Running Head: EFFECTIVENESS OF CCPT AND PCTC 1
The Effectiveness of Child-Centered Play Therapy and Person-Centered Teacher Consultation in Children Who Are Diagnosed As Intellectually Disabled, Down Syndrome, and ADHD.
Diana Charles
Laura Ramirez
Patricia Rodriguez
Sela N. Gomez
University of Texas at Brownsville
Abstract
This paper explores published articles that report on results from research conducted on the effectiveness of Child-Centered Play Therapy (CCPT) and Person-Centered Teacher Consultation (PCTC) in the learning of social skills in children who have been diagnosed with clinical or borderline levels of Down Syndrome, and Attention Deficit and Hyperactivity Disorder (ADHD), or Intellectual Disabilities. The articles and study will define the significance of CCPT and PCTC and provide results in the effectiveness of the two models used together used in conjunction with one another. The study will propose a better understanding of how both techniques are utilized and their positive and/or negative effects on students. This paper examines research in relation to the articles to suggest that both CCPT and PCTC can be beneficial in the development of social skills in children with these types of disabilities, for without early intervention, children can experience long-term effects as adults.
Keywords: Child-Centered Play Therapy, Person-Centered Teacher Consultation, Intellectually Disabled, Down Syndrome, Attention Deficit and Hyperactivity Disorder.
Introduction
It is essential for educators to create a safe and beneficial learning environment for all students in the classroom. It is significant in order to facilitate the academic, emotional, social and cognitive needs of each individual child with or without disabilities. For individuals who have been diagnosed with intellectual disabilities, Down syndrome, or ADHD, their development is crucial and facilitating their needs can become quite a task. Because play is fundamental in the development and growth of a child it is important to offer the ability for children to fully express concrete and symbolic experiences through pretend play, play materials, and role playing. It is through play that children most naturally express their inner selves; thus, therapy for children
that utilizes play may provide children the most developmentally appropriate means for communication and growth (Landreth, 2002). By participating in these activities children are able to communicate to themselves and others, learn and master new tasks, carry out responsibilities, and make meaning of their previous or new experiences. One of the many ways to tailor to their unique maturational needs is through a model referred to as Child Centered Play Therapy (CCPT).
Child-centered play therapy (CCPT) surfaced from the person-centered philosophy of Carl Rogers in the early 1940’s. His belief was that “each person’s drive for self-actualization gives the capacity for positive self-growth extended not only to adults, but to children” (Bratton, Ray, Edwards, Landreth, 2002). A student of Rogers, Virginia Axline used her principle in children’s capability to self-heal and ability to solve their own problems to apply nondirective techniques to play therapy. Her research and writing in the 1940s and 1950s positioned play therapy as a viable treatment modality for children and set the foundation for further developments in the field.
An additional model is the Person-Centered Teacher Consultation (PCTC) method which is philosophically and consistently aligned with CCPT. This model is a form of teacher consultation in which a counselor trained in person-centered counseling skills works with a teacher to impact an identified student. PCTC was designed to be effective in (a) reducing
Teacher-identified attention-deficit hyperactivity disorder (ADHD) behavioral problems; (b) improving on-task, attentive, and hyperactive behaviors in the classroom as rated by an observer; (c) reducing parent-identified ADHD behavioral problems; and (d) improving the teacher-student and parent-child relationships.
Therefore, in this proposal, both CCPT and PCTC will be used in conjunction with one another as an intervention to obtain the desired results.
Literature Review
The effectiveness of Child Centered Play Therapy and Person Centered Teacher Consultation in children with Intellectual Disabilities, Down Syndrome, and Attention Deficit and Hyperactivity Disorder has been around for many years (Wilson & Ryan, 2005). Identification of interventions tailored to fit the individual maturational needs of children with intellectual, mental, and physical disabilities is a growing concern in many countries. The following articles discuss nondirective Child Centered Play Therapy and its use as a progressive approach to treating a wide range of children’s needs and its effectiveness since 1940. This type of therapy has been acknowledged as a developmentally responsive and beneficial therapeutic intervention for children with or without disabilities. The CCPT technique includes play and a child’s natural means of expression emphasizing that all children acquire within themselves the capability and be competent enough to produce meaningful experiences and solve their own problems. The use of play in therapy is based on the principle that children are best understood from a developmental perspective (Wilson & Ryan, 2005), and from a CCPT perspective, is necessary in order for the therapist to create optimal therapeutic conditions for the child (Bratton, S., Edwards, N., Landreth, G., 2002). Throughplay therapy, the therapist is allowed the opportunity to enter into the child’s experience as itis played out. This article provides an overview of the theory and practice of CCPT and supports it effectiveness through example and research.
The authors of other articles discuss the continuous pattern shift in the theoretical structure utilized when providing children with needed counseling. This shift calls for developing counseling skills that are targeted to the child’s needs as opposed to altering basic adult skills to child counseling (Baggerly, J., Landreth, G., Tyndall-Lind, A., 1999).. One specific way to accomplish this is through Play Therapy and has been increasingly noted as an effective counseling treatment with children. This article describes CCPT and compares it to Adlerian Play Therapy while providing therapeutic considerations that are specific to the child’s needs. A focus on adapting an adult verbal process sends a clear message that children are not prized as unique in their own right but rather are squeezed into adult conceptual framework (Baggerly, J., Landreth, G., Tyndall-Lind, A., 1999).
In other documentation and review of the use of this type of interventions is supported by other articles to help maintain and strengthen their use (Guerney, Louise F, 1991). It stated that when an intervention program that has been established to help increase a positive change in a negative behavior with the use of several intervention methods such as child-centered play therapy and the single involvement of parental strategies that primarily use the understanding of certain skills that can decrease a child’s negative behavior, this intervention can be conducted in different settings such as home or classroom (Guerney, Louise F, 1991). The intervention is dedicated in helping children learn communicational skills that can improve negative behavior and emotional conditions while helping students in adjusting to any new environment. Another approach reviewed in this article is CREFT (child relationship enhancement family therapy). The main focus of CREFT is the inclusion of the child parents or guardians in helping to guide the child into another behavior. The CREFT approach is a therapeutic intervention that any individual can use successfully with the instruction of a trained supervisor (Guerney, 1991). Creating a level of accountability for the change of the behavior in the hand of the interventionist. the article further stresses that CREFT and CCPT can be successful intervention when provided by a well trained staff or individual those individuals that are not familiar with the type of therapy will require several training sessions (Guerney, 1991). According to the article communication is key, especially with parents or guardians for the child to achieve the highest improvement their behavior (Guerney, 1991).
The therapeutic theology leads to the use of what the author's describe as "team spirit" communication between all parties in order to ensure a level of involvement and emotional stability from the parents point of view. this also helps to ensure parental feedback is well accepted and judgments are limited (Guerney, 1991). From the discovery of CCPT and CREFT many alternative interventions have grown from these theories. Other theorist developed the idea that self labeling accepting sequences can help in removing negative feelings and help the individual develop self-acknowledgement and self-acceptance of their inner most feelings (Guerney, 1991).
The following research study will show that the quality of the student-teacher relationship intervention can produce a level of improvement in negative or aggressive behavior in children with different levels of mental disabilities (Helker, Schottelkorb, Ray, 2007). This article also reviews how the intervention helps to increase the student’s social and emotional growth. This intervention will help in the development of a relationship model that uses a continual adjustment for the student to be successful in any environment (Helker, et al, 2007) The implementation of the CONNECT intervention model, a model that implements child-centered play techniques, can also help to improve negative behavior or aggressive tendencies in an educational environment (Helker, et al, 2007)
The CONNECT intervention utilizes skills derived from Child-Centered Play Therapy for increasing positive behavior changes. Teacher involvement is another key issue in the CONNECT model which proposes techniques that require educators to demonstrate skills and attitudes that help form positive relationships with their students (Helker, et al, 2007). For proper implementation of child-centered play therapy a background evaluation of family relationships and discipline styles may be required to organize information in understanding the precursors to the student’s negative behavior and ill adjustment to different social environments (Helker, et al, 2007). To further propose proper implementation certain strategies and techniques of the CCPT intervention must create a strong level of communication of the between family, the child, and family members( Helker, et al, 2007).
According to the article a relationship between teacher and student can be very impactful and the proper development is necessary for the benefit of both the child and the teacher to reach a successful academic history (Helker, et al, 2007). The authors further stipulate that a continual level of early involvement and the delivery of quality teacher-student relationship is important for the development of a child's ability to cope and understand good behavior practices ( Helker, et al, 2007).
This article used a single-case design to determine the effect child-centered play therapy (CCPT) and person-centered teacher consultation (PCTC) had on four elementary students with Attention Deficit Hyperactivity Disorder. Child-Centered Play Therapy is utilized by counselors or therapists for the development of expressive freedom and creativity, and for building self-esteem and more mature, pro-social behaviors. “CCPT follows the principles of Client-Centered Therapy of creating a non-judgmental, emotionally supportive therapeutic atmosphere, but with clear boundaries that provide the child with psychological safety to permit the learning of emotional and behavioral self-regulation.” (Retrieved from on February 16, 2011). Person-Centered Teacher Consultation Person-centered teacher consultation (PCTC): is an individualized consultation between a counselor trained in person-centered counseling techniques and a teacher who referred a student participant for play therapy services.
The purpose of this study was to examine the effectiveness of CCPT and PCTC for children who have ADHD symptoms. (Schottelkorb, 2009). The study demonstrated that CCPT was effective in minimizing ADHD symptoms.Schottelkorb, A. (2009). Effectiveness of Child-Centered Therapy and Person Centered Teacher Consultation on ADHD Behavioral Problems on Elementary School Children: A Single Case Design. University of North Texas. Doctor of Philosophy (Counseling), 197 pp., 7 tables, 63 figures, references, 75 titles.
This article discusses a study investigating the impact of two school counseling interventions, child-centeredplaytherapy (CCPT) and teacher consultation, on teacher-child relationship stress. CCPT and teacher consultation were conducted with 93 (pre-kindergarten to fifth grade) elementary school students across three elementary schools deemed to be at risk and ethnically diverse. Students were divided into three treatment groups: CCPT only, teacher consultation only, and a combined CCPT and teacher consultation group. Results demonstrated significant differences between pretesting and post-testing on the Index of Teaching Stress. All treatment groups were found to have statistically significant reduction in teacher and student problem characteristics with large effect sizes for total stress (Ray, D. 2007).
Methods
Literature Review of CCPT and PCTC will be gathered and dissected for greater knowledge of this type of therapy. A single subject design will be done on five different students all between the ages of 11 and 14. Baseline data will be gathered in 10 days of the first 2 and half weeks of the observations that are taken during the 45 min. of vocational period. Teacher interviews will be done at the beginning of the study and at the end. Observation will take place 2 times daily at random times four times a week. The study will have a duration of 10 weeks. Observations will also be done in different settings, such as structured and unstructured times. Field notes will be taken and videotaping will take place only during interviews with counselor.
Setting
The data for this study will be gathered in a Life Skills Unit (Self-contained classroom). The Life Skills Unit is located in one of the local public middle schools and it is located in a low socioeconomic neighborhood.
Participants
The participants that will participate in this study are five students that are enrolled in a local public middle school and their age range is between 11 and 14. The five participants are diagnosed as Mentally Retarded (MR) with Down Syndrome and ADHD (Attention Deficit Hyperactivity Disorder).
Dependent Variable
The dependent variable in the proposed research study was to measure an individual change in behavior. The desired change in behavior is to learn more appropriate social acceptable reactions to an undesired directive (the child will decrease their level of outburst when an undesired reaction is not obtained from others, for example, the child will not have an exaggerated outbursts (screaming) when the child is not given an activity of their choice). The data obtained to analyze the children’s behavior was obtained through teacher interviews and direct classroom observations. During the teacher interviews, one of the major concerns that were expressed were that peer relation difficulties took place during less structured times such as recess, lunch, music, or art. In the classroom, the students’ primary difficulty was that the exaggerated outbursts were displayed when given an academic task.
Independent Variable
The independent variable in the proposed research is to find the effectiveness of Child Centered Play Therapy (CCPT) and Person-Centered Teacher Consultation (PCTC) in increasing a child’s level of social skills. Researchers taught the student the social skill and gave the mentor further training and supervision during the intervention phase. Structured activities (for example, role playing, peer modeling, video modeling and social stories)were used to help reinforce and practice the desired response to a given directive or an academic task. The mentoring goal was for the student to demonstrate the target social skill with 90% accuracy in the classroom across at least three observations.
All mentors in the involved study were trained during an orientation meeting and/or two training meetings held during the study.
Experimental Design
This study was designed as an ABAB design. The baseline was recorded for a period of 10 days before any interventions were implemented. Once the baseline was obtained, the intervention was introduced and the intervention was implemented for a period of 10 days. After the 10 days of intervention, the intervention was removed and baseline was obtained again. This second view of baseline would allow the researchers to see if the implemented of the intervention worked or not.
Data Collection
The data will be collected through direct observation in order to obtain and establish a baseline. The baseline will be collected for a period of 45 minutes during their vocational period (last period of the day). The students’ behavior that will be observed and that will be recorded for baseline will be the number of times that the students exhibit an exaggerated behavior (screaming) when given a directive or when not given an activity of their choice.
In order to ensure that the sought behavior is documented adequately and that the proper social skills and interventions are observed, the teacher and staff will receive training before any baseline is collected and any interventions are implemented. The teacher and staff will follow a pre-established criterion to determine if the behavior is observed.