GB-CBT caregiver group begins with a discus-
sion of caregiver reactions to previous caregiver and child group sessions.
Caregivers are then presented with information about what their children
covered during that week and the specific methods that were used. This is
followed by the rationale and psychoeducation about the topic and skills
that will be covered in the caregiver group. STGs are then utilized to further
develop their knowledge and to experientially practice the therapeutic skills
that were taught. Therapy sessions conclude with processing the session’s
activities and the assigning of homework to practice skills at home.
you feel when you had your first child? Talk about a time you felt scared).
This game begins with caregivers each randomly picking numbers written
on slips of paper. The number drawn designates when each caregiver will
be able to pick a question, starting with the caregiver who drew number
1. Upon receiving their question, caregivers read it aloud and then decide
whether to keep the question or trade it with a previously read question.
After everyone has chosen their questions and all of the exchanges have
been completed, starting with the person who drew number 1, caregivers
answer the current questions in their possession.
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or herself and is then awarded points based on the number of votes that his
or her response generated. The game continues with another scenario being
presented.
responses that each person generated is totaled and the caregiver with the
largest number of responses wins the round.
touched. Responses are then folded and placed in a hat. Finally, they are
read aloud and caregivers are asked to raise their hands if the response
relates to their child’s abuse experience. At this lower level of basic disclo-
sure, caregivers are not asked to talk about their children’s abuse but to
nonverbally acknowledge various aspects of it.
Caregivers then play a second basic disclosure game titled “Exposure
Card Game” in which caregivers roll a die and then share aspects of their
children’s abuse scenarios based on the number they roll. This higher level of
basic disclosure involves minimal verbal responses, although group clinicians
may encourage caregivers to elaborate on their answers. The six questions
are:
Graduation Session
The graduation session is a time that children and their caregivers come
together and celebrate their individual and joint achievements. During the
graduation ceremony, caregivers play a game, during which they are asked
to share their thoughts and feelings about the program, their child’s achieve-
ments, and their hopes and desires for their children’s futures. Caregivers are
provided with a card containing a question, a number, and a blank space
for them to include their names. Starting with the caregiver that has “card 1,”
caregivers are asked to say their name, their child’s name, read aloud and
answer their question. If they are willing and able to do so, caregivers are
asked to write their name on the card, which is entered into a raffle for a
pre-established prize (e.g., lottery ticket).
have experienced sexual abuse. During the first group session, Ms. Watts was
tearful and frequently expressed shock and disbelief about her son’s sexual
abuse, while Mr. Watts appeared frustrated and was argumentative with Ms.
Watts whenever she spoke. For example, during the “Getting to Know You
Stack,” Ms. Watts answered the question “What was one of your biggest
regrets as a parent?” by indicating that it was leaving Robert in Mr. Flynn’s
care. In response, Mr. Watts verbally attacked her, stating, “You should have
known better,” and stormed out of the room. After a short period of time, Mr.
Watts reentered the room and continued playing the game. As the game
progressed and nonabuse topics were discussed, Mr. Watts appeared more
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childhood sexual abuse. During the “Abuse Card Game Competition,” Ms.
Watts became tearful and expressed having a difficult time understanding
how so many children experience sexual abuse. Upon learning that sex-
ual abuse is often perpetrated by someone familiar to the child, Ms. Watts
reiterated her remorse and guilt for allow the perpetrator to have access
to Robert in light of her own victimization by her stepfather. Following
her disclosure, Mr. Watts became infuriated explaining that he could not
believe that Ms. Watts could have gone through this herself and still did not
have the wherewithal to recognize that Mr. Flynn was a “pedophile.” During
this exchange, another group member spoke up stating that she was also
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abused as a child and had not been able to prevent her child from being
abused. Furthermore, she defended Ms. Watts stating that people who sexu-
ally abuse children are manipulative, deceitful, and difficult to detect. Other
group members also expressed their support for Ms. Watts and stated that Mr.
Watts was out of line. These sessions concluded with Ms. Watts stating that
she understands Mr. Watts’s frustration and that she wants him to know that
this was unintentional and that she loves Robert more than anything in the
world. Mr. Watts acknowledged Ms. Watts’s sentiment and suggested that
they continue to focus on getting Robert the help that he needs.
Mr. and Ms. Watts arrived to session 6 together and appeared to be talk-
ing to each other in a more casual and relaxed manner. During “Knowledge
by Letter,” Mr. Watts provided a number of entertaining answers to which
Ms. Watts and the other group members responded with laughter and com-
pliments. Similarly, Mr. Watts provided supportive statements to Ms. Watts
and the other caregivers playing the game. Both Ms. and Mr. Watts at differ-
ent times during the session indicated that they enjoyed the game and that
humor made it easier to discuss the topic of sexual abuse.
During session 7, while playing “Who, What, Where in a Hat,” Mr. Watts
indicated that he was emotionally impacted by the similarity of the chil-
dren’s abuse experiences and the profound effect that it has had on them.
He also expressed that while it is difficult to admit, he believes that the abuse
could have as easily occurred when Robert was in his care because he also
trusted Mr. Flynn and had no idea that he was capable of hurting his son.
Another group member responded to Mr. Watts by praising him for his brav-
ery and insight. Following the “Exposure Card Game,” Ms. Watts indicated
that she was beginning to feel better discussing her son’s victimization and
highlighted that Mr. Watts’s support has been critical in helping her heal.
During session 8, when playing “What’s the Scoop?” Mr. Watts became visi-
bly upset when Ms. Watts’s partner was retelling Robert’s story, as related by
Ms. Watts. He exclaimed that he is sorry for blaming Ms. Watts for the abuse
and for criticizing her in the past.
When group members were informed that they would be pairing up
for the advanced disclosure game “My Parent My Idol,” Ms. and Mr. Watts
426 C. I. Springer et al.
indicated that they would like to work together. During this game, Ms.
and Mr. Watts realized that there were differences in the details that each of
them knew about what had occurred to Robert. They frequently made sup-
portive statements to one another and focused on their need to be united
in order to help their son. Moreover, they expressed their admiration for
each other for working through this difficult process. During their role-plays
in front of the group, they provided comfort and affection to each other as
each took turns acting as their son, giving hugs and making supportive state-
ments such as, “It’s not your fault.” Other group members observing these
role-plays applauded Ms. and Mr. Watts’s efforts and complimented them on
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their progress.
Mr. Watts showed great enthusiasm during session 10’s “Personal Safety
Trivia Competition” indicating that he not only wanted to keep his son safe
in the future but that he was also interested in helping other parents min-
imize risk within their families. Similarly, Ms. Watts expressed an interest
in developing an ongoing parent support group after treatment termina-
tion, which the other group members said that they would be interested in
joining. During the final two sessions, in which they played “Stress Away
Guess Away” and the “Guess Who Card Shuffle,” Ms. and Mr. Watts indi-
cated that they felt increasingly comfortable co-parenting and expressed their
admiration and appreciation to each other and the group.
At the conclusion of group, Ms. Watts indicated that she was no longer
experiencing depressive symptoms, guilt, or intrusive images of Robert’s
abuse. She also reported that she feels more confident in her ability to help
him. Mr. Watts similarly reported feeling better, indicating that he was no
longer experiencing anger toward Ms. Watts and stated that he feels closer
to Robert and hopeful that his son will be able to achieve his full poten-
tial. In addition, Robert’s posttreatment assessment indicated that he was no
longer experiencing symptoms of trauma or sexually inappropriate behav-
ior. During the group graduation, Ms. and Mr. Watts gave heartfelt speeches
about their family’s ability to overcome the abuse and that how they will
always be there for Robert in the future.
CONCLUSION
REFERENCES
AUTHOR NOTES