Introduction to Filial Therapy
Filial therapy is a special kind of play therapy. Literally thousands of families have been helped by this method developed by Bernard and Louise Guerney in the 1960s. It is a unique therapeutic method that involves parents and caregivers directly as the agents of therapeutic change.

Many play therapists practice some form of Child-Centered or Non-Directive play therapy. Filial therapy is a closely related form of Child-Centered Play Therapy. In traditional Child-Centered Play Therapy, the trained play therapist meets with parents or caregivers first and then works on his/her own with the child for a number of weeks or months. Every four weeks or so the play therapist meets with the parents to give feedback and discuss the child's needs and progress by focusing on the themes and meaning of the child's play rather than the details. The child's play sessions are private and the child forms an attachment relationship with the play therapist who is deeply listening to the child's expressed concerns during the non-directive play sessions.

In Filial therapy, parents are trained to conduct non-directive play sessions, usually referred to as "special play time", with their child. The training process itself is positive and playful. Subsequently, the parent conducts these non-directive play sessions with their child under the supervision of the therapist, thus deeply hearing the child's concerns and consequently strengthening the attachment with their child.

Filial Therapy usually takes 3-6 months to complete, and may last longer with follow-up sessions. It is suitable for children between the ages of 3 and 12 years old. Filial therapy is a very flexible model. As long as the essentials are taught to parents and the parents follow through, it can be adapted in various ways to meet the circumstances. Filial Therapy has been used successfully with many child and family problems: oppositional behaviors, anxiety, depression, perfectionism, abuse/neglect, single parenting, traumatic events, attachment/adoption/ foster care, relationship problems, divorce, family substance abuse, family reunification, chronic illness, and others

Filial Therapy Overview:
The therapist’s role is to be a combination of trainer, supervisor and coach who assists parents in learning how to conduct "special playtime" sessions with the child. Each parent/caregiver has a different relationship with their child, so each play session is conducted one parent to one child, and may be held with multiple children in the household. Filial therapy can be taught through a group model (usually a minimum of 12-15 sessions) or offered as an individual Filial therapy intervention.

Filial Therapy Process:
Stage One: Filial Therapy involves a series of stages. The Initial Stage is an assessment of the family, which includes an interview with parents/caregivers, a family play observation session, and parental observation of the therapist conducting a non-directive play session with their child/ren. The rationale for using Filial Therapy is explained at the end of this stage and parental consent to this process is acquired.

Stage Two is the training phase. Parents are taught how to conduct "special play time" sessions and then they carry out sessions with their child under the therapist's supervision. In the therapist's office, parents are trained how to conduct "special play time" sessions using the basic Filial skills of structuring, empathic listening, limit setting, and imaginary play. The therapist spends two or three weeks training the parents in the basic Filial skills through a playful, supportive method using lots of positive feedback to support effective learning.

Next, for 4-6 weeks, in the therapist's office, the parent gets to conduct 1:1 play sessions with their child while the therapist observes. After each session, the therapist meets alone with the parent to talk about what happened in the session (use of skills, play themes) and the therapist provides positive and detailed feedback and highlights maybe 1 or 2 skills to work on.

In the final piece, Stage Three, the parent-child Filial sessions are transferred to home. The parent conducts a 30-minute Filial session with their child every week at the same time, on the same day, and in the same place. Parents continue to hold a weekly 30-minute Filial session with their child for as long as necessary or as long as the child wants to for a minimum of 6 months.

After the transfer to home, the therapist initially meets with parents once a week, discussing the sessions, exploring the themes in the child's play, and helping parents generalize the basic parenting skills used in the Filial sessions to real life problems in the home. As the parents progress and positive changes are seen in the family relationships and the behavior of the child, the office sessions with the parents becomes less frequent (every two weeks, one time a month, to once in several months) and are followed by a final "check up" with parent and therapist to conclude the therapy.

Conclusion:
Typically children love having "special play time" with their parents. Parents also find that the time spent together in Filial play is so valuable and special that they are happy to do this. Filial Therapy helps parents develop a consistent parenting style. Parents usually find that their relationship and attachment to their child is greatly enhanced.

Filial Therapy helps children and families

Filial therapy can help children to express their feelings and fears through the natural activity of play. Over time, children may:

  • Understand their own feelings better
  • Become able to express their feelings more appropriately
  • Be more able to tell parents what they need, what is worrying them
  • Become more confident and skilled in solving problems as well as asking for help when they need it
  • Reduce their problem behaviors
  • Feel more secure and trust their parents more
  • Have a more healthy self esteem and increase their self-confidence.

Filial therapy can help parents to:

  • Understand their child's worries and other feelings more fully
  • Learn new skills for encouraging co-operation from their children
  • Enjoy playing with their children and giving them positive attention
  • Increase their listening skills and develop open communication with their children
  • Develop self confidence as parents
  • Become more able to trust their children
  • Deal in new ways with frustrations in family life

Filial therapy can help parents and children to form closer and happier relationships.

Frequently Asked Questions

How can play help?
Play is a child's natural way to explore their world. Children also use play to find solutions to problems. Play can be healing. Children's thoughts and emotions come to the surface during play. You can often find out more about how a child views the world by watching and joining in their play than you can by asking them to tell you what is wrong, or asking why they did something.

Why is Filial Therapy used with children ages 3 - 12?
Children between the ages of 3 and 12 can best express their emotions, their motivations, their wishes and dreams through the language of play, especially when difficult issues are involved. Usually children under the age of 3 do not yet play imaginatively. Children over 12 are better able to express themselves verbally, although Filial is often used with young teenagers if appropriate kinds of activities are used.

What is special about the play in Filial play sessions?

  • One parent plays with one child at a time.
  • The parent focuses exclusively on the child without interruption for 30 minutes.
  • The child gets to lead the play, not the parent.
  • The parent learns how to listen empathically to their child's feelings, thoughts and even actions without questioning, teaching or praising. Most parents find this very strange at first.
  • The parent learns a simple method to set limits on the child's behavior. This method of setting limits develops responsibility. Parents practice these skills in mock play sessions during training with the therapist.
  • Parents to learn to generalize these skills to real life situations in their lives.

What does "setting limits" mean?
In Filial sessions, a child can do almost anything s/he wants to, but if there is anything s/he may not do, then you as the parent "set the limit". For example, you will want to prevent either yourself or the child from getting hurt and property from being damaged. You will learn a three step limit setting procedure.

  • First, you set the limit or state the rule. (Cindy, the rule is you cannot throw a block at me, but you can do almost anything else.)
  • Second, you give the warning or state the consequence. (Cindy, the rule is you cannot throw a block at me, if you do it again "special playtime” will end. But you can do almost anything else)
  • Third, you enforce the rule. (Cindy, remember I told you cannot throw a block at me; you chose to throw a block again; special play time is over for today. It is time to leave the playroom. You will have another play session next week.)

This is a very effective method for a child to learn to be responsible for his/her own actions. Most children love their Filial play sessions and do not want to leave. When they realize that the parents mean what they say, then they stop and think, and change their behavior.

What would a child do in his or her Filial play sessions?
Your child will enter a play area which has toys that allow a child to imaginatively play out different therapeutic themes (aggression, family relationships, nurturing, fears, anxieties, etc). During a session a child is allowed to choose how to spend the time. S/he might play alone, play with you, or not play at all. S/he might talk a lot or remain silent. The parent accepts all feelings and any behavior unless there is a need for a limit (see above).

What does the parent do?

First, the parent is trained by the therapist in how to conduct these sessions. Then in the therapist's office, the parent conducts 30 minute play sessions with the therapist present. A play session is followed up by a discussion between the therapist and parent. The parent receives coaching and support from the therapist to help improve his/her skills and begin to understand the play themes. After 4-6 sessions, the parent begins to conduct 30 minutes play session one time a week with their child at home.

What happens after a parent is doing play sessions at home?
The parent meets weekly with the therapist to discuss the play sessions and begin to further explore the meaning of the child's play. The themes of the play will often help the therapist and parents understand what is motivating their child's behavior. This leads to a deeper appreciation and understanding of the child's inner struggles. The parents and therapist continue to work together to resolve the underlying issue that caused the difficulties.

What does the parent learn?
Parents learn special skills for use during the play sessions - empathic listening, limit setting, structuring and imaginative play. These skills are basic parenting skills, which later can be transferred to daily life to help with problems at home.

What does the Filial therapist do?
The therapist trains the parent(s) over a number of weeks, and then supervises the weekly Filial play sessions between parent and child in her/his office. When parent and child are ready, they have Filial play sessions at home without the therapist. Parent and therapist continue to meet for feedback and training. Together they determine the progress of therapy and when to gradually terminate formal therapy. The therapist remains available for future contact as needed.What about the other children in the family? Ideally, every child in the family will have either a Filial play session or a "special time" with one parent once a week. Sometimes parents can start weekly Filial sessions with all their children (on an individual basis). For some families this is not possible e.g. a single parent; several children; some children below 3 or above 12 year old. The therapist discusses these issues with parents.

Is Filial therapy new?

Filial therapy was developed in the 1960s by therapists Bernard and Louise Guerney. Rise VanFleet, Garry Landreth and Sue Bratton have all developed models of Filial therapy and continue to practice and research it. Filial therapy has been extensively researched in the last 40-45 years. It has been shown to help a wide range of families. Research also indicates that progress in family and child functioning tends to last rather than then fall off after the therapist's involvement ends.

What kinds of families can be helped by Filial therapy?
Families of many kinds have been helped by Filial therapy, including single parent families, blended families, foster families and adoptive families.

What kinds of problem can Filial therapy help with?
Filial therapy can be used as a treatment for a range of children's problems, e.g. acting out, acting in (depression or anxiety), perfectionism, oppositional behaviors, trauma and attachment problems, and self-regulation difficulties. Filial Therapy has been used successfully with many family problems: abuse/neglect, single parenting, traumatic events, attachment/adoption/ foster care, relationship problems, divorce, family substance abuse, family reunification, chronic illness, and others.

Filial therapy can also be used to prevent future difficulties.