Date of Graduation


Document Type


Degree Name

Doctor of Philosophy in Counselor Education (PhD)

Degree Level



Rehabilitation, Human Resources and Communication Disorders


Kristi Perryman

Committee Member

Anthony Vajda

Second Committee Member

Christine Holyfield

Third Committee Member

Samantha Robinson


adverse childhood experiences, child-centered play therapy, counselor education, play therapy, single-case research design, trauma


Adverse childhood experiences (ACEs) are defined as exposure to emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, loss of a parent, domestic violence, family member with addiction, family member with depression or mental illness, and family member incarcerated (Felitti et al., 1998). ACEs have been studied for many years and have shown to have long term negative health and social-emotional outcomes and costs the world over $1 trillion a year (Bellis et al., 2019; Felitti et al., 1998; Hughes et al., 2017). Due to the emotional, physical, and dollar amount cost to not addressing the impact of ACEs early, the Center for Disease Control and Prevention (CDC) (2020) recommends early victim-focused treatment if someone was exposed to an ACE. Child-centered play therapy (CCPT) has been shown to be effective with multiple populations and symptoms, but there has been a lack of research on it with children who have experienced trauma (Gutermann et al., 2016; Haas, 2017; Humble et al., 2019; Kram, 2019). This dissertation aimed to assess if CCPT could be an effective intervention for children who have been exposed to ACEs.

The purpose of this dissertation was to explore the effectiveness of using CCPT on externalized behaviors in the classroom with elementary students who have been exposed to ACEs that are attending a school for students who have experienced trauma. This dissertation utilized an A-B with maintenance single-case research design (SCRD) to examine the impact of CCPT on externalized behavior. Participants externalized behaviors were measured via the Attention-Deficit/Hyperactivity Disorder subscale on the Direct Observation Form. Participants were in the study for 13 – 16 weeks, which consisted of the three phases: phase A (no intervention), phase B (16 CCPT sessions), and maintenance phase (no intervention). After completing the visual analysis of data recommended for SCRD, the findings showed that 16 sessions of CCPT was effective in decreasing externalized behaviors in the classroom for children who have experienced trauma. The results of this dissertation support that CCPT could be an effective intervention for children who have been exposed to ACEs.