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Play Therapy Outcome Research Database

This database aims to include all available play therapy intervention outcome research since 1995 to the present published or translated in English that meets the definition of play therapy established by the Association for Play Therapy (APT).  View inclusion criteria

Studies included in the database meet the following criteria:

  • Treatment/Intervention met APT’s definition of play therapy: "the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development."
  • Experimental or Quasi-experimental research design including randomized and nonrandomized control/ comparison groups, single group, and single case designs using repeated measurements.
  • Study published in English. If not, and the abstract was published in English, the Center for Play Therapy had study methodology and results translated into English.

Note: Future plans include the addition of outcome research on play-based interventions that failed to meet the APT definition such as Parent Child Interaction Therapy (PCIT), Incredible Years (IY), and Child-Parent Psychotherapy (CPP).

The objective is an interactive, sortable database of treatment outcome research which can serve as a useful source of information regarding the evidence base for play therapy’s effectiveness. View key for abbreviations of study characteristics

Play therapy (PT) treatment models identified with acronyms:

CCPT = Child-Centered Play Therapy
CPRT = Child Parent Relationship Therapy
CTRT = Child Teacher Relationship Therapy
AdPT = Adlerian Play Therapy
CBPT = Cognitive Behavioral Play Therapy

Control group type denoted by:

WC = waitlist/delayed start control
AC = active control
COMP = comparison treatment

Ethnicity denoted by:

AfAm = African American
Asian = people of Asian descent living in the U.S.
Cauc = Caucasian/European American
Lat = Latino/Hispanic
NatAm = Native American


Database developed by: Dr. Sue Bratton, Eric Dafoe, Alyssa Swan, Kristie Opiola, Damian McClintock, & Gustavo Barcenas

Treatment Model

Filial PT

Research Design

Randomized-Active Control

Authors & Publication Information

Opiola, K., & Bratton, S. (In press). Efficacy of child parent relationship therapy (CPRT) for adoptive families: A replication study. Journal of Counseling and Development.

Child Sample Characteristics

N = 49 Adopted Children

  • Age: 2.5-9
  • 51% male, 49% female
  • 35% Cauc, 10% AfAm, 12% Latino, 22% Asian, 16% Biracial, 4% African

Study Characteristics

CPRT

  • 7 play sessions
  • 1x weekly; 30 mins
  • Measurements

    Measurement of Empathy in Adult-Child Interactions (MEACI)
    Child Behavior Checklist (CBCL)
    Parenting Stress Index 4 (PSI-4)

    Paraprofessional Characteristics

    N = 49 Adoptive Parents with Attachment Related Concerns

  • Age: 25-59

    • 61% female, 39% male
  • 85.7% Cauc, 2% AfAm, 6.1% Asian, 6.1% Latino
  • Findings

    Statistically significant findings and large treatment effects on all measures indicated the effectiveness of CPRT over the TAU on 1) reducing adopted children’s global behavior problems, 2) reducing parent-child relationship stress, and 3) increasing parent’s empathic behaviors as measured by objective raters blinded to the study. Finding s confirm Carnes-Holt and Bratton’s (2014) results.

    Expand for findings & study characteristics
    Treatment Model

    Child-Centered PT

    Research Design

    Randomized-Waitlist Control

    Authors & Publication Information

    Ritzi, R.M., Ray, D.C., & Schumann, B.R. (2017). Intensive short-term child-centered play therapy and externalizing behaviors in children. International Journal of Play Therapy, 26(1), 33-46.

    Child Sample Characteristics

    N = 24 children with behavioral concerns

    • Age: 6-9; M = 7
    • 75% male, 25% female
    • 71% Aus Cauc, 13% Lat, 8% Biracial, 4% Eng Cauc, 4% Asian

    Study Characteristics

    Individual CCPT

    • 20 sessions
    • 2x per day for 10 days; 30 mins

    Measurements

    Child Behavior Checklist (CBCL
    Teacher Report Form (TRF)

    Findings

    Compared to waitlist control group, children who received CCPT demonstrated statistically significant decreases in externalizing behavior scores, aggressive behavior subscale scores, and rule-breaking behavior subscale scores on the CBCL, all with large effect sizes. Compared to the waitlist control group, children who received CCPT also demonstrated statistically significant decreases in externalizing problems scores and aggressive behavior subscale scores on the TRF with large effect sizes.

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    Treatment Model

    Activity PT

    Research Design

    Randomized - Active Control

    Authors & Publication Information

    Yousef, D. & Bratton, S. (In press). Group activity play therapy for preadolescent females: Effects on low self-esteem. Journal for Specialists in Group Work.

    Child Sample Characteristics

    N = 29 girls referred by teachers for low self-esteem

    • Age: 9-11
    • 100% female
    • 45% Lat, 38% Cauc, 14% AfAm, 3% Asian

    Study Characteristics

    Group Activity PT

    • 16 sessions
    • 1x wkly; 45 mins
    AC = Social Skills Group Intervention (SSGRIN)
    • 13 sessions
    • 1x wkly; 45 mins

    Measurements

    Harter Self-Perception Profile for Children (SPPC)
    Teacher's Rating Scale for Children's Actual Behavior (TRS)

    Findings

    Compared to the active control group, the activity play therapy group demonstarted statistically significant improvements in self-esteem with moderate to large effect sizes according to child self-report on the global self-worth scale of the SPPC. According to teacher report on the TRS, the activity play therapy gorup did not demonstrate a statistically significant difference compared to the active control gorup and yielded a small effet size.

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    Treatment Model

    Child-Centered Group PT

    Research Design

    Randomized Waitlist Control

    Authors & Publication Information

    Cheng, Y. & Ray, D.C. (2016). Child-centered group play therapy: Impact on social-emotional assets of kindergarten children. The Journal for Specialists in Group Work, 41(3), 209-237.

    Child Sample Characteristics

    N = 43 children identified with social or emotional concerns

    • Age: 5-6; M = 5.14
    • 70% male, 30% female
    • 44% Lat, 33% Cauc, 23% AfAm

    Study Characteristics

    Group CCPT

    • 15-16 sessions
    • 2x weekly; 30min

    Measurements

    SEARS-P Social and Emotional Assets and Resilience Scales - Parent
    SEARS-T Social and Emotional Assets and Resilience Scales - Teacher

    Findings

    Factorial ANOVA results indicated a statistically significant interaction effect on SEARS-P Total score, Social Competence subscale, and Empathy subscale indicating positive impact of CCGPT with medium effect sizes. SEARS-T indicated no statistically significant differences between groups with a small effect size. Group size held similar results.

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    Treatment Model

    Adlerian PT

    Research Design

    Single Case Experimental Design

    Authors & Publication Information

    Meany-Walen, K.K. & Teeling, S. (2016). Adlerian play therapy with students with externalizing behaviors and poor social skills. International Journal of Play Therapy, 25, 2, 64-67.

    Child Sample Characteristics

    N = 5 children with disruptive classroom behaviors and/or poor social skills

    • Age: 1st-2nd grade
    • 80% male, 20% female
    • 100% Cauc

    Study Characteristics

    Individual and Group Adlerian PT

    • 10-12 play sessions
    • 2x wkly; 30min individual and 45 min group

    Measurements

    Direct Observation Form (DOF)

    Findings

    The five children were randomly split into a treatment group (N=3) or a control group (N=2). The children in the control group showed no statisticaly significant changes over the course of the study. All children in the tretamtn group showed statistically significant increases in on-task behaviors on the DOF. Though it was not part of the DOF, teachers reported an incrase in positive social behaviors from the children in the treatment group. These results remined consistent during the follow-up phase as well.

    Expand for findings & study characteristics
    Treatment Model

    Child-Centered PT

    Research Design

    Randomized-Waitlist Control

    Authors & Publication Information

    Su, S.H. & Tsai, M.H. (2016). Group play therapy with children of new immigrants in Taiwan who are exhibiting relationship difficulties. International Journal of Play Therapy, 25(2), 91-101

    Child Sample Characteristics

    N = 8 new immigrant children exhibiting interpersonal relationship difficulties

    • Age: 8-9; M = 8.5
    • 50% male; 50% female
    • 37.5% Vienamese, 37.5% Chinese, 25%Thai

    Study Characteristics

    Group CCPT

    • Avg: 12 Sessions
    • 1x weekly; 40mins

    Measurements

    Social Skill Behavior and Characteristics Scale for Elementary and Junior School Students (SSBCS)
    Parenting Stress Index (PSI)

    Findings

    Compared to control group, CCPT group demonstrated a statistically significant decrease in relationship difficulties on the SSBCS student and teacher versions. Compared to control group, CCPT group only demonstrated statistically significant decreases on the mood subscale of the PSI child domain and on the role restriction subscale of the PSI parent domain.

    Expand for findings & study characteristics
    Treatment Model

    Child-Centered PT

    Research Design

    Single Case Experimental Design

    Authors & Publication Information

    Balch, J.W., & Ray, D.C. (2015). Emotional assets of children with autism spectrum disorder: A single case therapeutic outcome experiment. Journal of Counseling and Development, 93, 429-439.

    Child Sample Characteristics

    N = 5 children diagnosed with ASD

    • Age: 6-9; M = 7.2
    • 60% male, 40% female
    • 60% Cauc, 20% Lat, 20% AfAm

    Study Characteristics

    Individual CCPT

    • 20 sessions
    • 2x wkly; 30mins

    Measurements

    Social-Emotional Assets and Resilience Scales for Parents (SEARS-P)

    Findings

    Explored the effect of CCPT on social competence, empathy, and self-regulation. Visual analysis demonstrated that CCPT was beneficial for 3 children, whereas results for 2 children were mixed.

    Expand for findings & study characteristics
    Treatment Model

    Child-Centered PT

    Research Design

    Randomized-Waitlist Control

    Authors & Publication Information

    Blanco, P. J., Muro, J. H., Holliman, R., Stickley, V. K., & Carter, K. (2015). Effect of child-centered play therapy on performance anxiety and academic achievement. Journal of Child and Adolescent Counseling, 1(2), 66-80. doi: 10.1080/23727810.2015.1079117

    Child Sample Characteristics

    N = 59 children

    • 6-7; M = 6.5
    • 53% male, 47% female
    • 69% Cauc, 17% Lat, 7% AfAm, 2% Asian, 5% Other

    Study Characteristics

    Individual CCPT

    • 16 sessions
    • 2x wkly; 30 mins

    Measurements

    Early Achievement Composite of the Young Children’s Achievement Test (YCAT)
    Woodcock Johnson III Total Brief Achievement (WJIII ACH)
    Revised Children’s Manifest Anxiety Scale (RCMAS-2)

    Findings

    Compared to the waitlist control group, children in the CCPT group demonstrated statistically significant increase in early achievement scores (YCAT). Additionally, children in the CCPT group demonstrated statistically significant lower mean scores on anxiety (RCMAS-2). Compared to the waitlist control group, children in the CCPT group demonstrated no significant difference on achievement test scores (WJIII ACH) between the groups.

    Expand for findings & study characteristics
    Treatment Model

    Child-Centered PT

    Research Design

    Meta Analysis

    Authors & Publication Information

    Lin, Y., & Bratton, S. C. (2015). A meta-analytic review of child-centered play therapy approaches. Journal of Counseling and Development, 93(1), 45-58. doi:10.1002/j.1556-6676.2015.00180.x

    Child Sample Characteristics

    52 controlled outcome treatment studies

    • N = 1848 children across studies (avg. 40 children per study)
    • Avg age: 6.7
    Ethnicity
    • 15 studies reported majority of non-Caucasian children
    • 15 studies reported majority Caucasian children
    • 16 studies reported mixed ethnicity
    • 6 studies ethnicity data not reported
    Sex
    • 33 studies reported majority males
    • 11 studies reported majority females
    • 8 studies failed to report sex

    Study Characteristics

    Avg: 11.87 sessions

    Measurements

    The 52 studies in this meta-analysis utilized a variety of instruments with behavioral measures predominant.

    Findings

    The authors reported a statistically significant overall moderate treatment effect size of 0.47 for play therapy interventions following CCPT methodology (filial therapy studies included). Findings further revealed statistically significant treatment effects for outcome constructs including global behavior problems (ES = 0.48), internalizing behavior problems (ES = 0.42), externalizing behavior problems (ES = 0.33), caregiver-child relationship stress (ES = 0.59), self-efficacy (ES = 0.63), and academic performance (ES = 0.46). The authors concluded statistically significantly higher treatment effect for non-Caucasian children, for children younger than eight years old, and for children whose parents were fully involved in the treatment process.

    Expand for findings & study characteristics
    Treatment Model

    Adlerian PT

    Research Design

    Single Case Experimental Design

    Authors & Publication Information

    Meany-Walen, K. K., Bullis, Q., Kottman, T., & Taylor, D. D. (2015). Group adlerian play therapy with children with off-task behaviors. The Journal for Specialists in Group Work, 40(3), 294-314.

    Child Sample Characteristics

    N = 2 children with disruptive classroom behaviors

    • Age: 6
    • 100% male
    • 100% Cauc

    Study Characteristics

    Group Adlerian PT

    • 6 play sessions
    • 2x wkly; 45 mins

    Measurements

    Direct Observation Form (DOF)
    Teacher-Caregiver Report Form (TRF)

    Findings

    Students' on-task behaviors improve during Group Adlerian PT with large effect sizes.

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