The use of sandplay therapy, the therapeutic relationship and the use of cognitive restructuring for the treatment of Prader-Willi syndrome: Case study.

摘要

The purpose of this case study was to evaluate and to determine the presence of the sandtray, cognitive restructuring and the therapeutic relationship with a female child with Prader-Willi Syndrome. According to the Prader-Willi Syndrome Association (2000), the prevalence of Prader-Willi Syndrome, an uncommon condition, is estimated to occur one in every twelve thousand to fifteen thousand children.; Prader-Willi Syndrome was first described by Drs. Prader, Labhart, and Willi in 1956. Hypotonia in early childhood is one of the first indications of this syndrome, with polyphagia, obesity and hypogenitalism following. Infantile hypotonia, hypogonadism, feeding difficulties, early childhood obesity, short statute, small hands and feet, intellectual disabilities and characteristic facial abnormalities, characterize symptoms of Prader-Willi Syndrome.; The case study will illustrate the 11 year-old female's meaning of her sandplay in terms of child psychotherapy. Starting back in the late 1920's, some of the prominent figures such as Melanie Klein, Anna Freud, and Eric Erikson had used the process of play and creativity in the therapeutic process (Labovitz & Goodwin, 2000). Each of these therapists had reinforced Carl Jung's theory that the use of imagination and play helps an individual in the process towards growth.; In reference to the therapeutic relationship the alliance of the client and the therapist has been the focus of research attention for over 20 years. Many personal traits of the therapist, such as being supportive, helpful and kind may be part of the quality of the therapeutic alliance. Bachelor and Salame presented different levels of the therapeutic relationship. One stage is the working alliance that consists of the client and the therapist having shared responsibilities regarding the treatment goals. The relationship deepens with time and as issues need to be worked through. In a more critical stage of therapy the therapist challenges and encourages the client to face maladaptive patterns (Bachelor and Salame).; The hypothesis states this child with Prader-Willi Syndrome would make marked improvements in her social skills and decrease her self-harming behaviors based on the therapeutic relationship and the therapeutic interventions.; Therefore the study endorses the importance of the therapeutic relationship. The results of this case study confirms her ability to express her feelings in a safe and constructive manner with the use of the sandtray, the focus on the therapeutic relationship, and with the use of cognitive restructuring.