16- Issues in Play Therapy

Chapter 16: (pp. 351-367)

Key Answer: B. It teaches children to only value therapy when rewarded

Explanation: Rewards such as stickers or candy make children view therapy as a performance for rewards rather than as a safe space for authentic expression. Play itself is intrinsically rewarding and does not require external reinforcement.

Which of the following best explains why giving a child candy or stickers at the end of a play therapy session is discouraged?

A. It makes children overly attached to the therapist
B. It teaches children to only value therapy when rewarded
C. It prevents children from forming emotional connections
D. It violates professional codes of ethics

Key Answer: B. Objects can be lost, while emotional growth remains with the child

Explanation: The therapeutic relationship is emotional in nature. What the child carries “in the heart” is more significant than any object, which can be lost. The goal is empowerment and independence, not attachment to a token.

Why is giving a child a tangible memento at the end of play therapy generally not recommended?

A. Children do not appreciate physical objects
B. Objects can be lost, while emotional growth remains with the child
C. Parents usually disapprove of gifts from therapists
D. It makes children dependent on material possessions

Key Answer: C. It communicates that their expressive “language” (play) is unacceptable

Explanation: Play is considered the child’s language. Requiring cleanup implies their expression was messy or wrong, potentially inhibiting free expression in future sessions. The therapist, not the child, restores the room.

Why is asking a child to clean up the playroom after a session discouraged in child-centered play therapy?

A. Children do not know how to clean properly
B. It wastes therapy time
C. It communicates that their expressive “language” (play) is unacceptable
D. It causes conflict with parents

Key Answer: B. Because it may shift the focus from the child to the problem

Explanation: Child-centered therapy focuses on the child’s self-expression and growth, not on fixing a problem. Telling children they are “in therapy because of X” risks labeling them as defective and making sessions problem-focused.

In child-centered play therapy, why is it unnecessary to inform children of the exact reason for their referral?

A. Because children are too young to understand problems
B. Because it may shift the focus from the child to the problem
C. Because parents already explained it to them
D. Because therapists must keep referrals secret

Key Answer: C. When the child has been sexually abused or is overly aggressive

Explanation: In cases of sexual abuse or aggressive behavior, the presence of peers can increase risks of reenacting harmful behaviors. These children typically require the therapist’s full attention in individual sessions.

When might it be inappropriate for a child to bring a friend into a play therapy session?

A. When the child has already had multiple sessions
B. When the child wants to show toys
C. When the child has been sexually abused or is overly aggressive
D. When the therapist has group play therapy training

Key Answer: C. Parents/siblings are usually excluded, but may view the playroom briefly at the end

Explanation: Parents and siblings are generally not present during play therapy sessions. However, brief visits after sessions may be permitted, provided they do not interfere with the therapeutic relationship.

Which of the following is most consistent with child-centered play therapy practice?

A. Parents and siblings are always allowed during sessions
B. Parents may join freely if the child invites them mid-session
C. Parents/siblings are usually excluded, but may view the playroom briefly at the end
D. Parents are expected to participate regularly

Key Answer: B. It can violate confidentiality and create competition among children

Explanation: Children’s artwork is a form of communication in therapy. Displaying it compromises privacy, influences other children’s play, and fosters competition, which undermines the therapeutic process.

Why should children’s artwork generally not be displayed on the playroom wall or hallway?

A. It discourages creativity
B. It can violate confidentiality and create competition among children
C. Parents usually object to displayed artwork
D. It is against school policies

Key Answer: C. Share only general impressions and avoid specifics

Explanation: Therapists balance confidentiality with parental involvement by providing general observations (e.g., “Chris seems angry”) without revealing specific behaviors or comments unless safety requires disclosure.

What is the general guideline for sharing information from sessions with parents?

A. Share every detail so parents know what they’re paying for
B. Share nothing, regardless of circumstances
C. Share only general impressions and avoid specifics
D. Only share if the child gives explicit permission

Key Answer: C. When the child reveals plans of self-harm or danger

Explanation: The therapist must ensure the child’s safety. Threats of suicide, running away, or serious harm require informing parents and guiding them in precautionary steps.

In which case must confidentiality be broken in play therapy?

A. When the child misbehaves in session
B. When parents insist on knowing details
C. When the child reveals plans of self-harm or danger
D. When the child shares family secrets

Key Answer: C. To follow the child’s lead and maintain boundaries

Explanation: The therapist may participate, but only as a following participant, keeping the child in the lead and maintaining professional boundaries, never as a playmate.

According to child-centered play therapy, what is the main role of the therapist when deciding whether to participate in the child’s play?

A. To lead the play and give structure
B. To act as a playmate and keep the child entertained
C. To follow the child’s lead and maintain boundaries
D. To prevent the child from making a mess

Key Answer: B. The child wants to test limits, gain approval, or feel secure

Explanation: Invitations to play may reflect the child’s search for approval, security, or a way of testing the therapist’s permissiveness rather than a true need for a playmate.

If a child invites the therapist to join play, what might this indicate?

A. The child simply needs more toys
B. The child wants to test limits, gain approval, or feel secure
C. The therapist is failing at therapy
D. The child has not yet learned to play independently

Key Answer: C. Following the child’s lead even if it means engaging in sexualized behavior

Explanation: Following the child’s lead never justifies harmful, sexual, or inappropriate actions. Boundaries and ethics override any request from the child.

Which of the following behaviors would be an unethical violation of child-centered play therapy boundaries?

A. Allowing the child to assign the therapist a role in pretend play
B. Refusing to spank or obey inappropriate commands from the child
C. Following the child’s lead even if it means engaging in sexualized behavior
D. Sitting with the child without actively playing

Key Answer: B. A flower picked by the child

Explanation: Non-purchased items (like a flower or artwork made by the child) are considered extensions of the child’s emotional expression and are acceptable. Purchased items risk obligation and blur emotional meaning.

Which type of gift is generally most acceptable for a therapist to receive in play therapy?

A. A purchased toy
B. A flower picked by the child
C. A box of chocolates from the store
D. A candy bar bought by parents

Key Answer: B. Decline gently, affirming the child’s thoughtfulness and redirecting

Explanation: Therapists should decline purchased gifts with empathy, highlighting the child’s emotional intent (“That shows you were thinking of me”) and affirming that no gift is needed to express feelings.

If a child brings a purchased gift, how should the therapist respond?

A. Accept it enthusiastically to avoid hurting the child’s feelings
B. Decline gently, affirming the child’s thoughtfulness and redirecting
C. Punish the child for breaking rules
D. Ignore the gift completely

Key Answer: B. The therapist’s emotional involvement and “being with” the child

Explanation: The therapist’s attitude of genuine presence and involvement (“being with”) is more crucial than whether or not the therapist actively plays. Children sense when the therapist is truly engaged.

What is emphasized as more important than the therapist’s actual play participation?

A. The therapist’s skill at drawing or role-playing
B. The therapist’s emotional involvement and “being with” the child
C. The therapist’s ability to entertain the child
D. The therapist’s strict adherence to rules