Is Child-Centered Play Therapy Neuroaffirming?

When speaking of neuroaffirming approaches to therapy with young people, the way a therapist approaches and engages in a particular approach can often determine whether it is neuroaffirming or not. Although Child-Centered Play Therapy (CCPT) is not technically a technique or intervention, it is considered a neuroaffirming approach.

According to Garry Landreth, Founder and Director of the Center for Play Therapy at the University of North Texas and internationally-recognized for his writings and work with children, Child-Centered Play Therapy is “a philosophy for living one’s life in relationships with children,” or a way of being with children.

In CCPT, the basis for change and healing is the relationship between the therapist and client. It recognizes that a child can become a person and develop a self only in interactions with other people, and the self will grow and changes as a result of continuing interactions with other people. So it is vital that the relationship between therapist and client is built on safety and connection.

CCPT states that the capacity and resilience of children is “constructively self-directed” and an attitude of non-directivity on the part of adults is what promotes a child’s self-sufficiency. The overall mantra of CCPT is to “follow the child’s lead.” CCPT therapists trust the child to lead the therapy experience because the child is the expert of their experience. The child also knows where the relationship between child and therapist should go.  

Many neurodivergent children, particularly those with Autism, ADHD or AuDHD, struggle with a sense that they lack control, and if they perceive a lack of control, they do not feel safe. Play allows children to regain a sense of control. The freedom and control experienced by children in CCPT provides encouragement and the development of confidence, positive coping skills, experimentation, decision-making and problem-solving in a non-threatening way—with a safe adult, in a safe environment.

The play experienced in CCPT is also a cathartic way for children to express their experience of trauma in a safe environment. Fantasy play allows children to control and change their story. Symbolic play allows them to experience mastery of traumatic events because (1) They have the ability to regulate their distance to traumatic events in session through the use of materials and symbolism, and (2) They can control how and when they decide to confront their trauma, if they choose to do so.

This aligns closely with the neuroaffirming practice of shifting treatment goals and instead of thinking about what the child needs to learn or change in order to make things easier for others, it considers what the child can learn or adjust to reduce their distress and build their self-esteem. It also ensures that there is no attempt to reduce neurodivergent traits that do not cause a child any difficulty or distress, and that any goals are appropriate for that child’s developmental level and ability.

The Relationship

CCPT recognizes that no healing or support can be effective if the child doesn’t feel safe in the relationship. The way to provide this sense of safety is through consistency, predictability, enforcing limits and a warm caring approach. Warm caring and acceptance grant the child permission to be fully themselves.  And as the child feels understood by the therapist, they feel encouraged to share more of themselves.

CCPT focuses on the present experience with the child and considers:

1.         The person rather than the problem

2.         The present rather than the past

3.         Feelings rather than thoughts or actions

4.         Understanding rather than explaining

5.         Accepting rather than correcting

The presence of unconditional positive regard (showing complete support and total acceptance of a person, regardless of what they say, do, or feel) is also neuroaffirming. And in CCPT, the therapist takes a step further and takes time to develop knowledge about a client’s interests to help strengthen that connection. This helps build attunement where the therapist can tune in to a client’s thoughts and feelings to better understand their experience. Lastly, CCPT and neuroaffirming therapy share a respect for consistency – because clients need to know that each time they see us, we will interact with them in the same, predictable way.  

Most of what is learned by children in play therapy is not a cognitive learning, but developing an experiential intuitive learning about the self that occurs over the course of the therapeutic experience, so by design, CCPT is affirming to a child’s identity, no matter what that identity might be.

Tara McDonnell, LCSW, RPT-S