Using the Children's Play Therapy Instrument to Measure Change in Psychotherapy: The Conflicted Player

The purpose of this paper is to describe the Children's Play Therapy Instrument (CPTI) (Kernberg et al. 1997), to demonstrate its clinical application as a measure to describe and quantify the play activity of a child in psychotherapy and as a tool to be used in the training of student therapists. The use of the CPTI to measure therapeutic change in a pervasively delayed child (Chazan 2000) and in the case of a child suffering from posttraumatic stress disorder (Chazan 2001) have been described previously. This paper, it is hoped, in reporting the treatment of a child diagnosed with a major depressive episode, will augment the establishment the CPTI as a means to measure change over time in play therapy, as well as methodology to articulate play profiles of various diagnostic groups (see also Chazan 2002).

Although several scales have recently been created to rate the play of children (Greenspan and Lieberman 1994, Lindner 1990, Schaefer et al. 1991), the CPTI was created specifically to be a comprehensive measure of a child's play activity in psychotherapy. Additional versions of the CPTI have been written for teachers (Chazan 1999a) and therapeutic groups (Chazan 1999b). The CPTI adapts several established scales (Bretherton 1984, Emde and Sorce 1983, Erickson 1940, Urist 1977) in order to measure play activity using a variety of parameters. The researcher or clinician can select subscales appropriate for his topic.

The CPTI enables the observer to systematically classify and describe a child's activity within a psychotherapy session. As co-creator of the scale and as trainer of the three independent raters in the initial reliability study,