How to Stop Dreading Your Complex Play Therapy Cases

Are you dreading that "challenging" case on your schedule?  

The client who wreaks your room or doesn’t talk during their play therapy session?  Or the parent session with a parent that seems to avoid you yet calls you frequently between sessions telling you everything that’s not working?

As play therapists, we often define a challenging case by the severity of the trauma, the intensity of the behaviors, or the complexity of the family system. 

But what if the "challenge" isn't the case itself, but how you make sense of the problem and the clinical framework you're using to navigate it?

In this week’s free podcast episode, we are redefining what it means to work with complex cases. 

We’ll explore why one play therapist feels overwhelmed while another feels manageable with the exact same client—and how a clear play therapy clinical framework makes all the difference.

In this podcast, we cover:

• Redefining "Challenging": Why complexity doesn’t have to mean chaos.
• The Power of Getting to the Root of the Problem: Moving beyond the psychosocial assessment form to create a "living map" for every play therapy session.
• Trusted Framework vs. White-Knuckling: How to stop guessing and start making intentional clinical decisions.
• Seeing REAL Progress: Learn to identify the stages of healing so you know exactly why you’re choosing specific interventions—whether directive or non-directive.

When you can identify why something is happening AND you have a framework guiding your clinical decisions, challenging cases stop being something you dread and start being something you can engage with intentionally. 

Don’t let your caseload lead to burnout. It’s time to move from "hoping it works" to knowing why it’s working.

Join the Conversation: When you hit a wall with a challenging play therapy case, what is the very first thing you do? Do you seek consultation, dive into research, or take a moment to pray? Let’s be honest in the comments—we’re all in this together!

🔗 CONNECT WITH RENEWING HEARTS PLAY THERAPY TRAINING:

🌐 Website: www.rhplaytherapytraining.com

Register for the free webinar - How to Provide Play Therapy Without Second-Guessing Every Clinical Decision, Even With Complex Cases: https://www.rhplaytherapytraining.com/f/ptec-webinar

Join my free Facebook Community Play and Expressive Arts Therapy Playground.

Check out my free resources for mental health professionals working with children, adolescents, and families who want to integrate play therapy and expressive arts into their clinical work.

I work with individuals and agencies to develop successful strategies and meet the treatment needs of your child and adolescent clients and their families using play therapy & expressive arts.

Contact me to schedule a free 30-minute video call if you're ready to level up your skills

Transcript

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Welcome to Next Level Play Therapy, a weekly podcast dedicated to supporting the next generation of child and adolescent therapists to provide exceptional play therapy services. We'll explore all things play therapy to elevate your work with children and adolescents using the therapeutic powers of play. I'll discuss practical tips and ideas so you can provide a transformative experience for your young clients and make a real difference in their lives. So get ready to take your play therapy skills to the next level and make a lasting impact in the lives of children, adolescents, and families. Hey there. Welcome to this week's episode of Next Level Play Therapy, where we talk about all things play therapy, and today's topic is going to be how are we defining challenging when we're working with clients. So for example, are you dreading that client who sh- shows up on your schedule? These are the clients who are usually the ones who maybe have wrecked your room, or maybe you can't get them to engage in the play therapy session, and you've tried everything and anything and nothing seems to be working. Or maybe that parent who is calling between sessions telling you all of the things that are happening. They're worried, they're worried play therapy's not working, but this is also the parent that you can't get to show up for the parent sessions so that you can work through some of these things. So how we define challenging is often gonna be defined by certain things like the severity of the trauma, or the intensity of the outbursts, or the frequency of those 911, I call those the 911 calls that w- the distress calls we get from parents, or maybe even, um, it's a, it's a Diagnosis that you are not very familiar with, and you didn't really figure that out until you already got started. These are the cases that we typically define as challenging, and I wanna kind of challenge, challenge us to think about that term a different way. What if we looked at challenging a different way, and then that's gonna influence how we are working with these clients. So if any of this resonates for y- with you, if you have those clients on your caseload that you dread and you feel overwhelmed by or not sure what to do, and you know which ones they are because we all have them. I'm gonna, I'm gonna talk about this topic, and this comes from a place of being in the child and adolescent mental health field for, I'm coming up on 35 years now. So the things that I've learned along the way, and because I talk to play therapists all the time, we talk about these things when people call me to schedule a 30-minute video call to see if Play Therapy Academy is a good fit, or maybe Play Therapy Elevation Circle is a good fit, or we talk about these things in Play Therapy Academy. And also, we were just talking about this the other day in Play Therapy Elevation Circle, this idea of, of challenging clients. And what I wanna do today is kind of look at that idea of what we are saying is challenging because it has to do with our mindset and how that mindset influences what we do and how we do it, as well as what are we doing. What are we doing in the play therapy sessions? And so that is our topic for today. My hope is that you're gonna walk away from today's livestream episode, if you're watching live or if you're listening or watching the replay or if you're listening to the podcast, my hope is that you're gonna walk away from today's episode having your mindset shifted a little bit, and with that shift comes a little more intention and an idea of how to navigate through it basic- So if you're watching live, I would love to see who's here today. Post in the comments where you're from, what population you work with. Um, we have somebody on Link- uh, YouTube posting, "Abuse recovery is challenging." I would definitely agree with that, and my hope is with today's episode, you're gonna maybe even think about that a little differently in a way that will help navigate this with more attention, less overwhelm, and, um, a clearer idea of how to work with these cases. Because the reality is we are going to have cases that feel overwhelming. They feel challenging. We're gonna feel stuck, and we are probably not gonna know what to do. And also, at the end of today's episode, um, so you may wanna stay tuned. I'm also gonna talk about a free webinar that I have coming up that's gonna go into this topic a little bit more in depth. So you'll definitely wanna register for that. And let's get started for today. Oh, I forgot to also say, if you're watching on the… I get distracted by the, the comments, 'cause I love it, the, the relevant ones. Sometimes people post comments and I'm like, "Really? Come on." Um, but that, uh, when you're actually joining in the conversation, it's very interesting. Anyways, I get a little distracted, like I did just now, going down my rabbit hole. Um, so if you're watching the replay, please feel, feel- please feel free to post in the comments as well. If you're listening on the podcast, I would love it if you would leave a review on Apple Podcast or Spotify. What's your takeaway from today's episode? Also, um, it also helps more people have access to the podcast episode, so leave a review. Or also, if you're listening to the podcast, feel free to follow me on Instagram@renewingheartstraining. Message me, post in the comments when we post the podcast episode on there, and follow along. If you're watching on YouTube, remember to hit that subscribe button and the notification so that you know when there are new episodes, um, coming and also that you don't miss out. Okay, so let's get started for today. All righty. Today's topic is how to stop dreading your complex play therapy cases. The first thing that we wanna look at is what makes a case challenging? How are we defining challenging? This is… And the reason this is important, because it has to do with our mindset, and here's the thing. I'm gonna g- I'm gonna give you an example. I'm gonna share some of my online struggles. I so I've been trying to figure out how to crack this Instagram code. I would rather stick needles in my eye than go and do a video to post on Instagram. There, I put it out there. It's live now. I, I, I hate social media and I hate doing videos, so think about what that does for my mindset. And I have to give myself a chat about this all the time. In fact, I was just chatting it, uh, about it with one of the programs I'm part of, about, about my mindset. Okay, so here's my mindset. I hate social media. I particularly, these days, hate recording videos to post on stupid Instagram. Okay, you get my mindset here. It's negative. I'm viewing it negatively. So that's gonna also influence how I show up in this, in, on videos. And if you watch my videos, you can tell which ones I'm tired and I don't wanna do it, and I do it anyway 'cause I'm trying to push through, right? I'm trying to white-knuckle it, which I don't think that's working very well. So I had a chat with myself this morning before I went live. I really have to focus on my mindset. So what does this have to do with play therapy? I would say everything. It has everything to do with your mindset about a client, about how you're conceptualizing what's going on, and Challenging, right? We all have them. We all, we're human, e- and we are going to have these clients because we are hu- human. And then our job is to figure out what's going on with that. Today's episode is hopefully to take one part of that. It's not everything. There's a whole bunch of things we look at, but maybe just take one part of it by looking at how are we defining challenging. And challenging is gonna then influence how we approach this play therapy session or how we approach the work that we're doing with our clients. And so let's, let's look at that idea about challenging. So challenging is typically the way that we define that is based on the presenting problem. So it might be the severity of the, of the trauma impact. It might be the personality of the parent that we're working with, and there might be what I call some adult attachment issues with the parent that you're working with. So it might be that. That might be challenging. It might be the severity of the emotion dysregulation that your client is experiencing, which is also gonna result in getting lots of phone calls from parents who are worried and distressed. But maybe these are also the same parents who you can't get to come in for a parent session so that you can begin to strategize and get some traction, uh, about what, how things are being handled at home. So maybe that's how you're defining challenging, and it's also the complexity of the family system. So here's the thing, though, and here's where I wanna challenge your mindset a little bit, not to overuse that word challenging, and apparently I am. It's a good word, actually. So let's, let's look at this a different way The same case that feels overwhelming to you might not feel overwhelming to another play therapist. And so why is that? And the difference isn't specifically the presenting issue, right? Let that sink in. The, it isn't usually the presenting issue, the reason one person feels overwhelmed by the case and another person does not. The difference I find, one, one of the big differences, there's usually some other things, but I'm gonna talk about this one specific one that I think definitely moves the needle when you are trying to help your clients. And I, I see this all the time. When I, when we're, when we're doing consultation in Play Therapy Academy, when we're doing consultation in Play Therapy Elevation Circle, this is the thing that makes all the difference All the difference. That makes the big difference. I would, I would honestly, I would say all the difference in a lot of ways. That makes all of the difference is when you have a clear clinical framework, that is gonna decide your decision-making, how you make sense of the problem, um, and it, it becomes something you can work with if you have that clinical framework. That clinical framework doesn't fix the problem What it does change is how you go about addressing and working with that client, and then it's not something that you feel like it's working against you. It's a way to help you navigate through it with a lot more intention. And so here's what a, here's what a clinical framework does with a challenging case, right? It takes what feels like chaos and organizes it. It asks what stage of play therapy is this child in? What does the therapeutic relationship need right now? And how am I gonna show up in that therapeutic relationship? What am I going to do? How am I gonna do it? And it also gives you indicators of when progress is being made, and if you're moving in the right direction with your clients. And so suddenly, that case that felt like a test with no answer key is now feeling like the puzzle where you understand where all the puzzle pieces fit, and now you feel like you have the tools to work through what's going on. And so, um, here's what I've seen way too many play therapists do when they get a challenging case or when they're working with challenging parents. They have a tendency to avoid them, or when they're feeling overwhelmed and then their imposter syng-- syndrome kicks in because they're second-guessing all of their decisions and thinking, "Oh, I shouldn't have taken this case," then they probably start thinking about referring out. And I'm not saying referring out is the wrong thing to do. What I wanna push back a little bit on with this, because I have seen this happen so many times, I'm not gonna lie, it's kind of my pet peeve. It's… I find it really, really frustrating, thing about our mental health field is, "Oh, this makes me really uncomfortable, and I don't know what to do, so I'm just gonna refer it out," rather than thinking about it more intentionally and you getting a clear clinical framework that's gonna help you navigate through it, and then probably, I would also say, have some support. I don't think we can do this job alone. I think being a play therapist, and I would say a mental health professional in general We need a community of support. We need people to think alongside with us to help us figure things out when we get stuck. So a challenging case also when you have a clear framework and a community of support no longer feels challenging. I see that all the time in Play Therapy Academy and Play Therapy Elevation Circle, where what felt challenging and now I don't know that I can work with this case now becomes, oh, okay, I see this more clearly. Here's my framework that I'm gonna use, and now I know what to do, and I have other ideas about what I want to do. So now you're not white-knuckling it anymore through every session hoping something sticks, because that doesn't help the child, and it doesn't help you,'cause it's probably why you're feeling overwhelmed. So tell me in the comments, have you ever had a challenging case? What's the first thing that you do when you get a challenging case? What's the first thing you do? Do you consult with somebody? What play therapy model do you refer back to? Do you hit the research like I do sometimes? Although, research is this whole other thing that is on my list these days. It's good, I like it, but I just heard something the other day about research and some, the way somebody used the research that made me go tilt, tilt, tilt. Um, do you pray? Do you like hit your Dr. Google and find all the activities? What, what do you do when you find a challenging case? So post that in the comments, or send me a message, or if you're listening on the podcast, send me an email. I would love to know what your thoughts are about that. So the, this brings us to the next thing, which is case conceptualization. And if you've listened to any of my previous episodes, you know this is something that I talk about a lot. What is case conceptualization? It's not something you do at your psychosocial assessment, a- ask all the questions, and then you never refer to it again. Your case conceptualization is kind of your, um, it's an ongoing process. So it, in some ways, it, it becomes a little bit of your roadmap because it influences your decision-making. It helps you figure out what's at the root of the problem, and then throughout the play therapy process, you are gonna be revisiting that. Uh, because from every session, you're getting more information. From every, um, conversation with parents or caregivers, you're getting more information. Everything is information. Even the meltdowns in the sessions, even the hard phone calls with parents. All of that is information And that's the key. You use that, go back to your case conceptualization and update it. It's kind of like I, I kind of think of it as, um, you know, you, you- as you go through, let's say you're using your GPS and you plugged in what you think is, uh, where you need to go, and then let's say you get off track, then your, your GPS system is gonna use the information from what it's picking up in that area with the satellite and update it. Um, so your case conceptualization is ongoing. Um, another Facebook, I mean, uh, YouTube person says, "I feel better and relieved. How did I forget what I learned in graduate school?" I know, right? Doesn't it feel a little bit like graduate school-y? Um, but here's the thing, all… That's the fundamentals, right? I think about this all the time, the fundamentals and the basics. Those are our roadmaps. That is what we come back to. It helps to ground us. So we're gonna use that case conceptualization to help figure out at the very beginning, what is at the root of the problem? What is my hypothesis about what's at the root of the problem? Because that's gonna guide my decision-making and give me the, um, give me some information about what I need to do. It's the key to the mystery, and the mystery is: why is my client acting this way? Well, when you do your case conceptualization, that gives you the key to the mystery, why your clients are struggling. And then you're gonna update it as you get more info going through the process. And so then you use that information with your play therapy model, because your play therapy model influences how are you making sense of what's going on in the playroom. For example, a child-centered play therapist is gonna make sense of what's going on in the playroom differently than an Adlerian play therapist, differently than a Gestalt play therapist, differently than a cognitive behavioral therapist, differently than somebody using EMDR or parts work. Your play therapy model is grounded in a theoretical lens, and that theoretical lens is gonna influence your case conceptualization, which is basically how are you making sense of what's at the root of the problem and why is it, this problem continuing to happen, the patterns and things like that. Then your play therapy model is actually the GPS map showing up on, in your car or on your phone. Now, your case conceptualization gave you the information about where you are, and your play therapy model is gonna be like your map showing, like, on, up on the screen and the voice coming across, um, you know, the voice of the GPS telling you where to go and when to go. Um, and so your play therapy model is gonna influence what play therapy interventions you choose. Are you gonna be directive or non-directive? What are you looking for for indicators of progress? How are caregivers involved? And, um, what you're gonna do, when you're gonna do it, and how you're gonna do it. And so all of this flows through from case conceptualization through your play therapy model, and when that piece is clear, then challenging cases stop being something you dread and start being something you can engage with with intention. Because when that piece, when that case conceptualization is unclear, then you don't really know what you're working on or why you're working on it, and this is usually where I find play therapists start doing the spaghetti against a wall method, where they're trying any and every play therapy activity they know in the session to try and see if something sticks. Like, that in and of itself is gonna unlock the whole problem, and that's, that's focusing on the external. You wanna go to the internal, meaning you wanna figure out what's actually going on with that behavior, and what does your play therapy model say? When you do that, you're looking at these challenging cases a different way, and then you're not white-knuckling it anymore. You're coming back to the foundation. You're coming back to the basics that's gonna ground you in what you're doing. All right, so we have another comment. Oh, oh, not a real comment, so we will skip that one. Um, and so here- here's the thing. When ch- um, what changes when you have a clear framework for these challenging cases? And so let me paint this picture for you. When you have a challenging case, clients with, say, a significant history of trauma or really dysregulated behaviors at home, at school, maybe in your playroom even Or caregivers who are really, really overwhelmed, and they are looking to you to figure out how this works, and maybe they're even skeptical that this play therapy thing is actually going to work, and you're picking up on that skepticism and feeling the pressure of it. So without a clear framework, and I'm gonna add community, without a clear framework and a community, you kinda walk into every play therapy session with not feeling… With feeling unsure, not sure what you should do. Um, you don't know what stage of play therapy they're even in to help you figure out if they're even making any progress. And maybe this challenging case because you can't tell if it's working, you're thinking you're not a good play therapist or maybe play therapy just doesn't work. Um, and you don't know what your role is in the play therapy session, so you're not even sure how to show up sometimes. Are you directing or not directing? And are you focused on trying to get them to talk rather than understanding how we use play as a vehicle therapeutically for change? And so when you don't have that framework, then all of these things are missing, and then what happens is when that child dysregulates or you get all of those phone calls, or maybe even your client just stands there in the middle of the session like a frozen statue and does nothing, right? Have you ever had those? I have. Uh, those are hard ones So how are you going to explain what is going on? How are you explaining the play therapy process? How are you explaining whether or not it's working or why it's working? How are you explaining what the client is struggling with? How are you explaining that to yourself? How are you explaining that to other people, like maybe other, uh, professionals who are involved, or maybe even parents? You don't know how to explain it because you don't know what's going on because you're thinking this challenging case is too hard, and it's kind of a mystery. So when the, um, when you don't have that clear framework, then you don't, you don't know how to do all of that. But when you have a clear framework, when you have clear case conceptualization, when you have a clear play therapy model and community to support you, then you walk into every session, even the challenging ones. I see this all the time. People will staff in our consultation meetings these, these really awful things that happen. We break it down, and then it's no longer awful. Now it's like, "Oh, cool. I got this. I know what to do. I know when to do it. I know how to do it, and if that doesn't work, I got like three or four backup things I can do." When you have that case conceptualization and framework and that community of support, then you have more confidence. You know what stage of play therapy they're in, the client is in. You know what type of approach you're using, so you know whether you're leading or following. And let's say you're using a play therapy model that, that allows leading. Um, I didn't like that word leading, that's why I hesitated. Yeah, I still don't know if I like that word. That- I'm gonna move on. Um, your play therapy model is gonna influence when you lead and when you follow, or if. If you're using child-centric play therapy, you are not asking questions, you are not leading. If you're using Gestalt play therapy, sometimes you're following, sometimes you're leading. Your play therapy model is gonna influence that decision-making of when and also why you are doing it, and how you are going to do it. What are you gonna say and how are you gonna say it? That's the difference when you have a clear framework. And here's the thing, I wanna go a little bit deeper on this, so I, I have a training coming up. It's a free training. It is called… Oh, the title is not… Oh, here it is. It's called How to Stop… I'm sorry. It's called How to Provide Play Therapy Without Second-Guessing Every Clinical Decision, Even Complex Cases. And that's p- it's a free webinar. It's 90 minutes, coming up on August 23rd. I'm gonna walk you through this in a little bit more depth. We're gonna use a case example to show you how this process works, to help you stop second-guessing every clinical decision and feel much more confident. So, if you're interested, then you're definitely gonna wanna register for that soon. You can register by popping over to my website at rhplaytherapytraining.com. That's renewingheartsplaytherapytraining.com. Register for the free webinar coming up on August 23rd, called How to Provide Play Therapy Without Second-Guessing Every Clinical Decision, Even With Complex Cases. We're also gonna put a link in the comments, or feel free to message me and we will send you that link. And so for now, I… That is it for today, and I will see you next week. Bye for now. Thank you for joining me on this episode of Next Level Play Therapy. I hope you found the discussion valuable and gained new insights and ideas to support your work helping children, adolescents, and families heal. If you enjoyed this episode, be sure to subscribe to the podcast and leave a review. Your feedback helps to improve and reach more people who can benefit from this information. Remember, play therapy is a powerful tool for healing and growth. Whether you're a new play therapist or experienced, I encourage you to continue your learning journey to unlock the potential of play in your own work and relationships. If you have any questions or topic suggestions for future episodes, I'd love to hear from you. Connect with me on social media and visit my website at Renewing Hearts Play Therapy Training to stay updated on upcoming episodes, trainings, and resources. Thank you once again for listening to Next Level Play Therapy. Until next time, keep playing, learning, and growing.