402 | Understanding Extreme Dysregulation and Trusting the CCPT Process

About this episode

This episode discusses the challenges of working with a dysregulated child in play therapy and emphasizes the importance of trust in the therapeutic process.

In this episode, I answer a question about a 7-year-old child whose play therapy sessions have been marked by extreme dysregulation, constant limit setting, destruction of materials, and very little observable progress after 16 sessions. I explore several possible explanations for this kind of presentation, including neurodivergence, developmental immaturity, a complete lack of experience with self-regulation and autonomy, and the possibility that the child is testing whether the therapeutic relationship can withstand his most challenging behaviors. I also discuss why children who appear chaotic externally are often revealing the chaos they experience internally, and why those behaviors can provide valuable insight into what is happening beneath the surface. Most importantly, I address the therapist's understandable concern that the process feels "clunky" and ineffective. When a child is this dysregulated, progress is often slower and less obvious, but that does not mean change is not occurring. I explain why these cases require extraordinary patience, trust, and adherence to the model, even when there is little external evidence that things are improving. Sometimes our most…

People in this episode

Host: Dr. Brenna Hicks

Topics covered

• extreme dysregulation
• child-centered play therapy
• therapeutic relationship
• self-regulation
• neurodivergence
• developmental immaturity

Keywords

• play therapy
• dysregulation
• self-actualization
• therapeutic process
• CCPT
• child behavior
• neurodivergence
• patience

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