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(CCPT) Modalities: a Meta-Analytic Review of Controlled Outcome Studies. Doctor of Philosophy

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(CCPT) Modalities: a Meta-Analytic Review of Controlled Outcome Studies. Doctor of Philosophy CONTEMPORARY RESEARCH ON CHILD-CENTERED PLAY THERAPY (CCPT) MODALITIES: A META-ANALYTIC REVIEW OF CONTROLLED OUTCOME STUDIES Yung-Wei (Dennis) Lin, M.A. Dissertation Prepared for the Degree of DOCTOR OF PHILOSOPHY UNIVERSITY OF NORTH TEXAS May 2011 APPROVED: Sue C. Bratton, Major Professor Dee Ray, Committee Member Janice Holden, Committee Member and Chair of the Department of Counseling and Higher Education Jerry R. Thomas, Dean of the College of Education James D. Meernik, Acting Dean of the Toulouse Graduate School Lin, Yung-Wei (Dennis). Contemporary research on child-centered play therapy (CCPT) modalities: A meta-analytic review of controlled outcome studies. Doctor of Philosophy (Counseling), May 2011, 171 pp., 30 tables, 3 figures, 252 titles. The present meta-analytic study estimated the overall effectiveness of child therapy interventions using CCPT methodology and explored the relationships between study characteristics and treatment effects. Fifty-two studies between 1995 and the present were included based on the following criteria: (a) the use of CCPT methodology, (b) the use of control or comparison repeated measure design, (c) the use of standardized psychometric assessment, and (d) clear reports of effect sizes or sufficient information for effect size calculation. Hierarchical linear modeling (HLM) techniques were utilized to estimate the overall effect size for the collected studies and explore relationships between effect sizes and study characteristics. Dependent variable included 239 effect sizes, and independent variables included 22 study characteristics. The mean age of all child participants in the collected studies was 6.7. In 15 studies, the majority of participants were Caucasian. An equal number of studies were made up of non-Caucasian participants, including 3 with majority African American, 4 with majority Hispanic/Latino participants, 5 with majority Asian/Asian American participants, and 3 with other ethnic populations. Study collection included 33 studies with majority of boys and 11 studies with majority of girls. HLM analysis estimated a statistically significant overall effect size of 0.47 for the collected studies (p < 0.001). This result indicated that the overall improvement from pre to posttreatment demonstrated by children in experimental groups was approximately 1/2 standard deviation better than by children in control groups. A statistically significant amount (49.2%) of between-study variance was found (p < 0.001), indicating the heterogeneity among the 52 studies. Statistically significant relationships were found between effect sizes and study characteristics including child age, child ethnicity, clinical level of referral, treatment integrity, presenting issue, source of data, population, and caregiver involvement. Effect size findings for CCPT and its moderators should be interpreted in light of the specific, and perhaps more rigorous statistical analysis method (HLM) and effect size calculation formula used for the present study, particularly in comparison to previous meta-analytic findings. Overall findings support CCPT’s beneficial treatment effect. Specifically, CCPT can be considered a developmentally and culturally responsive effective mental health intervention across presenting issues. Copyright 2011 by Yung-Wei (Dennis) Lin ii TABLE OF CONTENTS LIST OF TABLES .......................................................................................................................... v LIST OF FIGURES ...................................................................................................................... vii Chapter 1. INTRODUCTION ............................................................................................................... 1 Statement of the Problem .............................................................................................. 5 2. REVIEW OF THE LITERATURE ..................................................................................... 6 Rationale for and Development of Child-centered Play Therapy ................................. 6 Play ................................................................................................................... 6 Play Therapy ..................................................................................................... 8 CCPT................................................................................................................. 9 Filial Therapy/Child Parent Relationship Therapy ......................................... 12 Research Support for CCPT........................................................................................ 15 Controlled Outcome Research on CCPT Prior to 1995 .................................. 16 Controlled Outcome Research on CCPT from 1995 to Present ..................... 17 The Use of Meta-analysis as a Technique of Research Synthesis .............................. 21 Development of Meta-analysis ....................................................................... 21 Statistical Techniques to Meta-analysis .......................................................... 22 Meta-analysis Models ..................................................................................... 24 Advantages of Meta-Analysis ......................................................................... 26 Disadvantages and Criticisms of Meta-Analysis ............................................ 27 Summary ..................................................................................................................... 29 3. METHODOLOGY ............................................................................................................ 32 Research Questions ..................................................................................................... 32 Definition of Terms..................................................................................................... 32 Search Strategies ......................................................................................................... 33 Online Search .................................................................................................. 34 Offline Search ................................................................................................. 36 Data Collection and Inclusion Criteria ....................................................................... 37 Coding Procedures ...................................................................................................... 39 Dependent Variable/Effect Sizes ................................................................................ 41 Independent Variables/Study Characteristics ............................................................. 42 Analysis....................................................................................................................... 43 Standardized Effect Sizes ............................................................................... 43 iii Overall Mean Effect Size ................................................................................ 45 Hierarchical Linear Modeling ......................................................................... 46 Strategies for Assessing Publication Bias ....................................................... 47 4. RESULTS .......................................................................................................................... 48 Study Collection.......................................................................................................... 48 Description of Variables ............................................................................................. 51 Level 1 Variables ............................................................................................ 51 Level 2 Variables ............................................................................................ 54 Results of Statistical Analyses .................................................................................... 64 The Overall Effect Size ................................................................................... 64 The Within-study and Between-study Differences ......................................... 65 Relationships between Independent Variables and Effect Sizes .................... 66 Results of Final Model .................................................................................... 75 Post-Hoc Analyses .......................................................................................... 78 5. DISCUSSION AND CONCLUSION ............................................................................... 82 Overall Effectiveness of CCPT ................................................................................... 82 Relationships Between Independent and Dependent Variables.................................. 89 Effect Size Characteristics and Effectiveness ................................................. 89 Study Characteristics and Effectiveness ......................................................... 98 Final Model ............................................................................................................... 111 Summary ................................................................................................................... 111 Limitations ................................................................................................................ 114 Recommendations ....................................................................................................
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