The purpose of this study was to determine if parents trained in the Landreth Filial Therapy Model could demonstrate child-centered play therapy skills as effectively as graduate play therapy students who completed an Introduction to Play Therapy course. The participants in both the parent group and the graduate student group were videotaped in play sessions with children pre- and post-training in order to measure change in adult empathic behavior as defined on the Measurement of Empathy in Adult-Child Interaction (MEACI). The specific skills measured in this study were (a) communicating acceptance to the child, (b) allowing the child to direct his or her own play during the play sessions, (c) demonstrating appropriate levels of involvement in the child's play, and (d) demonstrating empathic behavior toward the child. The Landreth Filial Therapy Model is a training system that utilizes both didactic and dynamic means to train parents and other paraprofessionals to be therapeutic agents of change with children. Parents are taught child-centered play therapy skills to use in weekly home play sessions with their children in order to strengthen the emotional bond between parent and child. The Introduction to Play Therapy course is a graduate-level counseling course at the University of North Texas taught by Dr. Garry Landreth. The course focuses on the philosophy, theory, and skills of child-centered play therapy. Students enrolled in this course typically plan to use play therapy in professional settings. The filial-trained parent group (n = 21) consisted of the experimental group of single parents from Bratton and Landreth's (1995) study, Filial Therapy with Single Parents, Effects of Parental Acceptance, Empathy and Stress. The parents met for weekly 2-hour filial therapy sessions over the course of 10 weeks and conducted six or seven 30-minute play sessions at home with their child-of-focus. The graduate student group (n = 13) was enrolled in Dr. Landreth's Introduction to Play Therapy course during fall 2000. The class met over a course of a 15-week semester for three hours per week. During the course of the semester, the students completed two play therapy sessions outside of class and two supervised play therapy sessions during class time. Analysis of covariance revealed that the play therapy-trained graduate students preformed at a statistically significant higher skill level than the filial-trained parents on Total Empathy scores and the Involvement subscale, but that there was no statistically significant difference between the groups' skill level on Communication of Acceptance to the child and Allowing the Child Self-Direction. Although the graduate students' mean post-training scores revealed a higher attainment of skill level, the parents made greater mean change of score on all measures except Involvement. The study supports the use of the Landreth Filial Therapy Model to train parents to use the child-centered play therapy skills, especially those of communicating acceptance and allowing self-direction.

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.

The purpose of this qualitative interpretive descriptive study was to better understand children’s perceptions of the use of motivational interviewing (MI) as a communication style for childhood obesity treatment. Childhood obesity in the United States has reached epidemic proportions and much research effort has been dedicated to reversing this trend. One approach that has demonstrated positive outcomes in the clinical setting is MI. Leading organizations in pediatric healthcare now recommend MI as a communication style to be used for childhood obesity-related behavior change. Although empiric studies have demonstrated improvement in outcomes when this communication style is used with patients and families, no study to date had looked at MI from the perspective of the child. Thorne’s (2008) framework for interpretive descriptive research was used for this study. Individual interviews with children ages 7 through 13 were conducted in an outpatient weight management clinic that utilizes MI as the primary communication style for facilitating behavior change. Qualitative data analysis was conducted utilizing Thorne’s recommendations for interpretive descriptive research. Five themes emerged from the data: 1) Empowerment, 2) Freedom to be Me, 3) Educating without “Educating”, 4) Unconditional Support, and 5) Blossoming. A conceptual model was developed from the research findings to help clinicians working with children in similar contexts glean a deeper understanding of the use of MI with children. Future research endeavors should focus on the implementation of this model in clinical practice to strengthen the conceptual links and determine applicability to practice.

With the high prevalence of mental health disorders among children, there is a growing need for effective mental health interventions that will enhance overall wellness and functioning while meeting the developmental needs of children (Stagman & Cooper, 2010). In addition, there are increasing demands from policymakers, managed-care organizations, and educators to implement evidence-based interventions (EBIs), or treatments that are supported by strong research (Kratochwill & Shernoff, 2004). One treatment that shows promise as an effective, developmentally-appropriate intervention that meets the mental health needs of children is play therapy (Bratton, Ray, Rhine, & Jones, 2005; Landreth, 2002; Ray, 2011). Although results of play therapy studies have shown some significance in improving a variety of issues for children, the body of research has been criticized, primarily due to inconsistent or inconclusive results across studies or compromised research designs and methods (Phillips, 1985; 2010; Read, Hunter, & McMillan, 1999). In addition, the field also lacks differentiation among various theoretical play therapy approaches across the research base (Phillips, 2010). To address these gaps in the literature, this study utilized a strong research design to examine the effectiveness of child-centered play therapy (CCPT) on the challenging behaviors of three kindergarten students. A single-case multiple baseline design was used to maintain a high level of control with rigorous data collection methods (Kennedy, 2005; Ray and Schottelkorb, 2010). Research methods were designed to meet the What Works Clearinghouse pilot standards for single-case designs, which use stringent criteria in evaluating quality of research (U.S. Department of Education, 2014). The integrity of the CCPT intervention was assessed to ensure accurate implementation. Results from direct observational data suggested a relationship between CCPT and the improvement of classroom behaviors. In contrast to direct observational data, teacher ratings did not indicate improvements in behavior. Ratings by parents yielded significant results for improving behaviors at home. This study made valuable contributions to the literature by utilizing a strong research design and demonstrating promising findings for CCPT. Practical implications include using as few as eight sessions of CCPT as a behavioral intervention at school and engaging in ongoing teacher consultation to supplement CCPT.

Children experience a multitude of benefits in response to interactions with nature. Despite documented effects, children have increasingly spent less time outdoors over the last century and experienced higher rates of physical and emotional illnesses. Although child-centered play therapy (CCPT) is a culturally and developmentally responsive mental health treatment for children, researchers have limited study of environmental structure and materials employed in the therapeutic process of CCPT. In this study, I sought to further research on the integration of nature with CCPT by providing CCPT in an outdoor, contained playroom equipped with traditional CCPT toys and additional nature materials. Participants were 13 children in the southwestern U.S. with parent-reported attentional or self-regulation concerns (9 males, 6 females; ages 5-10, mean age M = 8.0). Parents reported participants' racial identities were 13% Black (n = 2), 13% Latinx (n = 2), 7% Turkish (n = 1), and 67% White (n = 10). Participants received 8 weeks of twice-weekly CCPT in an outdoor playroom. Results of two repeated measures ANOVAs revealed statistically significant improvement in attention on the Brown EF/A Scales and statistically significant improvement in social-emotional competencies on the SEARS-P. Results of this study illustrate the possible benefits of theoretically integrating CCPT and nature and the clinical impacts the novel approach could have on children's attention and social-emotional competencies. The study also provided insight into the viability of providing an outdoor CCPT intervention at a larger scale and some problems that may arise in creating and maintaining an outdoor playroom.

This study used a single case design to explore the relationship between individual child-centered play therapy on children with developmental delays by examining its effectiveness in: 1) increasing measured developmental age; 2) reducing problematic behaviors related to developmental delays; and 3) increasing developmentally appropriate behaviors. Three participants were assessed weekly with both developmental and behavioral measures during the three phases of the study: baseline, intervention, and follow up. Additionally, parents of the participants completed behavioral measures at pretest, midpoint, and posttest administrations. The participant's weekly standard scores were graphed and results were examined separately using visual analyses. Changes between phases: non-intervention baseline, intervention, and non-intervention follow-up were examined; specifically, the level, trend, and variability of the data across the phases were examined. Each of the three participants served as their own control group in this single case analysis and their results, and all three of the participants demonstrated improvement on the developmental measures after receiving the play therapy intervention. Results from this single case analysis suggest the need for further replication, use and reporting of single case interventions and designs, to promote the efficacy of counseling interventions and to potentially enhance the literature and research base for evidence based interventions.

There is a dearth of research available on child services in the community mental health setting in the fields of psychology and counseling. The purpose of this study was to conduct an experimental evaluation of university-based play therapy clinical services with children aged 3 to 10 years old and to explore dimensions of the effectiveness of child-centered play therapy (CCPT) with children. This study examined real-life clinical services to the largest number of child participants in decades of mental health research, especially in the field of play therapy. Archival data from cases of 364 children served through a university-based play therapy clinic in the southwestern United States was examined. The effectiveness of child-centered play therapy (CCPT) was measures by a decrease in a child's behavioral problems perceived by a parent/guardian measured by scores of the Internalizing Problems, Externalizing Problems and Total Problems on the Child Behavioral Checklist (CBCL) and a reduction of parent-child relationship stress manifested in the Child Domain, Parent Domain and Total Stress Score on the Parenting Stress Index (PSI). Data from pretest and posttest was gathered for use in the analysis. Independent samples t-test, repeated measures analysis of variance, and ordinary least squares regression, including effect sizes, were utilized to detect the differences between groups and the treatment effects. After receiving individual CCPT, results of this study demonstrated statistically significant differences on overall CBCL and PSI measures, with the exception on Parent Domain. Additionally, findings highlighted the effectiveness of individual CCPT through demonstrated moderate to large effects over time (partial η2 = .097 to .201). Individual CCPT also revealed very large effects (η2 = .26 to .37) when specifically examined with participants who completed play therapy treatment. Further, statistically significant predictions were found on CBCL and PSI measures, with the exception on Total Problems. Termination and family relationship concern variables were found as strong contributors on predicting greater improvement. Based on the statistical, practical, and clinical significances, the primary contribution of this study is the fully exploration of child characteristics and effectiveness of play therapy for children who seek mental health services.

Background: Advances in antiretroviral therapy have resulted in a significant increase in life expectancy for HIV-infected individuals, with more pediatric patients transitioning to adult care. The transition process from pediatric to adult care for adolescents with chronic diseases, such as HIV, is always a challenge. Purpose: The purpose of this secondary data analysis was to describe the characteristics, processes and practice models used by the Adolescent Trials Network (ATN) systems of care that assist adolescents with HIV disease to transition from child-centered care to adult-centered care. Method: This study used health care providers affiliated with the Adolescent Trials Network of HIV/AIDS Interventions (ATN) as key informants. One to three representatives from each site considered to be the most knowledgeable staff member(s) involved with their clinic's transition practice were interviewed. Analysis: The data set consisted of fourteen audio-taped interviews with nineteen key informants, as well as clinic documents that were submitted for review. An a priori coding framework was prepared prior to the initial preliminary analysis based on the study research questions and the interview questions. This initial coding framework was refined using the constant comparative method and subsequent coding discrepancies in the remaining analysis were resolved by consensus. Transcripts and clinic documents were analyzed using content analysis within an ATLAS.ti data management system. Results: Interviews were conducted with 19 staff members (7 social workers, 7 nurse practitioners, 3 physicians, 1 registered nurse, and 1 health educator) from 14 ATN clinics. There was a general consensus from site representatives as they described perceived facilitators of a successful transition and barriers to a successful transition. Descriptions of practice models were provided. Conclusion/Discussion: Two unanticipated findings were the lack of a consensus on the definition of "transition" and what constitutes a "successful" transition. Anecdotal evidence seemed to provide a consensus of opinions from the key informants when asked to describe facilitators and barriers to a successful transition. Examples of practice models that were used in several clinics with a structured transition program were described. Ideas for future research were suggested. A definition of health care transition is proposed.

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.

This study was designed to determine the effectiveness of short-term child-centered play therapy training with school counselor and teachers in Israel. A short-term child-centered play therapy course is an intervention that focuses on changing trainees attitudes and beliefs towards children while teaching them child-centered play therapy theory and skills. The experimental group, consisting of 18 volunteer school counselors and teachers in Israel received a total of 15 hours of child-centered play therapy didactic training with a variety of learning experiences. The control group consisted of 15 volunteer school counselors and teachers in Israel. The control group did not receive any training. All participants completed the Play Therapy Attitude-Knowledge-Skill Survey (PTAKSS) before and after the training as a means of measuring change in attitude, knowledge and skill. A second purpose of this study was to compare the effectiveness of short-term child-centered play therapy training with a comparison group semester long child-centered play therapy training course at the University of North Texas. An analysis of covariance revealed statistically significant positive increase in Knowledge subscale as compared to the control group. However the differences between the experimental and the control group were not significant on the participant's total score on the PTAKSS, their attitudes and beliefs towards children or their skill level. A t-test revealed no significant difference between the experimental and comparison groups on the skill subscale of the PTKASS. Results indicated that there was a significant difference between the experimental and the comparison groups on the Total score, Attitude and Knowledge subscales of the PTAKSS. This study supports the use of short-term play therapy training as an effective training model for increasing the trainee's knowledge of child-centered play therapy. It does not support the use of short-term play therapy training as an effective training model for increasing the trainee's attitudes towards children or increasing their confidence in applying play therapy skills.