Play Therapy

Research

Research is an integral part of the play therapy profession. Oftentimes, play therapy researchers utilize various research methods to explore how a play therapy modality rooted in a theoretical orientation works for whom and under what condition(s). Depending on the research topic, researchers use appropriate research methods to provide helpful information for the readers. Research can also be conducted within a wide range of quality, based on how the research was designed and carried out.

APT encourages high-quality play therapy research that:

• demonstrates the value and effectiveness of play and play therapy with culturally diverse populations experiencing different needs across settings and lifespan,

• increases play therapy knowledge or improves play therapy skills or techniques,

• explores the impact of play therapy training, and

• supports evidence-based play therapy practices.

Why is research important in play therapy?

Play therapy research serves as a way to advocate for children’s mental health as well as the play therapy profession. Research is important in play therapy because:

• Ongoing research that supports the use of play therapy lends itself to increased credibility and utility of a play therapy approach with clients, funders, other professionals, and stakeholders over time.

• Research that supports play therapy may lead to better client outcomes and reduce the likelihood that a play therapist may inadvertently cause harm.

• Research that supports the use of play therapy is an important resource that helps play therapists justify and advocate the use of it with the public.

• Research that supports the use of play therapy helps play therapists have an understanding of how change happens during the play therapy process.

• Research reveling an evidence base of support of the efficacy of play therapy aids in building a solid foundation of trust with clients, their caregivers, and support systems.

• Ethically, play therapists are required to stay abreast of ongoing play therapy research findings in order to provide the competent, up-to-date care to their clients.

What has research informed us about the impacts of play therapy?

With over 80 years of history, play therapy research has been providing evidence of positive impacts on clients across ages, ethnicities, presenting issues/needs, settings, and countries. Between 2000 and 2023, there are 137 quality play therapy research published. Of the 137 studies:

• 56 were randomized controlled designs

• 20 were quasi-experimental group designs

• 28 were experimental single-case designs

• 33 were repeated measures of single-group designs (Ray, in press)

Reference:

Ray, D. (in press). Research in play therapy. In D. Crenshaw, A. Stewart, and D. Ray (Eds.), Play therapy: A comprehensive guide to theory and practice (2nd ed.). Guilford.

Ongoing play therapy research helps the development of evidence-based play therapy practices. To date, a few play therapy theoretical approaches have been reviewed and designated as evidence-based practices with various ratings by state-level and/or national-level clearinghouses: Child Parent Relationship Therapy (CPRT), Child-Centered Play Therapy (CCPT), Child-Centered Group Play Therapy (CCGPT), and Theraplay®. To learn more about it, please click here to join APT.

Play therapy research has shown effectiveness on improving or supporting children experiencing various concerns/needs such as:

• Internalizing behaviors such as anxiety, depression, and others

• Externalizing behaviors such as aggression, disruptive behaviors, self-control, and others

• Attachment issue

• Academic performance

• Autism

• Attention deficit

• Homelessness

• Loss and bereavement

• Medical conditions

• Parents/caregiver/teacher relationship

• Self-concept/self-esteem

• Social-emotional assets

• Speech/language struggles

• Trauma, natural disaster, and PTSD

*Resource: Why Play Therapy is Appropriate for Children with Symptoms of PTSD?

Note: If you are interested in an area listed above, please search and read the relevant play therapy research articles for a full understanding of which, and how a play therapy modality rooted in a specific theoretical model works for whom and under what type of condition(s). APT members have access to the articles published in the International Journal of Play Therapy® (IJPT). Click here to learn how to join APT.

Misuse of term of play therapy: What play therapy is NOT

When learning from  play therapy research and what it means for the clients we serve, it is important to understand what play therapy is and what it is not. According to APT, Play Therapy is defined as “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." 

In addition, play therapy is NOT:

• Not a place for children to just have fun. For children in play therapy, the process of exploring, experiencing, and working on what needs to be work could be overwhelming and challenging.

• Not trendy, gimmick-like, unestablished approaches, models, or protocols with play as a means to an end and not a key ingredient are not play therapy.

• Not any therapy utilizing toys is play therapy. The intervention has to meet the definition of play therapy. Play therapy is an intentional and developmentally appropriate way of working with children that requires specialized training and supervision.

• Not a modality that can be utilized by anyone who does not have proper training that meets the requirements and standards of APT.

• Not random interventions that are labeled under the umbrella of play therapy. Instead, it is the intentional use of toys and theory to help a child heal, with a therapeutic relationship as the foundation.

• Not a way to get children to talk. Talking may and often does occur through the natural progression of play therapy, yet it is not the most important objective.

Elements to look for in a quality play therapy research

When reading research, it is important to ensure that the research meets certain standards related to design, analysis, and reporting. Research that meets these standards is more likely to demonstrate valid (accurate) results that can help inform readers’ understanding and decisions. Here are a few things to look for as you review play therapy research. Different research methods and topics require different elements. Please note that not all elements are included below, and not all elements listed below are required or applicable in a play therapy research. This is not a comprehensive list but a highlight of information.

Overall, researchers:

• Clearly define the sample size, sample population, and setting (the group that you want to draw conclusions about)

• Clearly describe the sampling process

• Clearly outline the play therapy theoretical orientation and modality used (e.g., child-centered group play therapy, intensive Adlerian play therapy, child-parent relationship therapy, etc.)

• Clearly outline the research design, process, and corresponding analyses used to answer the research question(s)

• Indicate if the modality is evidence-based (has research supporting it) or evidence-informed  (uses research to inform decisions, but may not specifically evaluate that particular modality)

• Indicate how the researchers used an informed consent process and abided by ethical guidelines for research

• Minimize cultural biases through carefully worded research questions and hypotheses

• Describe intervention fidelity

• Describe the qualifications of individuals implementing the intervention

• Describe that instruments used are appropriate for the current sample and the variable they are intended to measure

• Report the reliability and validity of the instruments used

• Outline steps used for triangulation (e.g., using multiple sources of data, multiple methods for analysis, involving multiple researchers, etc.) and other means of supporting trustworthiness

• Describe what efforts were made to avoid the researcher's own biases affecting the data collection as well as the interpretation of the results

• Report results using appropriate and accurate language

• Report statistical significance

• Identify a clinical significance (individual gains)

• Carefully draw conclusions and implications based on the research findings

• Acknowledge ecological validity (or the degree to which the results of the study can be generalized to real-life settings)

• Outline limitations of the study

• Adhere to a style of publication set by a professional organization such as the Publication of Manual of American Psychological Association (APA)

The APT Research Committee, Chaired by Yi-Ju Cheng, PhD, LPC, RPT, is committed to providing you with resources now and in the future that bring together the research behind play therapy!