Play therapy is practiced across mental health professions and, as a result, it is not specifically addressed in professional codes of ethics. For counselors who are interested in play therapy, this might cause some trepidation. To get some answers about common questions of ethics and play therapy, we spoke with longtime play therapist and counselor educator Franc Hudspeth, PhD, NCC, ACS, LPC-S, RPT-S™, RPh.
Play therapy is practiced across several mental health professions. From an ethical perspective, does that create the potential for any issues or confusion?
The Association for Play Therapy is so good about saying “follow your own codes of ethics.” When we have presentations, writings, conferences—anything like that —there’s somebody from every branch of mental health presenting on different aspects of play therapy: from a counseling perspective, a social work perspective, etc. So, if there’s ever a question posed to the Association for Play Therapy, the response is to follow our best practices and your own code of ethics.
What makes it complicated sometimes is that the membership of the Association for Play Therapy represents all the branches of mental health. Lay on top of that how that looks different across all the states, and I would say it’s not a confusion for play therapy; it’s a confusion for all of us as mental health practitioners because we have national organizations and we have state licensure boards and so it gets complicated with ethical versus legal rules: How is it interpreted at the state level versus the national level? Our principles and best practices are very in alignment with the philosophy of the codes of ethics and legal system.
What makes play therapy unique is that it’s typically used with children and adolescents. They’re minors and so can’t consent. Parents have to consent and then the child or adolescent has to assent. The basic principles that guide our counseling codes of ethics are still there: duty to warn, mandated reporting—all those concepts are very much in alignment with play therapy and with counseling.
Does play therapy present any unique ethical concerns for counseling?
Depending on what theoretical orientation of play therapy you’re using, therapeutic touch may be involved, and therapeutic touch is not really covered in our codes of ethics. So, it is very much described and talked about—appropriate nature and how it’s used and things like that — within play therapy. There’s a separate document on it.
That's the one thing that I would say because whether we're looking at the ACA Code of Ethics, AMHCA Code of Ethics, NBCC Code of Ethics, we don't really pull out something like that. But play therapy does, because across many theoretical orientations of play therapy, touch may be involved. There’s that need to have very specific guidelines and descriptions around ethical and legal appropriate use of therapeutic touch.
Is it practical and ethical to conduct play therapy using distance methods?
Virtually nobody was doing distance teleplay therapy or teleplay therapy until the pandemic. What the Association for Play Therapy did early in 2020 was put a task force together and put some guidelines around the use of play therapy via distance means.
That’s another topic that pretty much aligns with what we would say in counseling, and basically, you know what NBCC says in its Code of Ethics.
There are appropriate clients for teletherapy and there’s those that are not. That might be due to their level of mental stability, their age, etc. Play therapy is normally used starting at age 3, and my youngest play therapy client ever was 18 months. I’m not doing teleplay therapy with an 18-month-old! But an 8-year-old might be very appropriate. There are some specific guidelines put around that.
Basically, it gave us some parameters around how this is going to work, who it’s going to work best with. But they very much align with basic principles of teletherapy. What do you do about emergency situations? What about emergency contact? Consent? All those kinds of things. They’re very much similar to what I would do in telehealth with an adult in the state of Mississippi.
One of the unique things about teleplay therapy would be in that assessment of a good client for that is, of course, the age of the child or adolescent, but also how well they’re able to stay focused on what’s going on and is there a need for an adult facilitator to be present as well, like a parent or a caregiver. Sometimes it’s necessary to have someone in the home to facilitate the activity, and oftentimes just to keep the child focused on what’s going on.
There’s probably a good 4 or 5 years’ worth of experience now of doing teleplay therapy. It is not the most desired method for working with children just because what’s so important in play therapy is the toys and the playroom, and to try to accomplish that in a child’s home is going to be difficult. The caregiver needs to make sure certain things are in the room. They need to decide if the child’s bedroom is the best place to do it, or if there are too many distractors in that room.
Can any counselor ethically incorporate play therapy into their practice? Is specific training required?
Play therapy follows a model of competence, which is consistent with how competency is described in counseling ethical codes. What does competence mean? That means training, experience, and supervision. And so, you can incorporate play and even play techniques in a session, but you can't be a play therapist unless you're specifically trained in play therapy. Considering this, it is important to be aware our ethical codes and not practice outside our scope of training and expertise. The training to become a play therapist is a 2-year process. And it is a model where you're learning, practicing, and being supervised from beginning to end.
All three aspects of the competency model are incorporated, so that as you're learning about it, you're putting it to use, and somebody's supervising you. Many people are trained in play therapy through university settings or through certificate programs.
Counselors who aren’t play therapists may practice play therapy skills and principles in line with our normal scope of practice and competency rules. For example, my students are being trained in play therapy. They’re not play therapists yet, but they’re incorporating it into their practice. There are plenty across the different branches of mental health that incorporate play therapy perspectives, aspects, techniques, and skills in their work, but they are not play therapists.
If you want to do play therapy, remember what our codes of ethics say: what does it mean to be competent to do something? And that’s training, experience, and supervision.
Franc Hudspeth is Coordinator and Clinical Associate Professor in the EdS in Counselor Education-Play Therapy Emphasis, in the School of Education, at the University of Mississippi. He serves or has served in multiple roles across the Association for Play Therapy, Association for Creativity in Counseling, and Military and Government Counseling Association. He received his PhD in counselor education & supervision from the University of Mississippi, and is a Licensed Professional Counselor Supervisor and Registered Pharmacist. His writing and research interests include play therapy, trauma’s impact on brain development, psychopharmacology, neuroethics, and neuroscience influences on counseling.
