Literature Review


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  • Both participants were students at a high poverty elementary school in a large urban environment where only 29% of the 700 students tested at proficient levels in reading and 35% of the students tested a proficient levels in mathematics. The boys selected for the studies were both kindergarteners with documented histories of persistent defiance and aggression. The child-centered play therapy began with identification of the roles held by the boys and the therapist. Then, in the aggressive stage, the boys worked through their aggression issues through role-playing.
  • The study required some parents to participate in every one of their child’s therapy sessions, while other parents were only included in the beginning play therapy sessions in order to help their children feel as comfortable as possible in the therapy environment.
  • This particular study sheds light on the lack of research and treatment options currently available for children with FAS because of the fact that most of the resources focus more on prevention than on treatment.
  • While research has supported the theory that play therapy can help more accurately identify the reasons for behavioral aggression or disruptiveness in children with fetal alcohol syndrome, no research currently exists regarding the role of play therapy to prevent behavioral problems from ever beginning.
  • Literature Review

    1. 1. The Impact of Play Therapy onChildren with Behavioral Issues Kathryn Steele Argosy University
    2. 2. Abstract From family values to cultural beliefs, a child’s behavior is influenced by a variety of factors, all of which must be taken into account when observing and analyzing the reasons for specific behaviors being exhibited by an individual child.Play therapy is one method that therapists utilize to gain a thorough and correct comprehension of the motivations of individual children’s behavioral issues.
    3. 3. The Impact of Play Therapyon Children with Behavioral Issues
    4. 4. Introduction• “It is not an exaggeration to say that play is as basic to your child’s total development as good food, cleanliness, and rest” (Oppenheim, J., 2011).• Centered entirely around the individual child’s personality, emotional issues, and cultural background, play therapy provides children with a supportive environment in which they can express themselves through various types of play.
    5. 5. Introduction• Studies in recent years have investigated the correlation between such details of play therapy as duration of the therapy treatment and the level of parental involvement and the success level of the sessions.• Other studies conducted over the past decade investigated the effectiveness of play therapy when conducted in specific stages or as a treatment for children with abnormally high amounts of aggression or disruptive behavior.
    6. 6. Literature Review• In a study by Campbell and Knoetze (2010) researchers explored the effectiveness of play therapy by guiding and emotionally supporting children as they revisited traumatic memories in order to familiarize themselves with their fears.• In the therapist’s summarization of the child’s behavioral changes at each 8-week interval, it was noted that the child began working through the emotions surrounding the traumatic event of his parents’ divorce.
    7. 7. Literature Review• In a study by Cochran, Cochran, Cholette, and Nordling (2011), two separate case studies of boys were analyzed.• In two 30-minutes therapy sessions per week, the study focused on the foundation of establishing and enforcing structural limits that maintain a realistic level of self-expression with each child.• One of the children’s decline in behavior once the therapy concluded can potentially be linked to the sporadic scheduling of the child’s sessions.
    8. 8. Literature Review• In a third case study (Cochran & Cochran, Nordling, McAdam, & Miller, 2010), the method of the study involved detailed journal keeping by the therapists over the course of the study that described the children’s specific behaviors over time.• At the close of the study, the recorded behavioral changes support the idea that CCPT is more beneficial when conducted in a specific order of stages.• Consequently, as the relationship between child and therapist improved with each subsequent stage of therapy, the children’s mastery of their own behavior and their decreased level of defiance and disruptive behavior in the classroom environment was observed.
    9. 9. Literature Review• A fourth study regarding play therapy for children (Cochran & Cochran, Nordling, McAdam, & Miller, 2010) focused on the implementation of CCPL to treat children with extremely disruptive behavior and high levels of aggression.• The study found that highly disruptive behavior in children could result from hyper vigilance, as well as from feelings of depression or aggression towards others and concluded that play therapy taught the children self perception and self expression.
    10. 10. Literature Review• A study by Hill (2011) focused specifically on parental involvement in play therapy sessions for sexually abused children and how the varying levels of parental involvement in the sessions affected the level and rate of progress of the play therapy.• It was discovered that involving the parents in the children’s play therapy sessions provided multiple opportunities for the children and their parents to strengthen the parent/child relationship by facing and working through various issues as they arose throughout the sessions.
    11. 11. Literature Review• Liles and Packman (2009) in one study observed the correlation between neurological problems and behavioral issues such as hyperactivity in children diagnosed with FAS.• With the social and behavioral issues that children with FAS often exhibit often leading to depression, anxiety, and suicide, the study discussed the importance of identifying the underlying reasons for the negative thought processes in affected children in time to help the children to work through those feelings.
    12. 12. Literature Review• Another study (Norton, Ferriegel, and Norton, 2011) addressed how to effectively facilitate a child’s transition from a high level of internal stress to a lower and less traumatic level of internal stress following a traumatic experience.• The study noted by providing the traumatized child with a supportive and secure therapy environment and relationship, the children can begin to personalize their play styles to more accurately express their feelings.
    13. 13. Literature Review• A 2009 study (Ray, Blanco, Sullivan, and Holliman) addressed the decreased amount of aggression expressed by children who participated in fourteen sessions of child- centered play therapy in comparison to the children who did not participate in CCPT .
    14. 14. Literature Review• A study by Ryan and Edge (2011) concluded that play therapy proved to be more effective when linked to specific theories, such as Piaget’s theory of cognitive stages or Erikson’s eight stages of development.
    15. 15. Literature Review• Finally, an exploratory study by Tsai and Ray (2011) found a definite correlation between the number of play therapy sessions that a child participated in and the overall outcome of the child’s play therapy.
    16. 16. Conclusion• It may be concluded that play therapy is an effective therapeutic approach for children who exhibit abnormally high levels of anger or aggression.
    17. 17. Conclusion• One research question that presents itself throughout this particular path of research is to what extent play therapy can either prevent of delay the onset of behavioral symptoms of fetal alcohol syndrome.
    18. 18. Conclusion• Further research in this area is recommended to explore the relationship between consistency and duration of play therapy treatment and the level of improvement made in the behavior of the particular children being observed.
    19. 19. References• Campbell, M. M., &Knoetze, J. J. (2010). Repetitivesymbolic play as a therapeuticprocess in child-centered play therapy. InternationalJournal of Play Therapy,19(4), 222-234. doi:10.1037/A0021030• Cochran, J. L., Cochran, N. H., Cholette, A., &Nordling, W. J.(2011). Limits and relationship in child-centered play therapy:Two case studies. InternationalJournal of Play Therapy, 20(4), 236-251. doi:10.1037/a0025425.
    20. 20. References• Cochran, J. L., Cochran, N. H., Nordling, W. J., McAdam, A.,&Miller, D. T. (2010). Monitoring two boys processes through thestages of child-centered play therapy. International Journal of PlayTherapy, 19(2), 106-116.doi:10.1037/a0019092.• Cochran, J. L., Cochran, N. H., Nordling, W. J., McAdam, A., & Miller,D. T. (2010). Two case studies of child-centered play therapy forchildren referred with highly disruptive behavior. International Journalof Play Therapy, 19(3), 130-143. doi:10.1037/a0019119.
    21. 21. References• Hill, A. (2009). Factors Influencing the Degree andPattern of Parental Involvement in Play Therapy forSexually Abused Children. Journal Of Child SexualAbuse,18(4), 455-474. doi;10.1080/10538710903035214.• Oppenheim, J. (n.d.). Columbia World ofQuotations. Retrieved November 20, 2011 fromDictionary.comwebsite _not_an_ exaggeration_to_say_that .
    22. 22. References• Liles, E. E., & Packman, J. (2009). Play therapy forchildren with fetal alcohol syndrome. InternationalJournal of Play Therapy, 18(4), 192-206.doi:10.1037/a0015664.• Norton, B., Ferriegel, M., & Norton, C. (2011).Somatic expressions of trauma in experiential playtherapy. International Journal of Play Therapy,20(3), 138-152. doi:10.1037/a0024349.
    23. 23. References• Ray, D. C., Blanco, P. J., Sullivan, J. M., & Holliman, R. (2009). Anexploratory study of child-centered play therapy with aggressivechildren. International Journal of Play Therapy, 18(3), 162-175. doi 10.1037/a0014742.• Ryan, V. & Edge, A. (October 10, 2011). The role of play themes innon-directive play therapy. Clinical Child Psychology and Psychiatry.• Tsai, M., & Ray, D. C. (2011). Play therapy outcome prediction: Anexploratory study at a university-based clinic. International Journal ofPlay Therapy, 20(2), 94-108. doi:10.1037/a0023441.