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Play in Child Development and Psychotherapy: Toward Empirically Supported Practice

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Children’s pretend play is a complex phenomenon. Pretend play involves
a myriad of processes and behaviors that change from moment to
moment. Does pretend play have important functions in child development,
or is it simply something children engage in to pass the time—albeit
while having fun? This is a central question in the field of child
psychology today. It is an especially important question for child therapists.
Practitioners of a variety of theoretical persuasions use play in
working with children. As of 1992, play in some form was used in child
therapy by a majority of clinicians, according to Koocher and D’Angelo
(1992), who stated that “play-oriented therapy remains the dominant
and most enduring approach to child treatment ... practiced by clinicians
(p. 458). Many therapists use play because it is a natural activity and form
of communication of young children. Also, different theoretical schools
stress the importance of pretend play in the therapy process. Psychoanalytic,
psychodynamic, client-centered (nondirective) approaches, and
cognitive-behavioral approaches as well, have proposed that change occurs
in the child through the process of play.

What is the evidence for this proposition? The movement toward empirically
supported treatments is gaining increasing momentum. It is crucial
for the development of scientific principles of behavior change. Also,
the managed care system will be looking to research for guidance about its
policies. If play is to continue to be used as a major treatment modality, its
effectiveness must be empirically demonstrated.
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