Play therapists use children’s natural symbolic play as a method of mental health treatment (Landreth, 2012). Meta-analysis research has demonstrated the effectiveness of treating children with play therapy (Bratton, Ray, Rhine, & Jones, 2005), and child-centered play therapy (CCPT) has proven to be an effective treatment for children with externalizing behaviors such as aggression and other disruptive behavior (Bratton & Ray, 2000; Bratton et al., 2005). Some studies have demonstrated the effectiveness of brief and short-term CCPT, such as twice weekly within two to three months (Blanco & Ray, 2011; Shen, 2002) and when delivered in an intensive format, conducting 12 sessions within three weeks (Jones & Landreth, 2002). In this current study, I sought to determine the effectiveness of intensive CCPT with children identified as having externalizing problem behaviors. Participants were recruited from public schools in the urban area of Darwin, Northern Territory, Australia area. A total of 24 participants completed the study: 18 boys and 6 girls aged 6 to 9 years old (M = 7); 17 Australian Caucasians, 1 English (UK) Caucasian, 1 Asian, 3 Hispanic/Latino, and 2 Biracial. Participants were randomly assigned: 12 to the experimental group and 12 to the wait-list control group. Children in the experimental group received 20 intensive CCPT sessions: twice daily for 10 days. For each child participant, a parent completed the Child Behavior Checklist (CBCL) and a teacher completed the CBCL Teacher’s Report Form (TRF) three times: at pretest, posttest, and one-week follow-up. Mixed between-within ANOVAs were conducted applying an alpha level of .05 to interpret statistical significant and η2 calculation to assess practical significance. Follow-up results indicated a statistically significant interaction effect on CBCL Externalizing score, F (2, 44) = 14.747, p < .001, with a large effect size of η2 = .277. Results also indicated a statistically significant interaction effect on the TRF Externalizing score, F (2, 44) = 4.042, p = .024, with a large effect size of η2 = .135. Therefore, both parents and teachers indicated that children with externalizing behaviors who received intensive CCPT showed a significant decrease in those behaviors. The results of this study indicate that when time and financial resources call for short-term, intensive CCPT for children with problematic externalizing behaviors, practitioners may use it with confidence that its effectiveness has been demonstrated through this 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.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A Ludoterapia Centrada na CrianÃa, aqui entendida nÃo somente na proposta original de Axline, mas tambÃm a partir da Ãtica de VanFleet, Sywulak e Sniscak, tem como postulado a noÃÃo de que o brincar à um diÃlogo lÃdico que propicia a expressÃo dos sentimentos e a expansÃo das possibilidades na histÃria de vida da crianÃa. A terapia ajudaria a crianÃa a identificar, reconhecer e expressar melhor seus sentimentos. Cabe ao terapeuta, portanto, apresentar habilidades que possibilitem um espaÃo de seguranÃa para a expressividade da crianÃa. Essa habilidade do terapeuta à compreendida por Amatuzzi como uma predisponibilidade Ãtica. Para que a Ãtica da LCC seja pensada em seu viÃs filosÃfico, toma-se como base para este trabalho a Ãtica da alteridade radical de LÃvinas, que propÃs a responsabilidade como estrutura da subjetividade. A condiÃÃo Ãtica dar-se-ia na abertura e disponibilidade ao Outro, à sua diferenÃa. O Outro levinasiano nÃo conceituÃvel, antecedente e transcendente ao ser, estabelece uma relaÃÃo de assimetria com o Mesmo. Partindo dessas perspectivas, apresenta-se a questÃo norteadora desta pesquisa: qual o lugar destinado ao radicalmente Outro na Ludoterapia Centrada na CrianÃa? Para responder tal questionamento, o seguinte objetivo geral foi traÃado: analisar o lugar destinado ao Outro na Ludoterapia Centrada na CrianÃa. Os objetivos especÃficos sÃo: a investigaÃÃo entre alteridade e subjetividade, a partir da Ãtica levinasiana, na Ludoterapia Centrada na CrianÃa; a realizaÃÃo da releitura da Ludoterapia Centrada na CrianÃa, a partir do radicalmente Outro. A metodologia utilizada à a hermenÃutica filosÃfica de Gadamer, que propÃe a fusÃo de horizontes entre autor e intÃrprete para a criaÃÃo de um novo horizonte de compreensÃo. A partir das aproximaÃÃes entre a Abordagem Centrada na Pessoa e a Ãtica da alteridade radical, realizadas por Vieira e Freire e Schmid, apresenta-se como resultados a existÃncia de espaÃo para o Outro levinasiano na Ludoterapia Centrada na CrianÃa, desde que o terapeuta seja abertura e disponibilidade ao trauma que representa a chegada da crianÃa em sua diferenÃa absoluta. Verifica-se, tambÃm, que a crianÃa que chega para o atendimento se apresenta como Rosto, que remete ao Infinito e à transcendÃncia do Outro. A crianÃa, portanto, seria entendida como o Outro levinasiano, a quem o terapeuta à intimado a responder. Para que a abertura do terapeuta seja possibilitada, este deve vivenciar processos permanentes de inadaptaÃÃo no face a face com a crianÃa. Presta-se agradecimentos pelo apoio da CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior (CAPES) no desenvolvimento deste trabalho. / The Child-Centered Play Therapy, understood not only in the Axlineâs original proposal, but also from the VanFleet, Sywulak and Sniscakâs perspective, has as its premise the notion that the play is a ludic dialogue that promotes the expression of feelings and the expansion of possibilities in the childâs life. The therapy would help the child to identify, recognize and express his/her feelings. The therapist should, therefore, have the skills to enable a safe space for the childâs expression. This ability is understood by Amatuzzi as an ethical previous disponibility. For a philosophical perspective of the ethics of the Child-Centered Play Therapy, it is taken as basis the LÃvinasâ ethics of radical alterity, who proposed the responsibility as subjectivityâs structure. The ethical condition would be developed by the openness and availability to the Other, towards the Otherâs difference. The non-conceptuable levinasian Other, human beingâs antecedent and transcendent, establishes an asymmetric relationship with the Same. From these perspectives, it presents the guiding question of this research: what is the place for the radically Other in Child-Centered Play Therapy? To answer this question, the following general objective was traced: analyze the place reserved to the Other in the Child-Centered Play Therapy. The specific objectives are: inquiry the relation between otherness and subjetivity, based on levinasian ethics, in the Child-Centered Play Therapy; to develop a new reading of Child-Centered Play Therapy, based on radically Other. The chosen methodology was the Gadamerâs philosophical hermeneutics, which proposes the fusion of horizons between the author and the interpreter in order to create a new horizon of comprehension. From the similarities between the Person Centered Therapy and the Ethic of radical alterity, developed by Vieira & Freire and Schmid, it is presented as result that there is a place to the levinasian Other in the Child-Centered Play Therapy, as long as the therapist is openness and disponibility to the trauma that represents the arrival of the child in his/her absolute difference. It is also verified that the child who comes to the attendance, therefore, would be understood as the levinasian Other, whom the therapist is called upon to respond. To enable the therapist openness, he/she (the therapist) should experience permanent processes of inadequacy in the face to face relationship with the child. Grateful for the support of the CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior (CAPES) in the development of this research.

This study was designed to determine the effectiveness of culturally responsive child-centered play therapy when compared to a curriculum-based small group counseling intervention as a school-based intervention for Hispanic children experiencing behavioral problems that place them at risk for academic failure. Specifically, this study measured the effects of the experimental play therapy treatment, compared to Kids' Connection, on reducing Externalizing and Internalizing behavior problems of elementary school-age Hispanic children. Twenty-nine volunteer Hispanic children were randomized to the experimental group (n=15) or the comparison group (n=14). Subjects participated in a weekly 30 minute intervention for a period of 15 weeks. Pre- and posttest data were collected from parent and teachers using the Behavior Assessment Scale for Children (BASC). A two factor mixed repeated measures analysis of variance was computed for each hypothesis, to determine the statistical and practical significance of the difference in the pretest to posttest behavior scores of children in the two groups. According to parents' reports, the children receiving play therapy showed statistically significant decreases in externalizing behaviors problems, specifically conduct problems, and moderate improvements in their internalizing behavior problems, specifically anxiety. Teacher BASC results showed no statistical significance and negligible-to- small practical significance between the two groups at posttest as a result of treatment; however, problems with integrity of data collection of teacher BASCs were noted. This study determined that, according to parents' reports, culturally responsive child-centered play therapy is an effective intervention for school-aged, Hispanic children referred for behavioral problems that have been shown to place them at risk for both academic failure and future, more serious mental health problems. Additionally, culturally responsive considerations regarding counseling Hispanic children and families were explored. This was a progressive research study that, according to a review of the literature, is the first of its kind to focus on the effects of culturally responsive child-centered play therapy treatment with Hispanic, Spanish-speaking children.

This study examined the effectiveness of child centered play therapy (CCPT) with academically at-risk 1st graders. In this quasi-experimental design, twenty-one 1st grade students were assigned to the experimental group and 20 students were assigned to the no treatment control group. The children in the experimental group received two 30 minute play therapy sessions per week for the duration of eight weeks. Three hypotheses were analyzed. A two-factor repeated measures analysis of variances (SPANOVA) were performed on each dependent variable to determine if the experimental group performed differently from the control group across time according to the pretest and posttest results of the Young Child's Achievement Test (YCAT), the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSAYC), and the Student-Teacher Relationship Scale (STRS). Additionally, partial η2 was calculated to determine practical significance. One hypothesis was retained at the .05 level of significance. Findings indicated that academically at-risk 1st graders who participated in CCPT scored statistically significant higher on academic achievement. Specifically, children assigned to the experimental group demonstrated a statistically significant increase in Early Achievement Composite (p = .03) when compared to children assigned to the no treatment control group. No statistical significant results were found on Self-Concept and Student-Teacher Relationship Stress.

Bakgrund: Att vårdas på en barnintensivvårdsavdelning (BIVA) är en stressande miljö för både barn och föräldrar. Detta kan hindra föräldrar från att vara delaktiga i vården och nära sitt barn som är kritiskt sjuk. Barnets upplevelse av trygghet påverkas av förälderns mående och delaktighet i vården. Syfte: Studiens syfte var att undersöka föräldrars upplevelse av delaktighet i vården och förekomst av symptom på posttraumatisk stress (PTS) efter att deras barn vårdats på BIVA.  Metod: En retrospektiv deskriptiv design med kvantitativ och kvalitativ ansats användes, där 40 föräldrar besvarade två enkäter om upplevelse av delaktighet på BIVA och symptom på PTS. Resultat: Åttio procent av föräldrarna upplevde sig i stor utsträckning ha varit delaktiga i vården och i de beslut som rörde barnets vård. Föräldrarnas upplevelse av delaktighet resulterade i två huvudteman: Främjande och Hindrande faktorer för delaktighet. Det var en större andel mammor (41%) som visade symptom på PTS jämfört med pappor (12%) (p=0,038). Det var en större andel föräldrar som inte hade högskoleutbildning som visade symptom på PTS jämfört med föräldrar som hade högskoleutbildning (64% versus 14%). Slutsats: Föräldrar upplevde sig i stor grad vara delaktiga i beslut och barnets vård. Identifierade faktorer bland föräldrar med ökad förekomst att utveckla symptom på PTS var att vara mamma, yngre ålder och att inte ha en högskoleutbildning. / Background: Parents whose child was admitted to the pediatric intensive care unit (PICU) found it to be a stressful environment for both child and parent. This can restrict parents from being close and involved in their child's care. The child's sense of security is affected by the parents' feelings and involvement in care. Purpose: The aim of the study was to investigate parents' experiences of participation in the care and parents' symptoms of post-traumatic stress (PTS) after their child was discharged from the PICU. Method: A retrospective descriptive design was used with a quantitative and qualitative approach, where 40 parents answered two surveys about the experience of participation in PICU and symptoms of PTS. Result: Eighty percent of the parents felt that they had been involved in the care and in the decisions concerning the child's care. The parents’ experience of participation resulted in two main themes: promoting and inhibiting factors for participation. There was a higher proportion of mothers (41%) who showed symptoms of PTS compared to fathers (12%) (p=0,038). A higher percentage of parents who didn't have post-secondary education showed PTS symptoms, compared to those who did have post-secondary education (64% versus 14%). Conclusion: Parents reported that they had been involved in the care and in the decisions concerning the child's care. Symptoms of PTS among parents correlated with being a mother, younger age and lower educational level.

My dissertation analyzes the status of mixed offspring in the Hebrew Bible and Second Temple texts to understand the diverse ways children from intermarried couples were presented in pre-Mishnaic Jewish literature. Prior to the Mishnah (m. Qidd 3:12), there is no evidence of a monolithic ruling to regulate the status of mixed progeny. My goal, therefore, is to examine the different ways mixed offspring were treated, and to better understand whether they endured any social repercussions due to their mixed lineage. In turn, I explore the diverse ways Jewish identity was constructed in antiquity, and how matters like gender, lineage, and geography were used to establish social boundaries. Within contemporary scholarship, the study of mixed progeny in antiquity has been incidental to other research topics, including the expulsion narrative in Ezra 9–10, genealogical purity, and the matrilineal principle in Judaism. To date, no comprehensive approach has been undertaken to trace the status of mixed progeny in pre-Mishnaic Jewish literature. My dissertation seeks to fill this lacuna. Following a brief introduction in chapter 1, my subsequent chapters are divided into four time periods: the pre-Persian period (chapter 2); the Persian period (chapter 3); the Hellenistic period (chapter 4); and the early Roman period (chapter 5). Within each chapter, I analyze texts generally dated to those eras that include some information about mixed offspring. In my concluding chapter, I reveal three main factors that impacted the status of mixed progeny in antiquity: genealogy, residential location, and piety. I also provide a heuristic framework to categorize my findings of mixed offspring. While there were two main responses towards mixed progeny in antiquity (accepted or rejected), not every case fits nicely into these two classifications. Therefore, the treatment of mixed progeny must be understood on a spectrum to better appreciate the nuance within each text. / Thesis / Doctor of Philosophy (PhD)

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.

This qualitative study explores the perspective and practice of educators in after-school care through a child centered approach regarding the playground environment, rules, and resources aimed at promoting children's participation and well-being. Semi-structured interviews were conducted with educators in after-school care settings to investigate their perceptions and approaches. Educators strive to create an inclusive and meaningful playground environment by implementing clear and understandable rules. These rules aim not only to organize children's activities but also to break down gender norms and promote current societal issues. Educators are flexible and willing to adapt rules according to children's needs and interests to enhance their participation and autonomy. Regarding resources and play materials, educators aim to keep children active and engaged by providing a varied and stimulating environment. By allowing children to co-create their own play environment, their creativity and imagination are fostered. The study highlights the crucial role of educators in after-school care in creating an inclusive and meaningful playground environment for children. By implementing clear rules and providing appropriate resources, they aim to promote children's well-being and development effectively. By working with a child centered approach and being responsive to children's needs and interests, educators can create a positive and supportive environment where all children are given the opportunity to grow and thrive.