Child-Centered Play Therapy Research E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 780

Veröffentlichungsjahr: 2010

Beschreibung

The first book of its kind to provide exhaustive, in-depth coverage of play therapy research Child-Centered Play Therapy Research: The Evidence Base for Effective Practice offers mental health professionals, school district administrators, community agency administrators, judges, lawyers, child protection caseworkers, and medical professionals a comprehensive discussion of play therapy research studies. Guidance is provided on evidence-based methods, as well as on how¿future play therapy research should be conducted. Edited by renowned experts in the field of play therapy, this rich compilation features contributions by child-centered play therapy researchers, with relevant discussion of: * The history of play therapy research * A synopsis of current empirical support * Play therapy research on chronically ill children, child witnesses of domestic violence, and victims of natural disasters, among many other topics With coverage of important practice guidelines, Child-Centered Play Therapy Research identifies the most prominent and current play therapy research studies, as well as research directions for clinicians to design evidence-based research studies of their own.

Leseprobe

Table of Contents

Title Page

Copyright Page

Dedication

Foreword

Preface

REFERENCES

ORIGINAL SOURCES FOR RESEARCH STUDIES

About the Editors

Contributors

SECTION I - OVERVIEW OF PLAY THERAPY RESEARCH

CHAPTER 1 - What the Research Shows About Play Therapy: Twenty-First Century Update

INTRODUCTION TO PLAY THERAPY RESEARCH

DISCUSSION

REFERENCES

SECTION II - RESEARCH IN PLAY THERAPY

CHAPTER 2 - Increased Self-Efficacy: One Reason for Play Therapy Success

QUESTIONS AND IDEAS COME FROM PRACTICE

SELF-EFFICACY AND CHILD-CENTERED PLAY THERAPY THEORY

SELF-EFFICACY, CHILD-CENTERED PLAY THERAPY, AND CLASSROOM LEARNING BEHAVIORS

REFERENCES

CHAPTER 3 - The Efficacy of Intensive Individual Child-Centered Play Therapy ...

THE NEED FOR INDIVIDUAL PLAY THERAPY FOR CHRONICALLY ILL CHILDREN

METHOD

ANALYSIS OF DATA RESULTS AND DISCUSSION

RESULTS

DISCUSSION

CONCLUDING REMARKS

REFERENCES

CHAPTER 4 - Intensive Sibling Group Play Therapy with Child Witnesses of ...

INTRODUCTION

CHILD WITNESSES OF DOMESTIC VIOLENCE

INTENSIVE SIBLING GROUP PLAY THERAPY

METHOD

RESULTS

DISCUSSION

RECOMMENDATIONS

REFERENCES

CHAPTER 5 - Effects of Postearthquake Group Play Therapy with Chinese Children

PREVALENCE AND IMPACT OF EARTHQUAKES ON CHILDREN

METHOD

RESULTS

DISCUSSION

LIMITATIONS AND RECOMMENDATIONS

REFERENCES

CHAPTER 6 - Play Therapy Effect on Relationship Stress

CHILD RELATIONSHIPS WITH PARENTS AND TEACHERS

INDIVIDUAL CHILD-CENTERED PLAY THERAPY AND CHILD RELATIONSHIPS

STUDY 1: IMPACT OF PLAY THERAPY ON PARENT-CHILD RELATIONSHIP STRESS AT A MENTAL ...

STUDY 2: TWO COUNSELING INTERVENTIONS TO REDUCE TEACHER-CHILD RELATIONSHIP STRESS

STUDY 3: EFFECT OF SHORT- AND LONG-TERM PLAY THERAPY SERVICES ON TEACHER-CHILD ...

DISCUSSION

REFERENCES

CHAPTER 7 - Impact of School-Based Child-Centered Play Therapy on Academic ...

METHOD

RESULTS

CLINICAL SIGNIFICANCE

DISCUSSION

RECOMMENDATIONS FOR FURTHER RESEARCH

REFERENCES

CHAPTER 8 - Play Therapy with Children Exhibiting ADHD

PLAY THERAPY IMPACT ON CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

BRIEF LITERATURE REVIEW

METHOD

RESULTS

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 9 - A School-Based Group Activity Therapy Intervention with ...

MOTIVATION AND RATIONALE FOR STUDY

RESEARCH DESIGN

RESULTS

TOTAL BEHAVIOR

DISCUSSION

RECOMMENDATIONS FOR FURTHER RESEARCH AND PRACTICE

CONCLUSION

REFERENCES

CHAPTER 10 - School-Based Child-Centered Play Therapy with Hispanic Children

RATIONALE: PUTTING AWARENESS INTO ACTION

METHOD

RESULTS AND DISCUSSION

THE CASE OF THE BOY WHO COULDN’T WIN

REFERENCES

CHAPTER 11 - Effectiveness of Child-Centered Play Therapy for Children ...

USE OF PLAY THERAPY IN ELEMENTARY SCHOOLS

METHOD

RESULTS

RECOMMENDATIONS

REFERENCES

CHAPTER 12 - Effectiveness of Child-Centered Play Therapy and Person-Centered ...

A SINGLE-CASE PLAY THERAPY DESIGN FOR CHILDREN WITH ADHD

RATIONALE

METHOD

RESULTS

DISCUSSION

RECOMMENDATIONS

CONCLUSION

REFERENCES

CHAPTER 13 - Child-Centered Play Therapy and Child Development: A Single-Case Analysis

RELATIONSHIP BETWEEN CHILD DEVELOPMENT AND PLAY THERAPY

RESULTS AND DISCUSSION

REFERENCES

CHAPTER 14 - Children’s Perceptions of Play Therapy

RATIONALE

PLAY THERAPY

PLAY THERAPY IN ELEMENTARY SCHOOLS

METHOD

RESULTS AND DISCUSSION

LIMITATIONS AND RECOMMENDATIONS

REFERENCES

SECTION III - RESEARCH IN FILIAL THERAPY

CHAPTER 15 - Child Parent Relationship Therapy: A Review of Controlled-Outcome Research

HISTORY OF FILIAL THERAPY RESEARCH

META-ANALYTIC RESEARCH SUPPORT

RESEARCH SUPPORT FOR CHILD PARENT RELATIONSHIP THERAPY

SUMMARY

REFERENCES

CHAPTER 16 - Filial Therapy with Parents of Chronically Ill Children

CHILDHOOD CHRONIC ILLNESSES

METHOD

RESULTS

DISCUSSION

CONCLUSIONS

REFERENCES

CHAPTER 17 - Filial Therapy with Native Americans on the Flathead Reservation

INTRODUCTION

METHOD

RESULTS AND DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 18 - Filial Therapy with Chinese Parents

FILIAL THERAPY

METHOD

DISCUSSION

SUMMARY

REFERENCES

CHAPTER 19 - Child Parent Relationship Therapy with African American Parents

METHOD

RESULTS

DISCUSSION

RECOMMENDATIONS

REFERENCES

CHAPTER 20 - Child Parent Relationship Therapy with Hispanic Parents

METHODOLOGY AND PROCEDURES

RESULTS

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 21 - High School Students as Therapeutic Agents with Young Children

FILIAL THERAPY WITH HIGH SCHOOL STUDENTS

METHODS AND PROCEDURES

INSTRUMENTATION

RESULTS AND DISCUSSION

RECOMMENDATIONS

REFERENCES

CHAPTER 22 - Filial Therapy with Teachers of Deaf and Hard of Hearing Preschool Children

INTRODUCTION

METHOD

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 23 - Child-Centered Kinder Training for Teachers of Preschool Children ...

BENEFITS OF PLAY THERAPY

CHILD TEACHER RELATIONSHIP TRAINING

RESEARCH GOALS

METHODS

RESULTS

DISCUSSION

REFERENCES

CHAPTER 24 - An Early Mental Health Intervention for Disadvantaged Preschool Children

CHILD TEACHER RELATIONSHIP TRAINING: AN EARLY INTERVENTION FOR AT-RISK ...

RESEARCH METHODOLOGY

RESULTS AND DISCUSSION

LIMITATIONS AND RECOMMENDATIONS

CONCLUSION

REFERENCES

CHAPTER 25 - A Qualitative Study of Parents’ Perceptions of Filial Therapy in ...

“PLAY INTERVENTION”

RESEARCH METHODS

RESULTS AND DISCUSSION

CONCLUSION

REFERENCES

SECTION IV - FUTURE RESEARCH DIRECTIONS FOR PLAY THERAPY

CHAPTER 26 - Evidence-Based Standards and Tips for Play Therapy Researchers

EVIDENCE-BASED CRITERIA

TIPS FOR SUCCESS

WHERE ARE WE NOW?

CONCLUSION

REFERENCES

Author Index

Subject Index

This book is printed on acid-free paper.

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The Association for Play Therapy graciously provided permission to reprint methods and results sections from the following articles: Fall, Navelski, & Welch, 2002; Foley, Higdon, & White, 2006; Garza, & Bratton, 2005; Glover & Landreth, 2000; Green, & Christensen, 2006; Jones & Landreth, 2002; Jones, Rhine, & Bratton, 2002; Packman & Bratton, 2003; Post, McAllister, Sheely, Hess, & Flowers, 2004; Ray, Blanco, Sullivan, & Holliman, 2009; Ray, Schottelkorb, & Tsai, 2007; Shen, 2002; Smith & Landreth, 2004; Tew, Landreth, Joiner, & Solt, 2002; Tyndall-Lind, Landreth, & Giordano, 2001; Yuen, Landreth, & Baggerly, 2002.

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Library of Congress Cataloging-in-Publication Data: Baggerly, Jennifer.

Child-centered play therapy research : the evidence base for effective practice / Jennifer Baggerly, Dee C. Ray, Sue C. Bratton.

p. cm.

Includes index.

eISBN : 978-0-470-60910-1

1. Play therapy. 2. Child psychotherapy. I. Ray, Dee C. II. Bratton, Sue C. III. Title.

RJ505.P6B34 2010

618.92’8914—dc22

2009046307

From Jennifer Baggerly, I dedicate this book to my mother, Jean Louise Baggerly, who is the wind beneath my wings, and to my daughter, Katelyn Jean Baggerly, who also is learning to fly high.

From Dee Ray, I dedicate this book to all play therapists who want to research the difference they make in children’s lives but just have not had the chance yet. We hope this book inspires you. I also dedicate this book to my family who always inspires me to continue trying to make a difference.

From Sue Bratton, I dedicate this book to the play therapy pioneers whose vision and unfailing dedication amaze and inspire me. Specifically, I thank Garry Landreth, my mentor and friend, for his innovative contributions to the research and development of CCPT: Without you, this book truly would not be possible! I also want to acknowledge the many doctoral students as well as children and parents who have graciously participated in our research: You hold a special place in my heart! Finally, thank you, David and Lauren, for your love and encouragement. Without you, none of this would matter!

Foreword

PLAY THERAPY IS the most developmentally appropriate way to approach children in a counseling relationship, and it is in this safe, nurturing environment that children play out what they safe, nurturing environment that children play out what they have experienced, their reactions and feelings about those experiences, what they need in their lives, and how they feel about themselves. Thus, play therapy is a complete therapeutic modality. I have long thought that play therapy is the most effective way we can help to make the world a safer place for children because in play therapy there will be no harm. Play therapy is a place that is absolutely safe, a place where the child is accepted as the person he is. In this kind of relationship, the creative- and growth-promoting potential of children emerges. We know experientially that this process occurs and have an accumulation of research-based studies that verify this fact.

The work of researchers in the field of play therapy has largely been overlooked, though, by the mental health profession. Although there are a multitude of published research studies, the general assumption of mental health professionals seems to have been, first, that play therapy is not effective and, second, that there probably hasn’t been very much research. Consequently, the general population of mental health professionals has made little effort to find and become acquainted with existing play therapy research. Jennifer Baggerly, Dee Ray, and Sue Bratton have remedied this situation with the publication of this book, which pulls together significant research studies in the field of play therapy. A careful examination of 70 years of research, which has increased geometrically since the early 1940s, is a monumental undertaking, and the results are affirming, confirming, rewarding, supportive, encouraging, exciting, stimulating, and a significant contribution to the mental health field in general and the field of play therapy specifically. Does the use of play therapy and filial therapy result in changes in the behavior problems and adjustment of children? Yes, play therapy and filial therapy are effective as shown by the results of studies in this book.

The modalities of play therapy and filial therapy are no longer upstart “new kids on the block” as viewed by some. These modalities have matured into seasoned approaches. Likewise, the models, designs, and research methods used in play therapy research have become increasingly sophisticated and scientifically rigorous. Some of the most recent and best-designed play therapy and filial therapy research studies are included in this book.

Although the trend in the field of play therapy to become more scientific in measuring results has been necessary, the importance of the person of the child must never be overlooked. The person of the child is always more important than the child’s presenting problem. And although I agree with and support the need for research, I hope we will never be able to measure the person of a child, because if we were able to do that, we would be in a position to control children, and I fear that. As you read this book, I can assure you that although there is a focus and emphasis on the measurement of behavior, there is an undercurrent of sensitivity to the child and an obvious concern for the emotional needs and welfare of children. Although we may never be able to measure the intangible dimensions in the play therapy relationship, it just may be that these are the most important elements in the play therapy process. There is still much to be done in studying the area of process to increase our knowledge of this important dimension.

Perhaps it is enough at this time to have this book in our hands that brings together in a clear and understandable way some of the most important studies in the field of play therapy and filial therapy. A light has been shined on our pathway.

Garry L. Landreth

Regents Professor

University of North Texas

Preface

“WHERE’S THE PLAY therapy research? I haven’t seen any,” was asked by several of my colleagues. Frankly, I feel aggravated by this question. I always have to bite my tongue, smile politely, and say, “Oh, there is a growing evidence-base of play therapy research. It is mostly published in the International Journal of Play Therapy. The most recent study is . . . ” Then I proceed into a long lecture on play therapy research, to the point where my colleague becomes aggravated!

As the former research chair of the Association for Play Therapy and a play therapy researcher myself, I have answered this question about play therapy research in different formats through conference presentations, book chapters, university classes, and casual conversations. In fact, I have answered the question so often that I decided to follow one of my general rules—if you have to explain it more than two times, then write it down. Hence, the purpose of this book is to explain the most prominent play therapy research studies in this millennium, in a non-aggravating conversational tone with personal motivation by the researchers who actually conducted the studies.

Fortunately, I already knew most of the play therapy researchers from being a doctoral student at the University of North Texas and through my involvement with the Association for Play Therapy. Two of the most prominent play therapy researchers, Dr. Dee Ray and Dr. Sue Bratton, are my mentors and personal friends. Since they would be contributing a large amount of the chapters, it made sense to invite them to co-edit the book. Our common mentor, dissertation chair, and the “grandfather” of child-centered play therapy is Dr. Garry Landreth. He honored us by writing the foreword.

When reading this book, you will notice that all the research studies described are based on the child-centered play therapy (CCPT) theoretical orientation and filial therapy approach. This focus is because virtually all play therapy research studies that were published in a professional journal since the year 2000 were CCPT or filial therapy. Therefore, before describing the book contents, it will be helpful to provide a brief introduction to CCPT.

CCPT was popularized and operationalized by Virginia Axline (1947, 1964) who applied Carl Roger’s (1942) non-directive therapeutic principles in her work with children. More recently, CCPT was promoted by the writings of Landreth (1993, 2001, 2002) and Guerney (1983) in North America, as well as West (1996) and Wilson and Ryan (2005) in Britain. CCPT is defined as “a dynamic interpersonal relationship between a child and a counselor trained in play therapy procedures who provides selected play materials and facilitates the development of a safe relationship for the child to fully express and explore self through the child’s natural medium of expression, play” (Landreth, 2002, p. 16). The focus on the child’s innate tendency to move toward growth and maturity and a deep belief in the child’s ability to self-direct are the main tenets that set CCPT apart from other models of play therapy (Landreth & Bratton, 2006). The CCPT counselor allows the child to play freely with carefully selected toys. The play therapist initiates statements that reflect content and feeling (i.e., “you’re angry at him”), encourage (i.e., “you worked really hard and you did it”), return responsibility to the child (i.e., “you can decide what color you want to use”), and if needed, set limits (i.e., the paint is not for throwing”). The typical CCPT counselor is trained to not ask questions, direct behavior, or interpret the child’s words or actions. According to CCPT philosophy, these types of actions would serve to inhibit the child’s expression and movement toward health.

The description of CCPT provided above and the description of filial therapy provided in chapter 15 will serve as a common set of procedures for most of the research studies explained in this book. In the first section of this book, Dee Ray and Sue Bratton provide an overview of play therapy research in the twenty-first century including Bratton et al.’s (2005) meta-analysis. The second section focuses on CCPT research. Specifically, 10 quantitative pre-test, post-test experimental control or comparison group studies are explained including research on self-efficacy (Marijane Fall), chronically ill children (Elizabeth Jones and Kara Carnes-Holt), child witnesses of domestic violence (Ashley Tynall-Lind), Chinese earthquake victims (Jean Shen), relationship stress (Dee Ray), children with aggressive behaviors (P. J. Blanco), ADHD (Dee Ray and Natalya Edwards), learning disabled preadolescents (Jill Packman and Ireon LeBeauf), Hispanic children (Yvonne Garza), and academic achievement (Brandy Schumann). Two single-case design studies are presented on ADHD (April Schottelkorb) and developmental levels of young children (April Brown). Finally, a qualitative study on children’s perceptions of play therapy is described (Eric Green).

The third section describes filial therapy research published since the year 2000. Sue Bratton, Garry Landreth, and Dennis Lin provide an overview of Child Parent Relationship Therapy outcome research. Then, nine quantitative pre-test, post-test experimental control or comparison group studies are described including filial therapy with parents of chronically ill children (Kristi Tew), Native Americans (Geri Glover), Chinese parents (Tom Yuen), African American parents (Angela Sheely), Hispanic parents (Peggy Ceballos), high school students as therapeutic agents (Leslie Jones), teachers of deaf children (D. Michael Smith), teachers of at-risk children (Phyllis Post), and teachers of preschool children (Mary Morrison and Wendy Helker). A qualitative study of parents’ voices in filial therapy is also presented (Yuehong Chen Foley). In the final chapter, Baggerly provides future research directions by identifying evidence-based standards and tips for designing your own play therapy research study.

Since this is an edited book, each chapter author’s individual voice is preserved. Some are scientifically objective while others are deeply personal, thereby sustaining an important balance between the art and science in play therapy research. The authors were independently responsible for statistical analysis; and some studies were conducted prior to current standards regarding reporting of effect size, confidence intervals, and so forth. Thus, reporting of results vary. Readers will be able to see the progression of play therapy research and will be guided in contemporary standards for conducting their own research.

As you read this book, you will be ready to respond with confidence to your colleagues’ questions about play therapy (PT) and filial therapy (FT) research. To school district administrators who want to know why children should be released from “instructional” time to attend play therapy, you will describe research studies by Fall (self-efficacy PT), Packman (learning disabled PT), Ray and Edwards (relationship stress PT), Blanco (aggression PT), Schumann (academic achievement PT), Schottelkorb (ADHD PT), Green (children’s perceptions PT), Post (at-risk FT), M. Smith (deaf FT), Morrison and Helker (preschool FT), and L. Jones (high school therapeutic agents FT).

To community agency administrators who insist on empirically supported interventions, you will describe play therapy research studies by Shen (disaster PT), Brown (children’s development PT), Ray (ADHD PT), and Foley (parents’ voices FT), as well as the studies mentioned above and below.

To judges, lawyers, and child protection case workers who want researched interventions for their abused clients, you will explain Tyndall-Lind’s study (domestic violence PT).

To doctors and nurses who want research for their chronically ill patients, you will tell them about research studies by E. Jones (PT) and Tew (FT).

To multicultural advocates who want to know if your intervention is valid for culturally diverse children, you will explain research studies by Garza (Hispanic PT), Ceballos (Hispanic FT), Glover (Native Americans FT), Yuen (Chinese FT), and Sheely (African Americans FT).

To university professors who want to know your rationale and procedures for a research study, you will cite Ray and Bratton (current PT research and meta-analysis), Bratton and Landreth (current FT research), Ray and Schottelkorb (single-case design), and Baggerly (evidence-based standards and tips).

I hope this book will provide you with information and inspiration to respond graciously to questions about play therapy research and to conduct rigorous studies that contribute to play therapy’s evidence base for effective practice!

Play and Research Well,

Jennifer N. Baggerly

REFERENCES

Axline, V. (1947). Play therapy. New York: Ballantine Books.

Axline, V. (1964). Dibs: In search of self. New York: Ballantine Books.

Bratton, S. C., Ray, D. C., Rhine, T., & Jones, L. (2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes. Professional Psychology: Research and Practice, 36, 376-390.

Landreth, G. (1993). Child-centered play therapy. Elementary School Guidance and Counseling, 28, 18-28.

Guerney, L. (1983). Child-centered (non-directive) play therapy. In C. E. Schaefer & K. J. O-Connor (Eds.), Handbook of play therapy (pp. 21-64). New York: Wiley.

Landreth, G. (Ed.). (2001). Innovations in play therapy: Issues, process, and special populations. Philadelphia: Brunner-Routledge.

Landreth, G. (2002). Play therapy: The art of the relationship (2nd ed.). New York: Brunner-Routledge.

Landreth, G., & Bratton, S. (2006). Child parent relationship therapy: A 10-session filial therapy model. New York: Routledge.

Rogers, C. (1942). Counseling and psychotherapy. Boston: Houghton Mifflin.

West, J. (1996). Client-centered play therapy (2nd ed). London: Hodder Arnold.

Wilson, K., & Ryan, V. (2005). Play therapy: A non-directive approach for children and adolescents (2nd ed). Oxford, England: Elsevier.

ORIGINAL SOURCES FOR RESEARCH STUDIES

Fall, M., Navelski, L., & Welch, K. (2002).Outcomes of a play intervention for children identified for special education services. International Journal of Play Therapy, 11(2), 91-106.

Foley, Y. C., Higdon, L., White, J. F. (2006). A qualitative study of filial therapy: Parents’ voices. International Journal of Play Therapy, 15, 37-64.

Garza, Y., & Bratton, S. (2005). School-based child centered play therapy with Hispanic children: Outcomes and cultural considerations. International Journal of Play Therapy, 14, 51-80.

Glover, G. J., & Landreth, G. L. (2000). Filial therapy with Native Americans. International Journal of Play Therapy, 9(2), 57-80.

Green, E., & Christensen, T. (2006). Children’s perceptions of play therapy in school settings. International Journal of Play Therapy, 15(1), pp. 65-85.

Jones, E., & Landreth, G. (2002). The efficacy of intensive individual play therapy for chronically ill children. International Journal of Play Therapy, 11, 117-140.

Jones, L., Rhine, T., & Bratton, S. (2002). High school students as therapeutic agents with young children experiencing school adjustment difficulties: The effectiveness of a filial therapy training model. International Journal of Play Therapy, 11(2), 43-62.

Packman, J., & Bratton, S. (2003). A school-based group play/activity therapy intervention with learning disabled preadolescents exhibiting behavior problems. International Journal of Play Therapy, 12, 7-29.

Post, P., McAllister, M., Sheely, A., Hess, B., & Flowers, C. (2004). Child-Centered Kinder Training for Teachers of Pre-School Children Deemed At-Risk. International Journal of Play Therapy, 13(2), 53-74.

Ray, D., Blanco, P., Sullivan, J., Holliman, R. (2009). An Exploratory Study of Child-Centered Play Therapy with Aggressive Children. International Journal of Play Therapy, 18, 162-175.

Ray, D., Schottelkorb, A., & Tsai, M. (2007). Play therapy with children exhibiting symptoms of attention deficit hyperactivity disorder. International Journal of Play Therapy, 16, 95-111.

Shen, Y. (2002). Short-term group play therapy with Chinese earthquake victims: Effects on anxiety, depression, and adjustment. International Journal of Play Therapy, 11, 43-63.

Smith, D. M., & Landreth, G. (2004). Filial therapy with teachers of deaf and hard of hearing preschool children. International Journal for Play Therapy, 13(1) 13-33.

Tew, K., Landreth, G. L., Joiner, K. D., & Solt, M. D. (2002). Filial therapy with parents of chronically ill children. International Journal of Play Therapy, 11 (1), 79-100.

Tyndall-Lind, A., Landreth, G., & Giordano, M. (2001). Intensive group play therapy with child witnesses of domestic violence. International Journal of Play Therapy, 10, 53-83.

Yuen, T., Landreth, G. L., & Baggerly, J. N. (2002). Filial therapy with immigrant Chinese families. International Journal of Play Therapy, 11(2), 63-90.

About the Editors

Jennifer N. Baggerly, PhD, LMHC-S, RPT-S, is an associate professor in the Counselor Education program at the University of South Florida and director of the Graduate Certificate in Play Therapy. She is on the Board of Directors of the Association for Play Therapy (APT) and the former chair of the APT research committee. She holds a doctorate in counseling education with a specialization in play therapy from the University of North Texas. Dr. Baggerly is a Licensed Mental Health Counselor Supervisor, a Registered Play Therapist Supervisor, and a Field Traumatologist. Dr. Baggerly’s research projects and more than 40 publications include the effectiveness of play therapy with children who are homeless and counseling interventions for traumatized children.

Dee C. Ray, PhD, LPC, NCC, RPT-S, is an associate professor in the counseling program and director of the Child and Family Resource Clinic at the University of North Texas. Dr. Ray has published more than 40 articles, chapters, and books in the field of play therapy, and more than 15 peer-reviewed research publications specifically examining the effects of child-centered play therapy. Dr. Ray is the author of the Child-Centered Play Therapy Treatment Manual and former editor of the International Journal of Play Therapy (IJPT). She currently serves on the editorial board for IJPT and the Research Committee for the Association for Play Therapy. She is the recipient of the 2008 Outstanding Research Award for Association for Play Therapy, the 2006 Outstanding Research Award for Texas Counseling Association, and the 2006 Nancy Guillory Award for Outstanding Service and Contribution to the Field of Play Therapy from the Texas Association for Play Therapy.

Sue C. Bratton, PhD, LPC, RPT-S is an associate professor of counseling and director of the Center for Play Therapy at the University of North Texas. She is a past president of the Association for Play Therapy (APT), and currently serves on the APT Research Committee. She is the recipient of the 2007 APT Outstanding Research Award, the 2009 University of North Texas College of Education Faculty Excellence in Research Award, and the 2005 Nancy Guillory Award for Outstanding Service and Contribution to the Field of Play Therapy from the Texas Association for Play Therapy. Dr. Bratton is a frequent speaker at play therapy conferences both nationally and internationally, and has published more than 60 articles, chapters, books, videos, and other publications in the field of play therapy, including co-authorship of Child Parent Relationship Therapy (CPRT): A 10-Session Filial Therapy Model, the CPRT Treatment Manual and The World of Play Therapy Literature. Her research agenda focuses on investigating the effectiveness of CPRT and child-centered play therapy.

Contributors

Jennifer N. Baggerly, PhD, LMHC-S, RPT-SCounselor Education University of South Florida Tampa, FL

P. J. Blanco, PhDCounselor Education and Psychology Delta State University Cleveland, MS

Sue C. Bratton, PhD, LPC, RPT-SCounselor Education University of North Texas, Denton, TX

April Garofano-Brown, PhD, LPCCounselor Education Georgia State University Atlanta, GA

Peggy Ceballos, PhDCounseling University of North Carolina- Charlotte Charlotte, NC

Kara Carnes-Holt, MS Ed, LPC,NCC, RPT-SCounselor Education University of North Texas Denton, TX

Natalya A. EdwardsCounselor Education University of North Texas Denton, TX

Marijane Fall, EdD, LCPC,RPT-S (Deceased)Counselor Education University of Southern Maine Gorham, ME

Yuehong Chen Foley, PhD, LPC, NCC Gwinnett County Public Schools Atlanta, GA Grayson, GA

Yvonne Garza, PhD, LPC, RPTDepartment of Educational Leadership and Counseling Sam Houston State University Huntsville, TX

Eric Green, PhD, LPCP, RPT-SPrivate Practice New Orleans, LA

Geri Glover, PhD, LPCC, RPT-SEducation Department College of Santa Fe Santa Fe, NM

Wendy P. Helker, PhD, LPC-S,NCC, RPT Private Practice Corinth, TX

Elizabeth Murphy Jones, PhD,LPCPrivate Practice Fort Worth, TX

Leslie Jones, PhD, LPCPrivate Practice Prosper, TX

Garry L. Landreth, EdD, LPC,RPT-SUniversity of North Texas Denton, TX

Ireon LeBeaufUniversity of Nevada, Reno Reno, NV

Yung-Wei Dennis LinUniversity of North Texas Denton, TX

Mary O. Morrison, PhD, LPC-S, NCC, RPT-STexas State University San Marcos, TX

Jill Packman, PhD, LMFT, NCC,RPT-SDepartment of Counseling and Educational Psychology University of Nevada, Reno Reno, NV

Phyllis Post, PhD, NCC, RPTDepartment of Counseling University of North Carolina- Charlotte Charlotte, NC

Dee C. Ray, PhD, LPC, RPT-SCounselor Education University of North Texas Denton, TX

April Schottelkorb, PhD, LPC,NCC, RPT-SBoise State University Boise, ID

Angela I. Sheely Moore, PhD,LPC, NCCCollege of Education and Human Services Montclair State University Upper Montclair, NJ

Yih-Jiun Shen, EdD, NCC, CSCDepartment of Educational Psychology University of Texas-Pan American Edinburg, TX

Brandy Schumann, PhD, LPC,RPTPrivate Practice McKinney, TX

David Michael Smith, PhD,LMFT, RPT-SCommunity Reach Center Fort Collins, CO

Kristi Tew, PhDPrivate Practice Southlake, TX

Ashley Tyndall-Lind, PhD, LPC-S,RPT-SDallas Children’s Advocacy Center Dallas, TX

Tom Yuen, PhDCity University of Hong Kong Kowloon, Hong Kong

SECTION I

OVERVIEW OF PLAY THERAPY RESEARCH

CHAPTER 1

What the Research Shows About Play Therapy: Twenty-First Century Update

DEE C. RAY and SUE C. BRATTON

INTRODUCTION TO PLAY THERAPY RESEARCH

The field of mental health currently requires substantial evidence to support the use of interventions providing direct services to clients. Emphasis on evidentiary support of mental health interventions is not new. Many professional organizations, including the American Counseling Association (ACA), the American Psychological Association (APA), and the National Association of Social Workers (NASW), recognize the need for empirical support for practice (ACA, 2005; APA, 2002; NASW, 2008). Managed-care corporations often review interventions through panel evaluation of research and literature to help them make decisions regarding practitioner reimbursement. Over the last two decades, the field has observed the rise of the evidence-based movement of empirically supported treatments in which interventions are critiqued according to rigor of experimental research studies. Fortunately, play therapy research dates back more than 45 years, providing empirical support for even the harshest of critics. There are few interventions that can claim such a lengthy research history as well as a thriving body of current research.

We published our first review of play therapy research literature in 2000 in a simple article titled, “What the Research Shows About Play Therapy.” We reviewed 82 play therapy research studies in the article, from 1942 to 1999. Bratton and Ray (2000) was our initial attempt to summarize and critique decades of play therapy research, including all studies that included the term play therapy and at least one aspect of experimental design, such as single-group pre- and post-assessment or stringent comparison of play therapy intervention to a control or comparison group. The purpose of Bratton and Ray (2000) was to explore the issues researched by historical and current play therapy literature and begin a review of methodological features of such studies. We later published findings applying precise methodology of meta-analysis review to 93 criteria-based controlled play therapy studies (Bratton, Ray, Rhine, & Jones, 2005). This chapter summarizes our earlier findings on play therapy research for the last century and reviews recent research from the first decade of the new millennium.

OVERVIEW OF OUTCOME RESEARCH FROM THE TWENTIETH CENTURY

To progress to the current century, we quickly review here the findings of Bratton and Ray (2000). Reviewing six decades of play therapy research, we found that play therapy research peaked in the decade of 1970, with a record 23 studies. Research leveled off in the 1980s and 1990s, resting at 16 to 17 studies in each decade. Most of the studies compared a play therapy intervention group with a control or comparison group, although we also included one group pre- and post-assessment designs. Play therapy interventions ranged from 2 to 100 sessions with a median number of sessions at 12. Participants ranged in age from 3 to 17 years. Although most interventions were designated as nondirective, many studies did not clearly identify the type or scope of play therapy orientation or treatment protocol. We focused on studies that were labeled play therapy and did not include studies involving parents or other treatment providers beyond therapists. The majority of studies included measurements of social maladjustment, with secondary priority in areas of intelligence, maladaptive school behavior, self-concept, and anxiety. Early play therapy research focused on intelligence and school achievement, while later years (1970s and 1980s) focused on social adjustment and self-concept.

Our review of twentieth-century research revealed positive effects of play therapy in the following areas: social maladjustment, withdrawn behavior, conduct disorder or aggression, maladaptive school behavior, emotional maladjustment, anxiety and fear, autism and schizophrenia, multiculturalism, self-concept, intelligence, reading, physical or learning disability, speech or language problems, sexual abuse and domestic violence, depression, post-traumatic stress, ADHD and locus of control, divorce, and alcohol or drug abuse. Not all studies noted significant changes on all dependent variables; and, because of the extensive amount of data collected, we reported only the statistics that were significant. While the majority of studies were limited by small sample size, findings were favorable in support of the effectiveness of play therapy with a wide range of mental health issues.

META-ANALYTIC RESEARCH ON PLAY THERAPY

The average age of study participants was 7.0, reduced to 6.7 years when play therapy was conducted by paraprofessionals under the direct supervision of a professional trained in play therapy. This result contrasted meta-analytic findings conducted on a broad range of child psychotherapies that reported mean ages of 10.2 years (Kazdin, Bass, Ayers, & Rodgers, 1990) and 10.5 years (Weisz, Weiss, Han, Granger, & Morton, 1995). Brestan and Eyeberg (1998) reviewed studies focused on conduct-disordered children and also reported higher mean age (9.8 years) than the mean for play therapy studies. We believe the lower mean age of play therapy participants compared to other psychotherapeutic interventions for children is particularly meaningful in view of the national priority to identify effective early interventions that allow children to receive help when problems first arise (New Freedom Commission on Mental Health, 2003; Subcommittee on Children and Family, 2003; U.S. Public Health Service, 2000). The finding regarding age supports our belief that the developmental properties of play are responsive to children’s maturational needs, allowing them to meaningfully participate in therapy at a young age. Because play therapy can be used successfully with younger children, it conceivably has the potential to prevent the development of more severe and costly mental health problems that can develop over time.

The impact of treatment duration on outcomes was also of interest to us. Similar to LeBlanc and Ritchie’s (2001) findings, optimal treatment effects were obtained in 35 to 40 sessions. It is important to note, however, that many studies with fewer than 14 sessions produced moderate to large treatment effects. Finally, age and gender were not found to be significant factors in predicting play therapy outcomes. Play therapy appeared to be equally effective across age and gender. We were unable to compute an effect size for ethnicity because of the lack of specificity in the reporting of ethnicity in individual studies.

In summary, meta-analytic findings on play therapy (Bratton et al., 2005; LeBlanc & Ritchie, 2002) established play therapy’s utility as a mental health intervention and further confirmed that its effect on children’s outcomes was similar to other child interventions reported by contemporary meta-analytic researchers in the field of child psychotherapy (Casey & Berman, 1985; Kazdin, Bass, Ayers, & Rodgers, 1990; Weisz, Weiss, Han, Granger, & Morton, 1995). Showing that play therapy was comparable in treatment effect to other established and frequently used interventions was an important first step for the field in refuting critics that were skeptical of play therapy having any place within the broader field of child psychotherapy.

TWENTY-FIRST CENTURY OUTCOME RESEARCH

In contrast to the 2000 publication, we attempt to discern between rigorous and less rigorous research designs. Through the experience of meta-analysis, we discovered the need to differentiate levels of experimental research. Using Rubin’s (2008) conceptual framework, we applied his evidentiary hierarchy for evidence-based practice to the identification of individual research studies and specifically categorized the studies into three labels, including experimental, quasi-experimental, and evidentiary. The experimental label describes studies meeting the most stringent criteria for research design, including random assignment of subjects, comparison to a control group or another treatment group, clear methodology and treatment descriptions, and attention to internal and external validity threats. The quasi-experimental label represents studies that use comparison or control groups with clear methodology and attention to internal and external validity threats but not random assignment. As evidenced by play therapy studies categorized as quasi-experimental, randomization is often difficult when designing an intervention-based research design for children. We used the evidentiary label as descriptive of studies that provide evidence of play therapy effectiveness through pre- and post-assessment and clear methodology but typically do not use a comparison or control group.

In summarizing the findings of the 25 studies reviewed for this chapter, we categorized 13 studies as experimental, 4 as quasi-experimental, and 8 as evidentiary. The most researched mental health issue related to recent literature is externalizing and disruptive behaviors, with 10 studies specifically demonstrating the positive effect of play therapy on children’s disruptive behaviors. The second most researched dependent variable was parent-teacher relationship problems emphasizing the positive effect of play therapy in six studies. Evenly divided, internalizing problems, anxiety, and sexual abuse and trauma issues were explored in five studies. Other issues, such as multicultural populations, identified disability or medical condition, ADHD, language skills, moral reasoning, social behavior, homeless-ness, depression, and self-concept, were explored by one to three studies. Positive effect of play therapy can be seen in all research areas except sexual abuse, which provided mixed results in two studies.

Table 1-1Play Therpay Research 2000-2009

DISCUSSION

The identification and description of treatment protocol represents progress in conducting research in play therapy. Research conducted under the play therapy label but with a lack of clear structure related to theoretical conceptualization, however, is still a possible barrier to outcome. One example of this challenge emerged in review of this decade’s research evidenced by Carpentier, Silovsky, and Chaffin (2006). In their study of children exhibiting sexual behavior problems, they compared a cognitive behavioral intervention with a play therapy intervention. The play therapy intervention was described as client-centered and psychodynamic principled with different materials and activities and topics introduced each week to the child. For play therapists who are trained in psychodynamic or child-centered principles, there is recognition that these two approaches are vastly different. The label of play therapy following psychodynamic principles is vague and open to interpretation by the reader or researcher. Child-centered play therapy, a well-defined approach to play therapy (Landreth, 2002), would not typically introduce any topic or activity in play therapy, nor would it advocate the use of different materials for each session. The failure to clearly define procedures or mention the use of a treatment protocol were important limitations to consider in drawing the conclusion that findings were due to the superiority of one treatment over the other. The use of a manualized protocol that showed how these distinct approaches were integrated would provide clarity. From a research perspective, the description of play therapy provided by Carpentier et al. is broad and ill-defined and could possibly mislead the reader into concluding that play therapy was ineffective, when in fact it may have been the lack of a well-defined treatment and omission of treatment integrity measures that produced the results. Such an example reminds researchers that adhering to stringent research methods, including manualization of valid play therapy approaches and the assurance of treatment integrity, is critical in conducting research of sufficient rigor to advance the field of play therapy.

Another observation of current and historical play therapy research is related to the choices of dependent variables by researchers and how those might be affected by cultural pressures. In the last decade, there has been a rise in research related to disruptive and externalizing behaviors. This trend coincides with the rise of behaviorism in the schools and the focus on external achievement-related status in American culture. Play therapy researchers have responded to this cultural phenomenon in an effort to stay relevant in the minds of parents and other authorities. Fortunately, outcomes related to externalized behavior are positive. However, considering that most play therapy research is conducted according to child-centered philosophy, which directly emphasizes the inner world of the child, one might question this focus on behavior. Also, it can be observed that research related to self-concept is in decline, so much so that only two studies reported positive effects. Surprisingly, only one study focused on social behavior as an individual dependent variable compared to its rank as the most studied variable in the 2000 report. And finally, research related to multicultural populations continues to be sparse, with only one study on Hispanic children in the United States and two on children in Taiwan. Most studies, however, reported on ethnicity (unlike the 2000 report) and revealed a diversity of ethnic identification among participants. Considering the diversity of urban settings, play therapy research would benefit from the exploration of specific populations.

Overall, play therapy research continues to show strong evidence to support its use among a variation of populations and presenting problems. The last decade revealed changes in research methodology that allow play therapy to compete among other child interventions as a viable treatment. Strikingly, current play therapy research appears to be conducted by play therapists who are well-trained in both methodology and play therapy, leading to designs that accurately explore effectiveness variables related to play therapy. Play therapy research will continue to be strengthened through the progress of treatment manualization and description, delivery by trained professionals, and focus on specific dependent variables relevant to mental health issues among child populations.

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SECTION II

RESEARCH IN PLAY THERAPY

CHAPTER 2

Increased Self-Efficacy: One Reason for Play Therapy Success

MARIJANE FALL1

QUESTIONS AND IDEAS COME FROM PRACTICE

Melissa had not been to school for the last four months of the previous school year. Now she had already missed the first three weeks of her eighth-grade year. The principal asked me, the new school counselor, to call her home and see what could be done. Her mom answered the phone and said that she was glad I had called. Despite visits to several doctors, it was not clear what was wrong with Melissa. She had lost 30 pounds, was highly anxious, spent much time on the couch, and had visited a psychiatrist at the urging of her physician. No one had been able to help. When I asked her to bring Melissa to school to see me, she said Melissa did not want to come to school for fear she would get too anxious and be sick. After talking with Melissa, I arranged to see her at the school after school had closed for the day and the buses had left. My only surprise was that she came.