12.05.

2016

The 6th Congress for Psychomotricity of the

European Forum of Psychomotricity in
Switzerland

Psychomotor Therapy and Child

Development
Exploration, Play, and Movement: The
Core Elements to enhance Vitality
HfH Interkantonale Hochschule für Heilpädagogik
Prof. Dr. phil. Beatrice Uehli
03.05.2016

Topics of my presentation
• Psychomotor-therapy in Switzerland
• Anxiety disorder – the anxious child
• Milestone of child development related to
anxiety
• Specific therapeutic competences of a
Psychomotor therapist related to the core
elements of exploration, play and movement

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Psychomotor-Therapy in Switzerland
Psychomotor Therapy in Switzerland is a well-established
therapeutic intervention in the pedagogical field.

focusing on the interactive and dynamic processes of child

development.

Its theoretical background is based on a holistic view of

the child.

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Psychomotor-Therapy in Switzerland
Therapeutic
Required and
intervention in the
regulated by law
pedagogical area

Mostly children
Therapeutic setting: at the age of 4
small groups (2 to 4 to 10 years
children)

Methods: Involvement of the

• exploration parents, teachers
• movement an other
• role-play professionals

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Psychomotor-Therapy in Switzerland
Which are the most common problems of the children,
who come to the PMT?

Most of the kids are boys, age between 4 to 10

whose development in one or more area shows

noticeable problems.

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Psychomotor-Therapy in Switzerland
PMT in Switzerland has long and successful tradition in the
field of:
• Motor function (fine- and grapho-motor skills)
• perception

In the last 20 years there is an increase of children with

problems with:
• emotional skills or
• social behaviours

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Recent challenges in society

In the last decade nearly the whole attention of the
general public view as well as of the qualified experts
focused on:

the so called “fidgety children”, who have problems:

• following rules
• controlling impulses
• coping with frustration and anger
• etc.

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Recent challenges in society

There is a controversial debate within society about: the
influence of biological factors or
• a lack of education in the family
• the particular significance oft the increasing migration
movement of the last 25 years
• the globalisation in general and
• the loss of identity and traditional values

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Recent challenges in society

On the other hand:
Children with emotional problems are often overlooked!

High time not only to focus the loud and disruptive

behavior.

What makes PMT unique in comparison to other

therapeutic or pedagogical proposal like occupational
therapy, sport, A?

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Anxiety disorder or the “shy” child

Shyness at in social situations – e.g. at school –causes a
vicious circle, which isolate the child more and more.

Shy children at school are often underestimated

because of there lack of oral participation.

But how exactly do professionals define “shyness”?

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Shyness as a subclinical
phenomenon of anxiety disorder
Among experts exist various terms:
• anxious child
• social insurance
• timid child
• inhibited behavior
• social insecurity

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Shyness as a subclinical
phenomenon of anxiety disorder
Shyness is a subclinical phenomenon characterised by a
combination of fear in the presence of others and by the
advoidance of social situations.

13% - 46% of the children age 5 – 12 years show a

subclinical form of social anxiety

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Anxiety as a psychological disorder

Anxiety is one of the most common psychological
diseases in childhood.

Up to 23.5% of the children are affected by an anxiety

disease once in life.

In the clinical setting the rate is even higher – in a range

of 16% to 52%.
(Essau and Petermann, 2001).

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Prevalence for anxiety disorders

Age period social phobia social insecurity separation
social anxiety social anxiety / phobia anxiety disorder
(subclinical)

1% - 26%
ages 5–12: 13% – 46% 2 years: 15%
childhood 1% – 4%
ages 13–17: up to 56% 4 years: 8%
8 years: 26%

2% – 48%
adolescents
ages 13: up to 34%
and adults 1% – 7% 3%
ages 18: up to 48%
ages 25: up to 14%

Ahrens-Eipper, S., Leplow, B. (2004): Mutig werden mit Til Tiger. Göttingen, Hogrefe.

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Possible problems of clinical studies:

How can this wide range from 1% - 56% be explained

• Different concepts of anxiety disorder

• No difference between clinical and subclinical forms

• Different prioritisation of the symptoms “impaired

function“ respectively “the level of suffering”

• The age range varies from toddler to adults

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How to describe an anxious child:

Anxiety can be observed in all aspects of development

cognitive:
low expectation of self-efficacy, increasing anxious
expectation

physical:
enhanced arousal, perspiration, palpitation, repeated
stomach-pain, nausea or headache during or directly after
the separation from mother or father.

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How to describe an anxious child:

Emotional :
emotions of fear, shame, hopelessness and a low self-
esteem, nightmares, fear of being left alone

social behaviour:
increasing withdrawal, avoiding social contact with peers,
truancy, clinging, crying, screaming to avoid separation
from the primary carer

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Causes of anxiety in childhood

Emotional development:
• Bonding: anxious-resistant insecure attachment
• Lac of affect regulation
• Low self-esteem
• Poor early relationship experiences
• Conflicts between human basic needs and
respond from the environment
• Timid nature (genetic predisposition)

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Causes of anxiety in childhood

Depending on the reactions of the environment:
• Overprotecting parents
• Rigid relationship in families
• Inconsistent education
• If one of the parent itself suffer from an anxiety
disorder

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Criteria of a developmental Impairment

• If anxiety appears without noticeable threat
• Depending on its intensity and duration
• If it turns to a chronic condition
• If there is no meaningful context for the child
• If the child’s quality of life is strongly impaired.
• If there are no coping strategies or possibilities to reduce
the anxiety
(Essau, A. Angst bei Kindern und Jugendlichen, 2003).

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The milestones of child development

The this part of the presentation focus those issues
which are related to anxiety childhood:

• Emotional development in relation to social

interaction

• Developing of a strong and realistic “self-concept”

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Markers of emotional development

Emotional competences always reflect:
• The individual’s relationship history
• Individual factors, such as cognitive development and
temperament
• Social experience, including the cultural context
• The system of beliefs and values in which the child
lives.

(Saarni, C. 2011)

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Saarni (2011) defines emotional Competence:

• Awareness of one’s emotional state, including the
possibility that one is experiencing multiple emotions

• Skills in understanding others’ emotions, based on

situational and expressive cues.

• Skill in using the vocabulary of emotion.

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Saarni (2011) defines emotional Competence:

• Capacity for empathic involvement in others’ emotional
experiences.

• Skill in realizing that inner emotional state need not

correspond to outer expression, both in oneself and in
others.

• Capacity for coping with aversive or distressing emotions

by using self-regulatory strategies.

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Results of research demonstrate the causal relation between

emotional development and social behaviour of a child

Higher risk for behavioural

Low emotion vocabulary ->
disorder
Poor capacity to Higher risk for emotional
recognize fear and -> problems and behavioural
sadness disorder
Broad understanding of Predictor for popularity among
->
emotions peers
Ability to recognise
More frequent social contacts,
emotions in gesture and ->
higher social skills
facial expression

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The importance of relationship

• The attachment relationship with parents is the initial
context of a child’s emotional skills

• If the parents meet the basic needs, the infant comes to

internalize that the world is a safe place and that others
are trustworthy and responsive

• A secure attachment leaves the child free to explore the

world and engage with peers

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A child who experiences the world as unpredictable,

unresponsive or hostile must expend a tremendous amount
of energy self-managing emotional arousal

Insecure attachment is associated with emotional and

social incompetence, particularly in the areas of emotion
understanding

Perceptions of an indifferent or unfriendly social world

influence emotional responses and interpersonal behaviour

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Development of a strong and realistic

“self-concept”
The self-concept is an inner representation based on a
“social mirror”

It’s a image of the child’s experiences with his parents,

attachment figures, siblings, peers etc.

These representations influence the expectations of his

future experience, either positive or negative

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Definition of the construct “self-concept”

The self-concept involves all the complete knowledge
about itself, the child’s traits, capabilities, emotions,
behaviour and preferences. The self-concept has a
descriptive and an evaluative function (Hellmich, 2010)

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Developing of the self-concept

age Individual steps
Infant Learns through “double sensations” what
belongs to his body
At around 18 The child now recognizes his image in the mirror
month sign of a self-awareness
At the age of 2 The child starts talking about himself in the first-
person
From 2 to 5 Conflicting character traits are still unrelated
At the age of 4 Ability to take other perspectives
Theory of mind
Still an unrealistic positive self-esteem
at the age of 5
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Self-evaluation is still strongly affected by others

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Developing of the self-concept

At the age of 10 a child has a strong and meaningful self-
concept regarding his capabilities

Motivation and self-esteem are based on academic

performance and evaluated by social references

Self-evaluation is realistic and stable over time

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“Can do” – persuasion:

“reflects the belief of beeing able to control

challenging environmental demands by taking
adaptive action. It can be regarded as an optimistic
and self confident view of one’s capability to deal with
certain life stressors”

(Schwarzer 2002)

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Self-efficacy is a part of the general self-concept

(based on the Bandura 1997)

Children who think they can perform well on a task do

better than those who think they will fail.

Lack of self-efficay causes stress and in worst case

depression.(Seligmann, 1979)

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Bandura (1997) defines four different sources, which have

influence on the strength of self-efficacy:

• Performance accomplishments
• Vicarious Experience
• Verbal Persuasions
• Emotional Arousal

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Performance accomplishments are related to the

success of personal experience.

When strong efficacy expectations are established,

then the impact of occasional failures are reduced.

Children with a strong efficacy expectations also

have a high frustration tolerance

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Vicarious or “modelling” experience:

"If they can do it, I can do it as well.”

• When we see someone succeeding, our own self-

efficacy increases
• where we see people failing, our self-efficacy
decreases.
• This process is most effectual when we see
ourselves as similar to the model.

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(realistic) Verbal persuasion:

• generally manifests as direct encouragement or

discouragement from another person.

• Verbal persuasion is widely used because of the

potentially persuasive influence of suggestion.

• Discouragement is generally more effective at

decreasing a person's self-efficacy than
encouragement is at increasing it.

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Physiological or “emotional” arousal:

• A positive perception of an aroused state may energize

• while a negative perception of an aroused state may

inhibit coping behaviors

e.g. fear-provoking thoughts can cause an individual to

overestimate the intensity of a threatening situation.

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Self-efficacy is highly influenced by the child’s environment

Especially the parents own self-efficacy have a strong impact

on the child’s development

Risk: Anxiety of parents weaken the child’s self-efficacy

expectation

However efficacy perceptions also may be influenced by

differences in personality, motivation, and the task itself.

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Psychomotor - therapy
PMT a therapeutic approach for children with anxiety
problem in the area of: „self-efficacy and emotional
competences“ with the core elements exploration,
movement and therapeutic play.

If we are going to work with children with anxiety

problems – what have Psychomotor-Therapist to be
aware of?

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Research result
Therapeutic approach with movement or play do not
automatically have an impact on a child’s self-efficacy or
even on his self-concept

In early childhood a child defines his self-efficacy mainly

through motor activity

However, this effect does not seem to act directly in the

kindergarten and primary school age

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Research result
But only through evaluation and reflexion and put into
words the child’s self-concept can be affected and
experience inner strengthening.

Therefore specific methods and techniques could be

substituted. The key factors are the consecutive and
concomitant therapeutic measures.

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Therapeutic competence
(in Anlehnung an: Dirk Revenstorf 2008)

“A the therapist finds himself confronted with the dilemma

that in order to be convincing he has to use specific
concepts and techniques on the one hand and on the other
hand he is aware of the fact, that his concept and
technique could be substituted by a number of others.”

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levels of development – significance fort her therapeutic process:

• experience by play or movement
• express in words
• reflect the process
tic
p eu hip Regulation of
a s
er on emotions (Coping
Th lati with fears)
re practising

Experience-oriented Positive
learning
Comprehension
and cope
reflection Ability in building
relationships – a
necessity for healthy
development

Therapeutic approach

(In Anlehnung an: Amft, S. Brigitta Boveland, B., Hensler Häberlin, K., Uehli Stauffer, B. „Mitschwingen und
Resonanzbereitschaft “ Eine Studie zu den theoretischen Konzeptionen und beruflichem Selbstverständnis von
Psychomotoriktherapeutinnen motorik, Schorndorf, 35 (2012), Heft 3)

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Conclusion
Government and politicians ask for research and evidence
of efficacy of Psychomotor Therapy.

To justify and ensure the financial support:

The Psychomotor therapist should be able to explain his

theoretical background, his therapeutic approach, the
techniques he uses as well as his therapeutic
competences.

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Competent children do not experience lives free

of problems, but they are equipped with both
individual and environmental assets that help
them cope with a variety of life events.

Psychomotor therapy can A.......

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