What to Do When Children Clam Up in Psychotherapy

Interventions to Facilitate Communication

Edited by Cathy A. Malchiodi and David A. Crenshaw

HardcoverPaperbacke-bookprint + e-book
June 29, 2017
ISBN 9781462530434
Price: $73.00 $62.05
247 Pages
Size: 6" x 9"
June 30, 2017
ISBN 9781462530427
Price: $28.00 $23.80
247 Pages
Size: 6" x 9"
May 30, 2017
ePub and PDF ?
Price: $28.00 $23.80
247 Pages
print + e-book
Paperback + e-Book (ePub and PDF) ?
Price: $56.00 $30.80
247 Pages

Therapists who work with children and adolescents are frequently faced with nonresponsive, reticent, or completely nonverbal clients. This volume brings together expert clinicians who explore why 4- to 16-year-olds may have difficulty talking and provide creative ways to facilitate communication. A variety of play, art, movement, and animal-assisted therapies, as well as trauma-focused therapy with adolescents, are illustrated with vivid clinical material. Contributors give particular attention to the neurobiological effects of trauma, how they manifest in the body when children "clam up," and how to help children self-regulate and feel safe. Most chapters conclude with succinct lists of recommended practices for engaging hard-to-reach children that therapists can immediately try out in their own work.

This title is part of the Creative Arts and Play Therapy Series, edited by Cathy A. Malchiodi and David A. Crenshaw.

“Each chapter concludes with a list of best practices to guide the therapist through implementing the recommended approaches. Clinical educators and supervisors will find this book to be a valuable text to introduce trainees and supervisees to the principles and processes of child psychotherapy. Therapists new to working with children will appreciate the blend of theory and specific suggestions illustrated by engaging clinical examples to promote their understanding of both the content and process of dealing with silence in sessions. The book will also provide experienced therapists with the opportunity to update their knowledge of current best practices in assessing and treating silenced child clients.”

American Journal of Play

“This is one of those rare clinical books that not only will occupy a prominent place on the therapist's bookshelf, but also will be reached for time and time again between sessions. It is destined to be a cherished resource for child and adolescent therapists. Like having a cadre of expert supervisors at one's side, the volume successfully guides readers through one of the most common yet challenging types of treatment impasse, while expanding ideas of what therapy can look like. Innovators in the field offer sure-fire ways of engaging even the most reticent young people.”

—Craig Haen, PhD, private practice, White Plains, New York

“Psychotherapy with children can be an arduous and challenging process. Malchiodi and Crenshaw have provided an important, informative resource for child therapists. Regardless of the reader's therapeutic orientation, this book offers a wealth of cutting-edge ideas and strategies. Whether you are an experienced clinician or still in training, this unique volume is a valuable guide.”

—Sam Goldstein, PhD, Department of Psychiatry, University of Utah School of Medicine; Clinical Director, Neurology, Learning, and Behavior Center, Salt Lake City

“This is the best current book on a familiar treatment issue in child therapy. Honest, clear, and informative, the chapters offer multiple perspectives on how to facilitate children's communication in creative and insightful ways. Each chapter contains detailed hands-on applications. As a graduate educator in play therapy and expressive art therapy for more than 36 years, I am refreshed to find a book that provides even the neophyte therapist with such usable, inviting intervention strategies.”

—Julia Byers, EdD, Division of Expressive Therapies (Emerita), Lesley University

“The title immediately lets the reader know that this is a practical, accessible book. Malchiodi and Crenshaw have assembled leading experts to take us on a journey of discovering the impact of maturation, brain development, trauma, and culture on children’s communication styles. The volume presents models that highlight the primacy of creativity and relationship when counseling children. I recommend this book to counselors and therapists who wish to enter the world of children in the most effective ways, and as a complementary text for any course on child and adolescent counseling.”

—Dee C. Ray, PhD, LPC-S, NCC, RPT-S, Director, Center for Play Therapy, and Professor, Counseling Program, University of North Texas

Table of Contents

I. General Principles to Guide Practice

1. Why Children Clam Up in Therapy, Cathy A. Malchiodi & David A. Crenshaw

2. Resistance in Child Psychotherapy: Playing Hide-and-Seek, David A. Crenshaw

3. A Neurosequential Therapeutics Approach to Guided Play, Play Therapy, and Activities for Children Who Won't Talk, Richard L. Gaskill & Bruce D. Perry

II. Master Clinician Approaches

4. The Sound of Silence in Play Therapy, Anne L. Stewart & Lennis G. Echterling

5. Play Therapy with Children Who Don't Want to Talk: "Sometimes We Talk, and Sometimes We Play,"Nancy Boyd Webb

6. Polyvagal Informed Dance/Movement Therapy with Children Who Shut Down: Restoring Core Rhythmicity, Amber Elizabeth Gray & Stephen Porges

7. Play Therapy through the Lens of Interpersonal Neurobiology: Up and over the

Mountain, Theresa Kestly

8. Treating Adolescent Attachment Trauma: Ten Ways to Co-Regulate and Stay Connected, Martha B. Straus

9. Silencing and the Culture of Sexual Violence: The “Shadow Abuser,"Sarah Caprioli & David A. Crenshaw

10. Art Therapy Approaches to Facilitate Verbal Expression: Getting Past the Impasse, Cathy A. Malchiodi

11. Animal Assisted Play Therapy with Reticent Children: With a Little Help from Friends, Risë VanFleet & Tracie Faa-Thompson


About the Editors

Cathy A. Malchiodi, PhD, ATR-BC, LPCC, LPAT, REAT, is an art therapist, expressive arts therapist, and clinical mental health counselor, as well as a recognized authority on art therapy with children, adults, and families. She has given more than 400 presentations on art therapy and has published numerous articles, chapters, and books, including Understanding Children’s Drawings and Handbook of Art Therapy, Second Edition. Dr. Malchiodi is the founder and executive director of the Trauma-Informed Practices and Expressive Arts Therapy Institute. She has worked with a variety of community, national, and international agencies, particularly on the use of art therapy for trauma intervention, disaster relief, mental health, medical illness, and prevention. She is the first person to have received all three of the American Art Therapy Association's highest honors: Distinguished Service Award, Clinician Award, and Honorary Life Member Award. She has also received honors from the Kennedy Center and Very Special Arts in Washington, DC. A passionate advocate for the role of the arts in health, she is a blogger for Psychology Today. Dr. Malchiodi is coeditor (with David A. Crenshaw) of Guilford's Creative Arts and Play Therapy series.

David A. Crenshaw, PhD, ABPP, RPT-S, is Clinical Director of the Children’s Home of Poughkeepsie, New York, and Adjunct Faculty at Marist College. He has taught graduate courses in play therapy at Johns Hopkins University and Columbia University and has published widely on child and adolescent therapy, child abuse and trauma, and resilience in children. A Fellow of the American Psychological Association and of its Division of Child and Adolescent Psychology, Dr. Crenshaw has received lifetime achievement awards from the New York Association for Play Therapy and the Hudson Valley Psychological Association. He is a past chair of the board of directors of the Coalition against Sexual and Domestic Abuse and a member of the professional advisory board of the Courthouse Dogs Foundation and of the Dutchess County Task Force against Human Trafficking. He is coeditor (with Cathy A. Malchiodi) of Guilford's Creative Arts and Play Therapy series.


Sarah Caprioli, LMHC, private practice, Poughkeepsie, New York

David A. Crenshaw, PhD, ABPP, RPT-S, Clinical Director, Children’s Home of Poughkeepsie, New York

Lennis G. Echterling, PhD, Department of Graduate Psychology, James Madison University, Harrisonburg, Virginia

Tracie Faa-Thompson, MA, Turn About Pegasus, Lowick, Northumberland, United Kingdom

Richard L. Gaskill, EdD, Department of Counseling, Educational Leadership, Educational and School Psychology, Wichita State University, Wichita, Kansas

Amber Elizabeth L. Gray, MPH, MA, Restorative Resources Training and Consulting, Santa Fe, New Mexico

Theresa Kestly, PhD, Sand Tray Training Institute of New Mexico, Corrales, New Mexico

Cathy A. Malchiodi, PhD, ATR-BC, LPCC, LPAT, REAT, Trauma-Informed Practices and Expressive Arts Therapy Institute, Louisville, Kentucky

Bruce D. Perry, MD, The ChildTrauma Academy, Houston, Texas, and Feinberg School of Medicine, Northwestern University, Chicago, Illinois

Stephen W. Porges, PhD, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina

Anne L. Stewart, PhD, Department of Graduate Psychology, James Madison University, Harrisonburg, Virginia

Martha B. Straus, PhD, Department of Clinical Psychology, Antioch University New England, Keene, New Hampshire

Risë VanFleet, PhD, Family Enhancement and Play Therapy Center, Boiling Springs, Pennsylvania

Nancy Boyd Webb, DSW, LICSW, RPT-S, Graduate School of Social Service, Fordham University, Bronx, New York


Clinicians working with 4- to 16-year-olds, including child psychologists; art, play, and other creative therapists; social workers; counselors; and child psychiatrists.

Course Use

May serve as a supplemental text in graduate-level courses.