Non-directive and integrative play therapy (BAPT)

1. Introduction

Version followed: UK professional practice as set out by the British Association of Play Therapists (BAPT), mainly its Play Therapy Core Competences (2022), its Ethical Basis for Good Practice in Play Therapy (2023 edition), and its guidance for parents and carers and for schools. Non-directive technique follows Wilson & Ryan, Play Therapy: A Non-Directive Approach for Children and Adolescents (2nd edn, 2005), of which only the contents page is drawn on. The Play Therapy UK (PTUK) Integrative Holistic Model and the Play Therapy Dimensions Model are covered as a separate, contrasting UK version. The child-centred skills themselves (Axline's principles, tracking, reflecting, limit-setting) are written up in full in 157 Child-centred play therapy. This guide cross-refers to that tab and does not repeat it. Moustakas's relationship approach, one root of the non-directive tradition, is in 156 Relationship play therapy.

What it is. "Non-directive and integrative play therapy (BAPT model)" is not a single manualised therapy. It is the way BAPT, the main UK professional body, frames the discipline. Play Therapy is a postgraduate-trained mental health therapy that BAPT calls "child-centred, in which play is the primary medium and speech is the secondary medium" [source: BAPT, What is Play Therapy?]. On that child-centred base, BAPT-trained therapists are expected to understand directive, non-directive and developmental approaches and to integrate them [source: BAPT Core Competences, competence 5]. Historically, British play therapy grew from Axline's non-directive work, taught in the UK from the 1980s. Jennings and Cattanach later brought elements of it into a British integrative tradition [source: BAPT, History of Play Therapy].

How change happens. The child leads the play, chooses the materials, and does not have to explain anything in words. The therapist follows the play and reflects the child's feelings back. Within a consistent, confidential relationship, the child works through muddled feelings and upsetting events in symbolic form, at their own pace [source: BAPT, Information for Parents and Carers]. BAPT names the hoped-for gains as more confidence in expressing feelings, a richer emotional vocabulary, better social behaviour and self-esteem, better concentration, and more creative play [source: BAPT, What is Play Therapy?]. Wilson & Ryan place this inside a Piagetian account of symbolic play, with attachment theory added in the 2nd edition [source: Elsevier book page; contents only].

Professional frame. In the UK, "Play Therapist" is not an HCPC-regulated title. Registration is voluntary, through registers accredited by the Professional Standards Authority (PSA). BAPT keeps a PSA Register of Play Therapists [source: BAPT, What is Play Therapy?, link to PSA Register]. According to BAPT, a registered therapist should:

• be qualified at postgraduate or master's level;
• hold a current enhanced DBS check (or PVG in Scotland);
• have public liability insurance;
• receive clinical supervision;
• follow the BAPT Ethical Basis;
• have safeguarding training.

[source: BAPT, Information for Parents and Carers]

BAPT also says Play Therapy must be delivered by a "qualified and registered therapist". It separates this from therapeutic play: less structured work that nurses, teachers or parents can run after basic training [source: BAPT 2024 statement on Play Therapy vs Therapeutic Play].

Distinction from PTUK. Play Therapy UK (PTUK, Solihull) is a separate organisation. Its members practise and train in the Integrative Holistic Model (IHM), created by Monika Jephcott in 2002. The IHM integrates "the full therapeutic ToolKit of play and art media" with a holistic (developmental, relational, physiological) view of the child [source: PTUK, IHM page]. PTUK has also adopted Yasenik & Gardner's Play Therapy Dimensions Model (PTDM) as a standard for practice and supervision [source: PTUK, PTDM page]. Whether PTUK's register is also PSA-accredited is not confirmed in the pages [uncertain].

If you are a psychotherapist without a play therapy qualification, use the relational stance described here. Do not offer "Play Therapy" under that name, and do not take on this work with traumatised or maltreated children, until you have completed postgraduate play therapy training and arranged supervision with a play therapist. BAPT's ethics require you to work within your competence and to train and be supervised before taking on a new client group [source: BAPT Ethical Basis 4.7–4.9].

2. Framework

BAPT publishes no fixed phase protocol. The phases below combine the Core Competences (assessment → planning and contracting → intervention with monitoring → planned endings) with BAPT's parent and school guidance [source: BAPT Core Competences 18–21; BAPT Play Therapy in Schools]. Wilson & Ryan's chapters follow a similar line: process, assessment and planning, practice skills, and statutory settings [source: Elsevier contents]. Their internal stage model is not drawn on here [uncertain].

BAPT's schools guidance sums up the frame in its "Five Essential C's": Confidentiality, Consistency, Commitment, Consent and Child Protection [source: BAPT Play Therapy in Schools].

A tension between versions. BAPT's guidance for parents says the work is non-directive with no therapist-set agenda. Its 2024 statement says sessions are "planned and guided" towards specific goals. In practice, read these at two levels [synthesis]. The goals and the plan sit at case level (assessment, objectives, reviews). Inside each session, the child leads, and you move towards more directive work only for a clinical reason you can name and take to supervision.

3. Guiding principles

• Child-centred base [source: BAPT What is Play Therapy?]: whatever technique you add, the child's pace and choice come first.
• Play first, speech second [source: BAPT]: you never require the child to explain play in words.
• The child leads; the therapist follows and reflects [source: BAPT Parents]: no agenda for the content of a session (see 157 for the skills).
• Integrate on purpose [source: Core Competences 5, 20]: you may move between non-directive, directive and developmental methods, but each move is matched to the child's needs and agreed objectives.
• Consistency is the container [source: BAPT Parents; Schools]: same time, day, room and materials every week. Treat changes as clinical events.
• Confidential, with limits stated up front [source: BAPT Parents; Ethical Basis 3.4]: the child, carers and professionals all hear the safeguarding exception before therapy starts.
• Consent from adults, assent from the child, both recorded [source: Ethical Basis 3.9]: the child's assent counts even when the child cannot legally consent.
• Systemic awareness [source: Core Competences 3, 7, 28; Ethical Principle G]: family, school and agency all shape the child, so include the people who matter in decisions.
• Safety and stability before depth [source: BAPT Parents]: do not start, or pause, intensive work while the child is unsafe or in transition.
• Safe playroom and materials [source: Core Competences 29]: risk-assess the room and kit, keep them in good repair, and keep stored artwork confidential.
• Monitor outcomes [source: Ethical Principle B; Core Competences 20, 31]: review progress against the objectives and change the plan if it is not working.
• Anti-discriminatory practice [source: Core Competences 9, 25]: choose materials, dolls, figures and language that reflect the child's identity and culture.
• Competence and supervision [source: Ethical Basis 1.4, 4.7–4.10]: regular formal supervision, independent of line management, with a qualified play therapist where possible.
• Planned endings [source: Core Competences 21; Schools]: always plan the ending, and work through it over weeks.
• No diagnostic over-reading [synthesis]: play themes are clinical material, not evidence of abuse or disorder.

4. Intervention inventory

BAPT's sources name competences, not scripted procedures. Each item below gives the source for what is required. Where the steps go beyond the sources, they are marked [synthesis]. For the moment-to-moment non-directive responses (tracking, reflecting feelings, returning responsibility, therapeutic limit-setting, Axline's eight principles), use 157 Child-centred play therapy. BAPT's history page says Axline's eight principles "still inform many Play Therapists" in the UK [source: BAPT History].

4.1 Referral screening and timing

• Purpose: decide whether play therapy is right now, or whether safety and stability work must come first [source: BAPT Parents].
• Steps:
  1. Get the referral reason, history (trauma, loss, placement moves), current safeguarding status, and who holds parental responsibility.
  2. Check the three BAPT cautions: is the child still at risk of harm? Are the carers stable and supported? Is a major transition (school, home, carers) under way? If yes to any, defer, or offer carer or professional consultation instead (see 4.15) [source: BAPT Parents; Ryan 2004].
  3. Check the referral is within your competence (age, disability, complexity). Refer on if not [source: Ethical Basis 4.7–4.9].
  4. Note the setting's safeguarding lead and procedures before the first session [source: BAPT Schools].
• Example language (illustrative): "Before we start, I need to know Sam is settled where he is living. If a move is likely in the next few weeks, it may be kinder to wait, or for me to work with you first."
• Watch for: pressure to start straight away so a placement "holds". Name the risk of a premature ending and record your reasoning.

4.2 Assessment and setting objectives

• Purpose: assess emotional, psychological and social needs and set therapeutic objectives [source: Core Competences 18]. Wilson & Ryan give a full chapter to assessment and planning [source: Elsevier contents; chapter not drawn on, uncertain].
• Steps:
  1. Take a history from carers covering development (Core Competences 1–2: attachment, trauma, disability), family and culture, and school functioning.
  2. Meet the child in the playroom. Observe how they use materials, the level of their symbolic play, how they relate to you, and how they regulate themselves. This is observation, not testing [synthesis].
  3. Gather views from school or the social worker where relevant [source: Core Competences 28].
  4. Write two to four plain-language objectives (for example "can name and show anger without hurting others") that carers and the referrer can see changing [synthesis].
  5. Choose a baseline measure if your service uses one. BAPT requires monitoring but names no instrument [source: Ethical Principle B; uncertain which measure].
• Example language (illustrative), to the child: "This is the playroom. You can play with almost anything here in the way you want. I'll be here with you."
• Watch for: reading play themes as proof of abuse. Play content is never evidence on its own (see 5.8).

4.3 Contracting, consent and assent

• Purpose: agree aims, objectives, boundaries and rules through a therapeutic contract [source: Core Competences 19]. Obtain valid consent and the child's assent [source: Ethical Basis 3.9; BAPT Schools].
• Steps:
  1. Confirm who has legal authority to consent. Be careful with separated parents, looked-after children (local authority or carer delegated authority) and court involvement [synthesis].
  2. Get written consent from the parent, carer or person with legal responsibility before therapy starts [source: BAPT Schools]. BAPT publishes an example consent form; it is not drawn on here [uncertain].
  3. Get the child's verbal assent before starting, in words they understand. Explain the aims, the boundaries and what will happen. Take account of the child's preferences and best interests [source: BAPT Schools; Ethical Basis 3.9].
  4. If you are a trainee, tell the child and the guardian [source: Ethical Basis 3.9].
  5. For court-ordered work, tell the child and the person with legal responsibility, beforehand, what the service is and where confidentiality stops [source: Ethical Basis 3.9].
  6. Record consent, permission and assent [source: Ethical Basis 3.9]. Re-check assent if the child starts resisting coming (see 5.2) [synthesis].
  7. For young people who may be able to consent for themselves (in England and Wales, the "Gillick competence" test), assess and record their capacity. BAPT's Ethical Basis does not address this [uncertain; check local law and policy].
• Example language (illustrative): "You come here every Tuesday after lunch. You choose what to play. I don't tell your teacher or your mum what you play. The only time I would tell someone is if I was worried you or someone else might get hurt, and I'd tell you first if I could."
• Watch for: a child who complies to please adults. Watch their face and body as well as their "yes".

4.4 Explaining confidentiality and its limits

• Purpose: make the space safe enough for the child to explore, while everyone knows in advance about the safeguarding exception [source: BAPT Parents; Ethical Basis 3.3–3.4].
• Steps:
  1. Before therapy starts, explain to the child, the carers and the professionals what stays private and what is shared. Reviews and reports cover general themes and progress; risk to the child or others is passed on immediately [source: BAPT Parents].
  2. Tell the child, in their language, what will be shared at reviews.
  3. Share identifiable material (art, photos, case examples) for teaching or publication only if it is disguised, or the child assents and the guardian consents, or the law requires it [source: Ethical Basis 3.6].
• Example language (illustrative), to carers: "I'll tell you about themes, like 'Ana is working a lot on feeling safe', not what she built or said."
• Watch for: carers or school staff asking to see artwork or hear details. Point them back to the agreed review.

4.5 Setting up and keeping the playroom and materials

• Purpose: a safe, private, predictable room with consistent materials [source: Core Competences 29; BAPT Schools; Parents].
• Steps:
  1. Use a dedicated private room, available every week at the same time [source: BAPT Schools].
  2. Choose a range of materials that allows feeling-expression, symbolic and pretend play and creative media. BAPT names drawing, storytelling, dolls or action figures and pretend play as typical [source: BAPT 2024 statement]. Build a kit that reflects the children you see (skin tones, family forms, disability, faith) [source: Core Competences 25; detail is synthesis].
  3. Risk-assess the room and the kit [source: Core Competences 29]. Practical checks [synthesis]:
     • no small parts for under-threes or children who mouth objects;
     • non-toxic, washable paints and clay, with a wet-wipe routine (clay dust);
     • no glass or sharp tools, and only round-ended scissors, used with supervision;
     • sand kept damp or covered, and checked for foreign objects;
     • water play only on a non-slip floor;
     • anchored furniture, no blind cords, and no lockable cupboards a child could hide in;
     • an allergy check on play-dough (wheat) and food materials.
  4. Keep the same materials in the same places. Repair or replace broken items. Keep the child's artwork stored confidentially [source: Core Competences 29].
  5. Ask carers to send the child in old clothes, because sessions can be messy [source: BAPT Parents].
• Watch for: a child upset by changes to the room. Name the change briefly, and keep changes to a minimum.

4.6 Child-led, non-directive play (core method)

• Purpose: the main medium of change. The child explores at their own pace and the therapist follows and reflects [source: BAPT Parents; What is Play Therapy?].
• Steps: use the full skill set in 157 (structuring statement, tracking, reflecting content and feeling, returning responsibility, joining play when invited, limits). Within BAPT practice, add three things:
  1. Keep the same time, day, room and materials every week [source: BAPT Parents].
  2. Use the communication skills BAPT lists: active listening, empathic responding, questioning, paraphrasing, tracking, reflection and summarising [source: Core Competences 26]. In non-directive work, use questions sparingly [synthesis].
  3. Write session notes on the play sequence, themes, your responses and any risk indicators [source: Core Competences 24].
• Example language (illustrative): "You've decided the dinosaur goes in the jail... and now he's very quiet in there."
• Watch for: the signs that it is working, set out in 157. BAPT's parent guidance notes that behaviour can seem to get worse before it gets better [source: BAPT Parents].

4.7 Working within the metaphor (symbolic play)

• Purpose: use play as a therapeutic metaphor, so the child can approach painful material at a safe distance [source: Core Competences 6; Wilson & Ryan ch. 2, contents only].
• Steps [synthesis]:
  1. Stay inside the child's story. Speak to or about the characters, not the child's real life.
  2. Reflect the feelings of the characters ("the baby bear is so scared").
  3. Do not interpret the play into real events unless the child makes the link first. Even then, follow rather than lead.
  4. Track themes across sessions (safety, control, nurture, aggression, loss) and take shifts in them to supervision.
• Example language (illustrative): "That little rabbit keeps hiding whenever the big one comes."
• Watch for: the child collapsing out of the play into distress. That is a cue to steady them (see 5.3), not to go deeper.

4.8 Boundaries, rules and ending a session for safety

• Purpose: keep professional, personal and therapeutic boundaries clear [source: Core Competences 19, 22], and keep everyone physically safe.
• Steps:
  1. State the few room rules at contracting (keep the child, the therapist and the room safe; time boundaries) [synthesis]. For the step-by-step limit-setting sequence, see 157.
  2. If the child puts themselves or others at risk, consider ending the session. Explain why, and arrange the next appointment [source: Ethical Basis 3.10].
  3. Give time warnings before the end of each session [synthesis; see 157].
• Example language (illustrative): "I'm not for hitting. You can hit the cushion as hard as you like." If the danger continues: "It isn't safe today, so we're stopping now. I'll see you next Tuesday at the same time."
• Watch for: limits that become punitive. The relationship should hold through the limit.

4.9 Creative media within play therapy

• Purpose: support verbal, non-verbal and symbolic communication through play and creative media [source: Core Competences 27]. BAPT lists drawing, storytelling, dolls or action figures and pretend play as typical media [source: BAPT 2024 statement]. PTUK's IHM uses a wider "ToolKit" of play and art media; its individual parts were not listed on the page [source: PTUK IHM; detail uncertain].
• Steps [synthesis]:
  1. Have the media on open shelves so the child can choose.
  2. Respond to the process ("you're pressing really hard") more than the product, and do not praise or judge the result.
  3. Ask before you touch or move anything the child has made. Ask what should happen to artwork at the end of the session (kept in their folder, or taken home if agreed).
• Example language (illustrative): "You chose the black and the red today, lots of it."
• Watch for: unsafe use of materials (eating clay, flicking sand into eyes). Apply a limit (4.8).

4.10 Integrative moves: adjusting directiveness (Play Therapy Dimensions Model)

• Purpose: decide, for clinical reasons, when to stay non-directive and when to become more involved or interpretive. BAPT requires therapists to understand and integrate directive, non-directive and developmental approaches and to adapt technique to each child and family [source: Core Competences 5, 20]. One published framework for this is Yasenik & Gardner's PTDM, which grew out of Schaefer's prescriptive play therapy and is adopted by PTUK [source: PTUK PTDM page].
• The model's two dimensions [source: PTUK PTDM page]:
  • Directiveness: how immersed you are in the play and how much you interpret.
  • Consciousness: how much awareness the child shows in their play activities and in what they say during play. The model invites movement away from your starting approach (it does not require it), within a session or between sessions. It is used for analysing changes in play, planning sessions and supervision. Its four quadrants are set out in Yasenik & Gardner's book, which is not drawn on here [uncertain].
• Steps [synthesis built on the dimensions above]:
  1. Start non-directive by default.
  2. Each session, note where the child sits: playing without apparent awareness, or showing awareness (naming links to real life, asking for help with a problem).
  3. Note where you sit: observing and reflecting, or immersed and interpreting.
  4. Consider a move only with a reason. Examples: the child is stuck in a repetitive loop for weeks; the child asks for help; or the objectives need skills practice (such as calming strategies).
  5. Make the move small and reversible. Examples: offer a story stem, a role play, or a drawing invitation.
  6. Return to following. Take the shift to supervision.
• Example language (illustrative): "Would you like me to tell the start of a story with these animals, and you finish it?"
• Watch for: directiveness driven by your own anxiety or by pressure from the referrer, rather than by the child's needs.

4.11 Drawing, structured exercises and role play inside a non-directive frame

• Purpose: Wilson & Ryan's 2nd edition added material on using drawing, structured exercises and role play within a non-directive approach [source: Elsevier book page]. Their specific exercises are not drawn on here [uncertain]. Do not attribute particular exercises to them.
• Steps [synthesis]:
  1. Offer, never impose. Accept "no" without comment.
  2. Keep the invitation open-ended ("draw anything about your week").
  3. If the child takes it up, return to tracking and reflecting.
  4. Use structured work mainly with older children and adolescents who find unstructured play babyish.
• Example language (illustrative): "Some people your age like to draw or make a comic strip about things. It's up to you."
• Watch for: a child who becomes compliant and task-focused and stops playing. Withdraw the structure.

4.12 Touch and physical contact

• Purpose: keep physical contact safe, consented to and never sexual. BAPT's Ethical Basis bans sexual contact or intimacy with clients and their close relatives, and bans harassment and exploitation [source: Ethical Basis 4.12–4.13, 4.17, 4.20]. It does not set out touch procedures [uncertain]. The steps below are [synthesis] and should be checked against your service's policy.
• Steps [synthesis]:
  1. Agree a touch policy with your setting. Explain it to carers at contracting, including any physical comfort you may offer to a distressed young child and what physical holding is not allowed.
  2. Let the child start any contact. Do not start hugs, lap-sitting or tickling yourself. Redirect warmly ("high five instead", or a cushion between you).
  3. Ask before any contact a game would need, such as doctor play, face paint or hand-printing: "Is it OK if I put paint on your hand?" Tell the child they can say stop at any time, and stop the moment they do.
  4. Never take part in genital or sexualised touch or play. If a child sexualises contact, use a calm limit, redirect, record the exact behaviour, and take it to the safeguarding lead (4.16) and supervision.
  5. Keep a vision panel or open-door arrangement where the setting requires it. Never be alone with a child somewhere unobservable without agreement.
  6. Take extra care with children who have been abused, and with children whose cultural or family norms about touch differ from yours. Talk this through with the carers.
  7. Physical restraint: follow only your setting's trained restrictive-practice policy. Prefer ending the session (4.8).
• Example language (illustrative): "I can see you want to be close. We can sit side by side here."
• Watch for: your own discomfort or wish to rescue. Take it to supervision.

4.13 Work with parents and carers, and review meetings

• Purpose: explain the play therapy process to carers and, where appropriate, involve them [source: Core Competences 7]. Include significant others in decisions [source: Ethical Principle G].
• Steps:
  1. At the start, explain the method and confidentiality (4.4), and that behaviour may get worse before it improves [source: BAPT Parents].
  2. Give carers BAPT's practical advice [source: BAPT Parents]:
     • keep attendance regular;
     • don't quiz the child afterwards ("Resist the urge to ask your child what they did");
     • don't tell the child to "be good" in therapy;
     • don't push the child to share particular things;
     • raise worries with the therapist separately, not in front of the child;
     • show the child you support the process.
  3. Hold pre-agreed review meetings that cover general themes and progress. Agree fees for reviews in advance [source: BAPT Parents].
  4. Between reviews, keep a short channel open for carers to report events: a move, contact with a parent, a new incident [synthesis].
• Example language (illustrative): "When you collect her, a simple 'Nice to see you' is perfect. You don't need to ask about the session."
• Watch for: carers who feel judged or shut out. Offer more review time, or refer them for their own support.

4.14 Liaison with school and other professionals

• Purpose: inter-professional working within team and agency procedures [source: Core Competences 28; BAPT Schools].
• Steps:
  1. Agree with the school: the room, the time, how referrals are discussed, and a named contact (SENCO, behaviour lead or the designated safeguarding lead) for child protection, parent contact and staff support [source: BAPT Schools].
  2. Run regular reviews with parents or carers and teaching staff [source: BAPT Schools].
  3. Advise staff on strategies to support the child in class, without breaking session confidentiality [source: BAPT Schools].
• Watch for: the child being taken out of lessons they love, or the session moving week to week. Protect consistency.

4.15 Consultation and filial approaches for complex attachment cases

• Purpose: for looked-after children in transition with severe attachment difficulties, Ryan reports a brief, intensive non-directive intervention that was "largely unsuccessful". She recommends two alternatives. For complex cases needing shorter-term work: consultation with the adults, based on Heard and Lake's theory of attachment and interest-sharing, instead of direct work with the child. For longer-term work: filial therapy combined with that theory, to help carers build the attachment relationship [source: Ryan 2004, abstract].
• Steps [synthesis]:
  1. Map the child's adult network (carers, social worker, school).
  2. Offer consultation to that network on the child's attachment needs.
  3. Where the placement is stable, refer to or deliver filial therapy, or another parent-child play method in which you are trained. BAPT has promoted Child Parent Relationship Therapy (CPRT) training; the flyer is not drawn on here [uncertain].
• Watch for: direct therapy that strengthens the child's tie to you while the placement is about to end.

4.16 Safeguarding: concerns, disclosures and reporting

• Purpose: protect the child. BAPT says play therapists follow the setting's child protection procedures, the Children Act 2004 and the local authority's child protection procedures, and keep regular contact with the setting's safeguarding staff [source: BAPT Schools]. Risk to the child or others is passed on immediately, and everyone is told this beforehand [source: BAPT Parents]. Information may be shared without consent to protect the client or others from harm [source: Ethical Basis 3.5]. Practitioners need current knowledge of UK law and policy, including child protection [source: Core Competences 8].
• Steps [synthesis, consistent with the sources above]:
  1. During the session: if the child says something in words, listen calmly. Don't ask leading questions, don't promise secrecy, and don't investigate. Use the child's own words. If something is said only through play, keep reflecting within the play. Do not turn play themes into questions about real events.
  2. At the end of the session: tell the child, in simple words, that you need to tell someone whose job is to keep children safe, unless doing so would put the child at greater risk.
  3. The same day: report to the designated safeguarding lead or children's social care, following local procedures. If the child is in immediate danger, contact the police.
  4. Record the exact words and behaviour, the time and the context. Keep observation separate from interpretation. Do not record your hypotheses about the meaning of play as facts.
  5. Inform your supervisor. Agree with the safeguarding lead, not on your own, what to say to the carers.
  6. Mandatory reporting differs by jurisdiction [uncertain; check your local law]:
     • England, Wales, Scotland and Northern Ireland rely mainly on statutory guidance and local procedures, not a general reporting statute. One specific statutory duty exists in England and Wales: regulated professionals must report known female genital mutilation (FGM) in under-18s to the police.
     • In the US, every state makes mental health practitioners mandated reporters, with state-specific timelines and routes.
     • Australian states and territories set their own mandated-reporter categories and thresholds.
     • Ireland's Children First Act 2015 names mandated persons. Before you start practice, find out the law where the child lives and where you practise.
• Example language (illustrative): "Thank you for telling me. What you said is important. Part of my job is making sure children are safe, so I'm going to talk to Ms Patel, whose job is to help with that."
• Watch for: anything said by an older child in words, plus physical signs or the child's own explicit statements, which should prompt action. Sexualised or violent play on its own is a clinical concern to discuss with supervision and the safeguarding lead, not proof of abuse (see 5.8).

4.17 Monitoring progress and outcomes

• Purpose: BAPT requires monitoring of practice and outcomes [source: Ethical Principle B], monitoring and evaluation of each intervention [source: Core Competences 20], and evaluation of outcomes to improve services [source: Core Competences 31]. No specific instrument is named in the pages [uncertain].
• Steps [synthesis]:
  1. At each review, compare the objectives with carer and teacher observations.
  2. Use a standardised measure if your service has one, and collect it at the start, at reviews and at the end.
  3. Track session themes and play quality (more varied, more coherent, more relational play) in your notes.
• Watch for: improvement at home but not at school, or the other way round. Explore what differs between the settings.

4.18 Records, reports and court work

• Purpose: keep accurate records and write clear assessments and progress reports [source: Core Competences 24]. Keep, store and destroy records lawfully and confidentially [source: Ethical Basis 4.21, 4.23]. Wilson & Ryan cover statutory settings and "presenting therapeutic material in court" [source: Elsevier book page; chapter not drawn on, uncertain].
• Steps [synthesis]:
  1. After each session, note the date, attendance, play sequence, key verbatim statements, themes, your responses, any risk and any action taken.
  2. Store artwork and photos as part of the confidential record. Never use them for advertising or personal use [source: Ethical Basis 4.21].
  3. In reports, separate what you observed from your clinical opinion. State the limits of inferring events from play.
  4. In court-related work, explain the confidentiality limits beforehand [source: Ethical Basis 3.9], and get supervision and legal advice before you give evidence.
• Watch for: requests to state from play whether abuse happened. Decline, and explain why (see 5.8).

4.19 Planned endings

• Purpose: a coherent therapeutic ending [source: Core Competences 21], planned sensitively over several weeks, because premature or unplanned endings harm the child [source: BAPT Schools].
• Steps:
  1. Agree the ending date with the carers and referrer at a review.
  2. Tell the child several weeks ahead [source: BAPT Schools].
  3. Count down the remaining sessions each week. A visual countdown helps younger children [synthesis].
  4. Expect ending themes and some regression in the play, and reflect them [synthesis].
  5. Agree what happens to stored artwork [synthesis].
  6. Hold a final review [synthesis].
  7. For your own planned absences, make reasonable arrangements and tell the child in advance [source: Ethical Basis 3.11, 4.19].
• Example language (illustrative): "We have four more Tuesdays. After that our playtimes will finish. You might have lots of feelings about that, and they're all OK here."
• Watch for: sudden endings forced by a placement move or funding cuts. Push for at least one goodbye session.

4.20 Adaptations for particular groups

• Autism: in a single case study, non-directive play therapy (16 video-recorded sessions with a 6-year-old with severe autism) produced a therapeutic relationship and attachment behaviour towards the therapist, with gains in autonomy and pretend play and only mild change in ritualistic behaviour. The authors suggest it could be combined with behavioural treatments. They call this preliminary [source: Josefi & Ryan 2004, abstract]. Adaptations [synthesis]: a predictable routine, a visual timetable, sensory-safe materials, and parallel play before shared play.
• Looked-after children and attachment difficulties: see 4.15 [source: Ryan 2004].
• Adolescents: Wilson & Ryan's book covers adolescents [source: Elsevier]. In practice [synthesis], offer more creative, art and structured options (4.11), use an age-appropriate room or kit, and allow more verbal processing.
• Statutory settings (care proceedings, social work): see 4.18 [source: Wilson & Ryan ch. 7, contents only].
• Diversity: anti-discriminatory practice that attends to identity and cultural needs [source: Core Competences 9, 25].
• Online work: BAPT's Ethical Basis does not address remote play therapy [uncertain]. If you use it [synthesis]: agree a private space and an adult nearby at home, get separate consent, and have a safety plan for disclosures made remotely.

4.21 Use of supervision

• Purpose: ongoing, appropriate, formal and regular supervision, independent of line management, with a qualified play therapist where possible, and face to face unless distance prevents it [source: Ethical Basis 1.4]. Frequency ratios are set in BAPT's separate supervision policy, which is not drawn on here [uncertain].
• Steps [synthesis]:
  1. Bring play sequences and themes, your moves along the directiveness dimension (4.10), any risk, and your own reactions.
  2. Use frameworks such as the PTDM to look at how directive you were and how aware the child was [source: PTUK PTDM page].

5. Handling problems

BAPT's documents address only a few of these problems directly. Each one is tagged with its source. Everything else is [synthesis]. For in-session problems with the child-centred skills (testing limits, aggression, a child who won't play), see also 157.

• 5.1 Stuck or repetitive play.
  • First, assume the repetition may be the work. Track it for several sessions and look for small variations [synthesis].
  • If nothing has changed for weeks and there is no progress at review, consider a small, reversible move along the directiveness dimension (4.10) [source: Core Competences 20; PTUK PTDM].
  • Check whether something outside the room is keeping the child stuck: contact with an abuser, an unstable placement [source: BAPT Parents].
• 5.2 Resistance to coming, or assent withdrawn.
  • Explore it in the room first ("part of you didn't want to come today").
  • Then check with the carers how the session is framed at home: as a punishment, or a reward for "being good"? [source: BAPT Parents, on not asking the child to be good; the rest is synthesis].
  • If the child persistently does not assent, review the plan with the carers. Do not force attendance [source: Ethical Basis 3.9, assent and best interests].
• 5.3 Overwhelm or dysregulation in session.
  • Slow down, and stay in the metaphor or step out of it gently.
  • Offer grounding materials (sand, water, clay, soft toys).
  • Reduce stimulation, and give a time warning early [synthesis].
  • If the child or others are at risk, end the session with an explanation and a next appointment [source: Ethical Basis 3.10]. Update the carers afterwards about the child's state, not the content of the session.
• 5.4 Behaviour worse at home or school. Prepare the carers at the start: BAPT says behaviour can seem worse before it improves [source: BAPT Parents]. Review quickly if there is any risk, and give staff strategies [source: BAPT Schools].
• 5.5 Non-attendance or irregular attendance. Consistency is one of the Five C's [source: BAPT Schools]. Work out the barrier with the carers (transport, timing, the carers' own feelings about therapy), and write attendance expectations into the contract [source: BAPT Parents: encourage regular attendance]. After repeated gaps, review whether play therapy is viable now [synthesis].
• 5.6 Carers or school wanting session details. Go back to the confidentiality agreement made at the start (4.4). Offer themes and progress at the agreed review [source: BAPT Parents]. Offer extra parent sessions. Do not show artwork without the child's assent [source: Ethical Basis 3.6].
• 5.7 Ruptures with the child. After a limit, a missed session, or a change of room, name the event simply. Reflect the child's feelings about it, including anger at you. Keep the next session at the usual time [synthesis].
• 5.8 Play that looks like it shows abuse. BAPT's pages give no protocol for this [uncertain]. In practice [synthesis]:
  • Sexualised, violent or frightening play is clinical information and a reason to consult. It is not diagnostic evidence.
  • Do not interpret it to the child as a real event, and do not ask leading questions.
  • Record behaviour exactly and discuss it with the safeguarding lead and your supervisor.
  • A clear verbal disclosure, injuries, or a child's explicit account follow the reporting route in 4.16.
  • In reports and court, state plainly that you cannot say what happened from play themes alone.
• 5.9 Starting while the child is still unsafe, or mid-transition. BAPT warns that therapy may not help then [source: BAPT Parents]. Pause direct work, or switch to network consultation or filial-style work (4.15) [source: Ryan 2004].
• 5.10 Conflict between separated parents over consent. Confirm who holds parental responsibility and any court orders. Seek consent as your service's policy requires. Keep both parents informed in line with their legal rights. Get advice before starting if the parents disagree [synthesis; uncertain on local law].
• 5.11 Pressure to work directively ("teach him anger management"). Explain how the BAPT approach works and its integrative options (4.10). Agree objectives that fit play therapy, and refer for skills-based work if that is what is really needed [source: Core Competences 5, 20; the rest is synthesis].
• 5.12 Sexualised behaviour towards the therapist, or attempts at physical contact. Use a calm limit and redirect (4.12). Record exactly what happened, and take it to the safeguarding lead and supervision. Never respond in kind [source: Ethical Basis 4.20; the rest is synthesis].
• 5.13 Material or room hazards (a broken toy, a sand-in-eye injury, a child swallowing clay or a small part). Stop, give first aid or get medical help, and tell the carers. Record it, and update the risk assessment [source: Core Competences 29, risk assessment; the rest is synthesis].
• 5.14 Your own reactions (rescue fantasies, anger at carers, distress at traumatic play). BAPT requires you to stop practising if personal issues may impair your competence, and to use supervision and personal therapy [source: Ethical Basis 4.10; Core Competences 13–14].
• 5.15 Unplanned endings forced from outside. Advocate for at least one ending session. If that is impossible, send a short letter or picture message through the carers, with consent [source: BAPT Schools, on the harm of premature endings; the rest is synthesis].

Sources

Sources:

• Play Therapy – What is Play Therapy? (BAPT)
• Information for Parents and Carers (BAPT)
• Play Therapy in Schools (BAPT pdf)
• Ethical Basis for Good Practice in Play Therapy 2023 (BAPT pdf)
• Play Therapy Core Competences (BAPT, 2022, pdf)
• BAPT Statement 2024: difference between Play Therapy and Therapeutic Play (pdf)
• History of Play Therapy (BAPT pdf)
• Play Therapy Dimensions Model (PTUK)
• IHM: the Integrative Holistic Model of Play Therapy (PTUK)
• Play Therapy, 2nd Edition: A Non-Directive Approach for Children and Adolescents (Elsevier book page)
• Ryan (2004) Adapting non-directive play therapy interventions for children with attachment disorders (White Rose record)
• Josefi & Ryan (2004) Non-directive play therapy for young children with autism: a case study (White Rose record)

Further reading (not drawn on beyond the publisher's page or abstract):

• Wilson, K. & Ryan, V. (2005). Play Therapy: A Non-Directive Approach for Children and Adolescents (2nd edn). Baillière Tindall/Elsevier.
• Ryan, V. (2004). Adapting non-directive play therapy interventions for children with attachment disorders. Clinical Child Psychology and Psychiatry, 9(1), 75–87.
• Josefi, O. & Ryan, V. (2004). Non-directive play therapy for young children with autism: a case study. Clinical Child Psychology and Psychiatry, 9(4), 533–551.
• Yasenik, L. & Gardner, K., Play Therapy Dimensions Model book and DVD [uncertain: title, year and edition].

Further reading (not drawn on): BAPT's professional-practice page, qualification page, supervision policy and example consent form, and BAPT/PTUK touch or online-work guidance [uncertain]. For the child-centred skills and Axline's principles, see 157 Child-centred play therapy.