1. The Impact of Play Therapy on
Children with Behavioral Issues
Kathryn Steele
Argosy University

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. The Impact of Play Therapy
on Children with Behavioral Issues

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. References
• Campbell, M. M., &Knoetze, J. J. (2010). Repetitive
symbolic play as a therapeutic
process in child-centered play therapy. International
Journal 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. International
Journal of Play Therapy, 20(4), 236-251. doi:10.1037/
a0025425.

20. References
• Cochran, J. L., Cochran, N. H., Nordling, W. J., McAdam, A.,
&Miller, D. T. (2010). Monitoring two boys' processes through the
stages of child-centered play therapy. International Journal of Play
Therapy, 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 for
children referred with highly disruptive behavior. International Journal
of Play Therapy, 19(3), 130-143. doi:10.1037/a0019119.

21. References
• Hill, A. (2009). Factors Influencing the Degree and
Pattern of Parental Involvement in Play Therapy for
Sexually Abused Children. Journal Of Child Sexual
Abuse,18(4), 455-474. doi;
10.1080/10538710903035214.
• Oppenheim, J. (n.d.). Columbia World of
Quotations. Retrieved November 20, 2011 from
Dictionary.comwebsitehttp://quotes.dictionary.com/It_is
_not_an_ exaggeration_to_say_that .

22. References
• Liles, E. E., & Packman, J. (2009). Play therapy for
children with fetal alcohol syndrome. International
Journal of Play Therapy, 18(4), 192-206.
doi:10.1037/a0015664.
• Norton, B., Ferriegel, M., & Norton, C. (2011).
Somatic expressions of trauma in experiential play
therapy. International Journal of Play Therapy,20
(3), 138-152. doi:10.1037/a0024349.

23. References
• Ray, D. C., Blanco, P. J., Sullivan, J. M., & Holliman, R. (2009). An
exploratory study of child-centered play therapy with aggressive
children. 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 in
non-directive play therapy. Clinical Child Psychology and Psychiatry.
• Tsai, M., & Ray, D. C. (2011). Play therapy outcome prediction: An
exploratory study at a university-based clinic. International Journal of
Play Therapy, 20(2), 94-108. doi:10.1037/a0023441.