The Play and Humor-Infused Gradual Exposure Therapy approach described here draws on many of the principles of Levine & Chedd’s “Replays” approach, integrated with traditional cognitive-behavioral graduated exposure therapy.
Our manual and this accompanying website focuses specifically on the adaptation of Replays for children with Williams syndrome, but the approach was created to be feasible for any child with developmental disabilities or any child with strong emotional responding that interferes with personal and/or family functioning.
The approach also includes some other elements that are considered best practices in the field. In gaining an understanding of the child’s behavior, functional behavioral assessment approaches are used. The approach is also a client-directed outcome-informed therapy (Duncan & Miller, 2000) as there is deep involvement of families in choosing the targets with emphasis on what is useful for the family and on eliciting regular feedback about the acceptability and utility of the intervention and its particular direction.
The approach is fun and play-based and is aimed at improving the functioning of children who exhibit quick, intense emotional/behavioral reactions to a variety of “small” events such as loud noises, flushing toilets, and haircuts. The approach works through practicing these events with adult support in a “playful, exaggerated, symbolic re-enactment” (Levine & Chedd, 13). Individualized, child-specific humor is added to the situation by the adult, which relaxes the child and helps to put a fun and creative light on what otherwise may be an adverse event. “Practicing” experiencing a situation and practice with a different way of responding helps diminish emotional upset the next time the encounter happens.
Click the image above to open Overview of Behavioral Play Therapy Manual (PDF).