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Therapeutic Play Continuum - Defining Variables

Twelve variables are used to help to define each level in the continuum.
These variables are then used in a matrix which provides contextual definitions. Alternatively see the simplified definitions: Play   Play Work   Therapeutic Play Work  Therapeutic Play Filial Play   Play Therapy  Child Psychotherapy and Clinical Psychology (CPCP)

The 12 defining variables are:
  1. Objectives of the application
  2. Types of Intervention
  3. Description & Role of the Provider
  4. Age Range (Emotional)
  5. Environment
  6. Play or Creative Art Content (Proportion)
  7. The Degree to which Psychological Theories are applied
  8. Safety Issues
  9. Clinical Supervision
  10. Quality Management Aspects
  11. Code of Ethics
  12. Degree and Type of Training

The objectives of the use of play are a good place to start defining each level. The role of play ranges, through a number of levels of the continuum, from enjoyment and self development (‘pure’ play) at one end to acting as an adjunct to talking therapies at the other end. One way of defining the objectives of therapy where mental health and emotional state is involved is the level of the client’s functioning. Another way of describing objectives is the severity of the condition(s) that play is intended to alleviate. See examples below.

Degree of Condition




Hospitalisation for a minor operation Temporary impairment of well being; minor loss of functioning


Relationship issues: friendships, sibling rivalries Some loss of well being, on going impairment of functioning preventing the child reaching their full potential


Stress and trauma Child feels emotionally unwell, has considerable impairment of functioning, problems need to be dealt with promptly to prevent further deterioration.


Repeated physical and sexual abuse from several sources Mental illness or disorder; child at risk and unable to function as a normal person.

If conditions at any level are not treated and resolved with appropriate intervention then they may progress to a higher level.

This attribute indicates the type of intervention, if any, used to achieve the objective. Some interventions are therapeutic, others are not. This attribute also leads to consideration of the nature of activities that are required.

In these definitions it is assumed that there is a provider of care of some kind to provide, supervise or mediate the play activities. In the vast majority of cases this will be an adult but in some cases it could be another, normally older, child. This attribute helps to distinguish the level of skill required for the different applications of play.

This attribute is useful to separate some applications from others. The emotional age of the child, rather than the actual age, should be used.

One of the most important distinguishing points is the amount of knowledge that is needed of the informing psychological theories.

The more that interventions use psychological based techniques the greater the necessity for clinical supervision to make the client and therapy practice safe.

A further distinguishing factor is the environment in which play is used. Is it for example a clinical or non clinical environment?

The environment together with the type of intervention will determine the safety considerations - physical, emotional, psychological.

Another consideration is the extent to which play is used in the application. This may range from 100% where play is the sole activity to perhaps less than 5% where play is used as an adjunct to another type of therapy or activity.

In any application where play is ‘administered’ there is a need for some form of quality management which may range from simple basic monitoring to quite complex clinical governance procedures and systems.

Where any professional worker is involved with children observance of an ethical framework or code of ethics is essential.  This may be one of a professional organisation such as PTA or that of an employing organisation.

All of the above factors, when considered for a particular application of play, give a good indication of the degree and type of training required.

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