Child-Centered Group Play Therapy (CCGPT)

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

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):

  • Community Agency
  • Group Home
  • Hospital
  • Outpatient Clinic
  • Residential Care Facility
  • School

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

Education 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.

Education and Training Resources

There is a manual that describes how to implement this program , and there is training available for this program.

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

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

Training Contact:
Training is obtained:

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 if you’d like 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.

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 if you’d like 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., & Giordano, M. (2001). Intensive group play therapy with child witnesses of domestic violence. International Journal of Play Therapy, 10, 53-83. doi:10.1037/h0089443

Type of Study: Pretest-posttest study
Number of Participants: 10

Population:

  • Age — 4-10 years old (Mean=6.2 years)
  • Race/Ethnicity — 60% Caucasian, 20% Hispanic, and 20% African American
  • Gender — 6 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 comparison groups, outcomes, measures, notable limitations)
This study describes 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 and intensive individual play therapy on the dimensions identified above. Children who participated in the intensive sibling group play therapy (CCGPT) were a part of this study while children in the comparison and control group were members of a previous study that analyzed in Intensive Play Therapy with Child Witnesses of Domestic Violence. Ten children who volunteered for the experimental group received CCGPT. The comparison group (from the previous study) was comprised of 11 children, who received intensive individual play therapy. The control group (also from the previous study) consisted of 11 children, who remained on a waiting list for the previous study and received no intervention. Measures utilized include the Joseph Pre-School and Primary Self-Concept Screening Test (JPPSST) and the Child Behavior Checklist (CBCL). Results revealed children in the CCGPT 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. CCGPT was found equally effective as intensive individual play therapy with child witnesses of domestic violence. Limitations include reliance on self-reported measures, small sample size, comparison and control group is not included in this study but is a population from a previous study, and lack of follow-up.

Length of 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, 43-63. doi:10.1037/h0088856

Type of Study: Pretest-posttest with control group
Number of Participants: 30

Population:

  • Age — 8-12 years
  • Race/Ethnicity — 55% Latino/Hispanic, 27% Black/non-Hispanic, 9% White, 1% Other, and 9% Unknown
  • Gender — 56% Male and 44% Female
  • Status — Participants were parents and children who experienced an earthquake in 1999.

Location/Institution: Taiwan

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study investigated 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. 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 non-randomization of participants, small sample size, lack of data from comparison control groups and lack of follow-up.

Length of postintervention follow-up: None.

Baggerly, J. (2004). The effects of Child-Centered Group Play Therapy on self-concept, depression, and anxiety of children who are homeless. International Journal of Play Therapy, 13, 31-51. doi:10.1037/h0088889

Type of Study: One-group pretest-posttest
Number of Participants: 42

Population:

  • Age — 5-11 years (Mean=8 years)
  • Race/Ethnicity — 30 African American, 7 Caucasian, and 5 Hispanic
  • Gender — 31 Male and 11 Female
  • Status — Participants were referred by parents and teachers of homeless children with depression and anxiety.

Location/Institution: Not Specified

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purpose of this research study was to determine if Child-Centered Group Play Therapy (CCGPT) significantly increased self-esteem and significantly decreased depression and anxiety of children who were homeless. Measures utilized include the Joseph Pre-School and Primary Self Concept Screening Test (JPSPSCS), the Children's Depression Inventory (CDI), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Child Anxiety Scale (CAS). Results indicate children receiving CCGPT significantly improved in self-esteem, anxiety, and depression demonstrating a moderate to large effect size. Limitations include lack of control group, small sample size, and lack of follow-up.

Length of 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, 209-237. doi: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 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 comparison groups, outcomes, measures, notable limitations)
The current study explored 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 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 postintervention follow-up: 1 month.

Su, S., & Tsai, M. (2016). Group play therapy with children of new immigrants in Taiwan who are exhibiting relationship difficulties. International Journal of Play Therapy, 25, 91-101. doi: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 — Not specified
  • Status — Participants were 2nd and 3rd graders.

Location/Institution: Northern Taiwan

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purpose of the present 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 and control groups. Children in the experimental group received CCGPT once a week for 12 weeks. 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 revealed that CCGPT represented an effective treatment for interpersonal behavior, self-confidence, self-acceptance, and affection among the children of new immigrants. Limitations include reliance on self-reported measures, small sample size and lack of follow-up.

Length of postintervention follow-up: None.

Additional References

Landreth, G. (2012). Play therapy: The art of the relationship. New York, NY: 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: January 2019

Date Program Content Last Reviewed by Program Staff: July 2019

Date Program Originally Loaded onto CEBC: August 2019