Received 12/03/09

Revised 05/17/10
Accepted 06/25/10

Rest Practices
Play Therapy in Elementary Schools:
A Best Practice for Improving Academic
Achievement
Pedro J. Blanco and Dee C. Ray
T h i s pilot study of 1 st graders who are academically at risk examined the effectiveness of child-centered play therapy
(CCPT).The experimental group received biweekly, 30-minute play therapy sessions for 8 weeks. Findings indicated that
these 1st graders participating in CCPT (n = 21) demonstrated a statistically significant increase on the Early Achievement Composite of the Young Children's Achievement Test (Hresko, Peak, Herron, & Bridges, 2000) when compared
with children in the control group (n = 20). Results support using CCPT as an intervention for academic achievement.

The need for mental health services for children has been
labeled a crisis in the United States, with more than 20% of
children and adolescents experiencing mental health problems
(Committee on School Health, 2004; Mellin, 2009). Although
75% to 80% of children and youth who need mental health
services do not receive them (Kataoka, Zhang, & Wells,
2002), evidence suggests that if children obtain help, they
are most likely to receive mental health services in the school
setting (Foster, Rollefson, Doksum, Noonan, & Robinson,
2005; Rones & Hoagwood, 2000). In schools, children can
be identified, assessed, and provided mental health services
from a prevention and intervention perspective. The American
Counseling Association, American School Counselor Association (ASCA), National Association of School Psychologists,
and School Social Work Association of America (2006)
jointly called for interventions based on evidence to address
the mental health needs of children in schools.
Young children are especially susceptible to the link
between mental health issues and academic achievement.
Expulsion rates among preschoolers are higher than those for
school-age children and are partially attributed to lack of attention to social-emotional needs (Gilliam, 2005). Elementaryschool-age children are more likely to be unhappy at school,
absent, suspended, or expelled (National Center for Children
in Poverty, 2006). In the Columbia University TeenScreen
Program (2009), it is suggested that the No Child Left Behind
Act of 2001 created an environment in which mental health
needs might go unobserved and unmet because of heightened
academic pressure. There is an urgent need for interventions
that affect both mental health and academic achievement.

Child-centered play therapy (CCPT) is one possibility

for providing a mental health program in schools. CCPT is
defined as a dynamic interpersonal relationship between a
child and a counselor trained in play therapy who provides
selected play materials and facilitates the development of a
safe relationship for the child to fully express and explore
self through the child's natural medium of expressionplay
(Landreth, 2002). CCPT is based on the philosophy of Carl
Rogers (1942) and his person-centered approach to counseling adults. Virginia Axline, a pupil of Rogers, applied the use
of play and nondirective therapeutic principles in her work
with children, thereby popularizing the approach in the field
of psychotherapy (Axline, 1947b). Axline (1947b) developed
eight basic principles to use as guidelines for nondirective play
therapy. These principles are the establishment of a caring relationship between the therapist and the child; full acceptance
of the child for who he or she is; creation of a free atmosphere
in which the child feels capable of expressing a range of emotions; recognition and reflection of the child's feelings; respect
for the child's ability to internally solve difficulties and provision of opportunities to establish responsibility; allowance of
the child's leadership in play sessions; understanding of the
gradual process of therapeutic change; and, finally, provision
of therapeutic boundaries only when necessary.
Axline (1947b), Moustakas (1953), and Landreth (2002)
asserted the belief that children have the innate capacity to develop self-actualization through self-direction when provided
an atmosphere that is fully accepting of each child. The focus
on the child's innate tendency to move toward growth and
maturity and a deep belief in the child's ability to self-direct

Pedro J. Blanco, Department of Counselor Education, Delta State University; Dee C. Ray, Child and Family Resource Clinic and
Department of Counseling and Higher Education, University of North Texas. Pedro J. Blanco is now at Department of Counseling,
Texas A&M University-Commerce. This research was supported in part by grants from Chi Sigma lota and the Dan Homeyer Foundation. Correspondence concerning this article should be addressed to Pedro J. Blanco, Department of Counseling, Texas A&M
University-Commerce, PO Box 3011, Binnion 212A, Commerce, TX 75429-3011 (e-mail: pj_blanco@tamu-commerce.edu).

2011 by the American Counseling Association. All rights reserved.

Journal ofCounselingc Development Spring 2011 m Volume 8 9

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Blanco & Ray

are the main tenets that differentiate CCPT from other models
of play therapy (Landreth & Bratton, 2006). In practice, the
CCPT counselor initiates statements that reflect content and
feeling (e.g., "You're frustrated with her"); encourage (e.g.,
"You figured it out"); return responsibility to the child (e.g.,
"You can choose how you want it to look"); and, if needed,
set limits (e.g., "Toys are not for breaking"). Typically, the
CCPT counselor does not direct behavior or interpret the
child's actions or words (Ray, 2008).
Use of play in therapy allows school-age children to
naturally express emotions and experiences (Landreth, 2002;
Moustakas, 1959). Landreth (2002) suggested that because
of the unique relationship established in CCPT, the child perceives the playroom and the counselor as safe; the counselor
in the playroom will accept and reflect the child's emotional
expressions, thereby allowing the child to become more empowered and accepting of him- or herself As children feel
free to accept themselves, they will hypothetically be open
to accept others, including knowledge from others, such as
teachers. Landreth further stated that

Play Therapy Research and Academic

Achievement

ity to perform academically. However, it should be noted that

Axline ( 1949) did not conclude that play therapy increased
the intelligence of children, but she hypothesized that play
therapy allowed the child to overcome emotional limitations
that were hindering expression of intelligence and released
the child to demonstrate full potential.
In an attempt to further promote play therapy as an aid
in education, many research studies offered play therapy as
a suitable alternative intervention for reading enrichment.
Some early studies (Axline, 1947a; Bills, 1950; Seeman &
Edwards, 1954) presented positive results and suggested that
providing play therapy could be a way to release the inner
direction of the child and minimize performance anxiety
effectively. Later studies found mixed results as further experimental designs included a comparison control group, but
significant findings were not reported in reading achievement
(Boehm-Morelli, 2000; Crow, 1990; Kaplewicz, 2000). Of
the mixed-findings studies, Boehm-Morelli (2000) reported
numerous limitations and speculated that the brief number
of sessions may have limited reading achievement results.
Boehm-Morelli suggested a longer time frame for children
to experience an improvement in self-concept to activate the
mediating processes that affect achievement. Crow (1990),
who also observed reading improvement based on a playtherapy intervention, did not find a significant difference
in reading achievement between the children who attended
play therapy and the control group. Crow concluded through
anecdotal observations that even though behaviors appeared
to be changing, there was not enough time in the experiment
to demonstrate an improvement in reading.

An effort to enhance the child's ability to perform academically has been emphasized since the development of counseling children. Play therapy as a treatment modality is no
different. Early studies of play therapy attempted to measure
academic improvement and successful treatment by using IQ
scores, reading measurements, and language development.
Historical studies conducted in the field attempted to enrich
a child's ability to leam through play therapy. Early studies
(Axline, 1949; Dulsky, 1942; Leland. Walker, & Taboada,
1959; Moulin, 1970; Mundy, 1957; Shmukler & Naveh,
1984) attempted to measure the efficacy of play therapy on
achievement by placing a high emphasis on changing the
child's IQ score over the course of treatment. Research conclusions from early studies of Dulsky (1942), Axline (1949),
and Mundy ( 1957) and a later study by Shmukler and Naveh
(1984) suggested that providing play therapy to children can
help increase their IQ scores and thus their ability to leam
in the classroom. Providing play therapy for children with
learning disabilities was also significant in improving the
academic abilities of children through improvements in motor
functioning and teaming difficulties (Newcomer & Morrison,
1974; Siegel, 1971). More recent literature (Quayle, 1991;
Shechtman, Gilat, Fos, & Flasher, 1996) concerning play
therapy in schools has been noted as improving a child's abil-

Regardless of the limitations from past research, it is

possible that relying solely on reading achievement scores
as a means of interpreting academic achievement may
not be accurate. In recent years, the focus of determining
progress in play therapy has shifted to a more emotionally
and/or behaviorally driven component. In a comprehensive
review of play therapy research, Ray and Bratton (2010)
reported that play therapy research moved from a focus on
intelligence and school achievement in the early years to a
concentration on social adjustment and self-concept in the
1970s and 1980s. Most recently, research in play therapy
has concentrated on disruptive behavioral problems witb
no recent studies conducted on intelligence or academic
achievement. Ray and Bratton questioned the focus on
behavioral problems in schools as a dependent variable
for play therapy research because of CCPT's focus on the
inner world of the child.
Even though there has been a shift in focus of the dependent
variable, play therapist researchers have continued to concentrate on schools as an appropriate setting for intervention.
Several recent CCPT research studies have been conducted
in elementary schools, establishing a pattern of incorporating
play therapy in the school setting (Fall, Balvanz, Johnson,
& Nelson, 1999; Fall, Navelski, & Welch, 2002; Garza &

a major objective of using play therapy with children in an

elementary school setting is to help children get ready to profit
from the learning experiences offered.... Play therapy, then,
is an adjunct to the learning environment, an experience that
helps children maximize their opportunities to leam. (p. 148)

236

Journal of Counseling & Development Spring 2011 Volume 89

Play Therapy in Elementary Schools

Bratton, 2005; Muro, Ray, Schottelkorb, Smith, & Blanco,

2006; Ray, 2007; Ray, Blanco, Sullivan, & Holliman, 2009;
Ray, Schottelkorb, & Tsai, 2007; Schottelkorb & Ray, 2009;
Schumann, 2010). All ofthe aforementioned studies dealt with
children's externalizing behaviors and relationships, specifically attention-deficit/hyperactivity disorder, aggression, and
teacher-child relationships. On reviewing 21 CCPT research
studies conducted in school settings, Bratton (2010) concluded
that play therapy is responsive to the developmental needs of
children and has been successfully applied with diverse and
at-risk populations in schools.

Purpose of the Study

Although historical literature supports the use of play therapy to
improve academic achievement, and recent literature supports
its use to improve behavioral problems in schools, there is little
research to conclude that play therapy is a current and effective
intervention for academic progress. The purpose of conducting the current pilot study was to use a small but experimental
design to assess the effects of play therapy on the academic
achievement of young children at risk for school failure. As
discussed earlier, previous play therapy studies are dated and
difficult to interpret in current academic culture, specifically
focusing on intelligence and reading achievement that are only
small components of overall academic achievement. This study
differs fi'om previous research because we attempted to assess
multiple categories of leaming instead of solely measuring reading achievement. We used the manualized delivery of CCPT to
observe the effects ofthe intervention as a possible best practice
for early elementary, school-age children.

Method
Participants
Participants were 43 students from four elementary schools
in the southwestern United States. All schools were considered Title I schools targeted by the state for schoolwide
assistance because of high percentages of children qualifying for free or reduced lunch. School 1 listed 63.9% of its
population as disadvantaged. School 2 listed 72.5% of its
population as disadvantaged. School 3 listed 70.5% of its
population as disadvantaged, and School 4 listed 61.7% of
its population as disadvantaged. We requested that the school
counselors ofthe elementary schools send written informed
consents to parents or guardians of all first-grade students
in mainstream education who have been identified as academically at risk according to the school district. Students
academically at risk were defined by the school district as
elementary students meeting one ofthe following categories:
(a) the student did not previously advance from one grade
level to the next, (b) the student did not perform satisfactorily
on an assessment instrument or did not perform satisfactorily
on a readiness test, or (c) the student is in custody or care

ofthe state department of protective services. Furthermore,

the at-risk label was an indication of students in danger of
not progressing academically and was designated as a way
of identifying students who are falling behind. We obtained
written informed consents according to procedures by the
local human participants review board for 43 students.
Children were randomly assigned into treatment groups
by school according to playroom space. School 1 served 14
children. School 2 served eight children. School 3 served
10 children, and School 4 served 11 children. One student
from School 1 in the experimental group moved to School
3 and received treatment there. Two students from School
4, both in the control group, moved to different schools and
were removed from the study. The final participant number
of 41 represented 21 children assigned to the CCPT treatment group and 20 children assigned to the wait-list control
(WC) group. Overall, 26 boys and 15 girls participated
in the study. Of the boys, 16 were assigned to the play
therapy treatment (PT) group and 10 were assigned to a
WC group. Ofthe girls, five were assigned to the PT group
and 10 were assigned to the WC group. For the duration
of the study, all participants were between the ages of 6
and 7 years. Ethnicity breakdowns were as follows: seven
were African American (four PT group, three WC group),
14 were Hispanic (seven PT group, seven WC group), 19
were Caucasian (nine PT group, 10 WC group), and one
was Asian American (one PT group, zero WC group).
Instrument
The Young Children's Achievement Test (YCAT; Hresko,
Peak, Herron, & Bridges, 2000) was developed to measure
the achievement levels of young children ages 4 to 8 years
with respect to skills needed to succeed in school over five
domains. The YCAT is a comprehensive assessment that
measures early academic achievement levels and can be
used to monitor the student's progress. The YCAT is administered by a trained examiner and requires 25 to 45 minutes
to complete. The YCAT assesses an overall achievement
score in academic areas from the combination of five subtests. The results from the five subtests make up the child's
Early Achievement Composite score. This composite scale
reflects the child's school-related achievement across the
major areas of academic tasks. Hresko et al. (2000) further
indicated the Early Achievement Composite is the best
indicator ofthe child's overall academic abilities. The five
subtests are General Information, Reading, Mathematics,
Writing, and Spoken Language. Children responded to
questions both orally and in writing, depending on the subtest. The Mathematics and Writing subtests were responded
to in writing and orally. The other subtests did not include
a writing component. High reliability has been established
for the YCAT instrument. The internal consistency, or the
degree to which the items correlate with one another, averaged above 0.85. The test-retest reliability, meaning the

Journal of Counseling & Development Spring 2011 a Volume 89

237

Blanco & Ray

consistency of ratings by the same examiner over a short

time interval, was established at 0.98. Interrater reliability, the level of agreement among independent examiners'
ratings of the same child, averaged at 0.98 (Hresko et al.,
2000). The calculated Cronbach's alpha for this study was
.95, indicating high reliability for the current sample.
The YCAT demonstrated acceptable measures of validity.
YCAT subscale and composite scores correlate as high as
.99 with corresponding scores on other instruments, such as
the Comprehensive Scale of Student Abilities, the Kaufman
Survey of Early Academic and Language Skills, the Metropolitan Readiness Tests, and the Gates-MacGinitie Reading
Tests (Hresko et al., 2000). These results support the construct
validity of those YCAT dimensions. Further validity studies
have been conducted on the YCAT, thus establishing factorial and discriminant validity. The YCAT was specifically
chosen for this study because it does not require a significant
wait time needed for multiple administrations. It is possible
for individuals taking the assessment to have a small leaming effect. However, participants from both the PT and WC
groups were administered the posttest 8 weeks following the
initial assessment. Because both groups were given the same
test at pre- and posttest, any slight learning effect would be
accounted for by the control group comparison.
Procedure
Once informed consent from each student's parent or guardian
was received, all children were individually administered the
YCAT. YCAT administration was conducted by advanced doctoral counseling students who were well-trained in assessment
and who had no knowledge of group assignment at pre- or
posttest. Participants were then randomly assigned to one of
two treatment groups, PT or WC. Students were scheduled
to participate in either 8 weeks of play therapy or 8 weeks
of no intervention during the fall semester. At the end of the
8 weeks, each participant was individually administered the
YCAT as a postmeasure.
PT group. Twenty-one students were assigned to the PT
group, which consisted of 16 sessions of CCPT scheduled
over 8 weeks. Children receiving play therapy participated
in two 30-minute sessions per week for a period of 8 weeks
on-site in equipped school playrooms. All play therapy sessions followed procedures according to a CCPT treatment
manual (Ray, 2009) and were facilitated by doctoral-level
counseling students trained in play therapy or a master'slevel practitioner trained in play therapy. All therapists had
completed at least 42 hours in a graduate-level counseling
program that included an introduction to play therapy, an
advanced play therapy course, and one clinical course in
play therapy. All therapists received 1 hour of weekly play
therapy supervision during the course of the study to ensure
that each therapist was following CCPT protocol. At that
time, the play therapists, with their respective supervisors

238

present, were required to review their videotaped play therapy sessions. Each play therapist's supervisor ensured that
the play therapist was following CCPT protocol through
the use of the Play Therapy Skills Checklist (PTSC; Ray,
2009). Furthermore, a randomized check of play therapy
session recordings was conducted by the research team
using the PTSC to ensure that the play therapy sessions
were conducted using CCPT procedures.
Play therapy sessions were conducted in specially
equipped playrooms in each school setting, and playrooms
were equipped with a variety of toys specifically intended
to facilitate a broad range of expression following Landreth's (2002) suggestions. All therapists were required
to conduct treatment sessions using CCPT principles that
included both nonverbal and verbal skills outlined by Ray
(2009): (a) maintaining a leaning forward, open stance; (b)
appearing to be interested; (c) remaining comfortable; (d)
having a matching tone with the child's affect; (e) having
appropriate affect in responses; (f) using frequent interactive responses; (g) using behavior-tracking responses; (h)
responding to verbalizations with paraphrases; (i) refiecting
the child's emotions; (j) facilitating empowerment through
returning responsibility; (k) encouraging creativity; (1)
using self-esteem-boosting statements; and (m) using
relational responses. These skills are used to convey that
the therapist understands the child's world and sends the
message "I am here, I hear you, I understand, and I care"
(Landreth, 2002, pp. 205-206).
WC group. Twenty students were assigned to the WC group
that received no treatment intervention during the course of
the study. Following postadministration of instruments, each
WC-group child was placed in CCPT. Play therapy was provided to the WC-group children following the study to meet
ethical delivery of services.
Data Analysis
Following the completion of the study, we scored the pretest
and posttest data by using hand scoring on the YCAT according to the manual. To determine if PT and WC groups
were statistically equal, we performed a two-factor repeated
measures split-plot analysis of variance (SPANOVA; Time
X Treatment Group) on the dependent variable, academic
achievement, to determine if the PT group that received
16 sessions of CCPT performed differently than the WC
group did across time, which was a particular interest for
this study.
The two levels of group are defined as the experiential
group (PT group) and the nontreatment group ( WC group).
The two levels of time are pretest and posttest for the dependent variable. Significant differences between the means
across time were tested at the .05 alpha level. An effect size
was computed for each analysis using the eta-squared statistic to assess the practical significance of findings.

Journal of Counseling & Development Spring 2011 Volume 89

Play Therapy in Elementary Schools

Results
Results ofthe SPANOVA (see Figure 1) indicated that the
dependent variable. Early Achievement Composite, revealed
a statistically significant interaction effect of Time (pretest,
posttest) X Treatment Group (experimental, control), Wilks's
A = .56, F(l, 39) = 5.23,p = .03 (partial r\^ = .12); a statistically significant main effect for time, F(\, 39) = 30.14, p <
.01 (partial T]^ = .44); and no statistically significant main
effect for group, F(l, 39) = .lO,p = .75 (partial r]^ < .01).
These results indicate that when grouped together, children
who attended CCPT and the WC group obtained statistically significant higher scores on the Early Achievement
Composite subscale of the YCAT from pretest to posttest.
Furthermore, results from the SPANOVA interaction effect
and further analysis of means indicate that the children who
attended CCPT obtained statistically significantly higher
scores on the Early Achievement Composite from pretest to
posttest, when compared with the WC group from pretest to
posttest. The effect size of .44 for change over time indicates
a high effect size, and the effect size of .12 for interaction
indicates a moderate effect size according to Cohen's (1988)
guidelines.
Because the main effects and interaction effect were
significant, a paired-samples t test was calculated for
each treatment condition to explore group performance.
Results of a paired-samples / test indicated that the Early
Achievement Composite for the treatment group revealed
a statistically significant difference from pretest to posttest,
/(20) = -5.01,p< .01, Ti^ = .56. Results of a paired-samples
Treatment
=CCPT
a = Control

t test demonstrated that the Early Achievement Composite

for the WC group also revealed a statistically significant
difference from pretest to posttest, (19) = -2.53, p = .02,
ri^ = .25. Although both groups, PT and WC, demonstrated
large effect sizes, results indicated that the PT group had
an effect size that was twice as large as the WC group's.
YCAT Subscales
Because a significant difference was found between the PT
and WC groups on the overall achievement composite score,
we chose to run SPANOVAs on each subscale to investigate
whether achievement changes were centered on one area. Results from the four SPANOVAs conducted using the General
Information, Reading, Mathematics, Writing, and Spoken
Language subscales revealed no statistically significant interaction effects, which signified there was no statistically
significant difference between groups over time on those specific subscales. As can be seen in Table 1, the mean gains were
higher for the PT group on every subscale except Writing.

Discussion
Results of this study help to highlight the benefit of CCPT
with students at risk of academic failure. As previously
reported, the YCAT assesses the early academic achievement levels of young children using five domains; General
Information, Reading, Mathematics, Writing, and Spoken
TABLE 1
Mean Scores on the General Information, Reading,
iVIathematics, Writing, and Spoken Language
Subscales and Eariy Achievement Composite on
the Young Children's Achievement Test
PT Group
Variabie

82.00

Pretest

Posttest
Time

FIGURE 1
Early Achievement Composite Scores From
Pretest to Posttest
Note. CCPT = child-centered play therapy.

Pretest

General Information
M
89.95
SD
10.56
Reading
M
85.71
SD
12.50
Mathematics
M
89.76
SD
10.44
Writing
M
88.52
SD
11.31
Spoken Language
M
84.76
SD
17.74
Early Achievement
Composite
M
82.86
SD
13.71

WC Group
(n = 20)

Posttest

Pretest

Posttest

92.48
8.20

90.30
10.81

89.55
12.04

95.33
10.95

84.15
10.08

90.30
12.67

94.76
11.22

87.95
9.40

89.35
13.34

92.24
11.73

89.30
8.42

93.85
11.96

90.05
15.37

88.90
18.87

89.60
17.99

90.14
12.50

83.70
12.31

86.70
14.85

Note. An increase in mean scores indicates improvement in achievement. PT = piay therapy treatment; WC = wait-list control.

Journal of Counseling & Development Spring 2011 Volume 89

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Blanco & Ray

Language. From these domains, an overall achievement

score identified as the Early Achievement Composite, the
best indicator of the child's overall academic abilities, can
be computed (Hresko et al., 2000). Results of the analysis
indicated that from pretest to posttest, students who participated in the PT group scored statistically significantly
higher on the Early Achievement Composite of the YCAT
when compared with students who were placed in the WC
group. In analyzing post hoc group effects, we found that
the treatment group effect size for the CCPT intervention
was twice as large as the control group effect size for the
Early Achievement Composite, indicating the practical
significance of the study's findings. On the basis of mean
scores from pretest to posttest on the Early Achievement
Composite, the PT group had a 7.28 point increase in their
mean scores compared with a 3 point increase for the WC
group. Helpful clinical significance of findings for CCPT
treatment indicate that 36% of the children, as compared with
29% of children in the WC group, improved from at risk of
academic failure to one of normal functioning following their
participation in CCPT. These results provide a foundation for
future controlled studies measuring the impact CCPT may
have on academic achievement. Although it is noted that both
groups improved over time, children participating in play
therapy demonstrated statistically significant improvement
over children who did not.
The findings related to overall academic achievement are
similar to those of Quayle (1991) and Shechtman et al. (1996).
Quayle specifically noted improved self-confidence in children
who received CCPT, which as reported by the students' teachers
led to significant improvements in leaming skills and participation. Shechtman et al. further noted increased academic performance in children may be rooted in the child's ability to be
intrinsically motivated. Because CCPT is based on the creation of
a free atmosphere in which the child feels capable of expressing
him- or herself, with a therapist who honors the child's ability to
intemally solve difficulties, it may be likely that the children in
the experimental group began developing the ability to self-direct
and accept responsibility as a result of attending CCPT sessions.
Thus, the students may have begun seeking positive solutions to
academic problems (Carmichael, 2006).
In summary, it appears there was a cumulative effect of
scores for each individual subtest in every academic area for
children receiving CCPT. The treatment group performed
better on four subscaies of academic achievement leading
to an overall statistically significant increase on the Early
Achievement Composite score compared with the control
group. It is possible that children attending CCPT were
more open to learning overall. This effect may result from
the child-centered play therapist's facilitation of a warm,
caring, accepting relationship. Theoretically, the permissive
environment gave the child freedom to develop internal coping strategies and responsibility for his or her actions at his
or her own pace. Landreth (2002) suggested.

240

Risk taking, self-exploration, and self-discovery are not likely

to occur in the presence of threat or the absence of safety. The
potential learning experiences available in play therapy are
directly related to the degree to which the therapist is successful in creating a climate of safety within which children feel
fully accepted and safe enough to risk being and expressing
the innermost totality of their emotional being, (p. 90)
Because of this relationship, the child's innate capacity to
perform well academically is released.
As early as Axline's ( 1947b) study, implications for education using basic principles of CCPT have been offered. She
suggested children cannot be productive students while in
the midst of emotional turmoil. Principles such as accepting the child for who he or she is at the current moment and
recognizing the child's feelings may contribute to learning.
When educators display this acceptance, children are free from
expectations placed on them. This allows children to develop
a better sense of their current abilities in safety, without the
anxiety of performance, unlike that in the classroom. This
nonevaluative environment gives the child freedom to express
his or her feelings without judgment. Axline ( 1947b) proposed.
It is the permissiveness to be themselves, the understanding,
the acceptance, the recognition of feelings, the clarification
of what they think and feel that helps children retain their
self-respect; and the possibility of growth and change are
forthcoming as they all develop insight, (p. 140)
Furthermore, perhaps providing this warm, caring, safe
environment is a precondition for children to become eager
to learn.
Limitations and Implications for Future Research
Although the results of this study offer valuable information
regarding effectiveness of CCPT with first graders who are
academically at risk, there are limitations to this pilot study
that should be considered when interpreting results. Participants in the study represented a limited range in age and were
selected from a small sample residing near a southwestern
metropolitan area. Use of a limited range of grade level and
a population from a specific geographic location limits possible generalizations of the anticipated results to other areas.
Number of participants further limits possible generalization
of future findings. A larger scale replication study is suggested as a way of increasing generalizability. An additional
limitation of this study is the use of a nontreatment control
group. Changes found between the control group and the experimental group could result from the use of an intervention,
rather than if the findings resulted specifically from CCPT.
The use of a treatment comparison group provides support
for the present findings. A larger replication study including a
treatment comparison group is suggested as a way of increasing the assurance that findings were directly related to CCPT.

Journal ofCounseling & Development Spring 2011 Volume 89

Play Therapy in Elementary Schools

Implications for Practice

Although for this particular study the counselors providing
treatment were school-based counselors, the results offer support for the training and use of CCPT for school counselors
and school-based therapists. According to the ASCA National
Model (ASCA, 2003), school counselors are encouraged
to offer responsive services, such as individual and group
counseling, as one component of the overall school counseling program. Bratton (2010) supported the use of CCPT with
children for behavioral problems, and results from this study
indicate that CCPT might be helpfiil as an intervention for
children who are struggling academically. CCPT can be an
additional tool for the school counselor's set of skills. Schoolbased therapists who work as consultants might use CCPT
to respond to children's emotional, behavioral, and academic
needs because of its practical delivery methods. The practice
of CCPT is conducive to the school setting because it can
be delivered in 30-minute sessions, a typical time period
for school interventions. In addition to timing's alignment
to setting, Landreth (2002) proposed the use of a traveling
play kit for play therapists who work at multiple sites, such
as school-based therapists.

Conclusion
Because of No Child Left Behind (2001) legislation, all
U.S. schoolchildren are expected to meet certain academic
standards within their respective grade levels. However,
many children with mental illness have difficulty attaining
these standards because of emotional interference with
their academic learning. Furthermore, the President's New
Freedom Commission on Mental Health (2003) reported
that public school system's priority is to educate all attending students. The report also concluded that children
with mental illness are the students most likely to fail or
drop out of school. At-risk students, along with students
struggling to perform well in school, continue to "fall
through the cracks," making it important to continue targeting interventions that can assist and prevent academic
failure. Because of a strong correlation between emotional
development and academic success, development of a solid
mental health program within the school is necessary to
help promote academic achievement (Foster et al., 2005;
President's New Freedom Commission, 2003). Thus, it is
vital to identify and use effective mental health services
that benefit the emotional needs of school-age children
along with improving academic development.
Findings in this study indicate CCPT can significantly
increase academic achievement for first-grade children identified as academically at risk. In summary, CCPT has potential
as an effective intervention to positively affect academic
achievement with first graders who are academically at risk.
On the basis of an exhaustive review of literature, the present
study represents the largest controlled CCPT study to date

analyzing its effects on academic achievement. Because of

the importance for counselors in the school setting to promote
academics as well as emotional support to students, this study
contributes empirical data that support the use of CCPT within
the school system and possibly offer a new best practice for
counselors in schools.

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A counselor's story...
8:00 O.m.

Get to the office early. Start the coffee. Check

voice mail. Leave a brief message for my client
Brad. Don't want his wife over-hearing anything
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9:00 c m .

First client, Mark. Dealing with depression.

Lost his job of 15 years. Body language anxious.
Admits he is contemplating shooting his ex-boss.

10:00 O.m.

Christine has a long-running drug and alcohol

problem. Making great progress. Offers to clean
my house in return for counseling sessions.

11:00 a.m.

Mary gave me a big hug, again. She wants me to

testify at her son's child custody hearing. Let's me
know husband is going to subpoena her records.
She invites me to dinr^er.

12:00 p.m.

Grab lunch at desk. Check email.

Sign up for CE class on crisis management.
Read an article on lawsuits filed over 'client
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