Most counselors agree that the therapeutic relationship is essential in counseling. However, the current evidence-based treatment movement has resulted in a focus on treatment protocols and techniques in outcome research. Researchers have called for the inclusion of relationship variables in future outcome research. Child-centered play therapy (CCPT) is an empirically-supported, developmentally responsive intervention for children that emphasizes building a therapeutic relationship based on the philosophy of person-centered theory. Exploring the impact of the relationship on CCPT outcomes would be beneficial, but no current quantitative measure exists for obtaining the child’s view of the therapeutic relationship. The purpose of this study was to create a developmentally appropriate instrument to measure children’s perceptions of the therapeutic relationship. Established instrument development procedures were followed to create the Relationship Inventory for Children (RIC), a 15-item instrument for use in outcome research that measures the child’s perspective of the therapeutic relationship. Participants were 33 child experts who participated in interviews and preliminary testing of the instrument as well as 100 children whose scores on the 31-item pilot instrument were submitted to exploratory factor analysis (EFA). Children (62% male) ranged in age from 6 to 9 years (M = 6.92) and 53% identified as Caucasian, 14% as Hispanic, 14% as African American, 2% as Asian American, 0.8% as Native American, 8% as Multiracial, and 9% unreported. The EFA resulted in three factors: Positive Regard, Unconditional Acceptance, and Empathy. Implications for further development of the RIC, for use of the RIC in research, and for application of the RIC to person-centered theory are discussed.

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.

Filial therapy, originally developed by Bernard Guerney (1964), is a form of parent child therapy utilizing child-centered skills and limit setting strategies to improve the parent child relationship and to increase positive child behaviors. Parent Child Interaction Therapy (PCIT), developed by Sheila Eyberg (1988), is an empirically supported treatment for improving parenting skills and decreasing negative externalizing behavior with children. Child Parent Relationship Therapy (CPRT), developed by Garry Landreth (2002), is an up and coming form of Filial therapy, supported in the literature for improving the parent child relationship and improving the child’s general functioning. Children diagnosed with Autism Spectrum Disorders (ASD) often present with deficits in their socialization and communication abilities. These deficiencies can cause strain on the parent child relationship because of the challenges inherent to the maladaptive interactions common among families with a child diagnosed with ASD. Therefore, there is a need for effective interventions to improve the functioning between the parent and child. However, a review of the literature discovered a lack of research using Filial therapy with children diagnosed with ASD and no research comparing different forms of Filial therapy. In order to better inform practitioners, the current study utilized qualitative analysis through a deconstructing evidence approach to examine the experience of four participants in either the PCIT or CPRT group. Participants completed pre and post assessments measuring changes in the parent child relationship and their child’s adaptive functioning. The counselors of the group also recorded the parents’ reactions to the group through their weekly progress notes. The results yielded little support for one approach over the other. One participant in the CPRT had a very successful experience overall, reporting improvement in the parent child relationship and her child’s adaptive functioning. Furthermore, the counselors recorded a more positive reaction from the parents in the CPRT group as compared to the largely neutral or negative reactions from the parents in the PCIT group. However, overall, the study concluded that more research is needed on identifying a clearly superior Filial therapy approach for children diagnosed with ASD. / Department of Counseling Psychology and Guidance Services