This article was downloaded by: [The University of British Columbia]On: 20 November 2014, At: 09:18Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Journal of Creativity in Mental HealthPublication details, including instructions for authors andsubscription information:http://www.tandfonline.com/loi/wcmh20

Child-Centered Play Therapy: A CreativeApproach to Culturally CompetentCounselingEric S. Davisa & Jennifer K. Pereiraa

a Argosy University, Tampa, Florida, USAPublished online: 12 Jun 2014.

To cite this article: Eric S. Davis & Jennifer K. Pereira (2014) Child-Centered Play Therapy: A CreativeApproach to Culturally Competent Counseling, Journal of Creativity in Mental Health, 9:2, 262-274,DOI: 10.1080/15401383.2014.892863

To link to this article: http://dx.doi.org/10.1080/15401383.2014.892863

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the“Content”) contained in the publications on our platform. However, Taylor & Francis,our agents, and our licensors make no representations or warranties whatsoever as tothe accuracy, completeness, or suitability for any purpose of the Content. Any opinionsand views expressed in this publication are the opinions and views of the authors,and are not the views of or endorsed by Taylor & Francis. The accuracy of the Contentshould not be relied upon and should be independently verified with primary sourcesof information. Taylor and Francis shall not be liable for any losses, actions, claims,proceedings, demands, costs, expenses, damages, and other liabilities whatsoever orhowsoever caused arising directly or indirectly in connection with, in relation to or arisingout of the use of the Content.

This article may be used for research, teaching, and private study purposes. Anysubstantial or systematic reproduction, redistribution, reselling, loan, sub-licensing,systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions

Journal of Creativity in Mental Health, 9:262–274, 2014Copyright © Taylor & Francis Group, LLCISSN: 1540-1383 print/1540-1391 onlineDOI: 10.1080/15401383.2014.892863

Child-Centered Play Therapy: A CreativeApproach to Culturally Competent Counseling

ERIC S. DAVIS and JENNIFER K. PEREIRAArgosy University, Tampa, Florida, USA

Child-centered play therapy (CCPT) can be a valuable creativemethod to gain understanding of children’s life, culture, andneeds. This approach allows children to play out life problems inan accepting environment through the experiential and culturalcomponents inherent in creative interventions such as CCPT. Thismanuscript will share insights and examples in the use of CCPTto provide culturally competent services to a diverse population ofchild clients.

KEYWORDS play therapy, multicultural competence, creativity incounseling, child-centered play therapy

The population of professional counselors working with children is varied.This population includes professional counselors coming from training inmental health counseling, marriage and family therapy, school counseling,and social work. Within these disciplines are a number of specializationareas for providing counseling services to children in culturally competentand experiential ways; one of the most potentially effective ways is playtherapy, according to a meta-analysis of 93 research studies by Bratton, Ray,Rhine, and Jones (2005). Many counselors are adding play therapy as a cre-ative approach to their repertoire to gain additional knowledge and skill inworking with children. Play, in itself, is inherently creative. This modality fortherapy allows children to address their issues through the use of expres-sive mediums and materials (e.g., art materials, dress-up clothing, puppets).Training and knowledge in utilizing this creative approach is vital, as theneed for services for children suffering with emotional and behavioral disor-ders is increasing. For example, it is estimated that 75% to 80% of children

Address correspondence to Eric S. Davis, Department of Psychology and BehavioralStudies, Argosy University, 1403 N. Howard Ave., Tampa, FL 33607, USA. E-mail: esdavis@argosy.edu

262

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

Creative and Culturally Competent Counseling 263

who need mental health services will not receive them (Blanco & Ray, 2011;Bratton et al., 2005).

Simultaneously, there is a consistent call for increased emphasis onmulticultural competence in counseling across the globe (Garrett & Herring,2001; Lee, 2001; Penn & Post, 2012; Vontress, 1996). Multicultural counselingrefers to preparation and practice that integrates multicultural and culture-specific awareness, knowledge, and skills into counseling interactions(Arredondo et al., 1996). Counselors must take into account current social,economic, and political realities while responding to the developmentalneeds of children in rapidly changing multicultural societies (Ceballos,Parikh, & Post, 2012; Drewes & Schaefer, 2010; Garrett & Herring, 2001; Lee,2001). This point is of special interest considering that U.S. Census Bureau(2010) statistics indicate that 44% of children are identified as a minority pop-ulation with an estimation that this number will increase to 62% by the year2050. Play therapy can serve as a potentially valuable tool in integrating aculturally competent method of delivering counseling services to children.In particular, child-centered play therapy (CCPT) provides a creative, accept-ing, and safe environment for children to explore issues related to culture,development, and a variety of difficulties and issues in a creative and familiaravenue of play (Landreth, Baggerly, & Tyndall-Lind, 1999; Ray, Stulmaker, &Lee, 2013). CCPT is based in the humanistic orientation believing that whatfundamentally makes human relatedness is the quality of the relationshipalong with unconditional positive regard, genuineness, and presence to workwith children (Landreth, 2012; Rogers, 1959). CCPT, therefore, presents as ahumanistic lens through which to view therapeutic work with children thataddresses the continual need for multicultural competence in counselingby allowing children to explore their worlds and issues from their uniquecultural perspectives without judgment.

Creative interventions such as play have long been considered an impor-tant tool for children (Association for Play Therapy [APT], 2008). It was at onetime considered vital to becoming a successful adult as children rehearsedsuch activities as hunting, gathering, and child rearing; however, play in cur-rent society is often considered to be more focused on entertainment andcompetition rather than on addressing the true meaning of connection andeducational value (Landreth, 1993; Steffens & Gorin, 2007). As a result ofthese crucial learning and connective aspects of play, CCPT can be utilizedin counseling environments with children to gain a more full understandingof the issues, culture, and developmental level of the child as well as possiblesolutions across settings, age, gender, and race, among others (Bratton et al.,2005; Landreth, 2012; Ray, Lee, Meany-Walen, Carlson, Carnes-Holt, & Ware,2013). This understanding is vital when considering the need to addressmulticultural issues for children as an ever-growing minority and underrep-resented population in the mental health profession with developmentally

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

264 E. S. Davis and J. K. Pereira

appropriate interventions such as CCPT (Ceballos et al., 2012; Ray, Lee, et al.,2013; Schottelkorb, Doumas, & Garcia, 2012).

CHILD-CENTERED PLAY THERAPY: BACKGROUND ANDTECHNIQUES OF CCPT

CCPT is a creative extension of Rogerian client-centered therapy (e.g., empa-thy, unconditional positive regard; Rogers, 1959). The overarching rationaleof CCPT is based on Rogers’s (1959) belief that all individuals, includingchildren, have the innate capacity to develop in a positive direction if agrowth-promoting climate is provided. The application of this idea in workwith children then, according to Landreth (2012), implies that it is the taskof the therapist to facilitate a climate in which the child can safely expressand explore their feelings, thoughts, experiences, and behaviors. CCPT is anondirective theoretical orientation that focuses on the child’s ability to workthrough their issues as compared with other more directive approaches. Theprimary techniques employed by trained play therapists include tracking,reflective listening, and limit setting. Tracking is a skill that requires the ther-apist to narrate the child’s play as a way to monitor the play, show interestin the child’s process, and begin to understand and catalogue the metaphorsand underlying story in the play. Reflective listening is a process by whichthe therapist responds to the content and emotionality of the child’s work.This allows the therapist to provide support and insight and helps the childmove toward growth. Limit setting allows the counselor to set and maintainspecific boundaries for children to explore in a physically and emotionallysafe and consistent environment (Landreth, 2012). Additionally, there areeight basic principles of CCPT outlined by Axline (1947) that help to distin-guish it from other play therapy approaches. These eight basic principles aredescribed in the next section.

EIGHT BASIC CCPT PRINCIPLES

The tenets of CCPT make it appropriate for use as a counseling approach thatis responsive to the diverse and multicultural backgrounds of child clients.In CCPT, the therapist approaches the relationship from a place of respect,where the development of a warm, genuine relationship is established as aprimary goal. Effort is made by the therapist to communicate that the childis “OK” as she is. This is done through reflection of empathy and genuineacceptance of the child’s verbalizations and actions. It is the therapist’s roleto act as a partner on the child’s journey of healing and to accept the childexactly as she is in each moment, not as the counselor would like the childto be. The child is granted permission to do whatever they need within

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

Creative and Culturally Competent Counseling 265

established limits. This feeling of permissiveness is established in the rela-tionship so that the child feels free to express her feelings completely. Playis viewed as an expression of the child’s world and the therapist is respon-sible for working to understand that perspective, being alert to recognizethe feelings the child is expressing, and reflecting those feelings back insuch a manner that the child gains insight into their behavior (Axline, 1947;Landreth, 2012).

According to both Axline (1947) and Landreth (2012), a key componentof CCPT is that the therapist maintains a deep respect for the child’s ability tosolve her own problems at all times throughout the relationship. The respon-sibility to make choices and to institute change is the child’s. The therapistremains nondirective throughout the therapeutic relationship and does notattempt to direct the child’s actions or conversation in any manner. The childleads the way. The therapist follows. This means that the child is not hurriedthrough the counseling process. It is a gradual process that is recognized andvalued as such by the therapist. Following the child’s lead in the therapeuticprocess also allows the therapist to maintain a respectful appreciation for thechild’s culture and beliefs rather than imposing the therapist’s cultural back-ground on the process. Finally, the therapist only establishes limits whenthey are necessary to ground the child to reality and to make the child awareof his responsibility.

CCPT AND CULTURE

The CCPT approach accomplishes a different level of understanding of chil-dren and their issues through its emphasis on creating a safe and open spacefor the child to explore and direct his or her own growth (Axline, 1947;Ray, 2007). Prosocial behaviors and attitudes can be developed through thegenuine acceptance and understanding of the counselor, which is commu-nicated by the child’s natural language of play (Landreth, Ray, & Bratton,2009; Ray, 2007). CCPT provides all children, including marginalized popu-lations (Baggerly & Parker, 2005; Josefi & Ryan, 2004; Ramirez, Flores-Torres,Kranz, & Lund, 2005; Schottelkorb et al., 2012), with the ability to learnto express and cope with a range of feelings, a place where they assumeresponsibility, and an avenue for success (Post, 2001). It is the goal of theCCPT therapist that children will enhance communication through symboli-cally acting out feelings, thoughts, and experiences not able to be expressedin words resulting in improvement through vicarious experiences gainedfrom the play sessions (Bratton et al., 2005; Fall, Balvanz, & Johnson, 1999;Van Velsor, 2009). Further, the multicultural components of a child’s life areopen for free exploration through a sensitivity to cultural diversity and theability to develop skills within the context of cultural realities and history(Ceballos et al., 2012; Garrett & Herring, 2001, Landreth et al., 2009; Lee,2001). By allowing children to express themselves in their own culturally

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

266 E. S. Davis and J. K. Pereira

accepted ways (e.g., through the use of specific songs and dances, cultur-ally appropriate pretend foods, observance of cultural rituals, or the use oflanguage and storytelling), counselors can add to their understanding andultimately their effectiveness as professionals, resulting in a better abilityto help others to possess their own identities and create new possibil-ities (Gladding, 1997; Landreth et al., 2009). Orientations such as CCPTcan also assist counselors in fostering a culturally affirmative environmentwithout denying their own culture (Garrett & Herring, 2001; Ray, Lee,et al., 2013).

In the child-centered approach, children are assumed to be resilient, topossess an inherent tendency to move toward growth and maturity, and tobe fully capable of inner self-direction (Landreth, 2012; Landreth et al., 2009).An important characteristic that supports this individualized growth processis the counselor’s ability to provide a culturally appropriate and culturallysupportive environment (Landreth et al., 2009). CCPT places emphasis onproviding children with the support and guidance necessary to allow themto experiment with new ways of being and create new versions of self, whichrequires the therapist to engage in actively learning about the child’s culturalvalues (e.g., when a child client is experiencing distress over a family issue,knowledge of the family system and the cultural values can help the therapistmake sense of parental roles, roles of extended family, the possible familyview of the issues, and how many problems are solved according to culturalbeliefs).

Divergent views on what constitutes effective counseling are not new,nor are the difficulties in identifying the fundamental aspects or attributes ofsuccessful multicultural counseling, or what approach is most appropriate fora specific population. Bratton et al., (2005) found that “ . . . the effectivenessof play therapy did appear to vary depending on the theoretical model,with the humanistic therapies showing significantly larger effect sizes thannonhumanistic treatments” (p. 380). Therefore, the effectiveness seen withinthis concept of relationship again reinforces CCPT’s appropriateness as aculturally sensitive modality due to its abiding belief in the clients ability toheal in the right environment, the genuine acceptance of the counselor ofall aspects of the client, and the full openness of the theory to any and allcultural beliefs held by clients.

Application of Culturally Sensitive CCPT

In addition to providing children a voice through play, CCPT can leadto opportunities to express feelings, experience control, develop copingskills, and explore cultural identity (Bondy, Ross, Gallingane, & Hambacher,2007; Johnson, McLeod, & Fall, 1997). Numerous scholars (Landreth, 1993;Landreth et al., 2009; Penn & Post, 2012) state that a child’s behavior isa process to satisfy personal needs, and it is imperative that counselorsunderstand the child’s perception of reality and reactions to that reality.

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

Creative and Culturally Competent Counseling 267

They further state that CCPT can accomplish this with nonjudgmental accep-tance of all aspects of the child’s life (i.e., socioeconomic status, ethnicbackground, etc.) and play while focusing on the relationship rather thanthe problem. The creative process of play is full of decision-making oppor-tunities, thus improving cognitive skills without the pressure of judgment(Carmichael, 2006; Ray, 2007). The CCPT environment allows for potentiallylasting resolutions to be discovered, rehearsed, failed, rehearsed again, mas-tered, and adapted into life strategies (APT, 2008; Steffens & Gorin, 2007).Consequently, through interaction with play therapy materials, children canexperience improved sense of self-control, coping skills, and inner resolu-tion, resulting in better adjustment and improvements in other areas suchas learning and social interactions (Fall et al., 1999; Johnson et al., 1997;Landreth, 1993; Ray, Armstrong, Warren, & Balkin, 2005).

In an effort to be mindful of both the tenets of the CCPT approach and achild’s cultural heritage, it behooves the therapist to be prepared for culturalcomponents that may come into play in a session (e.g., specific vocabularyused in the culture, spiritual beliefs, heritage celebrations, views on life anddeath). The CCPT therapist has the task of being cognizant of the culturalheritage of the client and ensuring that culturally appropriate materials andtoys are available to children (Ray, Stulmaker, et al., 2013). There shouldbe a wide range of play and art materials that allow for freedom of expres-sion from any culture. Cultural heritage can be expressed through ethnicallydiverse dolls, puppets, dress-up clothing, miniatures, pretend foods, story-books, and art supplies. Providing materials that speak to all children in theplayroom helps children to tell their story through their own personal andcultural lens. This in turn can lead to emotional growth and development.The use of toys and play materials in counseling can convey the notionthat talking is not always required or expected (Drewes, 2001). Toys havethe specific purpose of enhancing and providing means of communicationfor children within the context of their cultural heritage (Berg & Steiner,2003; Ray, Lee, et al., 2013). CCPT offers the opportunity to organize real-life experiences that may be abstract for children without having to rely onthe typically verbal approaches to communication and counseling (Landreth,1993; Ray, Stulmaker, & Lee, 2013). All of these aspects can combine to openthe world for the child who is struggling to adapt and explain his or her lifedifficulties.

Cultural Effectiveness of CCPT

One of the key strengths to be considered with CCPT is the potentialmulticultural impact it can have. This is especially the case when consideringall societies vary in the upbringing of children, education, and influencessuch as parental expectations and task assignments, yet play is a componentalmost all cultures utilize to teach the skills of living (Ember & Ember, 2010;

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

268 E. S. Davis and J. K. Pereira

Steffens & Gorin, 2007). Additionally, it is the counselor’s responsibility toprovide counseling programs and interventions that reflect the needs andrealities of all children, regardless of cultural background, while consideringthe importance of cultural and sociopolitical influences on people’s func-tioning (Ceballos et al., 2012; Lee, 2001). It has been hypothesized by Post(2001) that “children of every race and socioeconomic status have the sameneeds for understanding, safety, and attention” (p. 108). CCPT fits this for-mula quite well as it is less limited by cultural differences and focuses onmore culturally relevant concepts such as an emphasis on social/emotionalenvironment and acceptance of all culturally based aspects that the childchooses to bring into therapy (Bondy et al., 2007; Landreth et al., 2009; Ray,Stulmaker, et al., 2013).

The following information from the literature and case examples offernumerous illustrations of the effectiveness of play with children of varyingbackgrounds related to race, culture, and condition. Significant reductionsin externalizing behavior problems and total behavior problems of Britishchildren related to domestic violence witnesses and substance abuse inparents have been seen with the use of play in a controlled group studyconducted with 20 school children ranging in age from 3 to 10 years old(British Association of Play Therapy [BAPT], 2004). Another British studyyielded positive improvements in depression, hyperactivity, and disruptivebehaviors through the use of nondirected play therapy with children identi-fied as having one parent suffering from alcohol or drug dependency (BAPT,2004).

There is a need for counseling approaches that are consistent withAfrican American worldviews and developmental needs based on conceptsof unity, purpose, and creativity, which are based in traditional Africanvalues. CCPT is a culturally sensitive approach that honors the four com-ponents of the African American worldview including emotional vitality,interdependence, collective survival, and harmonious blending (Baggerly& Parker, 2005). In practice, one of the authors worked with a 7-year-oldAfrican American boy. The child displayed aggression toward others andacting-out behaviors that showed he was unable to monitor and moderatehis emotions successfully himself. The therapist slowly built a relationshipwith the child by following the tenets of CCPT and allowing the child tolead sessions and direct the process. The child’s struggle with behavioralissues quickly showed itself through play themes to be due to anxiety andlow self-esteem, which pointed to an overly authoritarian parenting andeducation style. Through the use of CCPT, the child was able to find anaccepting environment where he could explore his emotions. Further, thechild was able to explore these emotions within the context of the fourcomponents of his African American worldview. For example, his emotionalvitality was expressed through singing and dancing during much of his play,while his interdependence was displayed through his regular inclusion of the

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

Creative and Culturally Competent Counseling 269

counselor in his play to work together toward a common goal (e.g., makingPlay-Doh hamburgers). The utilization of the tenets of CCPT (e.g., allowingthe child to lead the process) permitted this child to explore his emotionsand concerns in an open and safe environment though means that werecomfortable and familiar to the client’s culture and worldview.

The CCPT approach is also recommended for youth of MexicanAmerican descent as the counselor strives to see the child’s point of view,not impose beliefs or solutions, and work within the framework of the famil-ial belief and values while focusing on the Mexican American culture ofhuman interaction over task orientation (Ramirez et al., 2005). One exampleof how CCPT meets the needs of Mexican American child clients can beseen in how the child brings the need for understanding problems throughrelationships to others. A client one of the authors worked with struggledwith the sudden loss of his maternal grandmother. Awareness of the client’sculture assisted the therapist in understanding the issue from a number oflenses: the value placed on extended family relationships (the grandmotherlived with and helped raised the client), grief as a familial process versus amore American individualized approach, the death meaning financial stressdue to the need for additional nonfamilial child care, knowledge that thisculture frequently has more outward displays of grief and more physiologicreactions, and the strong reliance on faith, hope, and prayer to deal withthe death. Through the relationship with the child and family, the therapistwas able to help process the grief reactions of the child, the family mem-bers, and the family as a system. This helped speed the healing processand allowed the child to better understand how to value and use their cul-tural heritage to deal with grief and loss. The therapist’s humanistic stanceallowed the child to feel free to choose the issues relevant to their personalunderstanding of the issues rather than taking a more directive approach.Working with the client through a humanistic lens helped the therapistto convey respect for the child’s innate ability to guide his own healingprocess.

CCPT has also been shown as an effective intervention with children inaddressing issues related to trauma (Fitzgerald, Henricksen, & Garza, 2012)and with refugee children in reducing symptoms of posttraumatic stress dis-order as the humanistic nature of the therapy allows for the client’s voice tolead the therapeutic process (Schottelkorb et al., 2012). Yet another exam-ple is in the allowance of Korean American children to play out submissivemother routines showing the value of minimal social conflict (Baggerly &Parker, 2005). It is also suggested that CCPT can be implemented withpreschool children as it has shown effectiveness with separation anxiety andspeech disturbances (Johnson, Bruhn, Winek, Krepps, & Wiley, 1999). A 5-year-old client with whom one of the authors worked was referred due tosevere attachment issues stemming from adoption from China to a Chinese

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

270 E. S. Davis and J. K. Pereira

American family after an extended time in a Chinese orphanage. The clientdisplayed trust and bonding issues and avoided all contact with the therapistfor the first 6 weeks of treatment. The client passively allowed herself tobe led to the playroom but would not look at, speak to, or be in physicalproximity to the therapist. Because the therapist accepted the child whereshe was at each moment rather than trying to change her, the child was ableto find the strength to begin to trust the therapist’s actions and reactions.The client did respond to a set of small dolls of Asian heritage and a similarset with a Western appearance. She also gravitated to the collection of paperdolls and play foods that represented her birth culture. The client engagedin dramatic play while only mimicking her birth culture for the first severalmonths until gradually the Western food items and dolls began to be incor-porated. Again, meeting the child where she was emotionally created spacefor the child to begin to engage the therapist and ask for assistance. Thetherapist was careful to understand the culture (foods, family system, beliefs,celebrations, methods of honoring life and death, etc.) of the client, whichassisted greatly in understanding and helping the child to deeply process herplay themes and stories.

Play can help children explore and test a variety of cultural worldviewsand values in a safe and free environment and can give the counselor insightinto his or her cultural perspectives (Baggerly & Parker, 2005; Landreth, 1993;Post, 2001). It is suggested that with the appropriate materials and support,CCPT can aid in developing internal strength and resolution resulting in bet-ter adjustment, coping, and buffering in dealing with social justice issuessuch as poverty and racism (Baggerly & Parker, 2005; Bondy et al., 2007;Ceballos et al, 2012; Landreth, 1993). This is vital as experiences with racismand negative judgments from adults in authority can lead to levels of mistrustthat could hamper the sense of positive support and relationship building(Spencer, Jordan, & Sazama, 2004). Additionally, creative orientations such asCCPT can assist counselors in being better able to help child clients developand maintain responsibility for their own identities, become integrated, incor-porate outside knowledge, and create new possibilities (Gladding, 1997;Kottman, 2003; Van Velsor, 2009).

Embedded within the tenets of CCPT is the concept that children arefree to communicate in their play through whatever culturally based aspectsare practiced including storytelling, art, dance, music, and humor (Landrethet al., 2009). Storytelling, for example, can enlighten the counselor’s under-standing of the child’s perspective and ultimately his or her effectivenessas a professional providing culturally appropriate services (Gladding, 1997).In particular, storytelling can aid grieving children in maintaining healthyidentification with the deceased by allowing for the continual expressionof memories, emotions, and thoughts through a familiar process (Saldinger,Cain, Porterfield, & Lohnes, 2004). Humor plays a vital role in counseling as

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

Creative and Culturally Competent Counseling 271

it not only bolsters the relationship, but can also be seen as an importantcultural and spiritual component (Garrett, Garrett, Torres-Rivera, Wilber, &Roberts-Wilber, 2005). Music, art, and dance can aid counselors in helpingclients deal with emotions associated with trauma and loss as well as ingaining insight into culturally and historically important aspects of the client’sculture (Garrett & Herring, 2001; Gladding, 1997; Vontress, 1996). These com-ponents are vital due to the fact that psychotherapeutic interventions cannotexist separately from the society and culture of the people (Ceballos et al.,2012; Vontress, 1996). The CCPT therapist can encourage and explore thesecreative avenues by providing appropriate and diverse materials includingmusic, books, and art materials in an environment safe from judgment anddirection to allow children to express their own cultures through thesefamiliar mediums.

CONCLUSION

The tenets of CCPT, an inherently creative orientation, not only allow for, butpromote cultural diversity and multicultural awareness in therapy due to theabiding belief in the client’s innate ability to heal if a healing environment isprovided. While responding to a myriad of developmental and mental healthneeds of children in rapidly evolving multicultural societies, counselors mustutilize an appropriate counseling orientation such as CCPT to fully meetclient needs. It is paramount that therapists engage in a proper training pro-cess to develop the knowledge and skills required to best support childrenthrough the use of CCPT. For example, therapists can receive training andcredentialing through both the APT and the National Institute for RelationshipEnhancement. Therapists trained in CCPT are then well positioned to sup-port child clients in gaining a better understanding and perspective of theirissues within the context of their culture.

Although creative approaches are widely recognized as being inclusiveof client beliefs, values, and culture, there is a lack of research detailing theeffectiveness of culturally sensitive CCPT with children. Specifically, exam-ples of the effectiveness of interventions with certain populations dealingwith culturally relevant situations, appropriate selection and application ofplay materials with children of culturally diverse backgrounds, and acquir-ing knowledge of the cultural components of child clients would potentiallyadd to the therapist’s repertoire. CCPT’s adherence to the main tenets ofclient-centered theory makes it appropriate for use as a culturally respon-sive counseling approach for child clients. Therefore, CCPT helps meet thecontinued need for mental health counseling services for the increasingnumber of culturally diverse children suffering from emotional and behav-ioral disorders through the use of developmentally appropriate and creativetechniques.

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

272 E. S. Davis and J. K. Pereira

REFERENCES

Arredondo, P., Toporek, M. S., Brown, S., Jones, J., Locke, D. C., Sanchez,J., & Stadler, H. (1996). Operationalization of the multicultural counselingcompetencies. Alexandria, VA: Association for Multicultural Counseling andDevelopment.

Association for Play Therapy. (2008). Play therapy makes a difference! Retrievedfrom http://www.a4pt.org/ps.index.cfm?ID=1653

Axline, V. (1947). Play therapy. New York, NY: Ballantine.Baggerly, J., & Parker, M. (2005). Child-centered group play therapy with African

American boys at the elementary school level. Journal of Counseling andDevelopment, 83, 387–396. doi:10.1002/j.1556.6678.2005.tb00360.x

Berg, I. K., & Steiner, T. (2003). Communicating with children on their own terms. InI. K. Berg & T. Steiner (Eds.), Children’s solution work (pp. 68–115). New York,NY: W. W. Norton.

Blanco, P. J., & Ray, D. C. (2011). Play therapy in elementary schools: A best practicefor improving academic achievement. Journal of Counseling and Development,89, 235–243. doi:10.1002/j.1556-6678.2011.tb00083.x

Bondy, E., Ross, D. D., Gallingane, C., & Hambacher, E. (2007). Creating environ-ments of success and resilience: Culturally responsive classroom managementand more. Urban Education, 42, 326–348. doi:10.1177/0042085907303406

Bratton, S. C., Ray, D., Rhine, T., & Jones, L. (2005). The efficacy of play ther-apy with children: A meta-analytic review of treatment outcomes. ProfessionalPsychology: Research and Practice, 36 , 376–390. doi:10.1037/0735.36.4.376

British Association of Play Therapy. (2004). Play therapy in schools. London,England: Newnorth.

Carmichael, K. D. (2006). Play therapy: An introduction. Upper Saddle River, NJ:Pearson-Merrill Prentice Hall.

Ceballos, P. L., Parikh, S., & Post, P. B. (2012). Examining social justice attitudesamong play therapists: Implications for multicultural supervision and training.International Journal of Play Therapy, 21, 232–243. doi:10.1037/a0028540

Drewes, A. A. (2001). The possibilities and challenges in using play therapy inschools. In A. A. Drewes, L. J. Carey, & C. E. Schaefer (Eds.), School-basedplay therapy (pp. 41–61). New York, NY: John Wiley.

Drewes, A., & Schaefer, C. (2010). School based play therapy (2nd ed.). Hoboken,NJ: John Wiley.

Ember, C. R., & Ember, M. (2010). Cultural anthropology (13th ed.). EnglewoodCliffs, NJ: Prentice Hall.

Fall, M., Balvanz, J., & Johnson, L. (1999). A play therapy intervention and its rela-tionship to self-efficacy and learning behaviors. Professional School Counseling,2, 194–204.

Fitzgerald, K., Henricksen, R. C., Jr., & Garza, Y. (2012). Perceptions ofcounselors regarding the effectiveness of interventions for traumatized children.International Journal of Play Therapy, 21, 45–56. doi:10.1037/a0026737

Garrett, M. T., Garrett, J. T., Torres-Rivera, E., Wilber, M., & Roberts-Wilber,J. (2005). Laughing it up: Native American humor as spiritual tradi-tion. Journal of Multicultural Counseling and Development, 33, 194–204.doi:10.1002/j21611912.2005.tb.00016.x

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

Creative and Culturally Competent Counseling 273

Garrett, M. T., & Herring, R. D. (2001). Honoring the power of relation: CounselingNative adults. Journal of Humanistic Counseling, Education, and Development,40, 139–161. doi:10.1002/j2164-490X.2001.tb00113.x

Gladding, S. T. (1997). Stories and the art of counseling. Journal of HumanisticEducation and Development, 36 , 68–73. doi:10.1002/j.2164-4683.1997.tb00374.x

Johnson, L., Bruhn, R., Winek, J., Krepps, J., & Wiley, K. (1999). The use of child-centered play therapy and filial therapy with Head Start families: A brief report.Journal of Family and Family Therapy, 25, 169–176.

Johnson, L., McLeod, E. H., & Fall, M. (1997). Play therapy with labeled children inthe schools. Professional School Counseling, 1, 31–34.

Josefi, O., & Ryan, V. (2004). Non-directive play therapy for young children withautism: A case study. Clinical Child Psychology and Psychiatry, 9, 533–551.doi:10.1177/1359104504046158

Kottman, T. (2003). Partners in play (2nd ed.). Alexandria, VA: American CounselingAssociation.

Landreth, G. L. (1993). Child-centered play therapy. Elementary School Guidanceand Counseling, 28, 17–29.

Landreth, G. L. (2012). Play therapy: The art of the relationship (3rd ed.). Florence,KY: Accelerated Development.

Landreth, G. L., Baggerly, J., & Tyndall-Lind, A. (1999). Beyond adapting adultcounseling skills for use with children: The paradigm shift to child-centeredplay therapy. The Journal of Individual Psychology, 55, 272–287.

Landreth, G. L., Ray, D. C., & Bratton, S. C. (2009). Play therapy in elementaryschools. Psychology in the Schools, 46 , 281–289. doi:10.1002/pits.20374

Lee, C. C. (2001). Culturally responsive school counselors and programs: Addressingthe needs of all students. Professional School Counseling, 4, 257–261.

Penn, S. L., & Post, P. B. (2012). Investigating various dimensions of play thera-pists’ self-reported multicultural counseling competence. International Journalof Play Therapy, 21, 14–29. doi:10.1037/a0026894

Post, P. (2001). Child-centered play therapy for at-risk elementary school children.In A. A. Drewes, L. J. Carey, & C. E. Schaefer (Eds.), School-based play therapy(pp. 105–122). New York, NY: John Wiley.

Ramirez, S. Z., Flores-Torres, L. L., Kranz, P. L., & Lund, N. L. (2005). Using Axline’seight principles of play therapy with Mexican-American children. Journal ofInstructional Psychology, 32, 329–337.

Ray, D. C. (2007). Two counseling interventions to reduce teacher–child relationshipstress. Professional School Counseling, 10, 428–440.

Ray, D. C., Armstrong, S. A., Warren, E. S., & Balkin, R. S. (2005). Play therapypractices among elementary school counselors. Professional School Counseling,8, 360–365.

Ray, D. C., Lee, K. R., Meany-Walen, K. K., Carlson, S. E., Carnes-Holt, K. L., & Ware,J. N. (2013). Use of toys in child-centered play therapy. International Journalof Play Therapy, 22, 43–57. doi:10.1037/a0031430

Ray, D. C., Stulmaker, H. L., & Lee, K. R. (2013). Child-centered play therapy andimpairment: Exploring relationships and constructs. International Journal ofPlay Therapy, 22, 13–27. doi:10.1037/a0030403

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14

274 E. S. Davis and J. K. Pereira

Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationshipsas developed in the client-centered framework. In S. Koch (Ed.), Psychology: Astudy of a science: Vol. III. Formulations of the person and the social context (pp.184–256). New York, NY: McGraw-Hill.

Saldinger, A., Cain, A. C., Porterfield, K., & Lohnes, K. (2004). Facilitating attachmentbetween school-aged children and a dying parent. Death Studies, 28, 915–940.doi:10.1080/07481180490511993

Schottelkorb, A. A., Doumas, D. M., & Garcia, R. (2012). Treatment for childhoodrefugee trauma: A randomized, controlled trial. International Journal of PlayTherapy, 21, 57–73. doi:10.1037/a0027430

Spencer, R., Jordan, J. V., & Sazama, J. (2004). Growth-promoting relationshipsbetween youth and adults: A focus group study. Families in Society: The Journalof Contemporary Social Services, 85, 354–362. doi:10.1606/1044.3894.1496

Steffens, C., & Gorin, S. (2007). Learning to play, playing to learn: Curriculum andactivities for classroom and playground management (3rd ed.). Los Angeles,CA: Lowell House.

U.S. Census Bureau. (2010). Poverty: 2008 and 2009: American Community Surveybriefs. Retrieved from http://www.census.gov/prod/2010pubs/acsbr09-1.pdf

Van Velsor, P. (2009). School counselors as social-emotional learning consul-tants: Where do we begin? Professional School Counseling, 13, 50–58.doi:10.5330/PSC.n.2010-13.50

Vontress, C. E. (1996). A personal retrospective on cross cultural counseling. Journalof Multicultural Counseling and Development, 24, 156–166. doi:10.1002/j.2161-1912.1996.tb00298

Eric S. Davis, is an Assistant Professor in the Department of Psychology andBehavioral Studies at Argosy University, Tampa, Florida.

Jennifer K. Pereira, is an Assistant Professor in the Department ofCounseling Education at Argosy University, Tampa, Florida.

Dow

nloa

ded

by [

The

Uni

vers

ity o

f B

ritis

h C

olum

bia]

at 0

9:18

20

Nov

embe

r 20

14