CC was a 5 year old boy who was seen for regular, individual, weekly sessions of one hour each for 6 months in his school. He was referred for therapy due to concerns regarding his emotional development and behaviour. He would lash out unexpectedly at his peers and did not seem to display any empathy for their distress. In addition his behaviour and concentration were having an impact on his learning.
Social services were also involved due to concerns about chronic neglect. CC lived with both his parents, who had a history of drug abuse in a 1 bedroom flat. By the end of therapy, CC was due to be taken into foster care.
The aims of the intervention were agreed as being: to decrease aggression, improve attention and listening skills and increase self esteem.
At the beginning of the intervention, CC presented as wary, with a flat facial expression (affect). He often ignored the therapist and would shut down when it was time to end the session and say goodbye. He would flit from activity to activity and the therapist first took on the role of commentator as a means of connecting with him and becoming part of his play in a non-invasive way and making sense of what he was doing. This is often a developmental stage that occurs with parents and infants. CC tended to choose activities that involved trying things out or lining them up with little imagination or creativity.
As intervention progressed, CC began to demonstrate an ability to spend longer on single activities or would return to them to complete them. He also began to acknowledge the therapist in his play by asking questions or giving instructions. CC began to engage in more creative activities – making a mask on one occasion or playing imaginatively with puppets, where they would take on personalities of their own and were being used to tell simple stories or interact with the therapist.
By the end of the intervention, CC was able to focus on an activity of his choosing within the session for 15-20 minutes at a time. He was interacting fully with the therapist as part of role play. He was able to ask for help when stuck and demonstrated a full range of emotions. In addition, he helped the therapist when ‘hurt’ as part of a role play situation, indicating a development of empathy. CC was also able to say goodbye at the end of the session and asked to take a token ( a small toy) to remember the therapist by.
Throughout this time, trust developed between CC and the therapist and there were clear signs that a more secure attachment style was developing in this relationship which would suggest a more positive outcome for relationships in the future. By the end of the intervention teaching staff reported that CC’s attention and listening had showed some signs of improvement and he was less likely to strike out at other children. It should also be noted that the Dramatherapy intervention ended because the therapist was moving away and the school that CC went to was also closing. It was strongly recommended that CC continue with Dramatherapy to continue to build on the positive outcomes already achieved.