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Play-based therapy helps children deal with grief

At Kenzie's Gift, we're fortunate to have the compassionate and skilled Child and Adolescent Psychotherapist, Nicola Jackson, on our team. Through her unique play-based therapy, Nicola provides a nurturing and judgement-free space where children can express themselves without the constraints of language. Her work is invaluable for tamariki / children and whānau dealing with grief, loss, and trauma.

Nicola Jackson’s bright and welcoming consulting room looks more like a playroom than a clinic. It provides a safe and warm haven where the young children who come to see her are invited to choose from sand trays, figurines, art materials, dress-ups, building blocks and a doll’s house, and to play with them.

Nicola is a Child and Adolescent Psychotherapist who works with bereaved children, and is one of Auckland-based therapists for Kenzie’s Gift.
Her practice, which is based on psychodynamic and relational psychotherapy, focuses on families who are experiencing difficult feelings, behaviours or relationships, including grief, loss, separation and trauma.  A lot of the work she does with children is non-verbal.

She advocates the value of non-directive play-based therapy as part of her practice.

“This is when a child is given free rein to play with whatever resources they please – and however they like,” she says. “I don’t have an agenda about what they need to do, unless they need me to suggest activities. Equally, they’re free not to choose,” she says. “Some will talk, and a few will be silent. Some will play with me, and some of them prefer to be observed. Whatever they do, it gives me valuable information about them and is therapeutic for the child. Although it sounds simple, this kind of play develops emotional regulation, learning capacity, relationship building and communication.”

As part of its support for tamariki/children and mātātahi/young people affected by serious illness or grief, Kenzie’s Gift provides up to 12 sessions with a therapist, which also includes sessions for parents and caregivers.

Nicola first meets the parents or caregivers on their own, and depending on the child’s age and capacity, she normally sees the child on its their own. Over the course of the sessions, they start to form narratives of the child’s own story.

“Children are welcome to bring all parts of themselves,” she says. “I provide a space where even messy parts can be tolerated. Kids have big feelings too,” she says. “They develop coping strategies to deal with them which often comes across as disruptive behaviour. Through my therapy, part of the work can be helping parents and caregivers reframe behaviours as a reaction to anxiety and stress.”

‘Invisible mourners’

Nicola Jackson’s dissertation for her Master of Child and Adolescent Psychotherapy at AUT examined the experience of young children (aged two to six-years-old) bereaved by sibling stillbirth.

“Siblings bereaved by stillbirth have been described as invisible mourners because their loss is often unacknowledged,” she says. “Stillbirth has a devastating impact on whānau. The experience of bereaved parents is often, understandably, foremost in our minds and hearts. But the loss of an infant, before or after birth, has life-long consequences for the entire family.”

In her thesis, Nicola describes how the trauma of sibling stillbirth can manifest as learning difficulties, feelings of rejection and expressions of rage and anger at parental figures. She says that separation anxiety, generalised anxiety, somatic symptoms, perfectionism, rebellion and behavioural challenges may all have sibling stillbirth as a contributing factor.

As a child and adolescent psychotherapist, Nicola says her role is to help a bereaved young person and their family acknowledge the child’s experience in a developmentally appropriate way.

“Acknowledging and welcoming discussion about whakapapa, as is usually done during taking the developmental history, will also inform and assist my work,” she says.
“We work with relationships as part of what we do. It’s important for adults to know that young children have their own relationships with their dead siblings. In my therapy, children can be given the opportunity to connect with and integrate their sibling into their lives through play and symbol-based activities such as art, music and language.

“This is the natural habitat of the young child and “magical thinking”, rather than labelled a deficit, can be considered part of the young child’s subjective reality and used as part of the therapy process. We know that play is used by children to overcome anxieties. Through play, children will be able to recognise and relate to their sibling. Play is not as threatening as thinking directly about the issues at hand, but is located close enough for the play to be meaningful and the anxieties perhaps become more digestible for the young child.

“Under the guidance of a child and adolescent psychotherapist, the surviving child can meet their young sibling in a healthy reparative way, in a way which grieving parents may not be able to provide.”

You can read more about Nicola Jackson’s work on her blog here.