The current study is the first repeated-measures design exploring the impact of child-centered play therapy (CCPT), an evidence-based child psychotherapy intervention, on autistic children's social-emotional assets, and emotional and behavioral problems across four times during intervention based on teacher reports. Participants consisted of 19 autistic children recruited from two Title-1 elementary schools in the southwest United States who were aged between 5 years and 8.25 years (M = 6.22, SD = .91), presented with varied levels of cognitive functioning and speech and language abilities. Over 60% of participants were identified by their parents as children of color. Results indicated participants' increased time in CCPT predicted statistically significant improvement in social-emotional assets measured by Social-Emotional Assets and Resilience Scales-Teacher (SEARS-T) total score with a large effect size. Results also indicated participants' increased time in CCPT predicted a statistically significant reduction in emotional and behavioral problems of irritability, social withdrawal, and hyperactivity/ noncompliance, measured by Aberrant Behavior Checklist-Second Edition (ABC- 2), with large effect sizes. Findings of this study revealed substantive changes in social-emotional assets as early as 8 CCPT sessions, and reduction of emotional and behavioral concerns as early as 12 CCPT sessions. Clinical significance, implications for practice, and limitations of the study are discussed.

The present meta-analytic study examined the overall effectiveness of child-centered play therapy (CCPT) and child-parent relationship therapy (CPRT) for children experiencing internalizing problems. After conducting a comprehensive literature search and review, 25 studies published between 2000 and 2023 met the following inclusion criteria: (a) published and peer-reviewed; (b) used CCPT or CPRT as an intervention; (c) participants were ages 3 to 13 or parents of children ages 3 to 13; (d) study outcomes related to children's internalizing problems, such as anxiety, depression, or withdrawal; (e) used single group within study or between study design, including randomized controlled trials and non-randomized controlled trials; (f) published between January 2000 and April 2023; (g) published in English; (h) used standardized measurements; and (i) reported effect sizes, or means and standard deviations, or the author disclosed the means and standard deviations upon request. Final analysis included 28 individual effect sizes using a random effects model to determine the overall effect size for 6 analyses that included CCPT/CPRT combined between, CCPT/CPRT combined within, CCPT between, CCPT within, CPRT between, CPRT within. Moderating variables included gender, age, ethnicity, and number of CCPT sessions. CCPT and CPRT effect sizes were statistically significant and ranged from small to large effects. Results support the use of CCPT and CPRT with children for the reduction of internalizing problems. Procedures and results, including the coding process, limitations, and implications are discussed.

Childhood poverty is a prevalent concern in the United States and is associated with poor psychological and academic outcomes. Psychosocial stressors associated with life in poverty may interrupt the development of a positive self-concept, ultimately hampering the academic achievement of children in poverty. As the therapeutic objectives of child-centered play therapy (CCPT) support the development of an increasingly positive self-concept, I explored the impact of CCPT on the academic achievement of children in poverty. Participants were composed of 55 students between the ages of 4-7 years old from seven Title 1 elementary schools in the southern United States. Of the 55 study participants, 12 (22%) were female and 43 (78%) were male. Regarding participant ethnicity, 7 (13%) were African American, 1 (2%) was Asian American, 5 (9%) were multi-racial, 35 (64%) were Latino, 6 (11%) were Caucasian, and 1 (2%) did not report ethnicity. Participants were randomly assigned to either a 16 session CCPT treatment group (n = 25) or a waitlist control group (n = 30). A mixed between-within ANOVA was conducted to evaluate improvement in academic achievement scores between treatment and control groups across time. Results indicated a statistically significant interaction effect on the Early Achievement Composite Score of the Young Children's Achievement Test (p = .042). The standardized difference between groups was Cohen's d = .53 indicating a medium effect size. Overall, findings from this study support CCPT as an effective intervention to promote improvements in the academic achievement of children in poverty.

Virginia Axline developed a new field of child psychotherapy by applying a nondirective approach to the burgeoning experimentation of utilizing play in therapeutic work with children. While much biographical information is available regarding other leaders in the fields of counseling and psychology, historical research into Axline and her development of child-centered play therapy represent a gap in the literature. The purpose of the current study was to: 1) examine the professional contributions of Virginia Axline; 2) gather personal information regarding Axline that contributes to deeper understanding of her theory; and 3) identify life circumstances or events that influenced Axline's professional contributions. Historical methodology was utilized to locate and examine artifacts and materials necessary to create an interpretive biography of Axline's life and work, with a focus on her professional influences, experiences, and contributions. Historical methods utilized include historiography, oral history, and interpretive biography, with an emphasis on established and accepted source criticism and data synthesis processes. The research yielded a number of historically significant and previously unknown documents valuable to the field of CCPT including personal correspondence, academic writings, and interviews, as well as academic and government records. The research also established new information about and understandings of several of Axline's professional relationships. The research also calls into question the original authorship of scholarly contributions in the field of counseling for which Axline may have deserved, but not received credit. Included in the biography is information related to Axline's early life, higher education, career timeline, professional development, mentoring relationships, research interests, student perceptions, collegial relationships, personal hardships, professional interests and advocacy, teaching and learning methods, and her decline in later life.

Child-centered play therapy (CCPT) is an empirically supported and developmentally appropriate counseling intervention for young children. Despite the clinical effectiveness of CCPT with children, no known study has been conducted in which parents were surveyed or interviewed regarding the services they have received as a part of their children’s participation in CCPT. Therefore, this study was designed to gain a better understanding of parents’ reported needs and expectations in CCPT. This study utilized Q-methodology in which participants completed a Q-sort by actively sorting 40 items on a continuum of least important to most important. Items included services and processes regarded by CCPT scholars and child therapy practitioners as being important to working with parents. Data was collected from 19 parents of children receiving CCPT services in a community-based counseling clinic. Participants included 16 females and 3 males; 15 Caucasian and 4 Hispanic; and 14 biological parents, 2 adoptive parents, and 3 other biological caregivers. Data was analyzed using centroid factor analysis, and results revealed a one factor solution representing 18 of the 19 participants. Eighteen parents reported similar beliefs regarding the processes they consider most and least important to their experience in working with child-centered play therapists. In general, parents’ beliefs aligned with CCPT philosophy, particularly in regards to respecting children’s natural pace of development and healing. Furthermore, parents shared preferences for play therapists who demonstrate expert knowledge and training and who understand the individual needs of their children. Discussion includes implications for the practice of CCPT and training of future play therapists, limitations of the study, and implications for future research.

Anxiety is one of the most pervasive childhood disorders, with a poor prognosis if left untreated. Traditional methods of treating anxiety have been less effective with young children. Based on theoretical assumptions regarding the potential effectiveness of child-centered play therapy (CCPT) as a treatment approach, I sought to explore the effects and mediating factors of CCPT on young children with symptoms of anxiety. Fifty-three participants between the ages of 6 to 8 years old were recruited from four elementary schools, including 36 males and 17 females. Of participants, 11 were African American, 24 were Caucasian, 10 were Hispanic/Latino, one was Asian, and seven were biracial. Twenty-five participants were randomly assigned to an experimental group receiving a mean of 15 sessions of individual CCPT, and 28 participants were assigned to an 8-session active control group. Five factorial analyses of variance (ANOVA) were conducted applying an alpha level of .05 for interpretation of statistical significance and Cohen’s d to assess practical significance. ANOVA results indicated a statistically significant interaction with a large effect size on Total Anxiety score of the Revised Children’s Manifest Anxiety Scale-2nd edition (p = .013, d = .715). Subscale ANOVA results indicated a statistically significant interaction effect with large effect size on the Worry subscale (p = .006, d = .795), no statistically significant interaction on the Defensiveness subscale (p = .710, d = .110), no statistically significant interaction but moderate effect size on the Physiological subscale (p = .076, d = .506), and no statistically significant interaction but moderate effect size on the Social Anxiety subscale (p = .162, d = .398). Statistically significant differences with large practical effects were found in total anxiety and worry, suggesting that children who received CCPT decreased their overall levels of anxiety and worry whereas children who were in the active control group increased their levels of anxiety and worry. When examining differences in relationships between groups, the CCPT group relationship scores were significantly higher than the control group relationship scores, as reported by counselors. Although the groups were different in their relationships, the relationship was not considered a statistical mediator of anxiety due to the lack of correlation between relationship scores and outcome. Overall, children seemed to benefit from CCPT, and it may be considered a viable treatment for children who are anxious. Due to the lack of mediation of relationship found in this study, further research is encouraged to consider other mediating and/or moderating effects when attempting to investigate the therapeutic relationship as a mediator.

The primary goal of this pilot study was to compare the frequency of which children explore items, and engage in cultural conversations and verbalizations (COBV) in a multiculturally designed play therapy room (MCP) versus a historically recommended play therapy room (HRP). A quasi-experimental comparison group design was used to observe differences between the play therapy rooms. Participants consisted of 32 children with varying cultural identity makers, including age (M = 6.31, SD = 2), race, and gender. Children were recruited from two campus-based university therapeutic clinics and one early childhood education program. Results of independent samples t-tests indicated a statistically significant difference between mean scores of cultural behaviors exhibited in MCPs when compared to HRPs with a large effect size. Furthermore, a moderate practical significance was found between the mean difference in cultural verbalizations found in MCPs when compared to HRPs. Correlational analyses exploring the child's age, both the child's and therapist's gender, and the three dependent variables exposed significant relationships between the child's age and frequency of items used, child's gender and number of cultural verbalizations, number of cultural verbalizations and cultural behaviors. Results from group analyses revealed a statistically significant difference between the therapist's race on number of cultural verbalizations with a large effect. Results from the present study influenced implications for practice such as utilizing intentional selection of cultural toys, and research implications such as a replication study using a randomized controlled trial to encourage generalizability.

The current study is the first to explore the role of cultural humility, cultural comfort, and the therapeutic relationship in play therapy. Participants consisted of 69 parent-therapist dyads recruited from university clinics, private practices, and a non-profit counseling center in the southwestern United States. Parents completed a demographic questionnaire, Cultural Humility Scale, Therapist Cultural Comfort Scale, and Barrett-Lennard Relationship Inventory – Other to Self 40 (BLRI OS – 40). Play therapists completed a demographic questionnaire and BLRI MO – 40. A multiple regression analysis indicated that after controlling for the race/ethnicity of both play therapist and parent, parents' perceptions of play therapists' cultural humility and cultural comfort predicted parents' perception of their therapeutic relationship with their child's play therapist. Additionally, exploratory analyses suggested that when therapists report the occurrence of cultural conversation in parent consultations there may be an increase in parent-reported therapeutic relationship scores. However, when also controlling for the child's race/ethnicity, cultural humility and cultural comfort did not have a statistically significant impact on the play therapist's perception of the therapeutic relationship with their child client. These findings underscore the significance of play therapists' cultural humility and cultural comfort on the development of a strong therapeutic relationship with parents of children in play therapy. Limitations and implications for practice and future research are discussed.

The shortage of bilingual counselors is one barrier to young Latina/o children receiving mental health services. Child-centered play therapy (CCPT) is a developmentally responsive intervention based on the premise that play is children's natural means of communication across cultures. This randomized controlled study examined the effects of CCPT with young Spanish-speaking Latina/o children exhibiting clinical levels of school behavior problems. Participants were 57 pre-K to kindergarten Latina/o children (72% male; mean age = 4.0) randomly assigned to three treatment groups: CCPT with Spanish-speaking, bilingual counselors; CCPT with English-speaking, monolingual counselors; or active control (bilingual mentoring). Monolingual counselors participated in cultural competency training and supervision with bilingual counselors and supervisors. According to independent observers and teachers blinded to children's group assignment, both the bilingual CCPT group and the monolingual CCPT group demonstrated moderate treatment effects over bilingual mentoring, yet between-group differences were not statistically significant. Analysis of within-group change over time indicated that children in both CCPT interventions demonstrated statistically significant improvement, while the mentoring group did not. The percentage of children in each treatment group who improved from clinical to normal behavioral functioning suggests the clinical significance of the findings: 80% bilingual CCPT, 70% monolingual CCPT, 15% bilingual mentoring. Overall, findings indicate that CCPT, whether delivered by bilingual counselors or culturally-competent, monolingual counselors, is a promising intervention for young Latina/o children exhibiting behavior problems.