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PTISA News
The NGO sector currently experiences a number of challenges when it comes to delivering professional services. According to
South African Child Gauge South Africa certainly experience some gaps between service need and delivery (2008). To buffer
crimes against children, the South African Government implemented various acts, namely, the Sexual Offences Act
(Amendment 32,2007), the Children's Act (Amendment Act 41 of 2007) and the Child Justice Act (Act no 75, 2008). The
Department of Social development has two core functions, providing social security and delivering the service (SACG; 2008).
Challenges preventing service include shortage of social services practitioners, inappropriate use of Child protection service and
marginalization of prevention and early intervention services (SACG; 2008). According to the Department of Social Development
strategic plan 2011/12-2013/14 there remains a vast shortage of social workers which is one of the greatest resource
considerations to implement these acts. Play therapists should be considered as an extra recourse to assist in implementing
these acts.
Recent analysis of children's circumstances in South Africa
Population of children in SA
In mid-2009, South Africa's total population was estimated at 49.4 million people, of whom 18.6 million were children
(under 18 years). Children therefore constitute 38% of the total population. The child population has grown by about 6%
(1.1 million) over the eight-year period from 2002 to 2009.
Children living with parents
The General Household Survey indicates that, in mid 2009, 34% of children (0 - 17 years) in South Africa were resident
with both their biological parents. A further 24% of children were resident with neither biological parent. 7 million - were
living in households with their mothers but in which their fathers were not resident. Very few children live in households in
which their fathers are present and their mothers are not: the national average of 3% applies roughly across all provinces.
Between 2002 and 2009, there was a decrease of four percentage points (38% to 34%) in the proportion of children living
with both parents.
Orphanhood
(62%) of all orphans in South Africa are paternal orphans. The numbers of paternal orphans are high because of the higher
mortality rates of men in South Africa, as well as the frequent absence of fathers in their children's lives (1% or 185,000
children have fathers whose vital status is reported to be "unknown"). The number of children who have lost both a mother
and a father has more than doubled since 2002 (from approximately 350,000 to 860,000), indicating an increase of nearly
three percentage points in double orphans as a proportion of all children in South Africa (2002: 2.0%; 2006: 4.6%). These
increases are likely to be driven primarily by the AIDS pandemic.
Child-only households
An analysis of the General Household Survey 2008 indicates that there were 100,000 children living in a total of 56,000
child-only households across South Africa at the time of the survey. This is equal to 0.5% of all children (0 - 17-year olds)
and to 0.4% of all households in the country. The proportion of children living in child-only households relative to those living
in households where adults are resident is therefore small.
Child Rape
Exacerbating child vulnerability South African Health Info "suggests childhood rape has increased by 400% in South Africa
in the last decade" (Carey, 2011). The South African Police service released statistics in the annual report for the period
2009-2010 indicating 24,417 cases were reported for abuse against children (Department of Police, 2010:192), and the
latest crime report indicated a 2.6% increase in sexual offences against children (Department of Police, 2011:12).
This coincides with a survey by the South African Medical Research Council that found 27.6% of men who participated in
the survey raped, 4.6% admitted to rape in the past year and 4.6% confessed to attacking more than one victim
(Jewkes, Sikweyiya, Morrell & Dunkle, 2009:3). They added that this is as a result of the culture of rape in South Africa,
furthermore; often child rape is committed by children themselves. Further presenting a problem in South Africa is low
sentencing rates for crimes against children, which is not a new phenomenon. Research conducted on sentencing by the
South African Law commission (2000:19-20) confirms that, 11 years ago, child rape was the highest level of cases going
to court at 42% compared to 32% of reported adult cases and child rape showed a 9% conviction rate.
The above analysis indicates that children's circumstances in South Africa are regrettably not getting any better if not worse.
As we can see above children are especially vulnerable, particularly orphans, child-only households and rape victims. Indeed
the child protection systems, laws and human resources currently in place are not able to meet the service needs in child
protection to reduce the vulnerability of children. This call for considerations in getting more professionals to implement the
new Acts in child protection, Play Therapists could be one of the considered professions which will then call for regulation
of this profession.
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2. DEFINITION OF PLAY THERAPY
Play Therapy is a specific communication approach in which games, toys and mediums such as sand tray, clay, drawings,
puppets, movement, music, therapeutic stories and paint are used to help a child or adolescent to express their emotions,
thoughts, wishes and needs. It helps them to understand muddled feelings and upsetting events that they have not had the
chance or the skills to sort out properly. Rather than having to explain what is troubling them, as adult therapy usually
expects, children use play to communicate at their own level and at their own pace without feeling interrogated or
threatened.
"Through play a child is able to release pent-up feelings of anxiety, disappointment, fear, aggression, insecurity, and
confusion. Bringing these feelings to the surface encourages the child to deal with them, learn to master them, or abandon
them. Through symbolic representation, the child gains a sense of control over events that seem uncontrollable in reality.
Often, children are unable to verbally express what they are feeling; thus, in play therapy toys serve as children's words and
play as their language."
Play therapy can be used to assist children in the following areas:
- Emotional and behavior problems
- Social problems and learning difficulties
Specific mental health issues including depression, anxiety, stress, loss and bereavement, autism, ADHD, attachment problems.
- Forensic assessments/sexual abuse assessments
- Court work and expert witnessing
Within various contexts:
- Health sciences and social services
- Justice sector
- Youth and pastoral work
- Educational
- Research
4. WHAT PLAY THERAPISTS DO
A qualified Play Therapist requires to apply over 100 competencies in practice. The main ones cover:
- Assessing the emotional needs, wishes and feelings of children in consultation with other professionals in schools, hospitals,
clinics, social service teams and courts;
- Providing treatment of children as individuals and in groups. Therapy takes in sessions normally lasting 45-60 minutes;
- Providing a regular and consistent setting and time where play therapy can commence;
- Working in a multi-disciplinary team of social workers, social auxiliary workers, teachers, lawyers, prosecutors, magistrates,
nurses, medical doctors, psychiatrists, psychologists, and/or occupational therapists etc.
- Offering consultation and advice to professionals in the community
- Use play therapy skills to conduct abuse assessments/Forensic assessments
- Expert witnessing in court
- Child consultation / encouraging participation in decisions affecting the child
- Prepares reports/process notes
- Works within an ethical framework
- Maintains confidentiality
- Builds a therapeutic alliance with clients and their family network
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5. VALUE OF PLAY THERAPY IN THE SOUTH AFRICAN CONTEXT
- In terms of the four pillars of the child protection system in South Africa, Play therapy falls within the prevention and early
intervention services which have been emphasized by the Social welfare policy. In the absence of sufficient capacity by the
state to provide preventative and early intervention services, play therapy is one of the interventions that can be utilized to
provide the bulk of these services.
- Play therapy encourages Family preservation through creative arts and counselling services thus allowing children to be
raised in healthy families.
- Play Therapy is a preventative intervention that will minimise social problems caused by unresolved childhood problems.
Unresolved problems could lead to anti-social behavior that could end up getting the child into the child protection system.
- There is lack of coordination, collaboration, communication, among the different departments providing services for
children, whose rights have been compromised. Particularly collaboration between the Department of justice and Department
of health and social development has been a major issue. Play therapists can contribute in strengthening this collaboration
through, standing as expert witnesses for children whose rights have been violated, by using their play therapy skills to
conduct forensic assessments and keeping close communication with the department of justice.
- Currently the greatest obstacle to the implementation of the new Children's act is the acute shortage of suitable qualified
personnel. Immediate and creative solutions are needed to address this shortfall. These solutions need to include recognition
and remuneration of play therapists to support other professionals in the child protection system.
6. CURRENT SITUATION AND OBJECTIVES
Play Therapy is not recognized currently as a profession in South Africa. As there is no regulation of Play Therapists, anyone,
without accredited training, may set up as a Play Therapist with the considerable risk of harm to children. According to the
Sexual offences Act, all individuals working with children should be registered. As Play Therapy is not a regulated profession,
children could be at risk particularly due to the specialist nature of Play Therapy.
To give an indication of the number of Play Therapists, the University of Pretoria selected 20 students per year from 1997 - 2001
and reduced the number since 2002 to only 10. Huguenot College selects 45 students per year. Huguenot College has in the
interim merged with North West University.
Play Therapy professionals have received training at Master's level in play therapy. To insure that there are coherent standards
based on the competencies that are required for safe and effective practice, Play Therapy International will voluntarily assist with
content and competency regulation.
The lack of countrywide child protection procedures, backed by the Justice system, and support for children who have been
abused is inhibiting play therapy practice.
It is difficult to obtain funding for practitioners because of the absence of state regulation and practice based evidence which can
only be obtained once Play Therapy is regulated.
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7. ABOUT PLAY THERAPY INTERNATIONAL
In 1985, the founding efforts of two key Canadians in the field of child psychology and play therapy, Mark Barnes and
Cynthia Taylor, resulted in the establishment of Certification Standards through the non-profit Canadian child psychotherapy
and play therapy association which set the pace for a professional approach to play therapy. To this end a fledgling group of
practising Canadian child psychotherapists and play therapists worked on developing an organization to meet professional
needs. It gradually expanded and eventually a Board of Directors was formed; objects and by-laws were designed, revised,
re-revised and finally approved by the Government of Canada. The Canadian association was eventually recognized as a
non-profit organization in 1986.
Initial Board representation came from Charlottetown, Kingston, Toronto, Cambridge, Ottawa and Peterborough. This was the
first professional body in the world to offer a national program of Certification in Child Psychotherapy and Play Therapy that
involved rigorous and credible professional standards.
Continuing its pioneering efforts and remaining on the cutting edge of the field, The Canadian Play Therapy Institute was the
first child psychology and play therapy organization in the world to go on the internet with its own website located at
www.rmpti.com is the first version of this site.
PTI and IBECPT
During 1995/1996, a whole new horizon opened up for the profession of play therapy as a result of the
Canadian Play Therapy Institute's pioneering efforts on an International basis. Faculty members of CPTI were inundated with
an increasing and overwhelming number of international requests for training programs throughout the world. However, time
and energy were being taken away from the Canadian Institute. Thus, as a result of this pressure and demand, an entirely
separate and new organisation, The International Society for Child and Play Therapy/Play Therapy International (and
The International Board of Examiners of Certified Play Therapists) was founded to meet international needs. As a result of
intensive efforts throughout the world, Play Therapy International was established.
There now existed a mutually supportive recognition between Play Therapy International/The International Board of Examiners
of Certified Play Therapists, The Canadian Play Therapy Institute, as well as a number of other professional bodies throughout
the world.
Certification now became available on an international basis through the International Board of Examiners of Certified Child and
Play Therapists. The standards for International Certification are extremely high - the highest in the world - and offer highly
qualified professionals the recognition they deserve. Once again, Canada was a leader in their participation in the formation of
this International organization.
Policies for International Growth
PTUK in association with PTI organised the 2004 World Congress in Play Therapy at Chichester, England. This was the largest
international event of its type held anywhere with over 70 workshops/sessions and attended by over 400 delegates from 29
countries.
In 2004 PTI embarked upon a major change of direction. As a result of consultations at the World Congress PTI stated its four
main guiding principles:
Universality: We will work with any organisation in any country that has objectives similar to PTI, namely the improvement of
children's emotional state, behaviour and mental health. PTI recognises that there is a spectrum of needs that may be met
safely by a variety of interventions and levels of skills.
Autonomy: Each country has its own culture, social structure, statutory requirements etc and priorities. It is vital, in our
view, that the organisations representing the profession in each country are completely autonomous. It is very important that each
country should have its own national organisation - not a branch governed by a remote office in a country that does not fully
understand the country's needs.
Affiliation: PTI, as the first internationally orientated body in the field, uses its experience and resources to encourage and
support the start up and growth of sister organisations around the world through affiliation. PTI will allocate funds each year to
subsidise the start up of embryonic national organisations.
Professionalism: In order to gain the respect of the public and to satisfy regulation requirements any organisation
recognised by PTI must meet certain management as well as therapeutic criteria and demonstrate commitment. PTI provides
considerable support in this area including:
- The adaptation of training and education standards based on the minimum competencies required for safe practice
- Certification requirements
- Ethical frameworks and procedures
- Co-ordination of research
The benefits of an affiliation policy are considerable.
Recent History
The immediate impact of the 2004 'Chichester' principles were the establishment of three affiliates: Play Therapy Ireland (2004),
Play Therapy Romania (2005) and Play Therapy Canada (2005).
In 2006 financial and management support has been provided to set up:
- Play Therapy Ireland
- Play Therapy France (Therapie de Jeu)
- Play Therapy Germany (Spiel Therapie Deutschland)
- Play Therapy Malaysia
- Play Therapy Russian Federation
- Play Therapy Slovenia
- Play Therapy Spain (Terapia de Juego)
Since 2007 further affiliates were set up:
- Play Therapy South Africa
- Play Therapy Africa
- Play Therapy Hong Kong
- Play Therapy New Zealand
- Play Therapy Singapore
PTI continues to service direct members in the US and over 20 other countries. The 'Play for Life' journal is published with over 120
A4 four colour pages in each year making it the largest international journal of play therapy practice. This is distributed free of
charge to all members of PTI and its affiliates. The SEPACTO database of play therapy clinical outcomes was expanded to include
cases from all PTI affiliated organisations as well as PTUK. Currently data is held on over 11000 cases, a valuable and unique
research resource. This shows the efficacy of play therapy - between 70% and 82% of the children receiving play therapy from
practitioners trained to PTI standards show a positive change - the worse the problems, the better the improvement.
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8. STRATEGIC OBJECTIVES FOR REGISTRATION
Following upon the above we are suggesting the following strategic objectives with the assistance of Play Therapy International:
- Establish Government and public recognition that play and creative arts therapies (Play Therapy) are a safe and effective way
of alleviating individual children's emotional, behavioural, social and mental health problems.
- Set up and maintain a suitable professional infrastructure to be provided by an RSA professional organisation, supported and
funded by PTI initially to achieve objective (i)
- Identify the standards for safe and effective practice that are needed in the RSA to be implemented through appropriate
training and monitoring by the professional organisation.
- Work with the Justice and other sectors in child protection to establish effective child protection and support services for
children who have suffered abuse.
9. GOVERNMENT AND PUBLIC RECOGNITION
9.1 The most effective approach
The most effective way of achieving recognition is:
- The contribution that Play Therapy will make to minimising social problems caused by individuals whose unresolved childhood
problems lead to anti-social behaviour in adult life.
- The positive impact that Play Therapy has in the short term of enabling children's potential to learn (particularly in Education,
but also in Health and Social Services).
- The necessity to regulate the Play Therapy profession. This will be a major step towards gaining public recognition.
The most difficult is (i) due to the lack of longitudinal studies, which are difficult to organize and fund. (PTI is prepared to offer match
funding for this purpose) However neurobiology evidence coupled with recent socio-economic research from the UK makes a
convincing case. (ii) may be accomplished through the presentation of PTI's extensive research through programme evaluation. In
the case of (iii) PTI, through PTUK, has been at the forefront of working with Government to introduce 'Right Touch' Government
Regulation for many varied professions.
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10. PROFESSIONAL INFRASTRUCTURE
PTI & PTUK in association with the UK Professional Standards Authority for Health and Social Care are experienced in advising
upon the most effective way to establish National Play Therapy professional organisations and is able to supply some financial
assistance as well as advice and technical help.
11. CONFORMING TO STANDARDS - TRAINING NEEDS
11.1 The use of standards
Standards of training and practice are the key to professionalism. They provide:
- Users of play therapy services with a clear idea of expectations
- A basis of job descriptions and selection procedures
- Measures of job performance
- The foundation of learning objectives for all levels of training
11.2 PTI's standards
Over the years PTI has built up several sets of standards that have been adopted and adapted in many countries. The most important is
the Competency Framework covering clinical supervision, filial play coaching and play therapy research as well as play therapy practice.
It consists of over 200 competencies backed up by over 1000 behaviour indicators. The competencies required for a particular training
course or job specification may be easily chosen. For an example see:
http://www.playtherapy.org.uk/Standards/PSM/CompetencyProfilePlayTherapist.htm
PTI licences its affiliated National Play Therapy organisations to adapt its international standards for their own use. Usually only minor
changes are required to ensure that the standards are culturally appropriate.
Develop an agreed set of RSA standards based on the PTI model.
11.3 Aligning current skills to standards
PTI has examined an example syllabus of an RSA Master's level Play Therapy training programme. It is their preliminary view that a
conversion of course of about 5 days for each of the PG Certificate and PG Diploma levels, would provide practitioners who have undertaken
this or a similar course with the skills needed to meet the PTI/RSA standards.
Run a 2 hour consultative workshop to identify the specific learning objectives of the conversion course.
Deliver one or more conversion courses.
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12. CHILD PROTECTION ISSUES
It is essential that:
- Clear procedures are in place to handle child disclosures of abuse (including definitions)
- Support is available for the child and family, over the course of the criminal proceedings, in a form that is acceptable to the Courts
- Child-friendly facilities are in place for witnesses
- There are clear guidelines for Play Therapists who are called to give evidence and as expert witnesses
Assess the effectiveness of child protection legislation and procedures
13. A WAY FORWARD - IMPLEMENTATION PLAN
13.1 First stage plan
This is based on the tasks identified above with an additional one, which is derived from PTI's policy of making countries self-sufficient in terms of training capability and professional infrastructure management.
| Task |
PTI Responsibilities and amount of days |
|
Task 1: Workshop for Government and leading NGO policy makers
|
Prepare and deliver a two day event, with two facilitators, which covering 4 these tasks. (teleconferencing)
PTI will bring an appropriate training kit.
PTI can advise on publicity and provide some material
PTI will set up a web site to promote the event
Time in RSA: 4 man days
Time in UK: 1 day
|
|
Task 2: Meeting to agree how to set up the professional organisation
|
|
Task 3: Develop an agreed set of RSA standards based on the PTUK model approved by the PSA
|
|
Task 4: Identify the specific learning objectives of the conversion course
|
|
Task 5: Deliver one or more conversion courses
|
Prepare and deliver events according to the outcomes of task 4.
Time in RSA: Estimated at 10 man days per conversion course with a maximum of 30 participants per cohort.
|
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Task 6: Assess the effectiveness of child protection legislation and procedures
|
Include as a facilitated one hour discussion in the two-day workshop.
|
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Task 7: Longer term sustainability
|
Engage in discussions with Universities to include PTI/APAC material in their courses and the training of their staff to deliver it.
PTI will give the one day workshop free of charge and will only charge flights and accommodation for 2, the second day is
chargeable and so are the 5 day workshops.
|
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14. WHO WOULD REGISTER AS PLAY THERAPISTS
- Only persons who obtained a Masters degree in Play Therapy at a recognised institution
- Completed Practical hours
- Completed Research in the field of Play Therapy
- Passed the registration international criteria
15. SCOPE OF PRACTICE FOR PLAY THERAPISTS
Keywords for Play therapy practice:
- Play, verbal and nonverbal observation
- Attachment theory
- Child development theory
- PROCESS ORIENTATION (through play)
- COMMUNICATION (Child's language)
- Developmental expression
- Participatory challenges (assessment) rather than diagnosis
- Participatory (analysis) needs assessment
- Participatory (intervention) goal settings
- Section 10 from the Children's Act (child's participation in own healing process)
CHILD JUSTICE ACT (Act no 75, 2008)
CHILDREN'S ACT (Amendment Act 41 of 2007)
CHILDLINE, Annual report. 2011
CHILDLINE, Crisis line business plan. 2011
DEPARTMENT OF SOCIAL DEVELOPMENT. 2011/12-2013/14. Strategic Plan. Pretoria: Social Development
http://www.guardian.co.uk/world/2009/jun/17/south-africa-rape-survey
JEWKES, R., SIKWEYIYA, Y., MORRELL, R., DUNKLE, K. 2009. Understanding Men's Health and Use of Violence: Interface of rape and HIV in South Africa. Pretoria: Gender an Health Research Unit, Medical Research Council
http://www.nspcc.org.uk
http://www.playtherapy.org.uk/Standards/PSM/CompetencyProfilePlayTherapist.htm
http://www.rte.ie/news/2011/0510/childline.html;
http://www.sahealthinfo.org/mentalhealth/traumaeffect.htm (2011)
SEXUAL OFFENCES ACT (Amendment 32,2007)
SOUTH AFRICA, Department of Police. 2010. Annual report. Pretoria: Government Printer. 192p.
SOUTH AFRICA, Department of Police, 2011. Crime. Pretoria: Government Printer. 12p.
SOUTH AFRICAN LAW COMMISSION, 2000. Sentencing. A new sentencing framework. Pretoria: Law commission
Analysis by Katharine Hall Helen Meintjes & Andile Mayekiso, Children's Institute, University of Cape Town
Data Source Statistics South Africa (2003 - 2010) General Household Survey 2002 - 2009. Pretoria, Cape Town: Statistics South Africa.
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