Childhood trauma can have deep, lasting effects on a child’s emotional, cognitive, and social development. Children who experience traumatic events—such as abuse, neglect, the death of a loved one, or exposure to violence—may find it difficult to process their emotions and cope with the overwhelming feelings these events bring. Traditional therapy approaches may not always be suitable for young children, especially those who struggle to express themselves verbally. Child-Centred Play Therapy (CCPT) is a highly effective, developmentally appropriate therapeutic approach that supports children with trauma. It allows them to process their experiences in a way that suits their developmental stage and communication abilities.
Understanding Child-Centred Play Therapy (CCPT)
Child-Centred Play Therapy, developed by Virginia Axline in the 1940s, is based on the belief that play is a natural form of communication for children. It involves providing children with a safe, supportive environment where they can use toys, art, and role-playing to express their feelings, explore experiences, and work through trauma. In CCPT, the therapist takes a non-directive role, allowing the child to lead the session. This approach enables the child to engage with their emotions at their own pace, fostering healing and growth. The therapist’s role is to provide empathetic listening, validation, and emotional support, ensuring the child feels accepted and understood.
Why CCPT is Developmentally Appropriate for Children with Trauma
For children, particularly those affected by trauma, play often becomes the most accessible way to express complex emotions that they might not yet have the vocabulary or emotional capacity to verbalise. CCPT is particularly suited to the needs of young children because it meets them where they are developmentally, allowing them to process emotions non-verbally. Several features of CCPT make it an ideal therapeutic strategy for children who have experienced trauma:
Non-Verbal Expression
Children who have experienced trauma may find it difficult to articulate their emotions. Play offers a safe, non-verbal avenue for emotional expression. Through play, children can express fear, anger, or sadness indirectly. For example, a child who has witnessed domestic violence may use dolls or action figures to recreate scenes of conflict, illustrating their inner turmoil without having to directly confront it. This form of expression allows children to make sense of their experiences in a way that feels safe.
Safety and Control
Trauma often leads children to feel powerless. CCPT provides a space where the child has control, as they are able to choose how they engage with the toys and activities. This sense of autonomy can help restore a feeling of security and control. For example, a child who has experienced abuse may feel empowered when they can decide what toys to use and what scenarios to create. This regained sense of control is an important step towards emotional healing.
Emotional Regulation
One of the main goals of CCPT is to help children develop emotional regulation skills. Trauma can disrupt a child's ability to manage their emotions effectively, leading to outbursts, withdrawal, or difficulty forming healthy relationships. Through play, children learn to process and understand their feelings. A child who repeatedly uses play to express frustration or anger, such as smashing clay, may eventually learn healthier ways to express those feelings with the therapist's support.
Building Trust and Relationships
For children who have experienced neglect or abuse, developing trust in others can be a major challenge. CCPT is built on the foundation of a strong therapeutic relationship, in which the child feels heard, understood, and accepted without judgement. This relationship is crucial for rebuilding attachment and safety, allowing the child to form healthy relational patterns. For children who have been let down by adults, CCPT offers an alternative model of a supportive, safe, and consistent adult relationship.
Case Studies Demonstrating the Effectiveness of CCPT for Children with Trauma
Case Study 1: Sarah, A 6-Year-Old Child from an Abusive Home
Sarah, a 6-year-old child, was referred for therapy after experiencing emotional and physical abuse in her home. She displayed signs of anxiety, hyperactivity, and withdrawal in school and had difficulty expressing her emotions verbally. During the first few sessions, Sarah engaged with dolls and stuffed animals, using them to act out scenarios of conflict and aggression, mirroring the violence she had witnessed. The therapist used empathetic listening, reflecting Sarah's feelings of fear and sadness, which helped her process these emotions. Over time, Sarah’s play shifted from aggressive reenactments to more controlled problem-solving scenarios. Through CCPT, Sarah was able to gain emotional regulation, rebuild her sense of safety, and feel more connected to her school environment.
Case Study 2: Max, A 9-Year-Old Survivor of a Car Accident
Max, a 9-year-old boy, was referred to therapy after a traumatic car accident that left him with severe anxiety about riding in cars. Max struggled to verbalise his feelings of fear and helplessness but found comfort in using toy cars during therapy. At first, Max re-enacted the accident with the cars, repeating the traumatic event. The therapist allowed Max to express his fear while also guiding him to explore scenarios of safe driving and positive experiences in cars. Over time, Max's play reflected a shift towards control and mastery, where he "took charge" of car safety. By the end of therapy, Max had re-established a sense of safety and was able to get into a car without experiencing overwhelming anxiety.
Linking Social Work Theory to CCPT
As a social worker I utilise Person-Centred Theory by Carl Rogers to inform my framework for CCPT. The core principles of Person-Centred Theory align closely with the fundamental components of CCPT. These include the importance of empathy, unconditional positive regard, and congruence in the therapeutic relationship. Using CCPT enables me to create a safe, accepting space where the child feels heard and understood, fostering a sense of trust and emotional healing.
Additionally, I draw heavily on the Ecological Systems Theory, developed by Urie Bronfenbrenner, to provide a framework for understanding how a child's development is influenced by multiple layers of their environment, including their family, school, community, and society. CCPT recognises that trauma does not occur in isolation and seeks to understand how external factors (such as family dynamics or community violence) shape a child's emotional experience. This theory allows me to see the child within the broader context of their environment, acknowledging the external factors contributing to their trauma while providing interventions that focus on the child’s inner world.
CCPT as a Focused Psychological Strategy when advocating for medicare approval
CCPT fits within the context of Focused Psychological Strategies (FPS) as outlined in the Australian Psychological Society’s guidelines. FPS are interventions that are tailored to meet the specific needs of individuals based on their developmental stage, and CCPT aligns with this approach by being a flexible, child-friendly method that addresses the psychological impacts of trauma. By facilitating emotional expression and regulation, CCPT helps children process trauma in a developmentally appropriate way, offering a focused and targeted intervention for children who may be struggling to verbalise or process their experiences. CCPT fits within the FPS criteria for behaviour interventions and skills training.
Conclusion
Child-Centred Play Therapy offers a developmentally appropriate, effective approach to supporting children with trauma. By allowing children to express their emotions through play, CCPT enables them to process and work through difficult experiences in a safe and non-judgmental environment. For children who have experienced trauma, this form of therapy offers the chance to rebuild trust, emotional regulation, and a sense of control. From a social work perspective, CCPT draws on key theories, such as Person-Centred Theory and Ecological Systems Theory, to provide holistic support that considers the child's broader environment. Through its empathetic and child-centred approach, CCPT remains one of the most effective interventions for traumatised children in Australia.
References:
Bratton, S. C., Ray, D., Rhine, T., & Jones, L. (2005). Play therapy: A comprehensive guide to theory and practice. Guilford Press.
Landreth, G. L. (2002). Play therapy: The art of the relationship. Brunner-Routledge.
Thiel, L. A., & Kalu, M. (2017). Trauma-focused play therapy: A review of clinical research and implications for practice. Child and Adolescent Social Work Journal, 34(2), 175-185.
Rogers, C. R. (1961). On becoming a person: A therapist's view of psychotherapy. Houghton Mifflin Harcourt.
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
Comments