Fiercely independent, gifted children jealously guard their thoughts and creative impulses. Not surprisingly, they are suspicious of any therapeutic interventions. Their trust has to be earned. Gifted children do want to know that the therapist appreciates their giftedness, but they want the acknowledgement of their quirky personality, unusual imagination, and passionate interests to be low-keyed and indirect.

The best way to establish a therapeutic alliance with a gifted child is to convey that even in the face of all of the child’s marvelous accomplishments, there is a deeper part of them that is worried and in pain. The therapist suggests that together, they will work to discover what this pain may be and how to get rid of it.

Therapy with the gifted child begins the way therapy with all children begins—with play. Play serves a number of functions in a child’s normal growth and development. It allows children to experience their feelings in safe, vicarious ways. In the make-believe world of play, a gifted child can develop a sense of control, mastery, and competence that can be used in the real world. Play is also a displaced, nonthreatening way of discharging tensions about troublesome conflicts with family, friends, school, and in one’s self.

In therapy, children use play to communicate their problems. Gifted children will often create a complex and highly imaginative story using drawings, Legos, the dollhouse, car chases, or anything else at their disposal. At first, these stories may seem unconnected to the child’s problems. The therapist working with gifted children needs to understand that these seemingly unconnected stories are a reflection of a gifted child’s rich imagination and a way for a him/her to symbolically explain and express his/her feelings and conflicts about anger, sadness, jealousy, and worries. These stories are a way of introducing highly emotional material that she/he is not ready to discuss more directly.

Decoding the symbols into a narrative about the child’s real concerns, conflicts, and worries and the feelings fueled by them is one of the therapist’s first tasks. The timing of when to translate these metaphors into the child’s real personal concerns is crucial: too soon, and the empathic connection can be destroyed; too late, and the opportunity to tie the symbols to real experiences can pass.

Play for the older, school-aged child can seem less imaginative but it is no less disguised and symbolic. This kind of play may include board games, cards, or video games. The style of this kind of play is sometimes as important as the content. It can communicate the child’s problems with competition, the need to win or (no matter how brilliant) the desire to lose.

Sometimes play can be more than an expression of unconscious conflicts. For example, a number of gifted, older adolescent girls, well beyond imaginative or structured play, suddenly asked to play Candy Land (a game for young pre-readers). Although this seemed like a regression in the therapy, in fact it was a vehicle to minimize their discomfort as they began to discuss their questions and conflicts about their emerging sexual feelings.