What is child-centred play therapy (CCPT)?

Child-centred play therapy (CCPT) is an evidence-based psychotherapy approach to working with children that is based on their natural way of self-expression. It is the most researched theoretical model of play therapy and one of the most effective therapy modalities for children aged 3 to 11.

As this is a non-directive modality, children are not pushed to say or do anything they don’t feel ready to. CCPT allows children to take the lead in their sessions, where they make their own decisions and work at their own pace.

Play is seen as the child’s language and ‘toys’ as their words. Accordingly, the therapeutic materials in the playroom have been carefully selected to facilitate self-expression. The play may involve sand, arts and crafts, dress ups, music or roleplay.

But the most important resource in the playroom is the therapist. Just like in other types of therapy, the child-clinician relationship is the highest predictor of positive treatment outcomes.

Once children have developed a strong relationship with the therapist, they can start working through their struggles and difficult feelings, knowing that the therapist’s acceptance of them is unconditional.

CCPT follows the child’s own internal process. It is therefore important for parents to be patient and trust the process. Sometimes this can be hard to do, as symptoms may worsen before an improvement is seen.

Who can benefit from child-centred play therapy (CCPT)?

CCPT works well for children who are struggling with emotional/behavioural difficulties that affect their sense of well-being and ability to learn and grow optimally, such as:

  • Common childhood problems and concerns (e.g. low self-esteem, poor social skills, bullying and self-regulation issues).
  • Communication difficulties (e.g. struggling to express thoughts, feelings and emotions).
  • Anxiety and low mood.
  • Adjustment to life events (e.g. birth of sibling, starting school or moving house away from family and friends).
  • Trauma (e.g. childhood, medical, relational or developmental).
  • Grief and loss (including parent separation and family breakdown).

CCPT does not resolve problems of a neurological, biological or organic nature, such as ADHD, OCD or biochemical depression. But it is a highly effective complementary treatment for children with these diagnoses, as they tend to have concurrent emotional problems.

What skills can a child develop from engaging in CCPT?

Non-directive CCPT strengthens internal locus of control and self-regulation, promoting a sense of self-worth, self-responsibility and self-efficacy. This leads to an improvement in prosocial and problem-solving skills, including greater independence, autonomy, empathy and responsibility for own actions and behaviours.

These executive function skills are developed through co-regulation with the therapist and boundaries being consistently set —firmly but gently— when the child is testing them in session.

Having repeatedly experienced a range of positive interactions managing big emotions in therapy builds confidence to do so in the outside world. Over time, the child is increasingly able to self-regulate in stressful situations.

How many sessions are needed?

The average number of play therapy sessions is 25. But every child is different, and the length of therapy will also vary depending on the child’s situation. For some children, the optimal number of sessions may be 18 while for others it may be closer to 40.

Each session is 50 minutes long, allowing for transition time in and out of the playroom.

The therapist’s role

While the therapist’s role is non-directive, it is not a passive one. In order to create an optimal therapeutic environment, the counsellor needs to show deep empathy, unconditional positive regard and genuineness, as well as being fully present and available to the child. The therapist remains active and disciplined throughout treatment by doing the following:

  • Using their skills in a consistent, predictable manner to create an environment that promotes the child’s self-expression and self-direction;
  • Tracking a child’s actions and responding empathically (naming or reflecting feelings) to make them aware of the emotional meaning of their play;
  • Acknowledging and validating feelings, preferences, intentions or motivations;
  • Being attuned, offering support and co-regulation;
  • Being an empathic and unconditional witness throughout the child’s healing journey.

Further information

There are various types of play therapy, which are grounded on different theoretical models. These play therapy approaches sit on a continuum ranging from non-directive to directive. Child-centred play therapy (CCPT) is a humanistic intervention and the most non-directive of all play therapy modalities.

To access the latest play therapy research, including meta analyses and reviews, please visit https://evidencebasedchildtherapy.com