Puppets in therapy assessment and diagnosis

Abstract

Since children are generally not good candidates for “talk therapy”, play is often a modality that therapists use to enhance understanding and communication in treatment. Among many possible assessment tools suggested in work with children are puppets which appeal to a wide age range and are familiar toys to many. This article describes and compares nine different puppet therapy assessment techniques. The assessment techniques are: Spontaneous Group Puppetry; The Puppet Therapy Assessment Technique; The Family Puppet Interview; The Ross Family Puppet Technique; Puppets in Psychotherapy Scales; The Dynamics of Three; The Puppet Sentence Completion Task; The Berkeley Puppet Interview; and The Affect in Play Scale.

The current study is a qualitative interview study in which thematic analysis has been applied.   Five themes emerged in the analysis: methods and techniques in puppet assessment; assessment in therapy: assessment in diagnosis; different levels of structure; and what works for whom. The level of structure is emphasized in the discussion, as are age considerations. Conclusions suggest aspects in favor of, and against, using these assessments. Aspects in favor of using the techniques are, for example, the need for therapist flexibility; the necessity to create rapport; the importance of an appropriate assessment tool; and the requirement to adapt the level of structure to the client. Possible contraindications may be the child’s age, because young children may be too immature for symbolic play, and severely disturbed children may lack the necessary emotional and/or cognitive skills for puppet play.