What play therapists do within the therapeutic relationship of humanistic/non-directive play therapy

Play therapists are increasingly being employed in schools, yet there is confusion among many health, education and social care practitioners about the role of play therapists. This paper explains how play therapists position themselves and what they do through an examination of the therapeutic relationship between the therapist and child. It discusses the core conditions of congruence, acceptance and empathy with reference to recent research. Play therapists vary their practice in terms of verbal or non-verbal interaction, the tools in their playroom and how they physically place themselves. This paper argues for placing an emphasis on the non-verbal mirroring of the child, the incorporation of expressive media such as paint, clay and sand into the play room and the positioning of the therapist within the play space.

Allen, G. (2011) Early intervention: the next steps. An independent report to Her Majesty’s Government
(London, H.M. Government).
Asay, T. P., & Lambert, M. J. (1999) The empirical case for the common factors in therapy, in:
M. Hubble, B. L. Duncan & S. D. Miller (Eds) The heart and soul of change. What works in
therapy (Washington, American Psychological Association), 23–47.
Axline, V. (1969) Play therapy (rev edn) (New York, Ballantine Books).
Benedict, H. E. (2008) Object relations play therapy, in: C. E. Schaefer & H. G. Kaduson (Eds)
Contemporary play therapy. Theory, research and practice (New York, The Guildford Press).
Berrol, C. F. (2006) Neuroscience meets dance/movement therapy: mirror neurons, the therapeutic
process and empathy, The Arts in Psychotherapy, 33, 302–315.
Bowlby, J. (1988) A secure base (London, Routledge).
Bradway, K. & McCoard, B. (1997) Sandplay—silent workshop of the psyche (London, Routledge).
Bratton, S., Ray, D., Rhine, T. & Jones, L. (2005) The efficacy of play therapy with children: a
meta-analytic review of treatment outcomes, Professional Psychology: Research and Practice,
36(4), 376–390.
British Association of Play Therapy (2011) Ethical basis for good practice in play therapy. Available
online at: http://www.bapt.info/ethicalbasis.htm (accessed 1 March 2011).
Bronfenbrenner, U. & Ceci, S. J. (1994) Nature–nurture reconceptualised in developmental
perspective: a bioecological model, Psychological Review, 101(4), 568–586.
Carroll, J. (2002) Play therapy: the children’s views, Child and Family Social Work, 7, 177–187.
Clack, G., Crowley, K., Waycott, L., Prince, J. & Birdsey, N. (2010) Childcare practitioners’
knowledge and perceptions of play therapy, British Journal of Play Therapy, 6, 19–34.
Corsaro, W. A. (2003) We’re friends right? Inside kids’ culture (Washington, DC, Joseph Henry Press).
Cozolino, L. (2006) The neuroscience of human relationships (New York, W.W. Norton).
Department of Health (2010) Healthy lives, healthy people. Our strategy for public health in England
(London, Department of Health).
Department of Health (2011) No health without mental health: a cross-government mental health
outcomes strategy for people of all ages (London, Department of Health).
Dryden, W. (1989) The therapeutic alliance as an integrating framework, in: W. Dryden (Ed.)
Key issues for counselling in action (London, Sage).
Erikson, E. H. (1965) Childhood and society (London, Vintage UK).
Gerhardt, S. (2004) Why love matters. How affection shapes a baby’s brain (Hove, Routledge).
Giddens, A. (2006) Sociology (London, Polity Press).
Green, E. (2010) Children’s perceptions of play therapy, in: J. N. Baggerly, D. C. Ray & S. C.
Bratton (Eds) Child centered play therapy research (Hoboken, NJ, John Wiley & Sons), 249–
266.
218 S. Robinson
Downloaded by [ ] at 08:51 07 September 2011
Harvey, S. (2006) Dynamic play therapy, in: C. E. Schaefer & H. G. Kaduson (Eds) Contemporary
play therapy. Theory research and practice (London, The Guildford Press), 55–81.
Heard, D. & Lake, B. (1997) The challenge of attachment for care-giving (London, Routledge).
Holmes, J. (2008) Common factors revisited. How attachment theory can help us to understand
what we are doing as psychotherapists, paper presented at the Conference on Awakening and
Addressing Attachment Needs in Troubled Children, London, 17 May.
Homeyer, L. E. & DeFrance, E. (2005) Play therapy, in: C A. Malchiodi (Ed.) Expressive therapies
(London, The Guildford Press), 141–161.
Hough, M. (2002) A practical approach to counselling (Harlow, Pearson Education).
Hughes, D. (2008a) Building the bonds of attachment. Awakening love in deeply troubled children
(2nd edn) (London, Jason Aronson).
Hughes, D. (2008b) The discovering of one’s strengths and vulnerabilities within a safe relationship,
paper presented at the Awakening and Addressing Attachment Needs in Troubled Kids,
Teens and Adults Conference, Centre for Child Mental Health, London, 17 May.
Jernberg, A. M. & Booth, P. B. (2001) Theraplay. Helping parents and children build better relationships
through attachment-based play (2nd edn) San Francisco, Jossey-Bass.
Karver, M. S., Handelsman, J. B., Fields, S. & Bickman, L. (2006) Meta-analysis of therapeutic
relationship variables in youth and family therapy: the evidence for different relationship
variables in the child and adolescent treatment outcome literature, Clinical Psychology
Review, 26, 50–76.
Kelly, M. M. & Odenwalt, H. C. (2008) Treatment of sexually abused children, in: C. E.
Schaefer & H. G. Kaduson (Eds) Contemporary play therapy. Theory research, and practice
(New York, The Guildford Press), 186–211.
Landreth, G. (2002) Play therapy: the art of the relationship (Hove, Brunner Routledge).
Malchiodi, C. A. (Ed.) (2005) Expressive therapies (London, The Guildford Press).
Maslow, A. (1943) A theory of human motivation, Psychological Review, 50, 370–396.
Norton, C. C. & Norton, B. E. (2008) Experiential play therapy, in: C E. Schaefer & H. G.
Kaduson (Eds) Contemporary play therapy. Theory research, and practice (New York, The
Guildford Press), 28–54.
Oaklander, V. (1988) Windows to our children (Gouldsboro, ME, The Gestalt Journal Press).
Oates, J. & Grayson, A. (Eds) (2004) Cognitive and language development in children (Milton Keynes,
The Open University).
Oates, J. & Stevenson, J. (2005) Temperament and development, in: J. Oates, C. Wood & A.
Grayson (Eds) Psychological development and early childhood (Oxford, Blackwell/Open University),
167–210.
Play Therapy UK (2010) Ethical framework for play therapy and filial play and profession conduct
procedure (Uckfield, PTUK). Available online at: http://www.playtherapy.org.uk/index.html
(accessed 30 March 2011).
Play Therapy UK (2011) The UK society for play and creative arts therapies. Available online at:
http://www.playtherapy.org.uk/index.html (accessed 30 March 2011).
Roberts, R. (2006) Self-esteem and early learning (London, Paul Chapman).
Rogers, C. (1946) Significant aspects of client-centred therapy, American Psychologist, 1, 415–
422.
Rogers, C. R. (1957) The necessary and sufficient conditions of therapeutic personality change,
Journal of Consulting Psychology, 21(2), 95–103.
Rogers, C. (1991) Client-centred therapy (London, Constable).
Ryan, V. & Wilson, K. (2000) Case studies in non-directive play therapy (London, Jessica Kingsley).
Schaefer, C. E. & Kaduson, H. G. (Eds) (2008) Contemporary play therapy. Theory research, and
practice (New York, The Guildford Press).
Schore, A. (2001) The effects of a secure attachment relationship on right brain development,
affect regulation and infant mental health, Infant Mental Health Journal, 22, 7–
66.
What play therapists do within the therapeutic relationship 219
Downloaded by [ ] at 08:51 07 September 2011
Shirk, S. R. & Karver, M. (2003) Prediction of treatment outcome from relationship variables
in child and adolescent therapy: a meta-analytic review, Journal of Consulting and Clinical
Psychology, 71(3), 452–464.
Shirk, S. R. & Saiz, C. (1992) Clinical, empirical, and developmental perspectives on the therapeutic
relationship in child psychotherapy, Development and Psychopathology, 4, 713–728.
Siegel, C. L. (1972) Changes in play therapy behaviours over time as a function of differing levels
of therapist-offered conditions, Journal of Clinical Psychology, 28, 235–236.
Souter-Anderson, L. (2010) Touching clay, touching what (Dorset, Archive Publishing).
Stern, D. (1998) Diary of a baby (New York, Basic Books).
Sunderland, M. (2003) Helping children with low self esteem (Milton Keynes, Speechmark Publishing).
Thomas, J. (2008) Practice based research—latest clinical outcomes, Play for Life, Winter,
41–43.
Turner, B. (2005) The handbook of sandplay therapy (Cloverdale, CA, Temenos Press).
West, J. (1996) Child centred play therapy (2nd edn) (London, Arnold).
Wettig, H. H. G., Franke, U. & Fjordbak, B. S. (2008) Evaluating the effectiveness of theraplay,
in: C. E. Schaefer & H. G. Kaduson (Eds) Contemporary play therapy. Theory, research, and
practice (London, The Guildford Press) 103–135.
Wilson, K. & Ryan, V. (2005) Play therapy. A non-directive approach for children and adolescents
(London, Bailliere Tindall/Elsevier).
Winnicott, D. (1971) Playing and reality (London, Routledge).
World Health Organization. (2011) The impact of health and health behaviours on educational outcomes
in high-income countries: a review of the evidence (Copenhagen, World Health Organization
Regional Office for Europe).
Zins, J., Bloodworth, M. R., Weissberg, R. P., Walberg, H. J., et al. (2004) The scientific base
linking social and emotional learning to school success, in: J. Zins, R. P. Weissberg, M. C.
Wang, & H. J. Walberg (Eds) Building academic success on social and emotional learning: what
does the research say? (London, Teachers College Press), 3–22.