Counseling Children Through Play Therapy – Interview With An Expert

“It’s often hard for children to use words to talk about what’s going on for them because they’re cognitively not at the place where words come easy for them, or that they really represent what they’re trying to say, what they’re feeling, or what’s going on for them. So we use play therapy, where the toys are the children’s words and play is their language.”

Dee Ray, PhD, LPC-S, NCC, RPT-S

A study published in the Journal of the American Medical Association Pediatrics found that nearly one in seven children and teens in the US have a treatable mental health disorder. This translates into close to 7.7 million kids who have anxiety, ADHD, depression, conduct disorders, and more. However, traditional mental health therapy treatments aren’t always effective or appropriate. 

One of the most effective methods of mental health therapy for kids is a child-led technique called play therapy. “It’s often hard for children to use words to talk about what’s going on for them because they’re cognitively not at the place where words come easy for them, or that they really represent what they’re trying to say, what they’re feeling, or what’s going on for them. So we use play therapy, where the toys are the children’s words and play is their language,” says Dr. Dee Ray, registered play therapist and director of the University of North Texas College of Education Center for Play Therapy. 

While play therapy may seem like just playing with toys at first, it is much more than that. According to the Center for Play Therapy, this type of mental health treatment fosters “unique development and emotional growth of children through the process of play therapy, a dynamic interpersonal relationship between a child and a therapist trained in play therapy procedures.” The relationship is what allows children to open up and explore what is going on with them. 

Becoming a play therapist takes time, commitment, and effort. Aspiring play therapists must already be licensed mental health providers such as social workers, counselors, psychologists, psychiatrists, or school counselors. To earn a Registered Play Therapists (RTP) certification from the Association for Play Therapy (APT), candidates must complete education and work experience requirements. 

Continue reading learn more about the history of play therapy, what play therapy actually entails, and how to become a registered play therapist from one of the top experts in the field.

Meet the Expert: Dee C. Ray, PhD, LPC-S, NCC, RPT-S

Dr. Dee Ray is the director of the Center for Play Therapy at the University of North Texas College of Education. She is also a Distinguished Teaching Professor and Elaine Millikan Mathes Professor in Early Childhood Education. While she primarily supervises doctoral research, she also teaches courses such as intro to play therapy, applying quantitative research concepts in play therapy, and research in counseling. She holds a master’s in education in human development counseling from Vanderbilt and completed her doctorate in counselor education at the University of North Texas. 

Dr. Ray’s current research is focused on the quantitative analysis of play therapy, with a particular emphasis on the school setting. In addition to her duties at the University of North Texas, she is also an active member of the Association for Play Therapy. She is a National Board For Certified Counselors (NBCC) National Certified Counselor (NCC), Licenced Professional Counselor-Supervisor (LPC-S), and a Registered Play Therapist-Supervisor (RPT-S). She is also a prolific author with over 100 publications to her name.

What is Play Therapy?

The Association for Play Therapy (APT) provides the official definition of play therapy as “the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development.” 

More simply put, this is a methodology of providing therapy to children that is developmentally appropriate and utilizes the method in which kids can communicate the best: through play.  

“It’s our belief that play is the language of children. And so when children have something going on behaviorally or emotionally, they’re going to be more likely to play out what’s happening for them. We can have a better understanding of what’s happening for them when they’re playing. In play therapy, we offer them a space where they come in and there are lots of toys and materials. Then they’re able to work through whatever’s going on for them in that place with a therapist there,” says Dr. Ray. 

Play therapy can be used to treat a number of childhood behavioral problems such as anger management, grief, loss, abandonment, and trauma. It can also be utilized for behavioral disorders such as anxiety, depression, ADHD, autism, and more. It can even be helpful for kids who have conduct disorders, delayed academic or social development, or developmental, physical, or learning disabilities. 

According to Dr. Ray, play therapy is most typically used for kids from three to ten years old, although there are aspects of play therapy that can be utilized for adolescents and adults as well. Additionally, play therapy can be beneficial for those with developmental disabilities as well.

History of Play Therapy

Play therapy may sound like an innovative idea, but it isn’t. “The thing about play therapy is that people don’t realize it is not new. Play therapy has been around since the 1930s. And it’s one of the few interventions for anybody, children or adults, that has remained relevant over time,” says Dr. Ray. 

According to the American Counseling Association, the first recorded instance of play therapy was actually quite a bit earlier. In 1909, Freud wrote about using play therapy with a child who was experiencing phobias. In those early years, pioneers in psychology utilized free play to help children interpret their unconscious motivations. Eventually, several different treatment methods were established, including Relationship Play Therapy, Person-Centered Therapy, Release Therapy, and ultimately, in 1946, Child-Centered Play Therapy.  

In 1982 the Association for Play Therapy (APT) was established. The mission of the APT is to be a professional association and credentialing agency for play therapists. They also offer educational opportunities for aspiring and currently certified play therapists.

What Does Play Therapy Look Like?

“Play therapy is founded in the belief in the child’s capabilities,” says Dr. Ray. “The child actually leads the session, and they are the ones who decide what’s played with what’s talked about. They are leading that because we trust that it is within them to know what’s happening for them. And then the therapist’s role is to facilitate a type of safety so that the child can tap into their own resources.”

“I like to talk in specifics,” explains Dr. Ray. “For example, if a child is experiencing a lot of anxiety, in play therapy, the therapist provides an environment where the child gets to express ‘Hey, here are the things that scare me.’ Most children who are impaired by anxieties don’t have a sense of capability, that they could face this, or that they can handle what’s coming at them. So the therapist is there to build their self-concept. By building their self-concept and building a relationship, they start to experience themselves as capable. And then they start moving toward those coping skills.”

However, Dr. Ray notes that toys and play are the least important parts of play therapy: “A lot of times, people get focused on the play part and on the toys. And yes, we absolutely believe in both of those things but, what makes the difference, is the relationship between therapist and child. When the child feels safe to express themselves, then they will. Most often, they do that through their play, but there has to be that therapeutic relationship,” she says.

Play Therapy Outcomes

Because play therapy has been around for so long, there has been a significant amount of research and data collected on it. And that is precisely Dr. Ray’s area of expertise: research and outcomes. “Our outcomes are very strong,” she says. “What we know is after anywhere from ten to 20 sessions in play therapy, we start to see these large outcomes in all different areas. For example, if you have a child who has a lot of anxiety or you have a child who has a lot of aggression, they are able to start showing why that’s happening for them,” she says. 

“We have research that supports significant changes in anxiety, decreases in aggressive or disruptive behaviors, increases in empathy, improved social skills, and stronger self-regulation,” says Dr. Ray. “For 100 years, this method of therapy has remained relevant and works. And so we have a lot of research to support the effectiveness of it.”

Since 2000 there have been four significant meta-analyses of play therapy effectiveness. These analyses collectively examined 210 play therapy research studies from 1947 to 2011. They found that child-centered play therapy has a medium to large effect on behavioral issues, social adjustments, developmental concerns, and parental relationships.

Licensing and Certification for Play Therapists

Registered play therapists must hold a license to provide mental health therapy in the state in which they practice. This license can be in either social work, marriage and family therapy, psychology, psychiatry, school counseling, or counseling. Requirements for licensing vary by state and type of professional, so candidates should check with their local board to ensure they have the necessary qualifications. 

Aside from state licensing, there are voluntary certifications aspiring play therapists can earn. These credentials are relatively new and have added a degree of credibility to this field. “The credential piece has been huge because it used to be that therapists would put Candyland in their playroom, for example, and all of a sudden call themselves play therapists,” says Dr. Ray. “Now, you need to have the education and experience to be certified as a play therapist.”

“The primary credential is that of a Registered Play Therapist (RPT) with the Association for Play Therapy,” says Dr. Ray. “In order to gain that credential, you have to have quite a bit of education and then also quite a bit of experience. You have to have 150 hours of education and 350 direct contact hours.” There is no exam for this certification, but there is an application and application fee.

Resources for Current and Aspiring Play Therapists

Here is a list of useful resources for mental health professionals who are looking to become play therapists:

  • Center for Play Therapy at the University of North Texas College of Education – The Center for Play Therapy was established in 1987 as a place to research, therapy and education. They provide direct client services as well as train future play therapists. Also, they are deeply involved in play therapy research, particularly concerning measuring outcomes. 
  • Association for Play Therapy (APT) – The Association for Play Therapy is a professional organization and credentialing agency for play therapists. They issue certification of Registered Play Therapist (RPT) or Registered Play Therapists-Supervisor (RPT-S) to qualified mental health providers. 
  • British Association of Play Therapists – Founded in 1992, the British Association of Play Therapists is a professional association for play therapists. They also maintain a registry of play therapists who have met their rigorous standards. 
  • Theraplay Institute – Theraplay is a recognized child and family therapy method that has been recognized by the APT. They offer certifications and training on their specific method of play therapy.
Kimmy Gustafson

Kimmy Gustafson

Writer

Kimmy Gustafson is a freelance writer with extensive experience writing about counseling careers and education. She has worked in public health, at health-focused nonprofits, and as a Spanish interpreter for doctor’s offices and hospitals. She has a passion for learning and that drives her to stay up to date on the latest trends in healthcare. When not writing or researching, she can be found pursuing her passions of nutrition and an active outdoors lifestyle.