Getting comfortable with conversations about race and ethnicity in psychotherapy

Cardemil, E. V., & Battle, C. L. (2003). Guess who’s coming to therapy? Getting comfortable with conversations about race and ethnicity in psychotherapy. Professional Psychology: Research and Practice, 34, 278-286.

This article urges therapists to engage in open conversations with their clients about race and ethnicity as it applies to the client, the therapist, and the therapeutic alliance. By taking a more active stance and initiating such discussions, especially early in treatment, the therapist may enjoy improved treatment retention, therapeutic alliance, and treatment outcome. After defining race and ethnicity as similar but distinct constructs, the article acknowledges that such conversations will vary in terms of frequency and intensity over different clients and times. It then goes on to provide six recommendations for becoming more comfortable and knowledgeable with having such discussions.

First, it is acknowledged that a client's racial/ethnic background may not be obvious and that it is best to suspend preconceptions about a client and their family members. It is recommended that clients be asked early on in therapy how they identify themselves. Second, it is acknowledged that wide variability exists within racial and ethnic groups and that a client's racial identity development and acculturation process may change over time, thus affecting therapy. Third, it is important to consider how the therapist's own racial/ethnic background may affect the therapeutic process in terms of differences in communication styles and conceptualization of mental health/illness, self, and family/community. Fourth, it is acknowledged that racism, power, and privilege can affect the therapeutic process and that failing to acknowledge such societal issues may invalidate a client's painful personal experiences. Fifth, it is recommended that a client expressing reticence and/or frustration with the topics of race and ethnicity be met with an open and non-defensive explanation that such topics are relevant to many clients, but needn't be pursued if they are found irrelevant or uncomfortable. Lastly, resources for further education/training in race and ethnicity are provided.

Ethanol-conditioned flavor preferences compared with sugar- and fat-conditioned preferences in rats

Ackroff, K., Rozental, D., Scalfani, A. (2004). Ethanol-conditioned flavor preferences compared with sugar- and fat-conditioned preferences in rats. Physiology & Behavior, 81, 699-713.

Past studies in rats have suggested that the postingestive effects of various nutrients can condition strong flavor preferences. Research has been conducted on ethanol using oral conditioning (where the ethanol is mixed in with the flavoring, thus adding its own flavor to the mixture) and intragastic conditioning (where the ethanol is injected into the rat’s stomach after it ingests the flavoring, thus eliminating the ethanol’s flavor as a conditioning factor). However, the findings of these studies have been somewhat contradictory. Mehiel and Bolles (1988) found that rats equally preferred a flavor paired with ethanol and a flavor paired with sucrose, while Sherman et al. (1983) found that rats preferred a flavor paired with glucose to a flavor paired with ethanol. These studies different in terms of design, route of administration, and sugar used, but it is unclear which of these factors are responsible for the confliction. The present study examined this question in a series of four related experiments.

In the first experiment, sucrose and ethanol were compared to each other as well as to a control of water. These nutrients were each paired with a different flavor and administered through intragastric infusion. Unlimited access to alternating flavor/nutrient combinations was provided during a training period and then the amount of each combination consumed was measuring during a test in which the rats could choose between different combinations. The results were that (1) the rats preferred both sucrose- and ethanol-paired flavors to the water-paired flavor, (2) the rats strongly preferred the sucrose-paired flavor to the ethanol-paired flavor, and (3) the rats ingested more sucrose mixture than ethanol mixture during the training period.

The second experiment attempts to control for finding (3) in experiment one by adding the additional constraint that sucrose mixture consumption was limited to the previous day’s ethanol mixture consumption. Findings (1) and (2) did not change as a result.

In the third experiment, the oral conditioning method was used in place of intragastric infusion for nutrient administration. Once again, the findings did not change.

Finally, in the fourth experiment, ethanol was compared to fructose and corn oil using the intragastic infusions. Similar to the sucrose findings, the rats preferred these new sugars to ethanol, while still preferring ethanol to water.

This study supports the findings of Sherman et al. (1983) and eliminates training intakes, route of administration, and specific sugar/fat as explanations of Mehiel and Bolles’ (1988) contradictory findings. Something other than energy concentration affects the efficacy of ethanol as a reinforcer, making it less powerful than other sugars/fats.

Evidence for episodic memory in a Pavlovian conditioning procedure in rats

O'Brien, Jamus; Sutherland, Robert J. Evidence for episodic memory in a Pavlovian conditioning procedure in rats. Hippocampus. Vol 17(12) 2007, 1149-1152.

Several requirements have been proposed for establishing episodic memory in nonlinguistic species. Clayton et al. (2003) suggest that episodic memory competence requires integrated representations of “what", "where", and "when” content that can be flexibly updated as more information is gathered. Tests of episodic memory should be novel and unexpected, exceed the capacity of short-term memory (Dere et al., 2006), be unsolvable by familiarity judgments (Gallistel, 1990), and involve memories formed in unique one-trial learning episodes (Morris, 2001). In this article, O’Brien and Sutherland design and run an experiment that attempts to meet these requirements while testing for the flexible and integrated representations required for episodic memory.

In this experiment, twenty-two male Long-Evans rats were run through three experimental phases. In Phase 1, rats were given time to explore two different “contexts” (boxes A and B). These boxes were Plexiglas modular test chambers with steel grid floors. Box A had black colored walls and was scented with Quatzyl-D-Plus, while box B was white and scented with Clinicide. Each rat visited Box A on three successive mornings and Box B on three successive evenings. In Phase 2, rats were exposed to a single immediate shock in a “chimerical” box that was half black, half white, and unscented. For half the rats, this occurred in the morning and for the other half, it occurred in the evening; this is the study’s independent variable. In Phase 3, during mid-day, rats were placed in one of the contexts from Phase 1 (either Box A or Box B). Fear responses (this study’s dependent variable) were then measured by timing conditioned “freezing” behavior.

A repeated measure ANOVA was conducted on the percent of time spent freezing during Phase 3, and it was predicted that rats placed in the context congruent to the time of day of their shock would exhibit more freezing than rats placed in the incongruent context. (For example, if a rat was in Box A in the morning and Box B in the evening during Phase 1 and received its shock in the morning during Phase 2, then the congruent context would be Box A and the incongruent context would be Box B.) The results were a significant relationship in the direction predicted (F_(1,20) = 45.0, P < 0.001).

These findings support the idea that rats acquire memories laden with temporal context (or “when” content), such as the time of day, which is an important requirement of establishing episodic memory competence. Further studies could continue this line of research by establishing evidence for rats generating “what” and “where” content, and by exploring the nature of rats’ temporal cues – possibly endogenous circadian oscillators (Gallistel, 1990) or the age of granule cells in the dentate gyrus of the hippocampus (Aimone et al., 2006).

Statistical Functions

Zimmerman, D. W., & Zumbo, B. D. (1992). Parametric alternatives to the student t test under violation of normality and homogeneity of variance. Perceptual and Motor Skills, 74, 835-844.
*Rank order tests are effective only under violations of normality; modified t-tests are far better under conditions of violated homogeneity of variance

Clinch, J. J. & Keselman, H. J. (1982). Parametric alternatives to the analysis of variance. Journal of Educational Statistics, 7, 215-231.
*Different tests were compared under various assumption violations via Monte Carlo methods; the ANOVA F test did worst, while the Brown/Forsyth method did best overall

Tomarken, A. J. & Serlin, R. C. (1986). Comparison of ANOVA alternatives under variance heterogeneity and specific noncentrality structures. Psychological Bulletin, 99, 90-99.
*ANOVA F test alternatives were compared on Type I error rates and power under variance heterogeneity; the Welch test did best in all cases except when extreme means were paired with high variances, where the Brown/Forsyth method did better

Wilcox, R. R. (1998). How many discoveries have been lost by ignoring modern statistical methods? American Psychologist, 53, 300-314.
*Many nonsignificant research results could have been significant if modern statistical methods had been used; new methods also create more accurate confidence intervals

Alternatives to Null Hypothesis Significance Testing

Abelson, R. P. (1985). A Variance Explanation Paradox: When a Little Is a Lot. Psychological Bulletin. 97 (1), 129-34.
*Using percent variance to explain the influence of situational factors is misleading

Prentice, D. A., & Miller, D. T. (1992). When small effects are impressive. Psychological Bulletin, 112, 160-164.
*Interpretation of effect size requires careful consideration of the topic being researched

Bem, D. J., & Honorton, C. (1994). Does Psi Exist? Replicable Evidence for an Anomalous Process of Information Transfer. PSYCHOLOGICAL BULLETIN. 115 (1), 4.
*An example of meta-analysis in action, arguing that psi exists (and is replicable)

Kirsch, I. & Sapirstein, G. (1998). Listening to Prozac but hearing placebo: A meta-analysis of antidepressant medication. Prevention & Treatment, 1
*An example of meta-analysis in action, arguing that SSRI’s work through placebo effect

Krueger, J. (2001). Null Hypothesis Significance Testing: On the Survival of a Flawed Method. AMERICAN PSYCHOLOGIST. 56, 16-26.
*Critics and defenders of NHST use Bayesian ideas; the real issue at stake is replicability

Seaman, M. A., & Serlin, R. C. (1998). Equivalence Confidence Intervals for Two-Group Comparisons of Means. PSYCHOLOGICAL METHODS. 3 (4), 403-411.
*Equivalence confidence intervals can and should replace NHST for determining if two group means are practically equivalent

Duckworth, W.M. and Stephenson, W.R. Resampling methods: Not just for statisticians anymore. Invited paper presented at JSM 2003, San Francisco, CA.
*Explores how to teach resampling methods (jackknife and bootstrap) to psychologists

Controversy in Null Hypothesis Significance Testing

Macdonald, R. R. (1997). On statistical testing in psychology. BRITISH JOURNAL OF PSYCHOLOGY. 88 (2), 333-348.
*Criticisms of NHST apply to Neyman-Pearson approach, but not the Fisherian approach

Huberty, C. J. (1993). Historical Origins of Statistical Testing Practices. Journal of Experimental Education. 61 (4), 317-33.
*Textbooks in psychology confuse the use and interpretation of p-values and alpha-levels

Gigerenzer, G. (1993). The superego, the ego, and the id in statistical reasoning. In G. Keren & C. Lewis (Eds.), A handbook for data analysis in the behavioral sciences: Methodological issues (pp. 311-339). Hillsdale, NJ: Lawrence Erlbaum Associates.
*Textbooks present an incoherent “hybrid logic,” mixing Neyman-Pearson and Fisher

Kaiser, H. (1960). Directional statistical decisions. Psychological Review. 67, 160-167.
*When using two-sided tests, it makes no sense to use a non-directional test

Greenwald, A. G. (1975). Consequences of prejudice against the null hypothesis. Psychological Bulletin, 82, 1-20.
*The false ideas that null results are useless or more likely to be due to incompetence prevents (or at least slows) scientific progress

Rosenthal, R. (1979). The “File Drawer Problem” and tolerance for null results. Psychological Bulletin, 86, 638-641.
*Research that results in null results are rarely published, making a field of research look more “significant” than it might actually be

Rozeboom, W. W. (1960). The fallacy of the null-hypothesis significance test. Psychological Bulletin. 57, 416-28.
*Using statistical tests to make “decisions” is naïve and rejection criteria are arbitrary, calling for a use of confidence intervals and (if possible) Bayesian statistics

Bakan D. (1966). The test of significance in psychological research. Psychological Bulletin. 66 (6), 423-37.
*Statistical results are often misinterpreted, calling for Bayesian methods

Hunter, J. E. (1997). Needed: A Ban on the Significance Test. PSYCHOLOGICAL SCIENCE -CAMBRIDGE-. 8 (1), 3-7.
*NHST breaks down when H0 is false and most studies purposely use H0's they know to be false, causing the error rate (Type I and II) of NHST to be around 60%

Cohen, J. (1994). The Earth Is Round (p <.05). AMERICAN PSYCHOLOGIST. 49 (12), 997.
*The logic of NHST is flawed and backwards; we need to better understand our data

Cohen, J. (1990). Things I Have Learned (So Far). American Psychologist. 45 (12), 1304-12.
*Informed judgment from the researcher is indispensable; power analysis can help

Loftus, G. R. (1996). Psychology Will Be a Much Better Science When We Change the Way We Analyze Data. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE. 5 (6), 161-170.
*Null hypotheses are rarely possible, making “significance” useless; power is under-attended and the dichotomy of effects/non-effects is artificial

Harris, R. J. (1997). Reforming significance testing via three-valued logic. In Harlow, L.L., Mulaik, S.A., & Steiger, J.H. (Eds.) What if there were no significance tests? Hillsdale, NJ: Erlbaum.
*Three-valued logic can establish directionality and address Type III error

Wilkinson, L. (1999). Statistical Methods in Psychology Journals: Guidelines and Explanations. AMERICAN PSYCHOLOGIST. 54 (8), 594-604.
*APA decided not to ban NHST, instead urging researchers to distinguish between statistical and theoretical significance, and also use modern statistical graphics

Abelson, R. P. (1997). On the Surprising Longevity of Flogged Horses: Why There Is a Case for the Significance Test. PSYCHOLOGICAL SCIENCE -CAMBRIDGE-. 8 (1), 12-15.
*NHST can be used effectively in combination with other methods; enforcing a complete ban on it would be throwing away a tool that can be useful in a number of situations

Greenwald, A. G., Gonzalez, R., Harris, R. J., & Guthrie, D. (1996). Effect Sizes and p Values: What Should Be Reported and What Should Be Replicated? PSYCHOPHYSIOLOGY. 33 (2), 175-183.
*The interpretation of p-values in terms of replicability is widely mistaken

Harris, R. J. (1997). Significance Tests Have Their Place. PSYCHOLOGICAL SCIENCE -CAMBRIDGE-. 8 (1), 8-11.
*Three-valued logic can help NHST; using confidence intervals as an alternative runs into the same problems as NHST, while providing less information than a p-value would

Jones, L. V., & Tukey, J. W. (2000). A Sensible Formulation of the Significance Test. PSYCHOLOGICAL METHODS. 5, 411-414.
*Yet another iteration of the virtues of three-valued logic applied to NHST

Empowering Techniques of Play Therapy

Griffith, M. (1997). Empowering Techniques of Play Therapy: A Method for Working with Sexually Abused Children. Journal of Mental Health Counseling. 19 (2), 130-42.

This article, like many others, begins with a brief survey of play therapy theory. It is remarked that play is the natural medium of expression for children and that sexual abuse seems to block many basic developmental needs. Treatment goals are outlined and plotted along a pattern which the process of therapy follows. A case study is provided to articulate these points and exemplify the "five stages" of play therapy. These stages are the establishment of the therapeutic relationship, the later exploratory stage (in which regressive and repetitive behaviors often appear), the limit-setting stage (in which the child tests the boundaries and safety of the therapeutic setting), the growth stage (see below), and the termination stage. Treatment goals in the growth stage involve confronting the "four characteristics of sexual trauma" which are sexual traumatization, stigmatization, betrayal, and powerlessness. Sexual traumatization can lead to confusion between sexuality and affection, confusion about sexual norms, age-inappropriate sexual knowledge, and sexual behavior. It is believed that through the use of empowering techniques of play therapy (expressive/imaginative play and non-direction), the emotional distress of sexual abuse can be relieved and normal psychological development can resume.

Play therapy with sexually abused children

Hill, A. (2006). Play therapy with sexually abused children: Including parents in therapeutic play. CHILD AND FAMILY SOCIAL WORK. 11 (4), 316-324.

According to this article, situations in which sexual abuse has increased a child's separation anxiety can often be improved by including parents in play therapy. This allows the child to feel more secure in his/her primary attachment relationships, while presenting the often confused and uncomfortable parents with a positive model of interaction to emulate. It may also be beneficial for the therapist to witness and interact in the parent-child relationship which, if strained, can often exacerbate the trauma. It is noted that parents benefit from participating in the therapy by eliminating feelings of exclusion and jealousy they may have developed in response to the new therapist-child relationship, by countering feelings of guilt and failure in the role of parent/protector common to situations of child abuse, and by rebuilding confidence in their parenting abilities.

Possible complications of introducing parents into child therapy are discussed. Issues of the child's privacy and confidentiality are naturally raised, as well as the possibility that some parents might be unwilling to participate or counter-productive in the process. Suggestions or interventions by the therapist may be viewed as criticism by the parent.

Two case studies are provided to exemplify these points and to illustrate the situation of a child expressing anger towards his/her parents in response to sexual abuse (by someone else). While this is a common occurrence in play therapy, it becomes complicated when that parent is present. Lastly, it is noted that including parents in play therapy can counteract the "dynamic of secrecy" often imposed on the sexually abused child by the abuser.

Play Therapy with Sexually Traumatized Children

Kelly, M. M. (1995). Play Therapy with Sexually Traumatized Children: Factors That Promote Healing. Journal of Child Sexual Abuse. 4 (3), 1-11.

This article begins with a survey of play therapy theory, with special attention given to various writer's takes on the merits of directive vs. non-directive approaches. It is argued that the treatment of sexually abused children often involves a series of "resolution cycles" characterized by the alternation of active work and periods of respite. Each of these cycles comprises three phases: testing the therapeutic relationship, readdressing the trauma, and protective distancing and denial. Another cycle will then be initiated only if there is trust and respect between the child and the therapist. Cycles can take as long as four or more sessions to complete, or may play out in the course of a single session (as is common in the beginning stages of therapy).

Two case studies (one with a 7 year old girl and another with an 8 year old boy) are provided to illustrate the progression of such cycles and to show that the denial phase usually occurs when the child's personal resources are exhausted. It is argued that a clear understanding of these cycles can furnish a therapist with more realistic expectations when working with sexually abused children.

A case study using child-centered play therapy approach to treat enuresis and encopresis

Cuddy-Casey, M. (1997). A case study using child-centered play therapy approach to treat enuresis and encopresis. ELEMENTARY SCHOOL GUIDANCE AND COUNSELLING. 31 (3), 220-225.

Enuresis (bedwetting) and encopresis (bed-defecation) may come from one or more of the following causes: medical-genetic disorders, emotional disturbances, and failure to learn. Depending on the main cause, different treatments are used. Physicians are usually called to deal with the organic problems underlying medical-genetic disorders, while behavioral techniques are used to treat problems stemming from a failure to learn. However, problems rooted in emotional disturbances are commonly lumped into the "failure to learn" category and treated thusly. This article argues for an alternative treatment (i.e. non-directive play therapy) to be used in response enuresis and encopresis rooted in emotional disturbances.

A case example is provided in which an 8-year old male with enuresis and encopresis is treated with play therapy after medical-genetic disorders and failure-to-learn are ruled out. In these sessions, the child began to exhibit aggressive behavior and admitted to wanting to destroy the playroom's pictures and wall clock, which he believed to have cameras hidden behind them. After this admission was received with the permissiveness and acceptance that are the hallmarks of non-directive therapy, the child also admitted that he did not use public restrooms because of this fear of hidden cameras. He spent the next few sessions searching the playroom for cameras and, upon not finding any, began to have less and less problems with enuresis/encopresis.

Jungian Play Therapy in Elementary Schools

Allan, J., & Brown, K. (1993). Jungian Play Therapy in Elementary Schools. Elementary School Guidance and Counseling. 28 (1), 30-41.

This article discusses the Jungian approach to play therapy and provides a case study to exemplify its methods. As a (or perhaps the) proto-humanistic psychologist, Jung believed that growth and transformation are the main drives in the psyche. Thus, counseling involves mainly providing a safe and protective setting in which these internal processes can propel a child into change. This so-called self-healing archetype requires a healthy connection between the child's conscious and unconscious worlds. Therapy is thus also aimed at creating such a connection.

Jungian play therapy identifies three major themes or stages through which a child's play evolves: chaos, struggle, and resolution. It is through the progression of this resolution that the ego develops a sense of control and mastery as it learns to mediate the "struggle of opposites." Towards the end of therapy, common themes become construction, reparation, and healing.

Jungian play therapy is directive in its counseling style and makes use of interpretation interventions to "deepen affective expression." This is received much more positively by the child if it is initiated after a strong therapeutic relationship of rapport is established. This point and others are illustrated in the case study of a third grader with aggressive behavior problems. His sand play had a recurrent theme of "good guys" struggling against "bad guys." When, later in therapy, this theme was interpreted as analogous to his own feelings of isolation and confliction, he accepted it and showed remarkable change in the next session. In the next sand world he made, there was a fenced off area where kids could go and nothing could happen to them. It is argued that this opportunity to release his feelings allowed the child's positive, integrating mechanisms to guide him to growth, and that the direct interpretations expedited this process.

The Masterson Approach with Play Therapy

Mulherin, M. A. (2001). The Masterson Approach with Play Therapy: A Parallel Process between Mother and Child. AMERICAN JOURNAL OF PSYCHOTHERAPY. 55, 251-272.

This article illustrates the principles of the Masterson Approach with a long-term case study involving a child and his mother in adjunct therapy. The Masterson Approach (with which I am not very familiar) is a psychodynamic developmental self and object relations approach. It involves providing opportunities for diagnostic assessment, developing a working relationship within therapy, assisting in the breakdown of defenses, facilitating verbalization, providing cathartic release, and preparing the child for future life events. As will be seen, the diagnosis has a large effect on which treatment strategies are deemed appropriate.

The initial diagnosis for both the mother and son was distancing borderline disorder. As a result, the technique of confrontation was used as intervention. However, as confrontation led to increased anxiety in both patients, the diagnosis was changed to schizoid disorder of the self and interpretation of the schizoid dilemma became the primary therapeutic technique. This seemed to have drastic effect, as both patients responded positively. The new diagnosis was thus confirmed.

An interesting aspect of this case study was the enmeshment, or parallel progression of the mother and son. Often the son would act out (in his sand trays) the very same conflicts his mother struggled with in her verbal therapy. They both exhibited signs of the splitting defense mechanism, with the son accepting his mother while rejecting his father, and the mother having panic attacks as she fantasized about reuniting with her separated husband.

Two interesting events in the play therapy are also worth noting. First was when the son explicitly acknowledged the symbolic nature of his play by remarking (after destroying one of his sand worlds) that he was glad those "bad feelings [were] gone". And second was when the creation of a loss/death-themed sand world in his fifth year of treatment seemed to usher in a much more integrated child. After this cathartic experience, his regressive defenses completely disappeared.

Play therapy; the troubled child's self-encounter

Hyde ND. (1971). Play therapy; the troubled child's self-encounter. The American Journal of Nursing. 71 (7), 1366-70.

A general overview with anecdotal examples of non-directive play therapy from a psychiatric nurse. The article quotes largely and effectively from the major players (Axline, Moustakas, etc.). There is not much here that you can't get from the primary texts themselves, but it is not bad either. It outlines the theoretical framework of non-direction, permissiveness, and attentiveness on the part of the therapist. It also acknowledges the projection, darkness, and struggle for integration evident in children's play.

An experiment with play therapy

Smith LF. (1977). An experiment with play therapy. The American Journal of Nursing. 77 (12), 1963-5.

A summarized and anecdotal account of an amateur play therapist (nursing student) working with a withdrawn child. Only very limited dialogue is provided, more often utilizing descriptions of what actions and conversations took place. This article is another case study to read, but without dialogue and given the inexperience of the therapist, it leaves much to be desired as a learning tool. The child in this case study expressed his anxiety in an obsession with cleanliness, spending much of the time cleaning the windows and walls of the playroom. He also played extensively with a customizable doll house, deconstructing and reconstructing it, and had the therapist act out his own daily routines.

Using play therapy in outpatient settings

Meer PA. (1985). Using play therapy in outpatient settings. MCN. The American Journal of Maternal Child Nursing. 10 (6).

This article demonstrates the ambiguity existing in terms such as "play therapy" in research contemporary to it. What is described here is toys being used by nurses in calming children and preparing them for medical procedures, which is very different from the play therapies used by professional therapists in building permissive and accepting relationships with "troubled" children.

Aside from this rather frustrating catachresis, the article describes the interesting application of play-related concepts to children in health care settings. Specifically, puppets and dolls can be used to familiarize children with the equipment and procedures they will later be exposed to. Allowing children to participate in this play-acting can make them feel more control over the situation, assuaging some of their anxiety and leading to an overall feeling of independence.

Play Therapy With Abused Children: A Review of the Literature

White, J., & Allers, C. T. (1994). Play Therapy With Abused Children: A Review of the Literature. JOURNAL OF COUNSELING AND DEVELOPMENT. 72 (4), 390.

This article gives an overview of play therapy, identifies and explores seven characteristic behaviors exhibited by abused children, identifies and explores two general themes of play in abused children, and critiques play therapy research. The characteristic behaviors are developmental immaturity, opposition and aggression, withdrawal and passivity, self-deprecating and self-destructive behavior, hypervigilance, sexual behavior, and dissociation. The recurrent themes of play behavior are unimaginative/literal play and repetition/compulsion. Each of these behaviors and themes are elaborated on and special attention is paid to the differences between the behaviors exhibited by sexually abused, physically abused, and neglected children. Lastly, contemporary research is critiqued for its inconsistent definitions, nonstandardized methodologies, and flawed statistical designs.

Use of the telephone in child play therapy

Spero MH. (1980). Use of the telephone in child play therapy. Social Work. 25 (1), 57-60.

A brief exposition of the use and benefits of supplying a toy telephone in child play therapy settings. Spero begins by remarking that a toy is only as useful in a therapeutic context as the child's willingness to play with it. Thus, despite the potential goldmine of communication in a toy telephone, this is wasted unless the child decides to use it. Having said this, he continues on to highlight the potential uses the toy telephone might be to. A child may hold a conversation with an imaginary party, fantasize a connection with the deceased or unavailable, or even exercise projection by assuming the role of both parties. Four brief case studies are provided to illustrate these potential uses. It is remarked that children will often pretend to phone their therapist (early in therapy) in an attempt to form a connection with them, and that the act of forcibly hanging-up can be a powerful way for reserved children to learn to express their desires and frustrations.

Play therapy: the children's views

Carroll, J. (2002). Play therapy: the children's views. CHILD AND FAMILY SOCIAL WORK. 7, 177-188.

A qualitative study on children's reactions to non-directive play therapy. Interview questions pertained to how the children felt about their introduction to play therapy, their relationship with the therapist, the therapeutic processes, their likes and dislikes in therapy, and the termination of their therapy. Children's responses varied greatly, but several basic themes emerged. Notably, while children universally enjoyed their relationship with the therapist greatly, they were largely unable to pinpoint what aspects of the therapist's behavior were most helpful. The children appreciated the provisions of food at the beginning of therapy and described their sessions as being importantly "fun". Many seemed to dislike explicit "talking about their feelings". This is a truly fascinating project, but unfortunately only a small sample size was acquired. More research on this is needed.