Using the 10 -minute rule for Therapy

Jerry runs into the therapist’s office, screams as he throws himself on the floor. “You will take my toys away I know it!!!” He thrashes on the floor as he rolls into a ball. He moves from one end of the office to the other. His father stares with mouth gaping. He shakes his head and sits down. Jerry is still rolling, yelling, and kicking his feet in the air. Jerry is 7 and this behavior has been constant for the last 6 months.
Jerry is very young, so his father does not want him on medication. To be honest, would medication work at this point? Jerry has stopped yelling as he notices the adults are talking. They have given him no attention. He sits up, looks around, and decides to come to the therapist’s desk to see what the adults are discussing.
Jerry and his father have asked for help because he is no longer allowed in school. He can not be homeschooled due to logistics, work schedules, and commitment.
Jerry’s father is a single father who can not take off work to homeschool, go to the daily school summonses, or find a babysitter who will homeschool his son. To Jerry’s father, the situation looks hopeless.
Jerry and his father have come for help as a last resort. Families never come to therapy when things are going well, they come when it is no longer an option to stay away. Jerry and his therapist put together a plan for home and school. They also work out a therapeutic plan which includes sessions twice a week.
What would you do for this child?
People ask that question a lot! They are at their wit’s end and have no viable options. They look for help and can’t find what they need. They are judged, putdown, and talked about. The school questions what is going on with this family and home life. The neighbors blame Jerry’s father as he must be doing something wrong as a single father. They blame his mother as she is not in the picture. Blame is everywhere and no solutions can be found.
Punishment is never the answer, consequences may help but how do you enforce it? Where does this father go for help? Does his son have attention -hyperactivity disorder? Could it be something else? I have seen hyperactivity in children who were traumatized, have little structure in their lives, or in addition to another diagnosis.
Jerry is only 7 so he is naturally dramatic, hyper, and very active. He struggles with reading and sitting still in the school setting. He has not been assessed or tested for dyslexia or learning disabilities. He may need a smaller classroom setting due to regular classroom activity. He does not have an IEP so he is not afforded the extra help he may need. All these pieces to this puzzle much are researched and investigated to determine what is going on with Jerry. When the school will not work with a parent where does that parent go? Where do parents receive the help they need?
Jerry and his therapist began sessions with 10-minute intervals for playing. Jerry could not get up for 10-minutes. He came into the play therapy office and choose his toys. The toys he would choose gives his therapist an idea of the theme he likes or problems he may be working through. Jerry would grab the house, school, little people, and cars. He was asked to play for 10-minutes with only those toys. While playing the therapist would write down the conversations, the actions, and themes in his play.
Jerry was not able to complete 10-minutes of play before jumping up and running around the room. He would be redirected back to the play area and complete his time. Jerry’s play was normal for a child his age. His actions were sporadic and quick. He would create a ‘normal’ home life for his little people’s family. His person would go to school and fight. He would not learn and had to sit out in a safe seat. Jerry’s person did not have the appropriate language to address his emotional distress. He did have a full language of cursing which only ended him up with him going back to the safe seat. This play appeared to be an appropriate representation of his school day.
It took a few months and Jerry was able to choose his toys, play for 10-minutes, and put his toys away. He and his father incorporated this technique at home which helped with chores, bedtime, and dinner routines. Jerry and his father began a money jar. It was full of coins on Sunday and each tantrum Jerry lost a specified amount of coins. At the end of the week, Jerry was allowed to use his coins as he chose.
After a few months, Jerry was able to move to a new modality of therapy. The new modality was Theraplay. Theraplay was chosen for this family to help with attachment, attention, structure, and nurturing.
As we progressed Jerry was able to listen to cues when asking to move from one activity to another. He has thrived in the structure provided by the process of “ 1.2.3. go” for activities and daily involvement with others. The 10-minute rule is not always successful and sometimes takes longer than treatment allows; however, it is a good indicator of what the child may need to be successful.
Understanding the sensory needs of each child, knowing how to build a sensory diet, and separating the hyperactivity from the equation allows you to focus on the child and build a healthy relationship. This child’s hyperactivity was related to lack of structure, not understanding the boundaries, and fear of not being properly cared for. Once we established the boundaries, structure, expectations, and discussed the fear we were able to move forward with his treatment.
I have used this rule for children on the spectrum, sensory processing disorder, defiance, and ADHD. It works in most situations as children will thrive in a structured, accepting, and attentive environment.