RPT Assessment & Treatment Planning 5 — Questions and Answers
Question 1: A 9-year-old's play assessment reveals highly organized, rule-bound play with extreme distress when rules are violated. This pattern MOST warrants exploration of:
- Giftedness and advanced cognitive development
- Anxiety disorders or obsessive-compulsive features (Correct answer)
- Oppositional defiant disorder
- Social communication difficulties typical of extroverts
Correct answer: Anxiety disorders or obsessive-compulsive features
Highly rigid, rule-bound play with significant distress at violations is a clinical indicator of anxiety or obsessive-compulsive features warranting further assessment.
Question 2: Which assessment approach is MOST consistent with child-centered play therapy (CCPT) philosophy?
- Structured diagnostic interviews and standardized tests before first session
- Informal ongoing observation of the child's freely chosen play themes and behaviors (Correct answer)
- Parent-only intake with no direct child assessment before treatment begins
- Neuropsychological battery to establish cognitive baselines
Correct answer: Informal ongoing observation of the child's freely chosen play themes and behaviors
CCPT philosophy prioritizes informal, ongoing naturalistic observation of the child's freely chosen play as the primary assessment method, honoring the child's self-direction.
Question 3: A treatment plan goal is labeled 'distal.' This means it represents:
- A goal achievable within the first two sessions
- A long-term outcome expected at or after treatment termination (Correct answer)
- A goal requiring referral to an outside specialist
- A community-based objective beyond the therapy room
Correct answer: A long-term outcome expected at or after treatment termination
Distal goals represent long-term outcomes expected at or after the conclusion of treatment, in contrast to proximal goals that target immediate change.
Question 4: A child consistently assigns the 'villain' role to themselves during dramatic play across multiple sessions. This recurrent pattern is MOST clinically relevant because it may reflect:
- Creative storytelling preferences with no clinical significance
- Internalized shame, poor self-concept, or identification with the aggressor (Correct answer)
- Advanced moral reasoning about right and wrong
- A desire to control the play narrative
Correct answer: Internalized shame, poor self-concept, or identification with the aggressor
A child repeatedly casting themselves as the villain across sessions may reflect internalized shame, a negative self-concept, or identification with the aggressor — all clinically significant themes.
Question 5: The RPT receives a referral stating the child 'has ADHD.' The MOST appropriate assessment response is to:
- Accept the diagnosis and design a treatment plan targeting ADHD symptoms
- Conduct an independent play-based assessment to develop the RPT's own clinical formulation (Correct answer)
- Request the diagnosing provider's notes and begin treatment without further assessment
- Refer the child for neuropsychological testing before initiating play therapy
Correct answer: Conduct an independent play-based assessment to develop the RPT's own clinical formulation
The RPT should conduct an independent play-based assessment to develop their own clinical formulation rather than uncritically adopting a referral diagnosis.
Question 6: Which element of a play therapy treatment plan MOST directly addresses cultural humility?
- Number of planned sessions
- Incorporation of culturally relevant play materials and value-consistent goals (Correct answer)
- Theoretical orientation of the therapist
- Type of standardized assessments administered
Correct answer: Incorporation of culturally relevant play materials and value-consistent goals
Incorporating culturally relevant play materials and value-consistent goals directly reflects cultural humility and ensures the treatment plan is meaningful and appropriate for the child's cultural context.
Question 7: A play therapy assessment reveals the child's play is consistently at a developmental level 2 years below their chronological age. This finding MOST suggests the need to:
- Accelerate the treatment timeline to catch the child up developmentally
- Match therapeutic interventions to the child's developmental play level, not chronological age (Correct answer)
- Refer the child exclusively for academic remediation
- Dismiss the finding as temporary regression with no clinical meaning
Correct answer: Match therapeutic interventions to the child's developmental play level, not chronological age
The RPT should match therapeutic interventions to the child's observed developmental play level rather than chronological age to ensure developmentally appropriate and effective treatment.
RPT Assessment & Treatment Planning 5
A 9-year-old's play assessment reveals highly organized, rule-bound play with extreme distress when rules are violated.
This pattern MOST warrants exploration of: