KISEP Review 11 2 2000 Korean J Child & Adol Psychiatr 11161~178 놀이정신치료 PLAY PSYCHOTHERAPY 곽영숙 * Young Sook Kwak, M.D., Ph.D.* 요약 중심단어 역사와분류 161 Department of Psychiatry, Cheju National University Medical School, Cheju
162
놀이의기능과임상적응용 1. The Functions of Play Behavior Biological Learn basic skills Reflexes release excess energy Kinesthetic stimulations Intrapersonal Functionlust Mastery of situations Exploration Develop understanding of the functions of the mind, body, and world Cognitive development Mastery of conflicts Symbolism and wish fulfillment Interpersonal Development social skills Separation- individuationplay can serve as a distraction when significant others are absentit can be used to master the anxiety associated with separation and can utilize objects symbolically to replace significant others who are absent. Sociocultural Imitate desired roles 163
2. 놀이의임상적응용 3. 놀이실과장난감 1. 정신분석적치료 주요치료접근방법 ü 1) 쾌락원칙 (Pleasure principle): 욕구충족의쾌감 (Gratification pleasure) 과기능적쾌감 (Functional pleasure) ü ü 164
2) 반복 : 반복강박 (Repetition compulsion): 반추 3) 수동성에서적극성으로 4) 동화과정 (Assimilation process) 5) 속뚫림 (Abreaction) 6) 숙달본능 (The instinct of mastery) 7) 8) 환상과백일몽 (Fantasy and day dream) 165
2. 비지시적 (nondirective) 치료 166
놀이치료에서발달론적접근 1. 발달과정으로서의놀이 1) 감각-촉각탐색욕구 2) 근육-운동욕구 167
3) 기본신체적욕구와연관된표상적놀이와건설적놀이 (Representational & Constructive play) 1) 자기애적놀이 2) 전외디프스기놀이 168
3) 외디프스기놀이 4) 외디프스기이후의놀이 1) 감각운동놀이 2) 상징적또는가상놀이 169
3) 게임 2. 놀이발달모델의치료적이용 1) 감각운동놀이의치료적이용 170
2) 가상놀이의진단적, 치료적이용 171
3) 게임의치료적사용 3. 인지발달적측면 1) 감정, 동기, 자신을이해하는데있어서의발달적변화 172
173
2) 행동의동기와원인에대한아동의이해 3) 자기깨달음의변화 4. 치료과정 1) 놀이에서언어로 (From play to talk) 174
2) Erikson의심리적사회발달모델에따른치료과정과치료기술 175
References 1) Freud S(1909):Analysis of a phobia on a fiveyear-old boy. In:standard edition. London:New York, Hogarth 2) Hug-Hellmuth H(1921):On the technique of childanalysis. Int J Psychoanal 2:287-305 3) Klein M(1932):The psychoanalysis of children. London, Hogarth Press 4) Freud A(1965):Normality and pathology in childhood. New York, International Universities Press 5) Lowenfeld M(1939):The world pictures of children. Br J Med Psychol 18:65-101 6) Bender L, Schilder P(1936):Form as a principle in the play of children. J Genet Psychol 49:254-261 7) Erikson EH(1940):Studies In the interpretation of play. Genet Psychol Monogr 22:557-671 8) Levy D(1938):Release therapy in young children. Psychiatry 1:387-389 9) Solomon J(1983):Active play Therapy. Am J Orthopsychiatry 8:479-498 10) Hambridge G(1955):Structured play therapy. Am J Othopsychiatry 25:601-617 11) Rank O(1936):Will therapy. New york, Knopf 12) Taft J(1933):The dynamics of therapy in a controlled relationship. New York, Macmillan 13) Allen F(1942):Psychotherapy with childern. New York, Norton 14) Moustakas C(1959):Psychotherapy with children. New York, Haper & Row 15) Axline V(1947):Play Therapy. Boston, Houghton- Mifflin 16) Gerard ME(1948):Direct treatment of the child. In:LG Lowrey and V Slone(Eds.), Orthopsychiatry. New York, American Orthopsychiatric Association, pp494-523 17) Bixler RH(1949):Limits are therapy. J Consult Psychol 13:1-11 18) Ginott H, Lebo D(1961):Play therapy limits and theoretical orientation. J Consult Psychol 25(4): 337-340 19) Shaefer C, Millman H(1977):Therapies for Children. San Francisco, Jossey-Bass 20) O Connor KJ, Schaefer CE(1983):Major approaches to play therapy. In:Handbook of Play Therapy. CE Scharfer, KJ O connor(eds)., New York, John, 176
Wiley and Sons 21) 홍강의, 조수철 (1985) : 놀이의기능과의미. 정신의학보 8(6):191-196 22) 이재명 (1980): 놀이요법의이론과실제. 정신의학보 4(11):211-214 23) 진성태 (1979): 놀이의정신분석이론소고. 정신의학보 3(2):291-293, 311-313 24) Lewis M(1974):Interpretation in child analysis: developmental considerations. J Am Acad Child Psychiatry 13:32-53 25) Esman AH(1983):Psychoanalytic play therapy. In:Handbook of Play Therapy. CE Schaefer, KJ O connor(eds)., New York, John Wiley and Sons 26) Axline V(1969):Play therapy, rev. ed. New York, Ballantine Books 27) Guerney LF(1983):Client centered(nondirective) play therapy. In:handbook of play therapy. CE Schaefer, KJ O connor(eds)., New York, John Wiley and Sons 28) Hellersberg EF(1955):Child's growth in play therapy. Am J Psychotherapy 9:484-502 29) Peller LE(1964):Libidinal Development as Reflected in Play. In Child Psychotherapy. M Haworth(Ed), New York, Basic Book 30) Piaget J(1962):Play, dreams and imitation in childhood. New York, Norton 31) Jernberg A(1969):Here I am. 16mm film, available from The Theraplay Institute, 333 N Michigan Ave., Chicago, Ill. 60601 32) Pulaski M(1974):The importance of ludic symbolism in congnitive development. In:J Magary, M Poulson, G Lubin(Eds), Proceedings of the third annual UAP conference:piagetian theory and the helping professions. University of Southern California Press 33) Roseblatt D(1977):Developmental trends in infant play. In Biology of Play, Tizard B and harvey, D London, Heinemann SIMP 34) Marschak M(1979):Parent-child interaction and youth rebellion. New York, Gardner Press 35) Brody V(1978):Developmental play:a relationshipfocused program for children. Child Welfare 57(9): 591-599 36) Murphy L(1956):Methods for the study of personality in young children. New York, Basic Books 37) Slaveson SR, Schiffer M(1975):Group psychotherapies for children:a textbook. New York, International Press 38) Gardner RA(1971):Therapeutic communication with children:the mutual story telling technique. New York, Jason Aronson 39) Schachter RS(1974):Kinetic psychotherapy in thye treatment of children. Am J Psychotherapy 28(3): 430-437 40) Jernberg AM(1973):Coming alive throubh theraplay. Paper read at the American Personnel and Guidance Association, Sandiego, February 9-15 41) Harter S(1983):Cognitive-Developmental Considerations in the Conduct of Playtherapy 42) Inhelder B, Piaget J(1954):The growth of logical thinking from childhood to adolescence. New York, Basic Books 43) Selman R(1980):Interpersonal Understanding. New york, Academic Press 44) Spivack G, Shure M(1974):Social adjustment of young children:a cognitive approach to solving reallife problems. San Francisco, Jossey Base 45) Bowlby J(1976):The making and breaking of affectional bonds. Ⅱ. some principles of psychotherapy. Maudsley Lecture at the Royal College of psychiatry 46) Erikson EH(1963):Childhood and Society. New York, Norton, pp247-274 47) Bruner JD, Jolly A, Sylva K(1970):Play. New York, Basic Books 48) Alexander F(1946):The principles of corrective emotional experience. In:Psychoanalytic Principle, F Alexander and French TM(Eds)., New York, Ronald Press 49) Hong KM, Greenberg ML(1980):A developmental approach to teaching and practicing child psychotherapy. Psychiatry Bull 177
ABSTRACT Korean J Child & Adol Psychiatr 11161~178, 2000 PLAY PSYCHOTHERAPY Young Sook Kwak, M.D, Ph.D. Department of Psychiatry, Cheju National University Medical School, Cheju The author reviewed history and development of variable approaches of play psychotherapy. To understand basic concepts and practical factors of play, the functions of play behavior and it s clinical application were summarized. As major therapeutic approaches, both theoretical concepts and practical techniques of psychoanalytic approach and those of nondirective approach were presented. For clinician it is important to know developmental theories which can be applied to various therapeutic technics and to apply these theories to play therapy situations. So, to know the developmental approach in play psychotherapy, play as a developmental process, its therapeutic application, play in the perspective of cognitive development and the therapeutic process of play psychotherapy were reviewed. With the knowledge of developmental concept therapists can increase their abilities to prescribe an appropriate type of play therapy. KEY WORDSPlay psychotherapy History & classification The functions and clinical application of play Major therapeatic approaches Developmental perspective. 178