Prescriptive play therapy

Domain VIII · Creative & expressive arts therapies · Charles Schaefer, Heidi Kaduson, Donna Cangelosi · 1997

What it is

Prescriptive play therapy is a framework for choosing and combining play therapy approaches, not a single school with its own fixed techniques. Charles Schaefer (1933–2020; co-founder of the Association for Play Therapy with Kevin O'Connor in 1982) and colleagues first presented it in The Playing…

Format

• The published sources cited describe a sequence of assessment, case formulation, treatment planning and intervention rather than a numbered phase protocol with fixed session counts. Nash and Schaefer describe play therapy generally as moving through rapport building, working through and…
• Phase 0. Referral and parent/carer intake (session 1, adults only).

Who practises it, and how they are trained or regulated

• Drewes's demonstrated session structure for middle childhood (ages 6–12): (1) check-in; (2) directive, play-based techniques targeting the presenting problem; (3) a nondirective, child-led period for relaxation and self-regulation.
• Version followed: prescriptive play therapy as set out by Kaduson, Cangelosi and Schaefer in Prescriptive Play Therapy: Tailoring Interventions for Specific Childhood Problems (Guilford, 2019; 276 pp.), read together with Schaefer and Drewes's The Therapeutic Powers of Play: 20 Core Agents of Change (2nd ed., Wiley) and Drewes's prescriptive-integrative session model (APA video, 2017). Source status: the Guilford…
• Prescriptive play therapy is a framework for choosing and combining play therapy approaches, not a single school with its own fixed techniques. Charles Schaefer (1933–2020; co-founder of the Association for Play Therapy with Kevin O'Connor in 1982) and colleagues first presented it in The Playing Cure: Individualized Play Therapy for Specific Childhood Problems (1997, with Kaduson and Cangelosi) as an eclectic,…

Evidence status, as the guide reports it

• Overall length. No fixed course is prescribed. Nash and Schaefer report that two meta-analyses found about 30–35 sessions associated with the best outcomes. Treat this as an outcome-research average, not a protocol length.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• new play forms appearing spontaneously.
• spontaneous smiling, and initiating play.
• confusion if the pattern changes without warning.
• hopeful themes; the child naming people who help.
• spontaneous comments on others' feelings; repair attempts.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.