Pretend play and social play: The concurrent validity of the Child-Initiated Pretend Play Assessment.

In play therapy, assessment is more often of children’s behavioral or social issues than children’s play ability. However, understanding children’s play ability by using a reliable and valid play assessment can add to a therapist’s understanding of the child. The aim of this study was to investigate how a child’s performance on a play assessment was related to social peer play. Children’s pretend play was assessed using the Child-Initiated Pretend Play Assessment. Social peer play was assessed by preschool teachers completing the Penn Interactive Peer Play Scale. Fifty-three typically developing preschool children were assessed. A significant positive correlation was found between the level of a child’s elaborateness of play scores and peer play interaction. A significant negative relationship was found between a child’s ability to substitute objects and play disruption. A significant negative relationship was also found between a child’s ability to elaborate play and substitute objects with play disconnection. The results suggest that children’s social competence can be inferred from their play scores on the Child-Initiated Pretend Play Assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference play: Informing and enhancing therapist self-awareness through play.

The study of countertransference among therapists working with children and adolescents is a relatively recent phenomenon, but the lack of attention paid to resolving countertransference that arises during the course of play therapy is surprising. The most commonly suggested way to address countertransference in the literature is through the development of therapist self-awareness during verbal discourse in supervision. This article addresses the rationale for, and provides examples of, an active approach for dealing with potentially counter therapeutic reactions. This technique, known as countertransference play, derives from the field of art therapy and provides therapists with a logically derived means of understanding and working through countertransferential responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating play and family therapy methods: A survey of play therapists' attitudes in the field.

The researchers surveyed 295 members of the Association for Play Therapy on their attitudes related to working with families when treating children. The results indicated the majority of play therapists held attitudes conducive to involving families in their approaches with children. However, mixed findings were found in specific areas related to the implementation of play therapy with families, suggesting barriers may exist. These mixed findings included a decreased percentage of play therapists that felt like play therapy was effective in family therapy when compared with the high level who felt that play and family therapy approaches could be integrated. Moreover, the respondents were divided on issues such as parents' willingness to be involved in therapy with their children and if parents were actually resistant to being included in sessions with their children. These mixed findings suggest that a wide range of attitudes and experiences about parental involvement exist among play therapists in the field. The authors raise key questions for the play therapy field to consider in more depth and suggest improvements that may be needed in play therapy education to increase the efficacy of play therapists' skills in working with families. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Congruence in nondirective play and filial therapy: Response to Ryan and Courtney.

Differences in the training of nondirective play therapists between University of York (U.K.) approach and the Guerney and Landreth approaches (U.S.) has been raised by Ryan and Courtney (2009). York-trained therapists are encouraged to initiate expression of their own feelings at selective times to assure that therapists are congruent in their relationship with children in nondirective play-therapy. Congruence, an important component of the necessary and sufficient conditions for therapeutic personality change (Rogers, 1957), is based on the importance of therapist genuineness to maintain a trustful and safe therapeutic relationship. This article compliments Ryan and Courtney (2009) for introducing the importance of congruence in play therapy. The assumptions of nondirective play therapy in the Guerney approach was influenced significantly by their development of filial therapy and to the training of parents and therapists, This article asserts that congruence, in the Guerney approach, is incorporated by therapists expressing their own feelings only when this is initiated overtly or covertly by the child. Responding to a child in this way is dependent on the empathic attunement to a child's emotional motivation by a skillful parent or therapist. This raises questions about whether a nondirective stance is maintained in the York approach. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Legal and ethical issues in play therapy.

Play therapists work with minor children in their practice; therefore the play therapist must be cognizant of the special circumstances under the law and major professional codes of ethics that apply to this special population. Major court cases, legislation, and critical issues are condensed in this article. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis.

There has been significant interest in the role of anxiety sensitivity (AS) in the anxiety disorders. In this meta-analysis, we empirically evaluate differences in AS between anxiety disorders, mood disorders, and nonclinical controls. A total of 38 published studies (N = 20,146) were included in the analysis. The results yielded a large effect size indicating greater AS among anxiety disorder patients versus nonclinical controls (d = 1.61). However, this effect was maintained only for panic disorder patients compared to mood disorder patients (d = 0.85). Panic disorder was also associated with greater AS compared to other anxiety disorders except for posttraumatic stress disorder (d = 0.04). Otherwise the anxiety disorders generally did not differ from each other in AS. Although these findings suggest that AS is central to the phenomenology of panic disorder and posttraumatic stress disorder, causal inferences regarding the role of AS in these anxiety disorders cannot be made. Moderator analyses showed that a greater proportion of female participants was associated with larger differences in AS between anxiety and nonclinical control groups. However, more female participants were associated with a smaller AS difference between anxiety and mood disorder groups. This finding suggests that AS is less robust in distinguishing anxiety from mood disorders among women. Age also moderated some observed effects such that AS was more strongly associated with anxiety disorders in adults compared to children. Type of AS measure used also moderated some effects. Implications of these findings for the conceptualization of AS in anxiety-related disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Play therapy and psychopharmacology: What the play therapist needs to know": Correction.

Reports an error in "Play therapy and psychopharmacology: What the play therapist needs to know" by Daniel S. Sweeney and Ross J. Tatum (International Journal of Play Therapy, 1995, Vol 4[2], 41-57). The table "Childhood DSM-IV Diagnoses and Psychotropic Medications That May Be Indicated" on pages 46-47 contained three (3) errors. A corrected copy of the table is included with the erratum. (The following abstract of the original article appeared in record 1997-05134-004.) Provides a basic overview of pediatric psychopharmacology and examines specific related considerations for the play therapist. The article also addresses some medication considerations specific to the treatment modality of play therapy. It is argued that possession of even a cursory knowledge about child psychopharmacology places the play therapist in a better position to provide quality treatment. A list of childhood Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnoses and psychotropic medications that may be indicated is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The value and use of interpretation in play therapy.

Irrespective of the therapist's theoretical orientation, interpretation can be a very powerful tool within play therapy, supporting the essential change processes delimited by S. Shirk and R. Russell (1996). However, several issues often interfere with play therapists' optimal use of interpretation. One is the sense of conflict many child-centered therapists experience because they view interpretation as overly directive and inconsistent with their desire to follow the child's lead and pace in session. Second, the lack of a well-organized, stepwise model of interpretation formulation and delivery makes it difficult for therapists to be consistent in its use. Third, the absence of a solid understanding of how interpretation supports the therapy process reduces therapists' tendency to use this highly flexible technique. This article attempts to provide a model of interpretation that addresses each of these issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: A randomized controlled trial.

Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a 9-week, Internet-delivered, self-help program that was combined with 2 group exposure sessions in real life and minimal therapist contact via e-mail. Results were analyzed on an intention-to-treat basis, including all randomized participants. From pre- to posttest, treated participants in contrast to controls showed significant improvement on most measured dimensions (social anxiety scales, general anxiety and depression levels, quality of life). The overall within- and between-groups effect sizes were Cohen's d = 0.87 and 0.70, respectively. Treatment gains were maintained at 1-year follow-up. The results from this study support the continued use and development of Internet-distributed, self-help programs for people diagnosed with social phobia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sociocultural contexts for the early development of semiotic production.

Children constantly encounter signs during cultural practices, although many theories do not fully acknowledge sociocultural aspects of semiotic development. The author examines research on cultural practices and contexts in which children learn to produce signs involving representational drawing and pretend play. This work is contrasted with more individualistic views of semiotic development that fail to adequately address sociocultural aspects of semiotic functioning to varying degrees. The author also presents a theoretical model for understanding the structure of any sign system and for comparing semiotic systems, using examples from the drawing and pretense literatures. It is proposed that the sign-making practices in which children participate are shaped by a complex hierarchy of conventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparing play therapists for disaster response: Principles and procedures.

In the wake of numerous recent natural disasters such as the 2004 tsunami and 2005 hurricanes, play therapists have been asked to provide disaster response. However, the role of disaster response interventionists is vastly different from the typical role of play therapists. In order for play therapists to be prepared for disaster response, an explanation of disaster response principles and procedures is needed. This article will help educate play therapists about how to use their play therapy skills and knowledge in a disaster response environment. Specifically, this article will (a) explain basic principles such as following the Incident Command Structure; (b) discuss the play therapist's role in disaster response in light of the phase of disaster; and (c) recommend disaster response procedures. Examples from APT members' response to the tsunami and Hurricane Katrina are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term group play therapy with Chinese earthquake victims: Effects on anxiety, depression and adjustment.

Investigated the effectiveness of short-term child-centered group play therapy in elementary school settings with Chinese children in Taiwan who experienced an earthquake in 1999. 65 children (aged 8-12 yrs) were screened. Children in the experimental group scored significantly lower on anxiety level and suicide risk after play therapy than did children in the control group. The effects of the treatment support previous studies of play therapy with American children. These findings reveal the possibility of disaster intervention services adopting Western helping techniques with school children of non-Western cultures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

More than a mirror: The ethics of therapist self-disclosure.

Perspectives on the ethical implications of self-disclosure differ widely. Many authors warn that self-disclosure by a therapist can be exploitative. Some authors also highlight beneficent reasons for disclosing in therapy. The ethicality of a particular self-disclosure is likely to depend on the content of the disclosure, the therapist's rationale for the disclosure, the personality traits of the client to whom the disclosure is made, and the specific circumstances surrounding the disclosure. Research suggests that clients experience both positive and negative consequences as a result of their therapists' self-disclosures. Because of the ambiguity and complexity of this ethical issue, therapists must take into account numerous ethical principles when using interventions that involve self-disclosure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute effects of qigong exercise on mood and anxiety.

Psychosocial stress may lead to increased rates of anxiety and depression. Aerobic exercise and mind-body therapies are frequently described as having positive effects on psychological well-being by enhancing mood and reducing anxiety. Few studies, however, have investigated the acute psychological effects of qigong exercise. Fifty-nine regular qigong exercisers (mean age 50.8 years) were randomized to a Qigong or Control group. Pre- and postmeasurements were then compared. POMS-Depression, Anger, and Fatigue, and STAI-State Anxiety scores decreased significantly in the Qigong group but not in the Control group. Results thereby suggest that qigong exercise can produce desirable psychological effects, and Qigong exercise may therefore be included among other activities performed to boost resistance to daily stressors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample.

The comorbidity of current and lifetime DSM-IV anxiety and mood disorders was examined in 1,127 outpatients who were assessed with the Anxiety Disorders Interview Schedule for DSM-IV:Lifetime version (ADIS-IV-L). The current and lifetime prevalence of additional Axis I disorders in principal anxiety and mood disorders was found to be 57% and 81%, respectively. The principal diagnostic categories associated with the highest comorbidity rates were mood disorders, posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). A high rate of lifetime comorbidity was found between the anxiety and mood disorders; the lifetime association with mood disorders was particularly strong for PTSD, GAD, obsessive-compulsive disorder, and social phobia. The findings are discussed in regard to their implications for the classification of emotional disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Taking fiction seriously: Young children understand the normative structure of joint pretence games.

Joint pretence games are implicit rule-governed activities with a normative structure: Given shared fictional stipulations, some acts are appropriate moves, others are inappropriate (i.e., mistakes). The awareness of 2- and 3-year-old children of this normative structure was explored, as indicated by their ability to not only act according to the rules themselves but to spontaneously protest against 3rd party rule violations. After the child and a 2nd person had set up a pretence scenario, a 3rd character (a puppet controlled by another experimenter) joined the game and performed acts either appropriate or inappropriate to the scenario set-up. Children in both age groups protested specifically against inappropriate acts, indicating they were able to not only follow pretence stipulations and act in accordance with them but to understand their deontic implications. This effect was more pronounced in the 3-year-olds than in the 2-year-olds. The results are discussed in the broader context of the development of social understanding and cultural learning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bibliotherapy for children with anxiety disorders using written materials for parents: A randomized controlled trial.

The current trial examined the value of modifying empirically validated treatment for childhood anxiety for application via written materials for parents of anxious children. Two hundred sixty-seven clinically anxious children ages 6-12 years and their parents were randomly allocated to standard group treatment, waitlist, or a bibliotherapy version of treatment for childhood anxiety. In general, parent bibliotherapy demonstrated benefit for children relative to waitlist but was not as efficacious as standard group treatment. Relative to waitlist, use of written materials for parents with no therapist contact resulted in around 15% more children being free of an anxiety disorder diagnosis after 12 and 24 weeks. These results have implications for the dissemination and efficient delivery of empirically validated treatment for childhood anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structured play therapy: A model for choosing topics and activities.

This article presents a model to be used for structured play therapy for use with adolescents and children ages 7 yrs and older. Structured play therapy is a form of play therapy that is directive and uses planned, structured activities in almost every session. This model was developed to provide a framework for appropriate timing and sequence of structured activities. This article describes structured play therapy and how it differs from nondirective play, presents a structured play therapy model, presents specific guidelines for choosing appropriate structured activities and exercises, and presents a case study demonstrating application of the model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability of DSM-IV anxiety and mood disorders: Implications for the classification of emotional disorders.

The reliability of current and lifetime Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) anxiety and mood disorders was examined in 362 outpatients who underwent 2 independent administrations of the Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV–L). Good to excellent reliability was obtained for the majority of DSM-IV categories. For many disorders, a common source of unreliability was disagreements on whether constituent symptoms were sufficient in number, severity, or duration to meet DSM-IV diagnostic criteria. These analyses also highlighted potential boundary problems for some disorders (e.g., generalized anxiety disorder and major depressive disorder). Analyses of ADIS-IV–L clinical ratings (0–8 scales) indicated favorable interrater agreement for the dimensional features of DSM-IV anxiety and mood disorders. The findings are discussed in regard to their implications for the classification of emotional disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)