ABSTRACT
Children who are diagnosed with a developmental or intellectual disability can also benefit from this intervention, but clinicians should consider the child's intellectual ability. An important consideration when deciding the appropriateness of using a puppet to externalize the child's problem is the child's ability to pivot. The ability to pivot will allow the child to apply the conversation about the puppet to himself or herself. After considering the child's intellectual ability and age, clinicians should equip themselves with numerous puppets for the clinician, child, and family members to use during the activity. The goal of externalization is to help an individual realize that he or she is not the problem—the problem is the problem. The usefulness of externalization has been explained as creating distance between the problem and the client. During this intervention, the therapist will be asking questions about the "problem" in an effort to externalize it from the puppet.
