Effects and Mediation of Child-centered Play Therapy on Young Children Who Are Anxious

Anxiety is one of the most pervasive childhood disorders, with a poor prognosis if left untreated. Traditional methods of treating anxiety have been less effective with young children. Based on theoretical assumptions regarding the potential effectiveness of child-centered play therapy (CCPT) as a treatment approach, I sought to explore the effects and mediating factors of CCPT on young children with symptoms of anxiety. Fifty-three participants between the ages of 6 to 8 years old were recruited from four elementary schools, including 36 males and 17 females. Of participants, 11 were African American, 24 were Caucasian, 10 were Hispanic/Latino, one was Asian, and seven were biracial. Twenty-five participants were randomly assigned to an experimental group receiving a mean of 15 sessions of individual CCPT, and 28 participants were assigned to an 8-session active control group. Five factorial analyses of variance (ANOVA) were conducted applying an alpha level of .05 for interpretation of statistical significance and Cohen’s d to assess practical significance. ANOVA results indicated a statistically significant interaction with a large effect size on Total Anxiety score of the Revised Children’s Manifest Anxiety Scale-2nd edition (p = .013, d = .715). Subscale ANOVA results indicated a statistically significant interaction effect with large effect size on the Worry subscale (p = .006, d = .795), no statistically significant interaction on the Defensiveness subscale (p = .710, d = .110), no statistically significant interaction but moderate effect size on the Physiological subscale (p = .076, d = .506), and no statistically significant interaction but moderate effect size on the Social Anxiety subscale (p = .162, d = .398). Statistically significant differences with large practical effects were found in total anxiety and worry, suggesting that children who received CCPT decreased their overall levels of anxiety and worry whereas children who were in the active control group increased their levels of anxiety and worry. When examining differences in relationships between groups, the CCPT group relationship scores were significantly higher than the control group relationship scores, as reported by counselors. Although the groups were different in their relationships, the relationship was not considered a statistical mediator of anxiety due to the lack of correlation between relationship scores and outcome. Overall, children seemed to benefit from CCPT, and it may be considered a viable treatment for children who are anxious. Due to the lack of mediation of relationship found in this study, further research is encouraged to consider other mediating and/or moderating effects when attempting to investigate the therapeutic relationship as a mediator