User:Armasa17/sandbox

Play Therapy Edits
** Italics indicate my version. Underlined pieces are my edits to the section above.

==== Efficacy Play therapy has been considered to be an established and popular mode of therapy for children for over sixty years. Critics of play therapy have questioned the effectiveness of the technique for use with children and have suggested using other interventions with greater empirical support such as cognitive behavioral therapy. They also argue that therapists focus more on the institution of play rather than the empirical literature when conducting therapy Classically, Lebo argued against the efficacy of play therapy in 1953, and Phillips reiterated his argument again in 1985. Both claimed that play therapy lacks in several areas of hard research. Many studies included small sample sizes, which limits the generalisability, and many studies also only compared the effects of play therapy to a control group. Without a comparison to other therapies, it is difficult to determine if play therapy really is the most effective treatment. Recent play therapy researchers have worked to conduct more experimental studies with larger sample sizes, specific definitions and measures of treatment, and more direct comparisons. ====

==== Play therapy is research-backed and popular mode of therapy for children for over sixty years ''. Critics of play therapy have questioned the effectiveness of play therapy for children and have suggested using other interventions with greater empirical support such as cognitive behavioral therapy . They also argue that therapists focus more on the institution of play rather than the empirical literature when conducting therapy  . [My Note: it's unclear what is meant by this, and the citation is not easily accessed.] Of note, Lebo argued against the efficacy of play therapy in 1953, and Phillips reiterated his argument again in 1985. Both claimed that play therapy lacks in several areas of hard research. Many studies included small sample sizes, which limits the generalizability. Many studies also only compared the effects of play therapy to a control group, as opposed to comparing it with another form of therapy. Without a comparison to other therapies, it is difficult to determine if play therapy really is the most effective treatment. Recent play therapy researchers have worked to conduct more experimental studies with larger sample sizes, specific definitions and measures of treatment, and more direct comparisons.  A meta-analysis of 100 play therapy studies found a small to moderate benefit to play therapy for children; the paper notes that research quality for play therapy is unsatisfactory .'' ====

==== Research is lacking on the overall effectiveness of using toys in non-directive play therapy. Dell Lebo found that out of a sample of over 4,000 children, those who played with recommended toys vs. non-recommended or no toys during non-directive play therapy were not more likely to verbally express themselves to the therapist. Examples of recommended toys would be dolls or crayons, while example of non-recommended toys would be marbles or a checker game. There is also ongoing controversy in choosing toys for use in non-directive play therapy, with choices being largely made through intuition rather than through research. However, other research shows that following specific criteria when choosing toys in non-directive play therapy can make treatment more efficacious. Criteria for a desirable treatment toy include a toy that facilitates contact with the child, encourages catharsis, and lead to play that can be easily interpreted by a therapist. ==== ''Research is lacking on the overall effectiveness of using toys in non-directive play therapy. Dell Lebo found that, out of a sample of over 4,000 children, those who played with recommended toys vs. non-recommended or no toys during non-directive play therapy were not more likely to verbally express themselves to the therapist. Examples of recommended toys would be dolls or crayons, while example of non-recommended toys would be marbles or a checker game. There is also ongoing controversy in choosing toys for use in non-directive play therapy, with choices being largely made through intuition or clinical judgment rather than through research. However, other research shows that following specific criteria when choosing toys in non-directive play therapy can make treatment more efficacious. Criteria for a desirable treatment toy include a toy that facilitates contact with the child, encourages catharsis, and lead to play that can be easily interpreted by a therapist.  Despite the critique about the potential for variability in toy choices, research supports the efficacy of play therapy. ''

==== Several meta analyses have shown promising results toward the efficacy of non-directive play therapy. Meta analysis by authors LeBlanc and Ritchie, 2001, found an effect size of 0.66 for non-directive play therapy. This finding is comparable to the effect size of 0.71 found for psychotherapy used with children, indicating that both non-directive play and non-play therapies are almost equally effective in treating children with emotional difficulties. Meta analysis by authors Ray, Bratton, Rhine and Jones, 2001, found an even larger effect size for nondirective play therapy, with children performing at 0.93 standard deviations better than non-treatment groups. These results are stronger than previous meta-analytic results, which reported effect sizes of 0.71, 0.71, and 0.66. Meta analysis by authors Bratton, Ray, Rhine, and Jones, 2005, also found a large effect size of 0.92 for children being treated with non-directive play therapy. Results from all meta-analyses indicate that non-directive play therapy has been shown to be just as effective as psychotherapy used with children and even generates higher effect sizes in some studies. ==== No changes.

==== There are several predictors that may also influence the effectiveness of play therapy with children. Number of sessions is a significant predictor in post-test outcomes, with more sessions being indicative of higher effect sizes. Although positive effects can be seen with the average 16 sessions, there is a peak effect when a child can complete 35-40 sessions. An exception to this finding is children undergoing play therapy in critical-incident settings, such as hospitals and domestic violence shelters. Results from studies that looked at these children indicated a large positive effect size after only 7 sessions, which provides the implication that children in crisis may respond more readily to treatment Parental involvement is also a significant predictor of positive play therapy results. This involvement generally entails participation in each session with the therapist and the child. Parental involvement in play therapy sessions has also been shown to diminish stress in the parent-child relationship when kids are exhibiting both internal and external behaviour problems. Despite these predictors which have been shown to increase effect sizes, play therapy has been shown to be equally effective across age, gender, and individual vs. group settings. ==== No changes.