Treating the Tiers

Treating the Tiers: Play Therapy Responds to Intervention

in the Schools

Amanda Winburn, Denise Gilstrap, and Mandy Perryman

University of Mississippi

This article explores the potential of play therapy as a school-based intervention for

children who are experiencing behavioral difﬁculties within the K-12 school setting. A

model is presented describing the use of play therapy within the Response to Inter-

vention (RtI) model at the Tier 2 and Tier 3 level. This article explores the RtI model

and how play therapy can be incorporated by school counselors or school-based play

therapists using individual and small group sessions.

Keywords: behavioral interventions, response to intervention, school counseling

Research and practice support the notion that

play therapy ﬁts well within the school environ-

ment. Play therapy helps students develop a pos-

itive self-concept, assume personal responsibility,

become more self-directed and self-accepting, cre-

ate an internal source of evaluation, and enhance

coping skills (Landreth, 2012). These life tasks

parallel the lessons and goals of early childhood

education. Through the use of play therapy in

schools, students can problem-solve, motivate

themselves, and improve social skills (Schaefer &

Drewes, 2012). Because play therapy fosters re-

sponsibility, emotional awareness, and communi-

cation, it is a useful tool for school counselors and

teachers (Perryman & Doran, 2010). In addition,

play therapy aligns well with the American School

Counseling Association’s (ASCA) national model

because it is developmentally appropriate, multi-

culturally sensitive, and empirically supported.

Developmentally Appropriate

Children play naturally and spontaneously

for sheer enjoyment. They play without prompt-

ing or goal direction. As they play, they can

address their feelings about themselves, others,

and the world through metaphors and the ma-

nipulation of toys, rather than with words (Lan-

dreth, 2012). Because young children lack ab-

stract reasoning skills and the verbal ability to

articulate thoughts and feelings, it is through

play that they express themselves early in life.

Play provides children with a nonthreatening

means of bridging the gap between their expe-

riences and cognitions, thereby providing op-

portunities for learning.

Kottman and Meany-Walen (2016) outlines

how using play therapy with children provides

empowerment and self-understanding and also

improves self-control and responsibility. This

Adlerian approach outlines how counselors can

work with children through active and direct

engagement and promotes a partnership of

equal power and responsibility between the

counselor and child. According to Kottman

(2011), the goal of this approach is to provide a

sense of personal power to the child and support

the child to choose how to interpret situations,

events, and relationships.

Multiculturally Sensitive

Children from diverse backgrounds with dif-

ferent types of distress and dysfunction all at-

tend school together. They bring with them a

variety of mental health and social issues need-

ing attention. It is imperative school counselors

be aware, knowledgeable, skillful, and effective

as they serve a diverse student body (American

Amanda Winburn, Denise Gilstrap, and Mandy Perry-

man, Department of Leadership and Counselor Education,

College of Education, University of Mississippi.

Denise Gilstrap is now at Marriage & Family Therapy

and Counseling Studies, University of Louisiana at Monroe.

Correspondence concerning this article should be ad-

dressed to Amanda Winburn, Department of Leadership

and Counselor Education, College of Education, Univer-

sity of Mississippi, 109 Guyton Hall, University, MS

38677. E-mail: [email protected]

This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

2017, Vol. 26, No. 1, 1–11 1555-6824/17/$12.00 http://dx.doi.org/10.1037/pla0000041

School Counselor Association, 2010, E.2.d).

Because play therapy accepts each student as a

unique individual and does not attempt to re-

shape their life or alter them in deﬁnitive ways

(Axline, 1947; Landreth, 2012), it is a multicul-

turally sensitive approach to counseling. Addi-

tionally, “play is an integral component of most

cultures, and mental health professionals must

determine the role of play therapy for children

from multicultural backgrounds” (Coleman,

Parmer, & Baker, 1993, p. 68). Play is a volun-

tary action without a speciﬁed goal that assists

children in addressing their feelings about

themselves, others, and the world through the

manipulation of toys. Particularly in Child Cen-

tered Play Therapy (CCPT), the relationship

between the child and the counselor is the cat-

alyst for therapeutic healing and development,

further emphasizing that children are the best

resources about themselves and are capable of

directing their own growth (Axline, 1947). For

the counselor, the focus is on being present with

the child, as opposed to the application of spe-

ciﬁc procedures. It is that freedom to attend to

the unique needs of the client that makes play

therapy universal across cultures (Drewes,

2005). The counselor recognizes and respects

children’s innate capacity to grow, heal, and

make choices that will help them ﬂourish with-

out direct intervention on the part of the coun-

selor, who may have a completely different

background and worldview.

Empirically Supported

Play therapy draws on decades of research. In

the ﬁeld’s history it has evolved to include

numerous theoretical frameworks and treatment

modalities. Axline (1947) was among the ﬁrst to

study the effects of play therapy to validate her

work and outcomes with children. Her research

was rudimentary especially on issues of reliabil-

ity compared with today’s methodological stan-

dards. However, she was key in broadening the

acceptance of play therapy.

Over the last 15 years, four meta-analyses

have been conducted (Leblanc & Ritchie, 2001;

Bratton, Ray, Rhine, & Jones, 2005; Ray, Arm-

strong, Balkin, & Jayne, 2015; and Lin & Brat-

ton, 2015) to examine the effectiveness of play

therapy. According to Lin and Bratton (2015),

these four meta-analytic ﬁndings clearly con-

ﬁrm the effectiveness of play therapy, speciﬁ-

cally CCPT approaches including ﬁlial therapy.

ASCA’s National Model calls for accountabil-

ity and inherently requires empirically sup-

ported evidence for school-based interventions,

such as play therapy. Behavioral, social, and

emotional issues have been successfully ad-

dressed through various forms of play therapy

(Bratton, Ray, Rhine, & Jones, 2005), such as

reduced stress and more positive interactions

with teachers (Ray, Schottelkorb, & Tsai,

2007). Further, when reviewed across more than

20 studies, CCPT has been found effective spe-

ciﬁcally in the elementary school setting (Ray et

al., 2015), which includes beneﬁts in the area of

academic achievement (Blanco & Ray, 2011).

Response to Intervention and School-Based

Play Therapy

Clements and Sabella (2010) state that once a

counselor becomes familiar with the Response

to Intervention (RtI) process, he or she can

begin to understand that the foundation of RtI

highly correlates to the components of a com-

prehensive counseling program. Speciﬁcally,

the model stipulates that counseling programs

work to identify specialized services, such as

play therapy, based on the child’s level of risk

(2012). According to the U.S. Department of

Education (2005), counselors should have a

comprehensive knowledge and understanding

of how to recognize barriers to equal educa-

tional opportunities for students. These early

interventions are critical to a child’s success,

and school counselors play an integral part in

identifying children’s needs and assisting teach-

ers with differentiated instruction. School coun-

selors who are trained in play therapy can use

the modality to intervene with students who are

at risk of failure. These school-based play ther-

apy interventions can be employed individually

or in a small group setting.

Emergence of Response to Intervention

In 1975, the Education for all Handicapped

Children Act (PL 94 –142) was passed, and

since that time, there has been endless debate

about how to best serve students with disabili-

ties. According to Ysseldyke, Algozzine, and

Thurlow (1998), special education has been a

controversial topic since the Education for all

2 WINBURN, GILSTRAP, AND PERRYMAN

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Handicapped Children was ﬁrst mandated. This

controversy directly contributed to debates re-

garding the diagnostic procedures used to iden-

tify students with possible disabilities. The 1975

legislation included the discrepancy model,

which only labeled children as learning disabled

if there was signiﬁcant gap in achievement com-

pared with the student’s score on the intelli-

gence scale.

The discrepancy model has come under tre-

mendous criticism. Bradley, Danielson, and

Doolittle (2007) found that the model was not

useful in enhancing services for students, par-

ticularly in the area of early intervention. These

authors continued their criticisms by calling it a

“wait-to-fail” model, stating that students did

not receive services when ﬁrst observed, but

had to wait until there was a wide enough gap

between achievement and intelligence scores to

qualify for special education services.

Carbo (2010) claimed, “The use of the dis-

crepancy model meant teachers could not help

students with learning until they had fallen sub-

stantially behind and were struggling” (p. 121).

Other critics of the model have identiﬁed it as

culturally insensitive with its use being to overi-

dentify minority students for special education

services (De Valenzuela, Copeland, Qi, & Park,

2006; MacMillan & Reschly, 1998). In re-

sponse to these critics, leaders within the ﬁeld

of education proposed changes to the way stu-

dents are identiﬁed for special education ser-

vices.

The National Research Council’s study con-

ducted by Heller, Holtzman, and Messick

(1982) marked the emergence of Response to

Intervention (RtI). As a result, researchers

found that the quality of instruction and the

organization of special education services have

an impact on the effectiveness of student out-

comes. In 1983, The U.S. Department of Edu-

cation published the A Nation at Risk report.

This report once again spurred debate about the

nation’s education system, stressed the need for

educational reform, and increased discussion of

accountability measures (Ravitch, 1999).

In 2001, The No Child Left Behind Act

(NCLB) required the measuring of every stu-

dent’s educational skills and academic progress.

This act included students who fell within the

subgroup of special education and led to the

Individuals with Disabilities Education Im-

provement Act (IDEIA; 2004) reauthorization

law, which speciﬁed that students could not be

labeled as eligible for special education until

“the child fails to achieve a rate of learning to

make sufﬁcient progress to meet state-approved

results” (P.L. 108 –446, 300.309). These two

laws have established new guidelines for stu-

dent identiﬁcation as well as new accountability

measures for students and teachers in both the

general and special education classroom.

With these new guidelines, researchers and

educational leaders have greatly enhanced the

knowledge base from which educators now

practice. Research on student learning and ef-

fective interventions have dramatically in-

creased over the last two decades, and meta-

analytic research has been able to identify best

practices for learners (with and without disabil-

ities) who are struggling with core curriculum

(Kavale & Forness, 1999; Swanson, Hoskyn, &

Lee, 1999).

RtI was developed as an early intervention

for children who continue to fail to meet basic

standards within the school system. Several na-

tional studies, such as the Common Ground

Report (Roundtable, 2002), have made recom-

mendations regarding identiﬁcation, eligibility,

and intervention for students who are experienc-

ing difﬁculties. Researchers such as Marston

(2005) studied national reports such as the

Common Ground Report to see whether RtI

standards fulﬁlled the requirements outlined in

the report. Marston found that RtI positively

corresponded to each of the recommendation

statements; thus, the research study concluded

that RtI is a valid option for identifying whether

a student has a barrier to success.

In 2004, reauthorization of IDEIA took place

and continued to spur the debate about best

practices. The law states that a local education

agency “must use a process that determines if a

child responds to scientiﬁc, research-based in-

terventions as a part of the evaluation process”

(P.L. No. 108 – 446 614 b 6 A). This law is the

basis for a great deal of change and continued

debate within the educational system (Burns &

Gibbons, 2008).

In the reauthorization of IDEIA, the federal

government outlined objectives to improve spe-

cial education services within the United States,

and, while RtI is not federally mandated, IDEIA

does include RtI approaches within its regula-

tions and guidelines. This suggests a systematic

framework for screening, intervening, and mon-

3TREATING THE TIERS

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itoring to help determine a student’s response to

evidenced-based interventions (Burns & Gib-

bons, 2008). In 2015, the Every Student Suc-

ceeds Act (ESSA) was authorized by President

Obama. This most recent education legislation

expands upon No Child Left Behind and adds

ﬂexibility to the previous policies. The ESSA

legislation focuses not only on academic stan-

dards but also place emphasis on college and

career readiness.

Response to Intervention

Carbo (2010) deﬁnes RtI services as an ap-

proach that serves as a safety net to catch stu-

dents at risk of failure early and immediately

provide carefully monitored interventions to en-

sure academic and behavioral improvements.

Simply put, RtI is a process of implementing

high quality instructional practices that are

based on students’ needs, monitoring progress,

and then adjusting instruction based upon the

data collected from the students’ responses.

Moores (2008) states that the goal of RtI is to

prevent failure and ensure success for all stu-

dents using early identiﬁcation and progress

monitoring, along with research-based instruc-

tion. RtI focuses on evidenced-based interven-

tions and proven data to drive instructional de-

cisions that align with the goals of early

intervention. Effectively used, RtI will allow

teachers, counselors, and administrators to

know how to identify students who are at-risk

for failure using interventions grounded in re-

search and shown to be valid and reliable. Ac-

cording to Vaughn, Fuchs, and Fuchs (2008),if

these research-based interventions are intro-

duced to students in the early stages of their

education when struggles are initially identiﬁed,

no longer will students have to “wait to fail.”

Howard (2010) states that the tiered system is

designed to offer instructional support at in-

creasing levels of intensity according to the

student’s needs along with speciﬁc attributes.

Models for RtI are divided into a three-tier

system; each tier varies and is used to support

the needs of all learners. The three tiers provide

a framework for best practices.

Tier 1 serves as a universal foundation for

student learning and focuses on quality instruc-

tional strategies. This tier contains core curric-

ulum standards which help determine the effec-

tiveness of instructional delivery of core content

to students. Allington, (2011) states that Tier 1

interventions are the most critical. Students who

experience difﬁculties at the Tier 1 level and are

not growing at a pace equal to their peers should

be provided with additional differentiated in-

struction. According to Justice (2006), Tier 1

instruction should provide school personnel

with the opportunity to provide direct services

with a concentration on high-priority targets for

academic or behavioral development. Other

strategies include small groups or other best

practice interventions.

Tier 2 is for students who continue to dem-

onstrate difﬁculty with academic and behavioral

performances after receiving additional differ-

entiated instruction. Tier 2 interventions are

supplemental to Tier 1 instruction (Vaughn &

Roberts, 2007). Tier 2 interventions provide

small group experiences for those students who

were unable to experience success at the Tier 1

level. The Tier 2 groups are generally small so

that school personnel can attend to the needs of

the students while explicitly focusing on the

skill in need of development. Fuchs et al. (2008)

states that Tier 2 interventions should be exe-

cuted in small groups of four to six students and

should be designed to provide a strong focus on

skills that the students need to become proﬁ-

cient.

By design, Tier 2 is are highly structured

requiring consistent application. Recommenda-

tions for Tier 2 interventions are that each in-

tervention be provided within a 30-min time

frame and be monitored on a biweekly schedule

(Marston, 2005). As cited in Marston (2005),

Tilly states that Tier 2 instruction is a combina-

tion of core instruction and supplemental in-

struction. These interventions should include

structured tasks and be executed within an al-

lotted amount of time. Previously conducted

research suggests that, for Tier 2 instruction to

be effective, the interventions should reinforce

the learning goals and materials used in the Tier

1 instruction (Speece, Case, & Molloy, 2003;

Vellutino, 2003).

If students are still underperforming at the

Tier 2 level, they are then referred to Tier 3

instruction. Only a small minority of the student

population needs this level of instruction

(Coyne et al., 2004). Tier 3 is a much more

intensive set of instructional interventions. This

level of instruction should provide more strate-

gic planning and direct interventions than the

4 WINBURN, GILSTRAP, AND PERRYMAN

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previous two tiers. The frequency and intensity

of the Tier 3 interventions should increase from

the Tier 2 model.

Tier 3 interventions are the most intensive

level of intervention available within general

education. These interventions should center di-

rectly on the needs of the child (Stecker, 2007).

At the Tier 3 level, students generally receive

personalized interventions in individual ses-

sions or in smaller groups (no more than three

students). The length of interventions and fre-

quency of progress monitoring typically are

longer and more intensive than at the Tier 2

level. General education teachers often ﬁnd the

detail and involvement that is required with Tier

3 interventions to be overwhelming; therefore,

additional school personnel can be instrumental

at this level to help provide additional services

to these Tier 3 students.

While Tier 3 instruction does not automati-

cally qualify a student for special education

services, it may indicate the possibility for ad-

ditional testing and exploration of special edu-

cation services. According to Kashi (2008) after

a student has participated in Tier 3 instruction

for several weeks without any documented

progress, the student is then in a situation for

referral to special education services.

Tier 2 Group Play Therapy

Students may be referred for Tier 2 interven-

tion when Tier 1 support has not been effective

in changing behavior adversely impacting aca-

demics. There are various factors that may lead

to challenging behavior. For example, the be-

havior may be related to symptoms of attention-

deﬁcit/hyperactivity disorder (ADHD), which

can affect academic achievement and overall

functioning in the school environment

(McConaughy, Volpe, Antshel, Gordon, & Ei-

raldi, 2011; Voogd, 2014). Other behavioral

factors that may lead to Tier 2 intervention are

aggressive and disruptive behaviors, which can

cause difﬁculty in developing positive peer re-

lationships (Powers & Bierman, 2013). At an

early age, lack of quality friendships can affect

school adjustment and academic motivation

(Vitaro, Boivin, Brendgen, Girard, & Dionne,

2012). Additionally, students who show aggres-

sive behaviors may experience peer rejection,

which is important to address as peer accep-

tance can be crucial to academic achievement

and increased school engagement (De Laet et

al., 2015; Powers & Bierman, 2013).

Group-centered interventions can be effec-

tive in addressing deﬁciencies prohibiting stu-

dents from reaching their full academic poten-

tial (Harpine, 2008). Play therapy is a

developmentally appropriate intervention for

young children shown to be effective in treating

ADHD, aggression, anger management, and

disruptive behavior (Barzegary & Zamini,

2011; Fischetti, 2010; Meany-Waley, Bratton,

& Kottman, 2014; Ray, Blanco, Sullivan, &

Holliman, 2009; Swan & Ray, 2014). Group-

centered play therapy is one approach for school

counselors to use when combining group-

centered interventions and play therapy for Tier

2 interventions (Harpine, 2008). In small

groups, students can work through behavior and

emotional issues while increasing positive peer

relationships.

Group-centered play therapy allows children

to work through challenges in a positive, sup-

portive environment (Harpine, 2008). The envi-

ronment is primarily established through the

school counselors’ use of empathy and accep-

tance, modeled through interactions with stu-

dents (Allen & Barber, 2015). The school coun-

selor’s unconditional positive regard within a

safe environment is a form of modeling for

students participating in the behavior interven-

tion group. Expressing genuine acceptance and

teaching this to students helps them build rela-

tionships and develop empathy for others.

Group counseling with children in schools takes

much preparation and planning (Kestly, 2010).

Therefore, planning for Tier 2 group play ther-

apy should be done deliberately (see Figure 1).

Tier 2 group play therapy ideally consists of up

to 6 students in accordance with RtI recommen-

dations (Pierangelo & Giuliani, 2008). The

group is structured so the school counselor can

actively focus on the students’ goals (Kottman,

2011). Time should also be a consideration, as

the frequency and duration of Tier 2 interven-

tions are limited based on district or state reg-

ulations.

An Adlerian Approach to Group

Play Intervention

In consideration of an effective theoretical

framework for group play therapy, an Adlerian

approach is supportive of developing positive

5TREATING THE TIERS

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relationships, gaining insight into students’ per-

ceptions, and understanding the purposes for

misbehavior (Kottman, 2011). In addition,

Adlerian play therapy acknowledges that all

behavior is purposeful (Kottman, 2001, 2011).

This view aligns with the use of functional

behavior assessments in determining reasons

for students’ behavior, and an Adlerian ap-

proach in Tier 2 intervention supports the infor-

mation-gathering process. Studies have shown

the effectiveness of Adlerian play therapy in

decreasing hyperactive, aggressive, and deﬁant

behaviors and increasing social skills (Meany-

Walen, Bratton, & Kottman, 2014; Meany-

Walen, Kottman, Bullis, & Dillman Taylor,

2015; Meany-Walen & Teeling, 2016). More

speciﬁcally, Adlerian group play therapy has

been researched and found to be effective in

improving on-task behaviors (Meany-Walen,

Bullis, Kottman, & Dillman Taylor, 2015).

An Adlerian approach to group play therapy

allows the school counselor to strategically im-

plement directive and nondirective techniques

throughout the process (Kottman, 2011). The

school counselor begins phase one with a non-

directive approach with a focus on student em-

powerment and relationship-building. The rela-

tionship is essential in this approach because of

its recognition as a catalyst for encouraging

change (Kottman, 2001). The second phase is

more directive as the school counselor works to

understand how students perceive the world and

themselves, which may give insight to underly-

ing causes of behavior. In the third phase, the

school counselor alternates between a support-

ive, nondirective role to a challenging role. Be-

cause of emphasis on supporting students in

making changes, this phase could be conducive

to working with the students in goal-setting for

behavior improvement. The ﬁnal phase focuses

on actively helping students learn and practice

new skills and gain new perceptions. In the

small group play environment, students can

practice appropriate classroom behaviors and

engage in positive peer and adult interactions.

Limit Setting in Adlerian Group

Play Therapy

Limits are set to maintain safety in the play

environment (Kottman, 2011). For instance,

limit setting is important in working with chil-

dren with aggressive behaviors. Because group

play therapy can help foster positive peer rela-

tionships, limits should be set and maintained

for protection of all children in the group. In

addition, limit setting can allow the school

counselor to redirect inappropriate behaviors,

which may be an issue experienced in the larger

classroom setting.

The four-step process of limit-setting in

Adlerian play therapy aims to support students

in redirecting their own behavior (Kottman,

2011). The school counselor sets the limit,

makes a guess about the students’ feelings and

purpose of behavior, supports students in redi-

recting their own behavior, and discusses con-

sequences for continued limit violations (Kott-

man, 2001). In determining behavioral growth,

an assessment of progress could be the students’

Group

Focus

Behavior

Objective

Replacement

Behavior

Intervention

Method

Expected

Behavior

Outcomes

Duration

Assessment

of Progress

Increasing

positive

peer

interaction;

developing

social

skills

Student

will engage

cooperative

play

without

aggression

toward

peers

during free

play

activities at

least 4 days

a week.

Appropriately

express

needs;

engage in

acceptable

social

interaction

with peers.

Adlerian

Group Play

Therapy

Students

will

reduce

behavior

incidents

by 60%

within the

next 9

weeks.

9 weeks,

3 times a

week,

30-45

minutes

per

session

Child

Behavioral

Check List

(CBCL);

Teacher &

Parent

report; daily

behavior

report

Figure 1. Group play therapy plan summary. In this sample plan summary, a goal-focused,

directive approach to group play therapy is chosen as the best method for a small group of

students who collectively struggle in the class environment. The desire is to help students

develop a positive sense of play and healthy feelings expressions.

6 WINBURN, GILSTRAP, AND PERRYMAN

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ability to acknowledge feelings and purpose for

behavior, as well as a decrease in defying limits.

Tier 3 Individual Play Therapy

Intervention at the Tier 3 level is more inten-

sive and individually focused (Burns & Gib-

bons, 2008; Pierangelo & Giuliani, 2008). As

with Tier 2, play therapy should be used as

remediation for the student’s presenting prob-

lems. However, work with the student at this

level is now one-on-one instead of whole class

or small group. The school counselor’s ap-

proach with Tier 3 intervention still centers on

the child’s behavior goals or objectives outlined

in the behavior improvement plan (see Figure

2). The goal of Tier 3 therapy should be to show

adequate progress (Burns & Gibbons, 2008)by

eliminating or decreasing the severity of prob-

lematic behaviors. At this level, the student’s

progress is more closely monitored to determine

if a special education ruling is necessary.

Determining a play therapy approach is depen-

dent on the child’s individual goals. Understand-

ing the child’s needs is integral to utilizing an

approach that encourages progress through play

therapy. In addition, this understanding helps the

school counselor measure progress inside the

playroom and, with parents’ and teacher’s help,

outside of therapy. Whether the behavioral chal-

lenges result from deﬁance, impulsivity, or poor

relational skills, the school counselor should con-

sider what approach works best for the child. For

example, a nondirective approach may be consid-

ered if the focus is on using the therapeutic rela-

tionship to help students develop healthy commu-

nication and feelings expression (Kottman, 2011).

This may also be considered for students who

have trouble with aggression toward others. If the

student needs more structure with attention to

speciﬁc behavior goals as determined by the in-

tervention plan, then the school counselor may

consider a directive approach necessary. Directive

play therapy may be more efﬁcient at this level

because Tier 3 intervention is time-limited and

goal-oriented.

School counselors should still be deliberate

in planning with students at the Tier 3 level.

Consideration should be given to best interven-

tion approaches to address presenting problems

(Burns & Gibbons, 2008). Research-based ap-

proaches can assist school counselors in decid-

ing what approaches are beneﬁcial for decreas-

ing the unwanted behaviors. School counselors

should also be reﬂective of goals in the behavior

improvement plan and ways to assess progress.

This is pertinent to determining the next steps in

the special education referral process.

Application of Play Therapy: Brandon

The following is a presentation of how play

therapy can be applied as a tiered behavior inter-

vention. Brandon is a ﬁrst grader at Davis Ele-

mentary. Brandon has exhibited behavioral chal-

lenges since the beginning of the school year that

have affected his academic progress. Although he

is capable of performing at-level academically, he

struggles behaviorally in the classroom environ-

ment. Initially, Brandon had trouble following di-

rections and obeying classroom rules. His teacher

worked with his parents throughout the beginning

Current

Behavior or

Summary

Behavior

Objective

Replacement

Behavior

Intervention

Method

Expected

Behavior

Outcomes

Duration

Assessment

of Progress

Difficulty

engaging in

positive

social

interactions

with

classmates.

Student

will engage

in positive

social

interaction

during play

at least 3

out

of 5 school

days.

Sharing with

peers during

center time;

playing

without

pushing or

taking items

from peers

without

asking.

Child-

Centered

Play

Therapy

Participate

group/center

play without

incident

during 70%

of the

school day.

Twice a

week,

30-45

minutes

per

session

Child

Behavior

Checklist

(Parent and

Teacher

Report);

behavior

referrals

reduced by

50%

Figure 2. Behavior improvement plan summary for kindergartner. This sample plan focuses

on intervention for a kindergarten student struggling with peer interactions. Child-Centered

Play Therapy has been shown to be effective for children with aggressive behaviors and for

improving social skills. By emphasizing an accepting, supportive relationship, it is hoped that

the student builds self-conﬁdence and vocabulary to aid in feelings expression.

7TREATING THE TIERS

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of the semester to implement a positive reinforce-

ment system to help Brandon improve his behav-

ior. Brandon continued to have problems, which

affected his relationships with peers. He became

aggressive toward classmates, refusing to wait his

turn and often pushing or hitting others when he

did not get what he wanted. Brandon was sus-

pended twice during the ﬁrst half of the ﬁrst se-

mester for displaying aggressive behavior. After

additional suspensions and lack of improvement

with Tier 1 classroom-based interventions, the RtI

team and Brandon’s parents decided to move

Brandon to Tier 2 intervention with a 9-week

progress check date.

The RtI team decided on interventions to im-

plement to assist Brandon with engaging in posi-

tive peer interactions during free play and follow-

ing instructions without redirection during

instructional time. In addition to speciﬁc interven-

tions implemented in the classroom, it was de-

cided that Brandon would receive intervention

from the school counselor, also a member of the

RtI team. The school counselor met with Bran-

don’s teacher and parents to gather more informa-

tion about his behavior and requested they com-

plete the Achenbach Child Behavior Checklist

(CBCL; Achenbach & Rescorla, 2001). The

school counselor also observed Brandon’s inter-

actions with his peers during class activities. With

this information gathered, the school counselor

decided to implement group play therapy as an

evidence-based behavior intervention.

The school counselor relied on previous play

therapy training to begin the process of group

play intervention. Prior to forming the play

group, the school counselor screened for stu-

dents who functioned at similar developmental

levels and who could model target behaviors for

Brandon (Reddy, 2012). After receiving paren-

tal consent to involve selected students in group

play, Brandon was placed in a small group with

two other students. Because of Brandon’s difﬁ-

culty functioning in the classroom setting, ses-

sions were structured with a routine that was

manageable for the school counselor and easy

for students to follow. Also considered were the

group rules. These rules were written on a chart

to be reviewed with students before each group

play session. The school counselor was sure to

limit the number of rules and understood to

phrase them in “positive, proactive language”

(Reddy, 2012, p. 33).

Each group play session began with a review of

the routine and group rules. Group play included

interventions that supported cooperative peer in-

teractions and social skills building. The school

counselor used behavior management strategies

such as positive reinforcement, corrective feed-

back, and verbal prompts to support Brandon as

he engaged in interactions with the group (Reddy,

2012). The school counselor reiterated these strat-

egies with the other group members so they could

serve as models for Brandon. Appropriate behav-

ior and positive interactions were also modeled by

the school counselor. There were moments when

a less directive approach was taken to allow the

group to problem-solve on their own, with speciﬁc

attention to Brandon’s role in these interactions.

At times, he struggled with cooperative group

play. Brandon sometimes pretended not to hear

when the school counselor set limits and ignored

reminders of group rules. When this occurred, the

school counselor would give corrective feedback

and allowed Brandon an opportunity to change his

behavior. If this did not work, the school coun-

selor would deliver an effective command, being

speciﬁc and using a positive, encouraging tone.

At Brandon’s 9-week target monitoring up-

date, the RtI team reconvened to discuss

Brandon’s progress based on group play obser-

vations and classroom monitoring reports.

Brandon’s progress was further assessed using

follow-up CBCL reports. It appeared that Bran-

don’s classroom behavior was not improving.

His aggression toward classmates was still an

issue. The RtI team and Brandon’s parents

agreed to involve Brandon in Tier 3 intervention

as he needed a more targeted, individualized

intervention. A functional behavior assessment

(FBA) was completed by the RtI coordinator,

which consists of “methods and procedures that

are used to identify associations between the

behavior and variables in the environment”

(Dunlap et al., 1993, p. 275). A behavior im-

provement plan was created, and further inter-

ventions included weekly individual play ther-

apy sessions with the school counselor.

The school counselor began sessions with a

nondirective approach to establish a trusting rela-

tionship and to transition Brandon from group

play therapy. By using a child-centered approach,

the school counselor wanted to help Brandon to

understand the time in the playroom was for him.

Initially, sessions consisted of a lot of aggressive

play. Brandon often directed aggression at the

8 WINBURN, GILSTRAP, AND PERRYMAN

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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

school counselor by throwing balls or attempting

to hit with the play sword. To ensure a safe envi-

ronment, the school counselor set limits on ag-

gressive behavior (Kottman, 2011). Observation

of Brandon’s actions during sessions allowed the

school counselor to recognize when a limit needed

to be set prior to aggressive behavior. The school

counselor engaged in the session by tracking and

reﬂecting, making attempts to identify Brandon’s

feelings and emotions.

After six weeks of biweekly individual play

therapy, Brandon began talking more and inviting

the school counselor to play with him during ses-

sions. His aggression occurred less frequently. Be-

cause Brandon sometimes struggled with express-

ing feelings or emotions, the school counselor

incorporated activities to help Brandon create feel-

ings statements. In class, Brandon’s teacher no-

ticed him engaging in more frequent positive in-

teractions with adults and demonstrating less

aggression toward classmates. During the 9-week

Tier 3 progress monitoring meeting, reported ob-

servations and weekly behavior assessments re-

vealed a decrease in adverse classroom behaviors.

However, the teacher recognized that Brandon

still needed support as he continued to have occa-

sional challenges in group activities. Based on

Brandon’s progress and ongoing needs, the RtI

team decided to continue with Tier 3 support.

Brandon’s behavior improvement plan was mod-

iﬁed to include weekly individual play therapy

sessions and small group therapy. An additional

progress monitoring date was set for continued

evaluation of Brandon’s behavior.

Conclusion

If utilized properly, the RtI model offers numer-

ous opportunities for counselors to work and act

with students on both individual and group levels.

School counselors can promote the integration of

school-based play therapy and the RTI model to

advocate for and empower students to achieve

greater success. Through consultation, collabora-

tion, and direct services, school counselors can be

at the center of a successful RtI program that

advocates for the needs of all students. The mis-

sion of the RtI model and of play therapy align

naturally with a comprehensive school guidance

program. Counselors who engage in school-based

play therapy are in a unique position to work

simultaneously within the goals of each to facili-

tate an agenda that dynamically works to meet the

needs of children.

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Accepted September 12, 2016 䡲

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