Book Review– Aggression in Play Therapy: A Neurobiological Approach for Integrating Intensity (March 2025)

When children are told that their aggressive behavior or play is not OK, it can lead to:

A. Connection
B. Internalized shame
C. Increased self-worth
D. Decrease in behavior

If a therapist does not regulate during intense play, the risk is increased for:

A. Compassion fatigue
B. Emotional flooding
C. Vicarious trauma
D. All of the above

Which of the following is an example of a reflection question we may explore to understand how our own history with aggression influences our ability to stay present with it in the playroom?

A. Is it harder for me to witness aggressive play or to be an active participant in aggressive play? Why?
B. What happens in my body when the child becomes aggressive in the playroom?
C. When I think about aggression that I have experienced in my own life, what memories come to mind for me that still feel unresolved? What is the worst part of the memories?
D. All of the above

Which of the following statements are NOT true about emotional flooding?

A. Emotional flooding a part of every play therapy model, because it is part of relationship
B. When a child or therapist emotionally floods in session, the only task at hand is to create a neuroception of safety
C. Therapists should work hard to prevent emotional flooding from happening because emotional flooding isn't a good thing
D. When emotional flooding occurs, it means that the brain has registered that something is "too much"

Which of the following statements are true?

A. Observing intense play is less intense than being in the intense play directly
B. Being in the intense play directly is less intense that observing intense play
C. Listening to a child tell a story about something intense is less activating that observing intense play or being in intense play directly
D. Observing intense play, being in intense play directly and listening to intense stories are all activating because the brain can't tell the difference between real and imagined.

When a therapist feels an urge to rescue the child or toys in some way and/or make the aggression stop, the following is likely happening:

A. The therapist is struggling to stay connected to themselves in the midst of the intensity
B. The therapist is uncomfortable and is therefore trying to make the child stop, so that the uncomfortable feelings go away
C. The therapist's own history has been activated and their own protective patterns are surfacing
D. All of the above

When aggression enters the playroom, the therapeutic goal is NOT to:

A. Remain calm and teach the child how to calm down
B. Become the external regulator and support the child to move towards the intensity
C. Set a boundary by acknowledging and redirecting when the aggression starts to feel outside of the therapist's window of tolerance
D. Support the child to integrate the aggression and the dysregulated pattern in their nervous system

Aggression is:

A. A maladaptive strategy for trying to get what you want
B. A dysfunctional part of the activation of the autonomic nervous system- people need to grow out of it
C. A normal biological response that arises when someone feels that their physical safety, their idea about who they think they are, who others are supposed to be, and how they think the world is supposed to operate are compromised
D. Morally wrong and it is not ok to display aggressive behaviors

Which of the following are ways a therapist can regulate through hyper-arousal in the playroom?

A. Breathe- elongating the exhalation
B. Move- feeling it and letting it go
C. Be Vocal
D. All of the above

Which of the following is a recommended way a therapist can regulate through hypo-arousal/death play in the playroom?

A. While dead, talk out loud
B. Use mindfulness practices such as body scans and tracking their breath
C. Stand up and shake it out
D. Take a quick nap

How did this book help you better understand yourself and your role/capacity as an external regulator during aggressive play?

This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.

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