Play Therapy at a Crossroads: A Vision for Future Training and Research

Background

Play therapy as an expressive therapy for children is relatively new, with the majority of its development occurring since World War II. The Association for Play Therapy (APT) (2010a) defines 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” (para 2). APT is the American professional organization for play therapists, representing more than 5,000 members. Founded in 1982, APT registers play therapists and play therapy supervisors based on standards for training, practice, and continuing education since 1993, with more than 1,600 registered play therapists and play therapy supervisors (APT, 2010b).

Play therapy has a rich history. Schaefer and O’Conner (1982) saw the early history of play therapy as the diversification of psychoanalytic approaches into a variety of clinical approaches. Significant developments in the history of play therapy begin with the use of play in therapy with children by Hug-Hellmuth in 1919; 10 years later Anna Freud and Melanie Klein incorporated play into their sessions (Schaefer & O’Conner, 1982). Melanie Klein and Anna Freud proposed that play was the child’s way of free associating (Gil, 1991). In 1947, Virginia Axline published Play Therapy which brought to the forefront developments in the treatment of children that centered around play.

Play techniques had been mentioned as early as 1909 when Freud used play to uncover unconscious fears and concerns (Gil, 1991). Gil (1991) noted the development of play therapy evolved with the structured play therapies in which the therapist took an active role in determining the course and focus of therapy and the belief in the cathartic value of play followed by the emergence of the relationship therapies by such therapists as Rank, Rogers, and Moustakas. This approach promotes the full acceptance of the child and stresses the importance of the therapeutic relationship with the genuineness of the relationship as critical to success in therapy. Axline (1947) said that play therapy “was an opportunity that is offered to the child to experience growth under the most favorable conditions. . . . play is the natural medium for self expression. . . .” (p. 16).

Axline (1947) modified Roger’s client-centered approach into a play therapy technique. Her eight basic rules have become known as the credo of the approach (Schaefer & O’Conner, 1982). Schaefer and O’Conner noted that in 1949 Bixler presented the concept of the therapeutic limit as the primary vehicle of change in therapy. Ginott added to that perspective on the importance of limit setting as part of the therapeutic process (Schaefer & O’Conner, 1982).

Following these developments in the first half of the 20th century, there has been a proliferation of different theoretical orientations to the approach to play therapy and the development of applications of play therapy. For the most part, these were based on theory without the close examination of the efficacy of the models, with a few notable exceptions.