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Child-Centered Group Play Therapy (CCGPT)

Topic Areas
Scientific Rating
Child Welfare Relevance
Anxiety Treatment (Child & Adolescent)
3  — Promising Research Evidence
Medium

About This Program

Target Population: Children ages 3 to 10 who are experiencing social, emotional, behavioral, and relational problems

For children/adolescents ages: 3 – 10

Program Overview

CCGPT is designed to be a developmentally responsive, play-based mental health intervention for young children ages 3 to 10 who are experiencing social, emotional, behavioral, and relational disorders. The program aims to utilize play (the natural language of children) and the therapeutic relationship to provide a safe, consistent therapeutic environment. In this environment, a child can ideally experience full acceptance, empathy, and understanding from the counselor and, at the same time, process inner experiences and feelings through play and symbols. Additionally, CCGPT allows for children to experience social interactions with 2-3 group members which hopefully enable the children to learn and practice new social and coping skills. CCGPT is appropriate for children who struggle with peer or sibling relationships, as well as emotional and behavioral problems. In CCGPT, a child's experience within the counseling relationship is designed to be the factor that is most healing and meaningful in creating lasting, positive change. Based on person-centered principles, overarching goal of CCGPT is to unleash the child's potential to move toward functional relationships and self-enhancing ways of being. Child outcome goals include decreased symptomatic behaviors and improvement in overall functioning.

Program Goals

The goals of Child-Centered Group Play Therapy (CCGPT) are:

  • Develop a more positive self-concept
  • Assume greater self-responsibility
  • Engage in positive interactions with peers or siblings
  • Become more self-accepting
  • Become more self-reliant
  • Engage in self-determined decision making
  • Experience a feeling of control
  • Become sensitive to the process of coping
  • Develop an internal source of evaluation
  • Become more trusting of self and peers

Logic Model

The program representative did not provide information about a Logic Model for Child-Centered Group Play Therapy (CCGPT).

Essential Components

The essential components of Child-Centered Group Play Therapy (CCGPT) include:

  • Foundational Principles:
    • Children possess an innate capacity to strive toward growth and maturity. The play therapy relationship is designed to facilitate the development of that capacity.
    • Play is the children's most natural medium of communication.
    • Play is the concrete expression of the child and is the child's way of coping with their world.
    • Child's feelings are often inaccessible at a verbal level and play provides a means through which conflicts may be resolved and feelings may be communicated.
  • Establishment of a Therapeutic Working Relationship with Child:
    • Therapists provide a playroom with carefully selected toys to match the developmentally appropriate communication style of children, which is play, thereby supporting the message that the counselor seeks to understand the whole child in the context of their world.
    • The therapist aims to sensitively understand a child from the child's viewpoint so they can feel fully accepted, safe, and understood by the therapist.
    • By communicating sensitive understanding to the child, they can experience a sense of freedom to express themselves fully and process inner experiences through play and the therapeutic relationship
  • Facilitation of Therapeutic Working Relationships between Children:
    • The therapist recognizes the feelings of each child within the group and seeks to verbalize those feelings to group members in order to increase empathy and sensitivity among children.
    • The therapist facilitates interactions between children in order to raise levels of social awareness and outcomes.
  • Facilitative Responses and Esteem Building:
    • The twelve categories of responses utilized in CCGPT include:
      • Tracking behavior
      • Reflecting content
      • Reflecting feeling
      • Returning responsibility
      • Facilitating creativity
      • Esteem-building
      • Facilitating relationship
      • Reflecting deeper meaning
      • Facilitating relationships among children
      • Reflecting group behaviors
      • Bridging play behaviors between children
      • Limit-setting
    • Reflecting content, feeling, and meaning responses (as well as facilitating relationship responses) expresses empathy toward the child and between children. At the same time, the facilitator returns responsibility and limit-setting responses which provides opportunities for children to experience emotional expression and regulation.
  • Therapeutic Limit Setting and Choice Giving:
    • All feelings, desires, and wishes of the child are accepted, but not all behaviors are accepted.
    • Several specific steps are utilized in therapeutic limit setting in CCGPT:
      • (A) Acknowledge the child's feelings wishes, and wants
      • (C) Communicate the limit
      • (T) Target Acceptable Alternatives

Program Delivery

Child/Adolescent Services

Child-Centered Group Play Therapy (CCGPT) directly provides services to children/adolescents and addresses the following:

  • Social problems with peers or siblings, social anxiety, general anxiety, disruptive behaviors, depressive symptoms, empathy deficits, general impairment, trauma symptoms
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Regular, ongoing parent consultation is part of the CCGPT protocol in clinical mental health settings (e.g., parent consultation occurs every 3 to 5 group play therapy sessions); however CCGPT has been delivered in school settings with limited parent participation.

Recommended Intensity:

In clinical setting, 45-minute weekly group play sessions; in school setting, 30-minute twice weekly sessions

Recommended Duration:

In clinical setting, 16-20 weeks; in school setting, 8 weeks

Delivery Settings

This program is typically conducted in a(n):

  • Hospital
  • Outpatient Clinic
  • Community-based Agency / Organization / Provider
  • Group or Residential Care
  • School Setting (Including: Day Care, Day Treatment Programs, etc.)

Homework

This program does not include a homework component.

Languages

Child-Centered Group Play Therapy (CCGPT) has materials available in languages other than English:

Chinese, Korean, Mandarin

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • A playroom approximately 12 feet by 15 feet with shelves on two walls to provide space for toys and materials. The playroom also includes a chair for the play therapist and 2 or 3 chairs for group members, if needed.
  • Play is an essential part of communicative and emotional expression processes for children, so toys and materials for the playroom should be selected that facilitate a wide range of play activity, including toys from three broad toy categories: real life toys, aggressive toys, creative toys
  • Further recommendations for creating a fully equipped playroom, can be found at the following link: https://cpt.unt.edu/playroom

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Licensed mental health provider who has received extensive training and supervision in the CCGPT protocol which can include approved university coursework or postgraduate certification in child-centered play therapy.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Ray, D. (2011). Advanced play therapy: Essential conditions, knowledge, & skills for child Practice. Routledge.

Manual can be bought through bookstores, Amazon, Routledge Publishing, or Center for Play Therapy

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

UNT Center for Play Therapy hosts two levels of training needed for certification in Child-Centered Play Therapy:

  • CCPT 101: Basics in CCPT (which are also the basics in CCGPT)
  • CCPT 102: Practice and Application (which includes adaptation of CCPT for delivery of CCGPT).
Number of days/hours:
  • CCPT 101 - 12 hours over 2 days
  • CCPT 102 - 18 hours over 3 days

CCPT 101 must be completed at least one month prior to participation in CCPT 102.

Implementation Information

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Child-Centered Group Play Therapy (CCGPT).

Formal Support for Implementation

There is formal support available for implementation of Child-Centered Group Play Therapy (CCGPT) as listed below:

Implementation support is available through University of North Texas Center for Play Therapy (see contact information in the above training section). The Center for Play Therapy offers consultation for program development and training. The Center for Play Therapy provides individual consultation on best practices and response to therapeutic challenges through teleconferencing and email as long as the participant is involved in the certification process.

Fidelity Measures

There are fidelity measures for Child-Centered Group Play Therapy (CCGPT) as listed below:

The Child-Centered Group Play Therapy Checklist (CCGPT Checklist) is used to ensure treatment fidelity and quality implementation of intervention protocol.

The CCGPT Checklist is recommended for use on three levels of assessment including:

  • Supervision of a therapist new to CCGPT to assess practitioner skills
  • Self-assessment by an experienced therapist to monitor continued growth on CCGPT skills
  • Fidelity assessment of a research protocol

The CCGPT Checklist can be applied for evaluation of live sessions or videorecorded sessions. Contact the person in the above training section for more information.

Established Psychometrics:

Research on the PTSC (CCPT-RIC) reports a free marginal multirater kappa at 0.82 and an intraclass correlation coefficient at 0.95 indicating strong interrater reliability on the instrument (Ray et al., 2017):

  • Ray, D., Purswell, K., Haas, S., & Aldrete, C. (2017). Child-Centered Play Therapy Research Integrity Checklist: Development, reliability, and use. International Journal of Play Therapy, 26, 207-217. https://doi.org/10.1037/pla0000046

Implementation Guides or Manuals

There are implementation guides or manuals for Child-Centered Group Play Therapy (CCGPT) as listed below:

The CCGPT Implementation Guide is available to CCPT Certified Trainers. The implementation guide includes training documents for CCGPT, fidelity measure for CCPGT, and procedures for training, as well as responses to frequently asked questions or challenges in the implementation of CCGPT. Contact person in the above training section for more information.

Implementation Cost

There are no studies of the costs of Child-Centered Group Play Therapy (CCGPT).

Research on How to Implement the Program

Research has not been conducted on how to implement Child-Centered Group Play Therapy (CCGPT).

Relevant Published, Peer-Reviewed Research

Tyndall-Lind, A., Landreth, G. L., & Giordano, M. A. (2001). Intensive group play therapy with child witnesses of domestic violence. International Journal of Play Therapy, 10(1), 53–83. https://doi.org/10.1037/h0089443

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 32

Population:

  • Age — Intervention: Mean=6.2 years; Comparison: Mean=6.9 years; Control: Mean=5.9 years
  • Race/Ethnicity — Intervention: 60% Caucasian, 20% Hispanic, and 20% African American; Comparison: 46% Caucasian, 27% Hispanic, and 27% African American; Control: 70% African American, 15% Caucasian, and 15% Hispanic
  • Gender — Intervention: 6 Female and 4 Male; Comparison: 6 Female and 5 Male; Control: 7 Female and 4 Male
  • Status — Participants were children from a battered women's shelter who had witnessed domestic violence.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to describe the effectiveness of Intensive Sibling Group Play Therapy [now called Child-Centered Group Play Therapy (CCGPT)] with child witnesses of domestic violence in improving self-concept, reducing internalizing and externalizing behavior problems, and reducing overall behavior problems. A second objective of this study was to compare the effectiveness of Intensive Sibling Group Play Therapy with Intensive Individual Play Therapy on the dimensions identified above. Participants in Intensive Sibling Group Play Therapy were compared to a comparison group of children from a previous study who also received Intensive Individual Play Therapy, and a no-treatment control group. Measures utilized include the Joseph Pre-School and Primary Self-Concept Screening Test (JPPSST) and the Child Behavior Checklist (CBCL). Results indicate that children in the Intensive Sibling Group Play Therapy group exhibited a significant reduction in total behavior problems, externalizing and internalizing behavior problems, aggression, anxiety, and depression, and a significant improvement in self-esteem. Intensive Sibling Group Play Therapy was found equally effective as Intensive Individual Play Therapy with child witnesses of domestic violence. Limitations include the small sample size, the reliance on self-reported measures, and the lack of controlled postintervention follow-up.

Length of controlled postintervention follow-up: None.

Shen, Y. (2002). Short-term group play therapy with Chinese earthquake victims: Effects of anxiety, depression, and adjustment. International Journal of Play Therapy, 11(1), 43–63. https://doi.org/10.1037/h0088856

Type of Study: Randomized controlled trial
Number of Participants: 30

Population:

  • Age — 8–12 years
  • Race/Ethnicity — 100% Chinese
  • Gender — 51% Female and 48% Male
  • Status — Participants were parents and children who experienced an earthquake in 1999.

Location/Institution: Rural midwestern Taiwan

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to investigate the effectiveness of short-term Child-Centered Group Play Therapy (CCGPT) in elementary school settings with Chinese children in Taiwan who experienced an earthquake in 1999. Participants were randomly assigned to an experimental group that received CCGPT or to a control group, that received no play therapy treatment. Measures utilized include the Children's Mental Health Checklist (CMHC), the Filial Problem Checklist (FPC), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Multiscore Depression Inventory for Children (MDI-C). Results indicate that children in the experimental group (CCGPT) scored significantly lower on anxiety level and suicide risk after play therapy than did children in the control group. Limitations include small sample size, lack of follow-up, limited data on the theoretical approaches that comparison control groups may have received, lack of culturally adapted measures for Chinese students, and parental substitution of completing the posttest limited the chance of obtaining accurate parental perception of the changes of children.

Length of controlled postintervention follow-up: None.

Cheng, Y., & Ray, D. (2016). Child-Centered Group Play Therapy: Impact on social emotional assets of Kindergarten children. Journal for Specialists in Group Work, 41(3), 209–237. https://doi.org/10.1080/01933922.2016.1197350

Type of Study: Randomized controlled trial
Number of Participants: 43

Population:

  • Age — 5–6 years (Mean=5.14 years)
  • Race/Ethnicity — 19 Hispanic, 14 Caucasian, and 10 African American
  • Gender — 30 Male and 13 Female
  • Status — Participants were children enrolled in kindergarten from low-income families or referred by teacher or school counselor with emerging deficits in social-emotional assets as exhibited by specific behavioral, emotional, or interpersonal concerns.

Location/Institution: 3 Title I local elementary schools in the Southwest United States

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to explore the effects of Child-Centered Group Play Therapy (CCGPT) on social-emotional assets of kindergarten children and the therapeutic aspect of group sizes in CCGPT outcome. Participants were randomly assigned to either the intervention or waitlist control groups. Measures utilized include the Social Emotional Assets and Resilience Scale-Parent (SEARS-P) and the Social Emotional Assets and Resilience Scale-Teacher (SEARS-T). Results indicate that there is a statistically significant interaction effect on SEARS-P Total score, Social Competence subscale, and Empathy subscale indicating positive impact of CCGPT. SEARS-T indicated no statistically significant differences between groups. Group size resulted in similar results. Limitations include reliance on self-reported measures, small sample size, and length of follow-up.

Length of controlled postintervention follow-up: 1 month.

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. https://doi.org/10.1037/pla0000014

Type of Study: Randomized controlled trial
Number of Participants: 8

Population:

  • Age — Approximately 6–9 years old
  • Race/Ethnicity — Not specified
  • Gender — 50% Male and 50% Female
  • Status — Participants were second and third graders.

Location/Institution: Northern Taiwan

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to investigate the effect of Child-Centered Group Play Therapy (CCGPT) on children of new immigrants in Taiwan exhibiting relationship difficulties. Participants were randomly assigned into experimental groups (CCGPT) and control groups. Measures utilized include the Social Skill Behaviors and Characteristics Scale for Elementary and Junior School Students (SSBCS) Student Version and Teacher Version and the Parenting Stress Index (PSI). Results indicate that CCGPT represented an effective treatment for interpersonal behavior, self-confidence, self-acceptance, and affection among the children of new immigrants. Limitations include generalizability of the findings to different age groups and diverse nationalities, small sample size, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Blalock, S. M., Lindo, N., & Ray, D. C. (2019). Individual and group child‐centered play therapy: Impact on social‐emotional competencies. Journal of Counseling & Development, 97(3), 238–249. https://doi.org/10.1002/jcad.12264

Type of Study: Randomized controlled trial
Number of Participants: 56

Population:

  • Age — 5–10 years
  • Race/Ethnicity — 21 Hispanic, 17 White, 8 Multiracial, and 1 Asian
  • Gender — 46 Male and 10 Female
  • Status — Participants were children in Grades kindergarten through fourth.

Location/Institution: Four Title I elementary schools (i.e., schools with large concentrations of low-income students) in a Southwestern state

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the effectiveness of 16 sessions of Individual Child-Centered Play Therapy (CCIPT), and Group Child-Centered Play Therapy (CCPT) [now called Child-Centered Group Play Therapy (CCGPT)] in improving social-emotional assets, including self-regulation/responsibility, social competence, and empathy. Participants were randomly assigned to one of three groups: (a) CCIPT treatment group, (b) CCPT treatment group, or (c) wait-list control group. Measures utilized include the SEARS-P (parent version), and the SEARS-T (teacher version). Results indicate that both treatment conditions were correlated with substantial gains in overall social-emotional assets and in the constructs of self-regulation/responsibility and social competence. Limitations include participants were from a convenience sample in local area schools, thus limiting generalizability, parents’ and teachers’ knowledge of whether a child was receiving treatment could have resulted in a rater bias or placebo effect; use of two forms of the same measure; the possibility of a monomethod bias constitutes a threat to construct validity; study lacked African American participants; more children at high risk in the intervention group than in the wait-list control group; and lack of follow-up.

Length of controlled postintervention follow-up: None.

Zarra-Nezhad, M., Pakdaman, F., & Moazami-Goodarzi, A. (2023). The effectiveness of Child-Centered Group Play Therapy and narrative therapy on preschoolers’ separation anxiety disorder and social-emotional behaviours. Early Child Development and Care, 193(6), 841–853. https://doi.org/10.1080/03004430.2023.2167987

Type of Study: Randomized controlled trial
Number of Participants: 48

Population:

  • Age — 2.5–4 years
  • Race/Ethnicity — Not specified
  • Gender — 57% Female
  • Status — Participants were children who showed signs of separation anxiety disorder.

Location/Institution: Tehran, Iran

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the effectiveness of Child-Centered Group Play Therapy (CCGPT) and narrative therapy in reducing separation anxiety disorder (SAD) and boosting social-emotional behaviors in early childhood (2.5–4-year-olds). Participants were randomly assigned into four study groups: 1) the CCGPT group, 2) the narrative therapy group, 3) the combined group therapy, or 4) the waiting control group which also received intervention/therapy after the study. Measures utilized include the Spence Children’s Anxiety Scale and Strengths and Difficulties Questionnaire (SDQ). Results indicate that compared to the control group, CCGPT and combined group interventions showed a lower separation anxiety level. Participants in all three intervention groups showed lower behavioral problems and higher prosocial behaviors than the control group. Limitations include a small sample size, a limited age group which affects generalizability, and a lack of follow-up.

Length of controlled postintervention follow-up: None.

Additional References

Landreth, G. (2012). Play therapy: The art of the relationship. Routledge.

Contact Information

Dee C. Ray, PhD., LPC-S, NCC, RPT-S
Agency/Affiliation: Center for Play Therapy, University of North Texas
Website: cpt.unt.edu
Email:
Phone: (940) 565-3864

Date Research Evidence Last Reviewed by CEBC: September 2024

Date Program Content Last Reviewed by Program Staff: July 2019

Date Program Originally Loaded onto CEBC: August 2019