The Neuroscience of Play

So what really IS play therapy and how exactly does it work? Oftentimes parents and even well intentioned professionals mistake ‘play therapy’ as a nice and friendly therapist playing games with a child in order to get them to talk. 

Play, as defined by Burghardt (2005) is distinguished from other activities in the following three areas:

  • Play mimics a common or important purposeful behavior
  • Play is voluntary, pleasurable and has no immediate survival role or ‘purpose’
  • Play takes place in a non threatening, low duress context

If we are pushing children to talk by playing ‘feeling’ board games or telling them how or what to play with, these conditions are not met. Dr. Garry Landreth (2002) suggests that traditional ‘talk therapy’ is inappropriate for children due to the fact that they have not yet developed the cognitive skills to make meaning out of words in the way that adults and older adolescents might.

Over the past 30 years research has indicated that play therapy is a highly effective form of treatment and Child Centered Play Therapy has achieved evidence based status by the California Clearinghouse (Bratton et al 2005). Recent studies indicate that the maximum effectiveness of play therapy occurs between 30-40 sessions. It has also been shown that short term play therapy interventions may not be effective as children are just beginning to express and act out previously unexpressed emotions and are unable to continue processing those emotions and resolve these issues without adequate treatment time.

Drs Bruce Perry and Rick Gaskill (2012) have found that somatosensory interventions-manipulating objects/toys and the body through touch, movement, repetitive actions, sounds, music, etc. can actually REORGANIZE the neural networks in the brain to help a child regulate their emotional state. This can have a huge impact on behavior issues, AD/HD, anxiety, mood disorders, etc. All of which are affected by the neural regulatory system in the brain.

Perry & Gaskill (2012) further reported that the success of these interventions must occur when the therapist can speak a child’s ‘primal language’ which is defined as ‘gentle tones of voice; comforting, repetitive sensory experience; and soothing repetitive and patterned movements by patient, safe adults’. 

I often say that Play Therapy can be taught but speaking a child’s language is something that a person either has naturally or does not. Children are smart and perceptive and can often see through disingenuous people.  In working with children, their comfort, enjoyment and bond with myself or a therapist is THE key component to having a successful treatment experience. 

For more information about the Neuroscience of Play please find Bruce Perry & Richard Gaskill’s chapter on this at the following link


Bratton, S., Ray, D., Rhine, T., & Jones, L. (2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes. Professional Psychology: Research and Practice, 36(4), 376–390.

Burghardt, G. M. (2005). The genesis of animal play: Testing the limits. Cam- bridge, MA: MIT Press.

Gaskill, R. L., & Perry, B. D. (2012). Child sexual abuse, traumatic experiences,and their impact on the developing brain. In P. Goodyear-Brown (Ed.),Handbook of child sexual abuse: Identification, assessment, and treatment(pp. 30–47). Hoboken, NJ: Wiley.

Richard L. Gaskill and Bruce D. Perry (2014). The Neurobiological Power of Play. Chapter 11 in Creative Arts and Play Therapy for Attachment Problems. Edited by Cathy A. Malchiodi and David A. Crenshaw. New York, NY: The Guilford Press.

Landreth, G. (2002). Play therapy: Art of the relationship (2nd ed.). Muncie, IN: Accelerated Development.


Meet Kim Liberatore, MS, LPC, NCC

Kim Liberatore, LPC, NCC is our newest psychotherapist at Oak City Counseling. Kim comes to us all the way from Tennessee (however she is a Florida native) and has been busy running an Equine Assisted Psychotherapy program for kids and teenagers who have been in the foster care system.

Kim has helped develop programs for foster/adoptive parents and has specialized training in working with Internationally adopted children. In addition, Kim has spent much of her career utilizing horses in psychotherapy and is both a Certified Therapeutic Riding instructor and a Certified Equine Assisted Psychotherapist. 

Ms. Liberatore has also developed both pre and post-adoption curriculum for parents and is able to provide these programs for those looking to adopt either domestically or internationally.

Working with kids and teenagers is a passion for Ms. Liberatore who is especially gifted in working with teenagers struggling with depression, anxiety, self harm, self esteem and eating disorders. Kim’s natural approach and ability to remain focused yet down to earth appeals to kids and teens of all ages.

In working with parents Kim has specializations in areas of Play Therapy including understanding the neuroscience of play based on intense work with Dr. Bruce Perry with The Trauma Academy, thus Ms. Liberatore has studied the way the brain is affected by various types of play therapy. 

Kim is also a Registered Parent Educator with The Circle of Security®, an innovative program which incorporates parental attachment and early experiences (how a parent was parented) and explores how these patterns may be a factor in parent/child relationships and in behavior management. 

Ms. Liberatore has been trained in several different therapeutic sensory integration techniques which promote emotional and physical regulation of the body and emotions, drawing on Sensorimotor Psychotherapy, sensory motor occupational therapy and body-oriented therapies.

Kim works with children of all ages, adolescents/teenagers, parents and adults who are experiencing depression/anxiety and relationship conflict. 

In addition to her work with children/teenagers Ms. Liberatore is a Relationship Education Facilitator with the Prevention and Relationship Enhancement Program (PREP) which is a program used for healthy marriages, relationships, communication and managing conflict. 

OCC is thrilled to have Kim on staff and are excited to have her expertise and unique skills available in Raleigh!

For more information about Kim, please see her staff page here

Welcome Jackie!!

Jackie Hartman, MS, LPC joins Oak City Counseling with a wealth of knowledge and experience in working with children and adolescents!

Jackie has a Masters degree in Art Therapy which is a rare and unique area of the mental health field. With her expertise in utilizing various forms of art and creative therapeutic tools she also brings years of experience as a play therapist working with children and adolescents and specializes in trauma, attachment/bonding, parenting and child behavior issues.

We are lucky to have Jackie join our team and beginning in January she will have Saturday availability!! Jackie is in network with BCBS and is accepting new clients. Visit her page for more information about her.

How to pick your child’s therapist

In the current sea of child and adolescent therapists, how can you choose the ‘right’ therapist to help your child?

Oftentimes parents will ask their pediatrician, friend, school counselor or teacher for recommendations. Other web savvy parents may look online to try to find the right fit.  Everyone is different and what might work for one person might not work for another. A few things to keep in mind however in terms of child therapy are the following:

  • Make sure that the therapist has graduated from an accredited Masters degree program, if you haven’t heard of the institution, google them to find out more and to get a better sense of their educational background-did they attend in person or online?
  • Confirm that the therapist is licensed by a professional board to practice therapy independently in the current state. Most therapists in North Carolina will have an LCSW (Licensed Clinical Social Worker), LPC (Licensed Professional Counselor), LMFT (Licensed Marriage and Family Therapist), LPA (Licensed Psychological Associate) or LP (Licensed Psychologist). Also be aware that some therapists are fully independently licensed or are working towards their full licensure-usually identified as an ‘Associate’ with an A after the license, i.e.: LCSW-A, LPCA, LMFT-A.  Associate licensees must complete a certain amount of clinical hours under a supervisor and pass a licensure exam prior to being fully independently licensed.
  • Find a therapist who has extensive knowledge or training in a specific therapy for children. Children are not the same as adults! That’s why a lot of ‘adult’ approaches like traditional talk therapy may not be effective for children, especially children under age 10. Play therapy, family therapy, Theraplay®, Parent Child Interaction Therapy (PCIT) are a few interventions that are considered evidence based therapies for children.
  • Ask the therapist about their specific approach, what techniques do they use and what are they based out of? If they use ‘talk therapy’, what is their specific training with children in applying this? If they practice ‘play therapy’ what is their training and which type of play therapy do they use?-Oftentimes therapists may say that they practice play therapy however they may not have received formal training or be utilizing evidence based play therapy approaches. Having toys in a room or playing games with children while talking to them or asking questions is NOT play therapy and is not based on a specific technique or theoretical orientation.
  • If a therapist is practicing play therapy be sure to ask what play therapy specific training they have and what type of play therapy they practice. For more information about play therapy please visit The Association for Play Therapy website. A few play therapy techniques offered by Oak City Counseling include: Child Centered Play Therapy (also called Non Directive Play Therapy), Parent Child Interaction Therapy (PCIT), Theraplay®, sand tray therapy and Filial Play Therapy. Other approaches include Adlerian Play Therapy, Jungian Play Therapy, Psychodynamic Play Therapy, Object-Relations Play Therapy, Sand Play Therapy, Cognitive Behavioral Play Therapy, Schema Based Play Therapy, and MORE.