In this article, we examine the philosophy of child-centered play therapy (CCPT) and demonstrate its alignment with the neurodiversity- participant from Chung's (2023) study, facilitated by the second author (EA), who worked with an autistic boy. This case illustrates how the play therapist met the child where he was and facilitated substantive growth over 16 CCPT sessions.
Ray and colleagues (2012) recommend CCPT as a “relational at meeting their intrinsic needs to form safe, consistent, and warm the child to conform to neurotypical norms. The emphasis is on self- unconditional positive regard, empathy, and genuineness for autistic children. The therapist seeks to understand the child's all forms of communication, provides opportunities for the child to express themselves authentically, and helps facilitate a more positive self- concept by validating the child's inner resources (Ray et al., 2012). Similarly, Carden (2009) observed that in CCPT, the play therapist for the child to connect with the world and process their experiences.
Growing Research Supporting CCPT for
Autistic Children The application of CCPT with autistic children dates back over 60 years; Landreth (2024) documented his facilitation of CCPT with an autistic boy named Caleb (pseudonym) around 1961 (Landreth, 2024, personal communication). Since 2000, multiple case studies have reported therapeutic outcomes for autistic children, including enhanced self-awareness, improved coping skills (Carden, 2009), Ryan, 2004), and reduced aggressive behaviors (Guest & Ohrt, 2018). A recent study has shown CCPT’s effects in enhancing empathy and social competence while decreasing social withdrawal, irritability, and hyperactivity in autistic children (Chung, 2023). Additionally, empirical research indicates improvements in attachment-related behaviors and social competence, as well as reductions in emotional and behavioral problems (Schottelkorb et al., 2020; Ware Balch & Ray, 2015). Notably, Chan & Ouyang (2024) found in their randomized controlled trial that improvements in social skills were accompanied by increased alpha amplitude in electroencephalogram (EEG) the neuroplasticity in the brain of autistic children.
Meeting the Autistic Child Where They Are Among Landreth’s (2024) 10 tenets in CCPT, the assumption that “children will take the therapeutic experience to where they need to like all children, should be respected in their choice to direct their therapeutic process. This perspective challenges the common belief
CLINICAL EDITOR’S COMMENTS:
Child-Centered Play Therapy provides a nuerodiversity autism spectrum.
that autistic children require more instruction due to their supposed
CCPT Skills In CCPT, the play therapist utilizes both verbal and non-verbal skills to foster a growth-promoting relationship (Landreth, 2024). The intentions, facilitates decision-making and responsibility; and conveys acceptance and validation through esteem-building responses. When working with autistic children, the play therapist focuses on moments of attunement and connection, exploring the deeper meanings in the child’s actions and play, in order to gain insight into their self- perception and worldview. Additionally, therapeutic limit-setting is applied when appropriate, aiming to enhance the child's self-control and self-regulation rather than mere compliance. The intentionality and variety of responses make CCPT highly individualized for each autistic child. In the following case, we will guide readers through the therapist’s intentional decisions throughout the therapy process and address the challenges that arise.
The Case of David David (pseudonym), a 6-year-old bilingual (Spanish and English) autistic boy, was referred to play therapy due to his fear of restrooms and because he would not play. During play therapy, David did not receive other interventions, such as speech/language therapy or teacher reported that David did not know how to play, I remained curious and open to him. I worked to not place expectations on how he should be playing during our time together. Due to David’s limited speaking, I attempted to learn more from the teacher and the parent about his language use and understanding. However, it was unclear and thus I decided I would use both English and Spanish and assess as our relationship built.
willingly held my hand as we walked to the playroom. The playroom was in an outside portable classroom. Initially, I introduced myself and the playroom in both English and Spanish. I responded to him in both languages while attempting to understand his responses to each. When I noticed a brief eye contact, a sound he would make, or other the language he had a reaction to. When we entered the playroom for the
www.a4pt.org | March 2025 | PLAYTHERAPY | 11
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