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Theraplay Treatment Outcome Research

Theraplay has evidence-based status. Theraplay has been accepted by the U.S. Substance Abuse and Mental Health Services Administrationfor inclusion on the National Registry for Evidence-based Programs and practices

Theraplay has also been rated as demonstrating “promising research evidence” by The California Evidence-Based Clearinghouse (December, 2009). The Clearinghouse rates programs on a scale of 1-5. Ratings from 1-3 indicate that the program is well-supported by research, with a rating of 1 being the highest attainable.

With a rating of 3, Theraplay has been judged to meet the following standards:

  1. Two peer-reviewed studies utilizing some form of control have been published.
  2. The outcome data support the benefits of Theraplay.
  3. A manual is available: Theraplay: Helping children and parents build better relationships through attachment-based play, Booth and Jernberg, 2010.
  4. No empirical or theoretical evidence exists that Theraplay has a substantial risk of harming clients as compared to its possible benefits.

Theraplay has been rated as a promising practice by Washington State Inventory of Evidence-Based, Research-Based, and Promising Practices.  For Prevention and Intervention Services for Children and Juveniles in Child Welfare, Juvenile Justice, and Mental Health Systems under "Mental Health".  

Published research in peer-reviewed journals: Controlled Studies

Siu, A.F.Y. (2009). Theraplay in the Chinese world: An intervention program for Hong Kong children with internalizing problems. International Journal of Play Therapy18(1), 1-12. (Download .pdf)

A primary objective of this study was to evaluate the effectiveness of Theraplay on reducing internalizing problems among children. Described as at-risk for developing internalizing disorders, 46 children in grades 2-4 were randomly allocated to either the Theraplay condition (weekly Group Theraplay for 8 weeks) or the wait-list control condition. A standardized measure of internalizing symptoms (CBCL) was completed before and after the 8-week period. Results showed that children from the Theraplay condition showed significantly fewer internalizing symptoms when compared to the waitlist group.

Siu, A.F.Y. (2014). Effectiveness of Group Theraplay® on enhancing social skills among children with developmental disabilities. International Journal of Play Therapy23(4), 187-203.

Theraplay® is a play therapy approach that helps children form better relationships and attachments with others. It focuses on the nonverbal aspects of interaction. This study reports on a Group Theraplay program in a special school for children with developmental disabilities. Twenty-three students, arranged into four groups, participated in the year-long program that used Theraplay principles to enhance their social development. Results were compared with a group of 15 students who served as the comparison control. Data from the Social Responsiveness Scale showed that students from the Theraplay group had significant improvement in the subscale of “social communication” when compared with the comparison group. Feedback from teachers suggested new ideas in working with this group of children. A discussion of the rationale behind why Theraplay works for these children was presented. The limitations of this study and directions for future research are addressed.

Weir, K.N., Lee, S., Canosa, P., Rodrigues, N., McWilliams, M., & Parker, L. (2013). Whole Family Theraplay: Integrating Family Systems Theory and Theraplay to Treat Adoptive Families Adoption Quarterly, 16 (3-4), 175-200. 

http://www.tandfonline.com/doi/abs/10.1080/10926755.2013.844216#.UrnQJaUw1z9 (Article Link

This article regarding the effectiveness of Theraplay for the clinical treatment of adoptive families both outlines a model for integrating family systems theory with Theraplay to create a new approach entitled Whole Family Theraplay (WFT), as well as provides a preliminary report of a pilot study demonstrating the efficacy of that model. WFT integrates Theraplay with family systems approaches (Structural and Experiential Family Therapies) to treat parents and all the siblings within adoptive families. The findings indicate that WFT treatment may lead to statistically significant benefits in regard to family communication, adults’ interpersonal relationships, and children’s overall behavioral functioning.

Wettig, H. G.; Coleman, A. R.; Geider, F. J. (2011). Evaluating the effectiveness of Theraplay in treating shy, socially withdrawn children. International Journal of Play Therapy, 20(1), 26-37.

This study assessed the efficacy for dually diagnosed children with language disorder and shyness/social anxiety. Study 1 was longitudinal, with 22 children treated at a single institution by 1 therapist. Study 2 incorporated 167 subjects and therapists across multiple centers to evaluate generalizability. Results showed that children improved significantly on assertiveness, self-confidence, and trust. Social withdrawal was reduced. Expressive and receptive communication improved. Improvements were maintained over a 2-year period with no cases of relapse.

Published research in peer-reviewed journals: Model Reviews

Bennett, L.R., Shiner, S.K. and Ryan, S. (2006). “Using Theraplay in Shelter Settings with Mothers and Children Who Have Experienced Violence in the Home”, Journal of Psychosocial Nursing and Mental Health Service, 44 (10), 38-47.

Finnish peer-reviewed medical journal: Comparison of Theraplay model to Circle of Security, Wait, Watch and Wonder, Reflective Functioning, Cognitive behavioral Therapy, Incredible Years, Parent Child Interaction Therapy, Positive Parenting Program.

Fuller, W. (1995). Theraplay as a treatment for autism in a school-based day treatment setting. Continuum The Journal of the American Association for Partial Hospitalization 2, 2, 89-93.

Makela, J. (2005). The Importance of Touch in the Development of Children. Finnish Medical Journal, 60,1543–9.

Published research in peer-reviewed journals: Case or Program Descriptions

Makela, J. & Salo, S. (2011) Theraplay –vanhemman ja lapsen välinen vuorovaikutushoito lasten mielenterveysongelmissa. (Theraplay- Parent-child interaction treatment for children with mental health problems) Duodecim 127, 29-39.

Robison, M., Lindaman, S., Clemmons, M.P., Doyle-Buckwalter, K. & Ryan, M. (2009). “I Deserve a Family”: The Evolution of an Adolescent’s Behavior and Beliefs About Himself and Others When Treated with Theraplay in Residential Care. Child and Adolescent Social Work Journal. Vol. 26, Number 4, 291-306.

Tucker, C., Schieffer, K., Wills, T., Hull, C. and Murphy, Q. (2017). "Enhancing Social-Emotional Skills in At-Risk Preschool Students Through Theraplay Based Groups: The Sunshine Circle Model." International Journal of Play Therapy, No Pagination Specified (click here for abstract)

Other publications:

Cort, L. & Rowley, E. (2015). A case study evaluation of a Group Theraplay intervention to support mothers and their preschool children following domestic abuse (Research in Brief). British Psychological Society, Debate 156.

Makela, J. & Vierikko, I. (2005) From heart to heart: Interactive therapy for children in care. Report on the Theraplay project in SOS Children’s Villages in Finland 2001-2004. The SOS Children’s Villages Association, Finland.

Salo, S., Lampi, L. &Lindaman, S. (2010) Use of the emotional availability scales to evaluate attachment-based intervention-Theraplay-in substance abusing mother-infant dyads in Finland. Infant mental health Journal Supplement 2010: 32:77.

Theraplay Research