The present meta-analytic study estimated the overall effectiveness of child therapy interventions using CCPT methodology and explored the relationships between study characteristics and treatment effects. Fifty-two studies between 1995 and the present were included based on the following criteria: (a) the use of CCPT methodology, (b) the use of control or comparison repeated measure design, (c) the use of standardized psychometric assessment, and (d) clear reports of effect sizes or sufficient information for effect size calculation. Hierarchical linear modeling (HLM) techniques were utilized to estimate the overall effect size for the collected studies and explore relationships between effect sizes and study characteristics. Dependent variable included 239 effect sizes, and independent variables included 22 study characteristics. The mean age of all child participants in the collected studies was 6.7. In 15 studies, the majority of participants were Caucasian. An equal number of studies were made up of non-Caucasian participants, including 3 with majority African American, 4 with majority Hispanic/Latino participants, 5 with majority Asian/Asian American participants, and 3 with other ethnic populations. Study collection included 33 studies with majority of boys and 11 studies with majority of girls. HLM analysis estimated a statistically significant overall effect size of 0.47 for the collected studies (p < 0.001). This result indicated that the overall improvement from pre to post treatment demonstrated by children in experimental groups was approximately 1/2 standard deviation better than by children in control groups. A statistically significant amount (49.2%) of between-study variance was found (p < 0.001), indicating the heterogeneity among the 52 studies Statistically significant relationships were found between effect sizes and study characteristics including child age, child ethnicity, clinical level of referral, treatment integrity, presenting issue, source of data, population, and caregiver involvement. Effect size findings for CCPT and its moderators should be interpreted in light of the specific, and perhaps more rigorous statistical analysis method (HLM) and effect size calculation formula used for the present study, particularly in comparison to previous meta-analytic findings. Overall findings support CCPT's beneficial treatment effect. Specifically, CCPT can be considered a developmentally and culturally responsive effective mental health intervention across presenting issues.

This single case study provides a detailed description of a 7-year-old sexually abused child's sandplay, describes prominent themes in the child's sandplay, and concurrent family transitions and events. Included are reflections and meanings that the therapist attributed to the sandplay. Child-centered play therapy was the guiding theory for the therapy. Thirty-six consecutive therapy sessions are examined in this study. The therapy sessions were divided into three phases that were tied to significant life events and changes in the sandplay content and process, along with the therapist-child interactions were explored in each of the phases. There were many significant changes in the content and process of the child's play. He went from primarily using nonliving miniatures to using primarily living miniatures in his sand worlds. Specifically, the use of people and animals increased in his third phase sandplays. The categories of miniatures the child used also increased from one predominant category in the first phase to four or more miniature categories in the third phase. The child's sandplay moved from primarily static play to increasingly dynamic play. Changes in the child's play are linked to changes in his living environment. / Master of Science

Child-centered play therapy (CCPT) is an empirically endorsed approach for children facing specific clinical concerns and life circumstances alike. The majority of research to date has accrued data about clients from secondary sources, such as adult report and observation. The purpose of this study was to explore children's perceptions of participating in CCPT by implementing a developmentally accessible interview medium, allowing children to share their experiences directly. Ten children between the ages of 4 and 7 who had completed at least eight sessions of CCPT were invited to create a drawing and respond to an interview protocol with their counselor. Data sources included the picture produced, a transcript of the interview between the child and counselor, and observation notes of the interview process. Using a phenomenological approach, three themes were identified to describe children's awareness and experience of the intervention: expressions of relationship, experiences in the playroom, and reluctance to engage in counselor-directed activity. The first two themes reflect children's report of the intervention and the third represents reactions to the research activity. Findings from this study support conclusions that children are aware of relationship between themselves and their counselor and recognize the uniquely unstructured features of play therapy and the playroom, which are defining components of CCPT.

Child-centered play therapists are taught unique relationship building approaches and therapeutic methods to utilize when working with children. The purpose of this study was to determine if adult clients counseled by child-centered play therapists would demonstrate greater positive therapeutic outcomes than adult clients who were counseled by non-educated child-centered play therapists. This study also attempted to determine if the play therapists' clients would show greater, significant improvement in any particular areas of client distress (i.e., depression/anxiety, relationship issues), more so than the clients of the non-play therapists. Archival data from an assessment, The Adult Self-Report Inventory (ASR), was gathered to measure reported pre and post-test client symptomology. This study utilized a 2X2 repeated measure ANOVA design to analyze the impact of counselors who were educated in child-centered play therapy who saw adult clients, versus their non-play therapy counterparts who saw adult clients. Before treatment pre-test and after treatment post-test administration was collected for use in the analysis. The population consisted of 60 adult clients seeking counseling services at a major university in the southwest. All clients were seen by Master's practicum students for ten sessions. The clients were divided into two groups - 30 were seen by play therapists, 30 were seen by non-play therapists. Five scales on the ASR were measured using a 2x2 split-plot design and Eta squared. There were three independent variables: group, measurement occasion, and the interaction between group and measurement. The results of this study did not reveal any statistical significance. However, clinical significance was demonstrated as the play therapists' clients did report greater reductions in symptomology on all five scales, some more than others.

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.

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.

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.

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.

Externalizing behavior problems in children reflect negative actions toward the external environment and can have detrimental consequences for their academic, social, and mental well-being. These actions range from breaking the rules to exhibiting extremely disruptive and aggressive behaviors, and they frequently come with issues with social behavior and emotional control. Socioemotional competencies, such as empathy and emotion regulation, serve as protective factors against behavior problems, enabling children to effectively manage their emotions and behaviors. This study focuses on examining the effectiveness of child-centered play therapy (CCPT) in reducing externalizing problems and enhancing socioemotional competencies in children aged 3 to 12. CCPT utilizes play as a natural language to establish a therapeutic relationship between play therapists and children. This relationship provides a safe and accepting environment for children to express themselves and develop self-regulation skills. By accepting responsibility for their actions, children can progress toward self-actualization and improved behavior management. To investigate the effectiveness of CCPT in reducing externalizing behavior problems and increasing socioemotional competencies in children, a systematic literature review was conducted, considering studies published over the last decade. Four databases were analyzed, and six articles met the predetermined inclusion criteria. While the data extracted from the included articles demonstrated promising results regarding the effectiveness of CCPT in reducing externalizing problems, the impact of CCPT on enhancing socioemotional competencies was not clear. It is important to acknowledge the limitations of this study, including the scarcity of research in this field and small sample sizes, which impede the generalization of the results to all populations. However, this study identified a research gap concerning the effectiveness of child-centered play therapy in addressing externalizing problems and children's social and emotional functioning. Future research is required to have a more comprehensive picture of how CCPT reduces externalizing problems and what abilities it gives children to cope with their problems; otherwise, it is not possible to consider CCPT as an evidence-based intervention for externalizing problems and widely use it for all children based on current data in the literature.

The purpose of this study was to confirm the four-factor model of the Child Interpersonal Relationship and Attitudes Assessment (CIRAA) in order to establish the instrument’s factor/structure validity using a sample different than that used in instrument development. The CIRAA was the first parent-report instrument based on child-centered theory and designed to measure play therapy outcomes. Its four factors are Self-Regulation (formerly Self-Control), Interpersonal Relationships, Coping Skills, and Internal Locus of Evaluation. For this study, the CIRAA was administered to 206 parents; their children were 75 females and 131 males aged 3 to 10 years old. The distributions of children’s genders and ages in this study were similar to the distributions of the sample used to develop the CIRAA. Based on confirmatory factor analysis results of overall goodness-of-fit indices; localized areas of strain; and interpretability, size, and statistical significance (p < .001) of the model's parameter estimate, the four-factor model of the CIRAA was confirmed with both theoretical and empirical support. Internal consistency reliability for the subscales and total score were acceptable, with an overall reliability coefficient of .928. A medium negative correlation (r = -.417, n = 47, p < .01) was found between the CIRAA total scores and Child Behavior Checklist Total Problems scores, a result in the expected direction. All subscales and total scores, except the Internal Locus of Evaluation score, distinguished differences between non-clinical and clinical samples. Altogether, results indicated that the CIRAA is appropriate for making clinical decisions about individuals. Limitations, additional implications, and future research are discussed.