The latest estimates from Play Therapy UK (PTUK) show that as many as 23,000 play therapists are needed in the UK, up 19 per cent since the previous Census. This is mainly due to the growth in the population of children aged from four to 12 and also an increase in the number of sessions that an average child requires (from 12 to 15).
It is estimated that around 1,800 primary schools either use teaching staff in a dual role or contract out a therapy service to an individual practitioner or an external charity or organisation. Teachers and teaching assistants with at least two years' experience are well-qualified for training as registered play therapists. The overriding consideration is the need for a service that is safe, effective and sustainable.
Why is play therapy effective?
There are many modalities of therapies. Most are used with adults and based on talking. However, many children either cannot or will not talk about their problems. Play therapy uses creative arts media as well as other forms of play which access unconscious as well as conscious processes.
The children choose the medium. The therapist is trained to communicate with the child using the chosen medium. On average only seven per cent of the session time is spent by the child in talking. The proportion rises with age to 14 per cent, still only a small percentage and yes, girls do talk more than boys, even at a young age.
Measuring outcomes
One of the chief criticisms of some organisations providing play therapy services is that they fail to show how the money is spent in terms of precise measured outcomes, as opposed to their activities.
The clinical outcomes of play therapy, which is effective for primary school pupils, are easily measured using the Goodman Strengths and Difficulties Questionnaire. This has been used in two national surveys of the Mental Health of British Children and is highly regarded as a good all-round psychometric instrument. It takes about 10 minutes to be completed by the teacher and optionally by the parent. It is quick to score.
By taking pre and post-therapy measures, the changes in the pupils' emotional, behaviour and other mental health issues can be measured. The latest analysis of PTUK's national database of more than 25,000 cases shows that 73 per cent of all children show a positive change after they have received therapy delivered to PTUK's standards; 83 per cent of children with severe issues show a positive change.
Focus on the main objectives
Schools should focus on the support that therapy provides in enabling the potential of each pupil to learn, in the broadest sense. This is also fairly straightforward to measure once the school has agreed its therapy-related objectives, such as improved concentration on work, better listening, communication skills, reduced unauthorised absences etc.
A sound financial model
As a benchmark, PTUK's data shows that an average of 15 sessions is required at an average cost of £45 per session – i.e. £675 per pupil – to achieve the outcomes shown above. However, children at risk and who are not capable of functioning normally will need many more sessions than average.
How can a school prove the potential effectiveness of a play therapy service, without committing to a significant budget and so that expectations can be managed?
PTUK's accredited training provider working in a collaborative partnership with Leeds Beckett University manages one-year pilot schemes nationwide that test the feasibility, effectiveness and compatibility of a new service. The cost to a school is a few hundred pounds. This programme has a present capacity of 300 new schemes a year and is not dependent upon government, local authority or charitable funding.
Delegation without control
It is vital that the headteacher or an appointed deputy maintains tight control and integration of a play therapy service within the school. This means no "black boxes" where nobody knows exactly what is going on, no therapists "hiding" in their play room, but regular meetings and presentations to all school staff. Without breaking the personal confidentiality of the pupil's therapy, the progress of the pupil can and should be regularly reported upon. PTUK advises its registrants upon the format and content of service management reports and provides free software to produce them efficiently.
Quality assurance
Fortunately for schools there is now a robust method of quality assurance – only use therapists who are on a register overseen by the Professional Standards Authority (PSA).
Unfortunately too many examples keep coming to light of unsafe practice in schools. Too many schools are using organisations whose staff are not on an accredited register. An Ofsted official has stated that "it is not sufficient just to have a Disclosure and Barring Service check, when working with pupils' minds, they must be adequately trained and clinically supervised".
The PSA reports directly to Parliament and oversees all health and social care professions in the UK. In 2012, it was commissioned to produce a new more effective programme of registering health professions using Right Touch Regulation principles. This programme of Accredited Registers (AR) now includes play therapists, counsellors and child psychotherapists. There are a number of standards that an AR must meet and which are checked each year. They include protection of the public, public confidence, good risk-management, financial viability, ability to manage a register, corporate governance, registrant standards of practice, education/training and an effective complaints procedure.
- Jeff Thomas is the registrar of Play Therapy UK, a not-for-profit professional organisation whose register is concerned specifically with therapeutic work with children. Visit www.playtherapyregister.org.uk. For more on Play Therapy UK, go to www.playtherapy.org