His parents described him as rude, angry and messy. His teachers reported that he was unmotivated in his studies, and constantly getting into trouble.

Punishment – both at home and in school – did nothing to improve the upper primary school pupil’s behaviour. His parents, who are divorced, and his teachers were at a loss.

John (not his real name) was referred to therapy.

“In the initial sessions, he was quiet and unwilling to explore his family issues,” says Ms Ng Sook Wai, lead counsellor at Heart@Fei Yue, a child protection specialist centre run by Fei Yue Family Service Centre. John had witnessed domestic violence at home, says Ms Ng, and was also neglected. 

“It was important to create a safe space for him to express himself.” So she encouraged John to play.

Play is natural

Play therapy rests on a fundamental principle: For children, play is their natural language.

Ms Ng, a certified play therapist, explains: “Often, talking might not be helpful after experiencing violence or abuse, as (children and teenagers) might struggle to find words to articulate complex and often confusing feelings.” She declined to reveal her age.

She typically sees children between the ages of 4 and 12, though she works with teenagers too. The activities vary according to age.

Play therapy helps them open up and process their feelings “without the need to confront the difficulties verbally”, says Ms Ng, who has 18 years of experience working with children and at-risk youth. She has been trained in play therapy since 2012.

This indirect expression takes many forms. The centre’s therapy room is stocked with toys and art supplies, from dolls and cooking sets to building blocks and a sand tray. Children and teenagers can also choose to take a walk in the garden during the one-hour sessions.

The sessions typically last for about six months to a year.

Through their choices and actions during playtime, children reveal their inner world. Ms Ng connects with them in therapy, and notices any recurring themes, changes in how they interact with others, their energy levels, moods, and what they choose to focus on. “It tells us about how they see themselves, the world, and the people who are significant in their lives.

“I have (seen) little children who can’t talk about their daddy and mummy fighting, but once they play you can see the connecting themes.” For example, she says, they would repeatedly use the stronger dinosaurs to bite the smaller ones.

These symbolic actions can also help them process difficult experiences by expressing pent-up emotions and feelings they might struggle to articulate verbally, says Ms Ng.

Finding their voice

Play therapy goes beyond processing emotions. Ms Ng emphasises another key goal: Empowering children to find their voice – to garner the courage to speak to their network of safe adults and express their needs.

The sessions can begin with seemingly small steps. Therapists create a space where children have choices, from where to sit, to the activities they prefer.

Some children are unsure of themselves when they enter the therapy room, and constantly seek permission. “They have limited autonomy in their lives but when we work with them, they begin to experience having choices in the sessions,” she says. 

These choices may seem insignificant but over time, “something changes in them”, she says. “They make meaning of who they are and what they’re capable of through our interactions.”

Therapists prioritise active listening and validating these expressions in play and in the relationship. “My colleagues and I are conscious of ensuring that the child’s voice is heard and not dismissed,” she says. “Children and teenagers often do not speak up or speak of the ‘bad things’ that happened.

“When they struggle to understand their own behaviours and concerns, or when adults dismiss their emotions, they shut down.”

Play itself also fosters connection and openness. Children are less guarded when they’re playing, making them more likely to express their true feelings, explains Ms Ng.

This approach proved successful for John. Initially withdrawn, he gradually opened up about his frustrations at home after about six months. 

John had an honest conversation about his feelings with his father, Ms Ng shares, and realised their bond remained strong despite the break-up of the family. 

This newfound understanding helped alleviate his anxieties.

He stopped throwing tantrums at home and in school. His father and teachers also reported significant improvements in his behaviour and mood.

Ms Ng finds immense joy in seeing such transformations, and in helping children like John find their voice and discover their sense of self. “It’s very empowering for children and teenagers, because we’re not sitting here and teaching them; They are experiencing it for themselves.”

This journey of self-discovery is the foundation for healing. “Once the sense of self emerges, and we have addressed, to some extent, the negative impact of trauma, they can grow from there,” says Ms Ng.

Long shadow of violence

Domestic violence can have a long-term impact on children and teenagers, says Ms Ng Sook Wai, lead counsellor and play therapist at Heart@Fei Yue.

“When violence happens at home and the people who threaten and harm us are our own family members, it causes constant worry and fear,” she says. Children never know when the next episode might erupt, and they often live in fear for their parents’ safety.

Domestic violence refers to patterns of violent, threatening, abusive or controlling behaviours that leave victims feeling unsafe and fearful. It can take on many forms including physical, sexual, emotional and psychological abuse, and neglect. 

Domestic violence can occur in families, households, current or past intimate relationships.

Ms Ng observes that the emotional wounds can manifest in various ways:

• Fight: This can include physical or verbal aggression, rudeness, and defiance. Younger children might express this through hitting others or tantrums.
   
• Flight: Some children may fear going home, withdraw from school and social activities, experience mood swings, depression, anxiety, or become addicted to the computer. Younger children might exhibit this through bedwetting, nightmares, or clinginess.
   
• Freeze: Children may become withdrawn, unresponsive, or unable to express themselves verbally. They might appear zoned out or they may shut down emotionally.

The behaviours may not be consistent across environments, she explains. A child who appears well-adjusted at school might display aggression at home.

The emotional toll can also lead to the development of mental health issues and unhealthy coping mechanisms. The danger lies in internalising these coping strategies, she warns. 

“They could carry these (self-limiting) beliefs or labels into adulthood, and cannot get out of the anxious or the depressed state.”

They may also find it difficult to focus and learn, pursue interests, develop positive friendships, and acquire the skills and experiences crucial for their well-being and developmental growth.

While therapy can help children address their difficult feelings, Ms Ng emphasises the importance of addressing the underlying environment: “Part of the work with families is to provide parents or caregivers with knowledge on the developmental, emotional, and relational needs of their children.”

The challenging behaviours children exhibit are often a cry for help – a way to express unmet basic needs such as safety, connection, and protection, she explains.

But family involvement is not always possible. That’s where caseworkers become that “important bridge”, helping families understand their children’s needs and connecting them with necessary resources. 

Says Ms Ng: “Given their development phase, children will continue to require substantial support and understanding from their caregivers and schools to navigate primary school life and challenging teenage years.”

Break the Silence

Break the Silence is an ongoing campaign by the Ministry of Social and Family Development that aims to raise public awareness of domestic violence.

The campaign’s logo is the Signal for Help gesture – a non-verbal cue that victims can discreetly use to get help.

What to do if you spot the signal:

• Be discreet as you try to help the victim. Do not respond immediately to avoid alerting the perpetrator, who may be nearby
   
• Avoid direct confrontation with the perpetrator unless necessary, as it may potentially escalate the situation
   
• If possible, reach out to the victim using another form of communication, such as through text messages or social media
   
• Ask the victim “yes” or “no” questions to reduce risk and make it easier for them to respond. For example, you can ask if they need help or if you should call the police

In partnership with the Ministry of Social and Family Development