The future of play therapy: Elevating credibility through play therapy research.

Elevating credibility in play therapy through research has been a difficult task. This difficulty is represented well in the Myth of Sisyphus (wherein Sisyphus is cursed with the mandate of rolling a large boulder up a hill, only to have it roll back down every time he approaches the top of the hill). Play therapy, in some form, has been in mental health clinics, clinician’s offices, and in journals for more than a century—yet empirical research on play therapy has consistently lagged behind practice. Also, we have several decades of research supporting the use of play therapy in addressing many common childhood problems, yet there is little recognition of play therapy as an “empirically supported treatment.” To stretch the Myth of Sisyphus just a bit, if we are to see the effort to develop empirical support for play therapy as our task, we need to look carefully at who is pushing the boulder, what strategies are being used to get the boulder up the hill, and how we will we know when we’ve reached the top of the hill. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recommendations for supervising play therapists.

Although a number of articles have been published on the effectiveness of training play therapists, little has been developed on specific aspects that may facilitate the supervisory process in guiding the professional development of play therapists. Recommendations about effective approaches and strategies are offered to those involved in training and supervising play therapists. These recommendations evolved from the experience of a licensed clinical psychologist who teaches play therapy classes and has been involved in the practice of play therapy for over twenty years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child-centered play therapy with a seven-year-old boy diagnosed with intermittent explosive disorder.

Child-centered play therapy (CCPT) has been supported as an effective method for working with children. A case study is presented that describes treatment using CCPT with a 7-year-old boy diagnosed with intermittent explosive disorder (IED). This case study delineates 16 sessions of play therapy with a registered play therapist. The behavioral problems the child exhibited at the onset of therapy were greatly improved at the conclusion of the sessions. The outcome of this case study supported the use of play therapy for children with IED. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of play therapy outcomes.

The results of a meta-analysis of play therapy research are presented with an emphasis on characteristics of therapy that predicted treatment outcomes. Results of the analysis are based on experimental and quasi-experimental studies of play therapy. The results indicate that play therapy has a moderate positive effect on treatment outcomes with children. Parental involvement and treatment duration were significantly related to treatment outcome. Studies that involved therapy for 30–35 sessions produced the greatest effect. Nonsignificant predictors of treatment outcome are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repetitive symbolic play as a therapeutic process in child-centered play therapy.

Child-centered play therapy describes the therapeutic relationship between the child and play therapist as a facilitative environment that provides the child with an experience of congruence within their sense of self, promoting self-directed healing. Within this environment, the child is able to confront emotional pain imbedded in lived, relational experiences, processing and gaining mastery over it through repetitive symbolic play. However, very little research exists regarding repetitive symbolic play as a therapeutic process. This article aims to illustrate, through the use of a qualitative, interpretative case study and hermeneutic enquiry, how a 6-year-old boy's use of repetitive symbolic play assisted him toward healthier adjustment in his home and school environments. Hermeneutic analysis suggests that the child's use of repetitive symbolic play became a therapeutic process in and of itself that contributed toward self-directed change within his sense of self, which promoted healthier adjustment within his environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multicultural trends and toys in play therapy.

Because culture plays an increasingly important role in play therapy, the purpose of this article is to review existing literature on multicultural issues in play therapy and to discuss current trends and toys in play therapy reported from a group of play therapists. A group of play therapists (N = 505) registered with the Association for Play Therapy were asked to respond to two open-ended questions: What trends, if any, do you see in play therapy with your culturally diverse clients? What items do you include in your playroom to specifically represent culturally diverse populations? Responses to these open-ended questions were analyzed using open and axial coping as part of the inductive process. Results of the first question were grouped into five main categories and responses to the second question were categorized based on area and type of play. Based on the results of this study, implications for multicultural play therapy are discussed. (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)     

Introduction to play therapy research theme issue.

Play therapy is at a point in its history where outside forces are demanding that we look at ourselves and demonstrate that what we do has empirical value. Many of these outside forces have either ignored play therapy or have questioned, even denied, the capacity of play therapy to produce positive outcomes in therapy and counseling of children. It is from this perspective that the need for a special research theme issue was born. Detractors and supporters of play therapy need to know what the state of the art is in play therapy research, along with ways we can help move play therapy research exposure and credibility forward. Sandra Frick-Helms was invited to guest edit this first in a series of theme issues for the International Journal of Play Therapy. She in turn asked Athena Drewes to join her in coediting this issue because of her wide range of knowledge, skill, and contacts in the therapy and counseling fields. Together, they have compiled an impressive grouping of authors and researchers who offer the reader food for thought and practical tips for research application. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

1993: Axline's eight principles of play therapy revisited.

Examined V. Axlines's book, Play Therapy (1947) which includes 8 basic principles on non-directive play therapy. Student responses to learning these principles in play therapy classes were also examined. Each student was assigned a play therapy client and was observed and assisted directly by the instructor, a licensed clinical psychologist. Clients were mildly trouble children (aged 5–10 yrs) and were selected from a referral base by the instructor as appropriate for the course. As the semester progressed and students gained direct experience, weekly small (3–4 student) group discussions were held to explore in-depth understanding of play therapy principles and how these principles are put into practice. It is concluded that Axline's book remains a classic text and a foremost resource in the field. Coupling it with experiential learning is an invaluable basis for teaching play therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of client-centered group play therapy on self concept.

V. M. Axline's (1969) basic principles for client-centered play therapists direct the therapist to create an environment in which clients are granted the basic freedoms that V. Satir (1976) has delineated as necessary for self concept enhancement. This relationship between client-centered play therapy and self concept enhancement is evident when comparing their histories. This study investigated the effects of client-centered play therapy on self concept in a 10 session client-centered play therapy group involving 3 male and 3 female 6-9 yr olds with a variety of clinical problems. Two individual case studies from the group are presented which indicate that client-centered group play therapy enhances self concept. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of intensive individual play therapy for chronically ill children.

Examined the effectiveness of play therapy for children (aged 7-11 yrs) diagnosed with insulin-dependent diabetes mellitus (IDDM). Specifically, the intent of the study was to determine the effectiveness of an intensive play therapy intervention in (a) reducing symptoms of anxiety in children with IDDM, (b) reducing the overall behavior difficulties in children with IDDM, (c) increasing healthy adjustment in children with IDDM, (d) increasing diabetic's children's adherence to their diabetic regime, and (e) having an impact on these emotional and behavioral symptoms over time. The experimental group comprised 9 boys and 6 girls. Analysis of covariance revealed that the children in the experimental group significantly improved their adaptation to their diabetes following intensive play therapy. Results indicate that intensive play therapy may be an effective intervention for children diagnosed with IDDM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What the research shows about play therapy.

The results of a comprehensive literature review of 82 play therapy research studies from 1942–2000 are summarized with an emphasis on the effectiveness of play therapy with specific presenting issues and populations. Studies are organized by research topic in chart form to allow play therapists to readily utilize the information to educate parents, schools, judicial systems, managed care systems, other mental health professionals, and other populations with whom they work. Although positive outcomes were noted with each of the research areas, self-concept, behavioral adjustment, social skills, emotional adjustment, intelligence, and anxiety/fear are topics demonstrating the most significance regarding the efficacy of play therapy. Although not all outcomes have supported the use of play therapy as viable intervention, the authors focus primarily on significant findings regarding play therapy effectiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effectiveness of play therapy: Responding to the critics.

Notes that play therapy has long been criticized for a lack of adequate research base to prove its efficacy. For 6 decades, while play therapists conducted small research studies, critics challenged the utility and efficacy of play therapy as a viable psychotherapy intervention. The purpose of this study was to conduct a meta-analysis of 94 research studies focusing on the efficacy of play therapy, filial therapy, and combined play therapy and filial therapy. The following electronic databases were used in the authors 3-yr search for studies on play therapy: PsycLit, PsycINFO, ERIC, FirstSearch, and Dissertation Abstracts. Meta-analysis revealed a large positive effect on treatment outcomes with children. Play therapy appeared effective across modality, age, gender, clinical vs nonclinical populations, setting, and theoretical schools of thought. Additionally, positive play therapy effects were found to be greatest when there was parent involvement in treatment and an optimal number of sessions provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pretend play processes and anxiety: Considerations for the play therapist.

This study investigated the effect of anxiety on play processes in 43 first-, second-, and third-grade children. Using a mood-induction procedure, this study compared processes in play among children randomized to an anxious or neutral mood-induction procedure. Children were assessed using the Affect in Play Scale pre- and post-mood-induction. In addition, this study examined relationships between pretend play processes and self-reported state and trait anxiety levels using the State Trait Anxiety Inventory for Children. Findings demonstrated a significant negative relationship between baseline state anxiety level and organization of the play narrative. Consistent with previous research, children in both conditions significantly improved on multiple play scores over time. Although pretend play processes were not significantly affected by condition assignment, further analysis with a more sensitive measure of affect in play revealed a significant interaction between state anxiety and condition assignment on the amount of positive affect expressed in play. Results indicate that play processes can improve with time and greater state anxiety may impact organization and affective processes in play. Implications for play therapy are discussed in terms of the potential impact anxiety has on play processes. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The therapeutic use of ball play in psychotherapy with children.

Describes how ball play—noted as one of the earliest and most enduring forms of play—can be used as a directive play therapy technique to facilitate talk therapy with children. Four stages of the ball play therapy process are outlined: (1) rapport building, (2) creating a therapeutic context, (3) pacing and punctuating the dialogue, and (4) anchoring a solution. The author illustrates, using case examples, how the integration of ball play with talk therapy can be an effective intervention in psychotherapy with children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating the impact of child-centered play therapy training.

The researchers designed this study to determine the effects of a comprehensive child-centered play therapy training course for beginning play therapy graduate students in (1) improving positive attitudes and beliefs toward children, (2) improving play therapy knowledge, (3) improving confidence in applying play therapy skills, (4) reducing dominance tendencies in trainees, and (5) reducing intellectual efficiency in trainees. Results of the analyses of covariance reveal that students in the experimental group demonstrated a significant improvement in their positive attitudes and beliefs toward children, play therapy knowledge, confidence in applying play therapy skills and a significant reduction in their dominance tendency and intellectual efficiency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effective parent consultation in play therapy.

Effective communication with caregivers can contribute to successful play therapy outcomes. This article examines the structure of parent consultation in play therapy. The components of effective parent consultation are outlined, from the initial phone interview through termination, to provide guidance to play therapists for communicating with caregivers throughout the therapy process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)