Worry No More!
By: Mercedes Borrayo, LMFT
Working with children is difficult and trying to engage them in therapy is challenging to say the least. One of the most important steps in working with children and adults in a therapeutic setting is establishing rapport as cited by Norfolk, Birdi and Walsh, 2007. People want to feel like they are important and that they matter to the person attempting to engage them in therapy. In order to begin establishing rapport there are some techniques that can be used. Children and adults seek mental health treatment for several reasons: they were sent by their school due to negative behaviors; the legal system sent the person; or the individual initiated therapy because he or she feels the need for more assistance. Whatever the case may be, it is important that the person feels that the provider is empathetic towards them.
Creating worry dolls with your clients, individually or as a family activity, is an intervention that can be used by professionals and paraprofessionals alike; any client of any age who has problems with anxiety can benefit. Diagnoses of ADHD/ADD, Anxiety, Depression, and PTSD are some of the most common disorders for both children and adults currently, as cited by Silverman, Pina and Viswesvaran (2008). Therefore, an intervention like worry dolls that will assist the client in improving their anxious behaviors is important, though it works with less common diagnoses as well.
Worry dolls serve several tasks: they assist clients in learning how to slow down, take deep breaths, concentrate, and focus, just to name of few of the benefits. Upon the creation of the worry dolls the therapist may inquire as to the choice of colors, etc. the client has chosen. A paraprofessional can work on relaxation techniques, focus, and learning to share and to take turns. Research by Kercood, Grskovic, Lee, and Emmert, (2007), suggests that a child who has difficulties with attention will have a higher probability of completing the task at hand if using tactile techniques. Being able to develop fine motor skills also gives children an advantage as they progress in age (Brambring, 2007). In addition to giving clients the opportunity to improve their motor skills, this intervention provides a sense of comfort to children who are struggling with sleep problems. It is estimated that as many as 40% of children have difficulties with sleep even if it is for a short period of time (Alfano, Zakem, Costa, Taylor and Weems, 2009).
Clients who create worry dolls have an advantage over those who purchase them at the local flea market or other locations. These dolls become individualized and personal, not to mention the sense of accomplishment of having created their own masterpiece. Worry dolls go back as far as the Mayan culture. Recently in Guatemala during the civil war, parents wanted to provide more help to their children who were suffering anxiety and sleep difficulties due to the political conflict, so they sought out the help of shamans. The parents made one doll for each day of the week in order to help their children sleep and not be afraid. As cited by Huss, Sarid & Cwikel, 2010, “Using art as a self-regulating tool in a war situation…the creative arts…are especially effective in counteracting the stress of war situations...”
The purpose of these dolls is to take bad dreams and worries away from the person, and when they are made by the clients themselves they become more personalized and meaningful. The dolls serve as substitutes and are tools for symptom management. Depending on the discipline/scope of practice, on what the therapist will be working, or for what s/he will be looking during the creation of the dolls will vary.
Reference List
Alfano, Zakem, Costa, Taylor, & Weems (2009), SLEEP PROBLEMS AND THEIR RELATION TO
COGNITIVE FACTORS, ANXIETY, AND DEPRESSIVE SYMPSOMT IN CHILDREN AND
ADOLESCENTS., National Institute of Mental Health
Brambring (2007), Divergent Development of Manual Skills in Children Who are Blind or
Sighted., Journal of Visual Impairment & Blindness, April 2007
Huss, Sarid, & Cwikel (2010), Using Art as a Self-Regulating Tool in a War Situation: A Model for
Social Workers. Health & Social Work, August 2010.
Kercood, Grskovic, Lee & Emmert (2007), The effects of fine motor movement and tactile
stimulation on the math problem solving of students with attention problems. Springer
Science and Business Media, LLC 2007.
Kooistra, Crawford, Dewey, Cantell & Kaplan (2005), Motor Correlates of ADHD: Contribution of
Reading Disability and Oppositional Defiant Disorder. Journal of Learning Disabilities,
Volume 38, Number 3, May/June 2005.
Norlfolk, Birdi, & Walsh (2007), The role of empathy in establishing rapport in the consultation:
a new model. Blackwell Publishing, Ltd 2007, Medical Education 2007;41, 690-697.
Silverman, Pina & Viswesvaran (2008), Evidence-Based Psychosocial Treatments for Phobic and
Anxiety Disorders in Children and Adolescents. Journal of Clinical Child & Adolescent
Psychology, 37.