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|Clinicians Digest Jan/Feb - Page 4|
Does Play Therapy Work?
Play therapy for traumatized children and adolescents took a heavy hit in the media last September when a review from a task force connected with the Centers for Disease Control concluded that the efficacy of play therapy was unproven, and that only individual and group cognitive-behavioral therapy (CBT) had enough empirical support to be considered effective treatments for such children. The Association for Play Therapy (APT) quickly responded, but the media had already picked up on the report with headlines such as "Child Study Hits Unproven Therapies." A close reading of the review, however, raises questions about the way the popular media report such studies and about the way the review was carried out.
Over a decade ago, when the American Psychological Association (APA) began its initiative to designate empirically supported treatments, the committee in charge originally used the term "empirically validated" to designate treatments that had amassed sufficient evidence of efficacy. But they quickly softened the term to "empirically supported" to emphasize that treatments that hadn't garnered enough evidence weren't invalid, but merely unsupported as yet.
This subtle distinction is lost on the general public when reviews such as the one on child trauma treatments are reported in the popular media. In fact, the review, published in the September Journal of Preventive Medicine, doesn't "hit unproven therapies," but calls for more research on them, claiming there simply haven't been enough studies of play therapy for the task force to draw a conclusion.
The APT has found a number of shortcomings in the review itself. For instance, it found several CBT treatments that incorporated elements of play therapy to be effective, but the review classified them as CBT therapies, in spite of the fact that it's impossible to say which part of the success of those treatments was due to CBT and which part to play therapy. In addition, it appears that some of the other effective therapies may have had unreported play components. In at least one of the CBT studies which the review found effective, says Jennifer Baggerly, chair of the Research Committee of the APT, the study's researcher verified that the treatment had a large play-based element that she didn't fully describe in her write-up.
Another problem with the review's findings, says Baggerly, is that it doesn't take into account that play therapy is more developmentally appropriate than CBT for young children. She does, however, agree with one of the review's conclusions: that play therapy hasn't yet made a strong enough empirical case. "The review has motivated us to do some randomized controlled studies," she notes.