Research has indicated that filial therapy, an approach in which parents conduct play sessions with their young children, has strong effects on the participating parents and children. As a result, some have speculated that filial therapy improves the family system; however, minimal research exists to support this claim. Using a single-case, time-series design, I examined the impact of child parent relationship therapy (CPRT), a filial therapy approach, on the functioning of 8 diverse families (two-parent, biological children = 4; two-parent, adopted children = 3; single-parent, biological children = 1). 15 parents and 17 children (male = 15, female = 17) participated in the study. All but 1 parent was Caucasian. The children were more ethnically diverse (Caucasian = 5, Hispanic/Caucasian = 5, Hispanic = 3, Asian = 2). Parents’ ages ranged from 29 to 49 and children’s from 2 to 13. Results from simulation modeling analyses (SMA) indicated that 6 of 7 families experienced a statistically significant improvement in their targeted areas of family functioning, and the average effect size was moderate. Results from self-reported measures indicated that 7 families experienced notable improvements in family satisfaction, 4 in cohesion, 3 in communication, and 1 in flexibility. Data from an observational measure rated by independent assessors also indicated improvements pre- to post-intervention: 5 families in flexibility, 4 families in cohesion, and 4 families in communication. All families reported improved functioning in post-intervention interviews. The results support that the benefits of filial therapy may indeed extend to the family system.

Using a mixed methodology, the effectiveness of an 8-week modification of Landreth's (1991) 10-week group filial therapy training model was investigated with parents (n = 5) court-ordered for remedial parenting services due to physical abuse and/or neglect of their school-age children. A comparison group (n = 3) concurrently received an 8-week parent education course. Three primary questions were explored. Do filial therapy group participants demonstrate a greater decrease in child physical abuse potential and parenting stress following training when compared to parent education group participants? In addition, do filial therapy group participants show evidence of stronger parent-child relationships following training when compared to participants in the parent education group? Pre- and post-measures were utilized, and anecdotal and qualitative data were also collected. Following the analysis of both the quantitative and qualitative data, it was determined that the group quantitative results detracted from the richness of the qualitative findings, and the former were subsequently dropped. Instead, individual pre- and posttest quantitative scores, along with the anecdotal data, were compiled to create participant profiles that provided additional descriptive information to the emergent focus group themes. Due to the size of the sample (N = 8), findings were only preliminary and merit further study. Participants demonstrated social desirability in their assessment responses; therefore, it is recommended that qualitative or mixed methodology, as well as multiple measures of each construct, be incorporated to combat this phenomenon in future studies with this population. Results of this study further suggested that there are clinical benefits to utilizing a mixed sample of both court- and self-referred participants. In addition, the court-mandated population is heterogeneous and requires multiple treatment options coupled with screening protocol for appropriate treatment assignment. Future filial therapy research with this population should provide greater support to participants in conducting filial therapy sessions, as well as alternative ways of documenting these sessions. In addition, it is proposed that a combination of individual and group filial therapy models that is longer-term would be more effective with this population than the 8-week model used. / Ph. D.

The general purpose of this study was to both evaluate the effectiveness of filial therapy and describe the filial treatment process with parents court-referred for maltreatment. In filial therapy, parents learn basic play therapy skills in a group format that they implement in weekly home play sessions. They then generalize these skills into their parenting. Three research questions guided the quantitative portion of this investigation: (1) Is filial therapy effective at reducing the child abuse potential of parents court-referred for maltreatment? (2) Is filial therapy effective at reducing parenting stress for parents court-referred for maltreatment? (3) Is filial therapy effective at strengthening the parent-child relationship for parents court-referred for maltreatment? Qualitative data about parents' experience in the filial group was also collected and addressed the following questions: (1) How does the filial therapy process affect participants? (2) How does the filial therapy process affect treatment outcome? (3) What changes, in addition to those measured quantitatively, are reported by parents. The experimental group participants (n=7) received 8 weeks of filial therapy (modified from Landreth's (1991) 10-week model) in 1-1/2 hour weekly sessions. The control group (n=5) received a local agency's standard treatment. Parents completed two instruments, the Parenting Stress Index (PSI) and the Child Abuse Potential Inventory (CAP). Analyses of covariance indicated that parents significantly reduced there parenting stress and strengthened the parent-child relationship. Although parents did not significantly reduce their child abuse potential in this study, those results were based on an incomplete analysis. Most of the pre-test CAP scores for parents in the experimental group (6 of 7) were invalid as a result of excessive "faking good responses." As a result, only post-test scores could be compared between the experimental and control groups. The qualitative data revealed that parents made important changes during the filial therapy process. / Ph. D.

The purpose of this study was to determine the effectiveness of Intensive Filial Therapy in: (a) improving the self-concept of child witnesses of domestic violence; (b) reducing internalizing behavior problems, such as withdrawal, somatic complaints, anxiety and depression, of child witnesses of domestic violence; (c) reducing externalizing behavior problems, such as aggression and delinquency, of child witnesses of domestic violence; (d) reducing overall behavior problems of child witnesses of domestic violence; and (e) increasing communication of empathy between mothers and child witnesses of domestic violence. A second objective of this study was to compare the effectiveness of Intensive Filial Therapy with Intensive Individual Play Therapy and Intensive Sibling Group Play Therapy with child witnesses of domestic violence. The experimental group consisted of 11 child witnesses of domestic violence whose mothers received 12 Intensive Filial Therapy training sessions within a three week period and had 12 mother-child play sessions. The Intensive Individual Play Therapy comparison group, consisting of 11 child witnesses, and the non-treatment control group, consisting of 11 child witnesses, were utilized from the Kot (1995) study. The Intensive Sibling Group Play Therapy comparison group was utilized from the Tyndall-Lind (1999) study. Children in all studies completed the Joseph Preschool and Primary Self-concept Screening Test and the Child Behavior Checklist. Mothers who received Intensive Filial Therapy training conducted pretest and posttest play sessions for the Measurement of Empathy in Adult-Child Interaction. Analyses of Covariance revealed the children in the experimental group significantly increased in self-concept, and significantly reduced overall behavior problems. A comparison of t-test scores of the pretests and posttests revealed mothers in the experimental group significantly increased communication of empathy to their children.

This study was designed to determine the effectiveness of a filial/play therapy training model with high school juniors and seniors enrolled in a Peer Assistance and Leadership program (PALs). Filial/play therapy is an intervention that focuses on strengthening and enhancing adult-child relationships. The high students are trained to be a therapeutic change agent for primary school children identified as having adjustment difficulties by utilizing basic child-centered play therapy skills in weekly play sessions with young children. Specifically, this study is designed to determine the effectiveness of filial therapy in increasing: 1) the high school students' observed empathic behavior with young children, 2) the high school students' observed attitude of acceptance toward young children, 3) the high school students' observed ability to allow self-direction in young children, and 4) the high school students' observed level of involvement with young children. The experimental group, consisting of 16 volunteer high school students enrolled in a PALs class for high school credit, received a total of 24 weeks of filial/play therapy didactic training, application, and supervision for the playtimes they conducted with pre-kindergarten/kindergarten students identified with adjustment difficulties. The comparison group consisted of 15 volunteer high school students enrolled in a PALs class for high school credit. The comparison group received the standard PALs class curriculum. All students were videotaped playing with a young child 4 to 6 years of age before and after the training as a means of measuring empathic behavior with young children. An Analysis of Covariance revealed statistically significant findings in all four hypotheses. Specifically, the experimental group of high school students exhibited statistically significant increases in empathic interactions with young children when compared to the comparison group. The experimental group also exhibited statistically significant increases in communication of acceptance of young children's feelings and behaviors, acceptance and behavioral willingness to follow young children's lead rather than attempt to control their behavior, and attention to and participation in young children's play. This study supports the use of filial/play therapy as an effective training model for increasing high school students' empathic behavior with young children. Filial/play therapy offers significant possibilities for training high school students in a developmentally appropriate model for working with young children identified with school adjustment difficulties, in order to prevent future problems.

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.

This research study investigated the effectiveness of an intensive format of the traditional Landreth filial therapy training (LFTT) model compared to the traditional LFTT model. Specifically, this study compared the intensive LFTT group and the traditional LFTT group at post-testing in the areas of: (a) reducing stress related to parenting, (b) increasing parental empathic behavior with their children, (c) increasing parental acceptance toward their children, and (d) reducing perceived child behavior problems. The traditional LFTT group consisted of 13 parents in groups of up to six members for 10 90-minute weekly sessions. Traditional LFTT involved didactic instruction, required at-home laboratory playtimes, and supervision. Parents were taught child-centered play therapy skills of responsive listening, recognizing children's emotional needs, therapeutic limit setting, building children's self-esteem, and structuring required weekly playtimes with their children using a kit of specially selected toys. The intensive LFTT group consisted of 13 parents in groups of up to four members who met on four Saturdays for 4 hours each. The traditional LFTT model was modified to teach the same material over fewer sessions. The difference in this delivery was fewer opportunities for parents to have home playtimes and receive feedback from the researcher. To compensate for this difference and attempt to maintain the effectiveness of the traditional model, the researcher had parents bring their children to training. The researcher used the parents' children in live demonstrations of the skills being taught. Parents were able to practice the new skills with their own children under direct supervision from the researcher followed by immediate feedback. This modification provided supervision equivalent to that of the traditional LFTT model. The results of this study were no statistically significant differences between the intensive and traditional groups at post-testing on overall parenting stress, parental acceptance and empathic behaviors with their children, and in reported child behavior problems.

This study was designed to determine the effectiveness of filial therapy with incarcerated mothers as a method of increasing empathic behaviors with their children, increasing attitudes of acceptance toward their children, and reducing stress related to parenting. Filial therapy, a method of training parents to respond and interact therapeutically with their children, focuses on enhancing the parent-child relationship. The sample population of 22 volunteer subjects was drawn from a pool of incarcerated mothers in the Denton County Jail who had children between three and ten years of age. The experimental group parents, consisting of 12 incarcerated mothers, received 2-hour filial therapy training sessions biweekly for five weeks and participated in biweekly 30-minute play sessions with one of their children. The control group parents, consisting of 10 incarcerated mothers, received no treatment during the five weeks. The three written self-report instruments completed for pretesting and posttesting purposes by both groups were The Porter Parental Acceptance Scale, The Parenting Stress Index, and The Filial Problem Checklist. The parents were also videotaped in play sessions with their child before and after training as a means of measuring change in empathic behavior. Analysis of Covariance revealed that incarcerated mothers in the experimental group had significant change in 9 of 13 hypotheses, including (a) a significant increase in their level of empathic interactions with their children, (b) a significant increase in their attitude of acceptance toward their children, and (c) a significant reduction in the number of reported problems with their children's behavior. This study supports filial therapy as an effective intervention for enhancing the parent-child relationship with incarcerated mothers and their children. Utilizing instruction and practical application of positive therapeutic methods, filial therapy training empowers parents by increasing their parenting knowledge and skills, and indirectly empowers children who experience the parent-child relationship with an increase in unconditional acceptance and positive regard.

Children’s mental health is a topic of concern, not only in the escalating number of children who meet diagnostic criteria for disorders, but also for the practitioners desiring to treat them effectively. Parental involvement in treatment results in more favorable outcomes with longer treatment gains observed, thus reducing mental health issues. An additional factor in children’s mental health is the effect of levels of parental acceptance toward the child. Parental acceptance is a positive outcome that has been observed in previous studies conducted with Child-Parent Relationship Therapy (CPRT). There are many reported barriers to seeking treatment for mental health issues, including time, cost, distance, and access. Online therapies have been found to reduce or eliminate most barriers to treatment, and is a preferred format for certain populations. To date, however, there have been no studies conducted on whether CPRT is effective in increasing levels of parental acceptance in an online format. Eight participants from around the world completed the ten-week CPRT training in an online format. Levels of parental acceptance were measured by the Porter Parental Acceptance Scale (Porter, 1954; PPAS) in self-reported pre- and post-treatment assessments. A perception survey was also conducted to assess participants’ perception of the process of an online parent training format, including benefits and challenges. This mixed-methods study found that an online version of CPRT does significantly increase parental acceptance levels. Participants also reported positive perceptions of the online training format. Positive themes reported in the survey responses related to convenience, community, access, and user experience.

Utilizing a collective case study design, I examined and described the filial therapy (FT) process and adaptations discovered to be necessary and unnecessary in working with families who have a child with a life-threatening illness in the hospital setting. Data from a total of 7 parents was utilized, including those who terminated early, in order to gain a greater understanding of adapting FT for families who have a child with a life-threatening illness and their participation patterns. The parents attended 10 one- to two-hour FT sessions. The data was analyzed to examine for themes, patterns and relationships intrinsically with each case participant, as well as across cases. Analysis indicated that parents with a child with a life-threatening illness had great difficulty committing to attend FT; and a high rate of attrition occurred for those who did commit. A theme regarding flexibility was found to be of eminent importance in a variety of manifestations including therapeutic methods, session format, location and time of sessions, and intense vs traditional FT. Therapeutic adaptations in flexibility found to be important including openness to cathartic and personal parenting sessions, tolerance of forgetfulness, and lowering typical therapeutic concerns of dependency in the relationship. An inability for parents in this situation to benefit from intense FT methods was also noted. Changes noted in the child of focus included increased confidence, increased cooperation in the medical setting, increased communication with the parent and with medical staff regarding medical issues, and increased communication with the parent regarding personal feelings and issues. Changes noted in the parents included increased confidence in parenting skills, increased awareness of the child's perceptions of the environment, increased tolerance in allowing the child to struggle in and out of the medical setting, with both emotional and physical pain in order to gain coping skills, increased ability to allow the child to empower self, and increased abilities in limit setting.